Optimizing dialysis modalities for diabetic end-stage kidney disease: A focus on personalized care and resource-limited settings

Diabetes is the leading cause of chronic kidney disease(CKD)and end-stage kidney disease(ESKD)worldwide.While both haemodialysis(HD)and peritoneal dialysis(PD)are commonly used treatment options for ESKD,the choice of dialysis modality in diabetic ESKD patients remains a critical decision influenced by various patient-related,healthcare system,and socio-economic factors.This article examines the factors influencing the selection of dialysis modalities for diabetic patients,with a focus on the challenges and opportunities in low-resource settings.Key considerations include the impact of comorbidities such as peripheral arterial disease and CKD-related mineral bone disorder(MBD),as well as patient preferences,caregiver burden,and the availability of healthcare infrastructure.The article highlights the need for personalized approaches to dialysis selection,considering both clinical outcomes and quality of life.It also emphasizes the potential benefits of home dialysis,including home HD and PD,in improving patient autonomy and long-term survival.The article advocates for better government policies,increased awareness,and improved support systems to enhance the accessibility and efficacy of dialysis treatments,particularly in underserved populations.Further research comparing the outcomes of different dialysis modalities across diverse settings is essential to guide global treatment strategies for diabetic ESKD patients.

Preparedness,knowledge,and perception of nursing students about climate change and its impact on human health in India

Higher education plays an important role in all aspects of sustainability.Infusing climate change and sustainability into the curriculum is important to prepare future health-care professionals for climate change and sustainability actions to build resilient health systems.In this study,we evaluated the preparedness,knowledge,and perception regarding climate change and its impact on human health among Indian nursing students.A quantitative descriptive survey was conducted among 644 undergraduate nursing students studying in three institutes in the southern,northern,and western parts of India.We used a structured online questionnaire with established validity and reliability to collect data.The data were analyzed using Statistical Package for the Social Sciences version 26 software.The results showed that more than half of the students reported experiencing excessive increase(362;56.2%)and decrease(374;58.1%)in temperature in recent years.Though more than three quarters of the students(494;76.7%)accepted the general truth that climate change is mainly caused by human activities,only less than half of the students(309;48.0%)perceived the impact of climate change to be high.Three quarters of the students(483;75.0%)had a high level of knowledge regarding climate change.The students who had a high level of knowledge about climate change exerted a high perceived impact of climate change(χ^(2)=75.47;P<0.01).More than half of the students(50.9%)felt that they needed information about climate change to be included in the nursing curriculum,and only one sixth of the students(16.1%)were highly confident about engaging in climate change-related conversation with patients.Most of the students who participated in the study had basic knowledge about climate change and its impact on human health.However,there is an observed gap between knowledge and their preparedness and confidence to engage in climate change actions.Hence,we propose to strengthen the nursing curriculum by integrating various curricular and co-curricular activities related to climate change,so that future nurses are empowered to become climate change advocates.

Role of self-help groups on socioeconomic development and the achievement of Sustainable Development Goals(SDGs)among rural women in Cooch Behar District,India

This study examines the transformative role of self-help groups(SHGs)in the socioeconomic development of rural women in Cooch Behar District,India,and their contribution toward achieving Sustainable Development Goals(SDGs)of the United Nations.In this study,we explored the effect of SHGs on rural women by specifically addressing SDGs,such as no poverty(SDG 1),zero hunger(SDG 2),good health and well-being(SDG 3),quality education(SDG 4),and gender equality(SDG 5).Given this issue,a cross-sectional survey and comparison analyses are needed to assess the socioeconomic development of rural women and their awareness level before and after the participation of rural women in SHGs.The survey conducted as part of this study was divided into three sections,namely,demographic characteristics,socioeconomic development,and awareness level,with each focusing on different aspects.A group of 400 individuals who were part of SHGs completed the questionnaire survey form.The results showed that the participation of rural women in SHGs significantly improved their socioeconomic development and awareness level,as supported by both mean values and t test results.Memberships in SHGs and microcredit programs were the major elements that boosted the socioeconomic development of rural women,which also achieves SDGs 1,2,3,4,and 5.This study revealed that participation in SHGs and related financial services significantly aided rural women in economically disadvantaged communities in accumulating savings and initiating entrepreneurial ventures.Moreover,participation in SHGs was instrumental in enhancing the self-confidence,self-efficacy,and overall self-esteem of rural women.Finally,doing so enabled them to move more freely for work and other activities and to make family and common decisions.

