The combined burden of stunting and wasting in children under five years is a serious public health concern. The present study aimed to estimate the joint burden of stunting and wasting among children aged 6–59 months and explore its spatial variation across Nepal. The 2016 Nepal Demographic and Health Survey data was used to study acute and chronic childhood malnutrition. A Bayesian distributional bivariate probit geoadditive model was designed to study the linear association and geographical variation of stunting and wasting among 6–59 months, children. Child-related factors such as low birth weight, fever in the last 2 weeks preceding the survey and fourth or greater birth order were associated with a higher likelihood of stunting. The likelihood of a child being stunted was significantly less in the wealthiest households, having improved toilet facilities, and if mothers were overweight. Children from severely food insecure households were significantly more likely, and children from poorer households were significantly less likely to suffer both acute and chronic malnutrition simultaneously. Results from spatial effect showed that children from Lumbini and Karnali had a higher burden of stunting, and the likelihood that achild would have been wasted was significantly higher in Madhesh and Province 1. Immediate nutritional efforts are vital in low-income and severely food insecure households to lessen the risk of stunting and wasting in under children. Disproportionate geographic variations in stunting and wasting warrant sub-regional-specific nutrition intervention to achieve nutrition targets and reduce the burden of childhood malnutrition across the country.

Subjects donate individually (control group) or in pairs (treatment group). Those in pairs reveal their donation decision to each other. Average donations in the treatment group are significantly higher than in the control group. Paired subjects have the opportunity to revise their donation decision after discussion. Pair members shift toward each others’ initial decisions. Subjects are happier with their decision when their donations are larger, but those in pairs are less happy, controlling for amount donated. These findings suggest reluctant altruism due to peer pressure in charitable giving.

Organic matter water extract, or so-called ‘tea’, may be used to correct nutrient deficiencies in crops or enhance their defense systems. Such tea mixtures are prepared locally by Mediterranean farmers to offset a multitude of constraints, particularly a scarcity of organic manure or high synthetic input costs. However, the diverse range of tea production and usage practices and farmers' underlying rationales have yet to be thoroughly studied. Yet locally they constitute real alternatives that allow farmers to maintain their income levels while reducing reliance on chemical inputs. The main objective of this study was to gain insight into farmers' rationale and practices regarding the production of homemade dry manure tea (HMT) in North Africa, while also highlighting the benefits perceived by farmers. Nearly 50 interviews with farmers were thus conducted in three irrigated cropping areas in Morocco, Algeria and Tunisia. Our results showed that HMT is widely used in intensified family horticultural cropping systems that usually rely on drip irrigation and chemical fertilization. The analysis of farmers' practices revealed that HMT was generally made from aged manure that was pure or consisted of a mixture of sheep, cow or poultry dung. The production protocol varied in terms of drenching techniques, maceration time, container volume and type, and filtration techniques. Farmers applied the derived tea via the drip irrigation system, regularly or with a limited number of applications. The analysis of farmers' rationales and perceptions regarding HMT clearly highlighted that they felt that these practices played a positive role. HMT was considered to improve vegetative growth, yield and, to a lesser extent, soil properties. These benefits could in turn lead to decreased use of synthetic fertilizers by farmers, while boosting their income. The increased understanding of HMT and the underlying rationales showcased in this study could help scientists better analyze and assess these practices in the future. The findings could also facilitate improvement and wider dissemination of these practices to achieve more sustainable irrigation systems in the intensified irrigated cropping areas that abound in North Africa.

Myocardial fibrosis is associated with adverse events in idiopathic dilated cardiomyopathy. Cardiac MRI with late gadolinium enhancement can detect myocardial fibrosis. We evaluated the conditional survival of children and adolescents based on native T1 mapping (combined proton signal from myocytes and interstitium prior to contrast administration by the measurement of myocardial and blood relaxation time) as a means to assess myocardial fibrosis. This retrospective case–cohort over a 3-year period included all consecutive patients (aged ≤ 21 years) with advanced heart failure from dilated cardiomyopathy (echocardiographic left ventricular ejection fraction ≤ 45% and NYHA class ≥ 2) who underwent cardiac MRI.

