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Abstract Objectives Health literacy (HL) about healthy cognitive aging is essential in preventing cognitive decline and promoting cognitive well‐being. It is important that one such HL module should be scientifically designed, delivered in a technically sound manner to the audience, and specific to the context. The present study thus aimed at developing and validating educational multimedia about cognitive health. Methods The study followed a methodological framework and was carried out across three phases, that is, identification of themes, development and validation of educational script and design, and validation of educational multimedia. The module was scripted based on the Integrated HL framework and the recommendations made during the modified nominal group technique among the research team. Seven speech‐language pathologists (SLPs), with expertise in the field of cognitive sciences, and 15 representatives of the general public validated the module using the Educational Content Validation Instrument in Health and the Patient Education Materials Assessment Tool for Audiovisual Materials questionnaire. Results The scientific content of the educational script received satisfactory agreements among the experts (content validity index [CVI]: 0.93) and representatives of the general public (CVI: 0.86). The technical aspects of the educational multimedia were rated to have high understandability (experts: 92.8%; representatives of general public: 98.8%) and actionability (experts and representatives of general public 100%). Conclusion Overall, the developed educational multimedia scored optimally with respect to the objective, structure, relevance of the content, actionability and understandability of the multimedia. The developed module holds the potential to be used at community and national level health educational programs or awareness campaigns to enhance public knowledge and beliefs pertaining to cognitive health. Patient or Public Contribution SLPs with expertise in the field of cognitive science and representatives from the general public were included to validate and obtain feedback on the developed educational multimedia.

Mercury (Hg), a ubiquitous atmospheric trace metal posing serious health risks, originates from natural and anthropogenic sources. India, the world's second-largest Hg emitter and a signatory to the Minamata Convention, is committed to reducing these emissions. However, critical gaps exist in our understanding of the spatial and temporal distribution of Hg across the vast Indian subcontinent due to limited observational data. This study addresses this gap by employing the GEOS-Chem model with various emission inventories (UNEP2010, WHET, EDGAR, STREETS, and UNEP2015) to simulate Hg variability across the Asian domain, with a specific focus on India from 2013 to 2017. Model performance was evaluated using ground-based GMOS observations and available literature data. Emission inventory performance varied across different observational stations. Hence, we employed ensemble results from all inventories. The maximum relative bias for Total Gaseous Mercury (TGM) and Gaseous Elemental Mercury (GEM; Hg0) concentrations is about ±20%, indicating simulations with sufficient accuracy. Total Hg wet deposition fluxes are highest over the Western Ghats and the Himalayan foothills due to higher rainfall. During the monsoon, the Hg wet deposition flux is about 65.4% of the annual wet deposition flux. Moreover, westerly winds cause higher wet deposition in summer over Northern and Eastern India. Total Hg dry deposition flux accounts for 72–74% of total deposition over India. Hg0 dry deposition fluxes are higher over Eastern India, which correlates strongly with the leaf area index. Excluding Indian anthropogenic emissions from the model simulations resulted in a substantial decrease (21.9% and 33.5%) in wet and total Hg deposition fluxes, highlighting the dominant role of human activities in Hg pollution in India. [ABSTRACT FROM AUTHOR]

Air pollution caused by various anthropogenic activities and biomass burning continues to be a major problem in India. To assess the effectiveness of current air pollution mitigation measures, we used a 3D global chemical transport model to analyze the projected optical depth of carbonaceous aerosol (AOD) in India under representative concentration pathways (RCP) 4.5 and 8.5 over the period 2000–2100. Our results show a decrease in future emissions, leading to a decrease in modeled AOD under both RCPs after 2030. The RCP4.5 scenario shows a 48%–65% decrease in AOD by the end of the century, with the Indo‐Gangetic Plain (IGP) experiencing a maximum change of ∼ ${\sim} $25% by 2030 compared to 2010. Conversely, RCP8.5 showed an increase in AOD of ∼ ${\sim} $29% by 2050 and did not indicate a significant decrease by the end of the century. Our study also highlights that it is likely to take three decades for current policies to be effective for regions heavily polluted by exposure to carbonaceous aerosols, such as the IGP and eastern India. We emphasize the importance of assessing the effectiveness of current policies and highlight the need for continued efforts to address the problem of air pollution from carbonaceous aerosols, both from anthropogenic sources and biomass burning, in India. Plain Language Summary: Air pollution from human activities and biomass burning is a significant issue in India. To understand the efficacy of current efforts, a computer model is used to study the projected levels of carbonaceous aerosols (measured as optical depth) from 2000 to 2100. The results suggest that emissions are expected to decrease after 2030, leading to a drop in modeled aerosol levels. In an optimistic scenario of RCP4.5, aerosol levels could decrease by 48%–65% by the end of the century, with the Indo‐Gangetic Plain (IGP) showing the most improvement by 2030. However, in a scenario without any significant measures, aerosol levels may increase by 29% by 2050 and not improve significantly by the end of the century. The study indicates that it might take around 30 years for current pollution control measures to make a noticeable difference in heavily polluted regions like the IGP and eastern India. These findings underscore the importance of evaluating the effectiveness of current policies and the need to address air pollution in India caused by carbonaceous aerosols emitted from both, human activities and biomass burning. Results presented here are crucial for policymakers and the public to understand the progress made and the challenges that persist in combating air pollution over Indian region. Key Points: The future changes in carbonaceous aerosols carry significant consequences for air quality together with climate change in IndiaMitigation of carbonaceous aerosols is essential to maximize the co‐benefits for future air qualityFuture shifts in emissions will affect the degree of mitigation needed for anthropogenic sources over India after the year 2030 [ABSTRACT FROM AUTHOR]

