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Rainbow trout, a salmonid species has an economic importance worldwide and contributes to the indigenous food security. The present study was conducted in complete randomized design (CRD) to evaluate the dietary inclusion of citric acid with phytase as supplement on growth responses of rainbow trout. There were four treatments of diets with 0.5% citric acid (T1), 1% citric acid (T2), 1.5% citric acid (T3) and 0% control (T4) of citric acid incorporated with 1200FYT phytase as supplement. The treatments were replicated three times. Total harvest weight of fish in T3 (5720.2±105.6g) was significantly higher and different than T2 (4595.9±434.9g), T1 (4589.8±240.2g) and T4 (4567.5±217.3g). The highest daily growth rate was seen in treatment T3 (1.1±0.0) which was significantly different than T2 (0.9±0.0), T1 (0.9±0.0) and T4 (0.8±0.0). The highest specific growth rate was seen in the treatment T3 (0.8±0.01) which was significantly different than T1 (0.7±0.0), T2 (0.7±0.1) and T4 (0.7±0.0). The lowest food conversion ratio was seen in T3 (2.2±0.1) which was significantly different with T2 (2.6±0.1), T1 (2.7±0.1) and T4 (2.8±0.1). Similarly, the highest protein efficiency ratio was seen in treatment T3 (1.0±0.1) which was not significantly different with T2 (0.8±0.0) and T1 (0.8±0.1) but was significantly different than T4 (0.7±0.0). No significant changes were observed in water temperature, dissolve oxygen and pH under different treatments. The present findings demonstrated that dietary inclusion of citric acid with phytase as supplement enhance growth by reducing the pH in the gut which increases the phytate hydrolysis, kills the pathogens, decreases the rate of gastric emptying, improves mineralization and nutrient absorption.

Abstract LUX-ZEPLIN (LZ) is a second-generation direct dark matter experiment with spin-independent WIMP-nucleon scattering sensitivity above $${1.4 \times 10^{-48}}\, {\hbox {cm}}^{2}$$ 1.4 × 10 - 48 cm 2 for a WIMP mass of $${40}\, \hbox {GeV}/{\hbox {c}}^{2}$$ 40 GeV / c 2 and a $${1000}\, \hbox {days}$$ 1000 days exposure. LZ achieves this sensitivity through a combination of a large $${5.6}\, \hbox {t}$$ 5.6 t fiducial volume, active inner and outer veto systems, and radio-pure construction using materials with inherently low radioactivity content. The LZ collaboration performed an extensive radioassay campaign over a period of six years to inform material selection for construction and provide an input to the experimental background model against which any possible signal excess may be evaluated. The campaign and its results are described in this paper. We present assays of dust and radon daughters depositing on the surface of components as well as cleanliness controls necessary to maintain background expectations through detector construction and assembly. Finally, examples from the campaign to highlight fixed contaminant radioassays for the LZ photomultiplier tubes, quality control and quality assurance procedures through fabrication, radon emanation measurements of major sub-systems, and bespoke detector systems to assay scintillator are presented.

Summary: Background: Given the projected trends in population ageing and population growth, the number of people with dementia is expected to increase. In addition, strong evidence has emerged supporting the importance of potentially modifiable risk factors for dementia. Characterising the distribution and magnitude of anticipated growth is crucial for public health planning and resource prioritisation. This study aimed to improve on previous forecasts of dementia prevalence by producing country-level estimates and incorporating information on selected risk factors. Methods: We forecasted the prevalence of dementia attributable to the three dementia risk factors included in the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 (high body-mass index, high fasting plasma glucose, and smoking) from 2019 to 2050, using relative risks and forecasted risk factor prevalence to predict GBD risk-attributable prevalence in 2050 globally and by world region and country. Using linear regression models with education included as an additional predictor, we then forecasted the prevalence of dementia not attributable to GBD risks. To assess the relative contribution of future trends in GBD risk factors, education, population growth, and population ageing, we did a decomposition analysis. Findings: We estimated that the number of people with dementia would increase from 57·4 (95% uncertainty interval 50·4–65·1) million cases globally in 2019 to 152·8 (130·8–175·9) million cases in 2050. Despite large increases in the projected number of people living with dementia, age-standardised both-sex prevalence remained stable between 2019 and 2050 (global percentage change of 0·1% [–7·5 to 10·8]). We estimated that there were more women with dementia than men with dementia globally in 2019 (female-to-male ratio of 1·69 [1·64–1·73]), and we expect this pattern to continue to 2050 (female-to-male ratio of 1·67 [1·52–1·85]). There was geographical heterogeneity in the projected increases across countries and regions, with the smallest percentage changes in the number of projected dementia cases in high-income Asia Pacific (53% [41–67]) and western Europe (74% [58–90]), and the largest in north Africa and the Middle East (367% [329–403]) and eastern sub-Saharan Africa (357% [323–395]). Projected increases in cases could largely be attributed to population growth and population ageing, although their relative importance varied by world region, with population growth contributing most to the increases in sub-Saharan Africa and population ageing contributing most to the increases in east Asia. Interpretation: Growth in the number of individuals living with dementia underscores the need for public health planning efforts and policy to address the needs of this group. Country-level estimates can be used to inform national planning efforts and decisions. Multifaceted approaches, including scaling up interventions to address modifiable risk factors and investing in research on biological mechanisms, will be key in addressing the expected increases in the number of individuals affected by dementia. Funding: Bill & Melinda Gates Foundation and Gates Ventures.

