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The southern regions of Kerman Province have repeatedly encountered dust storms. Therefore, the objective of this study was to identify dust sources using effective parameters such as vegetation cover, land surface temperature, soil moisture, soil texture, and slope as well as to detect dust storms originating from these regions based on 31 MODIS images in 2016 and SRTM data. After normalizing parameters, the dust source map was prepared by fuzzy logic and assessed with an error matrix and available dust source map. Results showed that 30.5% of the study area was classified as a low source of dust, 39.55% as moderate, and 29.85% as severe-very severe. The overall accuracy of the produced map was about 70% and the producer and user accuracy of the severe-very severe class was more than 87%. The detection of dust storms originated from the identified dust sources also confirmed a crisis situation in the region. Due to the repeatability and continuity of obtained dust source map at pixel scale, it can be used to update available dust source maps and manage dust crisis in the region, properly.

Land Surface Temperature (LST) is an important parameter in weather and climate systems. Satellite remote sensing is a unique way to estimate this important parameter. However, satellite products have either low spatial resolution or low temporal resolution that limits their potential use in various studies. In recent years, the use of Spatio-temporal fusion techniques to produce high resolution simultaneous spatial and temporal images has been extensively investigated. In this study, a Flexible Spatio-temporal Data Fusion (FSDAF) was used to produce Landsat-like LST images with Landsat spatial resolution and MODIS temporal resolution. The quantitative and qualitative validation of the images was performed by comparing them with the Actual Landsat LST images. The results showed that the FSDAF algorithm has high accuracy in estimating daily LST data both qualitatively and quantitatively. The RMSE and MAE parameters of the images produced compared to the actual Landsat images were 1.18 to 1.71 and 0.88 to 1.29°C, respectively. The correlation coefficient above 0.87 and bias between -0.6 to 1.45°C also confirms the high accuracy of the algorithm in estimating Landsat-like land surface temperature on a daily time scale.

Background The Joint United Nations Programme on AIDS (UNAIDS) has emphasized on the incidence-prevalence ratio (IPR) and incidence-mortality ratio (IMR) to measure the progress in HIV epidemic control. In this paper, we describe the status of epidemic control in India and in various states in terms of UNAIDS’s recommended metrices. Method The National AIDS Control Programme (NACP) of India spearheads work on mathematical modelling to estimate HIV burden based on periodically conducted sentinel surveillance for providing guidance to program implementation and policymaking. Using the results of the latest round of HIV Estimations in 2019, IPR and IMR were calculated. Results National level IPR was 0.029 [0.022–0.037] in 2019 and ranged from 0.01 to 0.15 in various States and Union Territories (UTs). Corresponding Incidence-Mortality Ratio was at 0.881 [0.754–1.014] nationally and ranged between 0.20 and 12.90 across the States/UTs. Conclusions Based on UNAIDS recommended indicators for HIV epidemic control, namely IPR and IMR; national AIDS response in India appears on track. However, the program success is not uniform and significant heterogeneity as well as expanding epidemic was observed at the level of States or UTs. Reinforcing States/UTs specific and focused HIV prevention, testing and treatment initiatives may help in the attainment of 2030 Sustainable Development Goals of ending AIDS as a public health threat by 2030.

