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AbstractThe main purpose of this study is to assess the urban lake water quality along the coastal region of Miri City, Sarawak, East Malaysia. This study concentrates on the hydrochemical characteristics and the mechanisms controlling the suitability of the lakes for domestic, irrigation, and industrial purposes. A total of 15 lake water samples were collected and analysed for physical parameters, major ions, nutrients, BOD, COD, and heavy metals. The results show that Lakes 6, 7, and 8 commonly exceeded the National Drinking Water Quality Standards (NDWQS) limits, particularly in physical parameters and major ions. The cation dominance was Na+  > Mg2+  > K+  > Ca2+, while the anion dominance was Cl−  > HCO3−  > SO42−. It is inferred that lake 8 was affected by the seawater intrusion through the inlet flow, resulting in an excess concentration of ions present in that lake. The concentrations of heavy metals in these lakes were considerably low, indicating that most of them were from the geogenic source. Most of the lakes were NaCl water type and the main controlling mechanism were weathering and ionic exchange processes, with anthropogenic impacts. Based on the calculated Water Quality Index (WQI) according to the National Water Quality Standards (NWQS), all lakes were suitable for irrigation use (class IV), while most of these lakes fell under the "polluted" index. Apart from that, based on the National Lake Water Quality Standards (NLWQS), all lakes were classified under category D, indicating that the lakes must be kept in good condition. According to the irrigation quality indices, lakes 1, 2, 3, 4, and 5 were the most suitable for irrigation purposes. As for metal pollution indices (HPI and HEI), lakes 1, 2, 3, 4, 5, and 15 were considered safe with low pollution status. From the multivariate statistical analysis, it is deduced that both anthropogenic and geogenic impacts mostly influenced the quality of these lake waters. The outcome of this study will help the policymakers under the national water department in sustainable management of water resources in this region.

AbstractA comprehensive geochemical study was conducted in the Sibuti River estuary by considering water, suspended solids (SS), and sediment samples from 36 stations during southwest monsoon (SWM) and northeast monsoon (NEM). In this study, the distribution of in situ parameters, major ions, nutrients, trace metals, and isotopes (δD, δ18O) were analyzed in water samples, whereas sediments and SS were studied for trace metals. The distribution revealed that suspended solids were the major carrier of Cd, Zn, and Mn, whereas sediments worked as a major source of Co, Cr, Ba, Se, Cu, and Pb. Na-Cl water type and ion exchange dominated the lower part of the estuary during both seasons. However, the mixed mechanism of Ca–Cl, Ca–Mg–Cl, and higher weathering indicated reverse ion exchange in the intermediate and upper parts of the estuary. Isotopic signatures of δD and δ18O in estuarine water indicate that the precipitation over the Limbang area dominates during SWM, whereas higher evaporation was confirmed during NEM. The factor analysis revealed that seawater influence in the estuary majority controlled the water chemistry irrespective of seasons. Major ions were mainly regulated by the tidal influence during the low flow time of the river (SWM), whereas the mixing mechanism of weathering and seawater controlled the concentrations during NEM. Nutrients such as NO3, SO42−, NH3, and NH4+ mainly originated from the agricultural fields and nitrification along with ammonification were responsible for the recycling of such nutrients. Trace metals except Cd were found to be geogenic in nature and originating mainly from the oxidation of pyrites present in the sandstone and mudstones of the Sibuti Formation. Redox condition was catalyzed by microorganisms near the river mouth, whereas Al-oxyhydroxides and Fe-oxyhydroxides complexes in the intermediate and upper part under oxygenated conditions controlled the absorption of metals. Overall, the estuary was found to be absorptive in nature due to ideal pH conditions and was confirmed by the saturation index (SI) of minerals.

AbstractThe current study aims to investigate the spatiotemporal distribution of microplastics (MPs) in the Miri coast, targeting their occurrences, characterisation, and potential sources. For a periodical study, coastal sediments were collected from three different time intervals (monsoon, post-monsoon, and post-COVID) and subjected to stereomicroscope, ATR-FTIR, and SEM-EDX analyses. These results show a significant increase of MPs in post-COVID samples by approximately 218% and 148% comparatively with monsoon and post-monsoon samples, respectively. The highest concentration of MPs was detected near the river mouths and industrial areas where the waste discharge rate and anthropogenic activities dominate. Fibre-type MPs are the most abundant, with an average of nearly 64%, followed by fragments, films, microbeads, and foams. The most dominant polymer types were polytetrafluoroethylene (PTFE), polyethylene (PE), polypropylene (PP), polystyrene (PS), and polyester (PET). Overall, the current study shows a better understanding of MPs occurrence and potential sources in the Miri coastal area.

The digitization of healthcare and its usage in the delivery of healthcare have experienced exponential growth across the world in recent times. India's fast-growing diabetes population has been exerting immense pressure on the country's healthcare infrastructure. Various innovative and evolving technologies are converging to impact the trajectory of digital health in diabetes. The diabetes community has been adopting various technologies such as connected glucose meters, continuous glucose monitoring systems, continuous subcutaneous insulin infusion, closed-loop systems, digitalization of health data, and diabetes-related apps for the prevention and management of the condition. India has provided some excellent examples in exploiting the potential of digital transformation in revamping the diabetes ecosystem. Yet, there are still various hurdles in technology development, healthcare delivery, as well as concerns related to data privacy, digital divide, policies by the government, role of stakeholders, attitude, and absorption by healthcare professionals, and hospitals. This article provides an overview of the digital diabetes technologies currently practiced in India and recommends the need for strong technology adaptation and policy interventions for an ideal roadmap of digitalization of diabetes care in the Indian milieu.