Meat hygiene refers to all conditions and measures necessary to ensure safety and suitability of meat at all stages of the food chain. Inadequate hygiene practices allow consumers to be exposed to pathogens causing public health problems. Inadequate facilities and hygiene practices in meat shops results in meat contamination. The study aimed to identify factors associated with meat hygiene practices among meat handlers in the Metropolitan City of Kathmandu, Nepal. A cross-sectional study was designed with a semi-structured questionnaire and observation checklist that collected information about hygiene practices from 320 consenting meat-handlers by interviewer-administered technique. Data was entered in EpiData and analyzed using IBM SPSS version 21. Descriptive statistics of frequency distribution were used to report meat hygiene-practices and other independent variables, with multivariate logistic regression to establish predictors of meat hygiene-practices at 5% level of significance. The study revealed that less than half (44.4%) of the meat handlers had satisfactory meat hygiene practices. The adjusted regression analysis showed, strong evidence (p

Low birth weight is still an important public health problem worldwide. It is a major contributor to neonatal death in developing countries, including Nepal. The government of Nepal has developed and implemented different programs to improve maternal and neonatal health, including baby's birth weight. However, low birth weight is a major maternal and child health challenge. Maternal factors determining the birth weight of neonates have been poorly assessed in previous studies in Nepal. Thus, this study aims to assess the prevalence and risk factors associated with low birth weight in Nepal. An institution-based descriptive cross-sectional study was carried out in Paropakar Maternity Hospital and Tribhuvan University Teaching Hospital of Kathmandu district among 308 postnatal mothers. The data was collected through the face-to-face interview technique. The data was entered in EpiData 3.1 and exported to Statistical Package and Service Solutions version 21 for analysis. Multivariate logistic regression was used to obtain an adjusted odds ratio, while p-value < 0.05 with 95% Confidence Interval (CI) was considered significant. The findings showed that 15.3% of the children had low birth weight. The mean and standard deviation of childbirth weight was 2.96±0.59 kg. Mothers belonged to Dalit ethnic (AOR = 2.9, 95% CI = 1.2-7.1), Antenatal Care visited three or fewer (AOR = 2.6, 95%CI = 1.0-6.6) and did not comply with Iron and Folic Acid supplementation (AOR = 2.1, 95% CI = 1.0-4.4) were significantly associated with low birth weight. Nearly one in every six children had low birth weight. Maternal health services such as antenatal care and compliance with a recommended dose of maternal micronutrients significantly impact on birth weight. Maternal and neonatal health programs should consider these factors to reduce adverse birth outcomes in Nepal.

Introduction: Pancreaticoduodenectomy (Whipple procedure), even after significant evolution, continues to be associated with a high morbidity. The study aimed to find out the prevalence of complications following pancreaticoduodenectomies performed by a single surgeon over a span of 20 years in tertiary care hospitals of Nepal. Methods: This was a descriptive cross-sectional study conducted from hospital records of patients who underwent pancreaticoduodenectomy between 1999 and 2019 at different institutions in Chitwan, where the principal author was involved. Ethical clearance was taken from the Institutional Review Committee. Convenience sampling was done. Patients’ clinical characteristics and diagnoses were noted. Data entry was done using Statistical Package for the Social Sciences version 20. Point estimate at 95% Confidence Interval was calculated, with frequency and percentage. Results: Out of 327 patients who underwent pancreaticoduodenectomy, complications were found in 125 (38.2%) (32.9-43.7 at 95% Confidence Interval). Respiratory complications were the commonest 32 (9.8%), followed by septicemia 25 (7.6%) and cardiac complications 24 (7.3%). Delayed gastric emptying and postoperative pancreatic fistula were seen in 11 (6.8%) and 4 (2.5%) in the first decade respectively. In the second decade, delayed gastric emptying was noted in 2 (1.2%) and postoperative pancreatic fistula in 1 (0.6%) patient. Conclusions: The prevalence of complications in our study was comparable to other national and international studies. Surgery-specific complications such as delayed gastric emptying and postoperative pancreatic fistula showed a decline over the decade.

