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Non-Rigid Structure-from-Motion (NRSfM) reconstructs a deformable 3D object from the correspondences established between monocular 2D images. Current NRSfM methods lack statistical robustness, which is the ability to cope with correspondence errors.This prevents one to use automatically established correspondences, which are prone to errors, thereby strongly limiting the scope of NRSfM. We propose a three-step automatic pipeline to solve NRSfM robustly by exploiting isometry. Step 1 computes the optical flow from correspondences, step 2 reconstructs each 3D point's normal vector using multiple reference images and integrates them to form surfaces with the best reference and step 3 rejects the 3D points that break isometry in their local neighborhood. Importantly, each step is designed to discard or flag erroneous correspondences. Our contributions include the robustification of optical flow by warp estimation, new fast analytic solutions to local normal reconstruction and their robustification, and a new scale-independent measure of 3D local isometric coherence. Experimental results show that our robust NRSfM method consistently outperforms existing methods on both synthetic and real datasets., Accepted in TPAMI 2021

“Sustainability” is an integral part of the Indian ethos. The Gandhian philosophy of simple living in harmony with nature and community engagement, the Chipko movement of the 1970 s against deforestation, alternative, green energy projects, emphasis on environmental education in schools and institutes of higher education are only a few examples of Indians consciousness, care and commitment to sustainability issues In this scenario, the focus, in the workplace, is tilting towards a more inclusive and collaborative model of growth and development which values engagement of all stakeholders in safeguarding their larger common interests. This study has the prospect of fulfilment of desire, independence, marriage according to choice, better opportunity for development of children and of own, limitation of family size and above all the role in decision-making. The problems vary according to age, marital status and employment status. The young and unmarried women are more victimized at work place. The unmarried women in their parent house shoulder the responsibilities depending on family environment.

Performing third or fourth kidney transplantation (3KT and 4KT) in older patients is rare due to surgical and immunologic challenges. We aimed to analyze and compare the outcomes of younger (18-64 years) and older (≥65 years) recipients of 3KT and 4KT. Between 1990 and 2016, we identified 5816 recipients of 3KTs (153 were older) and 886 recipients of 4KTs (18 were older). The incidences of delayed graft function (24.3% vs. 24.8%, p = .89), primary non-function (3.2% vs. 1.3%, p = .21), 1-year acute rejection (18.6% vs. 14.8%, p = .24), and 5-year death censored graft failure (DCGF) (24.8% vs. 17.9%, p = .06) were not different between younger and older recipients of 3KT. However, 5-year mortality was higher in older recipients (14.0% vs. 33.8%, p

Background Recent surgical literature suggests that a relative decrease in hemoglobin (ΔHb) is predictive of adverse outcomes regardless of the absolute level. We aimed to examine the association between perioperative ΔHb and kidney transplantation (KT) outcomes. Methods This was a retrospective cohort study of transplant recipients, where ΔHb = [ Hb 0 – Hb 1 Hb 0 ] x 100 (Hb0 = hemoglobin pre-KT and Hb1 = lowest hemoglobin 24-h post-KT). The main outcome of interest was immediate graft function (IGF). Results Of the 899 eligible patients, 38% experienced IGF, and ΔHb was associated with 36% lower odds of IGF. Also, ΔHb was associated with higher all-cause graft failure and longer length of stay but not death-censored graft failure or mortality. ΔHb ≥30% was the threshold beyond which the odds of IGF were significantly lower even if Hb1 was ≥7 g/dL. Conclusion ΔHb is associated with inferior outcomes independent of Hb1; whether it can be used to guide transfusion practices should be explored.

