Colonizing Streets

BackgroundGlobal evidence suggests that Pre-Exposure Prophylaxis (PrEP) plays a pivotal role in reducing new HIV-infections among key populations (KP). However, the acceptability of PrEP differs across different geographical and cultural settings and among different KP typologies. Men who have sex with men (MSM) and transgender (TG) communities in India have around 15–17 times higher prevalence of human immunodeficiency virus (HIV) than the general population. The low rates of consistent condom use and poor coverage of HIV testing and treatment among the MSM and transgender communities highlight the need for alternative HIV prevention options.MethodsWe used data from 20 in-depth interviews and 24 focused group discussions involving 143 MSM and 97 transgender individuals from the two metropolitan cities (Bengaluru and Delhi) in India to qualitatively explore their acceptability of PrEP as a HIV prevention tool. We coded data in NVivo and conducted extensive thematic content analysis.ResultsAwareness and use of PrEP were minimal among the MSM and transgender communities in both cities. However, on being provided with information on PrEP, both MSM and transgender communities expressed willingness to use PrEP as an additional HIV-prevention tool, to complement inability to consistently use condoms. PrEP was also perceived as a tool that could enhance the uptake of HIV-testing and counseling services. PrEP awareness, availability, accessibility and affordability were identified as determining factors that could influence its acceptability. Challenges such as stigma and discrimination, interrupted supply of drugs and non-community-friendly drug dispensing sites were identified barriers to continuing PrEP.ConclusionsUsing qualitative data from two Indian settings, this study provides community perspectives and recommendations to stakeholders and policymakers for introduction of PrEP into programs as a prevention tool among MSM and transgender communities in India.

It's always important to save and preserve the natural tooth rather than fix a replacement for it. The aim of the study was to assess the awareness of transport media for avulsed teeth among public and pharmacists, and the availability of the same in pharmacies in a metropolitan city in India. Two separate structured questionnaires consisting of demographic details, and questions to assess the knowledge and attitude of the general public and the pharmacies were distributed. From the study it was elicited that the awareness among the general public as well as the pharmacists regarding transport media for avulsed teeth is inadequate. In most of the pharmacies the transport media for avulsed teeth was not available and the awareness among the pharmacists regarding the same was found to be inadequate.Within the limits of the study, it was found that inadequate availability and lack of awareness regarding transport media for avulsed teeth was noticed.

Data on complications in patients with diabetes from Indian metropolitan and non-metropolitan cities are unavailable. Hence, macro- and microvascular complications during the first year of LANDMARC, a 3-year nationwide prospective observational study (CTRI/2017/05/008452), were evaluated in patients from metropolitan versus non-metropolitan cities. LANDMARC included patients with T2D who were on ≥2 antihyperglycemic medications. Of the total 6236 patients, 2378 and 3858 were from metropolitan and non-metropolitan cities, respectively. Age, T2D duration, and baseline A1C were similar across groups (Table). At 1-year, microvascular complications were significantly higher in those from non-metropolitan than metropolitan cities (19.08% vs. 10.89%; P<0.0001) (Table). Neuropathy was the most common microvascular complication reported in both the groups. Among macrovascular complications reported, acute coronary syndrome and heart failure were the most common and were significantly higher in participants from non-metropolitan cities (Table). The present, first-of-its-kind, data from India demonstrates that patients from non-metropolitan cities may have higher complications, particularly microvascular. The LANDMARC results elicit patterns of disease progression among patients with T2D.View largeDownload slideView largeDownload slide DisclosureS. Kalra: Speaker’s Bureau; Self; Eli Lilly and Company, Novo Nordisk, Sanofi. R. Ghosh: Employee; Self; Sanofi. S. Krishnan: Employee; Self; Sanofi. A. Nair: Employee; Self; Sanofi. S. Mohanasundaram: Employee; Self; Sanofi. S. K. Menon: Employee; Self; Sanofi. V. Salvi: Employee; Self; Sanofi. D. Chodankar: Employee; Self; Sanofi. C. Trivedi: None. S. Wangnoo: None. A. H. Zargar: None. A. K. Das: Advisory Panel; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Novo Nordisk, Roche Pharma, Sanofi. N. Rais: None. S. Joshi: Advisory Panel; Self; Abbott, AstraZeneca, Biocon, Franco Indian, Glenmark, Lupin, Marico, Roche, Twinhealth, Zydus, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Merck Sharp & Dohme Corp., Novartis Pharmaceuticals Corporation, Novo Nordisk, Sanofi, Serdia Pharmaceuticals (India) Pvt. Ltd. A. Mithal: Advisory Panel; Self; Eris Lifesciences Limited, Consultant; Self; Glenmark Pharmaceuticals Limited, Lupin Pharmaceuticals, Inc., USV Private Limited, Speaker’s Bureau; Self; Abbott, AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Intas Pharmaceuticals Ltd., Novo Nordisk, Sanofi. K. Kumar: Advisory Panel; Self; Sanofi-Aventis. A. Unnikrishnan: Advisory Panel; Self; Sanofi-Aventis, Other Relationship; Self; Novo Nordisk A/S, Speaker’s Bureau; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Lilly Diabetes. H. Thacker: None. B. Sethi: None. S. Chowdhury: None.FundingSanofi

