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Stock market forecasts have always attracted the attention of many analysts and researchers. Popular theory suggests that stock markets are inherently straightforward, and trying to predict them is a trivial matter. It is a difficult problem in itself. The market behaves like a voting machine in the short term, but in the long term it behaves like a pair of scales. Therefore, there is room to predict market movements over a longer period of time. Applying machine learning techniques and other algorithms to stock price analysis and forecasting is a promising area. This white paper begins with a brief overview of the stock market and a taxonomy of stock market forecasting methods. We then highlight some research findings on resource analysis and forecasting. We discuss technical, fundamental, short- term and long-term approaches to equity analysis. Finally, we present some challenges and research opportunities in this area.

We sought to determine utilization and outcomes of perioperative temporary mechanical circulatory support (tMCS) in the current practice of cardiac surgery.tMCS is an evolving adjunct to cardiac surgery not fully characterized in contemporary practice.Using the nationwide inpatient sample we retrospectively analyzed hospital discharge data between January 1, 2016 and December 31, 2019. ICD-10-CM procedure codes were used to identify and divide patient hospitalizations into those who had preoperative tMCS (pre-tMCS) versus tMCS instituted the day of surgery or afterwards (sd/post-tMCS).In all, 1,383,520 hospitalizations met inclusion criteria. 86,445 (6.25%) had tMCS. tMCS was utilized in 8.74% of coronary artery bypass grafting (CABG), 2.58% of isolated valve, and 9.71% of valve/CABG; operations. 29,325 (33.9%) had pre-tMCS while 57,120 (66.1%) had sd/post-tMCS. The use of tMCS was associated with greater inpatient mortality (15.66% vs. 1.53%, p .001), longer length of stay (LOS) (14.4 vs. 8.5 days, p .001), and higher mean inflation-adjusted costs ($93,040 ± 1038 vs. $51,358 ± 296, p .001) compared to no use. Inpatient mortality (5.98% vs. 20.63%, p .001), LOS (13.87 vs. 14.68, p .001), and cost ($82,621 ± 1152 SEM vs. $98,381 ± 1242) were all significantly lower with pre-tMCS compared to sd/post tMCS. When analyzed separately, mortality was higher with later utilization of tMCS (5.98% pre, 17.1% sd, and 49.05% postsurgical date insertion, p .001).Perioperative tMCS is utilized in 6.25% of modern cardiac surgery, with two-thirds of cases instituted on the day of surgery or afterwards. The use of tMCS is associated with significantly higher mortality, longer LOS, and higher costs. Among patients undergoing tMCS, earlier utilization is associated with better outcomes.

Doxorubicin (DOX) is a highly effective chemotherapy agent prescribed for cancer treatment. However, the clinical use of DOX is limited due to off-target toxicity in healthy tissues. In this regard, hepatic and renal metabolic clearance results in DOX accumulation within these organ systems. Within the liver and kidneys, DOX causes inflammation and oxidative stress, which promotes cytotoxic cellular signaling. While there is currently no standard of care to treat DOX hepatic- and nephrotoxicity, endurance exercise preconditioning may be an effective intervention to prevent elevations in liver alanine transaminase (ALT) and aspartate aminotransferase (AST) and to improve kidney creatinine clearance. To determine whether exercise preconditioning is sufficient to reduce liver and kidney toxicity resulting from acute exposure to DOX chemotherapy treatment, male and female Sprague–Dawley rats remained sedentary or were exercise trained prior to saline or DOX exposure. Our findings demonstrate that DOX treatment elevated AST and AST/ALT in male rats, with no effects of exercise preconditioning to prevent these increases. We also showed increased plasma markers of renin–angiotensin–aldosterone system (RAAS) activation and urine markers of proteinuria and proximal tubule damage, with male rats revealing greater differences compared to females. Exercise preconditioning showed improved urine creatinine clearance and reduced cystatin c in males, while females had reduced plasma angiotensin II (AngII) levels. Our results demonstrate both tissue- and sex-specific responses related to the effects of exercise preconditioning and DOX treatment on markers of liver and kidney toxicity.

