Sensors and Systems for Monitoring Mental Fatigue: A systematic review

Mental fatigue is a leading cause of motor vehicle accidents, medical errors, loss of workplace productivity, and student disengagements in e-learning environment. Development of sensors and systems that can reliably track mental fatigue can prevent accidents, reduce errors, and help increase workplace productivity. This review provides a critical summary of theoretical models of mental fatigue, a description of key enabling sensor technologies, and a systematic review of recent studies using biosensor-based systems for tracking mental fatigue in humans. We conducted a systematic search and review of recent literature which focused on detection and tracking of mental fatigue in humans. The search yielded 57 studies (N=1082), majority of which used electroencephalography (EEG) based sensors for tracking mental fatigue. We found that EEG-based sensors can provide a moderate to good sensitivity for fatigue detection. Notably, we found no incremental benefit of using high-density EEG sensors for application in mental fatigue detection. Given the findings, we provide a critical discussion on the integration of wearable EEG and ambient sensors in the context of achieving real-world monitoring. Future work required to advance and adapt the technologies toward widespread deployment of wearable sensors and systems for fatigue monitoring in semi-autonomous and autonomous industries is examined.Comment: 19 Pages, 3 Figure

Analysis of agricultural growth and its determinant factors in Nepal

This paper critically analyzes the trajectory of agricultural growth and its determinants in Nepal. Agricultural growth is vital for stimulating overall economic growth. The World Bank research shows strong statistical link between agricultural and overall economic growth in less developed countries. Economic growth and agricultural growth in Nepal also show strong correlation (r = 0.7501***). Agricultural transformation is characterized by declining share of agriculture in national employment and GDP, and increasing share of secondary sectors like industry, service and manufacturing. However, this structural shift seems unplanned and ungoverned in case of Nepal. The contribution of agriculture to GDP is continuously declining, but, the growth of secondary sectors likes industry and manufacturing still looks stagnant. At this incipient stage of agricultural transformation, productivity growth in agriculture is both a necessary as well as sufficient condition for the development of economy as a whole. Agricultural growth depends on institutional (agricultural credit and land holdings), infrastructural (irrigated area, farm mechanization, electricity, storage, transportation, agricultural market), technological (high yielding varieties or improved seed, fertilizers and pesticides) and socioeconomic factors (population, poverty and literacy). Policies strengthening these determinants can help Nepal in achieving targeted sustained economic growth

Multi-drug Resistant Bacterial Isolates Associated with Blood Stream Infection

Multidrug resistant (MDR) bacteria complicate therapeutic management and limit treatment options. With the increase of antibiotic resistance among bacterial isolates, monitoring of the of drug resistance pattern became critical for appropriate empiric selection of antibiotic therapy. Between June 2014 to January 2015, a prospective study was carried out in Manmohan Memorial Medical College and Teaching Hospital, Kathmandu with an objective to determine the status of Extended Spectrum Beta- Lactamase (ESBL) and Biofilm producing MDR bacterial isolates from blood samples. Identification of the isolates was done by standard microbiological techniques and antibiotic susceptibility testing was done by Kirby Bauer disc diffusion method following Clinical and Laboratory Standard Institute (CLSI) guidelines. ESBL screening of gram negative isolates was done using Ceftriaxone, Aztreonam, Cefotaxime, Ceftazidime and Cefpodoxime followed by confirmation using MASTDISCSTM Extended Spectrum Beta- Lactamase (ES?L) Detection Discs and Biofilm detection was done by Congo-Red and Tube- adherence Method. The culture positivity of 16% and 10 different species of bacteria were isolated. The most frequently occurring isolate was Escherichia coli followed by Staphylococcus aureus. In vitro antibiotic susceptibility test showed that Amikacin remains the principle antibiotic of choice based on its effectiveness on both gram positive and gram negative bacteria.Ninety five percent of isolates were MDR with 77.19% ESBL producers and 72.5% were biofilm producers. A statistically significant relationship was found between increasing spectrum of drug resistance and ESBL production and drug resistant in biofilm production (p<0.05)