Global evidence suggest strong correlations between urbanisation and economic growth. Metropolitan cities generate increasing productivity due to agglomeration economies. India’s urbanisation trend is critical for its economic aspirations. Indian metropolitan cities must fulfill their potential as engines of economic growth for the country to become a high-income economy by 2047. The deterioration of services and lack of infrastructure in Indian cities is a cause of concern; they act as congestion forces limiting productivity and quality of life. Metropolitan cities are characterized by administrative polycentricity, with agencies of the centre, state and local governments engaged in planning, provision and maintenance of basic infrastructure and services. Integrated and coordinated functioning of these multiple organisations is essential for an improved quality of life in cities. In this paper, the author critically reviews the governance and institutional mechanism for infrastructure provision in four metropolitan cities in India. The overlapping functional and administrative jurisdictions of various agencies involved in delivering some of the key urban infrastructure and services is analysed. The paper contextualises the discussion of metropolitan governance in the current policy discourse and discusses aspects of the 74th CAA that requires critical rethinking.

This article provides insights into the challenges and current state of solid waste management in metropolitan cities of India. It emphasizes the importance of legal regulations in ensuring effective waste management to address environmental concerns. This research highlights the need for coordinated efforts among public authorities, adopting technologically advanced best practices globally, and incorporating Waste Hierarchy and Circular Economy concepts for efficient waste management. By addressing challenges like poor community engagement, understaffing, and political interference, the article underscores the significance of robust legal frameworks and strategic policies to mitigate environmental impacts and improve waste management practices in metropolitan cities. Recommendations include enhancing transparency in environmental information, establishing sustainable waste management systems, improving legislation, and promoting stakeholder engagement.

The present study focuses on the assessment of urban heat island (UHI) and urban energy fluxes over Indian metropolitan cities. For this purpose, a high-resolution numerical Weather Research and Forecasting (WRF) model and a coupled single-layer urban canopy model (WRF-UCM) has been implemented over Delhi, Kolkata and Hyderabad to evaluate the performance of these models in capturing the impact of urban areas in simulating the UHI over different land use land cover (LULC) classes. The model initial conditions are obtained from NCEP-FNL reanalysis data. The model simulations reveal that the air temperature at 2 m height (T2) and UHI intensity are overestimated by WRF whereas the WRF-UCM simulations are matching well with ERA5-Land reanalysis data considered as observations. For the WRF-UCM simulation, the statistical errors in T2 and UHI intensity are within the desirable limits and the index of agreement (IoA) is more than 0.8 over the built-up areas (BAs). By comparing with the satellite observations, the relative surface UHI is noticed to be better captured over the BA by WRF-UCM simulation. The sensible heat flux simulated by WRF is highly overestimated whereas WRF-UCM is in good agreement with the satellite observation over the BA. Interestingly, the latent heat flux is reasonably well simulated over all the LULC classes. The results derived from the present study have shown the performance of WRF-UCM in simulating the spatial variation of UHI and fluxes of sensible and latent heat-related varied LULC classifications over metropolitan cities of India.

