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A key open question in the study of layered superconducting nickelate films is the role that hydrogen incorporation into the lattice plays in the appearance of the superconducting state. Due to the challenges of stabilizing highly crystalline square planar nickelate films, films are prepared by the deposition of a more stable parent compound which is then transformed into the target phase via a topotactic reaction with a strongly reducing agent such as CaH2. Recent studies, both experimental and theoretical, have introduced the possibility that the incorporation of hydrogen from the reducing agent into the nickelate lattice may be critical for the superconductivity. In this work, we use secondary ion mass spectrometry to examine superconducting La1-xXxNiO2 / SrTiO3 (X = Ca and Sr) and Nd6Ni5O12 / NdGaO3 films, along with non-superconducting NdNiO2 / SrTiO3 and (Nd,Sr)NiO2 / SrTiO3. We find no evidence for extensive hydrogen incorporation across a broad range of samples, including both superconducting and non-superconducting films. Theoretical calculations indicate that hydrogen incorporation is broadly energetically unfavorable in these systems, supporting our conclusion that extensive hydrogen incorporation is not generally required to achieve a superconducting state in layered square-planar nickelates.

In response to growing environmental concerns about the adverse effects of conventional lubricants, there has been a surge in the demand for eco-friendly alternatives. Biodegradable lubricants, crafted from renewable sources, represent a sustainable solution to address these environmental apprehensions. This research describes the tribological, rheological properties and biodegradability of rapeseed oil with 0.25 to 1.25 weight percent TiO2 nanoparticles as additives. The lubricant samples were prepared using a magnetic stirrer and an ultrasonic device. Friction and wear properties such as coefficient of friction and wear scar diameter were determined using a four-ball tester. In comparison with SAE20W40, samples 1 (0.25 weight percentage of TiO2) and sample 2 (0.5 weight percentage of TiO2) shown remarkably improved tribological performance, with 73.32% and 66.76% decreases in coefficient of friction (COF), respectively. Shear stress, shear rate and dynamic viscosity are analyzed using a rheometer. The acquired results are juxtaposed with both pure canola oil and various mineral oils for comparison. The nano-lubricant synthesized in this study emerges as a viable alternative to SAE10, DXT3 (steering fluid), and SAE20W50 grade oils, demonstrating lower friction and a reduced wear scar diameter. Biodegradability tests were performed on all generated samples using the Biochemical Oxygen Demand (BOD) apparatus, and all samples exhibited a BOD to Chemical Oxygen Demand (COD) ratio better than 0.5, indicating biocompatibility. The findings of the research investigation indicate that the combination of canola oil with TiO2 blends holds significant promise as an alternative to conventional synthetic lubricant oils.

Abstract Introduction Non-Communicable Diseases (NCDs) place a significant burden on India's healthcare system, accounting for approximately 62% of all deaths in the country in 2017. The southern Indian state - Kerala - has some of the highest rates of NCDs. Within the state, the fisherfolk community has a high prevalence of risk factors such as tobacco use and alcohol consumption. Working in the fisheries industry demands physical exertion, night shifts alongside extended periods of time at sea (for seafaring fisherfolk). Evidence is scant on how these conditions relate to the health-seeking experiences of fisherfolk, particularly in the context of NCDs. We conducted a qualitative study in two districts of Kerala to fill this gap. Methods In-depth individual and small group interviews– as per participant preference – with male and female fishing community members living with NCDs were conducted between October 2022 and February 2023 in two districts of Kerala. Interviews were conducted to explore community members’ experiences with health-seeking for NCDs. Transliterated English transcripts were coded using ATLAS.ti software and analysed using thematic analysis with inductive generation of codes, with indexing against Levesque, Harris, and Russell’s 2013 access to healthcare framework. Results Thirty-three interviews with 42 participants were conducted. We found that NCDs were usually diagnosed late- either when admitted/consulted for other illnesses or when the symptoms became unbearable. Health-seeking patterns differed between seafaring and inland fishing subgroups, who were sampled from two districts in the state. Seafaring fisherfolk preferred public facilities for regular checkups and medicines while in-land fisherfolk relied on private facilities, although it was considered expensive. Ability to seek care was impacted by the working hours of the health centre which did not suit their working hours. Health constaints and related expenses also impacted their financial status and occupation, with some opting for less strenuous jobs. Conclusion This study highlights the NCD-related health-seeking experiences of the fisherfolk community in Kerala, India. Fisherfolk reported self neglect, delayed diagnosis, cost and livelihood constraints owing to the onset of NCDs, even as dual practice and medicine access in the public sector were appreciated. Overall, larger studies and policymaking processes should consider in depth the experiences faced by particular economic groups like fisherfolk, who may face unique health and care-seeking challenges.

