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Emotion recognition has emerged as a crucial research area in recent years due to its potential applications in various fields such as healthcare, marketing, and entertainment. In this study, we propose a novel approach to emotion recognition using the Internet of Things (IoT) and Machine Learning (ML) techniques. Our system consists of IoT devices equipped with sensors that capture physiological signals such as heart rate, skin conductance, and facial expressions. These signals are pre-processed and fed into an ML model for emotion classification. We evaluate our system on a publicly available dataset and achieve an accuracy of over 90%. Our results demonstrate the feasibility and effectiveness of using IoT and ML for emotion recognition, which can have significant implications for various industries. The proposed system can be extended to real-world applications such as personalized healthcare, customer feedback analysis, and content recommendation.

New thrust by the government to develop skill sets and entrepreneurship has resulted in massive inventions and rapid advancement of science and technology. complexity in monitoring, managing adapting, and registering innovations is becoming increasingly difficult due to a massive number of inventions. Maintaining standards for new innovations along with increased time for their scrutiny is causing delays in the adaptation of new inventions. The Intellectual property rights scrutiny towards judging the uniqueness of a particular innovation and prior art search has been made considerably easy by using artificial intelligence and machine learning. This latest technology can help to overcome the cumbersome processes for the allotment of intellectual property rights. This technology eases the burden of managing a large number of innovations filed as patent applications. Data mitigation becomes easy in the area of prior art searches. The world trade organization has announced certain stipulations in the form of law to avoid overlapping of the inventions and grant patents in line with the geographical restrictions. This article makes a concrete proposal to understand the complex interrelationship between trade law, jurisprudence, and the application of artificial intelligence in overcoming the hurdles concerning the patent grant process. The paper also proposes the use of artificial intelligence for patent-related dispute settlement in line with Trade-related aspects of intellectual property rights agreements. The paper advocates the use of artificial intelligence in the area of application and grant of patents.

Due to the unprecedented number of cars being purchased and sold, used car price prediction is a topic of high interest. Because of the affordability of used cars in developing countries, people tend more purchase used cars. A primary objective of this project is to estimate used car prices by using attributes that are highly correlated with a label (Price). The aim of this project is to develop a model for predicting the prices ofused cars. The study uses two popular regression algorithms, Random Forest and Linear Regression. Thedata used in the project is obtained from various sources and includes information about the make and model of the car, its mileage, age, and other factors that affect its price. The study evaluates the performance of the models using metrics such as Mean Absolute Error, Mean Squared Error, and R-Squared. Theresults show that both Random Forest and Linear Regression models can accurately predict used car prices, with Random Forest performing slightly better. The study provides valuable insights into the factors that influence the prices of used cars and can assist car dealerships, buyers, and sellers in making informed decisions then the model will be integrated into a webpage for general public to use.

In Ayurveda, Bhagandara (Fistula-in-ano) is considered as one of the Ashta Mahagaroga (8 major disease) by Acharya Sushruta due to high recurrence rate. In the present era anorectal disorders are increasing, due to sedentary life style and others factors. The word Bhagandara is composed of 2 words Bhaga and Darana. The formation of Pidika leads development of Bhagandara it is characterized by opening around the Guda Pradesha with painful discharge. Acharya Charaka mentions the line of treatment for Bhagandhara as Virechana followed by Paatana (Excision) or if Pakwa, Bhedana by Ksharasutra application. In India the Ksharasutra is having high success rate (96.67%) in the management of Bhagandhara (Anal fistula). A case of 36 years old female patient consulted with complaints of boil in the perianal / vaginal region associated with pain & foul-smelling discharge, was diagnosed as Vagino-Anal Fistula and treated with Ksharasutra therapy, along with some oral medications. Patient recovered well with complete excision of tract within a span of 4 months. Thus, Ksharasutra is very effective in treating this condition, with minimal surgical intervention.

