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Background: Health care providers worldwide are rapidly adopting electronic medical record (EMR) systems, replacing paper record-keeping systems. Despite numerous benefits to EMRs, the environmental emissions associated with medical record-keeping are unknown. Given the need for urgent climate action, understanding the carbon footprint of EMRs will assist in decarbonizing their adoption and use., Objective: We aimed to estimate and compare the environmental emissions associated with paper medical record-keeping and its replacement EMR system at a high-volume eye care facility in southern India., Methods: We conducted the life cycle assessment methodology per the ISO (International Organization for Standardization) 14040 standard, with primary data supplied by the eye care facility. Data on the paper record-keeping system include the production, use, and disposal of paper and writing utensils in 2016. The EMR system was adopted at this location in 2018. Data on the EMR system include the allocated production and disposal of capital equipment (such as computers and routers); the production, use, and disposal of consumable goods like paper and writing utensils; and the electricity required to run the EMR system. We excluded built infrastructure and cooling loads (eg. buildings and ventilation) from both systems. We used sensitivity analyses to model the effects of practice variation and data uncertainty and Monte Carlo assessments to statistically compare the 2 systems, with and without renewable electricity sources., Results: This location's EMR system was found to emit substantially more greenhouse gases (GHGs) than their paper medical record system (195,000 kg carbon dioxide equivalents [CO 2 e] per year or 0.361 kg CO 2 e per patient visit compared with 20,800 kg CO 2 e per year or 0.037 kg CO 2 e per patient). However, sensitivity analyses show that the effect of electricity sources is a major factor in determining which record-keeping system emits fewer GHGs. If the study hospital sourced all electricity from renewable sources such as solar or wind power rather than the Indian electric grid, their EMR emissions would drop to 24,900 kg CO 2 e (0.046 kg CO 2 e per patient), a level comparable to the paper record-keeping system. Energy-efficient EMR equipment (such as computers and monitors) is the next largest factor impacting emissions, followed by equipment life spans. Multimedia Appendix 1 includes other emissions impact categories., Conclusions: The climate-changing emissions associated with an EMR system are heavily dependent on the sources of electricity. With a decarbonized electricity source, the EMR system's GHG emissions are on par with paper medical record-keeping, and decarbonized grids would likely have a much broader benefit to society. Though we found that the EMR system produced more emissions than a paper record-keeping system, this study does not account for potential expanded environmental gains from EMRs, including expanding access to care while reducing patient travel and operational efficiencies that can reduce unnecessary or redundant care., (©Cordelia Kwon, Lernik Essayei, Michael Spencer, Tom Etheridge, Rengaraj Venkatesh, Natrajan Vengadesan, Cassandra L Thiel. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 06.02.2024.)

The entire world seems to have responded to COVID-19 pandemic in a knee-jerk manner with a short mindset without building on the existing strengths of public health infrastructure. National governments cannot be blamed for this as we are dealing with a crisis that comes once in a lifetime. Realising this, the Organized Medicine Academic Guild (OMAG) an association of major health associations in this country has suggested measures for long-term solutions to COVID-19-like pandemics in the form of a policy paper by OMAG. [ABSTRACT FROM AUTHOR]

The study on reading habits among higher secondary school students is a paper thought to access the use of library service and reading habits of higher secondary school students the findings from the table are differentiated into various categories and the table shows that the most of the students are very much enjoyable in reading books with fervor. therefore the study concluded that the reading habits of secondary school students should be given rapt attention because of the imminent danger of losing reading habits in the era of information & communication technology. the study recommends that there must be a fixed time for reading a variety of reading material that will appeal to students and that adopting different methods to arouse the interest of students could enhance their reading habit. [ABSTRACT FROM AUTHOR]

