Stress and Coping Mechanism among Students Residing in Private School Hostels

Background. Mental health problems can significantly impact a student’s academic performance, career, health, and future if they are not identified and managed in time. The poor mental health of young people is a global problem, including in Nepal. However, the scenario of perceived stress among adolescent students residing in academic hostels is not explored in Nepal. Therefore, this study aimed at determining the prevalence of perceived stress with its associated predictors, experienced stressors, and coping mechanisms among adolescent students residing in private hostels in Nepal. Methods. A cross-sectional study design was employed among all adolescent students of grades six to ten who resided in eight school hostels in Nepal. A total of 209 students responded to self-administered validated questionnaires for perceived stress (PSS-10) and coping scales. Results. More than half (51.67%) of the students experienced symptoms of perceived stress. Strict discipline in the hostel (77.03%) and groupism based on religion (5.26%) were the most common and least common stressors experienced, respectively. One-third of the students (n = 70, 33.5%) very often felt confident about handling personal problems. The presence of a mischievous element and neglect from friends were significant stressors determined. Seeking social support was the most used coping strategy over externalizing behaviours such as using bad words, yelling, and shouting. Conclusion. The study confirmed the presence of perceived stress among students living in hostels, where hostel residential factors were the predominant predictors. As a minority of the students can properly manage their stress, it is necessary to provide students with the appropriate educational counselling to help them deal with potential obstacles. Additionally, monitoring, increased communication with family and friends, and improving the hostel environment can be important in addressing students’ perceived stress

Continuing Pharmacy Education: Exploring the Status and Future Prospects in Nepal

Continuing pharmacy education (CPE) is an educational way for pharmacy professionals to develop competency in providing quality pharmaceutical care to patients. The CPE program helps maintain up-to-date knowledge and skills, increase the professionalism of pharmacists, and positively impact patient health outcomes. However, the concept and practice of CPE are still in their infancy in Nepal. Nepal’s conventional pharmacy education system involves didactic lectures focusing more on theoretical learning than practical and experiential approaches, leading to the generation of pharmacists theoretically knowledgeable but practically non-competent to deliver pharmaceutical care services in independent practice settings. Additionally, in the absence of CPE, the professionals might miss updated information on new therapies, technologies, and approaches in patient management. The community and hospital pharmacies in Nepal are often business-oriented rather than service, and may not even be staffed by pharmacists, so the CPE programs are rarely conducted for the pharmacy professionals. Hence, the present commentary aimed to explore the status of CPE and its barriers or challenges in implementation and to suggest solutions in Nepal

Global diversity and antimicrobial resistance of typhoid fever pathogens : insights from a meta-analysis of 13,000 Salmonella Typhi genomes

DATA AVAILABILITY : All data analysed during this study are publicly accessible. Raw Illumina sequence reads have been submitted to the European Nucleotide Archive (ENA), and individual sequence accession numbers are listed in Supplementary file 2. The full set of n=13,000 genome assemblies generated for this study are available for download from FigShare: https://doi.org/10.26180/21431883. All assemblies of suitable quality (n=12,849) are included as public data in the online platform Pathogenwatch (https://pathogen.watch). The data are organised into collections, which each comprise a neighbour-joining phylogeny annotated with metadata, genotype, AMR determinants, and a linked map. Each contributing study has its own collection, browsable at https://pathogen.watch/collections/all?organismId= 90370. In addition, we have provided three large collections, each representing roughly a third of the total dataset presented in this study: Typhi 4.3.1.1 (https://pathogen.watch/collection/ 2b7mp173dd57-clade-4311), Typhi lineage 4 (excluding 4.3.1.1) (https://pathogen.watch/collection/ wgn6bp1c8bh6-clade-4-excluding-4311), and Typhi lineages 0-3 (https://pathogen.watch/collection/ 9o4bpn0418n3-clades-0-1-2-and-3). In addition, users can browse the full set of Typhi genomes in Pathogenwatch and select subsets of interest (e.g. by country, genotype, and/or resistance) to generate a collection including neighbour-joining tree for interactive exploration.SUPPLEMENTARY FILES : Available at https://elifesciences.org/articles/85867/figures#content. SUPPLEMENTARY FILE 1. Details of local ethical approvals provided for studies that were unpublished at the time of contributing data to this consortium project. Most data are now published, and the citations for the original studies are provided here. National surveillance programs in Chile (Maes et al., 2022), Colombia (Guevara et al., 2021), France, New Zealand, and Nigeria (Ikhimiukor et al., 2022b) were exempt from local ethical approvals as these countries allow sharing of non-identifiable pathogen sequence data for surveillance purposes. The US CDC Internal Review Board confirmed their approval was not required for use in this project (#NCEZID-ARLT- 10/ 20/21-fa687). SUPPLEMENTARY FILE 2. Line list of 13,000 genomes included in the study. SUPPLEMENTARY FILE 3. Source information recorded for genomes included in the study. ^Indicates cases included in the definition of ‘assumed acute illness’. SUPPLEMENTARY FILE 4. Summary of genomes by country. SUPPLEMENTARY FILE 5. Genotype frequencies per region (N, %, 95% confidence interval; annual and aggregated, 2010–2020). SUPPLEMENTARY FILE 6. Genotype frequencies per country (N, %, 95% confidence interval; annual and aggregated, 2010–2020). SUPPLEMENTARY FILE 7. Antimicrobial resistance (AMR) frequencies per region (N, %, 95% confidence interval; aggregated 2010–2020). SUPPLEMENTARY FILE 8. Antimicrobial resistance (AMR) frequencies per country (N, %, 95% confidence interval; annual and aggregated, 2010–2020). SUPPLEMENTARY FILE 9. Laboratory code master list. Three letter laboratory codes assigned by the consortium.BACKGROUND : The Global Typhoid Genomics Consortium was established to bring together the typhoid research community to aggregate and analyse Salmonella enterica serovar Typhi (Typhi) genomic data to inform public health action. This analysis, which marks 22 years since the publication of the first Typhi genome, represents the largest Typhi genome sequence collection to date (n=13,000). METHODS : This is a meta-analysis of global genotype and antimicrobial resistance (AMR) determinants extracted from previously sequenced genome data and analysed using consistent methods implemented in open analysis platforms GenoTyphi and Pathogenwatch. RESULTS : Compared with previous global snapshots, the data highlight that genotype 4.3.1 (H58) has not spread beyond Asia and Eastern/Southern Africa; in other regions, distinct genotypes dominate and have independently evolved AMR. Data gaps remain in many parts of the world, and we show the potential of travel-associated sequences to provide informal ‘sentinel’ surveillance for such locations. The data indicate that ciprofloxacin non-susceptibility (>1 resistance determinant) is widespread across geographies and genotypes, with high-level ciprofloxacin resistance (≥3 determinants) reaching 20% prevalence in South Asia. Extensively drug-resistant (XDR) typhoid has become dominant in Pakistan (70% in 2020) but has not yet become established elsewhere. Ceftriaxone resistance has emerged in eight non-XDR genotypes, including a ciprofloxacin-resistant lineage (4.3.1.2.1) in India. Azithromycin resistance mutations were detected at low prevalence in South Asia, including in two common ciprofloxacin-resistant genotypes. CONCLUSIONS : The consortium’s aim is to encourage continued data sharing and collaboration to monitor the emergence and global spread of AMR Typhi, and to inform decision-making around the introduction of typhoid conjugate vaccines (TCVs) and other prevention and control strategies.Fellowships from the European Union (funding from the European Union’s Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie grant agreement No 845681), the Wellcome Trust (SB, Wellcome Trust Senior Fellowship), and the National Health and Medical Research Council.https://elifesciences.org/am2024Medical MicrobiologySDG-03:Good heatlh and well-bein