The experiment was carried out during 2019-20 at P-2 Pure Mysore Multivoltine Basic Seed Farm (BSF), National Silkworm Seed Organisation, Nagenahalli, Karnataka to know the effect of nutrient management on the growth and yield of G4 mulberry variety and its subsequent bioassay of multivoltine silkworm, Pure Mysore. The mulberry garden (three years old) with G4 variety planted in paired row system was used for the experiment with seven treatments and three replications. The growth parameters (average of 5 crops) viz., plant height, number of branches per plant, lowest number of leaf in 100g weight, weight of individual leaf, weight of 100 fresh leaf, leaf yield per plant and leaf yield per ha-1were significantly highest (134.6 cm, 14.0, 24.0, 4.18g, 384g, 800g and 55.55 Mt) with the application of 100 % RDF, poshan spray and application of vermicompost at5 t/ha/year. The results of the bio-assay (average of five rearings) also showed the superiority forweight of 10 full grown larvae (27.2 gm), single cocoon weight (1.27g), single shell weight (0.18g), shell ratio (14.25%), ERR (95.00%) pupation (92.00%), number of cocoons/kg (787) and yield per 100 dfls (52.10 kg) in the treatment having 100 % RDF, poshan spray and application of vermicompost of at5 t/ha than other treatments. Combined application of organic and inorganic sources of nutrients increased the productivity of the mulberry in G4 variety and subsequently better performance of Pure Mysore multivoltine seed cocoon parameters.

Ever increasing global population necessitates the need to increase availability of affordable foods with high nutritional quality. Chickpea being the second most important grain legume cultivated worldwide has the great potential to alleviate problems of protein malnutrition and hidden hunger. The objective of the present investigation was to characterize a diverse set of 402 germplasm comprising of more than 100 commercial cultivars widely cultivated and utilized by breeders for grain protein in two contrasting environments to explore the magnitude of natural genotypic diversity present in the cultivated chickpea and the scope for enhancing it and its quality through breeding. The cultivars containing more than 25 to 30.44% grain protein have been found in the study and large scale production of such protein rich cultivars is expected to increase availability as well as consumption of high quality chickpea necessary to overcome all forms of malnutrition. Trait specific germplasm containing grain protein up to 33.56% are also identified for their further utilization as potential donors in the chickpea improvement programme. The amino acid profiling of selected high and low protein containing genotypes showed considerably greater average amino acid score for all the essential amino acids than the WHO recommended requirement values and is comparable to those of the ‘complete protein’ sources of food suggesting that chickpea deserves to be considered as a ‘complete protein’ source.

A new genus and new species of gecarcinucid freshwater crab, Aradhya placida gen. et sp. nov., is recognized from the northern part of the Central Western Ghats of India. The new genus is diagnosed, and the new species from the Uttara Kannada district of Karnataka state, is described herein. The new genus most resembles Arcithelphusa Pati & Sudha Devi, 2015, Cylindrotelphusa Alcock, 1909, Rajathelphusa Raj, Kumar & Ng, 2021, and Pavizham Raj, Kumar & Ng, 2022, in having an ovate, relatively narrow and deep carapace, with the front narrow as compared to other Indian gecarcinucid genera. Aradhya gen. nov. is nevertheless separated from those genera by the characters in the carapace, epigastric and postorbital cristae, external orbital angle, cervical grooves, third maxilliped, chelipeds, male thoracic sternites/sternopleonal cavity/pleon, male second gonopod, and especially by the elongated male telson and the stouter ultimate article of the male first gonopod.

Introduction and Aim: Anterior cervical decompression and fusion (ACDF) is the go-to treatment for degenerative cervical illness that causes persistent radiculopathy. It has been suggested that a separate cage be used so that the patient's plates do not get damaged. This research aims to examine the radiological and functional results of discectomy and cage placement in patients with cervical disc prolapse. Materials and Methods: This study prospectively assessed patients who had anterior cervical decompression and fusion using a freestanding cage. Patients' pain levels on a Visual Analog Scale (VAS) and their level of impairment as measured by the Neck impairment Index (NDI) were taken before surgery. Post-operative pain assessment, looked out for cage related complications during follow up period at 3rd and 6th month post operatively by radiological evaluation. Results: Median age of neutral group and kyphosis was 45 and 34 respectively. Maximum number of patients had C5 - C6 IVDP. Median Cobb’s angle was higher in kyphosis group as compared to neutral group. Before surgery, at 10 days, and at 3 and 6 months after surgery, the kyphosis group had a higher median VAS and NDI score than the neutral group. Conclusion: The present study demonstrated that ACDF using a single cage successfully reduced the patient's preoperative neck pain and associated disability. The advantages of ACDF with a single cage include a shorter surgical time, better cervical lordosis and disc height, and no cage sinking. As a result, cage fusion as a stand-alone treatment option for cervical degenerative disease is likely to be regarded as a viable option.