Biofouling is one of the major factors causing decline in membrane performance in reverse osmosis (RO) plants, and perhaps the biggest hurdle of membrane technology. Chemical cleaning is periodically carried out at RO membrane installations aiming to restore membrane performance. Typical cleaning agents used in the water treatment industry include sodium hydroxide (NaOH) and hydrochloric acid (HCl) in sequence. Rapid biofilm regrowth and related membrane performance decline after conventional chemical cleaning is a routinely observed phenomenon due to the inefficient removal of biomass from membrane modules. Since extracellular polymeric substances (EPS) make up the strongest and predominant structural framework of biofilms, disintegration of the EPS matrix should be the main target for enhanced biomass removal. Previously, we demonstrated at lab-scale the use of concentrated urea as a chemical cleaning agent for RO membrane systems. The protein denaturation property of urea was exploited to solubilize the proteinaceous foulants, weakening the EPS layer, resulting in enhanced biomass solubilization and removal from RO membrane systems. In this work, we investigated the impact of repeated chemical cleaning cycles with urea/HCl as well as NaOH/HCl on biomass removal and the potential adaptation of the biofilm microbial community. Chemical cleaning with urea/HCl was consistently more effective than NaOH/HCl cleaning over 6 cleaning and regrowth cycles. At the end of the 6 cleaning cycles, the percent reduction was 35% and 41% in feed channel pressure drop, 50% and 70% in total organic carbon, 30% and 40% in EPS proteins, and 40% and 66% in the peak intensities of protein-like matter, after NaOH/HCl cleaning and Urea/HCl cleaning, respectively. 16S ribosomal RNA (rRNA) gene sequencing of the biofilm microbial community revealed that urea cleaning does not select for key biofouling families such as Sphingomonadaceae and Xanthomonadaceae that are known to survive conventional chemical cleaning and produce adhesive EPS. This study reaffirmed that urea possesses all the desirable properties of a chemical cleaning agent, i.e., it dissolves the existing fouling layer, delays fresh fouling accumulation by inhibiting the production of a more viscous EPS, does not cause damage to the membranes, is chemically stable, and environmentally friendly as it can be recycled for cleaning.

Chemical cleaning is routinely performed in reverse osmosis (RO) plants for the regeneration of RO membranes that suffer from biofouling problems. The potential of urea as a chaotropic agent to enhance the solubilization of biofilm proteins has been reported briefly in the literature. In this paper the efficiency of urea cleaning for RO membrane systems has been compared to conventionally applied acid/alkali treatment. Preliminary assessment confirmed that urea did not damage the RO polyamide membranes and that the membrane cleaning efficiency increased with increasing concentrations of urea and temperature. Accelerated biofilm formation was carried out in membrane fouling simulators which were subsequently cleaned with (i) 0.01M sodium hydroxide (NaOH) and 0.1M hydrochloric acid (HCl) (typically applied in industry), (ii) urea (CO(NH2)2) and hydrochloric acid, or (iii) urea only (1340 g/Lwater). The pressure drop over the flow channel was used to evaluate the efficiency of the applied chemical cleanings. Biomass removal was evaluated by measuring chemical oxygen demand (COD), adenosine triphosphate (ATP), protein, and carbohydrate content from the membrane and spacer surfaces after cleaning. In addition to protein and carbohydrate quantification of the extracellular polymeric substances (EPS), fluorescence excitation−emission matrix (FEEM) spectroscopy was used to distinguish the difference in organic matter of the remaining biomass to assess biofilm solubilization efficacy of the different cleaning agents. Results indicated that two-stage CO(NH2)2/HCl cleaning was as effective as cleaning with NaOH/HCl in terms of restoring the feed channel pressure drop (>70% pressure drop decrease). One-stage cleaning with urea only was not as effective indicating the importance of the second-stage low pH acid cleaning in weakening the biofilm matrix. All three chemical cleaning protocols were equally effective in reducing the concentration of predominant EPS components protein and carbohydrate (>50% reduction in concentrations). However, urea-based cleaning strategies were more effective in solubilizing protein-like matter and tyrosine-containing proteins. Furthermore, ATP measurements showed that biomass inactivation was up to two-fold greater after treatment with urea-based chemical cleanings compared to the conventional acid/alkali treatment. The applicability of urea as an alternative, economical, eco-friendly and effective chemical cleaning agent for the control of biological fouling was successfully demonstrated. Keywords: Reverse osmosis, Biofouling, Membrane fouling simulator, Chemical cleaning, Urea

Spin-orbit effects in non-magnetic semiconductors allow for the manipulation of electronic spins in the absence of an applied magnetic field. Here, the authors exploit a persistent spin helix state in single quantum wells to enhance the coherence length of electronic drift transport.

