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PURPOSE The outcomes of patients with myeloma from developing countries are often lacking because of poor record maintenance. Publications from such settings are also limited because of the retrospective nature of the data collection. Information technology can bridge these gaps in developing countries with real-time data maintenance. We present the real-time survival data of the patients with myeloma from a tertiary care center in North India using one such indigenously built software. PATIENTS AND METHODS These are real-time data of all patients with myeloma presenting to a tertiary care center from North India. The patient characteristics (demographics, baseline disease characteristics, risk stratification, and outcomes) were recorded contemporaneously. The survival of the study population was analyzed and grouped based on various disease characteristics at diagnosis. RESULTS The median age of the study population (N = 696) was 65.9 (34.9-94.9) years with male predominance (65%). The median follow-up was 3.7 years (0-18.6 years) with the median overall survival (OS) not achieved. The OS of the study population at 1, 3, and 5 years was 94% (n = 558), 87.5% (n = 394), and 83.1% (n = 267), respectively. Most of the patients presented in advanced stages based on International Staging System (III:70%). On Kaplan-Meier analysis, the presence of weight loss ( P = .01), renal dysfunction ( P = .047), and anemia at diagnosis ( P = .004) had a significant impact on survival. On Cox proportional model univariate analysis, the presence of renal dysfunction, anemia, and weight loss had the significant hazard ratio of 1.68 (1-2.82, P = .049), 3.18 (1.39-7.29, P = .0063), and 2.81 (1.22-6.42, P = .014), respectively, whereas on multivariate analysis of hypercalcemia, renal disease, anemia, and bone disease (CRAB) features, only anemia was found to have a significant hazard ratio of 2.56 (1.01-6.47, P = .046). CONCLUSION The real-world data show OS comparable with the published western literature. Only anemia was found to have significant impact on survival. The use of such software can aid in better data-keeping in resource-constrained settings.

The oral route is the best and most popular route for the administration of drugs in the systemic circulation. There are number of drugs which are given through the oral route. Gastro-retentive drug delivery system is very important system for the drug delivery system. The gastro-retentive drugs prolonged the drug time in the git and also improve their their bioavailability. These are widely used for site specific for the treatment of git disorders and diseases. There are number of approaches for gastro retentive drug delivery system such as floating system, mucoadhesive system, swelling system, high density system etc. In this review we discussed about approaches and various perspectives of gastro retentive drug delivery system.

Luster for a fiber/fabric system is a phenomenon to the reflectance of incident light to the surface, addressed as its shine or gloss. Presently, objective evaluation of the shine for straight hair...

With the advancements in sensor networks, Wireless multimedia sensor networks (WMSNs) have emerged and shifted the objectives of sensor nodes to multimedia devices which can retrieve audio, images, and video. In WMSNs, the sensor nodes are tiny microphones and cameras which can transmit image, audio or video using the network. However, these nodes are battery constrained (i.e., may become dead after passing certain iterations). Therefore, improvement of the network lifetime is a challenging issue of WMSNs. In this paper, a reinforcement-based energy-aware protocol is designed and implemented. To successfully implement the reinforcement-based protocol, a State-Action-Reward-State-Action (SARSA) is used for learning a Markov decision process. Extensive experiments are considered to evaluate the significant improvement of the proposed protocol. Comparisons are also drawn between the competitive protocols and the proposed protocol. From comparative analysis, it is found that the proposed protocol conserves more energy as compared to the competitive protocols.

This paper presents a halfway signaling exchange shared path protection (HSE-SPP) on the backup route for a fast connection recovery strategy. In the proposed HSE-SPP, a pre-assigned intermediate node on the backup route is chosen for signaling exchange. When connection fails, source and destination nodes simultaneously generate backup connection setup messages to the pre-assigned intermediate node on the reserved backup route. At the intermediate node, signaling process occurs, and acknowledgment is generated for data transmission to the respective end nodes. Consequently, connection recovery time by applying HSE-SPP becomes very low. Simulations are performed for network parameters and results are verified with existing strategies. The average recovery time (RT), bandwidth blocking probability (BBP), bandwidth provisioning ratio (BPR), and resource overbuild (RO) ratio of HSE-SPP for ARPANET is 13.54ms, 0.18, 3.02, 0.55, and for dedicated path protection (DPP) are 13.20ms, 0.56, 6.30, 3.75 and for shared path protection (SPP) 22.19ms, 0.22, 3.23, 0.70 respectively. Similarly, average RT, BBP, BPR and RO of HSE-SPP for COST239 are 8.33ms, 0.04, 1.64,0.26, and for DPP 4.23, 0.47, 3.50, 2.04, and for SPP 11.81, 0.08, 1.66, 0.27 respectively. Hence, results of the proposed strategy are better in terms of RT, BBP, BPR, and RO ratio.

Background: Clinical experience on details of CRRT initiation and outcomes in cardiac intensive care unit (CICU) patients is not available from developing countries like India. This study shares the 5-year clinical experience of managing CICU patients requiring CRRT in a tertiary care cardiac center of North India. Materials and methods: Medical records of all CICU patients with acute kidney injury (AKI) managed by CRRT from October 2011 to September 2016 at tertiary referral center in North India were retrospectively reviewed. Multiple logistic regression analysis was used to identify predictors of post-CRRT mortality. Results: A total of 630 patients received CRRT during the study period. Most commonly AKI developed in patients with acute coronary syndrome (30.2 %) with cardiogenic shock. 55.9 % of the CRRT patients were >60 years of age, and/or on multiple supports in ICU including, mechanical ventilation, high doses of inotropes & vasopressors and other cardiovascular support. Of those on CRRT, 130 (20.6 %) patients had died, 215 (34.1 %) were discharged and 285 (45.2 %) could not complete the desired course. Multivariate regression analysis showed independent association of mortality with high vasoactive-inotropic score, single CRRT cycle and low mean arterial pressure in CRRT patients. Conclusion: About 34.1 % of patients receiving CRRT were alive at discharge, emphasizing the feasibility and utility of CRRT as a promising modality in this population for improving outcomes.

