Non-zero θ13\theta_{13}, CP-violation and Neutrinoless Double Beta Decay for Neutrino Mixing in the A4×Z2×Z2′A_4\times Z_2\times Z_2^\prime Flavor Symmetry Model

We study the modification of the Altarelli-Feruglio $A_4$ flavor symmetry model by adding three singlet flavons $\xi'$, $\xi''$ and $\rho$ and the model is augmented with extra $Z_2\times Z_2^ \prime$ symmetry to prevent the unwanted terms in our study. The addition of these three flavons lead to two higher order corrections in the form of two perturbation parameters $\epsilon$ and $\epsilon^\prime$. These corrections yield the deviation from exact tri-bimaximal (TBM) neutrino mixing pattern by producing a non-zero $\theta_{13}$ and other neutrino oscillation parameters which are consistent with the latest experimental data. In both the corrections, the neutrino masses are generated via Weinberg operator. The analysis of the perturbation parameters $\epsilon$ and $\epsilon^\prime$, shows that normal hierarchy (NH) and inverted hierarchy (IH) for $\epsilon$ does not change much. However, as the values of $\epsilon^\prime$ increases, $\theta_{23}$ occupies the lower octant for NH case. We further investigate the neutrinoless double beta decay parmeter $m_{\beta\beta}$ using the parameter space of the model for both normal and inverted hierarchies of neutrino masses.Comment: 19 pages, 6 figures, 3 table

Outcome of Laparoscopic Nephrectomy in Benign Renal Disease

Introductions: Laparoscopic surgery is rapidly emerging option in urology. With the advances in technology and instruments currently this is viable alternative to treat complex surgical diseases as well as reconstructive surgery. Methods: This is a prospective observational study to analyze the outcome of laparoscopy nephrectomy. A total of 51 patients’ had undergone laparoscopy nephrectomy over the period of five years. The variables analyzed were, age, sex, operative time, estimated blood loss, length of hospital stay, conversion rate and complication. Results: The mean patient's age was 41.1 years (range 15 - 71 years). Indications of nephrectomy were non-functional kidney secondary to stone disease in 26 (50.98%). Mean operative time was 1.43 hours. Median hospital stay was 2.3 days. Conclusions:  Laparoscopy surgery is a safe and feasible treatment option for the benign renal disease with comparable outcomes. Non functional kidney secondary to renal stone was the major cause of nephrectomy in this study. Keywords: benign renal disease, laparoscopic nephrectomy, nonfictional kidney, nephrolithiasi

Neutrino Mass Model in the Context of Δ(54)⊗Z2⊗Z3⊗Z4\boldsymbol{\Delta(54) \otimes Z_2\otimes Z_3 \otimes Z_4} Flavor Symmetries with Inverse Seesaw Mechanism

Our analysis involves enhancing the $\Delta(54)$ flavor symmetry model with Inverse Seesaw mechanism along with two SM Higgs through the incorporation of distinct flavons. Additionally, we introduce supplementary $Z_2\otimes Z_3 \otimes Z_4$ symmetries to eliminate any undesirable components within our investigation. The exact tri-bimaximal neutrino mixing pattern undergoes a deviation as a result of the incorporation of extra flavons, leading to the emergence of a non-zero reactor angle $\theta_{13}$ that aligns with the latest experimental findings. It was found that for our model the atmospheric oscillation parameter occupies the lower octant for normal hierarchy case. We also examine the parameter space of the model for normal hierarchy to explore the Dirac CP ($\delta_{CP}$), Jarlskog invariant parameter ($J$) and the Neutrinoless double-beta decay parameter ($m_{\beta\beta}$) and found it in agreement with the neutrino latest data. Hence our model may be testable in the future neutrino experiments.Comment: 18 pages, 6 figures, 3 table