Abstract Single-cell RNA sequencing (scRNA-seq) can resolve transcriptional features from individual cells, but scRNA-seq techniques capable of resolving the variable regions of B cell receptors (BCRs) remain limited, especially from widely-used 3′-barcoded libraries. Here, we report a method that can recover paired, full-length variable region sequences of BCRs from 3′-barcoded scRNA-seq libraries. We first verify this method (B3E-seq) can produce accurate, full-length BCR sequences. We then apply this method to profile B cell responses elicited against the capsular polysaccharide of Streptococcus pneumoniae serotype 3 (ST3) by glycoconjugate vaccines in five infant rhesus macaques. We identify BCR features associated with specificity for the ST3 antigen which are present in multiple vaccinated monkeys, indicating a convergent response to vaccination. These results demonstrate the utility of our method to resolve key features of the B cell repertoire and profile antigen-specific responses elicited by vaccination.

Objective: The aim of the study was to describe how physical exercise affects metabolic control, insulin requirements and carbohydrate intake in children who use hybrid closed-loop systems. Methods: Cross-sectional study design. The sample included 21 children and adolescents diagnosed with type 1 diabetes. During the study, participants were monitored for a period of 7 days to gather comprehensive data on these factors. Results: Nine participants (42.9%) had switched to exercise mode to raise the target glucose temporarily to 150 mg/dL. The HbA1c values ranged from 5.5% to 7.9% (median, 6.5%; IQR, 0.75). The percentage of time within the target range of 70−180 mg/dL was similar; however, there was an increased duration of hyperglycaemia and more autocorrections on exercise days. The time spent in severe hyperglycaemia (>250 mg/dL) increased by 2.7% in exercise compared to non-exercise days (P = .02). It is worth noting that hypoglycaemic episodes did not increase during the exercise days compared with non-exercise days. Conclusion: The hybrid closed-loop system was effective and safe in children and adolescents with type 1 diabetes during the performance of competitive sports in real life. Resumen: Objetivo: El objetivo de este estudio es describir cómo el ejercicio físico afecta el control metabólico, las necesidades de insulina y el consumo de carbohidratos en niños usuarios de un sistema híbrido de circuito cerrado. Métodos: Diseño de estudio transversal. Se reclutaron veintiún niños y adolescentes diagnosticados con diabetes tipo 1. Durante el estudio, los participantes fueron monitoreados durante un período de 7 días para recopilar datos completos sobre estos factores. Resultados: Nueve participantes (42,9%) habían activado el modo de ejercicio, para elevar temporalmente la glucosa objetivo a 150 mg/dL. La HbA1c osciló entre 5,5% y 7,9% (mediana 6,5%, IQR 0,75). El porcentaje de tiempo dentro del rango de 70−180 mg/dL fue similar; sin embargo, hubo una mayor duración de la hiperglucemia y más autocorrecciones en los días en que se realizó ejercicio. El porcentaje de tiempo en hiperglucemia grave (>250 mg/dL) fue 2,7 mayor durante el ejercicio versus los días sin ejercicio (p = 0,02). En particular, los episodios de hipoglucemia no aumentaron durante los días de práctica de ejercicio, en comparación con los días sin ejercicio. Conclusiones: El sistema híbrido de circuito cerrado fue efectivo y seguro en niños y adolescentes diagnosticados con diabetes tipo 1 durante ejercicios físicos competitivos en la vida real.