RATIONALE & OBJECTIVE: While there are several well-known anatomical and physiological changes during pregnancy that could contribute to kidney stone formation, evidence that they increase the risk of kidney stones during pregnancy is lacking. This study aimed to determine whether there was an increased risk of a first-time symptomatic kidney stone during and after pregnancy. STUDY DESIGN: A population-based matched case-control study. SETTING & PARTICIPANTS: 945 female first-time symptomatic kidney stone formers aged 15–45 years and 1,890 age-matched female controls in Olmsted County, Minnesota from 1984–2012. Index date was the date of onset of a symptomatic kidney stone for both the case and their matched controls. EXPOSURE: The primary exposure was pregnancy with assessment for variation in risk across different time intervals before, during, and after pregnancy. Medical records were manually reviewed to determine the conception and delivery dates for pregnancies. OUTCOME: Medical record-validated first-time symptomatic kidney stone. ANALYTIC APPROACH: Conditional and unconditional multivariable logistic regression analysis. RESULTS: Compared to non-pregnant women, the odds of a symptomatic kidney stone in women was similar in the first trimester (OR, 0.92; p=0.8), began to increase during the second trimester (OR, 2.00; p=0.007), further increased during the third trimester (OR, 2.69; p=0.001), peaked at 0–3 months after delivery (OR, 3.53; p1 year ago) was also associated with a first-time symptomatic kidney stone (OR, 1.27; p=0.01). LIMITATIONS: Observational study design in predominantly white population. The exact timing of stone formation cannot be determined. CONCLUSIONS: Pregnancy increases the risk of a first-time symptomatic kidney stone. This risk peaks close to delivery and then improves by 1 year after delivery, though a modest risk of a kidney stone still exists beyond 1 year after delivery.

PurposeThe purpose of this study is to understand and interpret the fundamental meanings attached to consumer behavior through m-Government (m-Gov) experience and to derive insights. The study explores the extent to which the emergence of m-Gov is able to change citizens established behavior of accessing government services primarily focusing on experience as an important driver.Design/methodology/approachThe study used qualitative methods, and data were collected using semi-structured interviews of m-Gov users. Participants were identified through purposive sampling. Themes are identified from the collected data using thematic analysis.FindingsThe study reveals that m-Gov experience is highly satisfying since it meets citizens' expectations. The findings highlight that in many aspects, m-Gov services provide improved experiences compared to the traditional government and conventional e-Government (e-Gov) services (accessing public services from computers and laptop). The study also reveals a few negative experiences with m-Gov services, like limitations in the use of mobile devices due to their small screen size and high memory consumption, etc.Research limitations/implicationsThe qualitative method used in this study focuses clearly on unearthing depth and richness of understanding rather than the breadth of generalization. The sample size is apt for drawing reasonable conclusions. Scholars and information systems researchers may use some insights for future research.Practical implicationsm-Gov services in a developing economy like India is a new and emerging area for managers. The findings about the elements of m-Gov experience and how the experience influences citizens' acceptance decisions will benefit managers and policymakers in implementing m-Gov services or projects.Originality/valueThis study is one of the early attempts to explore the m-Gov experience. The research is important as experience affects users' attitude, a precursor to behavioral intention, which in turn, influences their behavior.Peer reviewThe peer review history for this article is available at: https://publons.com/publon/10.1108/OIR-10-2020-0482

The term "digital" has been ingrained in our culture. At a quicker rate than the rest of the world, every industry has adapted to the digital era. Apart from the website, the pharmaceutical sector has yet to fully embrace digital marketing. More pharmaceutical and healthcare firms are using social media sites or eCommerce sites as digital marketing platforms in the wake of the Corona Virus pandemic. Some businesses are attempting to comprehend the actual worth of digital, while others are incorporating it into their whole marketing plan. In the pharmaceutical and healthcare industries, digital marketing is displacing traditional marketing techniques. This research looked at a variety of topics, including marketing among youth, the present role of digital marketing in the pharmaceutical business, the influence of COVID-19, and current consumer buying behavior. The main goal is to learn about the past, comprehend the current shift, and forecast the consequences of pharmaceutical marketing in the future. This is accomplished by doing a thorough literature review and then presenting a questionnaire based on the findings for validation among the general public. KEY WORDS: Marketing, Health Services, Pharmaceuticals, COVID-19, Pandemic, Youth

The aim of this study is to obtain a clear picture of ENT related symptoms in active COVID-19 patients. This study also intends to determine the association of ENT symptoms with Olfactory and Gustatory dysfunction in these patients. Material and Methods: This is a prospective study on 70 active COVID-19 patients who were admitted in the Tertiary Care Hospital. History of all symptoms including Olfactory and Gustatory function were enquired after obtaining Informed Consent. Results: Throat related symptoms was 77.78%, Nasal symptoms accounted for 63.49% and Ear related symptoms constituted 14.28%. It was seen that Rhinorrhoea and Sneezing was significantly more associated in the presence of Olfactory dysfunction. The most common ENT symptoms were Sore throat (49.21%), Rhinorrhoea (34.92%), Sneezing (33.33%), changes in Smell perception (36.51%), changes in Taste perception (47.62%) and Headache (30.16%). 17.14% of the patients in this study had both Olfactory and Gustatory dysfunction. Ear related symptoms were also observed where 11.11% had Aural fullness, 3.17% with Tinnitus and 6.35% of the patients complained of Hearing loss which was either noticed for the first time or had worsened on contracting the COVID-19 disease. Discussion: Knowledge of ENT symptomatology in COVID 19 patients will aid in early quarantine and hence limitation of viral transmission. The manifestation of Anosmia or Hyposmia, Ageusia and Aural Fullness in SARS-CoV-2 infected patients can also act as an important tool and help in early isolation and quicker initiation of COVID-19 therapy.