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Airplane Landing Performance on Contaminated Runways and Adverse Conditions

In this research, we investigated operational landing and stopping phase of large-transport category airplanes on contaminated runways and under adverse conditions. Introduction of Heaviside step functions in the mathematical model ensures realistic time-delayed modeling of spoiler, brakes, and thrust reverse deployment. The model also accounts or variations in pilot performance and techniques. A simulation model consists of several distinct systems of simultaneous nonlinear ordinary differential equations, semi-empirical expressions, and many accompanied algebraic relationships for aerodynamic coefficients, friction data and relevant parameters. The full non-linear differential model was solved using Heun\u27s predictor-corrector method. Different landing scenarios including dry, icy, and wet runways were simulated to obtain realistic stopping distance, speed, and deceleration histories. The model accounts for different contaminated runways scenarios, hydroplaning, wind effect and other advanced features. This mathematical model and the accompanied in house designed MATLAB® program were used as a reliable operational landing distance calculator and as an educational demonstrator to simulate the operation with limited budget. The simulation analysis showed that FAA, wet-runways correction, is not sufficient calculating safe landing distances. Parametric analysis was performed to estimate contributions or significances of various effects. Due to many uncertainties, especially in aircraft aerodynamic data, we estimated the total uncertainty of the prediction to be approximately 1 % or 100 feet landing distance whichever is higher

Immune responses in neurodegenerative diseases

Neurodegenerative disease is a progressive loss of neurons from central nervous system and has a huge impact on health care system. Various causes have been proposed of which inflammation has been suggested to be a probable key factor in the most of such conditions. The involvement of immune cells including lymphocytes in such diseased condition of the CNS supports this notion. The effective therapy for these diseases has been sought for more than a half century but still lacking such therapy. On such basis this review article has mainly focussed on evidence of the involvement of immune cells in various neurodegenerative diseases including Alzheimer’s disease, Parkinson’s diseases and Multiple sclerosis and suggests a possible therapy of such diseased conditions of the CNS by the modulation of immune system

BER and PSD Improvement of FBMC with Higher Order QAM Using Hermite Filter for 5G Wireless Communication and beyond

Nowadays, multicarrier modulation schemes are being widely used in wireless communication system than single-carrier modulation techniques. Single-carrier modulation schemes are less capable of dealing with multipath fading channels than multicarrier modulation schemes, which results in lower spectral efficiency. Multicarrier modulation schemes have the ability to overcome multipath fading channels. Multicarrier modulation technique currently used in 4G technology in many countries is OFDM and it is easy for implementation, immune to interference, and provide fast data rate. However, the rising users demand on wireless communication resulted in need for further advancement of wireless communication system. The present OFDM transmission does not fulfill the requirements of 5G wireless communication system and beyond due to major limitations such as out of band emission and usage of cyclic prefix. To overcome the challenges of OFDM, different modulation schemes like Filter Bank Multicarrier with Offset-QAM, Filter Bank Multicarrier with QAM, Universal Filter Multicarrier, Filtered-OFDM, and Weighted Overlap and Added-OFDM are proposed. In this study, the Filter Bank Multicarrier with QAM using Hermite prototype filter is proposed to overcome drawbacks of OFDM and all other proposed waveforms. The performances of each multicarrier technique are analyzed based on power spectral density and bit error rate. Simulation result shows that the power spectral density of FBMC with QAM using Hermite filter resulted in 4.7 dB reduction of out of band emission compared to FBMC with QAM using PHYDYAS filter. The bit error rate is also reduced for Vehicular A, Vehicular B, Pedestrian A, and Pedestrian B channel models