Abstract Background Kerala has a history of achievements in health through acting on the distal social determinants, but certain communities like tribals were pushed back from the stream of social development and health achievements. Subsequently, the lifestyle and the poor living conditions of tribes make them more prone to several diseases including skin diseases. However, neither the burden nor the situation of the same in the tribal population in several parts including Kerala is seldom assessed. Main body The lack of awareness about the symptoms, complications, and management options as a part of the social backwardness has led to the concentration of certain diseases like Leprosy among the tribal community. In addition, the tribal population is under the threat of infectious diseases of public health significance like Leishmaniasis (CL). The tribal population owing to ignorance neglects the skin lesions or uses their local remedies. Tribes might have been using many local remedies for their issues, but the emerging skin diseases may not be amenable to local remedies and often impose significant public health concerns. Developing and maintaining an effectively functioning health system in these difficult-to-reach terrains is also a challenge. The pattern of skin diseases among tribals residing in environmentally sensitive localities is an indicator for the need for more social, economic and geospatial inclusion. Skin lesions of the tribal population should be kept under active surveillance activities through the integrated health information platform (IHIP) and it should follow a vigilant public health response if there are clusterings. A dedicated evidence-based system should be developed to diagnose and treat skin diseases of tribal people residing away from the availability of specialist care using local resources and community-level workers. Conclusion The rampant skin diseases among tribals are the product of their unacceptable socio-economic status and living conditions. It could only improve through interventions focusing on social determinants of health. Improvements in the living conditions of tribals are sustainable long-term solutions, but such solutions should be coupled with medium-term and short-term strategies.

Abstract A key open question in the study of layered superconducting nickelate films is the role that hydrogen incorporation into the lattice plays in the appearance of the superconducting state. Due to the challenges of stabilizing highly crystalline square planar nickelate films, films are prepared by the deposition of a more stable parent compound which is then transformed into the target phase via a topotactic reaction with a strongly reducing agent such as CaH2. Recent studies, both experimental and theoretical, have introduced the possibility that the incorporation of hydrogen from the reducing agent into the nickelate lattice may be critical for the superconductivity. In this work, we use secondary ion mass spectrometry to examine superconducting La1−x X x NiO2 / SrTiO3 (X = Ca and Sr) and Nd6Ni5O12 / NdGaO3 films, along with non-superconducting NdNiO2 / SrTiO3 and (Nd,Sr)NiO2 / SrTiO3. We find no evidence for extensive hydrogen incorporation across a broad range of samples, including both superconducting and non-superconducting films. Theoretical calculations indicate that hydrogen incorporation is broadly energetically unfavorable in these systems, supporting our conclusion that extensive hydrogen incorporation is not generally required to achieve a superconducting state in layered square-planar nickelates.

Abstract Rice is a staple food in the diets of more than half of the world's population. With India's irregular rainfall patterns and continual environmental anomalies, particularly in Kerala, the identification of climate-smart management practices which can withstand drought is critical. In this context, atrial was conducted in the experimental plots to evolve effective water and nutrient management practices under aerobic rice in lateritic soils of Kerala. However, during the experiment in a few treatments, rolling of leaves was observed, and when explored for the reasons, it was due to soil moisture deficit and plant water stress. When compared to other crop species, rice is highly vulnerable to water deficit. In this regard, an attempt has been made to study the leaf rolling pattern in aerobic rice and how this can be managed with a few soil amendments so that rice productivity can be sustained. The results showed that plant growth parameters, relative water content (RWC), membrane leakage (ML) and spectral signatures were significantly affected by the leaf rolling. It was found that leaf rolling affected plants have less RWC and higher ML and are under drought stress. Pearson correlation analysis showed a strong positive correlation (P

