An electroplating-based plasmonic platform for giant emission enhancement in monolayer semiconductors

Two dimensional semiconductors have attracted considerable attention owing to their exceptional electronic and optical characteristics. However, their practical application has been hindered by the limited light absorption resulting from their atomically thin thickness and low quantum yield. A highly effective approach to manipulate optical properties and address these limitations is integrating subwavelength plasmonic nanostructures with these monolayers. In this study, we employed electron beam lithography and electroplating technique to fabricate a gold nanodisc (AuND) array capable of enhancing the photoluminescence (PL) of monolayer MoS$_2$ giantly. Monolayer MoS$_2$ placed on the top of the AuND array yields up to 150-fold PL enhancement compared to that on a gold film. We explain our experimental findings based on electromagnetic simulations

Practical guidance on insulin injection practice in diabetes self-management in the Indian setting: an expert consensus statement

This consensus statement aimed to provide a simple and easily implementable practical educational guide- line for healthcare professionals (HCPs) and patients regarding insulin injection practice in diabetes self- management in the Indian setting. A group of experts analysed published data from guidelines, clinical trials and real world evidence to reach consensus recommendations on optimal insulin injection practices in terms of a) the injection sites (preparation of site of injection, choosing the injec- tion site, site rotation), b) choice of device and storage of insulins, and c) safety precautions, sharp disposal practice and complications. Findings from Global and Indian arm of 2014-2015 ITQ Study were considered to emphasize a need for improved practice by HCPs covering all the vital topics essential to proper injection habits. The consensus statement provides a simple and easily implementable practical educational guideline for HCPs and patients to optimize insulin injection practices in accordance with recent advances in device manufac- turing, newer research findings, and updated interna- tional guidelines as well as widespread concerns about neglected safety precautions such as single-patient use of pens and appropriate sharp disposal practices.This consensus statement aimed to provide a simple and easily implementable practical educational guide- line for healthcare professionals (HCPs) and patients regarding insulin injection practice in diabetes self- management in the Indian setting. A group of experts analysed published data from guidelines, clinical trials and real world evidence to reach consensus recommendations on optimal insulin injection practices in terms of a) the injection sites (preparation of site of injection, choosing the injec- tion site, site rotation), b) choice of device and storage of insulins, and c) safety precautions, sharp disposal practice and complications. Findings from Global and Indian arm of 2014-2015 ITQ Study were considered to emphasize a need for improved practice by HCPs covering all the vital topics essential to proper injection habits. The consensus statement provides a simple and easily implementable practical educational guideline for HCPs and patients to optimize insulin injection practices in accordance with recent advances in device manufac- turing, newer research findings, and updated interna- tional guidelines as well as widespread concerns about neglected safety precautions such as single-patient use of pens and appropriate sharp disposal practices

Mobile health application based intervention for improvement of quality of life among newly diagnosed type 2 diabetes patients

Background. Diabetes and its complications arebecominga major threat to public health. Quality of lifeamong diabetes patients is not optimum.Objective. To know the usefulness of the mobile healthapplication for improvement of QoL and diabetes selfmanagementactivities of the type 2 diabetes patients. Methods. The present study was conducted in a tertiarycare hospital for 2 years from October 2016 to October2018. In this study, 66 newly diagnosed type 2 diabetespatients, educated, techno-friendly smart phone users,aged between 18–60 years, were included. Theywere allocated to intervention and control group byblock randomization method. Intervention group wasallotted to use the android application and controlgroup was allotted to use the website. The data wereimported and analyzed by SPSS v 20. Results. Overall quality of life and general health was70.26 ± 16.51; for physical health it was 59.52 ± 7.15,for psychological it was 63.38 ± 9.2, for social relationsit was 74.87 ± 13.98 and for environment it was 71.87 ±± 8.38. The score of overall quality of life was increasedin both control and intervention group during follow-ups.It was found that there was significant improvement inglucose management, dietary control, physical activity,health care use and sum score. Wilk’s lambda was significantfor HbA1c both in control and intervention group. Conclusions. Mobile-based applications with focusingon diabetes self-management education may supportto reduce the complications of diabetes and improvethe QoL of diabetes patients

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Characterizing the Exit Process of a Non-Saturated IEEE 802.11 Wireless Network

In this paper, we consider a non-saturated IEEE 802.11 based wireless network. We use a three-way fixed point to model the node behavior with Bernoulli packet arrivals and determine closed form expressions for the distribution of the time spent between two successful transmissions in an isolated network. The results of the analysis have been verified using extensive simulations in QualNet. The methodology presented in the paper is novel and we believe that the analysis like ours can be used as an approximation to model the behavior of sub-components of a larger mesh or hybrid network. Categories andSubject Descriptor

Clinical experience with insulin detemir, biphasic insulin aspart and insulin aspart in people with type 2 diabetes: Results from the East India cohort of the A 1 chieve study

Background: The A1chieve, a multicentric (28 countries), 24-week, non-interventional study evaluated the safety and effectiveness of insulin detemir, biphasic insulin aspart and insulin aspart in people with T2DM (n = 66,726) in routine clinical care across four continents. Materials and Methods: Data was collected at baseline, at 12 weeks and at 24 weeks. This short communication presents the results for patients enrolled from East India. Results: A total of 2177 patients were enrolled in the study. Four different insulin analogue regimens were used in the study. Patients had started on or were switched to biphasic insulin aspart (n=1605), insulin detemir (n=230), insulin aspart (n=233), basal insulin plus insulin aspart (n=49) and other insulin combinations (n=54). At baseline glycaemic control was poor for both insulin naïve (mean HbA1c: 8.9%) and insulin user (mean HbA1c: 9.1%) groups. After 24 weeks of treatment, both the groups showed improvement in HbA1c (insulin naïve: -1.6%, insulin users: -1.6%). SADRs including major hypoglycaemic events or episodes did not occur in any of the study patients. Conclusion: Starting or switching to insulin analogues was associated with improvement in glycaemic control with a low rate of hypoglycaemia