AEROGEL – A Promising Building Material for Sustainable Buildings

The sustainable buildings can be defined as efficient buildings from the point of view of maintenance and operation costs, and of which value increases in time, through positive impact on the natural and social environment. The aim of rendering buildings sustainable can be achieved only by the production of new advanced materials, and by using them, especially at the glass surfaces, for more resistant envelopes at different external actions which may increase considerably the durability period of a building and may increase the energy efficiency through a high level thermal insulation. This paper, aims to explore the possibility of the use of Aerogels as a building material with reference to its chemical, physical characteristics and performance. The paper presents also an analytical application demonstrates that it is supposed to be an expensive method initially but is more advantageous, considering the low costs afterwards, mainly, because of reduced energy consumption. It talks about chemical adaptation of Aerogels for optical applications, chemical adaptation of Aerogels to thermal insulation and its various applications in Building Industry. Keywords: aerogel, sustainable building,, thermal insulation, life cycle cost

Diversity and abundance of insect pest of low land rice field in Lamahi, Dang district of Nepal

A study on diversity and abundance of insects in rice field was conducted at farmer field of Lamahi, Dang during July to October in 2019. Insects were collected using sweep net and light trap. Overall, 414 insect specimen representing 11 families and 8 orders were collected during the period. Grasshopper (23.98%) with including all species was the most abundance insect found in rice field as it followed by brown plant hopper (16.62%). Among the eight insect orders captured Orthoptera (29.16%) was the most abundance insect order followed by Homoptera (16.62%). As the diversity of insect pest in this area may responsible economic losses was found which will be useful to adapt appropriate management practices to keep them at normal area. The presence of natural enemies should conserve to enhance the natural biological control of insect pests

Acute Kidney Injury, Recurrent Seizures, and Thrombocytopenia in a Young Patient with Lupus Nephritis: A Diagnostic Dilemma

Introduction. Posterior reversible encephalopathy syndrome (PRES) is a constellation of clinical and radiologic findings. Fluctuations in blood pressure, seizures, and reversible brain MRI findings mainly in posterior cerebral white matter are the main manifestations. PRES has been associated with multiple conditions such as autoimmune disorders, pregnancy, organ transplant, and thrombotic microangiopathy (TMA). Case Presentation. A 22-year-old woman with history of Systemic Lupus Erythematous complicated with chronic kidney disease secondary to lupus nephritis class IV presented with recurrent seizures and uncontrolled hypertension. She was found to have acute kidney injury and thrombocytopenia. Repeat kidney biopsy showed diffuse endocapillary and extracapillary proliferative and membranous lupus nephritis (ISN-RPS class IV-G+V) and endothelial swelling secondary to severe hypertension but no evidence of TMA. Brain MRI showed reversible left frontal and parietal lesions that resolved after controlling the blood pressure, making PRES the diagnosis. Conclusion. PRES is an important entity that must be recognized and treated early due to the potential reversibility in the early stages. Physicians must have high suspicion for these unusual presentations. We present a case where performing kidney biopsy clinched the diagnosis in our patient with multiple confounding factors

Comparative Study on Effects of 2% Lidocaine Hydrochloride with Adrenaline (1:200000) on Blood Pressure Among Controlled Hypertensive and Non-hypertensive Patients During Dental Anesthesia

Introduction: Local anesthetic used for dental extraction is 2% lidocaine hydrochloride with adrenaline (1:200000). Lidocaine is cardiac depressant and adrenaline is cardiac stimulant; it decreases or increases blood pressure respectively. Methods: A total of 100 patients (50 controlled hypertensive and 50 non-hypertensive) were selected. The study was conducted over a period of 14 months from January 2020 to February 2021. Blood pressure was measured for patients who were planned for dental extraction by auscultatory method. Following that, 1.5-3 ml (depending upon the nerve block) 2% lidocaine with adrenaline (1:200000) was injected using a 3ml syringe (26 Gauge). Blood pressure was re-recorded after 10 minutes from the time of injection. Visual analog scale pain score was obtained during administration of local anesthesia. Paired t-test was applied to compare blood pressure change before and after administration of local anesthesia in controlled hypertensive and non-hypertensive patients. Results: There was a statistically significant increase in both systolic and diastolic blood pressure in non-hypertensive patients (p = 0.008, p = 0.017). This, however, was not the case with controlled hypertensive patients. There was statistically significant increase in systolic blood pressure (p < 0.001). Pain on injection (50% in non-hypertensive and 48% in controlled hypertensive patients) was the only adverse drug reaction that was reported in both groups. Conclusion: 2% lidocaine hydrochloride with adrenaline (1:200000) increased systolic but not diastolic blood pressure in controlled hypertensive patient