Abstract Glioblastoma is the most common and deadliest brain tumour in adults, with a median survival of 15 months under the current standard of care. Immunotherapies like immune checkpoint inhibitors and oncolytic viruses have been extensively studied to improve this endpoint. However, most thus far have failed. To improve the efficacy of immunotherapies to treat glioblastoma, new single-cell imaging modalities like imaging mass cytometry can be leveraged and integrated with computational models. This enables a better understanding of the tumour microenvironment and its role in treatment success or failure in this hard-to-treat tumour. Here, we implemented an agent-based model that allows for spatial predictions of combination chemotherapy, oncolytic virus, and immune checkpoint inhibitors against glioblastoma. We initialised our model with patient imaging mass cytometry data to predict patient-specific responses and found that oncolytic viruses drive combination treatment responses determined by intratumoral cell density. We found that tumours with higher tumour cell density responded better to treatment. When fixing the number of cancer cells, treatment efficacy was shown to be a function of CD4 + T cell and, to a lesser extent, of macrophage counts. Critically, our simulations show that care must be put into the integration of spatial data and agent-based models to effectively capture intratumoral dynamics. Together, this study emphasizes the use of predictive spatial modelling to better understand cancer immunotherapy treatment dynamics, while highlighting key factors to consider during model design and implementation.

Abstract The second most common type of malignant tumor worldwide is colorectal cancer. Histopathology image analysis offers crucial data for the clinical diagnosis of colorectal cancer. Currently, deep learning techniques are applied to enhance cancer classification and tumor localization in histopathological image analysis. Moreover, traditional deep learning techniques might loss integrated information in the image while evaluating thousands of patches recovered from whole slide images (WSIs). This research proposes a novel colorectal cancer detection network (CCDNet) that combines coordinate attention transformer with atrous convolution. CCDNet first denoises the input histopathological image using a Wiener based Midpoint weighted non-local means filter (WMW-NLM) for guaranteeing precise diagnoses and maintain image features. Also, a novel atrous convolution with coordinate attention transformer (AConvCAT) is introduced, which successfully combines the advantages of two networks to classify colorectal tissue at various scales by capturing local and global information. Further, coordinate attention model is integrated with a Cross-shaped window (CrSWin) transformer for capturing tiny changes in colorectal tissue from multiple angles. The proposed CCDNet achieved accuracy rates of 98.61% and 98.96%, on the colorectal histological image and NCT-CRC-HE-100 K datasets correspondingly. The comparison analysis demonstrates that the suggested framework performed better than the most advanced methods already in use. In hospitals, clinicians can use the proposed CCDNet to verify the diagnosis.

Abstract Blackgram, a protein-rich pulse crop (24%), is crucial for combating food insecurity, particularly in malnourished and economically weak countries. Enhancing blackgram production requires improved, input-saving management practices. Given the challenges of climate change and population growth, efficient water management is vital for increasing pulse productivity and water use efficiency with minimal investment. This study aimed to identify cost-effective irrigation methods to optimise blackgram yields. Experiments were conducted at the National Pulses Research Centre in Vamban, Pudukkottai, and the Agricultural College and Research Institute in Kumulur, Tiruchirappalli, during the kharif season of 2021 and 2022. The study compared different treatments of irrigation methods, such as check basin, raised bed, drip, sprinkler and rain hose irrigation. Results showed that the rain hose system maintained the highest soil moisture (23.93% at 10 cm depth and 19.71% at 20 cm depth). Even though drip irrigation resulted in a higher seed yield (1363 kg ha−1), the rain hose system proved to be more cost-effective, saving 27.09% in costs and achieving a 15.23% higher benefit–cost ratio. These findings suggest that the rain hose method, combined with current agronomic practices, is a viable low-cost technique for sustainable blackgram cultivation, optimising water use and maximising profits. This research provides valuable insights into water-saving irrigation methods for pulse crops.

