A Study of Scams and Frauds using Social Engineering in “The Kathmandu Valley” of Nepal

Social Engineering scams are common in Nepal. Coupled with inability of government to enforce policies over technology giants and large swaths of population that are uneducated, social engineering scams and frauds are a real issue. The purpose of the thesis is to find out the extent and impact of social engineering attacks in “The Kathmandu valley” of Nepal. The Kathmandu valley consists of 3 cities including the capital city of Nepal. To conduct the research, the newspaper “The Kathmandu Post” from the year 2019 to 2022 was downloaded and searched for keywords “scam” and “fraud”. After which the results were manually examined to separate news reports of social engineering attacks in Nepal and other countries. Also, a survey was conducted by visiting parks in the Kathmandu valley. A total of 149 people were interviewed to collect data by asking 21 questions regarding social engineering attack faced by the interviewee. Further, literature review of the research papers published related to social engineering and phishing was conducted. The main finding of the thesis was that public awareness program are effective reducing the extent and impact of social engineering attacks in Nepal. The survey suggests large percentage of population have become victims of social engineering attack attempts. More than 70 percent have received messages on WhatsApp regarding fake lottery wins

Effects of input data aggregation on simulated crop yields in temperate and Mediterranean climates

The modelling exercise for this study was highly supported by partner universities and research institutes in the framework of the MACSUR project and financially supported by the German Federal Ministry of Education and Research BMBF (FKZ 2815ERA01J) in the framework of the funding measure “Soil as a Sustainable Resource for the Bioeconomy – BonaRes”, project “BonaRes (Module B): BonaRes Centre for Soil Research (FKZ BOMA03037514, 031B0026A and 031A608A) and by the Ministry of Agriculture and Food (BMEL) in the framework of the MACSUR project (FKZ 2815ERA01J). In addition, the relevant co-authors from the partner institutes are separately financed by their respective projects. AV, EC, and EL were supported by The Swedish Research Council for Environment, Agricultural Sciences and Spatial Planning (220-2007-1218) and by the strategic funding ‘Soil-Water-Landscape’ from the faculty of Natural Resources and Agricultural Sciences (Swedish University of Agricultural Sciences). JC thank the INRA ACCAF metaprogramm for funding. KCK, CN, XS and TS were supported by MACSUR2 (FKZ 031B0039C). MK thanks for the funding by the UK BBSRC (BB/N004922/1) and the MAXWELL HPC team of the University of Aberdeen for providing equipment and support for the DailyDayCent simulations. FE acknowledges support by the German Science Foundation (project EW 119/5-1). GRM, TG, and FE thank Andreas Enders and Gunther Krauss (INRES, University of Bonn) for support. The authors also would like to acknowledge the support provided by the BMBF and the valuable comments of the scientists of the Institut für Nutzpflanzenwissenschaften und Ressourcenschutz (INRES), University of Bonn, Germany.Peer reviewedPostprin

Azithromycin and cefixime combination versus azithromycin alone for the out-patient treatment of clinically suspected or confirmed uncomplicated typhoid fever in South Asia: a randomised controlled trial protocol.

Background: Typhoid and paratyphoid fever (enteric fever) is a common cause of non-specific febrile infection in adults and children presenting to health care facilities in low resource settings such as the South Asia.  A 7-day course of a single oral antimicrobial such as ciprofloxacin, cefixime, or azithromycin is commonly used for its treatment. Increasing antimicrobial resistance threatens the effectiveness of these treatment choices. We hypothesize that combined treatment with azithromycin (active mainly intracellularly) and cefixime (active mainly extracellularly) will be a better option for the treatment of clinically suspected and culture-confirmed typhoid fever in South Asia. Methods: This is a phase IV, international multi-center, multi-country, comparative participant-and observer-blind, 1:1 randomised clinical trial. Patients with suspected uncomplicated typhoid fever will be randomized to one of the two interventions: Arm A: azithromycin 20mg/kg/day oral dose once daily (maximum 1gm/day) and cefixime 20mg/kg/day oral dose in two divided doses (maximum 400mg bd) for 7 days, Arm B: azithromycin 20mg/kg/day oral dose once daily (max 1gm/day) for 7 days AND cefixime-matched placebo for 7 days. We will recruit 1500 patients across sites in Bangladesh, India, Nepal, and Pakistan. We will assess whether treatment outcomes are better with the combination after one week of treatment and at one- and three-months follow-up. Discussion: Combined treatment may limit the emergence of resistance if one of the components is active against resistant sub-populations not covered by the other antimicrobial activity. If the combined treatment is better than the single antimicrobial treatment, this will be an important result for patients across South Asia and other typhoid endemic areas. Clinicaltrials.gov registration: NCT04349826 (16/04/2020)

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

Nitrogen Removal Ability and Characteristics of the Laboratory-Scale Tidal Flow Constructed Wetlands for Treating Ammonium-Nitrogen Contaminated Groundwater