In the medical image analysis, recognition of tumor in brain is very important task and it leads cancer which should be diagnosed at early stage. It is an irregular cell population in brain and for the cancer diagnosis; medical imaging techniques play an important role. The mostly used and efficient technique for the segmentation is Magnetic resonance imaging (MRI). There is huge progress the field of MRI imaging technique for accessing the brain injury and the brain anatomy exploring. The segmentation and detection of the tumor from the MRI images are done by the image processing techniques. Manual detection of brain tumor is the complex task, so the different image segmentation methods are developed for detection and segmentation of the tumor from the MRI images. The various recent brain tumor segmentation techniques are thoroughly discussed in this paper. The quantitative analysis of existing techniques and the performance evaluation is done and detailed. The paper revealed different image segmentation methods are briefly discussed. This survey article provides the detailed information of the different segmentation methods along with their merits and demerits. Effectiveness of the methods is shown in terms of the performance parameters.

HUIM (High utility itemsets mining) is a sub-division of data mining dealing with the task to obtain promising patterns in the quantitative datasets. A variant of HUIM is to discover the HAUIM (High average-utility itemsets mining) where average-utility measure is used to obtain the utility of itemsets. HAUIM is the refined version of FIM (Frequent itemset mining) problem and has various applications in the field of market basket analysis, bio-informatics, text mining, network traffic analysis, product recommendation and e-learning among others. In this paper, we provide a comprehensive survey of the state-of-the-art methods of HAUIM to mine the HAUIs (High average-utility itemsets) from the static and dynamic datasets since the induction of the HAUIM problem. We discuss the pros and cons of each category of mining approaches in detail. The taxonomy of HAUIM is presented according to the mining approaches. Finally,various extensions, future directions and research opportunities of HAUIM algorithms are discussed.

Background: Menopause is regarded as the marker for various symptoms such as physical, psychological, vasomotor, and sexual impairing the quality of life (QOL). Objectives: To assess the menopause-related QOL and determine associated factors among postmenopausal women. Materials and Methods: A cross-sectional study was conducted among 378 postmenopausal women attending the obstetrics and gynecology department of a tertiary care hospital using a standardized menopause-specific QOL (MENQOL) questionnaire consisting of physical, vasomotor, psychosocial, and sexual domains. Results: The study included 378 women aged above 40 years, with majority belonging to the age group of 46–50 years. The total MENQOL mean score was found to be 19.35 ± 16.20, with physical domain score the highest 14.89 ± 11.85, followed by vasomotor 1.98 ± 3.83, psychosocial 1.82 ± 3.29, and the least as sexual domain with score of 0.624 ± 2.21. Post menopausal women with age less than 50 years, No formal education, High socio-economic status, Home makers and duration of menopause less than 5 years was found to have statistical significant association with higher vasomotor domain score; No formal education, higher socio economic status and duration of menopause with greater than 5 years was found to be significant with higher sexual domain scores. Conclusions: Menopause may be associated with a decrease in QOL. Certain sociodemographic variables showed a statistically significant association with the vasomotor and sexual domains. Awareness and interventions that affect the modifiable factors may help in increasing the QOL at menopause.

Phyllodes tumours (PTs) of the breast are rare biphasic fibroepithelial neoplasm. They have potentiality to recur and metastasise. Majority of them follow a benign clinical course. We have treated one patient suffering from PT at the out-patient department of Sri Ram Medical & Homoeopathic Research Centre, Gorakhpur, India. After detailed case taking and repertorisation, first Conium maculatum and later on Phytolacca decandra and Calcarea fluorica were prescribed on the basis of individualisation to treat the case. Outcomes were assessed clinically every month for subjective improvement and objectively by ultrasonography reports at every 6-month interval. Gradual improvement was noted over time. The case has been assessed with MONARCH Inventory, which shows ‘definite’ association between the medicine and the outcome.

Background: Thrombocytopenia is a common hematological abnormality observed in neonatal sepsis and considered as early, nonspecific marker of sepsis. The studies related to organism specific platelet response are few. Objective: To assess the prevalence of thrombocytopenia and to study changes in various platelet parameters in relation to different isolated organism. Methods: A prospective observational study involving neonates with 1st episode of culture positive sepsis was done over a period of 18 months. The platelet parameters studied were incidence, degree, duration of thrombocytopenia; mean platelet volume and platelet nadir among neonate with specific organism isolated. Results: Out of 114 culture positive sepsis 31% Klebsiella, 30% Pseudomonas, 13% Citrobacter, 18% CONS, 4% Staphylococcus Aureus (S Aureus) and 3% had Acinetobacter sepsis. Overall prevalence of thrombocytopenia was 88%, of which klebsiella and S. Aureus sepsis observed 100% prevalence of thrombocytopenia followed by 88% pseudomonas, 80% coagulase negative staphylococci (CONS), 75% Acinetobacter and 66% Citrobacter sepsis. The proportion of severe degree of thrombocytopenia (18% Vs 4%), higher MPV (61% Vs 54%) and longer duration of thrombocytopenia (3.63 ± 0.49 Vs 2.95 ± 0.52) was observed more with Gram negative sepsis than with Gram positive sepsis and statistically significant difference in platelet nadir was observed with Gram negative sepsis. Severe degree of thrombocytopenia was seen in 50% neonates with Acinetobacter and 23% with Klebsiella sepsis. Acinetobacter, Klebsiella and Pseudomonas sepsis had higher mean MPV value, longer duration of thrombocytopenia and lowest platelet nadir. The platelet parameters were less affected with Gram positive organism. Conclusion: Thrombocytopenia is a frequent occurrence in neonates with sepsis especially with Gram negative organism. Sepsis with Acinetobacter, Klebsiella & Pseudomonas organism was associated with prolonged duration, higher MPV and lower platelet count as compared to other isolated organisms.