This article attempts to analyse the changes occurred in the behaviour of the customer for online buying of fashion products. The prime objective of this study is to bridge the gap by contributing to the literature about the impact of pandemic on consumer buying tendencies for fashion industry. This study proposes a model for impulse buying of fashion apparel based on consumers’ shopping behaviour during COVID-19 pandemic. The conceptual model was developed using stimulus organism response (S-O-R) theory using fashion involvement (FI), hedonic shopping value (HSV) and sales promotion (SP) as independent variables, positive emotions (PE) as a mediating variable and impulse buying (IB) as a dependent variable. The data was collected from 569 respondents from central Indian region, the collected data was analysed using PLS-SEM 3 software. The importance performance map analysis (IPMA) was used to understand the accurate performance of variables. The result shows the significant and positive impact of HSV and PE on IB, unlike FI and SP which were not showing significant impact. Moreover, PE is a significant mediator in the relationship of the constructs. This study contributes by providing original insights into the IB literature. The analyses of IPMA will help the fashion industry to rebound after COVID-19.

Purpose This study aims to investigate the shopping behaviour of consumers, mainly in fashion apparels, and intends to understand consumer buying patterns in Indian context. The study was designed to determine the level of consumer's sense of belonging towards apparel shopping by applying the concept of self-congruence. Design/methodology/approach The study used variance-based partial least squares structural equational modelling (PLS-SEM) on a cross-sectional study conducted on 569 consumers. The study was conducted by using questionnaire to collect the responses from the central zone of India. The results support most of the projected hypotheses. Findings The study focused on the shopping behaviour of consumer such as self-congruence, impulse buying, hedonic values and consumer satisfaction. The results of the study highlight the association of constructs and analysed the mediation relation of hedonic and impulse buying constructs. The results revealed a positive association among the constructs and also found a partial mediation effect in their relation with constructs. Research limitations/implications The findings are outcomes of an empirical study conducted in the fashion apparel industry of India based on the sample set of urban consumers. The study is restricted to the direct and indirect relationship of constructs. Further, research can examine by using moderating constructs like demographic factors (gender, age, income, etc.) and other shopping behaviours (like brand loyalty, brand love, brand attachment) for more clarity in results. Moreover, the study limited is with fashion apparel, whereas there are many categories in the fashion industry like accessories, perfumes, cosmetic products, footwear and also other products industry. Practical implications The study provided valuable inputs to the literature of marketing where self-congruence affects consumer shopping behaviour such as impulse buying, hedonic values and consumer satisfaction. The study proposes a practical approach that can help the marketing professionals and product developers to have a deep understanding about consumer shopping behaviour for facilitating consumer-oriented goods in the Indian fashion industry. Originality/value This is one of the first studies in the fashion industry to test the association of self-congruence with hedonic value and consumer satisfaction. This relation is not tested in context of fashion apparel. Additionally, this study also examined the mediating effect of hedonic value and impulse buying in relation with self-congruence and consumer satisfaction in the Indian context.

Robot assisted minimally invasive esophagectomy (RAMIE) has evolved over the past decade to become procedure of choice at many centers all over the world. The objective of this study is to present our experience of robot assisted minimally invasive esophagectomy with respect to perioperative morbidity and short-term oncological outcomes and a comparison of the same to a cohort of our patients who underwent open Mckeown’s esophagectomy. This is a retrospective analysis of prospectively collected data of patients from October 2011 to October 2019. A total of 56 patients in open group and 58 patients in robotic group were enrolled. Upper and middle third was the most common site for open esophagectomy while middle and lower third was more common site for robotic esophagectomy (p

Background The differential diagnosis of thrombotic microangiopathy (TMA) in pregnancy includes common conditions, such as preeclampsia. In women with kidney transplantation, additional causes of TMA must be considered. Case A 22-year-old primigravid woman with a transplanted kidney presented with fetal growth restriction, hypertension, acute kidney injury, and hemolysis at 28 weeks gestation. While her clinical presentation was initially consistent with preeclampsia, hemolysis persisted beyond 1 week postpartum. Diagnoses of TMA associated with tacrolimus and antibody-mediated rejection were considered. An elevated tacrolimus level likely contributed to her TMA and a decrease in dosage improved her clinical picture and laboratory markers. Conclusion We report the case of a pregnant kidney transplant recipient with TMA. A multidisciplinary approach is required to optimize the maternal health outcomes in this complex population.