Economics of chhari and marketable-size carps in Bara, Nepal

A study was conducted to analyze the economics of production of chhari and marketable-size carps in Bara, Nepal. All total 90 farmers; 45 chhari producing and 45 marketable-size carps producing farmers were selected randomly and surveyed through pre-tested semi-structured interview based schedule on the month of March, 2019. Data was entered and analyzed using STATA 12.1 and SPSS 25. Findings of the study revealed that the total cost of fish production per hectare of pond area was 971927 NRs/year. Chhari production was profitable in the study area as compared to marketable-size carps with a Benefit Cost Ratio of 1.97 and 1.67 respectively. Production function analysis including six explanatory variables, showed significant effect of feed, labour (p<0.01), maintenance, fuel and electricity (p<0.05) and lime, fertilizer and medicine costs (p<0.1) but seed cost was insignificant. The return to scale was found to be 0.906 and at II stage of Production. According to estimated allocative efficiency indices, it is suggested to reduce seed; and lime, fertilizer cum medicine cost by 159% and 72% respectively, and increase the maintenance; feed; fuel cum electricity; and labour cost by about 95%, 33%, 95%, and 50% respectively for chhari producers. Similarly for marketable-size carp producers, it is suggested to decrease fuel and electricity cost by 176% and increase maintenance; seed; feed; lime, fertilizer and medicine; and labour cost by 95%, 86%, 13%, 29%, and 30% respectively. Thus, fishery enterprise is in the stage of higher potentiality to increase the production in the study area

Economics of Rubber Production in Jhapa, Nepal

A study was conducted to examine cost structure and economic feasibility of rubber production in Jhapa district. It also aimed to assess determinants of increment in acreage of rubber cultivation in the study area. A total of sixty two rubber growers were selected by simple random sampling and interviewed with pre-tested semi structured schedule on the month of March, 2019. Study revealed that the total cost of natural rubber production per hectare of rubber orchard was 499774.8 NRs. /year. It was found to be economically viable and cost effective as indicated by satisfactory values of Benefit Cost Ratio (1.5), Net Present Value of NRs. 686547 at a discount rate of 12 percent and Internal Rate of Return 18 percent. Probit model revealed that trainings received, experience of rubber farming, ethnicity and membership in community organizations were significant factors that positively affected farmers’ decision in expanding rubber cultivation area. Received trainings solely could increase probability of acreage increment by 36.9 percent. Thus, it is recommended that extension services like training, farmers’ field school, and farm visits should be intensified for increment of profitability from rubber farming in Jhapa, Nepal

Rescue Therapy for Supratherapeutic Concentrations of Calcineurin Inhibitors Using Potent Cytochrome P450 Inducers

Introduction: Calcineurin inhibitors (CNIs), ciclosporin and tacrolimus, are utilized primarily in organ transplantation and the treatment of autoimmune diseases. Since patients depend on these drugs over long periods, they face a potential risk of intoxication. This risk increases substantially when patients are overdosed or inadvertently exposed to cytochrome P450 (CYP) 3A4 inhibitors. Objectives: To analyze the utility of CYP inducers as a plausible treatment modality for acute CNI intoxication using real-world data from the WHO global pharmacovigilance database (VigiBase™) and supporting evidence from published data. Methodology: We explored all individual case safety reports (ICSRs) regarding CNI intoxications registered in VigiBase™. The queries “overdose” or “drug intoxication” were applied against the active ingredients “ciclosporin” and “tacrolimus”. Regarding the utility of CYP inducers, an extensive literature analysis was undertaken. We also report an index clinical case of a 60-year-old liver transplant patient that developed severe tacrolimus intoxication with multiple organ dysfunction at a peak concentration of 33.1 μg/L after a single dose of intravenous fluconazole. Results: Out of 143,710 documented ICSRs reported in VigiBase™ since 1992, 0.26% and 0.02% were registered as CNI overdoses and intoxications, respectively. The main etiological factor for CNI intoxication was the interaction with CYP 3A4 inhibitors (40.0% vs. case reports: 50.0%). The most commonly reported manifestation was acute kidney injury (36.7% vs. case reports: 46.3%). A total of 16.7% of intoxications led to fatal outcomes after drug withdrawal or dose reduction; however, in 43.0% of cases the exact actions undertaken were not reported. In peer-reviewed reports, 34 distinct clinical cases were treated with CYP inducers. Diverse pharmacoenhancement strategies with phenobarbital (5), phenytoin (23) and rifampicin (6) were described with a mean time of achieving the therapeutic target after 2.7 (±0.7), 3.1 (±0.5) and 4.6 (±1.0) days, respectively. In the index case, a therapeutic concentration of 4.9 [4–6 μg/L] was achieved after a 3-day regimen of rifampicin. Conclusion: In addition to general supportive treatment, the administration of phenobarbital, phenytoin, or rifampicin to reverse acute CNI intoxication is a viable treatment modality. The relatively long half-life of phenobarbital coupled with its exclusive renal elimination are potential pitfalls to reckon with. In spite of the favorable pharmacokinetic advantages of rifampicin, phenytoin offers a competitive pharmacodynamic advantage that is indisputable in patients with overt neurotoxicity