Achtergrond Fibroadenoom van de borst is de meest voorkomende kwaal bij vrouwen met een aanzienlijk risico op overlijden. Uit de beschikbare literatuur blijkt dat borsttumoren verdwijnen door homeopathische behandeling. De huidige studie evalueerde de rol van homeopathische behandeling op borstfibroadenoma met behulp van ‘Triple assessment criteria’ (dubbel blind) en onderzoekt of homeopathische geneesmiddelen therapeutisch effect teweeg brengen door het veranderen van de oestrogeen en progesteron receptor (ER/PR) status op tumorweefsel. Materialen en Methoden Een open-label, prospectieve, single-arm, observationele studie werd uitgevoerd bij 64 vrouwelijke patiënten met fibroadenoom van de borst. Er werden drievoudige beoordelingscriteria gebruikt om de doeltreffendheid van de homeopathische behandeling van borstfibroadenomen te onderzoeken. Geïndividualiseerde homeopathische geneesmiddelen werden voorgeschreven. De meetresultaten vertoonden veranderingen in het klinisch beeld en het aantal en de omvang van de knobbels door middel van ultrasoonmammografie. ER/PR studie werd uitgevoerd door immunohistochemie met gebruik van quick score analyse. Resultaten Bij 23 gevallen (35,93%) van fibroadenomen was er na de behandeling geen knobbel meer meetbaar. Gedeeltelijke verbetering werd waargenomen in 22 gevallen (34,37%) met significante vermindering van de gemiddelde grootte (p Conclusie De studie toont aan dat de therapeutische effecten van toediening van geïndividualiseerde homeopathische geneesmiddelen een belangrijke rol spelen bij de behandeling van fibroadenomen van de borst. De resultaten van ER/PR laten een significante vermindering van ER zien, wat suggereert dat homeopathische geneesmiddelen een remmend effect hebben op ER.

Introduction Unlike lung adenocarcinoma patients, there is no FDA-approved targeted-therapy likely to benefit lung squamous cell carcinoma patients. Materials and methods We performed survival analyses of lung squamous cell carcinoma patients harboring therapeutically relevant alterations identified by whole exome sequencing and mass spectrometry-based validation across 430 lung squamous tumors. Results We report a mean of 11.6 mutations/Mb with a characteristic smoking signature along with mutations in TP53 (65%), CDKN2A (20%), NFE2L2 (20%), FAT1 (15%), KMT2C (15%), LRP1B (15%), FGFR1 (14%), PTEN (10%) and PREX2 (5%) among lung squamous cell carcinoma patients of Indian descent. In addition, therapeutically relevant EGFR mutations occur in 5.8% patients, significantly higher than as reported among Caucasians. In overall, our data suggests 13.5% lung squamous patients harboring druggable mutations have lower median overall survival, and 19% patients with a mutation in at least one gene, known to be associated with cancer, result in significantly shorter median overall survival compared to those without mutations. Conclusions We present the first comprehensive landscape of genetic alterations underlying Indian lung squamous cell carcinoma patients and identify EGFR, PIK3CA, KRAS and FGFR1 as potentially important therapeutic and prognostic target.

PURPOSE To determine predictive models (PM) that could improve the accuracy for identifying metastatic regional nodes in non-small cell lung cancer based on both PET and CT findings seen on 18F-FDG PET CT. METHODS Three hundred thirty-nine biopsy-proven NSCLC patients who underwent surgical resection and had a staging 18F-FDG PET CT were enrolled. PET parameters obtained were (1) presence of visual PET positive nodes, (2) SUVmax of nodes (NSUV), (3) ratio of node to aorta SUVmax (N/A ratio) and (4) ratio of node to primary tumour SUVmax (N/T ratio). CT parameters obtained were (1) short-axis diameter and (2) Hounsfield units (HU) of PET-positive nodes. PET and CT parameters were correlated with nodal histopathology to find out the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and overall accuracy. Different PM combining these parameters were devised and the incremental improvement in accuracy was determined. RESULTS Visual PET positivity showed sensitivity, specificity, PPV, NPV and accuracy of 72.4, 76.1, 30.1, 95.1 and 75.6, respectively. PM2 which combined visual PET positivity, NSUV and HU appears more clinically relevant and showed sensitivity, specificity, PPV, NPV and accuracy of 53.5, 96.5, 68.9, 93.6 and 91.2, respectively. PM6 which combined visual PET positivity, NSUV, N/A ratio and HU showed the maximum PPV (80.0%), specificity (98.3%) and accuracy of (91.9%). CONCLUSION PM combining parameters like nodal SUVmax, N/A ratio, N/T ratio and HU values have shown to improve the PPV, specificity and overall accuracy of 18FDG PET CT in the preoperative diagnosis of nodal metastases.

Dental Implants have changed the face of dentistry over the last 25 years. As with most treatment procedures in dentistry today, dental implants not only involve scientific discovery, research and understanding, but also application in clinical practice. As the implants are so successful in the field of dentistry there are also various complications associated to it. These complications are divided into two sections. The first section focuses on oral soft tissue complications and the second segment addresses hard tissue dilemmas. The complications may occur at any stage but the purpose of this review is to describe the complications in implantology during prosthetic phase that may be encountered during the construction of fixed implant retained prosthesis.

In the present study, attempts were made to compare the influence of protrusion method on the performance of liquefying and non-liquefying fuels which has different combustion processes in a hybrid rocket motor. The wax and PVC (Polyvinyl Chloride)-DOP (Dioctyl Phthalate) in the 50:50 ratios were used as the liquefying and non-liquefying fuel, respectively with gaseous oxygen as the oxidizer. The regression rate and combustion efficiency of a laboratory scale hybrid rocket motor were determined for the single, double and multi-protrusion cases. The nylon protrusion that regress with burn time was used as protrusion for liquefying fuel and graphite protrusion that do not burn were used as the protrusion for the non-liquefying fuel. The selection of these protrusions was such that the protrusion heights between them are comparable for the given experimental time. It has been observed that the use of three protrusions (0.2–0.5–0.8X/L) gave the highest improvement in regression rate for both fuels. The percentage improvement in regression rate was relatively similar for both the fuels with all the combinations of protrusion used and a minor difference was observed that was due to the difference in the height of protrusion. The improvement in combustion efficiency was observed to give the highest for both the fuels, when the protrusion was placed at 0.8X/L. The relative improvement with single protrusion in non-liquefying fuel was significant (around 42%) while with liquefying fuel it was only 8%. The use of double or three protrusion gave a minor improvement in the efficiency of liquefying fuel but reduction in efficiency was observed with non-liquefying fuel compare to the single protrusion.