We present a new empirical prescription for the mass-loss rates of carbon- and oxygen-sequence Wolf–Rayet stars as a function of their luminosity, surface chemical composition, and initial metallicity. The new prescription is based on results of detailed spectral analyses of WC and WO stars and improves the often applied Nugis and Lamers relation. We find that the mass-loss rates of WC and WO stars (with X = 0 and Y ≲ 0.98) can be expressed as (L/L⊙) + 0.44 log Y + 0.25 log (ZFe/ZFe,⊙). This relation is based on mass-loss determinations that assume a volume-filling factor of 0.1, but the prescription can easily be scaled to account for other volume-filling factors. The residual of the fit is σ = 0.06 dex. We investigated whether the relation can also describe the mass loss of hydrogen-free WN stars and showed that it can when an adjustment of the metallicity dependence () is applied. Compared to that of Nugis and Lamers, is less sensitive to the luminosity and the surface abundance, implying a stronger mass loss of massive stars in their late stages of evolution. The modest metallicity dependence implies that if WC or WO stars are formed in metal-deficient environments, their mass-loss rates are higher than currently anticipated. These effects may result in the formation of a larger number of SNe Ic and fewer black holes and may favor the production of superluminous SNe Ic through interaction with C- and O-rich circumstellar material or dense stellar wind. [ABSTRACT FROM AUTHOR]

The contact phase expected to precede the coalescence of two massive stars is poorly characterized due to the paucity of observational constraints. Here we report on the discovery of VFTS 352, an O-type binary in the 30 Doradus region, as the most massive and earliest spectral type overcontact system known to date. We derived the 3D geometry of the system, its orbital period day, components’ effective temperatures—T1 = 42 540 ± 280 K and T2 = 41 120 ± 290 K—and dynamical masses— and Compared to single-star evolutionary models, the VFTS 352 components are too hot for their dynamical masses by about 2700 and 1100 K, respectively. These results can be explained naturally as a result of enhanced mixing, theoretically predicted to occur in very short-period tidally locked systems. The VFTS 352 components are two of the best candidates identified so far to undergo this so-called chemically homogeneous evolution. The future of VFTS 352 is uncertain. If the two stars merge, a very rapidly rotating star will be produced. Instead, if the stars continue to evolve homogeneously and keep shrinking within their Roche Lobes, coalescence can be avoided. In this case, tides may counteract the spin down by winds such that the VFTS 352 components may, at the end of their life, fulfill the requirements for long gamma-ray burst (GRB) progenitors in the collapsar scenario. Independently of whether the VFTS 352 components become GRB progenitors, this scenario makes VFTS 352 interesting as a progenitor of a black hole binary, hence as a potential gravitational wave source through black hole–black hole merger. [ABSTRACT FROM AUTHOR]

Introduction: As family dynamics evolve, an increasing number of male residents are embracing parenthood during their training. Consequently, paternity leave has emerged as a crucial consideration. The aim of this study was to determine the gap in public availability of paternity leave policies in surgical residency programs across the United States., Methods: We evaluated publicly available information regarding paternity leave policies across both program-specific and Graduate Medical Education (GME) websites of 1242 surgical residency programs across eight surgical specialties. This information was further evaluated in relation to program size, program director gender, specialty type, and geographic location using logistic regression models., Results: Paternity leave policies were found on only 4.3% of program-specific websites and 18.8% of GME websites. Neurosurgery had the greatest number of programs that publicly advertised their policies-11.7% on program-specific websites and 82.5% on GME websites. Vascular surgery and ear, nose, and throat surgery had no policies available on program-specific websites, and general surgery had the least paternity leave policies publicly available as per the GME websites (7.9%). Programs in the northeast were significantly less likely to have paternal leave policies publicly available (odds ratio: 0.55; 95% confidence interval: 0.31-0.96; P = 0.034), whereas programs in the west were significantly more likely (odds ratio: 2.1; 95% confidence interval: 1.2-3.67; P = 0.009) compared to the midwest., Conclusions: This study highlights the pressing need for standardization and transparency across all surgical specialties regarding paternity leave policies. Addressing this gap is crucial for empowering applicants in family planning decisions and fostering a culture supportive of parental leave uptake., (Published by Elsevier Inc.)

