LiDAR-based reference aboveground biomass maps for tropical forests of South Asia and Central Africa.

Accurate mapping and monitoring of tropical forests aboveground biomass (AGB) is crucial to design effective carbon emission reduction strategies and improving our understanding of Earth's carbon cycle. However, existing large-scale maps of tropical forest AGB generated through combinations of Earth Observation (EO) and forest inventory data show markedly divergent estimates, even after accounting for reported uncertainties. To address this, a network of high-quality reference data is needed to calibrate and validate mapping algorithms. This study aims to generate reference AGB datasets using field inventory plots and airborne LiDAR data for eight sites in Central Africa and five sites in South Asia, two regions largely underrepresented in global reference AGB datasets. The study provides access to these reference AGB maps, including uncertainty maps, at 100 m and 40 m spatial resolutions covering a total LiDAR footprint of 1,11,650 ha [ranging from 150 to 40,000 ha at site level]. These maps serve as calibration/validation datasets to improve the accuracy and reliability of AGB mapping for current and upcoming EO missions (viz., GEDI, BIOMASS, and NISAR).

Obstacles to Early Diagnosis and Treatment of Pruritus in Patients with Chronic Kidney Disease: Current Perspectives.

Chronic kidney disease-associated pruritus (CKD-aP) is a common condition amongst patients with advanced chronic kidney disease (CKD). Several studies have confirmed that more than four out of ten early-stage CKD patients suffer from this condition, while its prevalence among CKD patients on dialysis reaches up to seven out of ten. It is noted to be associated with other disabling symptoms and serious outcomes. It has significant impact on sleep, mood, daily activities, and quality of life of CKD patients, and increased mortality risk of patients on hemodialysis. The Dialysis Outcomes and Practice Patterns Study found 17% higher mortality among patients with moderate to extreme pruritus compared with patients with no or mild pruritus. Despite its high prevalence, ill-effect, and suffering associated with it, CKD-aP remains surprisingly under-reported on the patient's part and under-recognized by the healthcare team. Even upon being noticed, it remains unattended and poorly treated. Its etiopathogenesis is complex and not fully understood. Many treatment options are available but good quality evidence about most of those is absent, and to date, only two medications are approved for use in this condition. While a validated guideline is very much required for the benefit of the patients and caretakers, further research on several aspects of this issue is required.

Cost-Effectiveness of Home Hemodialysis With Bedside Portable Dialysis Machine "DIMI" in the United Arab Emirates.

Background and objective The incidence and prevalence of patients requiring renal replacement therapies (RRTs) are increasing worldwide and a large number of these patients die prematurely due to the unavailability of treatment. While in-center hemodialysis remains the most commonly practiced modality globally, more and more patients find it unsuitable due to their frail condition, difficulty in ambulation, and time lost in traveling, etc. Such patients find the self-administered or nurse-assisted home hemodialysis (NAHHD) more suitable. The costly and recurring nature of these therapies prompted us to evaluate and compare the cost-effectiveness aspect of these two treatment modalities. Thus, the aim of the study was to investigate if home hemodialysis (HHD) with a portable hemodialysis machine was cost-effective in comparison to in-center hemodialysis for patients of end-stage renal failure (ESRF) in the United Arab Emirates (UAE). This is the first study of its kind to be conducted in the UAE. Methodology The study topic was developed based on an informal inquiry from the health regulator of Abu Dhabi if HHD was cost-effective compared to in-center hemodialysis with an emphasis on a portable dialysis machine. No such head-to-head study performed in the UAE was available. Hence, a systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) design was chosen as the investigative method. An outline of the study was drafted, and a literature search of Science of Web, PubMed, and Cochrane Evidence was performed using the keywords "Home Hemodialysis", "home-based Dialysis", "Cost-effectiveness of Dialysis", "Cost-effectiveness of renal replacement therapy", etc. A review of the article titles was performed to include the articles relevant to the cost of RRTs and the economic burden of ESRF. Full text and abstracts of those articles were retrieved, studied, and, the articles that were found not relevant were excluded. The remaining articles were studied and used in the evidence synthesis. DIMI was chosen to represent a standard type of recently developed portable dialysis machines. Results It was interesting to find out during the review that HHD and in-center hemodialysis had been developed simultaneously but the former had eventually fallen out of favor. The review revealed that HHD is not only as effective as in-center hemodialysis but is also associated with better survival benefits over the latter. Several studies have found it to be significantly cost-effective compared to in-center hemodialysis. Newer types of HHD machines make it easier for the patients or their family/caregivers to administer it safely and effectively at home and while traveling. They have regenerated interest in HHD and the Medicare administration in the USA has already decided to make use of it at a more frequent rate. Conclusion Based on the evidence in the available literature, HHD is cost-effective when compared to in-center hemodialysis in terms of survival benefits, quality of life (QoL) of patients, and monetary savings. Newer portable bedside dialysis machines provide better safety and have simplified the procedure of hemodialysis, making HHD more acceptable to patients and caregivers. We believe HHD should be the preferred modality of treatment instead of in-center hemodialysis, and that applies to UAE too.