Abstract: Cancer is a multi-step process involving alterations in epigenetic and genetic processes. Oral squamous cell carcinoma is a frequent oral malignancy that originates from the transformation of normal cells into malignant cells as a consequence of failures in a series of normal molecular and cellular processes. The mechanism of human carcinogenesis is often seen as a double-edged sword, with the body's system being thought to counteract the detrimental consequences of neoplastic cell proliferation while simultaneously promoting tumor development. Various transcription factors play a significant part in cancer regulation, with the activator protein-1 family of transcription factors (TFs) being the most prominent regulatory protein family. The Jun, Fos, ATF, and MAF protein families are all present in the AP-1 dimeric complex. While certain AP-1 proteins, including JunB and c-Fos, are known to be majorly oncogenic in function, experimental studies have shown that other AP-1 proteins, such as JunB and c-Fos, also play a critical role in tumor suppression. The aim of this review is to offer breakthrough information on the role of molecular mechanisms mediated by AP-1 TFs in tumor development and its environment.

Classic Toxic Epidermal Necrolysis (TEN) in Lupus Erythematosus (LE) is rare and that caused by oxcarbazepine is even rarer. It can be triggered/induced by various insults, the most prominent being drugs. Herein, we describe a young female, a diagnosed case of LE with lupus nephritis, with recent-onset central nervous system vasculitis (incidentally detected on neuroimaging while she was being evaluated for a recent-onset behavioural change), who within a month of exposure to the drug developed an extensive exfoliating skin rash with mucosal lesions, which on histopathological evaluation showed TEN in LE, triggered by Oxcarbazepine, which was commenced for seizure prophylaxis. She was managed with pulse methylprednisolone, followed by intravenous immunoglobulin (IVIg), after which she made a satisfactory recovery. It is highlighted that TEN in LE patterns must be recognized in an emergency and Acute Syndrome of Apoptotic Panepidermolysis (ASAP) concept applied promptly without awaiting diagnoses. Further, many common drugs possibly trigger this pathology making the rara-avis not rare anymore!

A rapid and environment-friendly green synthesis of silver nanoparticles (AgNPs) using Macaranga Indica (M. Indica) plant extracts was explored in this study. The obtained AgNPs were characterized by UV–Vis, XRD, FTIR, and SEM for antimicrobial and photocatalytic activities. The typical surface plasmon resonance peak around 440 nm confirmed the formation of AgNPs. The particles were found to be very tiny in the range of 15–20 nm size and showed fcc crystal symmetry. The FT-IR study showed the presence of bio-molecules on the surface of AgNPs and acting as capping agents. The in vitro antibacterial screen of AgNPs showed the bio-capped AgNPs have a higher inhibitory action for E. coli and S. aureus followed by C.albicans. The degradation property of the AgNPs towards Rhodamine B (RhB)under different conditions revealed that the degradation efficiency of phytochemicals-coatedAgNPs on RhB was found to be high and around 88.8% within 70 min

Bitcoin is a decentralized digital currency. It is a type of cryptocurrency because it uses cryptography to keep it safe. It is gaining popularity among individuals but it is still not common to use this technique because people still invest in traditional techniques like stock market. Additionally, there are various factors that affect the price of bitcoin such as total circulating supply, production costs, bitcoin mining, rules and regulations, and bitcoin sentiment. These factors and their combinations are used to determine which factor has the greatest influence on the price of bitcoin, and then use the studied factors and the history of the price of bitcoin to predict the evolution of bitcoin prices. Another emerging technique in computer science is deep learning, which is used for trend analysis. The models used are RNN, LSTM, and the model that gives the best result is selected for prediction.

