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Scrub typhus, a vector-borne bacterial infection, is an important but neglected disease globally. Accurately characterizing the burden is challenging because of nonspecific symptoms and limited diagnostics. Prior seroepidemiology studies have struggled to find consensus cutoffs that permit comparisons of estimates across contexts and time. In this study, we present a novel approach that does not require a cutoff and instead uses information about antibody kinetics after infection to estimate seroincidence. We use data from three cohorts of scrub typhus patients in Chiang Rai, Thailand, and Vellore, India, to characterize antibody kinetics after infection and two population serosurveys in the Kathmandu Valley, Nepal, and Tamil Nadu, India, to estimate seroincidence. The samples were tested for IgM and IgG responses to Orientia tsutsugamushi-derived recombinant 56-kDa antigen using commercial enzyme-linked immunosorbent assay kits. We used Bayesian hierarchical models to characterize antibody responses after scrub typhus infection and used the joint distributions of the peak antibody titers and decay rates to estimate population-level incidence rates in the cross-sectional serosurveys. Median responses persisted above an optical density (OD) of 1.8 for 23.6 months for IgG and an OD of 1 for 4.5 months for IgM. Among 18- to 29-year-olds, the seroincidence was 10 per 1,000 person-years (95% CI, 5-19) in Tamil Nadu, India, and 14 per 1,000 person-years (95% CI: 10-20) in the Kathmandu Valley, Nepal. When seroincidence was calculated with antibody decay ignored, the disease burden was underestimated by more than 50%. The approach can be deployed prospectively, coupled with existing serosurveys, or leverage banked samples to efficiently generate scrub typhus seroincidence estimates.

BackgroundHepatitis-E virus (HEV), an etiologic agent of acute inflammatory liver disease, is a significant cause of morbidity and mortality in South Asia. HEV is considered endemic in Nepal; but data on population-level infection transmission is sparse.MethodsWe conducted a longitudinal serosurvey in central Nepal to assess HEV exposure. At each visit, capillary blood samples were collected and analyzed for the presence of anti-HEV IgG antibodies. The study took place between February 2019 and April 2021, with up to 4 visits per participant approximately 6 months apart.ResultsWe collected 2513 samples from 923 participants aged 0-25 years, finding a seroprevalence of 4.8% and a seroincidence rate of 10.9 per 1000 person-years. Young adults and individuals consuming surface water faced the highest incidence of infection. Geospatial analysis identified potential HEV clusters, suggesting a need for targeted interventions.SignificanceOur findings demonstrate that HEV is endemic in Nepal and that the risk of infection increases with age.

BACKGROUND: Environmental surveillance, using detection of Salmonella Typhi DNA, has emerged as a potentially useful tool to identify typhoid-endemic settings; however, it is relatively costly and requires molecular diagnostic capacity. We sought to determine whether S. Typhi bacteriophages are abundant in water sources in a typhoid-endemic setting, using low-cost assays. METHODOLOGY: We collected drinking and surface water samples from urban, peri-urban and rural areas in 4 regions of Nepal. We performed a double agar overlay with S. Typhi to assess the presence of bacteriophages. We isolated and tested phages against multiple strains to assess their host range. We performed whole genome sequencing of isolated phages, and generated phylogenies using conserved genes. FINDINGS: S. Typhi-specific bacteriophages were detected in 54.9% (198/361) of river and 6.3% (1/16) drinking water samples from the Kathmandu Valley and Kavrepalanchok. Water samples collected within or downstream of population-dense areas were more likely to be positive (72.6%, 193/266) than those collected upstream from population centers (5.3%, 5/95) (p=0.005). In urban Biratnagar and rural Dolakha, where typhoid incidence is low, only 6.7% (1/15, Biratnagar) and 0% (0/16, Dolakha) river water samples contained phages. All S. Typhi phages were unable to infect other Salmonella and non-Salmonella strains, nor a Vi-knockout S. Typhi strain. Representative strains from S. Typhi lineages were variably susceptible to the isolated phages. Phylogenetic analysis showed that S. Typhi phages belonged to the class Caudoviricetes and clustered in three distinct groups. CONCLUSIONS: S. Typhi bacteriophages were highly abundant in surface waters of typhoid-endemic communities but rarely detected in low typhoid burden communities. Bacteriophages recovered were specific for S. Typhi and required Vi polysaccharide for infection. Screening small volumes of water with simple, low-cost (~$2) plaque assays enables detection of S. Typhi phages and should be further evaluated as a scalable tool for typhoid environmental surveillance.

