Tuberculosis Elimination in India: Bigger Goals, Smaller Commitments

India continues to remain the perfect host for one of the oldest and dreadful communicable disease -tuberculosis (TB) and accounts for one fourth of the global TB burden. With an incidence of 217 cases per lakh & mortality rate of 36 per lakh population in 2015, 28 lakhs new cases occurred and 4.8 lakh people died due to TB in year 2015.1We also have the highest burden of MDR cases in our country, which constitutes about 1.6% of all TB cases. India also bears second highest number of estimated HIV associated TB in the world. About 1.1 lakh cases also had HIV co-infection and this was responsible for about 37,000 deaths. However, the country has managed to maintain a falling trend of incidence and mortality rates from beginning of the millennium. These estimates will be looked back, once we have the final results from the 2015-16 national TB prevalence survey. Despite improvements, TB is still a nightmare for the public health experts of the country as total treatment coverage was just 57%, and the rest of the neglected patients face catastrophic cost of treatment. 

Impact of extracardiac vascular disease on outcomes of 1.4 million patients undergoing percutaneous coronary intervention.

OBJECTIVES: Extracardiac vascular disease (ECVD) is increasingly recognized as a cardiovascular risk factor, but its association with outcomes after percutaneous coronary intervention (PCI) has not been well characterized. METHODS: Using the National Inpatient Sample database, all patients undergoing PCI between October 2015 and December 2018 were stratified by the presence and organ-specific extent of extracardiac vascular comorbidity (cerebrovascular disease (CeVD), renovascular, aortic and peripheral arterial disease (PAD)). Primary outcome was all-cause mortality and secondary outcomes were (a) major adverse cardiovascular and cerebrovascular events (MACCE), (b) acute ischemic stroke and (c) major bleeding. Multivariable logistic regression was used to determine the adjusted odds ratios (aOR) and 95% confidence interval (95% CI). RESULTS: Of a total of 1,403,505 patients undergoing PCI during the study period, 199,470 (14.2%) had ECVD. Patients with ECVD were older (median of 72 years vs. 70 years, p < 0.001) and had higher comorbidity burden that their counterparts. All cause-mortality was 22% higher in patients with any ECVD compared to those without ECVD. PAD patients had the highest odds of all-cause mortality (aOR 1.48, 95% CI 1.40-1.56), followed by those with CeVD (aOR 1.15, 95% CI 1.10-1.19). Patients with extracardiac disease had increased odds of MACCE, ischemic stroke and bleeding, irrespective of the nature or extent (p < 0.05), compared to patients without ECVD. CONCLUSION: ECVD is associated with worse outcomes in patients undergoing PCI including significantly higher rates of death and stroke. These data should inform our shared decision-making process with our patients

Design and Techno-economic assessment of a new hybrid system of a solar dish Stirling engine instegrated with a horizontal axis wind turbine for microgrid power generation

The increasing interest in renewable microgrids have motivated the exploration of more sustainable alternatives to traditional energy supply. In this study, a novel hybrid renewable energy-based microgrid power system is proposed, designed and techno-economically assessed. The system consists of a concentrated parabolic solar dish Stirling engine and a horizontal axis wind turbine integrated with a battery bank. The novelty of the study lies in replacing conventional hybrid systems, such as a typical photovoltaic/wind assembly, with a novel solar dish/wind turbine system that has the potential to achieve higher efficiencies and financial competitiveness. The solar dish Stirling engine serves as the primary source of electrical power generation while the horizontal axis wind turbine, in conjunction with a battery bank, supplies backup electricity when the primary source of power is unavailable. The system has been designed through advanced modelling in the MATLAB/ Simulink® environment that efficiently integrates the individual energy technologies. A technical sensitivity analysis has been performed for all the units in order to reduce the respective design limits and identify optimum operational windows. Further, the performance of the model has been tested at two locations in Jordan, and a thorough techno-economic analysis of the integrated system has been conducted. The simulation results show that at the optimal design point the efficiency of the Stirling engine is 37% with a net output power of 1500 kWe. For the horizontal axis wind turbine, a module of 100 kWe with a power coefficient of 0.2–0.24 is suitable for operation in terms of cost, power, torque and farm size. Also, two economic indicators, namely, the levelised cost of electricity and hourly cost, have been calculated. The levelised cost of electricity lies between 0.13 and 0.15 $/kWh while the hourly cost is found to be around 4$/h. Thus, the economic evaluation revealed that the proposed system is very competitive with other integrated renewable energy technologies

First measurement of neutrino oscillation parameters using neutrinos and antineutrinos by NOvA.

The NOvA experiment has seen a 4.4σ signal of ν[over ¯]_{e} appearance in a 2&nbsp;GeV ν[over ¯]_{μ} beam at a distance of 810&nbsp;km. Using 12.33×10^{20} protons on target delivered to the Fermilab NuMI neutrino beamline, the experiment recorded 27 ν[over ¯]_{μ}→ν[over ¯]_{e} candidates with a background of 10.3 and 102 ν[over ¯]_{μ}→ν[over ¯]_{μ} candidates. This new antineutrino data are combined with neutrino data to measure the parameters |Δm_{32}^{2}|=2.48_{-0.06}^{+0.11}×10^{-3}  eV^{2}/c^{4} and sin^{2}θ_{23} in the ranges from (0.53-0.60) and (0.45-0.48) in the normal neutrino mass hierarchy. The data exclude most values near δ_{CP}=π/2 for the inverted mass hierarchy by more than 3σ and favor the normal neutrino mass hierarchy by 1.9σ and θ_{23} values in the upper octant by 1.6σ

Observation of seasonal variation of atmospheric multiple-muon events in the NOvA Near Detector

Using two years of data from the NOvA Near Detector at Fermilab, we report a seasonal variation of cosmic ray induced multiple-muon (Nμ≥2) event rates which has an opposite phase to the seasonal variation in the atmospheric temperature. The strength of the seasonal multiple-muon variation is shown to increase as a function of the muon multiplicity. However, no significant dependence of the strength of the seasonal variation of the multiple-muon variation is seen as a function of the muon zenith angle, or the spatial or angular separation between the correlated muons