Background: Financial toxicity is the detrimental impact of health care costs that must be mitigated to achieve universal health coverage. Catastrophic health expenditure (CHE) is widely used to measure financial toxicity but does not capture patient perspectives of unaffordable health care costs. Financial hardship (FH), a patient-reported outcome measure, is currently underutilized but may be an important adjunct metric. The authors compare CHE to FH as metrics evaluating financial toxicity., Methods: A prospective, multicenter cohort study was conducted across 3 public and private tertiary-care hospitals in India. Adult surgical trauma inpatients in plastic and orthopedic surgery departments were assessed. The development of CHE, health expenditures >10% of annual income, and FH, the patient-reported impact of financial toxicity in the form of asset liquidation, debt acquisition, and job loss, were compared by the health system and using logistic regression models., Results: Among 744 surgical trauma patients, low income, longer hospital stays, and increased injury severity were significantly associated with the likelihood of incurring CHE and FH (P<0.05). Only FH was significantly associated with lack of insurance (OR: 0.22; 95% CI: 1.14-2.71). Public hospitals had higher rates of FH than CHE (55% versus 23%). Private hospitals had more CHE than FH (53% versus 32%)., Conclusions: FH is an important metric of financial toxicity that provides important adjunct information to CHE for at-risk populations. FH is particularly informative for public institutions with low direct medical costs. Nuanced utilization of CHE and FH provides a more comprehensive, patient-oriented approach to evaluating unaffordable health care costs that can help shape financial risk protection policy., Competing Interests: K.R. received funding from Harvard Global Health Institute, Connors Center for Women’s Health and Gender Biology, and The Plastic Surgery Foundation. The remaining authors report no conflict of interest., (Copyright © 2024 by Mutaz B. Habal, MD.)

Aims: Lower limb fractures are common in low- and middle-income countries (LMICs) and represent a significant burden to the existing orthopaedic surgical infrastructure. In high income country (HIC) settings, internal fixation is the standard of care due to its superior outcomes. In LMICs, external fixation is often the surgical treatment of choice due to limited supplies, cost considerations, and its perceived lower complication rate. The aim of this systematic review protocol is identifying differences in rates of infection, nonunion, and malunion of extra-articular femoral and tibial shaft fractures in LMICs treated with either internal or external fixation., Methods: This systematic review protocol describes a broad search of multiple databases to identify eligible papers. Studies must be published after 2000, include at least five patients, patients must be aged > 16 years or treated as skeletally mature, and the paper must describe a fracture of interest and at least one of our primary outcomes of interest. We did not place restrictions on language or journal. All abstracts and full texts will be screened and extracted by two independent reviewers. Risk of bias and quality of evidence will be analyzed using standardized appraisal tools. A random-effects meta-analysis followed by a subgroup analysis will be performed, given the anticipated heterogeneity among studies, if sufficient data are available., Conclusion: The lack of easily accessible LMIC outcome data, combined with international clinical guidelines that are often developed by HIC surgeons for use in HIC environments, makes the clinical decision-making process infinitely more difficult for surgeons in LMICs. This protocol will guide research on surgical management, outcomes, and complications of lower limb shaft fractures in LMICs, and can help guide policy development for better surgical intervention delivery and improve global surgical care., Competing Interests: M. Pigeolet received publication support for this article from the Belgian University Foundation (WA-0544) and the Harvard Global Orthopaedic Collaboration. M. Pigeolet received a grant from the Belgian Kids’ Fund for Pediatric Research, which had had no influence on any aspect of this article. J. K. Agarwal-Harding, M. R. Askew, S. R. Bradley, and A. Shah received publication support for this article from the Harvard Global Orthopaedic Collaborative., (© 2024 Pigeolet et al.)

Massive stars are predominantly born in stellar associations or clusters 1 . Their radiation fields, stellar winds and supernovae strongly impact their local environment. In the first few million years of a cluster's life, massive stars are dynamically ejected and run away from the cluster at high speed 2 . However, the production rate of dynamically ejected runaways is poorly constrained. Here we report on a sample of 55 massive runaway stars ejected from the young cluster R136 in the Large Magellanic Cloud. An astrometric analysis of Gaia data 3-5 reveals two channels of dynamically ejected runaways. The first channel ejects massive stars in all directions and is consistent with dynamical interactions during and after the birth of R136. The second channel launches stars in a preferred direction and may be related to a cluster interaction. We found that 23-33% of the most luminous stars initially born in R136 are runaways. Model predictions 2,6,7 have significantly underestimated the dynamical escape fraction of massive stars. Consequently, their role in shaping and heating the interstellar and galactic media and their role in driving galactic outflows are far more important than previously thought 8,9 ., (© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)