Abstract Meteorological drought is one of the major natural hazards that affects the ecosystem of the Central Indian state of Chhattisgarh. This study delves into the analysis, comparison, and prediction of drought trends spanning the period from 1993 to 2023 in the study area. Employing a comprehensive methodology, utilization of the Modified Mann–Kendall test to analyze drought trends, while assessing drought severity through the Standardized Precipitation Index (SPI) and the Standardized Precipitation Evapotranspiration Index (SPEI) has been done. Further research entails assessing the link between SPI and SPEI utilizing the Pearson correlation coefficient and simple linear regression techniques. Additionally, the Support Vector Machine (SVM) and Random Forest (RF) methods were used for predictive modelling feasibility. The findings helped to deepen our understanding of drought dynamics in the region, providing important insights for drought mitigation and adaptation efforts. This study emphasizes the importance of using a variety of statistical techniques and machine learning algorithms to thoroughly analyze, compare, and forecast drought patterns, thereby informing evidence-based decision-making for sustainable water resource management and agricultural planning in Chhattisgarh, India.

ABSTRACTTyphoid fever is a significant public health concern with most of the sufferers between 15 and 25 y of age in Nepal. We undertook this study to demonstrate Vi polysaccharide conjugated with diphtheria toxoid (Vi-DT) conjugate vaccine which is non-inferior to Typbar typhoid conjugate vaccine, a Vi polysaccharide vaccine conjugated with tetanus toxoid (Vi-TT) with a focus on the adult population from Dhulikhel Hospital which was one of the total four sites in Nepal. In this study, we assigned the eligible participants in 1:1:1:1 ratio by block randomization, and stratified into three age groups (6 months to less than 2 y, 2 y to less than 18 y, and 18 y to 45 y), allotted to Group A, B, C, and D. Group A, B, and C received 25 μg (0.5 mL) of Vi-DT study vaccine and participants in Group D received 25 μg (0.5 mL) Vi-TT vaccine. We descriptively analyzed safety in all the participants receiving one dose of the investigational vaccine. The anti-Vi-IgG seroconversion rate in Vi-DT recipients was 99.71% (97.5% CI 98.04–99.96; 344 of 345 participants) and 99.13% (94.27–99.87; 114 of 115) in Vi-TT recipients which indicates that Vi-DT vaccine is non-inferior to Vi-TT vaccine. In safety aspect, 16.81% of total subject had at least one solicited adverse reaction and 22.61% of the Vi-TT participants experienced at least one solicited adverse reaction with most of them being local adverse reactions. None of the enrolled participants reported serious adverse events. Our study shows that a single dose of the Vi-DT vaccine is immunogenic, safe to administer and non-inferior to the Vi-TT vaccine four weeks after vaccination.

INTRODUCTION: Salmonella Typhi and Salmonella Paratyphi, fecal-oral transmitted bacterium, have temporally and geographically heterogeneous pathways of transmission. Previous work in Kathmandu, Nepal implicated stone waterspouts as a dominant transmission pathway after 77% of samples tested positive for Salmonella Typhi and 70% for Salmonella Paratyphi. Due to a falling water table, these spouts no longer provide drinking water, but typhoid fever persists, and the question of the diseases dominant pathway of transmission remains unanswered. METHODS: We used environmental surveillance to detect Salmonella Typhi and Salmonella Paratyphi A DNA from potential sources of transmission. We collected 370, 1L drinking water samples from a population-based random sample of households in the Kathmandu and Kavre Districts of Nepal between February and October 2019. Between November 2019 and July 2021, we collected 380, 50mL river water samples from 19 sentinel sites on a monthly interval along the rivers leading through the Kathmandu and Kavre Districts. We processed drinking water samples using a single qPCR and processed river water samples using differential centrifugation and qPCR at 0 and after 16 hours of liquid culture enrichment. A 3-cycle threshold (Ct) decrease of Salmonella Typhi or Salmonella Paratyphi, pre- and post-enrichment, was used as evidence of growth. We also performed structured observations of human-environment interactions to understand pathways of potential exposure. RESULTS: Among 370 drinking water samples, Salmonella Typhi was detected in 7 samples (1.8%) and Salmonella Paratyphi A was detected in 4 (1.0%) samples. Among 380 river water samples, Salmonella Typhi was detected in 171 (45%) and Salmonella Paratyphi A was detected in 152 (42%) samples. Samples located upstream of the Kathmandu city center were positive for Salmonella Typhi 12% of the time while samples from locations in and downstream were positive 58% and 67% of the time respectively. Individuals were observed bathing, washing clothes, and washing vegetables in the rivers. IMPLICATIONS: These results suggest that drinking water was not the dominant pathway of transmission of Salmonella Typhi and Salmonella Paratyphi A in the Kathmandu Valley in 2019. The high degree of river water contamination and its use for washing vegetables raises the possibility that river systems represent an important source of typhoid exposure in Kathmandu.