The paper compares the characteristics of URLs cited in Indian LIS conference proceedings papers. A total of 15,745 references appended to 1,700 articles published in three Indian LIS conference proceedings published during 2001-2010 were selected. From these references we extracted a total of 5698 URLs and were further classified according to their top level domains, file formats and path depths for further analysis. The results showed that the percentage of articles with at least one URL increased from 39.10% in 2001 to 91.67% in 2010. There was a constant and continuous increase in the number of articles with URLs over the years during 2001-2010. Of the 1,700 articles published in conference proceedings, there were 1,011 (59.47%) articles with URLs. Study also reveals the fact that, of the 5,698 URLs, more than 50% were shared by .org and .com domains which accounted for 1,799 (31.57%) and 1,474 (25.87%) URLs respectively. The highest percentage of cited URLs belonged to HTML (68.50%) followed by .pdf files (8.86%). The path depth levels 0 (no path), 2 and 3 collectively accounted for 67.67% of the extracted URLs. URLs with path depth 1 and 4 put together accounted for 25.31% of all the 5,698 URLs. [ABSTRACT FROM AUTHOR]

India has a large number of paper manufacturing units, with mills varying in size of operations and type of product, scattered all over the length and breadth of the country. Present study deals with the survey of four different pulp and paper mills (Mill A, Mill B, Mill C and Mill D) in India, differing in their scale of operation as well as raw material usage. Physico-chemical characterization of wastewaters produced by different processing units like digestor house liquors, bleaching section, paper machine backwaters, combined inlet to the ETP and outlet to ETP, for all the four mills, was conducted. Different parameters like pH, Color, COD, BOD, percent Na, SAR, TDS and Total hardness were analyzed and compared. Highly significant differences were thus found between all the processing units of all four mills with p values < 0.01. This evaluation showed that though these mills have effluent treatment facilities installed in their premises, improvements are still needed to increase their efficiencies for treating the discharged wastewaters. [ABSTRACT FROM AUTHOR]

Background: Detection of drug-resistant tuberculosis is essential for the control of the disease but it is often hampered by the limitation of transport and storage of samples from remote locations to the reference laboratory. We performed a retrospective field study to evaluate the performance of four supports enabling the transport and storage of samples to be used for molecular detection of drug resistance using the GenoType MTBDRplus., Methods: Two hundred Mycobacterium tuberculosis strains were selected and spotted on slides, FTA cards, GenoCards, and in ethanol. GenoType MTBDRplus was subsequently performed with the DNA extracted from these supports. Sensitivity and specificity were calculated and compared to the results obtained by drug susceptibility testing., Results: For all supports, the overall sensitivity and specificity for detection of resistance to RIF was between 95% and 100%, and for INH between 95% and 98%., Conclusion: The four transport and storage supports showed a good sensitivity and specificity for the detection of resistance to RIF and INH in M. tuberculosis strains using the GenoType MTBDRplus. These supports can be maintained at room temperature and could represent an important alternative cost-effective method useful for rapid molecular detection of drug-resistant TB in low-resource settings.

In the present study, plant-scale process integration was applied to an Indian paper mill using the water cascade analysis (WCA) technique. Three limiting constraints, chemical oxygen demand (COD), total dissolved solids (TDS), and adsorbable organic halides (AOX), were considered for the study. A nearest neighbor algorithm was used to distribute the freshwater and recycled water among the plant operations. It was found that the limiting critical constraint depends upon the types of processes and streams involved in the integration. The limiting critical constraint can differ for different sections of the same industry, and can differ in different schemes of integration. After process integration, a 55.6% reduction in effluent flow, a 36% reduction in COD, and a 73% reduction in AOX were observed. After process integration, a 35.21% reduction in pollution costs can be achieved and, assuming the average production of the mill to be 225 tons per day, a savings of Indian rupees (INR) 1.73 per kg of paper produced can be achieved by employing process integration. The water cess was calculated as INR 3024.77 per day without integration for the sections that were considered for integration, while after integration, a 41.53% savings in the form of water cess was calculated., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