Abstract Background Kerala, a southern state in India, is known to be atypical due to its high literacy rate and advanced social development indicators. Facing competition from a dominant private healthcare system, recent government health system reforms have focused on providing free, high-quality universal healthcare in the public sector. We carried out an analysis to ascertain the initial impacts of these measures among ‘hard to reach groups’ as part of a larger health policy and systems research study, with a focus on public sector health service utilisation. Methods We conducted Focus Group Discussions (FGDs) among identified vulnerable groups across four districts of Kerala between March and August of 2022. The FGDs explored community perspectives on the use of public healthcare facilities including enablers and barriers to healthcare access. Transliterated English transcripts were coded using ATLAS.ti software and thematically analyzed using the AAAQ framework, supplemented with inductive code generation. Results A total of 34 FGDs were conducted. Availability and cost-effectiveness were major reasons for choosing public healthcare, with the availability of public insurance in inpatient facilities influencing this preference. However, accessibility of public sector facilities posed challenges due to long journeys and queues. Uneven roads and the non-availability of public transport further restricted access. Gaps in acceptability were also observed: participants noted the need for the availability of special treatments available, reduced waiting times for special groups like those from tribal communities or the elderly mindful of their relatively greater travel and need for prompt care. Although quality improvements resulting from health reform measures were acknowledged, participants articulated the need for further enhancements in the availability and accessibility of services so as to make public healthcare systems truly acceptable. Conclusion The ‘Kerala Model of Development’ has been applauded internationally for its success in recent years. However, this has not inured the state from the typical barriers to public sector health care use articulated by participants in the study, which match global evidence. In order to deepen the impact of public sector reforms, the state must try to meet service user expectations– especially among those left behind. This requires attention to quality, timeliness, outreach and physical access. Longer term impacts of these reforms – as we move to a post-COVID scenario - should also be evaluated.

Abstract Background In 1993, WHO declared tuberculosis (TB) as a global health emergency considering 10 million people are battling TB, of which 30% are undiagnosed annually. In 2020 the COVID-19 pandemic took an unprecedented toll on health systems in every country. Public health staff already engaged in TB control and numerous other departments were additionally tasked with managing COVID-19, stretching human resource (HR) capacity beyond its limits. As part of an assessment of HR involved in TB control in India, The World Bank Group and partners conducted an analysis of the impact of COVID-19 on TB human resources for health (HRH) workloads, with the objective of describing the extent to which TB-related activities could be fulfilled and hypothesizing on future HR requirements to meet those needs. Methods The study team conducted a Workload Indicators and Staffing Needs (WISN) analysis according to standard WHO methodology to classify the workloads of priority cadres directly or indirectly involved in TB control activities as over-, adequately or under-worked, in 18 districts across seven states in India. Data collection was done via telephone interviews, and questions were added regarding the proportion of time dedicated to COVID-19 related tasks. We carried out quantitative analysis to describe the time allocated to COVID-19 which otherwise would have been spent on TB activities. We also conducted key informant interviews (KII) with key TB program staff about HRH planning and task-shifting from TB to COVID-19. Results Workload data were collected from 377 respondents working in or together with India’s Central TB Division (CTD). 73% of all respondents (n = 270) reported carrying out COVID-19 tasks. The average time spent on COVID-19 tasks was 4 h / day (n = 72 respondents). Multiple cadres highly instrumental in TB screening and diagnosis, in particular community outreach (ASHA) workers and CBNAAT/TrueNAAT laboratory technicians working at peripheral, block and district levels, were overworked, and spending more than 50% of their time on COVID-19 tasks, reducing time for TB case-finding. Qualitative interviews with laboratory technicians revealed that PCR machines previously used for TB testing were repurposed for COVID-19 testing. Conclusions The devastating impact of COVID-19 on HR capacity to conduct TB case-finding in India, as in other settings, cannot be overstated. Our findings provide clear evidence that NTEP human resources did not have time or essential material resources to carry out TB tasks during the COVID pandemic without doing substantial overtime and/or compromising on TB service delivery. To minimize disruptions to routine health services such as TB amidst future emerging infectious diseases, we would do well, during periods of relative calm and stability, to strategically map out how HRH lab staff, public health resources, such as India’s Health and Wellness Centers and public health cadre, and public-private sector collaboration can most optimally absorb shocks to the health system.