Scholars of ancient Ayurveda (Indian system of medicine) were extremely reasonable and had strong scientific rationality in fundamental concepts, which are also applied to drug manufacture and therapy. Bhavana is a unique traditional method of transformation of raw material/substances into the drug by levigation or wet grinding of powdered drugs with juice/decoction/solution of plant, animal, or mineral origin. This method adds the unique capability of affecting the physicochemical and biological properties of a drug, making the drug quicker, augmented, and persistent action with minimal dose. Despite the fact that Bhavana has a wide range of applications in Ayurvedic pharmaceutics, there is only a limited amount of knowledge of its fundamental notions. A comprehensive review was performed on the core concepts of Bhavana, alongside its possible pharmacotherapeutic effects and relevance in drug development, by probing Ayurvedic claims in light of published pharmaceutical, analytical, and pharmacological reports. Various processes, such as thermo- and photochemistry, physicochemical reactions, and mechanic chemical changes, appear to occur during Bhavana.

Introduction. Intensive lifestyle modification including a healthy diet changes the diagnostic status of patient from prediabetes to nondiabetes. In type 2 diabetes, improper eating habits increase insulin resistance. This study is aimed at assessing adherence to the dietary recommendation and its associated factors among people with type 2 diabetes. Methods. A cross-sectional descriptive study was conducted among systematically sampled type 2 diabetic patients using interview on Gandaki Medical College Teaching Hospital and Diabetes, Thyroid, and Endocrinology Care Center, Pokhara. The Perceived Dietary Adherence Questionnaire was used to assess dietary adherence. Data was entered in EpiData version 3.1 and analyzed on SPSS version 20. Logistic regression with adjusted odds ratio and the corresponding 95% confidence intervals were used to find out significance of association. Results. Among 204 participants, only 15.7% of the participants had good dietary adherence. The mean age and standard deviation were 53.03±11.90 years. Factors such as participants living in single family (AOR 2.7, 95% CI 1.0-7.4), participants who could afford recommended diet (AOR 2.9, 95% CI 1.0-8.3), participants having self-control on food (AOR 4.1, 95% CI 1.2-14.1), participants who were engaged in moderate to heavy physical activities (AOR 3.3, 95% CI 1.2-9.2), and participants who had adherence to medication (AOR 3.5, 95% CI 1.2-10.1) were significantly associated with adherence to dietary recommendation. Conclusions. Adherence to dietary recommendation among people with type 2 diabetes was low. Factors such as family type, affordability of recommended diet, self-control on food, physical activity, and medication adherence were significantly associated with adherence to dietary recommendations among people with type 2 diabetes. These factors should be considered by nutrition counselors and clinical decision-makers in patient counseling regarding dietary adherence.

BackgroundThe burden of non-communicable diseases like diabetes and hypertension is increasing worldwide including low-and middle-income countries. Good knowledge of such diseases among young people will make them adopt a healthy lifestyle from an early age, which will, in turn, prevent them from developing such non-communicable diseases. This study aimed to assess the knowledge, attitude, and practice of rural and urban school students regarding diabetes and hypertension. We also aimed to see the differences in the knowledge, attitude, and practice of students from rural vs. urban communities.MethodsA school-based cross-sectional study was conducted from May 1 2021 to June 30, 2021, in four schools in Nepal (1 from a metropolitan city, 2 from an urban municipality, and 1 from a rural municipality). The study was conducted among the secondary-level students of classes 9 and 10 in each school. The data were collected from the participants via pre-tested questionnaires and analyzed in the Statistical Packages for Social Sciences (SPSS) version 20.0. Logistic regression analysis was carried out to determine the determinants of knowledge and attitude regarding diabetes and hypertension.ResultsOf 380 respondents, 35.5% were residents of metropolitan city, 37.4% were from the urban municipality and 27.1% were from the rural municipality. The mean age of respondents was 15.61±0.99 years and 51.1% were male. Respondents having a family history of diabetes and hypertension were 21.1% and 37.9% respectively. Respondents from the metropolitan city had significantly higher mean knowledge scores than the respondents from the urban and rural municipality (pConclusionIn general, there was a good attitude towards diabetes and hypertension despite poor knowledge. The mean knowledge scores were lower in urban municipality and rural municipality compared to metropolitan city. Low knowledge scores on diabetes and hypertension among the students show an urgent need for school-based interventional programs focusing on non-communicable diseases and lifestyle modification with more emphasis on rural communities.