For photography, remote sensing, aerial surveillance disaster relief and motion picture filmmaking quadcopters are very useful today, and it is essential to find out its limits, so that we can predict in which atmospheric conditions, it works with perfection. And another important factor for quad copter is to know about its effect in order to run smoothly. To overcome these problems, A 3D model of the drone is created on SolidWorks and CFD is performed on Ansys. This simulation results help researchers to see the after effects of different flight condition.

Background: Sickness absenteeism is a potential epidemiological issue leading to loss of productivity in addition to increasing the cost of health care and provides a major tool in enhancing occupational health care preventive strategies. Aim and Objectives: To determine the prevalence of sickness absenteeism and their associated factors among Industrial Workers of Pharmaceutical Manufacturing industries in Hyderabad. Materials and Methods: A cross sectional study was taken up among 160 Workers at two Pharmaceutical Manufacturing companies in Hyderabad using simple random sampling technique. Data included Individual, Occupational and Organizational factors influencing their sickness absenteeism and general health conditions in the past six months through camp based approach. Data was analysed using descriptive statistics and multinomial logistic regression analysis to predict the variables associated with the outcome. Results: The prevalence of sickness absenteeism was found among 19% of the workers. Common causes were due to sickness among 25(84%) and social responsibilities among 5(16%). On multinomial logistic regression analysis- poor superior relationships, poor co-workers relationship and high mental stress were found to be significant. Conclusion: Sickness absenteeism was found to be high which can be reduced by improving relationships with superiors and co-workers and also by reducing mental stress among the workers.

This study investigates the effects of single, double, and multi-protrusion on the performance of a hybrid rocket with two different L/D ratio motors, mainly 12.5 and 18. Wax and gaseous oxygen wer...

The Indian experience, in use of remotely sensed data for land use/land cover analysis, gained over past many years through the implementation of various projects. The satellite IRS-1C which was launched on December 28th, 1995 provided a new dimension to the mapping capability of land use/land cover analysis on various scales. Based on different studies, it is concluded that WiFS data can be used for level-I classification for national and regional level applications, whereas LISS-III alone can be use up to level-III for subregional scale and a combination of LISS-III and PAN data can be used for village-level information. IRS-lC data have been extremely useful in the generation of district-wise land used and cover maps, depicting the information up to level-II on 1:250,000 scale for land use planning and National Wasteland Inventory Project. A systematic study was carried out to identify and map 13 different types of wastelands on 1:50,000 scale up to village and micro-watershed level for some districts using IRS 1C data. A digital data with standard codification system in four different spatial layers were generated for the entire country, and about 63.85 million ha have been estimated as wastelands through this study. Various watershed programs are being implemented in the country consulting this database. A successor to this project “Monitoring of Wastelands,” which aim at reporting the changes in wastelands statistics in India, considering various developmental programs launched by Govt. of India since early 1990 has been implemented using IRS 1C data.

Recently, emerged outbreaks of various viral infections, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), MERS-CoV, and ZIKA infections, are fatal for human life. These life-threatening infections to public health pointed out as a major cause responsible for initiating severe diseases globally. These viral infections heightened the morbidity rates and thus, it is a deadly fear to human life. Researchers left no stone unturned for searching newer therapeutic targets and remedies to treat these viral infections and outbreaks. Simultaneously, some of the researchers have gained success in the discovery of an efficient treatment and development of an effective vaccine [1]. In view of that, numerous developments have been made for innovating nanotherapies, which can treat viral infection and few of them are written off as nanomedicine, have been become reality.

In the central nervous system (CNS), a specific loss of focal neurons leads to mental and neurological disorders like dementia, Alzheimer’s disease (AD), Huntington’s disease, Parkinson’s disease, etc. AD is a neurological degenerative disorder, which is progressive and irreversible in nature and is the widely recognized reason for dementia in the geriatric populace. It affects 10% of people above the age of 65 and is the fourth driving reason for death in the United States. Numerous evidence suggests that the neuronal compartment is not the only genesis of AD, but transcription factors also hold significant importance in the occurrence and advancement of the disease. It is the need of the time to find the novel molecular targets and new techniques for treating or slowing down the progression of neurological disorders, especially AD. In this article, we summarised a conceivable association between transcriptional factors and their defensive measures against neurodegeneration and AD. The mammalian forkhead transcription factors of the class O (FoxO) illustrate one of the potential objectives for the development of new methodologies against AD and other neurocognitive disorders. The presence of FoxO is easily noticeable in the “cognitive centers” of the brain, specifically in the amygdala, hippocampus, and the nucleus accumbens. FoxO proteins are the prominent and necessary factors in memory formation and cognitive functions. FoxO also assumes a pertinent role in the protection of multiple cells in the brain by controlling the involving mechanism of autophagy and apoptosis and also modulates the process of phosphorylation of the targeted protein, thus FoxO must be a putative target in the mitigation of AD. This review features the role of FoxO as an important biomarker and potential new targets for the treatment of AD.