In the mobility market, there is a demand from customers for antimicrobial protection. As a result, the market has grown considerably to provide antiviral and antimicrobial polymers and coatings. This study examines how the efficacy of a non-commercial antimicrobial thermoplastic elastomer will change over the life of the application. Using an example application of an electric scooter handlebar grip, durability requirements were identified, and antiviral efficacy (exceeding a log value of 3 or >99.9 microbial growth reduction) was compared before and after testing. A scooter handlebar grip was selected as the ideal example application as it was a high-touch surface, with several different riders. During the start of this study, scooter companies were encouraging their riders to disinfect scooter handlebars before riding, use hand sanitizer, and wear gloves. If the handlebar grip could be antimicrobial, then they could eliminate these steps and provide a safe ride for the users. In order to simulate long-term durability, UV exposure, temperature, humidity, artificial sweat, sunscreen, insect repellent, and abrasion tests were performed and evaluated in terms of antiviral activity. Accelerated weathering reduced the virucidal activity of the sample versus unexposed antiviral thermoplastic elastomer (TPE). However, the efficacy increased with contact time from 90% to 96.83% at 30 and 120 min, respectively. Abrasion resistance of antiviral TPE showed a volume loss of 66 [mm.sup.3] compared to control samples of 83 [mm.sup.3]. The antiviral TPE sample exhibited slightly lower efficacy compared to the control after exposure to the artificial sweat (99.43% vs. 99.95%). Additionally, a skin tolerance test conducted on rabbits showed that antiviral TPE was not an irritant and showed no dermal toxicity. The outcome of this study will lead to the development of long-term durable antimicrobial material for the transportation industry. Highlights * The effectiveness of an antimicrobial material depends on various environmental factors. * Accelerated weathering of the antiviral TPE reduced the efficacy. * The antiviral TPE was non-irritating to the skin. * Significant research needs to continue in this area to provide safe and robust solutions. * This approach to antimicrobial incorporation can now be applied to the transportation industry. KEYWORDS aging, antiviral additives, thermoplastic elastomers, thermoplastics, 1 | INTRODUCTION The COVTD-19 pandemic has altered people's driving and travel habits and has dramatically increased the demand for cleanliness of a vehicle. Studies have shown that whether it [...]

Abstract Background The causative agents of Acute Encephalitis Syndrome remain unknown in 68–75% of the cases. In Nepal, the cases are tested only for Japanese encephalitis, which constitutes only about 15% of the cases. However, there could be several organisms, including vaccine-preventable etiologies that cause acute encephalitis, when identified could direct public health efforts for prevention, including addressing gaps in vaccine coverage. Objectives This study employs metagenomic next-generation-sequencing in the investigation of underlying causative etiologies contributing to acute encephalitis syndrome in Nepal. Methods In this study, we investigated 90, Japanese-encephalitis-negative, banked cerebrospinal fluid samples that were collected as part of a national surveillance network in 2016 and 2017. Randomization was done to include three age groups (15-years). Only some metadata (age and gender) were available. The investigation was performed in two batches which included total nucleic-acid extraction, followed by individual library preparation (DNA and RNA) and sequencing on Illumina iSeq100. The genomic data were interpreted using Chan Zuckerberg-ID and confirmed with polymerase-chain-reaction. Results Human-alphaherpes-virus 2 and Enterovirus-B were seen in two samples. These hits were confirmed by qPCR and semi-nested PCR respectively. Most of the other samples were marred by low abundance of pathogen, possible freeze-thaw cycles, lack of process controls and associated clinical metadata. Conclusion From this study, two documented causative agents were revealed through metagenomic next-generation-sequencing. Insufficiency of clinical metadata, process controls, low pathogen abundance and absence of standard procedures to collect and store samples in nucleic-acid protectants could have impeded the study and incorporated ambiguity while correlating the identified hits to infection. Therefore, there is need of standardized procedures for sample collection, inclusion of process controls and clinical metadata. Despite challenging conditions, this study highlights the usefulness of mNGS to investigate diseases with unknown etiologies and guide development of adequate clinical-management-algorithms and outbreak investigations in Nepal.