The present investigation aims to assess the phytoremediation potential of six aquatic macrophytes, viz. Eichhornia crassipes, Hydrilla verticillata, Jussiaea repens, Lemna minor, Pistia stratiotes and Trapa natans grown in paper mill effluent of JK Paper mill of Rayagada, Orissa, for remediation of heavy metals. The experiment was designed in pot culture experiments. Assessment of physico-chemical parameters of paper mill effluent showed significant decrease in pH, conductivity, total dissolved solids, total suspended solids, chlorine, sulphur, biological and chemical oxygen demand after growth of macrophytes for 20 days. Phytoremediation ability of these aquatic macrophytic species for copper (Cu) and mercury (Hg) was indicated by assessing the decrease in the levels of heavy metals from effluent water. Maximum reduction (66.5 %) in Hg content of untreated paper mill effluent was observed using L. minor followed by T. natans (64.8 %). L. minor showed highest reduction (71.4 %) of Cu content from effluent water followed by E. crassipes (63.6 %). Phytoextraction potential of L. minor was remarkable for Hg and Cu, and bioaccumulation was evident from bioconcentration factor values, i.e. 0.59 and 0.70, respectively. The present phytoremediation approach was considered more effective than conventional chemical treatment method for removing toxic contaminants from paper mill effluent.

Pulp and paper mills generate varieties of pollutants depending upon type of the pulping process being used. This paper presents the characteristics of wastewater from South India Paper Mill, Karnataka, India which is using recycled waste paper as a raw material. The raw wastewater consists of 80-90 mg L( - 1) suspended solid and 1,010-1,015 mg L( - 1) dissolved solid. However, pH varied from 5.5-6.8. The biochemical oxygen demand and chemical oxygen demand ranged from 200-210 and 1,120-1,160 mg L( - 1), respectively. Aerobic treatment of raw effluent attribute to significant reduction in suspended solid (range between 25 to 30 mg L( - 1)) and total dissolved solid (range between 360 to 390 mg L( - 1)). However, pH, temperature, and electrical conductivity were found superior after treatment. Copper, cadmium, iron, lead, nickel, and zinc were found in less quantity in raw effluent and were almost completely removed after treatment. The dendrogram of the effluent quality parameters clearly indicate that South India Paper Mill does not meet Minimal National Standard set by central Pollution Control Board to discharge in agricultural field.

The genetic and functional diversity of Bacillus and Bacillus-derived genera was analyzed in soil samples collected from three different fields near Century Paper Mill, Lal Kuan, Uttarakhand, India. Two had been subjected to concentrated and diluted effluent irrigation for the past 25 years and were designated as a concentrated effluent irrigated field (CEIF) and a dilute effluent irrigated field (DEIF), respectively. The field irrigated with fresh water was designated as a water irrigated field (WIF). Increase in pH, Na and Zn content and decrease in Fe content was observed due to effluent irrigation. The population count of Bacillus and Bacillus-derived was maximum in DEIF followed by WIF and CEIF. Variations in plant growth-promoting traits and extracellular enzymes were observed among the isolates from the three different field soils. Based on the amplified ribosomal DNA restriction analysis (ARDRA) with three restriction enzymes, all the selected 104 isolates were clustered into 14 groups. The sequencing of the representative isolates revealed that the majority belonged to the genus Bacillus, while three isolates belonged to Paenibacillus, Lysinibacillus and Orthinibacillus. There were a few species like Orthinibacillus contaminans, B. oleronius, B. safensis, B. methylotrophicus, B. stratosphericus, B. aryabhattai, B. asahii and B. bataviensis that were prevalent only in DEIF and CEIF but not in WIF field soil. The diversity index parameters like the Shannon Index, indices of species richness and species evenness based on biochemical profiling and ARDRA profiling revealed that Bacillaceae members in the fresh water irrigated field were diverse.