Conditional survival (follow-up ≥ 6 months after cardiac MRI) was assessed to include NYHA functional class and time to event (death or heart transplantation). A total of 57 patients (mean age 11.7 ± 6.1 years; 58% male) had a median NYHA Class III (31/57) and median left ventricular ejection fraction 25% (20–38%). Survival data were available in 82% patients (46/57) and the crude mortality rate was 24% (11/46) and one patient (2%) underwent heart transplantation. The median native T1 was elevated at 1351 ms (95% CI 1332, 1394) and it showed no difference between the groups who survived to those who died. Performing a multilevel regression analysis on prognosis failed to predict 6-month conditional survival.

An estimated 6,500 undocumented immigrants in the United States have been diagnosed with end-stage renal disease (ESRD). These individuals are ineligible for the federal insurance program that covers dialysis and/or transplantation for citizens, and consequently are subject to local or state policies regarding the provision of healthcare. In 76% of states, undocumented immigrants are ineligible to receive scheduled outpatient dialysis treatments, and typically receive dialysis only when presenting to the emergency center with severe life-threatening symptoms. ‘Emergency-only hemodialysis’ (EOHD) is associated with higher healthcare costs, higher mortality, and longer hospitalizations. In this paper, we present an ethical critique of existing federal policy. We argue that EOHD represents a failure of fiduciary and professional obligations, contributes to moral distress, and undermines physician obligations to be good stewards of medical resources. We then explore potential avenues for reform based upon policies introduced at the state level. We argue that, while reform at the federal level would ultimately be a more sustainable longterm solution, state-based policy reforms can help mitigate the ethical shortcomings of EOHD.

Self-focusing of Gaussian laser beam has been investigated in quantum plasma under the effect of applied axial magnetic field. The nonlinear differential equation has been derived for studying the variations in the beam-width parameter. The effect of initial plasma electron temperature and the axial magnetic field on self-focusing and normalized intensity are studied. Our investigation reveals that normalized intensity increases to tenfolds where quantum effects are dominant. The normalized intensity further increases to twelvefolds on increasing the magnetic field.

This paper presents an investigation on the self-focusing of a cosh-Gaussian laser beam in the thermal quantum plasma (TQP) by taking into account the effects of relativistic nonlinearity. An appropriate nonlinear Schrödinger equation has been solved analytically by applying the variational approach. The self-focusing and the self-phase modulation are examined under a variety of parameters. The self-trapping of a cosh-Gaussian laser beam is further studied at various values of the decentered parameter, b with different absorption levels, ${k}^{\prime}_i$. Numerical analysis shows that these parameters play a vital role in propagation characteristics. The significant contribution of the quantum effects to enhance the self-focusing and minimize the longitudinal phase has been observed. Further, a comparison has been made with the classical relativistic (CR), the relativistic cold quantum (RCQ), and the thermal quantum (TQ) regimes. The self-focusing is found to occur earlier and is strongest for the case of TQP in the present analysis.

In the present paper, we have investigated self-focusing of the quadruple Gaussian laser beam in underdense cold quantum plasma. The non-linearity chosen is associated with the relativistic mass effect that arises due to quiver motion of electron and electron density perturbation caused by ponderomotive force. The non-linearity modifies the plasma frequency in the dielectric function and hence the refractive index of the medium. The focusing/defocusing of the quadruple laser depends on the refractive index of the medium. We have set up non-linear differential equation that controls the beam width parameter by using well-known paraxial ray approximation and Wentzel–Krammers–Brillouin approximation. The effect of intensity parameter and electron temperature is observed on laser beam self-focusing in the presence of cold quantum plasma. From the results, it is revealed that electron temperature and the initial intensity of the laser beam control the profile dynamics of the laser beam.

The paper presents an investigation on self-focusing of cosh-Gaussian (ChG) laser beam in a relativistic–ponderomotive non-uniform plasma. It is observed numerically that the selection of decentered parameter and initial beam radius determines the focusing/defocusing of ChG laser beam. For given value of these parameters, the plasma density ramp of suitable length can avoid defocusing and enhance focusing effect significantly. Focusing length and extent of focusing may also be controlled by varying slope of the ramp density. A comparison with Gaussian beam has also been attempted for optimized set of parameters. The results establish that ChG beam focuses earlier and sharper relative to Gaussian beam. We have setup the non-linear differential equation for the beam width parameter using Wentzel–Kramers–Brillouin and paraxial ray approximation and solved it numerically using Runge–Kutta method.