BACKGROUND: The Global Typhoid Genomics Consortium was established to bring together the typhoid research community to aggregate and analyse Salmonella enterica serovar Typhi (Typhi) genomic data to inform public health action. This analysis, which marks 22 years since the publication of the first Typhi genome, represents the largest Typhi genome sequence collection to date (n=13,000). METHODS: This is a meta-analysis of global genotype and antimicrobial resistance (AMR) determinants extracted from previously sequenced genome data and analysed using consistent methods implemented in open analysis platforms GenoTyphi and Pathogenwatch. RESULTS: Compared with previous global snapshots, the data highlight that genotype 4.3.1 (H58) has not spread beyond Asia and Eastern/Southern Africa; in other regions, distinct genotypes dominate and have independently evolved AMR. Data gaps remain in many parts of the world, and we show the potential of travel-associated sequences to provide informal sentinel surveillance for such locations. The data indicate that ciprofloxacin non-susceptibility (>1 resistance determinant) is widespread across geographies and genotypes, with high-level ciprofloxacin resistance (≥3 determinants) reaching 20% prevalence in South Asia. Extensively drug-resistant (XDR) typhoid has become dominant in Pakistan (70% in 2020) but has not yet become established elsewhere. Ceftriaxone resistance has emerged in eight non-XDR genotypes, including a ciprofloxacin-resistant lineage (4.3.1.2.1) in India. Azithromycin resistance mutations were detected at low prevalence in South Asia, including in two common ciprofloxacin-resistant genotypes. CONCLUSIONS: The consortiums aim is to encourage continued data sharing and collaboration to monitor the emergence and global spread of AMR Typhi, and to inform decision-making around the introduction of typhoid conjugate vaccines (TCVs) and other prevention and control strategies. FUNDING: No specific funding was awarded for this meta-analysis. Coordinators were supported by fellowships from the European Union (ZAD received funding from the European Unions Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie grant agreement No 845681), the Wellcome Trust (SB, Wellcome Trust Senior Fellowship), and the National Health and Medical Research Council (DJI is supported by an NHMRC Investigator Grant [GNT1195210]).

A lightweight strawberry detection and localization algorithm plays a crucial role in enabling the harvesting robot to effectively harvest strawberries. The YOLO model has often been used in strawberry fruit detection for its high accuracy, speed, and robustness. However, some challenges exist, such as the requirement for large model sizes, high computation operation, and undesirable detection. Therefore, the lightweight improved YOLOv5s-CGhostnet was proposed to enhance strawberry detection. In this study, YOLOv5s underwent comprehensive model compression with Ghost modules GCBS and GC3, replacing modules CBS and C3 in the backbone and neck. Furthermore, the default GIOU bounding box regressor loss function was replaced by SIOU for improved localization. Similarly, CBAM attention modules were added before SPPF and between the up-sampling and down-sampling feature fusion FPN–PAN network in the neck section. The improved model exhibited higher mAP@0.5 of 91.7% with a significant decrement in model size by 85.09% and a reduction in GFLOPS by 88.5% compared to the baseline model of YOLOv5. The model demonstrated an increment in mean average precision, a decrement in model size, and reduced computation overhead compared to the standard lightweight YOLO models.

Understanding disturbances that are of significant significance requires a critical focus on preventing forest degradation and addressing problems related to vegetation loss. Hence, the primary objective of this work was to examine the structure of species and the patterns of regeneration at various density gradients within the Achanakmar-Amarkantak Biosphere Reserve in India. This study involved the selection of one closed site (CS) and one open site (OS) from both the Mixed Sal Forest (MSF) and the Pure Sal Forest (PSF). In order to ascertain population structure and regeneration status, plants were classified into seedlings, saplings, and adults based on their Girth at breast height (GBH). The results of our study revealed that the population density of seedlings, saplings, and trees was higher in MSFCS (49250, 980, and 920 ind/ha) compared to PSFCS (41500, 740, 890 ind/ha), MSFOS (16750, 580, and 370 individuals ind/ha), and PSFOS (9750, 180, and 334 ind/ha). Both forests exhibited a reverse-J shaped curve in the CS and an interrupted reverse-J shaped curve in the OS of overall tree species. Nevertheless, the distribution curve at the species level displayed diverse patterns. For instance, Shorea robusta displayed irregular shapes in the OS of both forests, while Terminalia tomentosa displayed a bell-shaped GBH density distribution population curve across all the sites. Differences in regeneration status were observed among different tree species. At the four sites, 18.75% of the species showed good regeneration, 21.87% showed fair regeneration, and a substantial portion, 35.94%, displayed poor to no regeneration. Additionally, 23.44% of the species showed new regeneration. Among these species, Diospyros melanoxylon and Syzygium cumini showed strong regeneration capabilities, while Shorea robusta shown moderate regeneration potential. In the future, the population structure, dominance, and richness of the present tree community may undergo changes. Hence, it is imperative to conduct study on the survival of seedlings and use appropriate management techniques in order to guarantee the long-term viability of the forests.