Charting the course:India's health expenditure projections for 2035

Objectives Understanding past trends and forecasting future changes in health spending is vital for planning and reducing reliance on out-of-pocket(OOP)expenses.The current study analyzed health expenditure patterns in India and forecasted future trends and patterns until 2035.Methods Data on health expenditure in India from 2000 to 2019 was collected from the Organisation for Economic Co-operation and Development(OECD)iLibrary and National Health Accounts 2019 databases.Gross domestic product(GDP)data from the World Bank was also utilized.Descriptive statistics analyzed the composition and pattern,while the exponential smoothing model forecasted future health expenditures.Results The findings revealed that expenditure made by OOP is the primary health financing source,followed by government and pre-paid private spending.The percentage of GDP allocated to total health expenditure remains stable,while the per capita health expenditure fluctuates.Variations in expenditure among states are observed,with Karnataka relying heavily on pre-paid private coverage.Future projections suggest a decline in per capita and total health expenditure as a share of GDP,with a slight increase in the government’s share.Pre-paid private expenditure per capita and OOP health expenditure as a share of the total is projected to remain relatively constant but still high in absolute terms.Conclusion The study highlights variations in health spending in India,characterized by high OOP spending,limited public coverage,and a need for investments,and reforms to improve healthcare access and equity.

Offshore high-grade limemud resources of west coast of India:Economic potential and industrial applications

Limestone is one of the essential raw materials in the cement,paint,steel,ceramic,glass,chemical,pharmaceutical,paper,and fertilizer industries.In India,only 8%of the limestone resources are placed under the reserve category,of which 97%is of cement grade.Thus,India depends on imports to bridge the demand‐supply gap of steel,blast furnace,and chemical‐grade limestone.Efforts of Geological Survey of India(GSI)to locate alternate sources for limestone led to the discovery of enormous quantities of carbonate minerals called limemud from the continental shelf margin of the west coast of India.GSI carried out systematic studies to explore the nature of the disposition,quality,quantity,and suitability of the offshore limemud for various industrial applications.A preliminary estimate of resources using high‐resolution subbottom profiling and sediment core sample studies established the occurrence of more than 172 billion tonnes of high‐grade(The content of CaCO3 is greater than 80 wt%)limemud in 0.4–28.0m thick stratified sediment layers spread over an area of 18000 km2.Chemical,physical,mineralogical,beneficiation,and agglomeration studies found the offshore limemud as a potential replacement for limestone in the cement,filler,blast furnace,steel melting shop,lime production,paint,and Grade‐I steel industries.An assessment of mining and transportation costs indicates that the offshore limemud(USD 5–6/ton)is more cost‐effective than that imported from other countries(USD16‐18/ton).With several advantageous factors like low impurity,mode of occurrence in overburden‐free stratified form,fine‐grained slurry nature,and shallow water depth,sustainable mining of offshore limemud could be a future reality with controllable technological,economic,and environmental challenges.

Assessing the role of forest resources in improving rural livelihoods in West Bengal of India

Forest resources play a vital role in supporting the livelihoods of rural communities residing in forest-rich areas.In India,a forest-rich country,a significant proportion of non-timber forest products(NTFPs)is consumed locally,supporting numerous rural communities relying on forests for essential resources,such as firewood,timber,and NTFPs.This study focuses on two forest-dominant districts in West Bengal of India,namely,Jhargram District and Paschim Medinipur District.Furthermore,this study aims to enhance the understanding of forest-dependent communities by comparing the standard of living among different village classes.Thus,we categorized villages into three classes based on the distance from home to forests,including inner villages,fringe villages,and outer villages.Through focus group discussions and household surveys,we explored the sources of local economy,income sources of household,and reasons for economic diversification in different village classes.The study findings confirm that substantial variations existed in the income sources and the standard of living in these villages.Forest income varied dramatically among the three village classes,with inner villages having greater forest income than fringe villages and outer villages.Meanwhile,households in outer villages depended on forests and engaged in diverse economic activities for their livelihoods.Compared with inner and fringe villages,households in outer villages derived a significant portion of their income from livestock.This discrepancy can be attributed to challenges,such as inadequate transportation,communication,and underdeveloped market chains in inner villages.Moreover,these findings emphasize the need to develop sustainable forest management practices,create alternative income-generation opportunities,and improve infrastructure and market access in inner villages,as well as promote economic diversification in outer villages.Through targeted policy measures,these forest-rich regions can achieve improved livelihoods,enhanced standard of living,and increased resilience for their communities.