There is no consensus on the best donor for children with nonmalignant disorders and immune deficiencies in the absence of a matched related donor (MRD). We evaluated the 2-year overall survival (OS) after umbilical cord blood transplantation (UCBT) in patients with nonmalignant disorders from 2009 to 2020 enrolled in a prospective clinical trial using either 5/6 or 6/6 UCB as the cell source. Patients receive a fully ablative busulfan, cyclophosphamide, and fludarabine without serotherapy. Fifty-five children were enrolled, median age 5 months (range, 1-111 months); primary immune deficiency (45), metabolic (5), hemophagocytic lymphohistiocytosis (1), and hematologic disorders (4). Twenty-six patients had persistent infections before transplant. Nineteen of them (34%) were 6/6 matched, and 36 (66%) were 5/6 human leukocyte antigen–matched. The OS at 2 years was 91% (95% cumulative incidence, 79-96), with a median follow-up of 4.3 years. The median time to neutrophil and platelet recovery were 17 days (range, 5-39 days) and 37 days (range, 20-92 days), respectively. All but one evaluable patient achieved full donor chimerism. The cumulative incidence of acute GVHD grades 2-4 on day 100 was 16% (n = 9). All patients with viral infections at the time of transplant cleared the infection at a median time of 54 days (range, 44-91 days). All evaluable patients underwent correction of their immune or metabolic defects. We conclude that in the absence of MRD, UCBT following myeloablative conditioning without serotherapy is an excellent curative option in young children with nonmalignant disorders. This trial has been registered at www.clinicaltrials.gov as NCT00950846.

We consider last passage percolation on $\mathbb Z^2$ with general weight distributions, which is expected to be a member of the Kardar-Parisi-Zhang (KPZ) universality class. In this model, an oriented path between given endpoints which maximizes the sum of the i.i.d. weight variables associated to its vertices is called a geodesic. Under natural conditions of curvature of the limiting geodesic weight profile and stretched exponential decay of both tails of the point-to-point weight, we use geometric arguments to upgrade the assumptions to prove optimal upper and lower tail behavior with the exponents of $3/2$ and $3$ for the weight of the geodesic from $(1,1)$ to $(r,r)$ for all large finite $r$. The proofs merge several ideas, including the well known super-additivity property of last passage values, concentration of measure behavior for sums of stretched exponential random variables, and geometric insights coming from the study of geodesics and more general objects called geodesic watermelons. Previously such optimal behavior was only known for exactly solvable models, with proofs relying on hard analysis of formulas from integrable probability, which are unavailable in the general setting. Our results illustrate a facet of universality in a class of KPZ stochastic growth models and provide a geometric explanation of the upper and lower tail exponents of the GUE Tracy-Widom distribution, the conjectured one point scaling limit of such models. The key arguments are based on an observation of general interest that super-additivity allows a natural iterative bootstrapping procedure to obtain improved tail estimates., 45 pages, 6 figures

Background. Intrinsic capacity (IC) is conceptualized by World Health Organization (WHO) with a focus on healthy aging. Identifying impairment could help in making a person-centred plan for the care of older adults. Objectives. Establish the prevalence of IC among community-dwelling older adults age >60, the prevalence of impairment in each domain, and identify factors associated with an impairment in IC. Methods. This cross-sectional observational study in the community setting included 1000 older adults aged 60 years and above in two-year study period. The 6 domains of IC including cognition, locomotor capacity, psychological, vitality, hearing, and vision were derived from the comprehensive geriatric assessment. The IC composite score was calculated based on these domains, and a higher IC score indicated greater IC. Results. During the study period, 1000 older adults, with the median age of 66.5 (IQR-63-73) were included, and 629 (62.9%) were women. Only in 157 (15.7%) community-dwelling older adults, all 6 domains were intact. Impairment in one, two, and three domains was seen in 442 (42.2%), 305 (30.5%), and 91 (9.1%), respectively. The most prevalent impaired domain was locomotor (593, 59.3%), followed by vision (441, 44.1%), hearing (193, 19.3%), cognition (106, 10.6%), mood (38, 3.8%), and vitality (37, 3.7%). The factors associated with lower IC included increasing age (β-coefficient −0.01, 95% CI: −0.02 to −0.01, p value = 0.002), impaired activities of daily living (β-coefficient −0.13, 95% CI: −0.49 to −0.18, p value p value = 0.001). Conclusions. In conclusion, we found that impairment in IC was frequent in community-dwelling older adults, and it is associated with age, presence of chronic neurologic illness, and declining functionality. The adoption of IC should be seen as an opportunity to disseminate geriatric care in our healthcare systems which lack the necessary attention to the needs of older persons.