This paper presents a framework for mutual authentication between a user device and a point of sale (POS) machine using magnetic secure transmission (MST) to prevent the wormhole attack in Samsung pay. The primary attribute of this method is authenticating the POS terminals by an authentication server to bind the generated token to a single POS machine. To secure the system from eavesdropping attack, the data transmitted between the user device and the machine is encrypted by using the Elgamal encryption method. The keys used in the method are dynamic in nature. Furthermore, comparison and security analysis are presented with previously proposed systems.

This study highlights the role of utilitarian shopping, hedonic shopping, and online advertisement on cognitive dissonance Impulse Buying plays a role as a mediator in this research The objective of this research is to investigate how utilitarian shopping value, hedonic shopping value, and online advertising influence the cognitive dissonance of customers 338 response data have been collected from consumers involved in fashion apparel;respondents are majorly from central zone of India Partial least square (PLS) - Structural equation modelling (SEM) is implemented using Smart PLS 3 0 The simulation result shows that utilitarian shopping value, hedonic shopping value, and online ads are found to be important in predicting cognitive dissonance and impulse buying, whereas impulse buying is impeccable in terms of predicting positive relationships with cognitive dissonance Moreover, Impulse buying is playing as positive mediating effect in relation with constructs Hence, this research suggests that a complex representation which may better understanding about consumer shopping behaviour Conclusively, this research’s major contribution towards authors’ knowledge, and help the marketing expert to focus on important parameter of consumer buying behaviour © 2020 All Rights Reserved

Introduction: World is still facing heart diseases in pregnancy as a major problem, particularly in poor countries. Although the reported incidence varies between 0.1 and 4%, 1-3 cardiac disease remains a significant cause of maternal death worldwide. Cardiac disease in the pregnant patient can present challenges in cardiovascular and maternal-fetal management.in normal patients, pregnancy imposes some dramatic physiologic changes. Materials and Methods: This observational study was conducted in the department of obstetrics and gynecology of M.G.M healthcare institute, Kalamboli, Maharashtra, India. This study includes total of 8 pregnant women, both referred and registered cases with history of cardiac disease were admitted in obstetric ward from January 2016 to September 2016. Results: 75% of our study cases were between the age group of 20 years to 25 years, whereas 25% cases presented between the age group of 26 years to 30 years. This study reports the most common lesion as RHD with mitral stenosis. 38% of the patients from our study had Rheumatic heart disease and most of the patients had more than one lesion. Discussion: According to present study, the cardiac disease appears to be a risk factor for maternal and neonatal morbidity and mortality. Rheumatic heart disease was observed to be the predominant lesion in our case series. Conclusion: Heart disease in pregnancy is a high risk condition. It is a major determinant of pregnancy and its outcome. Keywords: Heart diseases in pregnancy, Pre-Eclampsia, Pregnancy induced hypertension, RHD in pregnancy.

Introduction: Vitamin D is a fat-soluble vitamin which comes primarily from exposure to sunlight, and only few foods acts as a source of it. Vitamin D deficiency is a preventable health problem. Research shows that during pregnancy, adequate vitamin D intake is necessary for maternal, fetal and child health. This study was conducted to determine prevalence of vitamin D deficiency in pregnant women and neonates and will also help us to determine if 400IU daily recommended dose is sufficient to treat hypovitaminosis D. Materials and Methods: The study was carried out for 1 ½ years on 100 pregnant, divided in two groups in which one group was given supplementation and 2nd group was of unregistered patients. Results: The prevalence of Vitamin D deficiency was observed as 82% in present study. On supplementing the subjects with 400IU vitamin D with calcium 1000 mg daily, the prevalence reduced to 14% while normal levels were achieved in 58% as compared to 8% during the first trim which was significant with p value of Conclusion: We recommend evaluation of the status of vitamin D in all pregnant women along with D3 supplementation. Routine supplementation of pregnant mothers with 400IU vitamin D with calcium 1000 mg daily resulted in significant improvement of vitamin D levels in study group, but sufficient levels were reached in just over half of the females. We thus propose further research on the daily dosage recommendations along with other factors affecting vitamin D levels in pregnant females like eating pattern, compliance to prescribed drugs and sun light exposure. Keywords: Vitamin D levels, Vitamin D deficiency in pregnancy.