Background: Out-of-pocket costs are burdensome for breast cancer patients. Cost-reducing interventions, though implemented, have unclear comparative efficacy. This study aimed to critically evaluate characteristics of successful versus unsuccessful interventions designed to decrease out-of-pocket costs for breast cancer patients., Methods: A systematic review was conducted in accordance with the PRISMA checklist. Embase, PubMed, Global Index Medicus, and Global Health were queried from inception to February 2021. Articles describing a financial intervention targeting costs for breast cancer screening, diagnosis, or treatment and addressing clinical or patient-level financial outcomes were included. Methodological quality was evaluated using the QualSyst tool. Interventions were organized in accordance with timing of implementation, with narrative description of intervention type, success, and outcomes., Results: Of the 11,086 articles retrieved, 21 were included in this review. Of these, 14 consisted of interventions during screening, and seven during diagnosis or treatment. Free/subsidized screening mammography was the most common screening intervention; 91% of these programs documented successful outcomes. Patient navigation and gift voucher programs demonstrated mixed success. The most successful intervention implemented during diagnosis/treatment was reducing medication costs. Low-cost programs and direct patient financial assistance were also successful. Limitations included lack of standardization in outcome metrics across studies., Conclusions: Financial interventions reducing prices through free screening mammography and decreasing medication costs were most successful. Less successful interventions were not contextually tailored, including gift card incentivization and low-cost treatment modalities. These findings can facilitate implementation of broader, more generalizable programs to reduce costs and improve outcomes during evaluation and management of breast cancer., Competing Interests: K.R. is supported by the Harvard Global Health Institute, Connors Center for Women’s Health and Gender Biology, the National Endowment of Plastic Surgery and is funded by the Center for Surgery and Public Health. L.P. is supported by the National Cancer Institute. All the other authors have no financial interest to declare in relation to the content of this article., (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.)

Massive stars (those ≥8 solar masses at formation) have radiative envelopes that cannot sustain a dynamo, the mechanism that produces magnetic fields in lower-mass stars. Despite this, approximately 7% of massive stars have observed magnetic fields, the origin of which is debated. We used multi-epoch interferometric and spectroscopic observations to characterize HD 148937, a binary system of two massive stars. We found that only one star is magnetic and that it appears younger than its companion. The system properties and a surrounding bipolar nebula can be reproduced with a model in which two stars merged (in a previous triple system) to produce the magnetic massive star. Our results provide observational evidence that magnetic fields form in at least some massive stars through stellar mergers.

Competing Interests: The authors have declared that no competing interests exist.