Possession of a firearm without a certified valid license is against Nepalese law. After the civil war, the government issued a stringent rule of not allowing the public to keep firearms without a valid reason, despite having a license. However, there are still people who keep firearms in their homes. The present case reports the accidental death of a teenage boy who used a musket for hunting a wild animal. The present case highlights the fact that despite the stringent law, illegal possession of arms for trophy hunting is still prevalent in rural Nepal. Furthermore, this study aims to highlight the importance of paramedics in early intervention, stabilization and transport of the sick and injured to the hospital in emergency situations. Recruitment of paramedics in the ambulance service might prevent untimely death in many patients while being transported to the hospital which was lacking in the present case.

Firearm-related mortality is not frequently encountered in a country like Nepal where there are stringent laws prohibiting the buying, selling, carrying or storing of firearms. To possess a firearm a person must have a valid license. Wounds produced by firearms have typical characteristics the knowledge of which helps to identify the type of firearm used, range of fire, the position of the victim, and whether the manner of death was homicidal, suicidal, or accidental. The present case is the first autopsy-based study from Nepal which discusses the wounds produced by firearms with an interpretation of such findings for medicolegal purposes. The present case highlights a social problem where the victim, a psychiatric patient, had no access to prescription medication due to coronavirus disease (COVID-19) related lockdown.

Firearm related mortality is not frequently encountered in a country like Nepal where there us a stringent law prohibiting buying, selling, carrying or storing of firearms. It is required to have a valid license to have a firearm in possession. Wounds produced by firearm have a typical characteristic the knowledge of which helps to identify the type of firearm used, range of fire, position of the victim and whether the manner of death was homicidal, suicidal or accidental. The present case is a first autopsy-based study from Nepal which discusses the wounds produced by firearm with interpretation of such findings for medicolegal purposes. The present case highlights a social problem where the victim, a psychiatric patient, had no access to prescription medication due to coronavirus disease (COVID-19) related lockdown.

Background The opioid epidemic across the U.S. poses an array of public health concerns, especially HCV transmission. HCV is now widely curable, yet incident rates are increasing due to the opioid epidemic. Despite the established trajectory from oral prescription opioids (OPOs) to opioid use disorder (OUD), OUD to injection drug use (IDU), and IDU to hepatitis C virus (HCV), OPOs are not a defined risk factor (RF) for HCV infection. The objective of this study was to observe rates of HCV testing and Ab reactivity (HCVAb+) in patients receiving OPOs to substantiate them as a RF, ultimately contributing to HCV elimination. Methods Data from MedStar Health patients receiving OPOs from 1/2017 to 12/2018 were collected and analyzed using chi-squared or student t -tests and logistic regression for uni- or multi-variable analyses, respectively. Statistical significance was defined as P

Possession of a firearm without a certified valid license is against Nepalese law. After the civil war, the government issued a stringent rule of not allowing the public to keep firearms without a valid reason, despite having a license. However, there are still people who keep firearms in their homes. The present case reports the accidental death of a teenage boy who used a musket for hunting a wild animal. The present case highlights the fact that despite the stringent law, illegal possession of arms for trophy hunting is still prevalent in rural Nepal. Furthermore, this study aims to highlight the importance of paramedics in early intervention, stabilization and transport of the sick and injured to the hospital in emergency situations. Recruitment of paramedics in the ambulance service might prevent untimely death in many patients while being transported to the hospital which was lacking in the present case.