The Obesity Reduction and Awareness of Non-communicable disease through Group Education (ORANGE) Phase II program, is a school-based intervention aimed at healthy lifestyle practices for sixth and seventh grade adolescents (n = 2345) attending private (n = 1811) and government (n = 534) schools in Chennai. The objectives of this paper are (a) to describe the intervention activities and their outcomes qualitatively and (b) to report changes in body mass index (BMI) of the intervention group participants. This intervention strategy used a teacher-peer-training model in each school for long-term sustainability of the lessons learned from this program. During each intervention session, teachers led a classroom discussion on the health topic of interest, and peers facilitated small-group learning activities. Anthropometric measurements of participants were assessed pre- and post-intervention. We found government school students perceived hygienic actions (e.g., drinking clean water, taking baths daily) as healthy habits for preventing diabetes, whereas private school students associated an expensive lifestyle (e.g., eating at restaurants, riding a car) with diabetes prevention. Overall, the mean post-intervention BMI (18.3 kg/m2) was in the normal range compared to the pre-intervention BMI (17.7 kg/m2) (p < 0.0001). These results suggest that future interventions should be tailored for adolescents from different socio-economic groups while acknowledging their varied perceptions.

The collaborative care model is an evidence-based intervention for behavioral and other chronic conditions that has the potential to address the large burden of mental illness globally. Using the World Health Organization Health Systems Framework, the authors present challenges in implementing this model in low- and middle-income countries (LMICs) and discuss strategies to address these challenges based on experiences with three large-scale programs: an implementation research study in a district- level government hospital in rural Nepal, one clinical trial in 50 primary health centers in rural India, and one study in four diabetes clinics in India. Several strategies can be utilized to address implementation challenges and enhance scalability in LMICs, including mobilizing community resources, engaging in advocacy, and strengthening the overall health care delivery system.

Abstract Background To determine the prevalence of Gestational Diabetes Mellitus (GDM) in urban and rural Tamil Nadu in southern India, using the International Association of Diabetes and Pregnancy Study Groups (IADPSG) and the World Health Organization (WHO) 1999 criteria for GDM. Methods A total of 2121 pregnant women were screened for GDM from antenatal clinics in government primary health centres of Kancheepuram district ( n = 520) and private maternity centres in Chennai city in Tamil Nadu ( n = 1601) between January 2013 to December 2014. Oral glucose tolerance tests (OGTT) were done after an overnight fast of at least 8 h, using a 75 g glucose load and venous samples were drawn at 0, 1 and 2 h. GDM was diagnosed using both the IADPSG criteria as well as the WHO 1999 criteria for GDM. Results The overall prevalence of GDM after adjusting for age, BMI, family history of diabetes and previous history of GDM was 18.5 % by IADPSG criteria with no significant urban/rural differences (urban 19.8 % vs rural 16.1 %, p = 0.46). Using the WHO 1999 criteria, the overall adjusted prevalence of GDM was 14.6 % again with no significant urban/rural differences (urban 15.9 % vs rural 8.9 %, p = 0.13). Conclusion The prevalence of GDM by IADPSG was high both using IADPSG as well as WHO 1999 criteria with no significant urban/rural differences. This emphasizes the need for increasing awareness about GDM and for prevention of GDM in developing countries like India.

AIMS/HYPOTHESIS: We aimed to estimate the lifetime risk of diabetes and diabetes-free life expectancy in metropolitan cities in India among the population aged 20 years or more, and their variation by sex, age and BMI. METHODS: A Markov simulation model was adopted to estimate age-, sex- and BMI-specific lifetime risk of developing diabetes and diabetes-free life expectancy. The main data inputs used were as follows: age-, sex- and BMI-specific incidence rates of diabetes in urban India taken from the Centre for Cardiometabolic Risk Reduction in South Asia (2010-2018); age-, sex- and urban-specific rates of mortality from period lifetables reported by the Government of India (2014); and prevalence of diabetes from the Indian Council for Medical Research INdia DIABetes study (2008-2015). RESULTS: Lifetime risk (95% CI) of diabetes in 20-year-old men and women was 55.5 (51.6, 59.7)% and 64.6 (60.0, 69.5)%, respectively. Women generally had a higher lifetime risk across the lifespan. Remaining lifetime risk (95% CI) declined with age to 37.7 (30.1, 46.7)% at age 60 years among women and 27.5 (23.1, 32.4)% in men. Lifetime risk (95% CI) was highest among obese Indians: 86.0 (76.6, 91.5)% among 20-year-old women and 86.9 (75.4, 93.8)% among men. We identified considerably higher diabetes-free life expectancy at lower levels of BMI. CONCLUSIONS/INTERPRETATION: Lifetime risk of diabetes in metropolitan cities in India is alarming across the spectrum of weight and rises dramatically with higher BMI. Prevention of diabetes among metropolitan Indians of all ages is an urgent national priority, particularly given the rapid increase in urban obesogenic environments across the country. Graphical abstract.