Ni cluster embedded (111)NiO layers grown on (0001)GaN films using pulsed laser deposition technique

(111) NiO epitaxial layers embedded with crystallographically oriented Ni-clusters are grown on c-GaN/Sapphire templates using pulsed laser deposition technique. Structural and magnetic properties of the films are examined by a variety of techniques including high resolution x-ray diffraction, precession-electron diffraction and superconducting quantum interference device magnetometry. The study reveals that the inclusion, orientation, shape, size, density and magnetic properties of these clusters depend strongly on the growth temperature (TG). Though, most of the Ni-clusters are found to be crystallographically aligned with the NiO matrix with Ni(111) parallel to NiO(111), clusters with other orientations also exist, especially in samples grown at lower temperatures. Average size and density of the clusters increase with TG . Proportion of the Ni(111) parallel to NiO(111) oriented clusters also improves as TG is increased. All cluster embedded films show ferromagnetic behaviour even at room temperature. Easy-axis is found to be oriented in the layer plane in samples grown at relatively lower temperatures. However, it turns perpendicular to the layer plane for samples grown at sufficiently high temperatures. This reversal of easy-axis has been attributed to the size dependent competition between the shape, magnetoelastic and the surface anisotropies of the clusters. This composite material thus has great potential to serve as spin-injector and spinstorage medium in GaN based spintronics of the future

Water quality of springs and lakes in the Kumaon Lesser Himalayan Region of Uttarakhand, India

The scarcity of drinking water has become a bitter reality in many countries. The gap between demand and supply of water has been increasing exponentially year by year. Deforestation, vigorous use of groundwater for agricultural practices, and pollution of our present water resources such as rivers, lakes, and wells are triggering the freshwater scarcity problem. Ninety percent of people in Uttarakhand depend on springs for their daily life activities. In such a case, the quality and quantity of spring water should be a prime topic to be focussed on. In the Kumaon region of Uttarakhand, spring water quality is good but there is an issue with its availability, especially in summer. This review paper details the studies that have been conducted on nutrient status, hardness, heavy metals, and the presence of microbiological diversity in spring water. It also uncovers information on some critical springs, geological settings of their aquifers, and the steps that have been adopted to rejuvenate the spring. Some other measures have been carried out by the government and local communities for springs’ revival and their improvement in discharge rate, including the construction of percolation pits, contour trenches, check dams, and improvement of water resources. It has been observed among the analyzed sample that the Kumaon region is dominated by arsenic, cadmium, chromium, and lead, whereas aluminum, barium, cobalt, and manganese are more in the Garhwal region. Apart from springs, this review paper also reveals the physicochemical characteristics of the spring-fed rivers and lakes of the Kumaon region

Evaluation of prescription pattern of antimicrobials in the treatment of respiratory tract infections in pediatric patients attending a tertiary care hospital

Background: Irrational use of antimicrobials is a complex and multifactorial problem in developing countries. Prescriptions not adhering to the treatment guidelines, self-medication, inappropriate use of drugs by patients can inadvertently lead to development of antimicrobial resistance. An observational study was designed to evaluate antimicrobial use in pediatric population with respiratory tract infections and its adherence to national treatment guidelines. Methods: This was a cross sectional observational study initiated after taking institutional ethics committee permission. The prescriptions of children diagnosed with upper respiratory tract infections and lower respiratory tract infections (LRTI) were screened. Their demographic profile and details of drugs prescribed were recorded. Results: Out of 230 pediatric prescriptions,155 (67%) were from outpatient department and 75 (33%) from those admitted in ward. Total 145 children were diagnosed with URTI whereas 85 had LRTI. In this study, 60 children with URTI received combination of amoxicillin and clavulanic acid (Co-amoxiclav) whereas 66 children with LRTI received Co-amoxiclav,18 ceftriaxone (N=18), 6 vancomycin (N=6) and 18 were prescribed oseltamivir (N=18), either alone or in combination. Other drugs prescribed included, paracetamol for fever and cough syrups. Out of 195 drugs prescribed by brand names, 138 (70.8%) were antimicrobials. Fixed dose combination amoxicillin and clavulanic acid, paracetamol and cough syrups were available from hospital pharmacy. None of the prescriptions had polypharmacy. Conclusions: URTI was treated using single antimicrobial whereas LRTI was treated with more than one antimicrobials or combination of antimicrobial and antiviral agent. The prescriptions were in accordance with the national treatment guidelines

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose: Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods: Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results: The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion: We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes

Multi-stage error control technique for improving 3DV transmission over OFDM wireless systems

The transmission of the three-dimensional video and image over wireless channels always have random corruption occurrences and burst due to Orthogonal Frequency Division Multiplexing wireless systems' predictive coding structure. This paper aims to decrease multi-stage errors during three-dimensional video transmission to reduce the processing rate and increase Peak-Average-to-Power-Ratio. For the implementation and simulation, we have chosen four different datasets with 40 different three-dimensional videos. The proposed system consists of two techniques: the modulated entropy coding and adding guard interval to avoid ISI on the wireless channel during the three-dimensional video transmission process. The proposed method reduces the errors based on the multi-stage error control technique and improves the transmission process performance and video quality. The obtained results showed that the processing time, Bit Error Rate, and Peak-Average-to-Power-Ratio decreased noticeably by 20%, 40%, and 50%, respectively, compared to state-of-the-art solutions (i.e. less processing time and less error rate with high Peak-Signal-to-Noise-Ratio). Additionally, the Peak-Signal-to-Noise-Ratio has been increased by nearly 40% for the three-dimensional video transmission over the Orthogonal Frequency Division Multiplexing wireless channels

Intersectional stigma and gender non-affirmation hinder HIV care engagement among transgender women living with HIV in India

Among transgender women living with HIV (TGWLH) in India, little is understood about the mechanisms through which multiple intersecting stigmas impact HIV care engagement, or intervention strategies that might mitigate this impact. We conducted focus groups with TGWLH (N = 30) in three Indian cities and analysed data using theoretical frameworks related to HIV stigma, gender affirmation, and syndemics. Findings revealed that enacted and anticipated stigma due to transgender identity, HIV, or sex work status, and lack of gender affirmation (e.g., misgendering) in healthcare settings delayed ART initiation and promoted care disengagement. Having supportive physicians and counsellors within ART centres and peer outreach workers facilitated ART initiation, adherence, and retention. Findings also revealed that HIV stigma within TGW communities led to concealment of HIV status or syndemic conditions such as depression and alcohol use, thereby affecting care engagement. However, the TGW community itself was also described as a resilience resource, offering emotional, psychological and tangible support that decreased the impact of discrimination on care engagement. HIV care engagement efforts among Indian TGWLH could be strengthened by reducing intersecting stigmas in healthcare settings and within TGW communities, providing gender-affirming and culturally competent healthcare, addressing psychosocial syndemic conditions, and strengthening support within transgender communities