Knowledge, attitude and reported practice regarding donning and doffing of personal protective equipment among frontline healthcare workers against COVID-19 in Nepal: A cross-sectional study.

BackgroundCoronavirus Disease 2019 (COVID-19) is a respiratory infection with a high rate of transmission primarily via airborne route and direct contact. Proper use of personal protective equipment (PPE) is a proven and effective way to prevent COVID-19 spread in healthcare settings. This study was done aiming to assess the knowledge, attitude, and reported practice, and identify the associated factors regarding donning and doffing of PPE among frontline healthcare workers in Nepal.MethodsA cross-sectional study was conducted from 25th April to 30th July 2021 among 205 frontline healthcare workers of Nepal selected randomly from among the contacts of the investigators. A structured self-administered questionnaire prepared in google form was used as a study tool and shared via social media to the participants to obtain information on socio-demographic and workplace characteristics along with their knowledge, attitude, and reported practice regarding donning and doffing of PPE.ResultA total of 79.5% of participants had satisfactory knowledge while 75.6% had satisfactory practice scores regarding donning and doffing of PPE. Factors such as the profession of the participants (p-value = 0.048), their workplace (p-value = 0.005), provision of PPE at workplace (p-value = 0 .009), and availability of designated space at workplace for methodical donning and doffing of PPE (p-value = 0.010) were significantly associated with satisfactory knowledge score whereas availability of designated space at workplace for donning and doffing of PPE was significantly associated with good practice score (p-value = 0.009).ConclusionThis study demonstrated an overall good knowledge, attitude, and reported practice regarding donning and doffing of PPE among frontline healthcare workers in Nepal. However, the reported shortcomings like poor knowledge regarding the sequence of donning and doffing and corresponding flawed practice behaviors need to be addressed

Complex consequences of conservation success: Emerging human-tiger conflicts in Nepal

Between 1910 and 2010, range-wide tiger populations plummeted from around 100,000 to an estimated 3,200. Poaching, habitat destruction and human-wildlife conflict have all contributed to this dramatic decrease. In Nepal, the Bardia-Banke Complex, consisting of Bardia National Park (BNP) and Banke National Park (BaNP) and their buffer-zones, is a critical habitat to the Bengal tiger Panthera tigris. Conservation efforts in recent decades have contributed to increasing the tiger population. Despite this increase, no human fatalities associated with human-tiger conflict were reported in the decade prior to 2019: a crucial feature of conservation success. In 2019, ten reported human-tiger incidents resulted in seven human fatalities, three people badly injured, and one tiger taken into captivity. The question of why conflicts involving humans and tigers have suddenly increased requires urgent answers to inform future policy. The development and implementation of case-specific coexistence strategies is a prerequisite to the conservation of this iconic species. This paper explores the complex unintended consequences of conservation success and critically evaluates the circumstances that may explain this recent surge in human deaths and injuries