Gallbladder cancer:Progress in the Indian subcontinent

Gallbladder cancer(GBC)is one of the commonest biliary malignancies seen in India,Argentina,and Japan.The disease has dismal outcome as it is detected quite late due to nonspecific symptoms and signs.Early detection is the only way to improve the outcome.There have been several advances in basic as well as clinical research in the hepatobiliary and pancreatic diseases in the West and other developed countries but not enough has been done in GBC.Therefore,it is imp-ortant and the responsibility of the countries with high burden of GBC to find solutions to the many unanswered questions like etiopathogenesis,early diagn-osis,treatment,and prognostication.As India being one of the largest hubs for GBC in the world,it is important to know how the country has progressed on GBC.In this review,we will discuss the outcome of the publications from India highlighting the work and the developments taken place in past several decades both in basic and clinical research.

南亚三大安全挑战同频共振

In 2023, South Asia faced three major security challenges, namely, intensifying US efforts to incorporate South Asia into the “Indo–Pacific” strategy framework, the emergence of India's ambition to dominate South Asia, and the threat of a new round of violence and terrorism.

Epidemiology of EGFR Mutation in Adenocarcinoma NSCLC Patients in India: A Systematic Review and Meta-Analysis

Studies reporting the Indian prevalence of Epidermal Growth Factor Receptor (EGFR) mutation are mostly single centers with small sample sizes. This systematic review and meta-analysis summarized the available evidence of EGFR mutation epidemiology in Indian patients with adenocarcinoma (ADC) Non-Small Cell Lung Cancer (NSCLC). We conducted a structured literature search in PubMed, and EMBASE databases from January 2004 through October 2019. The primary outcome of interest was prevalence of EGFR mutation by gender, smoking status, and mutation subtype. The review included 34 studies. EGFR mutation prevalence was 39.5% in patients with ADC, and significantly higher in females, non-smokers, and patients with exon 19 deletions. The EGFR mutation frequency in Indian patients with ADC was higher than reported in Caucasians but at a lower range of that reported in East Asians. These findings support the use of EGFR mutation testing to guide choice of treatment.

Liver transplantation for hepatocellular carcinoma in India: Are we ready for 2040?

BACKGROUND Liver transplantation(LT)for hepatocellular carcinoma(HCC)has been widely researched and is well established worldwide.The cornerstone of this treatment lies in the various criteria formulated by expert consensus and experience.The variations among the criteria are staggering,and the short-and long-term outcomes are controversial.AIM To study the differences in the current practices of LT for HCC at different centers in India and discuss their clinical implications in the future.METHODS We conducted a survey of major centers in India that performed LT in December 2022.A total of 23 responses were received.The centers were classified as high-and low-volume,and the current trend of care for patients undergoing LT for HCC was noted.RESULTS Of the 23 centers,35%were high volume center(>500 Liver transplants)while 52%were high-volume centers that performed more than 50 transplants/year.Approximately 39%of centers had performed>50 LT for HCC while the percent distribution for HCC in LT patients was 5%–15%in approximately 73%of the patients.Barring a few,most centers were divided equally between University of California,San Francisco(UCSF)and center-specific criteria when choosing patients with HCC for LT,and most(65%)did not have separate transplant criteria for deceased donor LT and living donor LT(LDLT).Most centers(56%)preferred surgical resection over LT for a Child A cirrhosis patient with a resectable 4 cm HCC lesion.Positron-emission tomography-computed tomography(CT)was the modality of choice for metastatic workup in the majority of centers(74%).Downstaging was the preferred option for over 90%of the centers and included transarterial chemoembolization,transarterial radioembolization,stereotactic body radiotherapy and atezolizumab/bevacizumab with varied indications.The alphafetoprotein(AFP)cut-off was used by 74%of centers to decide on transplantation as well as to downstage tumors,even if they met the criteria.The criteria for successful downstaging varied,but most centers conformed to the UCSF or their center-specific criteria for LT,along with the AFP cutoff values.The wait time for LT from downstaging was at least 4–6 wk in all centers.Contrast-enhanced CT was the preferred imaging modality for post-LT surveillance in 52%of the centers.Approximately 65%of the centers preferred to start everolimus between 1 and 3 months post-LT.CONCLUSION The current predicted 5-year survival rate of HCC patients in India is less than 15%.The aim of transplantation is to achieve at least a 60%5-year disease free survival rate,which will provide relief to the prediction of an HCC surge over the next 20 years.The current worldwide criteria(Milan/UCSF)may have a higher 5-year survival(>70%);however,the majority of patients still do not fit these criteria and are dependent on other suboptimal modes of treatment,with much lower survival rates.To make predictions for 2040,we must prepare to arm ourselves with less stringent selection criteria to widen the pool of patients who may undergo transplantation and have a chance of a better outcome.With more advanced technology and better donor outcomes,LDLT will provide a cutting edge in the fight against liver cancer over the next two decades.