Introduction: Abruptio placenta is a serious obstetric complication which is characterised by the premature separation of the placenta. It is also associated with premature deliveries, maternal and fetal morbidities. Multiple factors are known to be associated with increased risk of placental abruption as alcohol and cocaine use and cigarette smoking, and nutritional deficiencies etc. Materials and Methods: It was a retrospective study conducted among 47 cases of abruptio placentae admitted under the department of obstetrics and gynecology, in MGM Hospital, Kalamboli, Navi Mumbai, for a period of 2 years (December 2015 to December 2017). Results: The mean age of presentation was reported to be 26.59 years. The incidence of abruptio placentae was found to be least after the age of 35 years (Table 1). Majority of cases were multigravida, while 32% cases presented with AP were primigravida. Among the multigravida cases, the majority of cases were of gravida 2 and 3 and the mean gravida order was 2.4. Conclusions: From the current study, we can conclude that multiparty, cesarean section, previous abortion, and placental abruption can be considered at high risk of placental abruption. Keywords: Abruptio placenta, Obstetric complications, Premature delivery, Maternal mortality, Maternal morbidity.

3D reconstruction of deformable objects using inter-image visual motion from monocular images has been studied under Shape-from-Template (SfT) and Non-Rigid Structure-from-Motion (NRSfM). Most methods have been developed for simple deformation models, primarily isometry. They may treat a surface as a discrete set of points and draw constraints from the points only or they may use a non-parametric representation and use both points and differentials to express constraints. We propose a differential framework based on Cartan's theory of connections and moving frames. It is applicable to SfT and NRSfM, and to deformation models other than isometry. It utilises infinitesimal-level assumptions on the surface's geometry and mappings. It has the following properties. 1) It allows one to derive existing solutions in a simpler way. 2) It models SfT and NRSfM in a unified way. 3) It allows us to introduce a new skewless deformation model and solve SfT and NRSfM for it. 4) It facilitates a generic solution to SfT which does not require deformation modeling. Our framework is complete: it solves deformable 3D reconstruction for a whole class of algebraic deformation models including isometry. We compared our solutions with the state-of-the-art methods and show that ours outperform in terms of both accuracy and computation time.