Background: Intrahepatic cholestasis of pregnancy is a common pregnancy-specific liver disease associated with increased risk of adverse fetal and maternal outcomes. We sought to determine its prevalence, risk factors and feto-maternal outcomes. Methods: A retrospective review of data of 164 pregnant women diagnosed with intrahepatic cholestasis of pregnancy at Chitwan Medical College, Nepal from August 2018 to September 2020 was done. Socio-demographic data, clinic-laboratory profile and feto-maternal outcomes were obtained from clinical audit books and electronic records. A multivariate logistic regression analysis was used to evaluate the predictors of adverse neonatal outcome. Results: The prevalence of intrahepatic cholestasis of pregnancy was 2.5% (164 out of 6539 deliveries). The mean age was 27.5 ± 4.4 years and 51.2% were multigravida. The preterm delivery rate was 15.2% and Caesarean delivery rate was 69.5%. 22% of the neonates needed intensive care admission out of which Respiratory Distress Syndrome or Transient Tachypnea of Newborn was seen in half of them. There were 2 cases of Intrauterine Fetal Death. In multivariate analysis, delivery

Spin waves, collective dynamic magnetic excitations, offer crucial insights into magnetic material properties. Rare‐earth iron garnets offer an ideal spin‐wave (SW) platform with long propagation length, short wavelength, gigahertz frequency, and applicability to magnon spintronic platforms. Of particular interest, thulium iron garnet (TmIG) has attracted huge interest recently due to its successful growth down to a few nanometers, observed topological Hall effect, and spin‐orbit torque‐induced switching effects. However, there is no direct spatial measurement of its SW properties. This work uses diamond nitrogen‐vacancy (NV) magnetometry in combination with SW electrical transmission spectroscopy to study SW transport properties in TmIG thin films. NV magnetometry allows probing spin waves at the sub‐micrometer scale, seen by the amplification of the local microwave magnetic field due to the coupling of NV spin qubits with the stray magnetic field produced by the microwave‐excited spin waves. By monitoring the NV spin resonances, the SW properties in TmIG thin films are measured as a function of the applied magnetic field, including their amplitude, decay length (≈50 µm), and wavelength (0.8–2 µm). These results pave the way for studying spin qubit‐magnon interactions in rare‐earth magnetic insulators, relevant to quantum magnonics applications. [ABSTRACT FROM AUTHOR]

Abstract Background Palliative patients generally present with symptoms of dyspnea, easy fatigability, lethargy and feeling of being unwell which can broadly be attributed to one root cause: cancer-related anemia. So, packed red cell transfusion is often carried out aiming to improve patients’ functional status. Different cut off hemoglobin values have been suggested, with Hb 10 g/dL. A mean 1.36 units were transfused. Statistically significant improvement was observed in patient reported symptoms of fatigue and breathlessness among both transfused and non-transfused palliative patients. Conclusion Anemic cancer palliative patients were found to benefit following packed red cell transfusion, suggesting a favorable association between the transfusion and patient-reported fatigue and dyspnea.

Sweet potatoes are nutritionally rich and can be converted into chips using a simple frying technique. However, frying processing variables affect the quality of chips significantly and optimization of processing variables is necessary to produce the desired quality chips. The objective of this study was to optimize the pre-drying time and the frying conditions (time and temperature) to obtain quality sweet potato chips with low fat. RSM with CCRD was used to develop regression and response surface models to observe the effect of pre-drying time and frying variables and optimize the frying conditions for the desired physicochemical properties of chips as response variables. The regression and response surface modeling indicated that the pre-drying time, frying temperature and frying time had a linear effect on moisture content, water activity, oil content and total color difference and a quadratic effect on L value, hardness and crispness of the sweet potato chips. The numerical and graphical optimization indicated that the quality of the chips was improved in the range of pre-drying (25-30 min), frying temperature (155-160°C) and frying time (5-6 min). The findings of this research will be helpful for a commercial setting of processing variables for sweet potato chips development within the experimental range.

This paper explores the ways change is addressed in Sāṅkhya, one of the major Hindu schools of philosophy, specifically in light of the classical debate between Hindu and the Buddhist philosophers regarding intrinsic nature (svabhāva) and the concept of transformation (pariṇāma). When we closely analyze Sāṅkhya categories, the issue of temporality stands out, because for Sāṅkhya philosophers time is not a distinct category and is infrequently addressed in classical Sāṅkhya. Nonetheless, we can still extract two different notions related to time, dynamism intrinsic to rajas, and temporality that is enclosed within the notion of space and spatial objects. What this implies is that the temporality implicit within the concept of change is only applicable to the last of the evolutes, according to Sāṅkhya cosmology. However, the Sāṅkhyan idea of 16 transformations (pariṇāma) applies to all categories, except puruṣa. By exploiting the parameters of these arguments, this paper makes the case for a closer analysis of the category of transformation in classical Sāṅkhya. Reading about change in the light of svabhāva, the intrinsic nature of an entity, versus the idea of its termination, allows us to have a wider conversation on what it means for something to change from within the Sāṅkhya paradigm.