BACKGROUND: Understanding strategic commitments and policy responses to overcome antimicrobial resistance at the national, regional, and global levels is required to evaluate current progress and direct future planning. National action plans (NAPs) are the primary mechanism for guiding national strategy and action for antimicrobial resistance governance. Although several NAPs have been developed, no comprehensive content analysis of these plans exists. Using a governance framework, we aimed to assess all publicly available NAPs on antimicrobial resistance.METHODS: We systematically reviewed the contents of NAPs on antimicrobial resistance from 114 countries, applying a governance framework containing 18 domains and 54 indicators in three integral areas: policy design, implementation tools, and monitoring and evaluation. As well as manually searching NAPs and doing online and literature searches that were relevant to specific indicators from repository inception to June 1, 2022, several data sources were used to generate scores, including the Tripartite Antimicrobial Resistance Country Self-Assessment Survey, the Global Antimicrobial Resistance and Use Surveillance System, the Global Antimicrobial Resistance Research and Development Hub, and various WHO datasets. NAPs were included if the country had also submitted the NAP to the Tripartite Antimicrobial Resistance Country Self-Assessment Survey 2020-21, if the NAP was retrievable through a publicly accessible database or website, and if the NAP was either published in English or eligible for machine translation. Three researchers independently reviewed each NAP and were initially blinded to the evaluations of other researchers. They generated a score using a quantification system for each of 54 indicators. The Cochrane protocol for ensuring reliability was followed. The three researchers were then unblinded and met to resolve any disagreements in scoring to reach a consensus agreement. In each case of discrepancy, consensus was reached between the researchers. We developed criteria to standardise the process of quantifying each indicator. We also weighted and collated relevant national data from various sources to generate composite scores concordant with the key governance areas. We transformed these data to a scale of 0 (worst) to 100 (best), ranked countries on the basis of their mean scores, and used descriptive statistics to analyse global and regional trends.FINDINGS: 306 NAPs were identified and 114 were eligible for analysis. Between 2020 and 2021, the mean antimicrobial resistance governance score was 51 (SD 14). Norway had the highest governance score (mean 85 [SD 32]), and the Federated States of Micronesia had the lowest governance score (28 [37]). The highest scoring domain was participation (83 [16]), and the lowest scoring domains were accountability (30 [18]) and feedback mechanism (30 [25]). Domains relating to policy design (55 [13]) and implementation tools (54 [17]) scored similarly, whereas monitoring and evaluation (38 [20]) efforts were lower.INTERPRETATION: International efforts to control antimicrobial resistance varied considerably between countries. Monitoring and evaluation efforts need improving for continuous understanding of national and international progress. International response might not be commensurate with the scale and severity of antimicrobial resistance.FUNDING: None.

In the current environment, data security is paramount, and any confidential files we must have with us everywhere we go raise the chance of losing such files. To prevent this inconvenient method of transporting private information, our suggested solution uses the cloud to store users' myriad of files of any size in encrypted form, encrypting them using the AES-256 version technique to ensure that your private data remains secret. The user no longer has to be concerned about security breaches when sharing his file with the intended recipient, since he may now provide permission to access his document to only the people he chooses, and it will only be accessible to him. With this approach, the saving and exchange of data is made possible. Our encryption algorithm uses the AES-256 version, in which all data is grouped into a string of bits and is subsequently converted into 128-bit blocks.

Background: Diabetic complications are becoming common community problems. The outcomes of diabetic complications are increased hospitalization, increased direct patient costs, and mortality. In Dessie, the prevalence of diabetic complications is not well studied so far. Aim: This study aims to assess the prevalence of diabetic complications and associated factors among adult diabetic patients in north India. Method & Materials: A cross-sectional study was conducted from Jan to March 2020, in the general medicine department. All diabetic patients who visited the clinic during the study period were included. Data was collected using an interview-guided-administered questionnaire. the presence of complications and the type of medications the patient was on were identified through a review of patient records. Results: Eighty-one (81) diabetic patients who came to the follow-up clinic during the 3 months of data collection were included in the study. The majority of the patients (57.4%) were males. The median age of the patients was 45 (±17.677) and they were known diabetic patients for a mean duration of 5.00 (±5.70) years. Complications were strongly associated with the occurrence of diabetic complications but self-reported adherence, attitude, and knowledge level of patients. Conclusion: The prevalence of complications among diabetic patients in Dessie Referral Hospital was high. Targeted counseling and health information provided to the patients by the clinical staff will help reduce avoidable morbidity and mortality in the patients. Keyword : — Diabetes, Complication, Ketoacidosis, Hypoglycemia, Prevalence