User Manual: Plastic pollution assessment methodologies suitability toolkit (PLAST)

PLAST is a Microsoft Excel VBA tool designed to characterize and compare plastic pollution assessment methodologies to suggest the most suitable options based on a user's requirements. The user manual details the aim, installation, method, and use of the toolkit

Clinical Characteristics and Outcomes of Drug-Induced Acute Kidney Injury Cases

Introduction Drug-induced acute kidney injury (DI-AKI) is a frequent adverse event. The identification of DI-AKI is challenged by competing etiologies, clinical heterogeneity among patients, and a lack of accurate diagnostic tools. Our research aims to describe the clinical characteristics and predictive variables of DI-AKI. Methods We analyzed data from the DIRECT study (NCT02159209), an international, multi-center, observational cohort study of enriched clinically adjudicated DI-AKI cases. Cases met the primary inclusion criteria if the patient was exposed to at least one nephrotoxic drug for a minimum of 24 hours prior to acute kidney injury (AKI) onset. Cases were clinically adjudicated and inter-rater reliability (IRR) was measured using Krippendorff's alpha. Variables associated with DI-AKI were identified using L1 regularized multivariable logistic regression. Model performance was assessed using the area under the receiver operating characteristic curve (ROC AUC). Results 314 AKI cases met the eligibility criteria for this analysis, and 271 (86%) cases were adjudicated as DI-AKI. The majority of the AKI cases were recruited from the United States (68%). The most frequent causal nephrotoxic drugs were vancomycin (48.7%), non-steroidal anti-inflammatory drugs (18.2%), and piperacillin/tazobactam (17.8%). The IRR for DI-AKI adjudication was 0.309. The multivariable model identified age, vascular capacity, hyperglycemia, infections, pyuria, serum creatinine trends, and contrast media as significant predictors of DI-AKI with good performance, ROC AUC 0.86. Conclusions The identification of DI-AKI is challenging even with comprehensive adjudication by experienced nephrologists. Our analysis identified key clinical characteristics and outcomes of DI-AKI compared to other AKI etiologies

Production of He-4 and (4) in Pb-Pb collisions at root(NN)-N-S=2.76 TeV at the LHC

Results on the production of He-4 and (4) nuclei in Pb-Pb collisions at root(NN)-N-S = 2.76 TeV in the rapidity range vertical bar y vertical bar <1, using the ALICE detector, are presented in this paper. The rapidity densities corresponding to 0-10% central events are found to be dN/dy4(He) = (0.8 +/- 0.4 (stat) +/- 0.3 (syst)) x 10(-6) and dN/dy4 = (1.1 +/- 0.4 (stat) +/- 0.2 (syst)) x 10(-6), respectively. This is in agreement with the statistical thermal model expectation assuming the same chemical freeze-out temperature (T-chem = 156 MeV) as for light hadrons. The measured ratio of (4)/He-4 is 1.4 +/- 0.8 (stat) +/- 0.5 (syst). (C) 2018 Published by Elsevier B.V.Peer reviewe

Environmental Health and Child Survival in Nepal: Health Equity, Cost-Effectiveness, and Priority-Setting