FIRST PRINCIPLE INSIGHT INTO Co-DOPED MoS2 FOR SENSING NH3 AND CH4

In this work we present the atomistic computational study of the adsorption properties of Co doped MoS2 adsorbed ammonia (NH3) and methane (CH4). The adsorption distance, adsorption energy (Ead), charge transfer (Qt), bandgap, Density of States (DOS), Projected Density of States (PDOS), transport properties, sensitivity and recovery time have been reported. The diffusion property of the system was calculated using Nudge Elastic Band (NEB) method. The calculated results depict that after suitable doping of Co on MoS2 monolayer decreases the resistivity of the system and makes it more suitable for application as a sensor.  After adsorbing NH3 and CH4, Co doped MoS2 bandgap, DOS and PDOS become more enhanced. The adsorption energy calculated for NH3 and CH4 adsorbed Co doped MoS2 are -0.9 eV and -1.4 eV. The reaction is exothermic and spontaneous. The I-V curve for Co doped MoS2 for CH4 and NH3 adsorption shows a linear increase in current up to 1.4 V and 2 V, respectively, then a rapid decline in current after increasing a few volts. The Co doped MoS2 based sensor has a better relative resistance state, indicating that it can be employed as a sensor. The sensitivity for CH4 and NH3 were 124 % and 360.5 %, respectively, at 2 V. With a recovery time of 0.01s, the NH3 system is the fastest. In a high-temperature condition/environment, the Co doped MoS2 monolayer has the potential to adsorb NH3 and CH4 gas molecules. According to NEB, CH4 gas molecules on Co doped MoS2 has the lowest energy barrier as compared to NH3 gas molecules. Our results indicate that adsorbing NH3 and CH4 molecules in the interlayer is an effective method for producing Co doped MoS2 monolayers for use as spintronics sensor materials

Implementing Diagnostic Imaging Services in a Rural Setting of Extreme Poverty: Five Years of X-ray and Ultrasound Service Delivery in Achham, Nepal

Introduction: Diagnostic radiology services are severely lacking in many rural settings and the implementation of these services poses complex challenges. The purpose of this paper is to describe the implementation of diagnostic radiology services at a district-level hospital in Achham, a rural district in Nepal. Methods and Materials: We conducted a retrospective review of the implementation of diagnostic radiology services. We compiled a list of implementation challenges and proposed solutions based on an internal review of historical data, hospital records, and the experiences of hospital staff members. We used a seven-domain analytic framework to structure our discussion of these challenges. Results: We documented the first five years of challenges faced and lessons learned by the non-profit organization Possible while implementing and providing diagnostic radiology services for the first time in a remote location. Additionally, we documented the uptake of these services through the first five years of operations. During this time, the number of X-rays performed increased 271%, while ultrasounds increased 258%. The main challenges included educating the community about the appropriate use of these services, recruiting trained providers, and coordinating referral care and consultations for higher-level diagnostics and treatment. Finally, investments in training providers and technicians, as well as investments in infrastructure, primarily the installation of solar panels to maintain a power supply, were critical to sustaining services. Discussion: This experience demonstrates that reliable and sustained services can be deployed even in extremely remote areas and identifies challenges that other implementers may face in similar program implementation

Integrated approach for the management of common bean rust (Uromyces appendiculatus) under field conditions

A field experiment was conducted to test the efficacy of different management practices and fungicide application timings for common bean rust management in Chitwan, Nepal. It was conducted in a randomized complete block design (RCBD) with two factors: management practices (Azoxystrobin, Trichoderma viride, maize intercropping + Trichoderma viride, Neem + Garlic extracts, and inoculated and untreated controls) and fungicide application timings (8 days after inoculation and 3 days after inoculation), each with three replications. The minimum disease severity was found with azoxystrobin, which was at par with neem + garlic extract and maize intercropping + Trichoderma at 50 days after inoculation (DAI). The maximum number of rust pustules per cm2 was observed in the control plots (7.56), followed by Trichoderma (4.79) at 50 DAI. The maximum necrotic colonies (%) were observed with the control (36.88%), followed by Trichoderma (25.15%), while the effects of other treatments were at par at 40 DAI. Maize intercropping with Trichoderma resulted in a maximum plant height (201.56 cm), which was at par with azoxystrobin (197.81 cm). The plants treated with azoxystrobin showed maximum green pod yield at one picking (2411.35 g) which was at par with maize intercropping + Trichoderma and neem + garlic extracts. Rust was controlled more effectively when the fungicides were sprayed at 4 DAI than 8 DAI. The maximum disease control was observed with Azoxystrobin; however, as other treatments also had comparable effects, an integrated approach could be adopted for the sustainable management of common bean rust

Carbon footprint of Nepalese healthcare system: A study of Dhulikhel Hospital [version 1; peer review: 2 approved, 1 approved with reservations, 1 not approved]