Background: Hemodynamic stability is an important aspect to the anesthesiologist for patients. Laryngoscopy and endotracheal intubation can cause striking changes in Hemodynamics as result of intense stimulation of sympathetic nervous system. ProSeal LMA (PLMA)minimizes this response without compromising the airway. The aim of this study was to compare PLMA and Endotracheal tube with respect to intra-operative hemodynamic responses in patients undergoing general anaesthesia. Material and Methods: This prospective observational study was conducted on 30 patients of either sex, age group of 18-60 years, ASA (I or II), Mallam Pati (I or II) posted for elective surgery under general anaesthesia. They were randomly divided into two group 15 each. For group A, airway was secured with laryngoscopy and intubation with appropriate size endotracheal tube and for group B, appropriate size PLMA was inserted to secure airway. The hemodynamic responses like Heart rate and Blood pressure were recorded at base line, at insertion, after 1st min, 3rd min, 5th min and after extubation. Mean increase was statistically more after endotracheal intubation than PLMA insertion. The elevation in theseResults: hemodynamic parameters signicantly persisted for a longer period of time in the ETT group, where it returned to the baseline value by 5 minutes as compared to the PLMA group where it returned by 3 minutes. The hemodynamic response produced when PLMA was used forConclusion: securing airway was less than the laryngoscopy and endotracheal intubation. Thus, PLMA proved to be a suitable alternative to endotracheal tube for airway management with stable hemodynamic.

INTRODUCTION: Shortcomings of fixation has been reported as a source of graft failure in ACL reconstruction. While interference screws have long been used as fixation devices for ACL reconstruction, they are not without complication. Previous studies have highlighted the use of bone void filler as a fixation method, however no biomechanical comparisons using soft tissue grafts with interference screws exist to our knowledge. The purpose of this study is the studies to evaluate the fixation strength of a calcium phosphate cement bone void filler compared to screw fixation in an ACL reconstruction bone replica model with human soft tissue grafts. METHODS: 10 ACL grafts were constructed using semitendinosus and gracilis tendons harvested from 10 donors. Grafts were affixed with either an 8-10mmx23mm PEEK interference screw (n=5) or with approximately 8mL of calcium phosphate cement (n=5) into open cell polyurethane blocks. Graft constructs were tested to failure in cyclic loading under displacement control at a rate of 1mm per second. RESULTS: When compared to screw construct, cement construct showed a 978% higher load at yield, 228% higher load at failure, 181% higher displacement at yield, 233% higher work at failure, and a 545% higher stiffness. Normalized data for the screw constructs relative to the cement constructs from the same donor showed 14±11% load at yield, 54±38% load at failure, and 172±14% graft elongation. DISCUSSION: The results of this study indicate that cement fixation of ACL grafts may result in a stronger construct compared to the current standard of fixation with interference screws. This method could potentially reduce the incidence of complications associated with interface screw placement such as bone tunnel widening, screw migration and screw breakage.

Recently, more emphasis has been placed on patient-reported outcomes in clinical trials, which has inadvertently led to an increase in respondent burden. In this investigation, we found that the Skindex-16 form captures patient-reported quality of life in dermatomyositis as well as the Skindex-29 form, but with fewer questions. Additional questions regarding photosensitivity, body image, and cosmetic use did not correlate with skin activity in dermatomyositis.

Doxorubicin (DOX) is a first-line chemotherapeutic agent used to treat a wide range of malignancies including breast and lymphatic cancers. However, the clinical use of DOX is limited due to off-target toxicity to healthy organs. DOX-induced nephrotoxicity is established in both cancer patients and experimental models, where it is hypothesized that oxidative damage to renal cells increases glomerular capillary permeability and tubular atrophy. In contrast, endurance exercise preconditioning has the potential to reduce renal edema and inflammation, improving glomerular filtration rate and urine creatinine clearance rate. Therefore, the purpose of this study was to investigate whether exercise preconditioning can protect against DOX-induced nephrotoxicity and elucidate differences between male and female rats. Young-adult male and female Sprague-Dawley rats were randomly separated into 4 groups: i) sedentary saline; ii) sedentary DOX (20 mg/kg IP); iii) exercise-trained saline; and iv) exercise-trained DOX. Exercise trained animals underwent 2 weeks of treadmill preconditioning for (5 days/wk, 60 min/day, 30 m/min @ 0% grade). Animals received saline or DOX 24hrs after the final exercise bout, followed by endpoint 48hrs post-treatment. Evaluation of inflammatory markers within the urine (i.e. IP10, AGP and NGAL) demonstrated elevated levels in DOX-treated males and females, regardless of exercise. Male rats receiving DOX had elevated levels of clusterin which was not found in female rodents suggesting a possible sex-difference. Moreover, urine creatinine levels were significantly increased following DOX treatment and reduced with exercise in males, with no significant differences in females. In summary, animals treated with doxorubicin had higher levels of markers for inflammation and renal disease, with minimal effects of exercise preconditioning to prevent these changes. Additionally, males demonstrated higher levels of renal toxicity suggesting that females may have a greater resistance to DOX-induced nephrotoxicity.R01 HL153140R01 HL144858 R01 HL144858 and R01 HL153140 This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Supplementary Figure from An Ex Vivo Organotypic Culture Platform for Functional Interrogation of Human Appendiceal Cancer Reveals a Prominent and Heterogenous Immunological Landscape