The central Arctic cryosphere is influenced by the Arctic amplification (AA) and is warming faster than the lower latitudes. AA affects the formation, loss, and transport of aerosols. Efforts to assess the underlying processes determining aerosol variability are currently limited due to the lack of ground-based and space-borne aerosol observations with high spatial coverage in this region. This study addresses the observational gap by making use of total aerosol optical depth (AOD) datasets retrieved by the AEROSNOW algorithm over the vast cryospheric region of the central Arctic during Arctic spring and summer. GEOS-Chem (GC) simulations combined with AEROSNOW-retrieved data are used to investigate the processes controlling aerosol loading and distribution at different temporal and spatial scales. For the first time, an integrated study of AOD over the Arctic cryosphere during sunlight conditions was possible with the AEROSNOW retrieval and GC simulations. The results show that the spatial patterns observed by AEROSNOW differ from those simulated by GC. During spring, which is characterized by long-range transport of anthropogenic aerosols in the Arctic, GC underestimates the AOD in the vicinity of Alaska in comparison with AEROSNOW retrieval. At the same time, it overestimates the AOD along the Bering Strait, northern Europe, and the Siberian central Arctic sea-ice regions, with differences of - 12.3 % and 21.7 %, respectively. By contrast, GC consistently underestimates AOD compared with AEROSNOW in summer, when transport from lower latitudes is insignificant and local natural processes are the dominant source of aerosol, especially north of 70° N. This underestimation is particularly pronounced over the central Arctic sea-ice region, where it is - 10.6 %. Conversely, GC tends to overestimate AOD along the Siberian and Greenland marginal sea-ice zones by 19.5 % but underestimates AOD along the Canadian Archipelago by - 9.3 %. The differences in summer AOD between AEROSNOW data products and GC-simulated AOD highlight the need to integrate improved knowledge of the summer aerosol process into existing models in order to constrain its effects on cloud condensation nuclei, on ice nucleating particles, and on the radiation budget over the central Arctic sea ice during the developing AA period. [ABSTRACT FROM AUTHOR]

ABSTRACT Purpose The aim of the present study was to conceptualize and develop a novel context-based working memory (WM) task which would possess the potential to assess the context-based WM in an Indian scenario and incorporate a task-linked metacognitive facet to understand an individual's self-perception of performance. Methods Employing the ADDIE instructional design model, comprising Analysis, Design, Development, Implementation and Evaluation phases, the present study focused on the initial four phases. In the Analysis-phase, the needs and objectives for creating a context-based WM task were identified. Design-phase included task conceptualization and content validation of the conceptualized context-based WM task. In the Develop-phase, the designed context-based WM task was developed in an animated video format. Five content experts and fifteen lay experts were involved in the content validation process. In the Implementation-phase, a pilot study was done on ten adults to assess the feasibility of the novel context-based WM task. Results The task obtained good content validation index and understandability scores on the Patient Education Materials Assessment Tool. Preliminary data trends from the implementation-phase revealed the task's potential to detect age-related WM differences. Significantly correlated with established WM tasks, the novel Activity Ordering Task (AOT) effectively measured WM-spans. Observed discrepancies between performance and prediction/postdiction spans during metacognitive facet administration highlighted the AOT's utility in evaluating metacognition. Conclusion Addressing the limitations of context in traditional tasks, the AOT appears to be a promising tool that not only measures WM but also assesses metacognition, thereby enhancing its utility beyond an everyday WM assessment.