Tablet is defined as solid pharmaceutical dosage form containing drug substance generally with suitable diluents and prepared by either compression which is given as a single unit and are known as solid unit dosage form. Tablets remain popular as a dosage form because of the advantages afforded, both to the manufacturer (e.g. simplicity and economy of the preparation, stability, and convenience in packing, shipping and dispensing) and the patient. The excipients include diluents, Binders and adhesives, disintegrates, etc. Tablets vary in shape and differ greatly in size and weight depending on the amount of the medicinal substance. The ingredients must be granulated prior to compression to assure an even distribution of the active compound in the final tablet. There are two basic techniques which can be used to granulate powders for compressions into a tablet are wet granulation and dry granulation. In this review article tablet manufacturing and evaluation have been discussed. Keywords- Tablet, Granulation, Picking and sticking, Dissolution test, weight variation

Response assessment after chemo-radiotherapy (CTRT) in locally advanced esophageal cancer is usually performed using a PET-CT scan, an upper GI endoscopy (UGIE) and histological correlation with biopsy or cytology. We aim to study the incremental value of brush cytology in addition to PET-CT for response assessment. In this retrospective analysis, 40 patients with Stage II- IV carcinoma esophagus treated with radical intent between June 2015 and August 2019 were included. Patients were treated with either upfront concurrent CTRT or neo-adjuvant chemotherapy followed by CTRT. All patients underwent PET-CT and UGIE for initial staging and response assessment on follow-up. Patients with esophageal stricture (disease related or treatment induced) had brush cytology done during UGIE. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of brush cytology were calculated considering serial clinical follow-up as gold standard. Twenty-three male (57.5%) and 17 (42.5%) female patients with median age of 57 years (range: 27 – 79 years) were analyzed. Concurrent CTRT was delivered in 52.5%; 75% patients were treated with intensity-modulated radiotherapy (IMRT); median RT dose was 63 Gy (range- 41.4 to 64 Gy). At a median follow-up of 16 months (range 6- 54 months), 20 patients (55.5%) were clinically controlled, 9 (25%) had local recurrence, 5 (13.8%) had loco-regional recurrence and 2 had distant metastasis. Considering clinical follow-up as the gold standard, sensitivity, PPV and NPV of PET-CT combined with brush cytology improved compared to PET-CT alone and was found to be 75%, 90%, 85.7% and 81.8% respectively. We found that brush cytology on endoscopy is a simple tool with high specificity which adds value to the findings of response assessment PET-CT scan and thereby can increase the confidence of the treating oncologist in making clinical decisions.

Gastrointestinal stromal tumors (GISTs) are rare tumors but are most common mesenchymal tumors of the digestive tract. They are commonly seen in the stomach (60%) and small intestine (30%). GISTs are likely derived from the interstitial cells of Cajal or their stem cell precursors. They are best characterized by computerized tomography and have a specific staining pattern on immunohistochemistry, i.e., C-Kit and DOG-1. The treatment of GIST is based on the risk assessment for relapse, and patients with localized GIST require resection with or without adjuvant imatinib mesylate (IM). Advanced unresectable tumors are usually treated with IM, with a number of further options available for patients post progression on IM. There is an increasing emphasis on identifying C-Kit and platelet-derived growth factor receptor alpha mutations in all patients with GIST, as these are driver mutations with current and future therapeutic implications.

An attempt has been made in the present study to realize the effect of multi-location swirl injection on the improvement of regression rate and combustion efficiency of hybrid rocket by using two different length to diameter (L/D) ratio of the motor. It is 12 and 24. The fuel used for the study was Polyvinyl chloride (PVC)-Dibutyl Phthalate (DBP) in the ratio of 50:50. The gaseous oxygen was used as the oxidizer. The significance of this method is that a single swirl injection at the head end of the hybrid rocket is not sufficient to provide swirling flow till the nozzle end, if the length of the motor is sufficiently long and the regression rate decreases beyond certain length. In the present study, it has been observed that the 220 mm length is sufficient to get the improvement with single swirling injection. For the 24 L/D motor, the use of multi-location swirl injector motor gave twice the improvement in regression rate compare to the conventional hybrid rocket motor where showerhead injector has been used. Combustion efficiency obtained with multi-location swirl injection gave lower improvement with 24 L/D motor (from 70% to 76%), but the improvement was significant with 12 L/D motor with single swirl injector (from 50% to 74%). Improvement in regression rate as well as the efficiency was observed to be significant, if the mid injector was used as the cavity instead of supplying oxygen through it. The value of mass flux exponent (n) was observed to be 0.51 with multi-location swirl injection and the relatively uniform regression rate from head end to the nozzle end was observed.

Background Eligibility criteria and endpoints for cancer cachexia trials—and whether weight loss should be included—remain controversial. Although most cachexia trials enrol patients after initial cancer diagnosis, few studies have addressed whether weight loss well after a cancer diagnosis is prognostic. Methods We pooled data from non‐small cell lung cancer patients from prospectively conducted trials within the Alliance for Clinical Trials in Oncology (1998–2008), a nationally funded infrastructure. We examined (i) weight data availability and weight changes and (ii) survival. Results A total of 822 patients were examined. Of these, 659 (80%) were on treatment at the beginning of Cycle 2 of chemotherapy; weight was available for 656 (80%). By Cycles 3 and 4, weight was available for 448 (55%) and 384 (47%), respectively. From baseline to immediately prior to Cycle 2, 208 (32%) gained weight; 225 (34%) lost

PurposeThe purpose of this paper is to improve the understanding of the role of the bottlenecks in the dynamic software development supply chains. The paper examines the effects of the task priorities in the software development and investigates the possible strategies to manage them effectively.Design/methodology/approachIn this paper, a software development supply chain has been simulated. This includes modeling of the various sizes of software requirement, different priorities, variations in development times, quality defects, etc. The model assumes a fixed set of resources of various skills. The model is studied for the bottlenecks, throughput, work in progress (WIP), etc. under various work preemption scenarios.FindingsThe results indicate that job priorities impact the bottleneck formulation, throughput and WIP of the software development. The work interruption policies to accommodate priority jobs adversely impact the throughput. Selective introduction of interruptions by leaving the bottlenecks from interruptions helps balancing the throughput and priorities.Research limitations/implicationsThe impact of the learning curve and knowledge acquisition time needed by the resources to restart the interrupted work has not been considered in this paper, which can be a future area of research.Practical implicationsThe paper helps the practicing managers evaluate the dynamics of the bottlenecks with various task management approaches and comprehend the possible tradeoffs between priority and throughout.Originality/valueThe paper looks at software development from a perspective of workflow dynamics. This is a pioneer effort, as it utilizes simulation and modeling approach in understanding the software supply chains better.