OBJECTIVES/SPECIFIC AIMS: The specific objectives of this project are (1) identify, test, and validate the parameters for a simplified NLOM imaging probe that will provide specific research and point-of-care information on biofilm presence, therapeutic need and response of individual wounds to treatment. (2) Identify specific proteomic and metabolomic biomarkers of (i) wound susceptibility to infection, (ii) wound response to the most commonly used antibacterial measures in wounds, and (iii) establish criteria for more effective interventions. METHODS/STUDY POPULATION: First, optimal use parameters for NLOM including illumination, field of view, focal length, linear Versus concentric image acquisition, detection and filter wavelengths were identified. Parameters for evaluation included ease and speed of imaging, ability to map diagnostic criteria. Next, using the optimised NLOM imaging modality in bacterial biofilm isolates and subsequently a rabbit ear model of biofilm wound infection, proteomic and metabolomic biomarkers of susceptibility to infection were identified. The effects of 2 standard debridement and anti-infective treatments, polyvidone-iodine solution or cetrimide 15%+ chlorhexidine gluconate 1.5% were mapped in situ for up to 10 days using the NLOM probe. RESULTS/ANTICIPATED RESULTS: Using the novel custom NLOM probe, high resolution mapping of wound biofilm infection, as well as the underlying tissue was performed throughout the onset, development, treatment, and resolution of wound biofilm infection. Specific microbiological, microstructural, oxygenation, and pH parameters were mapped at defined surface and subsurface locations and time-points. Findings included the determination that some standard antimicrobial formulations provide a supportive environment for wound infection, and that micro-channels within the biofilm and their interface with the tissues serve as an important predictor and indicator of wound infection establishment, progression, and response. DISCUSSION/SIGNIFICANCE OF IMPACT: The novel multimodality in vivo NLOM imaging approach establishes an important tool for earlier and more specific diagnosis of wound infection risk, virulence, and invasiveness along with markers of successful treatment, and a simple clinical imaging tool for improving wound infection prevention and treatment.

Concerted efforts by stakeholders could overcome the hurdles and enable a viable recycling system for automotive LIBs by the time many of them go out of service.

Lithium-ion batteries (LIBs) were commercialized in the early 1990s and gained popularity first in consumer electronics, then more recently for electric vehicle (EV) propulsion, because of their high energy and power density and long cycle life. Their rapid adoption brings with it the challenge of end-of-life waste management. There are strong arguments for LIB recycling from environmental sustainability, economic, and political perspectives. Recycling reduces material going into landfills and avoids the impacts of virgin material production. LIBs contain high-value materials like cobalt and nickel, so recycling can reduce material and disposal costs, leading to reduced EV costs. Battery recycling can also reduce material demand and dependence on foreign resources, such as cobalt from Democratic Republic of the Congo, where much production relies on armed aggression and child labor.

Several companies are finding ways to commercialize recycling of the increasingly diverse LIB waste stream. Although Pb-acid battery recycling has been successfully implemented, there are many reasons why recycling of LIBs is not yet a universally well-established practice. Some of these are technical constraints, and others involve economic barriers, logistic issues, and regulatory gaps. This paper first builds a case as to why LIBs should be recycled, next compares recycling processes, and then addresses the different factors affecting LIB recycling to direct future work towards overcoming the barriers so that recycling can become standard practice.

In the present paper, we have studied self-focusing of Gaussian laser beam in weakly relativistic magnetized cold quantum plasma. When interparticle distance is comparable to the de Broglie wavelength of charged particles, we cannot neglect the quantum contribution of plasma constituents. Therefore, propagation characteristics are studied by taking in to account quantum contribution in the presence of static magnetic field applied along the beam propagation. Our results show that the magnetic field plays a key role in achieving additional focusing, it modifies the quiver motion of electrons by adding cyclotron frequency to the natural frequency of oscillating electrons during laser beam propagation. The results are compared with those of weakly relativistic quantum plasma and weakly relativistic magnetized plasma. The self-focusing is found to be more pronounced when axial magnetic field is increased in the present model. We have setup the non-linear differential equation for the evolution of beam-width parameter by well-known paraxial ray approximation and solved it with the help of computational technique.