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We have re-examined Mukhanov parametrization for inflationary equation of state, 1 + ω = β ( N + 1 ) α , in the light of Planck 2018 results and latest bound of tensor-to-scalar ratio employing Hamilton–Jacobi formalism. We have found that the current observational values of scalar spectral index and tensor-to-scalar ratio can be used efficiently to constrain the model parameters. The recent bound of r < 0.032 has been used to put an upper bound on one of the model parameter. Whereas 1- σ bound of the scalar spectral index 0.9607 ≤ n S ≤ 0.9691 along with the upper bound of tensor-to-scalar ratio provided restriction on the other model parameter 1.50 < α ≤ 2.20 . These bounds however depend on the number of e-foldings still left before the end of inflation and whenever 1.50 < α ≤ 2.20 we can find appropriate values of the other model parameter β so that the observational predictions are in tune with the latest available inflationary observables. We have further utilized the predictions from forthcoming CMB missions in the likes of CMB-S4 and LiteBIRD in order to obtain bounds on the model parameters. We find that detection of gravity waves would help us constrain the model parameters further. But in the absence of detection of primordial gravity wave signal by these CMB missions may rule out Mukhanov parametrization.

We have revisited quasi-exponential model of inflation in the light of recent ACT-DR6 and Planck data along with latest constraint on the amplitude of primordial gravitational waves. For our analysis we have followed Mukhanov approach for inflationary equation-of-state employing Hamilton–Jacobi formulation. We find that the model is capable of mimicking latest Planck results by providing excellent fit to scalar spectral index and its running. Not only that, amount of primordial gravitational waves is also within the present observational bound, r < 0.032 . In addition to that, when the combination of ACT-DR6 and Planck joint with BICEP/Keck 2018 data is taken into account inflationary predictions from quasi-exponential model are in excellent agreement. The model also yields sublime fit to the result of joint analysis of ACT-DR6, Planck joint with BICEP/Keck 2018 and DESI-Y1 data. The futuristic CMB missions LiteBIRD, Simons Observatory and CMB-S4 are promising to detect primordial gravitational waves if r ≥ 0.003 . We have also forecasted inflationary predictions from quasi-exponential model of inflation assuming the sensitivities of LiteBIRD, Simons Observatory and CMB-S4 along with combination of LiteBIRD and CMB-S4. We found that in each case quasi-exponential inflation may render excellent fit provided r ≥ 10 - 2 . However, non-detection of primordial gravitational waves by LiteBIRD, Simons Observatory and CMB-S4 will potentially rule out quasi-exponential model.

Exclusive breastfeeding in the first six months of life and continuation of breastfeeding until the second year are recommended for the healthy growth and development of infants and young children. However, the use of commercial milk formula has increased in recent decades in low and middle-income countries, including Nepal. Understanding the trends and determinants is crucial for designing evidence-based and context-specific infant and young child feeding support programs. There is limited evidence on the use of commercial milk formula in Nepal. Therefore, this study aimed to explore the trends and prevalence of commercial milk formula feeding practices and their associated factors among mothers of children aged 0-23 months in Nepal. We used data from four consecutive nationally representative surveys (2006, 2011, 2016, and 2022). A total weighted sample of 7,705 (0-5 months: 1,978; 6-23 months: 5,727) children aged 0-23 months was included in the analysis. The trends were presented as frequency distributions. Multivariable logistic regression was performed to assess the association between individual and underlying factors with commercial milk formula feeding in the first two years of life. For enhanced analytical clarity and programmatic relevance, we stratified our analysis into two distinct age groups: 0-5 months and 6-23 months. Over the study period (2006-2022), the prevalence of commercial milk formula feeding among infants aged 0-5 months increased steadily from 1.95% (95% confidence interval (CI): 0.83-4.55) to 11.09% (95% CI: 8.01-15.16). A similar but less upward trend was observed among children aged 6-23 months, with prevalence rising from 2.03% (95% CI: 1.26, 3.27) to 6.68% (95% CI: 5.26, 8.45). Among 0-5 months, infants born to mothers with secondary and higher education (adjusted odds ratio (aOR): 12.48; 95% CI: 2.63, 59.14), mothers aged 25-34 years (aOR: 2.29; 95% CI: 1.14, 4.60), and born by caesarean section (aOR: 2.16; 95% CI: 1.01, 4.59) were more likely to receive formula feeding compared to their counterparts. Similarly, among 6-23 months, children who were male (aOR: 1.67; 95% CI: 1.15, 2.42), perceived as small at birth (aOR: 2.76; 95% CI: 1.48, 5.15), first born (aOR: 2.59; 95% CI: 1.02, 6.56), born in health facilities (aOR: 3.18; 95% CI: 1.16, 8.73), and whose fathers had secondary or higher education (aOR: 3.14; 95% CI: 1.22, 8.10) were more likely to receive commercial milk formula. The prevalence of commercial milk formula feeding practices has increased during 2006-2022. Evidence-informed, context-specific interventions are essential to halt and reverse commercial milk formula feeding practices and protect, promote, and support breastfeeding and recommended infant feeding practices. A program designed to address this issue should target vulnerable groups and leverage the specific factors identified in this study.