BackgroundHepatitis-E virus (HEV), an etiologic agent of acute inflammatory liver disease, is a significant cause of morbidity and mortality in South Asia. HEV is considered endemic in Nepal; but data on population-level infection transmission is sparse.MethodsWe conducted a longitudinal serosurvey in central Nepal to assess HEV exposure. At each visit, capillary blood samples were collected and analyzed for the presence of anti-HEV IgG antibodies. The study took place between February 2019 and April 2021, with up to 4 visits per participant approximately 6 months apart.ResultsWe collected 2513 samples from 923 participants aged 0-25 years, finding a seroprevalence of 4.8% and a seroincidence rate of 10.9 per 1000 person-years. Young adults and individuals consuming surface water faced the highest incidence of infection. Geospatial analysis identified potential HEV clusters, suggesting a need for targeted interventions.SignificanceOur findings demonstrate that HEV is endemic in Nepal and that the risk of infection increases with age.

Abstract Biosensor nodes of a wireless body area network (WBAN) transmit physiological parameter data to a central hub node, spending a substantial portion of their energy. Therefore, it is crucial to determine an optimal location for hub placement to minimize node energy consumption in data transmission. Existing methods determine the optimal hub location by sequentially placing the hub at multiple random locations within the WBAN. Performance measures like link reliability or overall node energy consumption in data transmission are estimated for each hub location. The best-performing location is finally selected for hub placement. Such methods are time-consuming. Moreover, the involvement of other nodes in the process of hub placement results in an undesirable loss of network energy. This paper shows the whale optimization algorithm (WOA)-based hub placement scheme. This scheme directly gives the best location for the hub in the least amount of time and with the least amount of help from other nodes. The presented scheme incorporates a population of candidate solutions called "whale search agents". These agents carry out the iterative steps of encircling the prey (identifying the best candidate solution), bubble-net feeding (exploitation phase), and random prey search (exploration phase). The WOA-based model eventually converges into an optimized solution that determines the optimal location for hub placement. The resultant hub location minimizes the overall amount of energy consumed by the WBAN nodes for data transmission, which ultimately results in an elongated lifespan of WBAN operation. The results show that the proposed WOA-based hub placement scheme outperforms various state-of-the-art related WBAN protocols by achieving a network lifetime of 8937 data transmission rounds with 93.8% network throughput and 9.74 ms network latency.

As conventional direct connections of synchronous generators are being phased out, inverter-based resources (IBRs) with grid support functions are increasingly being integrated into power systems. This transition requires the development of accurate dynamic models for IBRs to predict how power systems will adapt to varying levels of IBRs penetration, establish grid code requirements, and ensure compliance. This study introduces an active probing signal-based data-driven modeling technique to accurately derive the dynamics model of a smart photovoltaic inverter operating in Volt-Watt and Freq-Watt modes, in compliance with the IEEE 1547–2018 standard. The paper focuses on investigating how the dynamics of the PV inverter model respond to fluctuations in solar irradiance, utilizing real-time digital simulator experimentation. The experimental analysis demonstrates that the amplitude of dynamics fluctuates with changes in irradiance across both operational modes and confirms the active power’s dependence on irradiance levels. Furthermore, the nature of inverter dynamics varies distinctly between the different modes of activation. Critically, our findings indicate that dynamic models require DC-gain adjustments to accommodate contrasting irradiance levels, highlighting a negative gradient linear relationship between the DC-gain of each model and the irradiance.

Energy storage systems (ESSs) are a flexible resource that will be vital to meet the aggressive clean energy targets of the future. However, the economic gains from ESSs can be limited due to large capital investments and monetization challenges. It is thus desirable to utilize ESSs for multiple techno-economic benefits to justify deployment costs. In this work, a framework to simultaneously dispatch ESSs for energy arbitrage and power quality applications is presented. More specifically, a model predictive control (MPC)-based framework that can dispatch energy storage to accomplish multiple techno-economic objectives is proposed. This is achieved without impacting market revenues while satisfying all power system and ESS constraints. Simulation results indicate that power quality applications such as voltage regulation and power factor correction can be stacked with arbitrage without significantly impacting arbitrage revenues and in some cases even improving the revenues. A controller-hardware-in-the-loop (CHIL) study of the proposed framework is also performed to demonstrate the practical feasibility of the framework.