In the present study the effect of laboratory exposure to wastewaters from Aligarh (AWW) and Saharanpur (SWW) on the activities of cytochrome P450 (CYP450) isozymes like ethoxyresorufin-o-deethylase (EROD), pentoxyresorufin-o-deethylase (PROD) and N-nitrosodimethylamine demethylase (NDMA-d) were investigated in the liver and kidney of rats. The industrial wastewater samples from Saharanpur city of northern India resulted 12, 3.5 and 1.5-fold rise in the EROD (CYP1A1), PROD (CYP2B1) and NDMA-d (CYP2E1) activity, respectively, in the liver of treated animals. Renal EROD and PROD activities were found to be enhanced by around 5 and 7-folds, respectively, as a result of SWW treatment. On the other hand, Aligarh samples showed significant inhibition in these test CYP450 enzymes both in hepatic as well as renal tissues. Strong induction of CYP1A1 (>10-fold) suggests that EROD can serve as a potent biomarker of SWW in the liver of treated animal. However, PROD and EROD can also act as fairly good biomarkers in case of renal tissue. Marked elevation of EROD activity in SWW treated animals strongly suggests the overwhelming levels of EROD inducers in the Saharanpur sample while a meagre amount of inducers accompanied with significant levels of inhibitors in the Aligarh sample., (Copyright (c) 2010 Elsevier Ltd. All rights reserved.)

Background: Developing countries are facing a rise in noncommunicable diseases (NCD), which is a cause for concern. The World Health Organization has recommended a stepwise approach for NCD risk factor surveillance. Screening for risk factors in remote populations is difficult due to lack of resources and technical expertise, including standardized laboratory facilities. The collection of samples on filter paper for the assessment of risk factors circumvents the need for blood processing, storage, and shipment at ultralow temperatures., Method: Samples were collected on 3-mm Whatman filter paper from one industry (National Thermal Power Corporation) located in the periphery of Delhi as part of a surveillance carried out in industries from different parts of India. Total cholesterol was measured in serum and dried blood by the cholesterol oxidase/p-aminophenazone method and triglycerides by the glycerophosphate oxidase-peroxidase/aminophenazone method. Values obtained by the two methods were compared using Pearson correlation, and Bland-Altman plots were prepared to assess bias., Results: The correlation coefficient "r" was 0.78 for cholesterol and 0.94 for triglycerides between dried blood spots and serum. Bland-Altman plots suggest that differences in values obtained by the two methods were within two standard deviations for most of the samples., Conclusions: Blood samples dried on filter paper can be a successful option for population screening in remote areas, provided preanalytical variations arising due to the method of blood spot preparation and storage are well controlled., ((c) 2010 Diabetes Technology Society.)

Background: Infection with Staphylococcus aureus was initially considered a major problem in hospitals, but over the last few decades the incidence of community-acquired infection has also increased. Paper currency has recently been identified as another mode of spread by which community-acquired S. aureus infection may be transmitted, since paper currency is frequently transferred from one person to another. In the present study, S. aureus strains were isolated from paper currency and screened to detect virulence-associated genes., Methods: Paper currency was collected randomly from operators in mutton shops, vegetable shops, hospitals, medical stores, snacks corners, and restaurants in the two cities of India, Dehradun and Delhi. Samples were screened for pathogenic S. aureus by various biochemical assays. Three isolates were used to study the survival of S. aureus on paper currency. Virulence genes were amplified by PCR. Antibiotic susceptibility was determined against nine antibiotics by the disk diffusion method., Results: Sixty-seven isolates of Staphylococcus aureus were isolated from paper currency from the two Indian cities. The maximum number of isolates was recovered from hospitals, followed by mutton shops, and the minimum from restaurants. The test isolates could survive on paper currency for eight days under in vitro conditions (27 degrees C temperature and 30% relative humidity). A set of four virulence genes viz. cna (16 isolates), icaA (19 isolates), hlg (21 isolates), and sdrE (18 isolates) was amplified using gene-specific primers. Only eight isolates possessed all four virulence genes. Antimicrobial susceptibility tests showed that those isolates having all the tested virulence genes were more resistant., Conclusions: This study clearly suggests that paper currency can serve as a carrier for the spread of resistant bacterial pathogens.

Agro-based pulp and paper mills in India are one of the most polluting industries; in addition, they are high consumers of raw water. Growing scarcity of high quality freshwater as well as stringent regulatory standards is compelling these units to explore appropriate water management options. Based on data obtained through a questionnaire survey and plant visits, this work provides an overview of the water use and effluent treatment status in Indian agro-residue and recycled pulp and paper mills. The challenges faced by this sector are reviewed and practices adopted by progressive units to minimize freshwater use are illustrated through case studies.