Pediatric palliative care is a holistic care of children suffering from life-threatening or life-limiting illnesses and encompasses care of a child’s body, mind, and spirit and involves giving support to the family. According to the Global Atlas of Palliative Care, 6% of the global need for palliative care is in children. In order to provide palliative care, one needs to identify and diagnose the conditions requiring palliative care. There has always been a confusion in identifying pediatric conditions requiring palliative care. There is a lot of inconsistency in the diagnosis of such conditions particularly in pre-verbal patients. This study attempts to generate more data about the common palliative care conditions and complaints with which the children present to tertiary care hospitals. To study the socio-demographic details, clinical profile, CCC (complex chronic conditions) designation, and the ACT/ RCPCH (Association for Children with Life-threatening or Terminal Conditions and the Royal College of Pediatrics and Child Health) classification of children suffering from chronic conditions requiring palliative care. The study was conducted as a single-center retrospective observational study of pediatric patients enrolled for palliative care at a tertiary care hospital in a metropolitan city in India from 01.06.2021 to 31.06.2022. The total sample size was 400. The socio-demographic data and the clinical profile were recorded from the case records of all the 400 patients. Classification of the conditions was done as per the CCC as well as the ACT/ RCPCH classification system. The mean age in our study was 5.15 years and there was a slighter male (59.5%) preponderance. They presented in OPDs with acute symptoms such as fatigue and fever, and they had other symptoms like tightness of the body, constipation, seizures, and difficulty in swallowing. Majority of the children (55%) were suffering from neurologic and neuromuscular conditions as per CCC followed by hematologic and immunologic conditions (10%). Category 4 (irreversible but non-progressive conditions causing severe disability, leading to susceptibility to health) was reported as the most common category according to the ACT/RCPCH. Conclusion: Children suffering from chronic disease conditions requiring palliative care usually suffer from multiple symptoms which affect their daily life. As most of the patients belong to category 4 according to ACT/RCPCH which is an irreversible but non-progressive life-limiting condition, the course of the disease is prolonged, therefore requiring comprehensive care and services for a long time. It is necessary to establish more pediatric palliative care units to address the needs of such children.What is known:• Pediatric palliative care is a specialized area within palliative care, which focusses on the needs of children with life-limiting illnesses.• Data on pediatric palliative care has largely been limited to oncological conditions. There is a paucity of literature documenting the needs among children suffering from non-cancerous chronic conditions.What is new:• This study provides vital information with respect to palliative care burden among children mainly suffering from non-oncological conditions.• It also provides clinical and socio-demographic profile of the children suffering from chronic life-limiting conditions requiring palliative care in a tertiary hospital setting in a LMIC (low- or middle-income country).

This paper proposes a Technical and Cost-Effective Analysis of Hybrid Renewable Energy System (HRES) in Metropolitan Cities in India using a Hybrid Optimisation Model for Electric Renewable (HOMER). In the current situation, standalone Solar Energy Conversion and Wind energy Conversion together or separate schemes have been supported around the region on a comparatively larger scale. These balanced systems cannot make available unbroken source of energy, as they are cyclic. Consequently, energy back-up systems could be necessary of those structures to satisfy the user load demands for every time. Typically storage devices or equipment are highly priced and the dimensions have to be reduced to a minimal viable for the renewable Energy System to be cost-effective. The hybrid power system can be used to reduce electricity garage necessities. A HRES mixes the time of strength through the Sun and wind energy conversion system.

Air pollution: A review and analysis using fuzzy techniques in Indian scenario

Emerging Trends Towards Online Food Delivery Apps in India

Rapid transformations of rural vernacular settlements to urban areas and peri urban areas to cities happen across the world, driven by economic opportunities leading to profound societal changes. They heightened include environmental increased concerns infrastructure needs and making them to face challenges of infrastructure, housing and resources. These processes are aggravated around metropolitan cities that hold the highest proportion among the cities with millions of people. Invariably, similar trends have imposed immense infrastructural strain on many Indian cities, propelling rural urban transformations. It is assumed that in the future, they will perpetuate even more urban challenges to both urban as well as rural settlements alike. Therefore, planning of cities in India meaningfully is necessary to achieve sustainable rural urban transformations. In this context, this paper offers an examination of the rapid transformation processes prevalent around many Indian metropolitan cities. This research analyzes 58 research papers related to this issue. It examines the post-Independence evolution of these transformations in India, exposing the strategies adopted across various periods. It discusses these developments through five-year plans, smart city initiatives, organizational advancements and policy formulations. The paper presents the significance of metropolitan cities as well as the rural villages in determining India’s trajectory in the forthcoming decades. Thus, it emphasizes the need for urban planners and decision-makers to focus on these transformations to surmount urban challenges and attain sustainable development of human settlements.