Purpose:Epithelial neoplasms of the appendix are difficult to study preclinically given their low incidence, frequent mucinous histology, and absence of a comparable organ in mice for disease modeling. Although surgery is an effective treatment for localized disease, metastatic disease has a poor prognosis as existing therapeutics borrowed from colorectal cancer have limited efficacy. Recent studies reveal that appendiceal cancer has a genomic landscape distinct from colorectal cancer and thus preclinical models to study this disease are a significant unmet need.Experimental Design:We adopted an ex vivo slice model that permits the study of cellular interactions within the tumor microenvironment. Mucinous carcinomatosis peritonei specimens obtained at surgical resection were cutoff using a vibratome to make 150-μm slices cultured in media.Results:Slice cultures were viable and maintained their cellular composition regarding the proportion of epithelial, immune cells, and fibroblasts over 7 days. Within donor specimens, we identified a prominent and diverse immune landscape and calcium imaging confirmed that immune cells were functional for 7 days. Given the diverse immune landscape, we treated slices with TAK981, an inhibitor of SUMOylation with known immunomodulatory functions, in early-phase clinical trials. In 5 of 6 donor samples, TAK981-treated slices cultures had reduced viability, and regulatory T cells (Treg). These data were consistent with TAK981 activity in purified Tregs using an in vitro murine model.Conclusions:This study demonstrates an approach to study appendiceal cancer therapeutics and pathobiology in a preclinical setting. These methods may be broadly applicable to the study of other malignancies.

Supplementary Table from An Ex Vivo Organotypic Culture Platform for Functional Interrogation of Human Appendiceal Cancer Reveals a Prominent and Heterogenous Immunological Landscape

Supplementary Data from An Ex Vivo Organotypic Culture Platform for Functional Interrogation of Human Appendiceal Cancer Reveals a Prominent and Heterogenous Immunological Landscape

Supplementary Tables 1-3 from Genetic Analysis of Transforming Events That Convert Chronic Myeloproliferative Neoplasms to Leukemias

STUDY OF BIOMEDICAL WASTE MANAGEMENT IN DIFFERENT TYPES OF MEDICAL FACILITIES Research article

Among children, neonates have the highest incidence of thrombosis. Thrombolytic agents are used for the management of life and/or organ-threatening thrombosis. Literature on the efficacy and safety of thrombolytic agents in neonates is limited. We reviewed the evidence on dosing, administration, monitoring and treatment duration of tissue plasminogen activator (tPA), streptokinase and urokinase (URK) in neonates (≤ 28days). A systematic literature search was conducted of current databases from inception until 31 March 2021. The initial search yielded 6881 articles and 18 were retained for review. tPA, streptokinase and URK was utilized in 12, seven and four studies on 115, 51 and 16 patients, respectively. The dose range for tPA, streptokinase and URK was 0.01 -0.6 mg/kg/h, 50-2000 and 1000-0 000 units/kg/h, respectively, and treatment duration ranged from 30 min to 30 days. This is the first study to objectively summarize the efficacy and safety of thrombolytic agents in neonates. Overall, thrombolysis was associated with 87.9% complete or partial thrombus resolution and 7.4% recurrence risk. The bleeding risk associated with thrombolytic agents was 23.1% on pooled analysis, which is higher than other anticoagulants. Larger prospective studies are required to determine effective dosing regimens of these therapeutic drugs and further clarify their efficacy and safety. Blood Coagul Fibrinolysis 33:000-000 Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