Tilapia lake virus (TiLV) is a highly contagious pathogen that has detrimental effects on tilapia farming. This virus was discovered in 2014 and has received tremendous global attention from the aquaculture sector due to its association with high fish mortalities and its strong economic impact on the tilapia aquaculture industry. Currently, TiLV has been reported in 16 countries, and this number is continuing to rise due to improved diagnostic assays and surveillance activities around the world. In this review, we summarize the up-to-date knowledge of TiLV with regard to TiLV host species, the clinical signs of a TiLV infection, the affected tissues, pathogenesis and potential disease risk factors. We also describe the reported information concerning the virus itself: its morphology, genetic make-up and transmission pathways. We review the current methods for virus detection and potential control measures. We close the review of the TiLV story so far, by offering a commentary on the major TiLV research gaps, why these are delaying future TiLV research and why the TiLV field needs to come together and proceed as a more collaborative scientific community if there is any hope limiting the impact of this serious virus.

Background:Wireless Sensor Networks (WSNs) refer to a group of sensors used for sensing and monitoring the physical data of the environment and organizing the collected data at a central location. These networks enjoy several benefits because of their lower cost, smaller size and smarter sensors. However, a limited source of energy and lifetime of the sensors have emerged as the major setbacks for these networks.Methods:In this work, an energy-aware algorithm has been proposed for the transmission of variable data packets from sensor nodes to the base station according to the balanced energy consumption by all the nodes of a WSN.Results:Obtained simulation results verify that the lifetime of the sensor network is significantly enhanced in comparison to other existing clustering based routing algorithm.Conclusion:The proposed algorithm is comparatively easy to implement and achieves a higher gain in the lifetime of a WSN while keeping the throughput nearly same as LEACH protocol.

Immunoglobulin A (IgA)-nephropathy (IgAN) is one of the major reasons for renal failure. It provides vital clues to estimate the stage and the proliferation rate of end-stage kidney disease. IgA stage can be estimated with the help of MEST-C score. The manual estimation of MEST-C score from whole slide kidney images is a very tedious and difficult task. This study uses some Convolutional neural networks (CNNs) related models to detect mesangial hypercellularity (M score) in MEST-C. CNN learns the features directly from image data without the requirement of analytical data. CNN is trained efficiently when image data size is large enough for a particular class. In the case of smaller data size, transfer learning can be used efficiently in which CNN is pre-trained on some general images and then on subject images. Since the data set size is small, time spent in collecting large data set is saved. The training time of transfer learning is also reduced because the model is already pre-trained. This research work aims at the detection of mesangial hypercellularity from biopsy images with small data size by utilizing the transfer learning. The dataset used in this research work consists of 138 individual glomerulus (× 20 magnification digital biopsy) images of IgA patients received from All India Institute of Medical Science, Delhi. Here, machine learning (k-nearest neighbour (KNN) and support vector machine (SVM)) classifiers are compared to transfer learning CNN methods. The deep extracted image features are used by machine learning classifiers. The different evaluation parameters have been used for comparing the predictions of basic classifiers to the deep learning model. The research work concludes that the transfer learning deep CNN method can improve the detection of mesangial hypercellularity as compare to KNN, SVM methods when using the small data set. This model could help the pathologists to understand the stages of kidney failure.

To study various parameters, including Middle ear risk index (MERI) and their correlation with outcome of middle ear surgery. The study was conducted from September 2015 to May 2017 in Department of Otolaryngology at our institute. It included 185 cases of safe type of chronic suppurative otitis media. These patients were admitted and treated surgically and record was kept for at least 3 months follow-up in postoperated period. The study concluded that a good correlation exist between MERI and result of tympanoplasty.

BACKGROUND Tuberculosis is a prehistoric disease and confirmation of its existence was seen in the Vedas. The oldest of them (Rigveda, 1500 BC) calls the infection yaksma. It claimed millions of lives in Europe and was called `The White Plague’. Robert Koch has written that tuberculosis killed one third of Europeans of middle age. METHODS This is a descriptive study. Tuberculous lymphadenitis isolates from sputum samples of clinically suspected cases of tuberculosis seen in Vardhman Institute of Medical Sciences, Pawapuri, Nalanda, Bihar and Associated Hospital of Bihar between March 2019 and March 2020 were included in the study. The study protocol was approved by the hospital ethics committee. RESULTS A total of 200 fine-needle aspirated specimens from lymph nodes were integrated in the study. Out of 200 cases, 90 aspirates were reported as cytomorphology suggestive of tuberculous lymphadenitis. Compared to the reference standard, Xpert MTB/RIF correctly identified 88 out of 90 TB cases (sensitivity, 97.80%). The possible false-negative result had a prolonged transit interval of 9 days before Xpert MTB/ RIF testing, which may have affected the result. Xpert MTB/ RIF was positive in two cases, with negative cytomorphology and culture (specificity, 95.65%). The cytomorphology from one of the false-positive results showed a necrotizing suppurative lymphadenitis, which is consistent with TB. However, no organisms could be identified on microscopy or culture. The cytomorphology of the other false positive result showed an epithelial inclusion cyst, and the reason for this false-positive result remains unknown. CONCLUSIONS FNAB is a simple procedure which can be performed in an outpatient setting by clinicians or nursing staff after a short training period (21, 22). It is ideal for use in resource-limited settings, including more remote and rural areas (22). Specimen collection is simple and safe. With the use of a transport vial, virtually no sample preparation is required and there is minimal risk of contamination. Furthermore, the transmission risk to the operator may also be reduced. Combining FNAB and rapid genotypic diagnosis using automated systems should greatly improve access to appropriate diagnosis and treatment for patients with tuberculous lymphadenitis.