Background: Though direct greenhouse gas emissions cannot be observed in health care sectors, there can exist indirect emissions contributing to global climate change. This study addresses the concept of the carbon footprint and its significance in understanding the environmental impact of human activities, with a specific emphasis on the healthcare sector through gate-to-gate (GtoG) life cycle assessment. Transportation, energy consumption, and solid waste generated by hospitals are the primary sources of carbon emissions. Methods: Different standards, guidelines and parameters were used to estimate emissions from both the primary and secondary data. All steps and sub-steps involved in GtoG were accessed and analyzed within the standard ISO 14040:44 guideline. An extensive review of existing literature was carried out for the evaluation and verification of secondary data. Results: The total carbon footprint of generators, electricity consumption, transportation activities, LPG cylinders, PV systems was found to be 58,780 kg-CO2-eq/yr, 519,794 kg-CO2-eq/yr, 272,375 kg-CO2-eq/yr, 44,494 kg-CO2-eq/yr, 35,283 kg-CO2-eq/yr respectively and the emissions from non-biodegradable solid waste was found to be 489,835 kg-CO2/yr. Local air pollutants such as PM10, CO, SO2, NOX, and VOCs generated by generators and transportation were also estimated. The CH4 emissions from liquid waste were 1177.344 kg CH4/BOD yr, and those from biodegradables were 3821.6954 kg CH4/yr. Conclusions: Healthcare professionals and policymakers can take action to reduce the sector's carbon footprint by implementing best practices and encouraging sustainable behavior. This study can be taken as foundation for further exploration of indirect emissions from healthcare sectors not only in Nepal but also in south Asian scenario

Assessment of Pressure Ulcer Risk among Patients Admitted in Intensive Care Unit at a Tertiary Level Hospital

Background: Pressure ulcer continues to be a major health problem and prevention has been the main emphasis of patient care. Rigorous evaluation of patients in intensive care unit is necessary for early identification of those at risk of developing pressure ulcer. Multiple risk assessment scales are in practice for its prevention. This study aims to assess pressure ulcer risk of the patients admitted in intensive care unit using Braden Scale. Methods: A cross-sectional descriptive study was conducted among 272 patients admitted in intensive care unit of Nepal Medical College Teaching Hospital from August 2019 to January 2020. Consecutive sampling technique was used to collect data from the patients. Data was analyzed using chi-square test and multiple binary logistic regression in the statistical package for social sciences in version 16. Results: Among 272 patients, the mean Braden score of pressure ulcer risk was 18.23±3.51. Nearly half of the patients 127 (46.7%) had risk of developing pressure ulcer, while two of them eventually developed pressure ulcer. The mean age was 51.11±18.82 years. Majority of the patients 221 (81.2%) were admitted in intensive care unit with medical disorders. Risk of developing pressure ulcer was significantly associated with age, gender, fever, use of ventilator, pressure ulcer prevention device, total duration of the hospital stay and duration of Intensive Care Unit stay (p= <0.05). The predictors of pressure ulcer risk were mechanical ventilation (P=0.001, Adjusted Odds Ratio =6.99) and fever (p=0.011, Adjusted Odds Ratio =3.61). Conclusions: Routine use of Braden Scale helps in early identification of pressure ulcer risk. Nurses need to consider the patients with ventilatory support and fever as these are the strong predictors of pressure ulcer risk

Patient Safety and organizational Safety Culture in Surgery: A Need of an Hour in the developing countries

Every year, more than 200 million surgeries are performed around the world, and recent statistics show that adverse event rates for surgical pathologies remain unacceptably high, despite several national and global patient safety initiatives over the last decade. Patient safety is diverse and highly complicated in nature, with several critical components. Although concern for patient safety is fundamental in health care practice, its transition into knowledge is comparatively recent, and hence patient safety may be deemed a "new" field. Current surgical safety guidelines and checklists are generic and not adapted to specific patient concerns and risk factors in surgical subspecialties. All surgical practitioners and health care organizations must therefore become better aware of the fundamental context of patient safety, actively participate in endeavors to integrate patient safety measures in daily practice, and foster a patient safety culture. The purpose of this review article is to outline patient safety in surgical techniques that should be adopted and implemented