Background Adrenal masses are common, but radiology reporting and recommendations for management can be variable. Purpose To create a machine learning algorithm to segment adrenal glands on contrast-enhanced CT images and classify glands as normal or mass-containing and to assess algorithm performance. Materials and Methods This retrospective study included two groups of contrast-enhanced abdominal CT examinations (development data set and secondary test set). Adrenal glands in the development data set were manually segmented by radiologists. Images in both the development data set and the secondary test set were manually classified as normal or mass-containing. Deep learning segmentation and classification models were trained on the development data set and evaluated on both data sets. Segmentation performance was evaluated with use of the Dice similarity coefficient (DSC), and classification performance with use of sensitivity and specificity. Results The development data set contained 274 CT examinations (251 patients; median age, 61 years; 133 women), and the secondary test set contained 991 CT examinations (991 patients; median age, 62 years; 578 women). The median model DSC on the development test set was 0.80 (IQR, 0.78-0.89) for normal glands and 0.84 (IQR, 0.79-0.90) for adrenal masses. On the development reader set, the median interreader DSC was 0.89 (IQR, 0.78-0.93) for normal glands and 0.89 (IQR, 0.85-0.97) for adrenal masses. Interreader DSC for radiologist manual segmentation did not differ from automated machine segmentation (

Tuberculosis (TB) is the second leading cause of death due to infectious diseases globally, and delay in the TB care cascade is reported as one of the major challenges in achieving the goals of the TB control programs. The main aim of this study was to investigate the delay and responsible factors for the delay in the various phases of care cascade among TB patients in two Indian states, Jharkhand and Gujarat. This cross-sectional study was conducted among 990 TB patients from the selected tuberculosis units (TUs) of two states. This study adopted a mixed-method approach for the data collection. The study targeted a diverse profile of TB patients, such as drug-sensitive TB (DSTB), drug resistance TB (DRTB), pediatric TB, and extra-pulmonary TB. It included both public and private sector patients. The study findings suggested that about 41% of pulmonary and 51% of extra-pulmonary patients reported total delay. Delay in initial formal consultation is most common, followed by a delay in diagnosis and treatment initiation in pulmonary patients. While in extra-pulmonary patients, delay in treatment initiation is most common, followed by the diagnosis and first formal consultation. DR-TB patients are more prone to total delay and delay in the treatment initiation among pulmonary patients. Addiction, co-morbidity and awareness regarding monetary benefits available for TB patients contribute significantly to the total delay among pulmonary TB patients. There were system-side factors like inadequacy in active case findings, poor infrastructure, improper adverse drug reaction management and follow-up, resulting in delays in the TB care cascade in different phases. Thus, the multi-disciplinary strategies covering the gambit of both system and demand side attributes are recommended to minimize the delays in the TB care cascade.

Background The COVID-19 pandemic highlighted gaps in health surveillance systems, disease prevention, and treatment globally. Among the many factors that might have led to these gaps is the issue of the financing of national health systems, especially in low-income and middle-income countries (LMICs), as well as a robust global system for pandemic preparedness. We aimed to provide a comparative assessment of global health spending at the onset of the pandemic; characterise the amount of development assistance for pandemic preparedness and response disbursed in the first 2 years of the COVID-19 pandemic; and examine expectations for future health spending and put into context the expected need for investment in pandemic preparedness. Methods In this analysis of global health spending between 1990 and 2021, and prediction from 2021 to 2026, we estimated four sources of health spending: development assistance for health (DAH), government spending, out-of-pocket spending, and prepaid private spending across 204 countries and territories. We used the Organisation for Economic Co-operation and Development (OECD)'s Creditor Reporting System (CRS) and the WHO Global Health Expenditure Database (GHED) to estimate spending. We estimated development assistance for general health, COVID-19 response, and pandemic preparedness and response using a keyword search. Health spending estimates were combined with estimates of resources needed for pandemic prevention and preparedness to analyse future health spending patterns, relative to need. Findings In 2019, at the onset of the COVID-19 pandemic, US$9 center dot 2 trillion (95% uncertainty interval [UI] 9 center dot 1-9 center dot 3) was spent on health worldwide. We found great disparities in the amount of resources devoted to health, with high-income countries spending $7 center dot 3 trillion (95% UI 7 center dot 2-7 center dot 4) in 2019; 293 center dot 7 times the $24 center dot 8 billion (95% UI 24 center dot 3-25 center dot 3) spent by low-income countries in 2019. That same year, $43 center dot 1 billion in development assistance was provided to maintain or improve health. The pandemic led to an unprecedented increase in development assistance targeted towards health; in 2020 and 2021, $1 center dot 8 billion in DAH contributions was provided towards pandemic preparedness in LMICs, and $37 center dot 8 billion was provided for the health-related COVID-19 response. Although the support for pandemic preparedness is 12 center dot 2% of the recommended target by the High-Level Independent Panel (HLIP), the support provided for the health -related COVID-19 response is 252 center dot 2% of the recommended target. Additionally, projected spending estimates suggest that between 2022 and 2026, governments in 17 (95% UI 11-21) of the 137 LMICs will observe an increase in national government health spending equivalent to an addition of 1% of GDP, as recommended by the HLIP. Interpretation There was an unprecedented scale-up in DAH in 2020 and 2021. We have a unique opportunity at this time to sustain funding for crucial global health functions, including pandemic preparedness. However, historical patterns of underfunding of pandemic preparedness suggest that deliberate effort must be made to ensure funding is maintained. For complete list of authors see http://dx.doi.org/10.1016/S2214-109X(23)00007-4