In this work we re-investigate pros and cons of mutated hilltop inflation. Applying Hamilton–Jacobi formalism we solve inflationary dynamics and find that inflation goes on along the W-1 branch of the Lambert function. Depending on the model parameter mutated hilltop model renders two types of inflationary solutions: one corresponds to small inflaton excursion during observable inflation and the other describes large field inflation. The inflationary observables from curvature perturbation are in tune with the current data for a wide range of the model parameter. The small field branch predicts negligible amount of tensor to scalar ratio r∼O(10-4), while the large field sector is capable of generating high amplitude for tensor perturbations, r∼O(10-1). Also, the spectral index is almost independent of the model parameter along with a very small negative amount of scalar running. Finally we find that the mutated hilltop inflation closely resembles the α-attractor class of inflationary models in the limit of αϕ≫1.

Background Over the past two decades, child health indicators in Nepal have improved significantly at the national level. Yet, this progress hasn’t been uniform across various population subsets. This study identified the determinants associated with childhood full vaccination, assessed wealth-related inequalities, and delved into the key factors driving this inequality. Methods Data for this study were taken from the most recent nationally representative Nepal Demographic and Health Survey 2022. A total of 959 children aged 12–23 months who had received routine childhood basic antigens as per the national immunisation program were considered for analysis. Binary logistic regression models were conducted to identify the associated factors with outcome variable (uptake of full vaccination). The concentration curve and Erreygers normalized concentration index were used to assess inequality in full vaccination. Household wealth quintile index scores were used to measure wealth-related inequality and decomposition analysis was conducted to identify determinants explaining wealth-related inequality in the uptake of childhood vaccination. Results The coverage of full vaccination among children was 79.8% at national level. Several factors, including maternal health service utilisation variables (e.g., antenatal care, institutional delivery), financial challenges related to visiting health facilities, and mothers’ awareness of health mother group meetings within their ward, were associated with the uptake of full vaccination coverage among children. The concentration curve was below the line of equality, and the relative Erreygers normalized concentration index was 0.090, indicating that full vaccination was disproportionately higher among children from wealthy groups. The decomposition analysis identified institutional delivery (20.21%), the money needed to visit health facilities (14.25%), maternal education (16.79%), maternal age (8.53%), and caste (3.03%) were important contributors to wealth related inequalities in childhood full vaccination uptake. Conclusions There was notable wealth-related inequality in full vaccine uptake among children in Nepal. Multisectoral actions involving responsible stakeholders are pivotal in reducing the inequalities, including promoting access to maternal health services and improving educational attainment among mothers from socioeconomically disadvantaged communities.

Japanese encephalitis (JE) is a major public health problem in Nepal. For the effective management and surveillance of JE, a clear understanding of its epidemiology is essential. Therefore, we conducted descriptive and spatial analyses to understand the spatio-temporal distribution of JE in human in Nepal. From 2007 to 2015, 1,823 JE cases were reported with a cumulative mean incidence of 0.735/100,000 population and a case fatality rate of 6.6%. The death rate in the up-to-24 years of age group was 74%. The JE cases were most commonly reported in the age group of 1-14 years. There is a strong seasonal pattern of JE occurrence in Nepal which peaked in August and declined by October each year, which corresponds to the monsoon season. The JE cases were reported in 63 of 75 districts (84%), expanding in the mountain and hill regions. There was a strong clustering of JE incidence in the south-western and south-eastern Terai region, which is endemic for JE. Therefore, the JE surveillance system should be improved to better understand the drivers of disease expansion in Nepal for instituting a control program.