Estimation of gross primary production of irrigated maize using Landsat-8 imagery and Eddy Covariance data.

A study was conducted to understand the potential of Landsat-8 in the estimation of gross primary production (GPP) and to quantify the productivity of maize crop cultivated under hyper-arid conditions of Saudi Arabia. The GPP of maize crop was estimated by using the Vegetation Photosynthesis Model (VPM) utilizing remote sensing data from Landsat-8 reflectance (GPPVPM) as well as the meteorological data provided by Eddy Covariance (EC) system (GPPEC), for the period from August to November 2015. Results revealed that the cumulative GPPEC for the entire growth period of maize crop was 1871 g C m-2. However, the cumulative GPP determined as a function of the enhanced vegetation index - EVI (GPPEVI) was 1979 g C m-2, and that determined as a function of the normalized difference vegetation index - NDVI (GPPNDVI) was 1754 g C m-2. These results indicated that the GPPEVI was significantly higher than the GPPEC (R2 = 0.96, P = 0.0241 and RMSE = 12.6%). While, the GPPNDVI was significantly lower than the GPPEC (R2 = 0.93, P = 0.0384 and RMSE = 19.7%). However, the recorded relative error between the GPPEC and both the GPPEVI and the GPPNDVI was -6.22% and 5.76%, respectively. These results demonstrated the potential of the landsat-8 driven VPM model for the estimation of GPP, which is relevant to the productivity and carbon fluxes.

X-Ray Diffraction of different samples of Swarna Makshika Bhasma.

INTRODUCTION: Shodhana and Marana are a series of complex procedures that identify the undesirable effects of heavy metals/minerals and convert them into absorbable and assimilable forms. Study on the analytical levels is essential to evaluate the structural and chemical changes that take place during and after following such procedures as described in major classical texts to understand the mystery behind these processes. X-Ray Diffraction (XRD) helps to identify and characterize minerals/metals and fix up the particular characteristics pattern of prepared Bhasma. AIM: To evaluate the chemical changes in Swarna Makshika Bhasma prepared by using different media and methods. MATERIALS AND METHODS: In this study, raw Swarna Makshika, purified Swarna Makshika and four types of Swarna Makshika Bhasma prepared by using different media and methods were analyzed by XRD study. RESULTS: XRD study of different samples revealed strongest peaks of iron oxide in Bhasma. Other phases of Cu2O, FeS2, Cu2S, FeSO4, etc., were also identified in many of the samples. CONCLUSION: XRD study revealed that Swarna Makshika Bhasma prepared by Kupipakwa method is better, convenient, and can save time.