Introduction: Mortality and morbidity due to infectious disease have got reduced in the last couple of decades. Diphtheria is one of the infectious diseases which can be preventable with a complete immunization. Objective: To understand trends and identify factors affecting the outbreak of diphtheria in Banaskantha district of Gujarat. Method: A retrospective study based on the available case records for the years 2019, 2020 and 2021(till June). The study was conducted after the reported diphtheria cases in a district. The study was a public health response and intended to provide specific geographical recommendations to the district. The data was recorded from the reported case record and immunization registers. The data were analyzed for defined variables. Results: Out of the 366 cases identified during years 2019-2021.Almost 74% cases have occurred during 2019, with a 7.7% mortality rate. Total 48% of cases were among the age group of 5-10 years, with an increasing number of cases during August-December with specific geographical distribution. Among all the cases, 164 (44.5%) have never taken any vaccine in their lifetime or are unaware of the vaccination status, and 87.9% of cases have not taken third dose of DPT or Pentavalent Vaccine, which is associated statistically with the mortality. Conclusion: The prevalence of diphtheria cases was high in children who have not taken all three doses of DPT or Pentavalent vaccine. These have shown an essential role of immunization, focusing on the vaccine for all doses and need to create a customized awareness communication plan.

BACKGROUND The five-year ahead of global target of eliminating Tuberculosis (TB) in India by 2025 depends critically on one of the components of health system strengthening, the capacity of human resources. Due to the rapid transposition of standards and protocols, the human resources for TB health are lacking in understanding recent updates and acquire needful knowledge. OBJECTIVE With a focus on the digital revolution in healthcare, there is no such platform to deliver the key updates in the national TB control program with easy access. Thus, this manuscript narrates the evolution of a digital platform for the capacity building of the Indian health system’s workforce in management of TB patients. METHODS A qualitative method study was conducted, i.e., qualitative personal interviews to understand the basic requirements of staff working in management of TB patients and then, participatory consultative meetings with the stakeholders to validate and develop the content. This study collected qualitative information from the Purbi Singhbhum and Ranchi districts of Jharkhand and Gandhinagar and Surat districts of Gujarat State. Secondly, a series of participatory workshops were conducted as part of the content validation exercises during 2021-22. RESULTS The first phase collected information from 126 healthcare staff, with the mean age of participants being 38.4 ± 8.9 years and the average work experience of 8.9 years. The assessment revealed that more than two-thirds of participants needed further training and lacked knowledge of the most current updates to the NTEP guidelines. The consultative process determined the training requirements in easily accessible formats and ready reckoner content to deliver practical solutions to programme implementation's operational issues. The digital platform should be adaptable and flexible enough to accommodate future programme revisions. CONCLUSIONS The development of staff capacity is vital to the success or failure of any programme or intervention. Having up-to-date information provides confidence to the staff when interacting with patients in the community and aids them in making quick judgements when handling case scenarios. The NI-KSHAY SETU could be one of the other examples of a digital capacity-building platform for enhancing human resources skills working for TB elimination.

This study aims to understand how consumers are impacted by various aspects in the context of electronic commerce (e-commerce), as well as how e-satisfaction and e-loyalty are related. As the Internet has developed into a platform for online transactions, businesses now need to understand how customers see online shopping. This study began with the integration of pertinent literature before examining the factors that influence consumers' decisions to make purchases online. This study follows a consumer's behaviour and attitude towards online shopping. This study also examines a customer’s point of view and how a customer feels towards online shopping. This study revolves around the basic idea and concept of online shopping and its impact on a consumer and how a consumer starts to differentiate between online and offline shopping.