Children in the developing world continue to face an onslaught of disease and death from largely preventable factors. These children are especially susceptible to poor environmental conditions, which put them at risk of developing illnesses in early life. In many developing countries, programs to improve child health have typically focused on improved feeding practices, micronutrient supplementation, national immunization campaigns, and measures to strengthen health systems (improving the availability of drugs, ensuring better treatment of cases, and hiring more trained personnel). However, with continued exposure to contaminated water, inadequate sanitation, smoke and dust, and mosquitoes, children in developing countries are still falling sick, imposing a sustained and heavy burden on the health system. Recognizing the environment’s contribution to overall child survival, there is an urgent need to broaden the spectrum of interventions beyond the health sector. Yet, environmental health interventions (which are defined as those aimed at environmental risks such as inadequate water and sanitation, and indoor air pollution) remain relatively neglected in the process of devising and implementing child survival intervention packages in most developing countries. In this thesis, only environmental health risks associated with sanitation coverage is addressed. In developing countries like Nepal, sanitation coverage (defined as access to improved sanitary facilities)–an important contributor to child health – has been overlooked (JMP 2012). Politically, attention to provide access to water, especially piped water, has received much more attention, and strategies to expand access to water have often focused on urban areas. This neglect of sanitation becomes even more stark when one looks at it through the lens of health equity – with lower socio-economic sections (as measured by wealth quintiles) of the population being disproportionately impacted. This dissertation, through three related papers, employs different types of analyses to investigate the importance and relevance of including environmental health interventions such as sanitation to address child health. These three papers focus on Nepal – where poor environmental conditions and malnutrition together continue to threaten child survival and development. The first paper highlights how expanding sanitation coverage may have the potential to differentially impact the poor, and may contribute to reducing health inequities across wealth quintiles in Nepal. The second paper investigates if cost-effectiveness of environmental health interventions to address diarrhea in children under five years old in Nepal varies across wealth quintiles. The third paper studies how environmental health interventions are prioritized among child health interventions by public health decision-makers in Nepal. The first paper involves an estimation of the lives saved under two scale-up scenarios for improved sanitation in Nepal at the national level and across the 5 wealth quintiles using the Lives Saved Tool (LiST). This paper attempts to demonstrate the differential impact on child mortality and diarrheal incidence of scaling up sanitation coverage across wealth quintiles, through the use of the LiST model. The results suggest that many more lives of children under five are saved when sanitation scale-up is targeted to the lowest quintiles. It is important to note that welfare improvements made by sanitation clearly may go beyond child mortality; providing a healthier environment to children is likely to not only affect their short-term, but also their long-term physical and mental development, labor-force productivity, and lifetime earnings (Alderman et al 2006; Grantham-McGregor et al 2007; Lorntz et al 2006; Maluccio, Hoddinott, and Behrman 2006). The second paper estimates how cost-effectiveness of sanitation scale-up may vary across wealth quintiles in Nepal. Results suggest that incremental cost-effectiveness ratios (ICERs) associated with scaling up sanitation are relatively low across all wealth quintiles in Nepal, and may be comparable to other child health interventions such as vaccines. Between the equal scale-up and pro-poor scale-up scenarios, there are no real differences in the ICERs for each quintile. This demonstrates that for Nepal, from a cost-effectiveness (efficiency) perspective, there is no advantage of a pro-poor scale-up approach (however, for equity reasons, this may still be valid). A sensitivity analysis showed that while the scaling up of sanitation can be cost-effective, the degree of cost-effectiveness is sensitive to the intervention costs, diarrhea incidence, and effectiveness ratios. The absence of information/ research on differences in sanitation effectiveness across wealth quintiles, as well as the poor information of sanitation costs disaggregated by wealth quintile and type of technology, limits the interpretation of these results. The first two papers present the equity and efficiency (cost-effectiveness) perspective when looking at scaling up sanitation. In health systems around the world policymakers share the common concern on how to find the right balance between these objectives. Ultimately, decisions on such programs to address child health involve prioritization of interventions across health and non-health sectors. The third paper uses a multi-criteria decision making approach to better understand how environmental health interventions might be prioritized relative to other interventions relevant for child health in Nepal. For this a discrete choice experiment survey was conducted in Kathmandu, with responses received from forty-six sanitation and public health decision-makers. This explorative analysis suggested that non-health benefits may be relevant in priority setting in child health while including a larger range of relevant criteria for priority setting. Environmental health interventions (both water and sanitation – which help reduce diarrheal incidence, as well as rural clean energy solutions –which help reduce incidence of acute respiratory infections) may be ranked as the highest priority in the context of child health in Nepal. Together, these papers help investigate the attractiveness and potential for the inclusion of environmental health interventions within the scope of broader child health programs in developing countries like Nepal. More generally, this thesis illustrates the potential benefits of building on and extending various existing tools and methodologies to a range of environmental health interventions which lie outside the health sector. It also specifically applies these methodologies at a disaggregated level (by wealth quintiles) to explore the differences across the socioeconomic sub-groups. There are still need for more customized and country-specific research needed on intervention effectiveness and costs, including specifically in programmatic settings to gather evidence on scalability and sustainability. Uncertainty in several parameters and the lack of data at a disaggregated level limit the generalizability of the findings. But the economics of sanitation –from an equity-efficiency perspective –as shown in this thesis can help to inform the policy dialog on scaling up sanitation for better child health. This is an important step towards addressing the unfinished health agenda among the most vulnerable groups—children less than five years of age and in poorer households, who are disproportionately exposed to and affected by health risks from environmental hazards

