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Chronic exposure to groundwater containing elevated concentrations of geogenic contaminants such as arsenic (As) and uranium (U) can lead to detrimental health impacts. In this study, we have undertaken a groundwater survey of representative sites across all districts of the State of Bihar, in the Middle Gangetic Plain of north-eastern India. The aim is to characterize the inorganic major and trace element aqueous geochemistry in groundwater sources widely used for drinking in Bihar, with a particular focus on the spatial distribution and associated geochemical controls on groundwater As and U. Concentrations of As and U are highly heterogeneous across Bihar, exceeding (provisional) guideline values in ~16% and 7% of samples (n = 273), respectively. The strongly inverse correlation between As and U is consistent with the contrasting redox controls on As and U mobility. High As is associated with Fe, Mn, lower Eh and is depth-dependent; in contrast, high U is associated with HCO3−, NO3− and higher Eh. The improved understanding of the distribution and geochemical controls on As and U in Bihar has important implications on remediation priorities and selection, and may contribute to informing further monitoring and/or representative characterization efforts in Bihar and elsewhere in India.

Arsenic poisoning through groundwater is the world’s greatest normal groundwater catastrophe which got an immense effect on worldwide general wellbeing. India is confronting the outcomes of arsenic poisoning in the zone of Ganga Brahmaputra alluvial plains. In Bihar, out of 38 districts, 18 districts are exceptionally influenced with groundwater arsenic defilement. In the present study, we have assessed the current situation of arsenic exposure in Sabalpur village of Saran district of Bihar after reporting of breast, renal, skin and thyroid cancer cases from this village along with typical symptoms of arsenicosis. Such cancer patients were identified at our institute and were taken for the study. The present investigation deals with the quantification of arsenic in groundwater, hair and nail samples of subjects as well as the survey of entire village to know the overall health status of the village people. A total of n=128 household handpump water samples as well as n=128 human hair and nail samples were collected from over n=520 households. Using the graphite furnace atomic absorption spectrophotometer (GF-AAS), all the samples were analysed. The investigation resulted that the 61% of the analysed samples particularly the groundwater had the arsenic levels more than the permissible limit of WHO (> 10 μg/L) with 244.20 μg/L as the highest arsenic contamination in one of the handpump water sample. The exposure effect of hair sample was worst as 88% of all the collected samples were having high arsenic levels more than the permissible limit (> 0.2 mg/Kg). In case of nail samples, 92% of the samples were having high arsenic concentration more than the permissible limit (> 0.5 mg/Kg). The health survey study revealed high magnitude of disease burden in the exposed population with symptoms such as asthma, anaemia, hepatomegaly, diabetes, cardiac problem, skin fungal infections, breathlessness and mental disability. Few cancer cases of renal, skin, breast and cervix were also found among the exposed population of this village. The percentage of cancer cases in this village was 0.94% that was low, but it would be an aggravated situation in the near future if people will continue drinking arsenic-contaminated water. Therefore, a mitigation intervention was carried out in March 2020 by installing an arsenic filter plant. The health situation in the village in the present scenario is hope to improve in the coming years. However, motivation and awareness among the village population are still required.

The reduced performance of a diesel engine with biodiesel can be overcome by inclusion of nanoparticles. This study uses a novel binary mixture of Prosopis juliflora biodiesel (PJB) and 200 ppm of metal-based nanoparticles [cerium oxide (CeO 2 ), manganese dioxide (MnO 2 ), and titanium dioxide (TiO 2 )], to operate and examine the behaviour of a four-stroke, one-cylinder, naturally aspirated, water-cooled diesel engine. The work comprises a new comparison of energy, exergy, and sustainability performance through energy distribution and utilisation inside the engine using first and second laws of thermodynamics for the fuel samples PJB0, PJB100, PJB100Ce, PJB100Mn, and PJB100Ti. The boundary conditions for the analysis are set to a compression ratio of 17.5, an engine speed of 1500 rpm, and injection timing of 23° crank angle bTDC. The addition of various nanoparticles into the pure PJB fuel increased the energy and exergy efficiency by 6.1–7.3%, the exergy performance coefficient by 9.9–14.6%, and the sustainability index by 3.6–6.8% and reduced the exergy destruction by 3.5–6.4% at full engine load. Among the various blends analysed, PJB100Ti performed superiorly as compared to others. From the detailed analysis, energy, exergy, and sustainability provide insightful information about the engine’s operation and its impact on the engine system. The adoption of nanoparticle-enhanced biodiesel is not only a promising alternative in the search for cleaner but also more effective energy sources. This study suggests more investigation and development in the areas of alternative fuels, engine optimization, and the development of sustainable energy solutions. Graphical abstract