Background Dyslipidaemia is a major modifiable risk factor for atherosclerotic cardiovascular disease. At the time the study was conducted, guidelines recommended a low-density lipoprotein cholesterol (LDL-C) target of less than 1.8 mmol/l and a reduction of at least 50% if the baseline LDL-C was between 1.8 and 3.5 mmol/l in patients with either very high cardiovascular risk or established atherosclerosis. In South Africa, there is a paucity of data on attainment of LDL-C goal in patients with very high cardiovascular risk who are on maximum tolerated statin with or without ezetimibe. Objective The aim was to assess the percentage of very high cardiovascular risk South African patients with dyslipidaemia not reaching an LDL-C goal of less than 1.8 mmol/l, despite maximum tolerated statin with or without ezetimibe. Methods This was a multi-centre, observational, cross-sectional study conducted at 15 private healthcare sector sites and one public sector site. Adults (> 18 years) with very high cardiovascular risk of familial hypercholesterolaemia receiving stable, maximum-tolerated statin therapy for at least four weeks prior to their latest lipid profile were enrolled into the study, and electronic case report forms were completed after written informed consent was provided. LDL-C goal attainment was modelled, first assuming an increase in the statin dose to the registered maximum, followed by the addition of ezetimibe or a PCSK9-inhibitor. Results In total, 507 patients were screened, of whom 492 were eligible for study participation. One patient was excluded from the analysis because of a missing LDL-C value. Most participants were male (male 329, 67%; female 162, 33%). Most patients were either obese (223, 46.0%) or overweight (176, 36.3%). Hypertension and diabetes mellitus were frequent co-morbidities and were found in 381 (77.6%) and 316 (64.4%) patients, respectively. Eighty (16.3%) patients reported current smoking. Only 68 (13.8%) patients were taking ezetimibe in addition to a statin. Reasons for not using ezetimibe included no requirement for ezetimibe in the opinion of the treating physician (229, 48.7%), cost (149, 31.7%), Physician's choice (39, 8.3%), or other (53, 11.3%). Only 161 (32.8%) of the patients attained their goal LDL-C level. In our modelling analysis, increasing the statin dose to the registered maximum and adding ezetimibe brought an additional 34.5% of patients to goal, while adding a PCSK9-inhibitor, irrespective of any other changes to lipid-lowering therapy brought over 90% of not-at-goal patients to goal. Conclusions Most study participants were not at LDL-C goal despite maximum-tolerated statin, highlighting the need for treatment intensification in this high-risk population. Although intensifying treatment by adding a PCSK9-inhibitor brought more patients to goal, the initial addition of ezetimibe would be more reasonable, given the cost of PCSK9-inhibitors.

To determine the accuracy of 18F-Fluorodeoxyglucose positron emission tomography computed tomography (FDG-PET CT) in predicting response to neoadjuvant chemoradiation (NACRT) in esophageal squamous cell cancer (SCC) and impact of such response on survival. Retrospective analysis of patients with esophageal SCC (cT2-4N0-N+M0) who underwent PET CT before and 6 weeks after NACRT followed by surgery was carried out in this study. Metabolic response was assessed by change in standardized uptake value (ΔSUVmax) after NACRT and the pathological response was graded. A receiver operating characteristic curve (ROC) was used to identify the optimal cut off value of SUVmax to predict histopathological response. The impact of metabolic response and pathological response on survival was determined. Of the 73 patients analyzed, 27 had complete metabolic response, while 24 had pathological complete response (PCR). However, only 14 of the 27 complete metabolic responders actually had PCR. At 67% ΔSUVmax, the optimum balance between sensitivity (70.83%) and specificity (69.23%) was achieved and the correlation between metabolic response and pathological complete response achieved statistical significance (p = 0.0009). However, ΔSUVmax of 67% was found to have no significant association with survival (p = 0.51). PCR was the only significant determinant of improved survival (p = 0.04). PCR which is a significant determinant of survival is not ideally predicted by ΔSUVmax on PET CT.

In recent years, contactless transactions have risen rapidly. It includes NFC, MST, contactless cards, and many other payment methods. These payment methods have certain security issues, and attackers are in a regular search for the exploits to break its security. These security issues require proper analysis to secure user data from attackers. This article will discuss the contactless smart cards and payment systems in detail including the techniques used for securing user data and different possible attacks on the technology used for communication. The article also presents some countermeasures to prevent the attack and issues with those countermeasures. In addition, the article includes some future research issues and suggestions to overcome the security issues in contactless payment system.