Environmental Health and Child Survival in Nepal: Health Equity, Cost-Effectiveness, and Priority-Setting

Children in the developing world continue to face an onslaught of disease and death from largely preventable factors. These children are especially susceptible to poor environmental conditions, which put them at risk of developing illnesses in early life. In many developing countries, programs to improve child health have typically focused on improved feeding practices, micronutrient supplementation, national immunization campaigns, and measures to strengthen health systems (improving the availability of drugs, ensuring better treatment of cases, and hiring more trained personnel). However, with continued exposure to contaminated water, inadequate sanitation, smoke and dust, and mosquitoes, children in developing countries are still falling sick, imposing a sustained and heavy burden on the health system. Recognizing the environment’s contribution to overall child survival, there is an urgent need to broaden the spectrum of interventions beyond the health sector. Yet, environmental health interventions (which are defined as those aimed at environmental risks such as inadequate water and sanitation, and indoor air pollution) remain relatively neglected in the process of devising and implementing child survival intervention packages in most developing countries. In this thesis, only environmental health risks associated with sanitation coverage is addressed. In developing countries like Nepal, sanitation coverage (defined as access to improved sanitary facilities)–an important contributor to child health – has been overlooked (JMP 2012). Politically, attention to provide access to water, especially piped water, has received much more attention, and strategies to expand access to water have often focused on urban areas. This neglect of sanitation becomes even more stark when one looks at it through the lens of health equity – with lower socio-economic sections (as measured by wealth quintiles) of the population being disproportionately impacted. This dissertation, through three related papers, employs different types of analyses to investigate the importance and relevance of including environmental health interventions such as sanitation to address child health. These three papers focus on Nepal – where poor environmental conditions and malnutrition together continue to threaten child survival and development. The first paper highlights how expanding sanitation coverage may have the potential to differentially impact the poor, and may contribute to reducing health inequities across wealth quintiles in Nepal. The second paper investigates if cost-effectiveness of environmental health interventions to address diarrhea in children under five years old in Nepal varies across wealth quintiles. The third paper studies how environmental health interventions are prioritized among child health interventions by public health decision-makers in Nepal. The first paper involves an estimation of the lives saved under two scale-up scenarios for improved sanitation in Nepal at the national level and across the 5 wealth quintiles using the Lives Saved Tool (LiST). This paper attempts to demonstrate the differential impact on child mortality and diarrheal incidence of scaling up sanitation coverage across wealth quintiles, through the use of the LiST model. The results suggest that many more lives of children under five are saved when sanitation scale-up is targeted to the lowest quintiles. It is important to note that welfare improvements made by sanitation clearly may go beyond child mortality; providing a healthier environment to children is likely to not only affect their short-term, but also their long-term physical and mental development, labor-force productivity, and lifetime earnings (Alderman et al 2006; Grantham-McGregor et al 2007; Lorntz et al 2006; Maluccio, Hoddinott, and Behrman 2006). The second paper estimates how cost-effectiveness of sanitation scale-up may vary across wealth quintiles in Nepal. Results suggest that incremental cost-effectiveness ratios (ICERs) associated with scaling up sanitation are relatively low across all wealth quintiles in Nepal, and may be comparable to other child health interventions such as vaccines. Between the equal scale-up and pro-poor scale-up scenarios, there are no real differences in the ICERs for each quintile. This demonstrates that for Nepal, from a cost-effectiveness (efficiency) perspective, there is no advantage of a pro-poor scale-up approach (however, for equity reasons, this may still be valid). A sensitivity analysis showed that while the scaling up of sanitation can be cost-effective, the degree of cost-effectiveness is sensitive to the intervention costs, diarrhea incidence, and effectiveness ratios. The absence of information/ research on differences in sanitation effectiveness across wealth quintiles, as well as the poor information of sanitation costs disaggregated by wealth quintile and type of technology, limits the interpretation of these results. The first two papers present the equity and efficiency (cost-effectiveness) perspective when looking at scaling up sanitation. In health systems around the world policymakers share the common concern on how to find the right balance between these objectives. Ultimately, decisions on such programs to address child health involve prioritization of interventions across health and non-health sectors. The third paper uses a multi-criteria decision making approach to better understand how environmental health interventions might be prioritized relative to other interventions relevant for child health in Nepal. For this a discrete choice experiment survey was conducted in Kathmandu, with responses received from forty-six sanitation and public health decision-makers. This explorative analysis suggested that non-health benefits may be relevant in priority setting in child health while including a larger range of relevant criteria for priority setting. Environmental health interventions (both water and sanitation – which help reduce diarrheal incidence, as well as rural clean energy solutions –which help reduce incidence of acute respiratory infections) may be ranked as the highest priority in the context of child health in Nepal. Together, these papers help investigate the attractiveness and potential for the inclusion of environmental health interventions within the scope of broader child health programs in developing countries like Nepal. More generally, this thesis illustrates the potential benefits of building on and extending various existing tools and methodologies to a range of environmental health interventions which lie outside the health sector. It also specifically applies these methodologies at a disaggregated level (by wealth quintiles) to explore the differences across the socioeconomic sub-groups. There are still need for more customized and country-specific research needed on intervention effectiveness and costs, including specifically in programmatic settings to gather evidence on scalability and sustainability. Uncertainty in several parameters and the lack of data at a disaggregated level limit the generalizability of the findings. But the economics of sanitation –from an equity-efficiency perspective –as shown in this thesis can help to inform the policy dialog on scaling up sanitation for better child health. This is an important step towards addressing the unfinished health agenda among the most vulnerable groups—children less than five years of age and in poorer households, who are disproportionately exposed to and affected by health risks from environmental hazards