Activating mutations of FLT3 contribute to deregulated hematopoietic stem and progenitor cell (HSC/Ps) growth and survival in patients with acute myeloid leukemia (AML), leading to poor overall survival. AML patients treated with investigational drugs targeting mutant FLT3, including Quizartinib and Crenolanib, develop resistance to these drugs. Development of resistance is largely due to acquisition of cooccurring mutations and activation of additional survival pathways, as well as emergence of additional FLT3 mutations. Despite the high prevalence of FLT3 mutations and their clinical significance in AML, there are few targeted therapeutic options available. We have identified 2 novel nicotinamide-based FLT3 inhibitors (HSN608 and HSN748) that target FLT3 mutations at subnanomolar concentrations and are potently effective against drug-resistant secondary mutations of FLT3. These compounds show antileukemic activity against FLT3ITD in drug-resistant AML, relapsed/refractory AML, and in AML bearing a combination of epigenetic mutations of TET2 along with FLT3ITD. We demonstrate that HSN748 outperformed the FDA-approved FLT3 inhibitor Gilteritinib in terms of inhibitory activity against FLT3ITD in vivo.

Anosmia and parosmia refer to the loss or dysfunction of smell, respectively. Dysgeusia refers to taste disturbance. The coronavirus disease 2019 (COVID-19) pandemic and the subsequent phenomenon of Long COVID syndrome have been associated with an increased incidence of anosmia and dysgeusia. Smell and taste disturbances associated with COVID-19 are usually self-limiting but can persist for longer periods in some cases. Imbalances of the autonomic nervous system, especially dysregulation of the sympathetic system, are implicated in the persistence of anosmia and dysgeusia post-COVID-19 infection. Stellate ganglion block (SGB) can diminish the increased sympathetic activity and potentially resolve anosmia and dysgeusia occurring due to Long COVID. The authors report the successful resolution of persistent anosmia and dysgeusia due to Long COVID in a female patient after she underwent SGB.

[...]the impact of GBCAs on human health and their mechanism of toxicity is mostly unknown.1 2 GBCAs are also used as an alternative to iodinated contrast agents for neuraxial procedures routinely performed by interventional pain physicians.3 A patient with chronic pain with shellfish allergy inadvertently received 2 mL of gadobutrol (a type of GBCA) intrathecally during lumbar epidural steroid injection, which was confirmed fluoroscopically (figure 1A,B). GBCAs have varying molar concentrations, and similar volume limits cannot be used across different GBCAs. [...]the safe dose limit of 2.5 μmol/g brain tissue, based on animal studies, fails to correlate with humans as humans may be more sensitive to intrathecal GBCA than animals.4 5 The authors conclude that GBCAs may cause catastrophic neurological injury, and proceduralists should exercise caution when using GBCAs during interlaminar epidural steroid injections. J Korean Med Sci 2010; 25: 505–8. doi:10.3346/jkms.2010.25.3.505 http://www.ncbi.nlm.nih.gov/pubmed/20191058 5 Provenzano DA, Pellis Z, DeRiggi L. Fatal gadolinium-induced encephalopathy following accidental intrathecal administration: a case report and a comprehensive evidence-based review.