Broadly neutralizing antibodies (bnAbs) develop in a subset of HIV-1 infected individuals over 2–3 years of infection. Infected infants develop plasma bnAbs frequently and as early as 1-year post-infection suggesting factors governing bnAb induction in infants are distinct from adults. Understanding viral characteristics in infected infants with early bnAb responses will provide key information about antigenic triggers driving B cell maturation pathways towards induction of bnAbs. Herein, we evaluate the presence of plasma bnAbs in a cohort of 51 HIV-1 clade-C infected infants and identify viral factors associated with early bnAb responses. Plasma bnAbs targeting V2-apex on the env are predominant in infant elite and broad neutralizers. Circulating viral variants in infant elite neutralizers are susceptible to V2-apex bnAbs. In infant elite neutralizers, multivariant infection is associated with plasma bnAbs targeting diverse autologous viruses. Our data provides information supportive of polyvalent vaccination approaches capable of inducing V2-apex bnAbs against HIV-1., Some infants develop broadly neutralizing antibodies (bnAbs) to HIV in a shorter time frame than adults, but the reasons aren’t well understood. Here, the authors study a cohort of 51 HIV-1 clade C perinatally infected infants of Indian origin and find that multivariant infection is associated with bnAbs in elite neutralizers.

Cardiovascular events are among the leading cause of mortality in kidney and liver transplant recipients. Thus, screening for cardiovascular disease and risk stratification for cardiovascular events constitute an important part of the pretransplant evaluation. In this review, we first summarize current guidelines in the cardiac risk assessment of kidney and liver transplant candidates. We then elaborate on the limitations of these guidelines, summarize the current knowledge gaps, and narrow down a spectrum of 6 themes that serve as challenges to research and practice development. This spectrum pertains to understanding the disease itself, which is challenging due to the altered cardiac physiology in these patients and current guidelines that do not adequately account for nonischemic diseases and events. We then describe the challenges in assessing these patients, their symptoms, and individualizing their risk of cardiovascular events with a special consideration for nontraditional risk factors. We also explore the limitations of the current and novel diagnostic tests and the lack of evidence of therapeutic efficacy in intervening in patients with asymptomatic disease. The transplant procedure itself can be a potential modifiable risk factor for cardiovascular events, that is, surgical technique, type of donor, and induction immunosuppression. Lastly, we describe the potential issues with the current literature when defining cardiac diseases and events across different studies and shortcomings of extrapolating data from the nontransplant literature. We conclude by proposing research and practice implications of our discussion and that there is a need for evidence to guide the revision of current guidelines.

In this paper it is intuitively reasoned as to how effect of Green Brand on cutthroat leverage which consist company sale and its Advertisement, which leads to corporate advantage in the form of change its consumer attitude and created in the area that would not only hold maximum value for any organization in general but also be the one to hold critical importance and a present challenge before all Corporate functions. This research was chosen from various stores, shops and malls of Delhi cities. A sum of 155 samples is accidentally chosen from city and after that similar online and offline survey was given to them, in which they indicate the view on market magnitude in the cities. This attempts to measure the attitude of customers when they purchase products how much they consider green in them which help in getting to measure leverage.

The term “electronic healthcare” refers to patient records that are stored in digital format. Patient-centered data allows any authorized individual to view the data from any place and at any time. E-health insurance leads to more social and health benefits as well as fewer health mistakes. An electronic health record is a digital repository of a patient's personal history created by one or more care delivery organizations. The term blockchain was formed from the terms block and chain, as well as the list of transactions known as a block, which is associated with the cryptographic technology. Each block is linked to the block header that came before it. A blockchain only stores one patient's record. This article outlines a strategy for safeguarding healthcare data. The suggested model's key features are interoperability and safe storage and access to patient data.

According to current scenario, technology play a vital role in the field of communication and services. Internet technology is a big success to interact people virtually. It provide ease to communicate via mail, audio calls and video calls. In the industries point of view raising the business is the main need. For this, website quality is majorly impact on the customers. Therefore, website quality, website reputation are the major parameters to enhance the purchase intention in customer’s perspective. To analyse this we proposed a research model to check the purchase intention over website quality and website reputation based on various statistical algorithms. SPSS Statistics is software to solve the complex problem over the model defined. The simulation results shows remarkable results.