Myeloid cells represent a dominant cellular compartment of tumor lesions and play key roles in tumor inception, progression, metastasis, and response to treatment. Mononuclear phagocytes (MNPs), which include dendritic cells and macrophages, are unique among myeloid cells, as they not only shape both the broader composition and state of the tumor microenvironment but can also specifically instruct cancer-specific, T cell–mediated tumor cell killing, making them especially attractive targets for cancer treatment. Although MNPs remain difficult to modulate therapeutically, our understanding of MNP biology in the antitumor immune response has expanded significantly, offering hope for new possibilities in cancer immunotherapy. Here, we review the recent advances in our study of the cellular identity, molecular diversity, and spatial organization of MNPs in tumors, and we discuss the importance of tailoring therapeutic strategies to incorporate these new insights into cancer treatment design.

Introduction: Summative assessments play a major role in shaping the student’s learning. There is little literature available on validity of summative assessment question papers in Forensic Medicine & Toxicology. This study analyses 30 question papers from 6 reputed universities for content validity. Methods: A retrospective cross-sectional record-based observational study was conducted where 30 university summative question papers in Forensic Medicine & Toxicology from 6 universities across India were evaluated for content validity. The learning domain assessed, the type of questions asked, and sampling of the content was compared and presented in the results. Results: From the results of the study, it was noted that 80% weightage was allotted to recall in most papers and only one paper tested for application. 70 to 80% of the marks were allotted to Forensic Pathology leading to disproportionate sampling. Core areas in Toxicology and Medical Jurisprudence were sparsely assessed. Conclusion: The content validity of the summative question papers in Forensic Medicine and Toxicology was unsatisfactory, emphasising the need for evaluation of the clarity and efficacy of the blueprints being used by the universities. Faculty training to motivate and influence a change in the mindset is necessary to bring about a course correction.

The NCCN Guidelines for Non–Small Cell Lung Cancer (NSCLC) provide recommendations for management of disease in patients with NSCLC. These NCCN Guidelines Insights focus on neoadjuvant and adjuvant (also known as perioperative) systemic therapy options for eligible patients with resectable NSCLC.

The current global population is expected to reach 9.7 billion by 2050, which will put immense pressure on the food production system to meet the growing demand. However, the traditional farming system alone is not sufficient to meet this demand due to various limitations such as limited land availability, environmental factors, and inefficient use of resources. As a result, there is a real need for adapting new farming systems that can help stimulate plant growth faster and more efficiently. One such technique is Hydroponics, which is a soil-less method of growing plants using mineral nutrient solutions in a water solvent. Hydroponics has been proven to be more efficient than traditional farming systems, as it allows for higher crop yields in less time and with fewer resources. Therefore, creating awareness about this new farming technique and providing farmers with the necessary resources and support to implement it on their farms can help address the food production challenges. In addition to the farming technique, farmers are also facing issues related to intermediaries, who take a cut of their profits, resulting in losses for the farmers. To address this problem, a platform is being created to enable direct interaction between farmers and buyers By implementing this solution, farmers can increase their income, improve their standard of living, and contribute to the development of a sustainable and efficient food production system.

Abstract: Artificial intelligence (AI) speeds up the drug development process and reduces its time, as well as the cost which is of enormous importance in outbreaks such as COVID-19. It uses a set of machine learning algorithms that collects the available data from resources, categorises, processes and develops novel learning methodologies. Virtual screening is a successful application of AI, which is used in screening huge drug-like databases and filtering to a small number of compounds. The brain’s thinking of AI is its neural networking which uses techniques such as Convoluted Neural Network (CNN), Recursive Neural Network (RNN) or Generative Adversial Neural Network (GANN). The application ranges from small molecule drug discovery to the development of vaccines. In the present review article, we discussed various techniques of drug design, structure and ligand-based, pharmacokinetics and toxicity prediction using AI. The rapid phase of discovery is the need of the hour and AI is a targeted approach to achieve this.