Effect of ethnicity on head form anthropometry of 17-26 year old normal population in Eastern Nepal

The human body dimensions are affected byecological, geographical, populational, sex andage- related factors. Craniometry has wide applications in Forensic Medicine, Plastic Surgery, Orthodontics, Archeology and identification of the origins of ethnical groups. This study was designed to determine the influence of ethnicity on head forms present in adult males and females of Eastern Nepal. This non-interventional comparative cross-sectional study was conducted in a normal healthy pure ethnic population with a sample size of 600 (300 male and 300 female)belonging to a 17-26 age group in the Sun sari and Morang districts of Eastern Nepal. Data were collected among each ethnic group, i.e., Indigenous, Indo-Nepalese and Tibeto-Nepalese, each consisting of 200 individuals (100 male and 100female) between November 2010 to January2012. The Maximum Head Length in mm and Maximum Head Breadth in mm were measured, and Cranial Indices were calculated. Anova and independent t-test were used to compare the means among different groups. A 'P' value o f 0.05 was considered to be statistically significant. Both males and females of Eastern Nepal were Brachycephalic (81.16±3.16 and 81.85±3.02 respectively). The CI of Tibeto-Nepalese, Indigenous and Indo-Nepalese was 84.75±0.99(Brachycephalic), 82.17±1.17 (Brachycephalic), and 77.60±0.65 (Mesocepalic) respectively. The CI were 84.70±1.06 (Brachycephalic), 81.42±1.10 (Brachycephalic) and 77.35±0.67 (Mesocephalic) for Tibeto-Nepalese, Indigenous and Indo-Nepalese males. The CI were 84.80±0.91 (Brachycephalic), 82.92±0.63 (Brachycephalic) and 77.85±0.52 (Mesocephalic)for Tibeto-Nepalese, Indigenous and Indo-Nepalese females respectively. The results showed ethnic variations in all parameters, indicating the influence of ethnicity on cranial anthropometry

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Analytical study of raw Swarna Makshika (Chalcopyrite) and its Bhasma through TEM and EDAX.

Ayurveda, the Indian System of Medicine deals with a number of metals and minerals. Swarna Makshika (SM), a chalcopyrite one such minerals has iron (Fe), copper (Cu), and sulphur (S) as major ingredients along with other trace elements of therapeutic importance. Studies related with characterization of SM are very few. In the current study SM and SM Bhasma were analysed through Transmission Electron Microscope (TEM) and Energy Dispersive X-Ray Analysis (EDAX). Analysis reveals the presence of iron, copper, and sulphur in SM. In addition to these elements, SM Bhasma found to contain Potassium, Magnesium, Aluminum, and Silicon in trace amount. TEM study reveals that, grain size of the SM (5-10 microns) is significantly reduced in SM Bhasma to 50-200 nm.

Prison, a missing target to address issues related to drug detoxification and rehabilitation: Nepalese experiences.

PURPOSE: Drug use has numerous consequences on health, the economy, culture and the peace and security of families and communities. Drug users often engage in various criminal activities, including drug dealing, to sustain their drug use. Under Nepalese law, consumption, possession and sale of drugs are illegal, which increases the risk of incarceration for drug users. DESIGN/METHODOLOGY/APPROACH: Using a phenomenological/qualitative approach, the paper explores how various activities can lead to the arrest of drug users, how they cope without taking drugs in custody and prison and how they plan abstinence after release. FINDINGS: Participants engaged in various categories of criminal activity, including stealing, looting, etc. Most of the drug users were in custody and prison at least once. Drug use relapses led the participants to re-engage in criminal activities including drug dealing. Parents were often overburdened by their sons and daughter's drug use and were worried about their repeated relapses. Finally, some parents negotiated with their sons and daughters to keep them in prison where they would be able to stay without taking drugs and their involvement in crimes and conflicts would decrease. ORIGINALITY/VALUE: Keeping substance abusers in prison does not appear to be an effective strategy, as many participants relapse after release from prison. However, a prison-based educational and health promotion strategy would be beneficial for drug users to develop knowledge and skills on staying drug-free. However, to date, no effort has been made to provide such services to drug users and develop their coping strategy after release.

A critical study of Rasamritam and it's applied aspects.