In older adults (≥65), access to and outcomes following kidney transplantation (KT) have improved over the past 3 decades. It is unknown if there were parallel trends in re-KT. We characterized the trends, changing landscape, and outcomes of re-KT in older adults.Among the 44,149 older kidney-only recipients (1995-2016) in the Scientific Registry of Transplant Recipients, we identified 1743 who underwent re-KT. We analyzed trends and outcomes (mortality, death-censored graft failure [DCGF]) by eras (1995-2002, 2003-2014, and 2015-2016) that were defined by changes to the expanded criteria donors and Kidney Donor Profile Index policies.Among all older kidney-only recipients during 1995-2002, 2003-2014, 2015-2016 the proportion that were re-KTs increased from 2.7% to 4.2% to 5.7%, P 0.001, respectively. Median age at re-KT (67-68-68, P = 0.04), years on dialysis after graft failure (1.4-1.5-2.2, P = 0.003), donor age (40.0-43.0-43.5, P = 0.04), proportion with panel reactive antibody 80-100 (22.0%-32.7%-48.7%, P 0.001), and donation after circulatory death (1.1%-13.4%-19.5%, P 0.001) have increased. Despite this, the 3-y cumulative incidence for mortality (22.3%-19.1%-11.5%, P = 0.002) and DCGF (13.3%-10.0%-5.1%, P = 0.01) decreased over time. Compared with deceased donor retransplant recipients during 1995-2002, those during 2003-2014 and 2015-2016 had lower mortality hazard (aHR = 0.78, 95% confidence interval, 0.63-0.86 and aHR = 0.55, 95% confidence interval, 0.35-0.86, respectively). These declines were noted but not significant for DCGF and in living donor re-KTs.In older retransplant recipients, outcomes have improved significantly over time despite higher risk profiles; yet they represent a fraction of the KTs performed. Our results support increasing access to re-KT in older adults; however, approaches to guide the selection and management in those with graft failure need to be explored.

During the COVID‐19 pandemic, there has been wide heterogeneity in the medical management of transplant recipients. We aimed to pragmatically capture immunosuppression practices globally following the early months of the pandemic. From June to September 2020, we surveyed 1267 physicians; 40.5% from 71 countries participated. Management decisions were made on a case‐by‐case basis by the majority (69.6%) of the programs. Overall, 76.8% performed ≥1 transplantation and many commented on avoiding high‐risk transplantations. For induction, 26.5% were less likely to give T‐cell depletion and 14.8% were more likely to give non‐depleting agents. These practices varied by program‐level factors more so than the COVID‐19 burden. In patients with mild, moderate and severe COVID‐19 symptoms 59.7%, 76.0%, and 79.5% decreased/stopped anti‐metabolites, 23.2%, 45.4%, and 68.2% decreased/stopped calcineurin inhibitors, and 25.7%, 43.9%, and 57.7% decreased/stopped mTOR inhibitors, respectively. Also, 2.1%, 30.6%, and 46.0% increased steroids in patients with mild, moderate, and severe COVID‐19 symptoms. For prevalent transplant recipients, some programs also reported decreasing/stopping steroids (1.8%), anti‐metabolites (10.3%), calcineurin inhibitors (4.1%), and mTOR inhibitors (5.5%). Transplant programs changed immunosuppression practices but also avoided high‐risk transplants and increased maintenance steroids. The long‐term ramifications of these practices remain to be seen as programs face the aftermath of the pandemic.

Pleural tuberculosis (pTB) is diagnosed by using a composite reference standard (CRS) since microbiological methods are grossly inadequate and an accurate diagnostic test remains an unmet need. The present study aimed to evaluate the utility of Mycobacterium tuberculosis (Mtb) antigen and DNA-based tests for pTB diagnosis. Patients were classified as 'Definite TB', 'Probable TB' and 'Non-TB' disease according to the CRS. We assessed the performance of in-house antigen detection assays, namely antibody-based Enzyme-Linked ImmunoSorbent Assay (ELISA) and aptamer-based Aptamer-Linked Immobilized Sorbent Assay (ALISA), targeting Mtb HspX protein and DNA-based tests namely, Xpert MTB/RIF and in-house devR-qPCR. ROC curves were generated for the combined group of 'Definite TB' and 'Probable TB' vs. 'Non-TB' disease group and cut-off values were derived to provide specificity of ≥98%. The sensitivity of ALISA was ∼93% vs. ∼24% of ELISA (p-value ≤0.0001). devR-qPCR exhibited a sensitivity of 50% vs. ∼22% of Xpert (p-value ≤0.01). This novel aptamer-based ALISA test surpasses the sensitivity criterion and matches the specificity requirement spelt out in the 'Target product profile' for extrapulmonary tuberculosis samples by Unitaid (Sensitivity ≥80%, Specificity 98%). The superior performance of the aptamer-based ALISA test indicates its translational potential to bridge the existing gap in pTB diagnosis.