Radionuclide imaging is a non-invasive modality based on tracer physiology widely utilized in the diagnosis, staging, therapeutic evaluation, and monitoring of metastatic disease in a spectrum of malignancies. Calcific tendinopathy is a well-recognized disorder related to the deposition of calcium hydroxyapatite crystals within tendons. We describe a patient with urothelial carcinoma of the bladder revealing increased uptake at the left hip on 99mTc labeled methylene diphosphonate scintigraphy suggesting a metastatic lesion. Cross-sectional imaging with magnetic resonance imaging confirmed the accurate diagnosis of calcific tendinopathy of gluteus maximus insertion. This case report highlights the importance of a thorough clinical evaluation and complementary imaging in assessing benign pathologies which may mimic metastatic bone lesions.

Objectives: There has been a significant increase in insufficiency fractures of the pelvis. Early diagnosis is essential to decrease morbidity and mortality. We describe the incidence of demographics of insufficiency fractures in different parts of the pelvis. Material and Methods: A retrospective search of the radiology database for insufficiency fractures was performed at a tertiary orthopedic center. We analyzed the location of insufficiency fractures and demographics. Results: There were 323 insufficiency fractures, with the majority being in the sacrum and pelvis. Insufficiency fractures of pubis, acetabulum and sacrum were in relatively older patients. Conclusion: Early diagnosis and management are crucial.

With the rise of e-commerce, consumers are becoming accustomed to shopping online and leaving reviews of their experiences on retailer and review websites. These op-ed pieces provide future customers with useful information for making decisions, and they also help businesses improve their goods and/or services. Yet, when the number of reviews increases quickly, users are forced to deal with a serious information overload issue. Several opinion mining techniques, such as opinion summarization, opinion polling, and comparative analysis, have been suggested to address this issue. How to correctly estimate the sentiment direction of review sentences is the main challenge. Sentiment analysis is a quickly developing subfield of the study of Natural Language Processing (NLP).In recent years, it has drawn a lot of interest. Sentiment analysis is used to assess or investigate user comments in order to make judgements about their opinions. Sentiment analysis is a machine learning (ML) technique in which computers classify and investigate human attitudes, feelings, and viewpoints towards the things that are communicated through text, star ratings, thumbs up and down, and other textual or graphical representations. The data for this study came from online product reviews acquired from the model website we created. Adjectives and adverbs can convey the opposite feeling with the use of negative prefixes. Such words are located using a negative phrase identification method. By using evaluation measures, the performance is assessed. Finally, we provide insight. Finally, we also provide a preview of our upcoming sentiment analysis research.

By using the solid-state reaction approach, composite polycrystalline samples of (Bi0.98In0.02)2Te2.7Se0.3/x%Bi2Se3 were created with varying amounts of Bi2Se3, (x = 5%, 10%, 15%, and 20%). The hexagonal crystal structure of the composite was revealed by x-ray diffraction (XRD) with a space group of R$$\overline{3 }$$ 3 ¯ m. The surface of the samples was seen to have secondary particles using a field emission scanning electronic microscope. Every sample displayed the typical semi-conducting behaviour across the entire temperature range. In the complex (Bi0.98In0.02)2Te2.7Se0.3, it was found that bismuth was coordinated with six selenium atoms and there were significant selenium vacancies. With an increase in bismuth selenide concentration, the dissolution pattern shifted to a substitutional pattern. A two fold decrease in electrical resistivity for (Bi0.98In0.02)2Te2.7Se0.3/20%Bi2Se3 composition was seen compared to (Bi0.98In0.02)2Te2.7Se0.3/5%Bi2Se3. The granular material was produced by sintering and scattering of potential barrier, a thermal process that increases the Seebeck coefficient. A 200% increase was observed in thermopower for (Bi0.98In0.02)2Te2.7Se0.3/20%Bi2Se3 compared to (Bi0.98In0.02)2Te2.7Se0.3/5%Bi2Se3 compound. Graphical Abstract

The emergence of the Internet has caused substantial change in many industries. The internet, as a global computer network, has made people's life easier since they can often more quickly obtain any information they want. Communication is one of the primary areas that the internet has altered. Communication has become very simple as a result of the internet's integration of communication technology. Email is frequently regarded as the most secure means of transmitting or receiving sensitive data over the Internet. Because these gadgets need visual awareness, using them may be difficult for persons with visual impairments. A visually impaired person cannot use the current email software without the aid of others who send emails on their behalf. This, however, does not secure that person's protection and confidentiality. This lead to the creation of a voice-based email that requires minimal training. It employs speech recognition as well as mouse clicks. Facial recognition is used to improve user authentication, security, and privacy. Voice-mail allows users to easily send, receive, and delete emails. Each user activity is accompanied by an interactive speech response. It might be used by both visually impaired folks and ordinary people.