This research investigates the impact of service convenience dimensions (access, transaction, decision, benefit, and post-benefit convenience) on consumers’ behavioral intention and the mediating e...

In a band-limited spectrum, an increase in requests for various services of wireless applications is a matter of apprehension. To fulfill the expectations of immense wireless users, effective management and efficient use of the band-limited spectrum is highly desired. Cognitive Radio emerges as a solution to the problem of spectrum scarcity by opportunistically sharing the spectrum among licensed and unlicensed users. A careful balance of spectrum usage among different priority class users must be ensured to avoid network congestion. A robust congestion controller with three different reaching laws has been studied in this work for optimal spectrum utilization in Cognitive Radio Network. The sliding mode controller, which is eminent for its robustness and disturbance rejection capabilities has been combined with a novel dynamic event-triggering scheme to reduce energy expenses and computational complexities. The controller adequacy has been supported by simulations.

Colorectal cancer (CRC) is the third most common cancer, and the fourth most common cause of cancer mortality worldwide. In Trinidad and Tobago, it is the third most common type of cancer in both sexes. Since there is scanty research on the risk factors associated with CRC, this study was conducted to determine the correlation between risk factors, including associated comorbid conditions, and CRC in Trinidad. A cross-sectional study was conducted amongst diagnosed CRC patients (&gt, 18 years) using a pre-tested questionnaire consisting of sections on demographic data, lifestyle before diagnosis, quality of life, and depression status. Additional information such as recurrence of cancer, Body Mass Index (BMI), Hypertension (HT), blood glucose levels and family history of cancer were collected from the medical records. Of the total participants, the majority were males (58%), and the mean age of diagnosis in both sexes was 65 years. The retrospective chart review showed that 68% were found to have a comorbid condition (Diabetes or HT). Upon review of the medical records, 93.2% of the subjects did not have a familial history. However, the questionnaire data showed that 73% of subjects had a family history. Around 50% of CRC patients were alcohol consumers and 30% were cigarette smokers prior to their cancer diagnosis. Interestingly, a majority of patients (91%) had never been screened for CRC prior to their diagnosis. Subjects with CRC displayed minimal depression, indicating that being diagnosed with CRC did not have a grave impact on their state of mind or quality of life. Our findings showed that prevalence of CRC was higher in males and amongst individuals of African descent. However, larger prospective studies may be warranted to fully demonstrate this effect.

PurposeE-government quality (e-GovQual) and e-government user value (e-GUV) are multidimensional concepts. While previous studies have identified apparent factors influencing e-government satisfaction (e-GovSat) and e-government adoption intention (e-GovAI), such as e-GovQual and e-GUV, but they have neglected to explain the influence of the dimensions of these two concepts. The purpose of this research is to study e-government service value chain (e-GSVC) one-GovQual dimensions, e-GUV dimensions, e-GovSat and e-GovAI.Design/methodology/approachThe study employs a quantitative method to test the hypotheses and validate the proposed model. Data are collected from 378 e-government users across different parts of India comprising of different demographic characteristics. The model is analyzed using structural equation modeling.FindingsThe findings highlight the impact of the dimensions of e-GovQual (efficiency, trust, reliability and citizen support) on the dimensions of e-GUV (functional, economic, social and emotional value) as e-GUV dimensions affect e-GovSat, which in turn influences e-GovAI. The results validate the e-GSVC and also stress the partial mediating role of the dimensions of e-GUV on the relationship between the dimensions of e-GovQual and e-GovSat.Research limitations/implicationsThe sample size of 378 may not be a proper representation of a country like India, which has huge diversity within its vast population.Practical implicationsThe study offers practitioners a clear picture and a useful guide to better understand the drivers of value, satisfaction and adoption in the case of e-government users.Originality/valueThis study is probably the first attempt toward demonstrating the process influencing e-GovSat via e-GUV dimensions originating from excellent e-GovQual dimensions to ultimately trigger e-GovAI.

PurposeThis paper seeks to examine the export competitiveness and concentration level of the 15 top sugar exporting countries over the last 18 years (2001–2018) with special reference to India.Design/methodology/approachFirst, the paper utilizes a review based approach and explains the structures of major sugar economies in context to protected and unprotected perspectives. Subsequently, empirical research was carried out to assess the competitiveness level of sugar using Revealed Comparative Advantage (RCA) approach and Hirschman Herfindahl Index.FindingsThe study found structural changes in cane or beet sugar, and molasses over the time period between 2006 and 2015. Further, the findings confirmed that despite the stringent regulations in European Union, the United States of America, Guatemala, Mexico, Thailand, China, and India, the comparative advantage is high up to seven to nine sugar categories. Besides, despite the indulgent regulations in the Colombia, Brazil, and Canada, the comparative advantage is only consistent up to two to three sugar categories.Research limitations/implicationsThis study provides an overview of competitiveness patterns of 15 sugar exporting countries and further compare their comparative and concentration levels. In this context, in future, it would be interesting to study the macro-economic and firm and industry-specific factors which may strengthen the study findings.Practical implicationsThis study suggests that the sugar export of few countries (i.e. Mexico and Canada) is restricted up to their trade pacts and free trade zones which is restricting the competitiveness level and performance. Accordingly, such countries need to enlarge their business boundaries to foster their export competitiveness level. Rational subsidies and governmental assistance in diversification schemes in terms of products' range and sustainable processes can make India a consistent exporter in more categories.Originality/valueAlthough, the previous studies attempted to examine the sugar industry with particular country context, this study enlarge the body of knowledge through simultaneously examining the sugar export scenario of fifteen sugar exporting countries and providing a broad comparative view of their competitiveness and concentration levels.