Prevalence of obesity,determinants,and its association with hyperglycaemia among community dwelling older adolescents in India

BACKGROUND Globally,obesity and diabetes mellitus(DM)are emergent public health concerns in the adolescent population.India,home to the largest adolescent population and the second largest diabetes cohort is experiencing rapid but unplanned urbanization,with accompanying unhealthy nutritional transition,and sedentary lifestyle.AIM To determine prevalence and determinants of obesity and hyperglycaemia and their association among community-dwelling older adolescents(15-19 years)in India.METHODS This cross-sectional analysis from the national family health survey-5 included data of 258028 adolescents aged 15-19 across India(2019-2021).The survey employed stratified two-stage sampling,with systematic random sampling in rural and urban areas.Statistical analysis included descriptive statistics,bivariate,and multivariable logistic regression,employing generalized linear models.RESULTS The weighted prevalence of DM was 1.09%including 0.77%[95%confidence interval(CI):0.72-0.83]previously diagnosed and 0.32%(95%CI:0.29-0.35)newly diagnosed cases detected on survey screening.On adjusted analysis,increasing age,higher education levels,higher wealth index,and overweight/obesity were the factors significantly associated with presence of DM.Only 61%of the adolescents with previously diagnosed DM were on anti-diabetes treatment.The weighted prevalence of overweight/obesity among older adolescents was 6.9%with significantly higher odds in the male sex,having higher educational levels,urban residence,and those with a higher wealth index.CONCLUSION Nearly one in hundred older adolescents in India have diabetes,with one in three undiagnosed.Strengthening DM screening and treatment access among adolescents through public health programs is urgently warranted.

First Known Case of Carcass Guarding by Black Kite (Milvus migrans) in Urban Landscape, North India

Behavioral traits of species can play an important role in the functioning of the ecosystem and in evolving behavioural adaptations to survive according to environmental conditions.This note documents evidence of adding a rare observation by providing photographic evidence of the entanglement of a carcass of a juvenile Black Kite(Milvus migrans)from a nest and the use of nest by an adult individual,guarding the carcass.Documenting such behavior contributes to our understanding of the natural history and management of native species in an urban environment.Further,scientific studies/observations are needed to be conducted to reach some conclusion as to why species perform such behaviour.

Vice-President Ai Ping Meets Secretary-General Saqib of India China Economic and Cultural Council

On March 26th,CAFIU Vice-President Ai Ping met Secretary-General Mohammed Saqib of the India China Economic and Cultural Council.The two sides exchanged views on China-lndia relations and people-to-people exchanges.Vice-President Ai Ping said that the development of relationship between two states is based on their peoples.Strengthening people-to-people exchanges between China and India and promoting mutual understanding between the peoples are important for the improvement of the relationship between the two countries.

Recent and Forthcoming Events

The‘Spring Cup’Table Tennisand Badminton International Championship Held by China Cultural Centerin Benin。On March 16,China Cultural Center in Benin,together with the Benin Badminton and Table Tennis Association,held the 2024"Spring Cup"Table Tennis and Badminton International Championship at the Palace of Arts,Entertainment and Sports in Cotonou.More than 100 athletes from China,Benin,Togo,India and other countries gathered to show their talents.