Background The benefits of exclusive breastfeeding (EBF) have been universally documented, with evidence of positive impacts on a child’s optimal growth, development, and survival. However, EBF practices in Nepal have fluctuated and declined over the last 25 years. In addition to the individual factors of mothers and infants, EBF practices are affected by multiple community-level factors. Understanding these factors is essential for designing breastfeeding promotion programs to improve child nutritional status in Nepal. This study investigated the individual- and community-level determinants of EBF practices among young infants aged 0–5 months in Nepal. Method We used the dataset from the Nepal Demographic and Health Survey 2022. Information on EBF in the past 24 h was available for 540 infants aged 0–5 months. A multilevel mixed-effect logistic regression was used to identify individual- and community-level factors associated with EBF among infants aged 0–5 months in Nepal. Results The 24-hour prevalence of EBF among infants aged 0–5 months was 57.46% (95% confidence interval (CI): 52.18, 62.57). The infant’s age was inversely associated with EBF prevalence at the individual level. Compared with infants aged < 1 month, infants aged three months (adjusted odds ratio (AOR): 0.14, 95% CI: 0.05, 0.40), four months (AOR: 0.11, 95% CI: 0.04, 0.28), and five months (AOR: 0.07, 95% CI: 0.03, 0.20) were less likely to receive EBF. At the community level, community-level variables such as ≥ 4 ANC visits coverage, maternal employment status, and poverty level were generated by aggregating the individual characteristics in a cluster and were categorized using quartiles into low (“< 25%”), moderate (25–75%), and high (≥ 75%). Mothers from communities with moderate ≥ 4 ANC visits (AOR: 3.30, 95% CI: 1.65, 6.57) and high ≥ 4 ANC visits (AOR: 2.70, 95% CI: 1.40, 5.22) coverage had higher odds of EBF practices than did those from communities with low ≥ 4 ANC visits coverage. Similarly, communities with moderate (AOR: 2.67, 95% CI: 1.34, 5.30) and high (AOR: 2.34, 95% CI: 1.10, 4.99) levels of maternal employment status and moderate levels of poverty (AOR: 2.20, 95% CI: 1.13, 4.28) were associated with a higher likelihood of EBF practices. Subnational level variation was evident, with infants in Lumbini province having lower odds of EBF (AOR: 0.32, 95% CI: 0.13, 0.77) relative to Koshi province. Approximately 9% of the variation in EBF practices was observed among mothers while mapping across clusters in this study. Conclusion Various individual- and community-level factors influence the uptake of EBF in Nepal, underscoring the need to improve the approaches and strategies of EBF programs. This study highlighted the significant association of community-level factors (≥ 4 ANC visits coverage, poverty level, and maternal employment status) with EBF among infants under 6 months. It revealed approximately 9% variability in EBF across clusters. Future efforts to promote EBF should focus on older infants and communities with low poverty levels and low coverage of recommended ≥ 4 ANC visits. Furthermore, context-specific adaptation of such efforts might be required considering the variation observed between the communities in the present study.

Fishing, fish processing, and tourism are important actors in the blue economy. These industries depend on fishery resources and natural environments. However, overfishing and congestion in tourist areas can also lead to environmental pollution and resource depletion. In addition, wastewater from the fish-processing industry can damage the environment and resources, hindering sustainable development. This study analyzes whether fishery environmental policies can lead to sustainable development in blue economies using an R&D-based growth model that includes firm location. Both policies promote economic growth, but fishery policy leads to pollution havens from North to South and increases tourism consumption through improved environmental quality. Under certain parameter conditions, environmental policy leads to pollution havens from South to North and decreases tourism consumption through worsened environmental quality. However, when these conditions change, the environmental policy leads to pollution havens from South to North. Then, fisheries and environmental policies have complementary effects on pollution havens from the South to the North. This study result stating that fishery policies, not environmental ones, can achieve sustainable blue tourism. This outcome relies on the cost of exogenous rent-seeking for ITQs being passed on to fishing prices. Hence, in the blue economy, this rent-seeking could have serious negative impacts on marine ecosystems. Besides, this study suggests that in the blue economy, fisheries and environmental policies may have unintended adverse government impacts on fisheries resources and pollution emissions through their interdependent effects. In achieving a sustainable blue economy, policymakers should consider the indirect effects of these policies on marine ecosystems.

This work presents the analysis of combustion characteristics of high ash Indian coal (28%–40%) collected from different mines of Singaurali coalfield, India. All the coal samples were characterized by proximate and gross calorific value analysis. Combustion performance of the coals were characterised using thermo-gravimetric analysis to identify the burning profile of individual coals. Various combustion kinetic parameters such as ignition temperature, peak temperature and burnout temperature, ignition index and burnout index, combustion performance index plus rate and intensity index of combustion process, activation energy were determined to analyse the combustion behaviour of coal. Further all these combustion properties were compared with the volatile matter, ash, fixed carbon and fuel ratio of each coal. Theoretical analysis shows that with increase in ash content, combustion performance initially increases and later descends. Further, coal with (25 ± 1.75)% volatile matter, 20%–35% ash and fuel ratio 1.4–1.5 were found to be optimum for coal combustion.

Aim: The aim of this study is to ascertain the prevalence of diabetic retinopathy (DR) in diabetic patients across the nation and attempt to establish history-based risk factors. Materials and Methods: A cross-sectional study of diabetic patients was conducted as an initiative of the All India Ophthalmological Society from 14th November to 21st November 2014. Known diabetics were evaluated voluntarily by members of the society at 194 centers using a structured protocol provided by the society for examination. The results were evaluated to ascertain the prevalence of DR in the population studied and to establish relation with gender, age, and history-based risk factors such as duration of diabetes, insulin use, and other end-organ disease using the Chi-square test. Results: A total of 6218 known diabetics were screened. Totally, 5130 data entry forms were considered suitable for further evaluation. About 61.2% were males, 88.6% were between 40 and 80 years of age, almost two-thirds of the patients were from the west and south zones, and over half had diabetes more than 5 years. The data set was predominantly urban 84.7% and 46.1% had no family history. DR prevalence in the entire data set was 21.7%. Prevalence was more in males (P = 0.007), diabetics more than 5 years (P = 0.001), those above 40 years (P = 0.01), insulin users (P = 0.001), and history of vascular accidents (P = 0.0014). Significantly 22.18% of patients detected with DR had a vision of 6/18 or better in the worse eye. Conclusion: The study reiterated the findings of earlier regional studies on a pan Indian scale and put data in perspective.