Nano-additives are being employed in successive generations of biodiesels to increase the performance characteristics and output of diesel engines. In this study, the impact of mixing carbon nanotubes (CNT) with three different generations of biodiesel in a diesel engine is assessed. With 100 ppm of CNT nanoparticles mixed together, pure biodiesels made from first-generation oil (soybean), second-generation oil (neem), and third-generation oil ( Nannochloropsis oculata microalgae) are used for the analysis. With an engine load ranging from 0 to 100%, a one-cylinder, four-stroke, direct injection diesel engine is employed. The engine has a water-cooling system, a compression ratio of 17.5:1, and a fuel injection angle of 23° before TDC. The evaluated engines’ improved performance and lower emissions serve as proof of the outcomes. The results are evidenced by the lower emissions and higher performance of the tested engines. The biodiesel containing CNT nanoparticles enhanced the cylinder pressure by 0.8–10.69%, the heat release rate (HRR) by 6.38–21.69%, and the brake thermal efficiency (BTE) by 0.32–1.62%. Subsequently, it reduced the brake-specific fuel consumption (BSFC) by 2.53–8.13%, the brake-specific energy consumption (BSEC) by 1.07–3.77%, the smoke opacity (BSN) by 6.26–12.85%, the particulate matter (PM) emissions by 11.04–18.33%, and the carbon dioxide (CO 2 ) emissions by 2.53–8.14% at full engine load. However, an increase in 13.62–18.37% nitrogen emissions (NOx) emissions is also observed with the addition of CNT at 100% load. The investigation supports the use of CNT nano-additives in diesel engines for improved performance and reduced emissions. Graphical Abstract

Background & objectives: The World Health Organisation recommended immediate initiation of antiretroviral therapy (ART) in all adult human immunodeficiency virus (HIV) patients regardless of their CD4 cell count. This study was undertaken to ascertain the cost-effectiveness of implementation of these guidelines in India. Methods: A Markov model was developed to assess the lifetime costs and health outcomes of three scenarios for initiation of ART treatment at varying CD4 cell count <350/mm[3], <500/mm[3] and test and treat using health system perspective using life-time horizon. A few input parameters for this model namely, transition probabilities from one stage to another stage of HIV and incidence rates of TB were calculated from the data of Centre of Excellence for HIV treatment and care, Chandigarh; whereas, other parameters were obtained from the published literature. Total HIV-related deaths averted, HIV infections averted and incremental cost-effectiveness ratio per quality adjusted life years (QALYs) gained were calculated. Result: Test and treat intervention slowed down the progression of disease and averted 18,386 HIV-related deaths, over lifetime horizon. It also averted 16,105 new HIV infections and saved 343,172 QALYs as compared to the strategy of starting ART at CD4 cell count of 500/mm[3]. Incremental cost per QALY gained for the immediate initiation of ART as compared to ART at CD4 cell count of 500/mm[3] and 350/mm[3] was ₹ 46,599 and 80,050, respectively at reported rates of adherence to the therapy. Interpretation & conclusions: Immediate ART (test and treat) is highly cost-effective strategy over the past criteria of delayed therapy in India. Cost-effectiveness of this policy is largely because of reduction in the transmission of HIV.

We design two estimation schemes, Method I and Method II, for rapidly obtaining separate estimates of the number of active nodes of each traffic type in a heterogeneous machine-to-machine (M2M) network with T types of nodes (e.g., those that send emergency, periodic, normal type data etc.), where T≥2 is an arbitrary integer. Method I is a simple scheme, and Method II is more sophisticated and outperforms Method I. Also, we design a medium access control (MAC) protocol that supports multi-channel operation for a heterogeneous M2M network with T types of nodes, operating as a secondary network using Cognitive Radio technology. In every time frame, our Cognitive MAC protocol uses the proposed estimation schemes to rapidly estimate the active node cardinality of each type, and uses these estimates to find the optimal contention probabilities to be used. We compute a closed form expression for the expected number of time slots required by Method I to execute, and a simple upper bound on it. Also, we analytically obtain expressions for the expected number of successful contentions per frame and the expected amount of energy consumed. Finally, we evaluate the performances of our proposed estimation schemes and Cognitive MAC protocol using simulations.