Purpose The purpose of this paper is to develop a framework to evaluate and assess the performance of the COVID-19 vaccine distribution process that is sensitive to the unique supply-side and demand-side constraints exhibited in the US vaccine rollout. Design/methodology/approach A queuing framework that operates under two distinct regimes is formulated to analyze service rates that represent system capacity to vaccinate (under the first regime) and hesitancy-induced throughput (under the second regime). These supply- and hesitancy-constrained regimes form the focus of the present paper, as the former reflects the inherent ability of the nation in its various jurisdictions to mobilize, whereas the latter reflects a critical area for public policy to protect the population’s overall health and safety. Findings The two-regime framework analysis provides insights into the capacity to vaccinate and hesitancy-constrained demand, which is found to vary across the country primarily by politics and region. The framework also allows analysis of the end-to-end supply chain, where it is found that the ability to vaccinate was likely constrained by last-mile administration issues, rather than the capacity of the manufacturing and transportation steps of the supply chain. Originality/value This study presents a new framework to consider end-to-end supply chains as dynamic systems that exhibit different regimes because of unique supply- and demand-side characteristics and estimate rollout capacity and underlying determinants at the national, state and county levels.

Background: Turner syndrome (TS) is the commonest chromosomal abnormality in females with an incidence of 25–50 per 100,000 females. Girls with TS universally have short stature (95%), along with gonadal failure (>90%) and infertility (99%); however, the ethnic differences are not well elaborated. Objectives: This study has been planned to evaluate the presentation and course of Indian girls with TS. Methods: Patients with TS presenting to our referral endocrinology clinic were included in this study. Diagnosis of TS was done by karyotyping. A retrospective chart review of these patients formed the basis of this study. Results: A total of 55 patients with TS karyotype were seen, and the mean age at diagnosis was 12.3 years. The commonest presenting features were short stature alone seen in 37 (65.45%) and short stature with delayed puberty in 18 (32.72%). The earliest age at presentation was 4.5 years who presented with short stature. The mean height was 124.17 cm and mean BMI 17.54 kg/m2. The most common karyotype was 45, XO found in 34 (61.6%) of the cases. 15 (27.27%) the cases were started on growth hormone therapy. 26 cases (47.27%) required pubertal induction. Conclusion: A vast number of cases with TS in India remain undiagnosed until puberty or present very late. A high degree of clinical suspicion can help us diagnose these children earlier. If TS is diagnosed earlier, growth can be achieved up to their maximum potential. Early identification and management will help us provide multidisciplinary care and hence prevent complications.

Aim: To assess and summarize effect of computerized anesthesia techniques in reducing pain as compared to conventional technique in adult patients undergoing dental treatment. We conducted a comprehensive Methods: literature search on four electronic databases, PubMed, net of information, google scholar, and Cochrane library for this systematic review after registering with Prospero. The inclusion and exclusion was stringent to conduct the filtering and select the Randomised Control Trial/ Clinical Trial which were eligible for qualitative and subsequent quantitative analysis. The heterogeneity was analyzed with the I2 values and risk of bias was conducted with appropriate tool form Cochrane. Review Manager 5.3 was used for meta-analysis. Out of 24 studies, 08 studies were further Results: included for quantitative analysis and the meta-analysis was interpreted with the forest plot. The outcome which we assessed was the pain outcome after anaesthesia. The mean cumulative difference was -1.73 (CI: -3.01to -0.45). The heterogeneity was I2=91%, hence we applied the random effects model for analysis. The CCLAD seems to be a promising Conclusion: device, offering a less painful method of anaesthesia administration; which showed that the pain was higher in conventional group when compared to other interventional techniques.