Background: Collection and compilation of spatial, meteorological, entomological, and virological data are critical in mitigating climate-sensitive emerging infections like dengue. This study was a holistic attempt to understand the dengue situation in the Kasaragod district of Kerala, India. Methods: This cross-sectional study was conducted in 13 health institutions from June to July 2021. Adult patients presenting with fever and testing positive for NS1 ELISA were subjected to Dengue RT-PCR and serotyping. The spatial and clinical features of the RT-PCR-positive patients, the district’s meteorological data, and the vector indices were studied. Results: The pre-epidemic months were marked by intermittent rainfall, peak ambient temperature and high larval indices. Among the 136 dengue RT-PCR patients studied, 41.2% had DENV2 followed by DENV1 (22.8%), DENV3 (5.9%) and DENV4 (4.4%); with 25% mixed infections. DENV1 showed a higher risk of gastrointestinal manifestations (80.6%, p=0.019) and musculoskeletal symptoms (77.4%, p=0.026) compared with other serotypes. Conclusions: In the context of dengue hyperendemicity, the possibility of an emerging serotype’s dominance coupled with the mixing up of strains should warn the health system regarding future outbreaks. Furthermore, the study emphasizes the importance of monitoring larval indices and the window of opportunity to intervene between environmental predictors and dengue outbreaks.

Abstract Increasing demand for bio-interfaced human-machine interfaces propels the development of organic neuromorphic electronics with small form factors leveraging both ionic and electronic processes. Ion-based organic electrochemical transistors (OECTs) showing anti-ambipolarity (OFF-ON-OFF states) reduce the complexity and size of bio-realistic Hodgkin-Huxley(HH) spiking circuits and logic circuits. However, limited stable anti-ambipolar organic materials prevent the design of integrated, tunable, and multifunctional neuromorphic and logic-based systems. In this work, a general approach for tuning anti-ambipolar characteristics is presented through assembly of a p-n bilayer in a vertical OECT (vOECT) architecture. The vertical OECT design reduces device footprint, while the bilayer material tuning controls the anti-ambipolarity characteristics, allowing control of the device’s on and off threshold voltages, and peak position, while reducing size thereby enabling tunable threshold spiking neurons and logic gates. Combining these components, a mimic of the retinal pathway reproducing the wavelength and light intensity encoding of horizontal cells to spiking retinal ganglion cells is demonstrated. This work enables further incorporation of conformable and adaptive OECT electronics into biointegrated devices featuring sensory coding through parallel processing for diverse artificial intelligence and computing applications.

Background & objectives: Leishmaniasis is caused by various species of parasite Leishmania. Approximately twenty of them are pathogenic to mammals. In Sri Lanka, cutaneous leishmaniasis (CL) is an established vector-borne disease. CL originates and spreads mainly through sandfly bite in many endemic countries. The aim of the present study was to compare the geographical distribution and demographic features of CL cases in Hambantota district, Sri Lanka in 2014 and 2016. Methods: The patients who were presented to the Tangalle Base Hospital from June to December in 2014 and 2016 were examined and a descriptive study was carried out using a structured-questionnaire. Slit-skin smears were collected from each patient, Giemsa-stained and examined under the light microscope to identify Leishmania amastigotes. Results: Out of 256 and 314 suspected CL patients, 156 and 155 were identified positive for the year 2014 and 2016, respectively. Out of 12 District Secretary Divisions (DSD) in Hambantota district, the highest number of CL cases, 85 and 86 was reported from Tangalle DSD in 2014 and 2016 respectively. Number of identified CL patients in Beliatta DSD had increased from 50 to 67 during the study period. In both years, majority of CL patients were ≥50 years old with males more infected than females. Although CL association with occupations were insignificant, housewives were the highly (23%) infected occupants in this area. Interpretation & conclusion: Based on the present findings, geographical distribution within DSDs in Hambantota district had changed. This emphasizes the importance of CL as a health problem in Hambantota district.