Enabling effective climate action plans at city level: Insights from India's metropolitan cities

Objectives: This research paper explores the intricate landscape of healthcare delivery in metropolitan cities, focusing on addressing challenges such as environmental impact, resource management, and patient accessibility. Theoretical Framework: This paper investigates the integration of Green Healthcare System principles with Healthcare 4.0 technologies in metropolitan cities The study applies concepts of sustainability from Green Healthcare Systems and technological advancements from Healthcare 4.0 to explore their synergy in enhancing urban healthcare delivery. Method: Using NVivo Pro 12, the research employs qualitative analysis of interviews and field observations to identify key factors, challenges, and opportunities associated with implementing these systems in metropolitan settings. Findings reveal that leadership commitment, stakeholder collaboration, financial resources, and regulatory frameworks are crucial for successful integration. Results and Discussion: The findings reveal the transformative potential of combining green healthcare practices with digital technologies, underscoring the importance of stakeholder collaboration, leadership, and supportive policies in realizing sustainable healthcare delivery. The integration offers a comprehensive approach to meeting Sustainable Development Goals (SDGs) and advancing urban healthcare systems. Research Implications: The research contributes to understanding sustainable healthcare practices in urban environments and provides a roadmap for integrating green initiatives with advanced technologies to enhance healthcare accessibility and quality. Originality/Value: This study enriches the literature on sustainable healthcare by exploring synergies between Green Healthcare System and Healthcare 4.0, offering valuable insights for researchers and practitioners in metropolitan settings.

The present technology of human beings has been increasing with the development of automobile. Present scenario of Automobile industry faces challenging tasks for satisfying customers by adapting latest technologies such as AI technique. Now a days, customers has given importance to safety travelling system such as cabs in urban areas or metropolitan cities in India. The most prior able issues are accidents by drowsiness of cab drivers and their heavy work load which in turn reflects their mood swings so this results in accidents and the life of driver and passenger is in danger. This paper deals with above issues and in order to compensate there is a need of companion to driver which helps him to be in conscious state all the time and also complete his work with less pressure. This idea is implemented by using Support vector machine algorithm. As it is a five-level process i.e., dataset training, face detection, feature extraction, prediction of emotion, voice approach. The dataset that is used to train the model is Olivetti faces to detect the emotions of a person and through this system the accuracy is calculated at frame/sec. In this regard by using SVM the system is developed which can act according to the emotions of that person and supports him through the speech delivery.

Background:The coronavirus disease 2019 (COVID-19) pandemic has resulted in inducting trainee resident doctors (RDs) in the care of COVID-19 patients. Limited research has been conducted to understand the impact of domains other than physical and emotional health on their lives. The focus has been to understand the negative consequences of COVID-19 duties, disregarding the possibility of any positive impact that could have emerged.Aim:This mixed-methods study (qualitative and quantitative) aims to explore the holistic and comprehensive impacts of COVID-19 duties on RD's lives.Materials and Methods:This is a mixed-methods convergent design study conducted in a 1400-bed multispecialty teaching hospital in a metropolitan city in India. A phenomenological approach was used for the qualitative part of the study, and the data were collected using focus group discussions (FGDs). For quantitative purposes, the World Health Organization Quality of Life Brief Version (WHOQOL-BREF) questionnaire was administered.Results:Qualitative findings show themes of negative impact covering domains of physical, emotional, social, and professional life. Themes that reveal a positive impact have emerged in the social, professional, and personal domains of the RDs' lives. Quantitative and qualitative results were in agreement with all the questions covered in the WHOQOL-BREF scale; however, the qualitative data findings extend far beyond.Conclusion:In the course of the COVID-19 duties, the RD has suffered in multiple domains, yet it has allowed them to self-reflect and change. As a consequence, they have grown as individuals in many areas of their lives. Working in COVID-19 wards has had a holistic impact on the RDs and has transformed them into better doctors.