What do consumers say? : Exploring Consumers' Opinion on Femvertising in Fashion

Fashion advertising has long been repudiated for fostering narrow and stereotypical imagery of women. Today consumers demand advertisements to be inclusive and real in their portrayals. As a result, there is an increasingly visible marketing phenomenon, called Femvertising, which merges the feministic ideology of empowerment and liberty with brand image and sales. The purpose of the study is to explore consumers’ opinions about femvertising by fashion brands. Within this, the thesis seeks to explore how consumers feel about these advertisements and the outcome they perceive these to have. Through snowballed sampling focused on reaching diverse people connected via social media, a wide array of thoughts and perspectives on femvertising is sought to fulfill the purpose. The research employs a mixed method with a deductive approach to analyze its findings in relation to literatures and theories reviewed. The study used an open-ended online questionnaire designed through literature review and advertising theories and distributed it electronically to collect data. Using snowball sampling, the respondents were gathered via social media, who further distributed the questionnaire. The findings demonstrated that our sampling mainly expressed positive responses to the femvertising due to its inclusive, diverse and empowering portrayals. Moreover, these advertisements were viewed as a harbinger of change within the fashion industry. They also, generally view the media and advertising to shape people’s perception about gender roles, albeit if femvertising and its ideals are implemented for the long-term. Within this, respondents also urged brands to ‘walk the talk’ and implement the portrayed ideals within their own businesses’ functioning for larger impact. The findings are useful for fashion marketers and researchers, by showing how femvertising within popular media culture is expected to push forward ideals of feminism both within the fashion industry and society. This thesis contributes to the knowledge of consumers’ opinions and perspectives on femvertising and its potential to profit brands and engender more empowerment and liberty to female gender-based roles