Paper industries using different raw materials such as hard wood, bamboo, baggase, rice-straw and waste papers and bleaching chemicals like chlorine, hypochlorite, chlorine dioxide, hydrogen peroxide, sulphite and oxygen were studied to estimate organic pollution load and Adsorbable Organic Halides (AOX) per ton of production. The hard wood based paper industries generate higher Chemical Oxygen Demand (COD) loads (105-182 kg t(-1)) and Biochemical Oxygen Demand (BOD) loads (32.0-72 kg t(-1)) compared to the agro and waste paper based industrial effluents. The bleaching sequences such as C-EP-H-H, C-E-H-H, C-E-Do-D1 and O-Do-EOP-D1 are adopted in the paper industries and the molecular elemental chlorine free bleaching sequence discharges low AOX in the effluent. The range of AOX concentration in the final effluent from the paper industries was 0.08-0.99 kg t(-1) of production. Water consumption was in the range of 100-130 m(3) t(-1) of paper production for wood based industries and 30-50 m(3) for the waste paper based industries. Paper machine effluents are partially recycled after treatment and pulp mill black liquor are subject to chemical recovery after evaporation to reduce the water consumption and the total pollution loads. Hypochlorite bleaching units of textile bleaching processes generate more AOX (17.2-18.3 mg l(-1)) and are consuming more water (45-80 l kg(-1)) whereas alkali peroxide bleaching hardly generates the AOX in the effluents and water consumption was also comparatively less (40 l kg(-1) of yarn/cloth).

The seasonal physico-chemical and microbial quality of Gola river water has been analyzed after confluence of pulp paper mill waste. The study revealed that it has enhanced 20-30 times pollution load of BOD, COD, TDS, TSS, sulphate, chloride, sodium, nitrate, potassium, lignin and phenol after mixing of pulp paper mill waste with river water in all season. Further, it induced the bacterial growth by increasing most probable number value of E. coli was 1.57 x 10(4), 1.6 x 10(4), 1.37 x 10(4) and SPC count was 1.68 x 10(4), 1.64 x 10(4), 1.67 x 10(4)/100 ml during summer, monsoon, winter respectively. While the most probable number value in river water before mixing of pulp paper mill waste was 1.4 x 10(2), 1.82 x 10(2), 1.5 x 10(2) and SPC count was 2.8 x 10(3), 2.89 x 10(3), 2.78 x 10(3)/100 ml during summer, monsoon and winter respectively. This indicated from 88-114 fold increase in most probable number value of E. coli and 56.55-60.0 times increase in SPC count of river water after mixing of effluent in summer, monsoon and winter. Moreover, the most probable number value in effluent itself before mixing was 3.4 x 10(2), 3.3 x 10(2), 2.8 x 10(2) and SPC count was 6 x 10(4), 6.5 x 10(4), 6 x 10(4)/100 ml during summer, monsoon, winter, respectively. Furthermore, it was revealed that the seasonal variation also regulated the bacterial population dynamics as per the physico-chemical quality, in which E. coli was found highest at the rate of (5.9 x 10(4)), E. aerogenes (5.3 x 10(4)), P. aeruginosa (1.3 x 10(4)), S. aureus (3.2 x 10(3)), K. pneumoniae (2.6 x 10(4)), Enteritidis (1.1 x 10(4)) on monsoon season and V. cholerae (7.4 x 10(2)), V. vulnificus (9.2 x 10(2))/100 ml in river water when contaminated with pulp paper mill waste in monsoon season. Thus, the monsoon season showed presence of FC and TC indicated the thermo-tolerant and disease causing group of bacterial population in effluent and its sequence was observed as monsoon>summer>winter. This indicated the growth of many pathogenic and non-pathogenic bacteria for health hazards with contamination of pulp paper waste in aquatic ecosystem within the vicinity of pulp paper mill industry.