Introduction: Knee joint problems, such as Osteoarthritis (OA), primarily affect the upper weight-bearing end of the tibia. Total and unicompartmental knee arthroplasty are commonly performed as treatment options. However, existing studies on morphometric assessment of the knee joint mainly focus on the Western population, with a lack of data among the Indian population. Obtaining such data is crucial for designing tibial components of knee prostheses tailored to the Indian population. Aim: To compare the morphometric data of the upper end of the tibia between the North and East Indian populations. Materials and Methods: A cross-sectional observational study was conducted in the Department of Anatomy at FMHS Medical College, SGT University, Gurugram, Haryana, North India, involving 41 dry tibias, and at Medical College and Hospital Kolkata in East India, involving 43 dry tibias. Measurements of the Anteroposterior (AP) and Transverse Diameters (TD) of the Medial Tibial Condyle (MTC), Lateral Tibial Condyle (LTC), and Total Tibial Condyles (TTC) were performed using digital Vernier callipers with a least count of 0.01 mm. The data was statistically analysed using Statistical Package for Social Sciences (SPSS) (version 21.0), and Student’s t-test was applied, with p

ObjectiveTo estimate the proportion of SARS-CoV-2 infected children experiencing hospitalization, intensive care unit (ICU) admission, severe outcomes, and death.Data SourcesPubMed, Embase, and MedRxiv were searched for studies published between December 1, 2019 and May 28, 2021. References of relevant systematic reviews were also screened.Study SelectionWe included cohort or cross-sectional studies reporting on at least one outcome measure (i.e., hospitalization, ICU admission, severe outcomes, death) for ≥100 children ≤21 years old within 28 days of SARS-CoV-2 positivity; no language restrictions were applied.Data Extraction and SynthesisTwo independent reviewers performed data extraction and risk of bias assessment. Estimates were pooled using random effects models. We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.Main Outcomes and MeasuresPercentage of SARS-CoV-2 positive children experiencing hospitalization, ICU admission, severe outcome, and death.Results118 studies representing 3,324,851 SARS-CoV-2 infected children from 68 countries were included. Community-based studies (N = 48) reported that 3.3% (95%CI: 2.7–4.0%) of children were hospitalized, 0.3% (95%CI: 0.2–0.6%) were admitted to the ICU, 0.1% (95%CI: 0.0–2.2%) experienced a “severe” outcome and 0.02% (95%CI: 0.001–0.05%) died. Hospital-based screening studies (N = 39) reported that 23.9% (95%CI: 19.0–29.2%) of children were hospitalized, 2.9% (95%CI: 2.1–3.8%) were admitted to the ICU, 1.3% (95%CI: 0.5–2.3%) experienced a severe outcome, and 0.2% (95%CI: 0.02–0.5%) died. Studies of hospitalized children (N = 31) reported that 10.1% (95%CI: 6.1–14.9%) of children required ICU admission, 4.2% (95%CI: 0.0–13.8%) had a severe outcome and 1.1% (95%CI: 0.2–2.3%) died. Low risk of bias studies, those from high-income countries, and those reporting outcomes later in the pandemic presented lower estimates. However, studies reporting outcomes after May 31, 2020, compared to earlier publications, had higher proportions of hospitalized patients requiring ICU admission and experiencing severe outcomes.Conclusion and RelevanceAmong children tested positive for SARS-CoV-2, 3.3% were hospitalized, with rates being higher early in the pandemic. Severe outcomes, ICU admission and death were uncommon, however estimates vary by study population, pandemic timing, study risk of bias, and economic status of the country.Systematic Review RegistrationPROSPERO, identifier [CRD42021260164].

BackgroundHealthcare workers, including residents, are prone to various mental health disorders especially given the context of the COVID-19 pandemic. Residents, particularly, are already under undue stress due to their respective training program demands.MethodsThis cross-sectional, online survey-based study from August to November 2020 collected demographic and mental health measurements from all residents at the Aga Khan University Hospital, Nairobi. The questionnaire investigated demographic variables, information regarding direct care of COVID-19 patients, prior history of mental health and mental health outcomes using the Patient Health Questionnaire, Generalized Anxiety Disorder scale, Insomnia Severity Index, Impact of Event Scale-Revised Questionnaire and Stanford Professional Fulfillment Index Questionnaire.ResultsA total of 100 residents completed the survey (participation rate 77.5%). Participants were about equal in gender (women [53%]), with a median age of 31.28 years, and majority were single (66.7%). A total of 66 participants (66%) were directly engaged in COVID-19 care. Depression: 64.3%, anxiety: 51.5%, insomnia: 40.5%, distress: 35.4%, and burnout: 51.0% were reported in all participants. Statistical significance was found in median depression, professional fulfillment and interpersonal disengagement when comparing frontline resident directly involved in care of COVID-19 patient versus second line residents.ConclusionResidents directly involved with caring for COVID-19 patients had statistically higher incidences of depression and interpersonal disengagement and lower professional fulfillment compared to second line residents. Keeping in mind the limited resources in sub-Saharan Africa, urgent and geographically specific strategies are needed to help combat mental health disorders in this specific population.