Historical studies of Rasa shastra reveal the use of metals and minerals, both for alchemical and therapeutical purposes in ancient past. But, gradually the alchemical use of the subject, declines and the therapeutical use takes over. Rasamritam is the latest doctrine in the field of Rasa shastra which compiles the extract of the older books and adopted some new and contemporary concepts. The practical aspects of this text influence both the academicians as well as physicians in large extent. Keeping the wealthier, timely concept of this text in mind, we are trying to review and analyze it critically for the benefit of researchers and practitioners and hope the idea will be fruitful.

Preoperative chemotherapy for operable breast cancer is associated with better compliance with adjuvant therapy in matched stage II and IIIA patients.

INTRODUCTION: Preoperative chemotherapy (PC) for operable breast cancer has shown significant benefits in prospective trials. Many patients are treated in the community setting and some may question the applicability of PC outside the university setting. METHODS: Retrospective review was performed of stage II and IIIA breast cancer patients treated from January 2002 to July 2009. Fifty-three of 57 patients who underwent PC were matched based on age, tumor size, and hormone receptor status with 53 patients who did not undergo PC. Differences in patient compliance with physician recommendations for all types of adjuvant therapy were evaluated. Crude odds ratios and adjusted odds ratios derived from conditional logistic regression models were calculated. RESULTS: There were 106 patients included. Patient compliance with chemotherapy was better in the PC group than in the adjuvant chemotherapy (AC) group (100% versus 70%; p = .0001). Similarly, more patients in the PC group completed radiation therapy (96% versus 65%; p = .0003) and initiated hormonal therapy (100% versus 62%; p = .0001). Conditional logistic regression revealed that higher pathologic stage and current cigarette smoking were associated with poorer compliance with chemotherapy. For radiation therapy, the univariate model revealed that compliance with chemotherapy and being employed were associated with completion of radiation, whereas current cigarette smoking and larger pathologic size were associated with poorer compliance with radiation. For hormonal therapy, current cigarette smokers were more likely to be noncompliant with initiation of hormonal therapy. CONCLUSIONS: PC for operable breast cancer can improve patient compliance with chemotherapy. Current cigarette smokers were more likely to be noncompliant with all types of adjuvant therapy.

Preoperative chemotherapy for operable breast cancer improves surgical outcomes in the community hospital setting.

BACKGROUND: Preoperative chemotherapy (PC) for operable breast cancer has demonstrated significant benefits in clinical trials. Many patients are treated in the community setting and some may question the applicability of PC outside the university setting. The potential benefits of PC in terms of surgical outcomes in a community practice were examined. METHODS: A retrospective review was performed of stage II and stage IIIA breast cancer patients from January 1, 2002 to July 31, 2009. Surgical outcomes of margin status, volume of lumpectomy, rate of lumpectomy, and re-excision lumpectomy were evaluated. RESULTS: There were 212 patients included. Seventy-nine percent of patients who underwent PC had a clinical response and 25% had a pathologic complete response. For clinical stage T2 and stage T3 tumors, the PC group underwent lumpectomy more often than patients in the adjuvant chemotherapy (AC) group (78% versus 50%; p = .016 and 60% versus 29%; p = .015, respectively). The rate of close or positive margins in the PC group was half the rate in the AC group (23% versus 46%; p = .04) and this resulted in fewer re-excisions (p = .01). The volume of tissue removed was also smaller in the PC group (143.6 cm³ versus 273.9 cm³; p = .003). Conclusions. PC for operable breast cancer can significantly improve surgical outcomes in community-based practice.

Disparity in health care: HIV, stigma, and marginalization in Nepal.