Ganges and Brahmaputra River System: Need for a Multi-Country Plan for Cleaning, Mitigation, Restoration and Protection

The Ganges and Brahmaputra River system is in the plains of the northern Indian subcontinent. The river is a wide sluggish stream flowing through densely populated and fertile agricultural regions of the world. The Ganges is known as the Hinduism holy river. In Bangladesh, the Brahmaputra is joined by the Teesta River. The western branch of the Brahmaputra confluences with the Ganges and contains most of the river flow. The eastern branch joins the Meghna River near Dhaka. The basin covers parts of four countries including India, Nepal, China, and Bangladesh. Of greater concern, however, has been the degradation in quality of the river water itself. The primary objective of this research is to encourage the development of a multi-country clean-up, mitigation, and protection plan for the Ganges-Brahmaputra rivers. This article constitutes a real tool for the restoration, enhancement and protection of the Ganges-Brahmaputra River system and its environment. The Ganges and Brahmaputra rivers are known for stream bank erosion, shifting channels, and sandbars that continually emerge in their course. The Ganges and Brahmaputra watershed is home to hundreds of millions of people, with the result that the river’s water over much of its course is highly polluted. Arsenic contamination of groundwater in Bangladesh continues to be the largest case of human poisoning in history. Catastrophic floods have prompted the World Bank to prepare a long-term flood-control plan for the region. Scores of cities and towns contribute to treated sewage into the river and its main tributaries, and dozens of manufacturing facilities contribute industrial waste. Also contributing to high pollution levels are agricultural runoff, the remnants of partially burned or unburned bodies from funeral pyres, and animal carcasses. High levels of disease-causing bacteria, as well as such toxic substances as chromium, cadmium, and arsenic, have been found in the Ganges and Brahmaputra. External research and funding of adsorptive media systems to help mitigate the high arsenic levels in drinking water (river and groundwater) is needed. The Ganges-Brahmaputra River system is of colossal importance to its entire environment. Restoration and protection measures must be adopted appropriately and at the scale of the concerned countries.

Performance of a Combined Energy System Consisting of Solar Collector, Biogas Dry Reforming and Solid Oxide Fuel Cell: An Indian Case Study

An energy production system consisting of a solar collector, biogas dry reforming reactor and solid oxide fuel cell (SOFC) was assumed to be installed in Kolkata, India. This study aims to understand the impact of climate conditions on the performance of solar collectors with different lengths of parabolic trough solar collector (dx) and mass flow rate of heat transfer fluid (m). In addition, this study has evaluated the amount of H2 produced by biogas dry reforming (GH2), the amount of power generated by SOFC (PSOFC) and the maximum number of possible households (N) whose electricity demand could be met by the energy system proposed, considering the performance of solar collector with the different dx and m. As a result, the optimum dx was found to be 4 m. This study revealed that the temperature of heat transfer fluid (Tfb) decreased with the increase in m. Tfb in March, April and May was higher than that in other months, while Tfb from June to December was the lowest. GH2, PSOFC and N in March, April and May were higher than those in other months, irrespective of m. The optimum m was 0.030 kg/s.

从殖民文学到后殖民文学:“东方”印度书写与文化身份探索——“英语世界中的印度书写”研究系列之六

吉卜林、福斯特和奈保尔是殖民与后殖民文学的三位重要作家,其创作与印度关系紧密。他们的印度书写不同程度地带有东方主义的思想痕迹,其作品均体现了文化身份认同之思考。探讨三位英语作家的印度书写及其文化身份思索对于深化殖民与后殖民文学研究有着重要的意义。

Failure of Aspired Understanding Among the Human Race——On the Theme of A Passage to India

The author attempts to interpret the theme of A Passsage to India by analyzing the major events and characterization. It is indicated in the thesis that E.M.Forster highlights the failure of aspired understanding between different races, different people and even within a person. In other words, in many cases people have aspirations for understanding, but in reality the real understanding is very difficult to fulfill.

国名下的风趣——貌合神离

本文就英语词语译成汉语词语时常见的貌合神离的范例 。

An Analysis of the Performance of Orientalism in A Passage to India and the Exorcization of Orientalism in Maxine Hong Kingston's Works

This thesis tries to study two novels:firstly,the performance of Orientalism in the novel A Passage to India;secondly the Exorcization of Orientalism in the novel the Woman Warrior written by Maxine Hong Kingston.