This is a case report of unilateral bifid ureter with Double Superior Vena Cava (DSVC) which was observed during the routine dissection on a 60-year-old male cadaver. The finding is of interest due to the presence of urogenital and vascular anomalies. The case belonged to the category of incomplete double renal pelvis and ureter along with a Persistent Left Superior Vena Cava (PLSVC) with an enlarged coronary sinus and a normal Right Superior Vena Cava (RSVC). Incomplete double ureter with the angled point of junction of the two ureters creates a narrowing that can further obstruct normal flow, predisposing to uretero-ureteric reflux and associated complications such as hydronephrosis, as well as increases the possibility of ureteral injury during surgery. PLSVC is usually an insignificant finding, however, its presence makes it difficult for insertion of central venous catheter via left internal jugular vein and is important to surgeons and interventionalists.

Mobile ad hoc network (MANET) is now days become very famous due to their fixed infrastructure-less quality and dynamic nature. They contain a large number of nodes which are connected and communicated to each other in wireless nature. Mobile ad hoc network is a wireless technology that contains high mobility of nodes and does not depend on the background administrator for central authority, because they do not contain any infrastructure. Nodes of the MANET use radio wave for communication and having limited resources and limited computational power. The Topology of this network is changing very frequently because they are distributed in nature and self-configurable. Due to its wireless nature and lack of any central authority in the background, Mobile ad hoc networks are always vulnerable to some security issues and performance issues. The security imposes a huge impact on the performance of any network. Some of the security issues are black hole attack, flooding, wormhole attack etc. In this paper, we will discuss issues regarding low performance of Watchdog protocol used in the MANET and proposed an improved Watchdog mechanism, which is called by I-Watchdog protocol that overcomes the limitations of Watchdog protocol and gives high performance in terms of throughput, delay.

Studies on population assessment and threat categorization in selected populations of Malaxis acuminate D. Don., a rare, terrestrial, endangered medicinal orchid of Himalayan region and an important "Astverga" plant were undertaken. Status was determined on site-to-site basis as well as for entire Kumaun region. Based on species occurrence in selected areas, the species were identified as critically endangered to endangered in different sites studied. The results also revealed that natural distribution of the species was narrowing down due to habitat destruction and over exploitation. Immediate remedial measures are needed for the conservation of natural sites to ensure sustainable mode of utilization.

Background: Ultrasonography is the diagnostic method of choice for visualization and rational work-up of abdominal organs. The dilatation of the common bile duct helps distinguish obstructive from non-obstructive causes of jaundice. Availability of normal measurements of the common bile duct is therefore important. There exists significant variations in the anthropometric features of various populations, regions and races. Aim: Study was conducted to obtain data on sonographically measured diameters of common bile duct in a series of normal Rajasthani population and to measure its correlation with age, sex and anthropometry. Setting and Design: Cross-sectional hospital-based study conducted at Mahatma Gandhi Medical College and Hospital, Jaipur, India. Materials and Methods: Study included 200 participants with equal proportion belonging to either sex. Common bile duct was measured at three locations- at the porta hepatis, in the most distal aspect of head of pancreas and mid-way between these points. Anthropometric measurements including height, weight, chest circumference, circumference at transpyloric plane, circumference at umbilicus and circumference at hip were obtained using standard procedures. Statistical Analysis: Univariable analysis with measures of frequency and standard deviation and bivariable analysis using correlation. Results: Mean age of study subjects was 34.5 years (Range 18- 85 years). Mean diameters of the common bile duct in the three locations were: proximal, 4.0 mm (SD 1.02 mm); middle, 4.1 mm (SD 1.01 mm); and distal, 4.2 mm (SD 1.01 mm) and overall mean for all measures 4.1 mm (SD 1.01 mm). Average diameter ranged from 2.0 mm to 7.9 mm, with 95 percent of the subjects having a diameter of less than 6 mm. We observed a statistically significant relation of common bile duct with age, along with a linear trend. There was no statistically significant difference in common bile duct diameter between male and female subjects. The diameter did not show any statistically significant correlation with any of the anthropometric measurements. Conclusion: Our study reported the upper limit of normality as 7.9 mm. The diameter increased progressively from 3.9 mm among those aged 18-25 years to 4.7 mm among those in the age group more than 55 years. This was found to be statistically significant. Ductal diameters beyond these limits should prompt the need for further investigations.