BACKGROUND: The provision of effective health care to people with HIV and those from usually marginalised backgrounds, such as drug users and sex workers is a growing concern in Nepal, because these populations often do not seek health care, as willingly as the general population. Exploration of the factors, which hinder them seeking health care is crucial. The 'lived' experiences of the usually marginalized participants in this research will reflect on the constraining factors, and contribute to the development of appropriate strategies, which will facilitate people with HIV and other marginal populations to seek more readily appropriate health services. METHODS: This study explored the healthcare-seeking experiences of 20 HIV-positive participants in Nepal, as well as 10 drug-using participants who had never had an HIV test and did not know their HIV status. Using grounded theory, this study investigated the perceptions and experiences of HIV-positive persons, or those perceived to be at risk for HIV, as they sought health care services in locations around Kathmandu Valley. RESULTS: Health professionals were perceived to lack knowledge and sensitivity in providing health care to often marginalized and stigmatized injecting drug users, sex workers and HIV-positive people. Stigma and marginalization seem to interfere with doctors' and other health professionals' decisions to voluntarily treat persons who they perceive to be at high risk for HIV infections. Doctors and other health professionals appear suspicious, even unaware, of contemporary biomedical knowledge as it relates to HIV. The fear that certain marginalized groups, such as injecting drug users and sex workers, would be infected with HIV has further intensified stigma against these groups. CONCLUSION: The study identified the beginning of a change in the experiences of HIV-positive people, or those at risk of HIV, in their seeking of health care. With focused, contemporary HIV education and training, the beginning of positive changes in the knowledge base and attitude of health providers seemed to be apparent to some participants of this study.

Diffuse large B-cell lymphoma presenting as multiple lymphomatous polyposis of the gastrointestinal tract.

Primary gastrointestinal (GI) lymphomas constitute 5%-10% of all gastrointestinal tumors. Involvement of the entire GI tract as multiple polypoid lesions is very rare. Multiple lymphomatous polyposis is a distinctive and rare type of malignant GI lymphoma. Multiple lymphomatous polyposis is thought to represent mantle cell lymphoma of the GI tract. Approximately 60 cases of MLP have been reported so far. We report the first case of diffuse large B-cell lymphoma presenting as multiple lymphomatous polyposis of the GI tract in a 49-year-old patient with HIV and describe the clinicopathologic features. The patient was treated with a combination therapy of highly active antiretroviral therapy and CHOP (cyclophosphamide/doxorubicin/vincristine/prednisone) and exhibited complete remission.

Karyotype revealed 47, xxy chromosome (Klinefelter syndrome): a case report.

The Klinefelter syndrome is most common chromosomal cause of male infertility. However, the many cases of the syndrome remain undiagnosed due to variations in clinical presentation. A patient attended to surgical OPD with complaints of loss of secondary sexual characteristics and infertility. Physical examination revealed tall stature, thin built, small testes size, and absence of beard and pubic hairs. Karyotype and biochemical tests were performed to detect chromosomal abnormality as well hormonal level to confirm the diagnosis of androgen deficiency syndrome. Chromosomal complement confirmed the case of Klinefelter syndrome (47, XXY) causing androgen deficiency. Timely detection of Klinefelter syndrome is important to formulate further treatment modalities for the benefit of the patient.

Effect of phosphamidon on the testes of albino rats: a histological study.

The present study shows the qualitative and quantitative histological changes in testes of albino rats treated with two doses of phosphamidon 35 and 50 parts per million(ppm) for 1 month time period. Rats were treated by drinking water containing 35 ppm (low dose) and 50ppm (high dose) concentration of phosphamidon for 30 days. After 30 days, they were sacrificed, the testes were fixed in vivo and were taken out. The histological slides of these testes were prepared and were studied under light microscope. The decrease in the weight of testes and diameter of seminiferous tubules, increase in the interstitial space, the decrease in the numbers of germ cells and supporting cells, Cytoplasmic vacuolization of the germ cells, distortion of seminiferous tubules were the findings of present study. phosphamidon seems to be toxic on male reproductive system if exposed for prolong period. The awareness regarding the impact of phosphamidon should be given to farmer and they should be encouraged to practice biological means to control pests and herbs instead of these harmful chemical compounds.

Unusual venous drainage of face: a case report.

Facial region has enormous blood supply. The maxillary vein, facial vein and superficial temporal vein are chief venous draining channels. There are numerous reports of unusual venous system of face, in the present case, retromandibular vein divides into anterior and posterior division soon after its formation, external carotid artery lying lateral to retromandibular vein, formation of common venous channel between internal jugular vein and anterior jugular vein where facial, lingual and submental vein drain.