Constructed wetlands (CWs) are an effective technology to remove organic compounds and nitrogen (N) from wastewaters and contaminated environmental waters. However, the feasibility of CWs for ammonium-N (NH4+-N)-contaminated groundwater treatment is unclear. In this study, zeolite-based laboratory-scale CW was operated as a tidal flow CW with a cycle consisting of 21-h flooded and 3-h rest, and used to treat NH4+-N (30 mg L−1) contaminated groundwater. In addition to NH4+-N, nitrite (NO2−-N) and nitrate (NO3−-N) were also not detected in the effluents from the tidal flow CW. The N removal constant remained high for a longer period of time compared to the continuous flow CW. The higher and more sustainable N removal of the tidal flow CW was due to the in-situ biological regeneration of zeolite NH4+-N adsorption capacity. Vegetation of common reeds in tidal flow zeolite-based CW enhanced nitrification and heterotrophic denitrification activities, and increased the functional genes of nitrification (AOB-amoA and nxrA) and denitrification (narG, nirK, nirS, and nosZ) by 2‒3 orders of magnitude, compared to CW without vegetation. The results suggest that the combination of zeolite substrate, tidal flow, and vegetation is key for the highly efficient and sustainable N removal from NH4+-N contaminated groundwater

Characterization of Laboratory-scale Tidal Flow Constructed Wetlands in the Removal of Organic Carbon and Nitrogen from Sewage

Tidal flow constructed wetlands (TFCWs) have been proposed as a new type of CW for enhanced wastewater treatment. However, the characterization of TFCWs in the removal of organic carbon and nitrogen remains unclear. This study investigated the efficiencies and characteristics of lab-scale TFCWs in removing organic carbon and nitrogen from sewage; in particular, the dynamics of dissolved total organic carbon (DOC), nitrogen, and dissolved oxygen (DO) were observed. Pumice- and zeolite-TFCWs were prepared, which treated sewage at 21 E fill and 3 E rest cycles. Sewage was rapidly oxidized in these TFCWs after inflow. The experimental results showed that DOC was efficiently decreased by aerobic biodegradation with DO consumption. Additionally, NH4+-N was oxidized to NO3∁EN by nitrification, the DO content decreased, and NO3∁EN was removed by denitrification in the TFCWs. The processes of aerobic-anaerobic switching, organic carbon biodegradation, and nitrification-denitrification were observed in the TFCWs. During 128-days of operation, the pumice- and zeolite-TFCWs exhibited the DOC removal capacities of 4.2 and 4.3 E-DOC/m2/d, respectively, and total dissolved inorganic nitrogen removal capacities of 3.1 and 5.1 E-N/m2/d, respectively. These results revealed the higher organic carbon and nitrogen removal capacities and mechanisms of pumice- and zeolite-TFCWs treating sewage

Hydrogenotrophic Denitrification of Groundwater Using a Simplified Reactor for Drinking Water: A Case Study in the Kathmandu Valley, Nepal

High nitrate-nitrogen (NO3−–N) content is a typical feature of groundwater, which is the primary water source in the Kathmandu Valley, Nepal. Considering the Kathmandu Valley’s current problem of water scarcity, a user-friendly system for removing NO3−–N from groundwater is promptly desired. In this study, a simplified hydrogenotrophic denitrification (HD) reactor was developed for the Kathmandu Valley, and its effectiveness was evaluated by its ability to treat raw groundwater. The reactor operated for 157 days and showed stability and robustness. It had an average nitrogen removal efficiency of 80.9 ± 16.1%, and its nitrogen loading rate and nitrogen removal rate varied from 23.8 to 92.3 g–N/(m3∙d) and from 18.3 to 73.7 g–N/(m3∙d), respectively. Compared to previous HD reactors, this simplified HD reactor is a more user-friendly option for the Kathmandu Valley, as most of the materials used for the reactor were locally available and require less maintenance. The reactor is recommended for groundwater treatment at the household level. It has a current treatment capacity of 40 L/d, which can fulfill the daily requirements for drinking and cooking water in a household with 4–5 people

Tuberculosis in Staff and Students of Patan Hospital.

BACKGROUND There is a high risk of occupational exposure to tuberculosis among healthcare workers in endemic countries. Regular screening for tuberculosis among healthcare workers is not carried out in Nepal. Infection control measures are also not routinely implemented. The aim of this study was to determine the prevalence of active tuberculosis among staff/students at Patan Hospital. METHODS Participants were given a self-administered questionnaire and invited to undergo chest radiography. Cases were scored and reviewed based on predetermined criteria, and presumptive tuberculosis cases were invited to undergo sputum smear and culture. Participants were categorized according to the extent of patient contact and asked about history of tuberculosis medication. RESULTS Among 560 participants, 76.8% had direct contact with patients. Fifty-eight (10.4%) gave history of cough >2 weeks. Based on symptom history and chest radiography, 20.0% (n=112) cases were reviewed, and 12.5% (n=14) of those reviewed had sputum tested for acid-fast bacilli. One participant had culture-positive tuberculosis. Fifty participants (8.9%) reported tuberculosis in the past, among which 42.0% (n=21) occurred after employment at Patan Hospital and 42.0% before joining Patan Hospital. Security staff, radiology technicians and ward cleaning staff had the highest proportion of cases with a history of tuberculosis.History of tuberculosis medication had no relation with age, sex, education, body mass index and smoking.The incidence rate of tuberculosis at Patan Hospital was 3.6 per 1000 person-years. CONCLUSIONS Overall incidence of tuberculosis among healthcare workers is noteworthy. However, this study suggests when symptomatic tuberculosis occurs in healthcare worker at Patan Hospital, it is diagnosed and there is not a large pool of undiagnosed tuberculosis