Background: Burns constitute a major global health challenge, causing over 11 million injuries and 300,000 deaths annually and surpassing the economic burden of cervical cancer and HIV combined. Despite this, patient-level financial consequences of burn injuries remain poorly quantified, with a significant gap in data from low- and middle-income countries. In this study, we evaluate financial toxicity in burn patients., Methods: A prospective, multicenter cohort study was conducted across two tertiary care hospitals in India, assessing 123 adult surgical in-patients undergoing operative interventions for burn injuries. Patient sociodemographic, clinical, and financial data were collected through surveys and electronic records during hospitalization and at 1, 3, and 6 months postoperatively. Out-of-pocket costs (OOPCs) for surgical burn treatment were evaluated during hospitalization. Longitudinal changes in income, employment status, and affordability of basic subsistence needs were assessed at the 1-, 3-, and 6-month postoperative time point. Degree of financial toxicity was calculated using a combination of the metrics catastrophic health expenditure and financial hardship. Development of financial toxicity was compared by sociodemographic and clinical characteristics using logistic regression models., Results: Of the cohort, 60% experienced financial toxicity. Median OOPCs was US$555.32 with the majority of OOPCs stemming from direct nonmedical costs (US$318.45). Cost of initial hospitalization exceeded monthly annual income by 80%. Following surgical burn care, income decreased by US$318.18 within 6 months, accompanied by a 53% increase in unemployment rates. At least 40% of the cohort consistently reported inability to afford basic subsistence needs within the 6-month perioperative period. Significant predictors of developing financial toxicity included male gender (odds ratio, 4.17; 95% confidence interval, 1.25-14.29; P = 0.02) and hospital stays exceeding 20 days (odds ratio, 11.17; 95% confidence interval, 2.11-59.22; P ≤ 0.01)., Conclusions: Surgical treatment for burn injuries is associated with substantial financial toxicity. National and local policies must expand their scope beyond direct medical costs to address direct nonmedical and indirect costs. These include burn care insurance, teleconsultation follow-ups, hospital-affiliated subsidized lodging, and resources for occupational support and rehabilitation. These measures are crucial to alleviate the financial burden of burn care, particularly during the perioperative period., Competing Interests: Conflicts of interest and sources of funding: Dr Kavitha Ranganathan received funding from Harvard Global Health Institute, Connors Center for Women's Health and Gender Biology, and The Plastic Surgery Foundation. No other authors have any funding or conflicts of interest to disclose., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Bempedoic Acid (BA) is a novel drug that has a potential to serve as an alternative to statins to decrease lipid levels and improve cardiovascular disease (CVD) outcomes, particularly for statin-intolerant individuals. However, insufficient statistical power has limited our understanding of the efficacy and safety of BA. This meta-analysis utilizes the latest data to improve our knowledge of BA's effects on lipids and CVD with increased statistical power., Methods: MEDLINE, Embase, Cochrane Central, Clinicaltrials.gov, abstracts of national and international conferences, and reference lists of studies were searched for relevant studies. Rayyan was used to screen the search results, and Revman 5.3 was used for the meta-analysis and sensitivity analysis., Results: Our final analysis included seven randomized control trials (RCTs) with 17,782 participants, 53.6 % in the BA group (n = 9535) and 46.4 % in the placebo group (n = 8247). BA significantly decreased major adverse cardiovascular events (MACE) (OR: 0.86; 95 % CI 0.78-0.95; p = 0.03), non-fatal myocardial infarction (OR 0.72; 95 % CI 0.61-0.85; p = 0.0001), and new onset/worsening diabetes (OR:0.55; 95 % CI 0.30-0.98, p = 0.04), while reducing low-density lipoprotein cholesterol (LDL-C) levels by 22.5 % (MD: -22.53 %; 95 % CI -25.54 to -19.52, p < 0.00001)., Conclusion: The findings of this meta-analysis suggest that BA is a promising and effective alternative to statin therapy, particularly for statin-intolerant and high CVD-risk patients. However, further studies with diverse populations are needed to quantify the long-term efficacy and safety endpoints., Competing Interests: Declaration of competing interest: The authors have no conflicts of interest to declare. All co-authors have seen and agree with the contents of the manuscript and there is no financial interest to report. We certify that the submission is original work and is not under review at any other publication., (© 2024 Greater Baltimore Medical Center.)

Objective: To identify evidence-based interventions that reduce greenhouse gas emissions in health-care systems in low- and middle-income countries and explore potential synergies from these interventions that aid climate change adaptation while mitigating emissions., Methods: We systematically searched 11 electronic databases for articles published between 1990 and March 2023. We assessed risk of bias in each article and graded the quality of evidence across interventions in health-care operations, energy and supply chains., Findings: After screening 25 570 unique records, we included 22 studies published between 2000 and 2022 from 11 countries across six World Health Organization regions. Identified articles reported on interventions spanning six different sources of emissions, namely energy, waste, heating and cooling, operations and logistics, building design and anaesthetic gases; all of which demonstrated potential for significant greenhouse gas emission reductions, cost savings and positive health impacts. The overall quality of evidence is low because of wide variation in greenhouse gas emissions measuring and reporting., Conclusion: There are opportunities to reduce the greenhouse gas emissions from health-care systems in low- and middle-income countries, but gaps in evidence were identified across sources of emissions, such as the supply chain, as well as a lack of consideration of interactions with adaptation goals. As efforts to mitigate greenhouse gas intensify, rigorous monitoring, evaluation and reporting of these efforts are needed. Such actions will contribute to a strong evidence base that can inform policy-makers across contexts., Competing Interests: Further potential conflicts of interest, including relationships with relevant parties other than financial relationships, ((c) 2024 The authors; licensee World Health Organization.)

An elusive population of stripped binary stars is finally revealed.