BACKGROUND Surgical resection is a treatment of choice for gallbladder cancer (GBC) patients but only 10% of patients have a resectable disease at presentation. Even after surgical resection, overall survival (OS) has been poor due to high rates of recurrence. Combination of surgery and systemic therapy can improve outcomes in this aggressive disease. AIM To summarize our single-center experience with multimodality management of resectable GBC patients. METHODS Data of all patients undergoing surgery for suspected GBC from January 2012 to December 2018 was retrieved from a prospectively maintained electronic database. Information extracted included demographics, operative and perioperative details, histopathology, neoadjuvant/adjuvant therapy, follow-up, and recurrence. To know the factors associated with recurrence and OS, univariate and multivariate analysis was done using log rank test and cox proportional hazard analysis for categorical and continuous variables, respectively. Multivariate analysis was done using multiple regression analysis. RESULTS Of 274 patients with GBC taken up for surgical resection, 172 (62.7%) were female and the median age was 56 years. On exploration, 102 patients were found to have a metastatic or unresectable disease (distant metastasis in 66 and locally unresectable in 34). Of 172 patients who finally underwent surgery, 93 (54%) underwent wedge resection followed by anatomical segment IVb/V resection in 66 (38.4%) and modified extended right hepatectomy in 12 (7%) patients. The postoperative mortality at 90 d was 4.6%. During a median follow-up period of 20 mo, 71 (41.2%) patients developed recurrence. Estimated 1-, 3-, and 5-years OS rates were 86.5%, 56%, and 43.5%, respectively. Estimated 1- and 3-year disease free survival (DFS) rates were 75% and 49.2%, respectively. On multivariate analysis, inferior OS was seen with pT3/T4 tumor (P = 0.0001), perineural invasion (P = 0.0096), and R+ resection (P = 0.0125). However, only pT3/T4 tumors were associated with a poor DFS (P < 0.0001). CONCLUSION Multimodality treatment significantly improves the 5-year survival rate of patients with GBC up to 43%. R+ resection, higher T stage, and perineural invasion adversely affect the outcome and should be considered for systemic therapy in addition to surgery to optimize the outcomes. Multimodality treatment of GBC has potential to improve the survival of GBC patients.

Blindness and visual impairment affect the quality of life of the affected individual and their family; it also impacts the socio-economic order of the country in many ways. A prevalence study in 2015 showed that of the 4.2 million blind people, 2.6 million people lived in East-, South-, and South-East Asian countries [1]. Corneal diseases are significant causes of blindness worldwide, second only to cataract [1, 2]. Many times, corneal blindness is treated by corneal grafting. Hence, corneal transplantation statistics are a proxy by which a country’s ability to address corneal blindness can be measured. This chapter discusses the important causes of corneal blindness in the South-East Asia region and the available infrastructure to deal with these.

The transparency and validity of assessing the candidacy of a patient for a solid organ transplant have recently been called into question by the media.1 Transplant centers perform a lengthy medical, surgical, and psychosocial evaluation on candidates with organ failure. This process ensures that there are no contraindications to surgery and to the use of long-term immunosuppressive medications. In addition, it helps ascertain if transplant candidates are likely to benefit from the transplant surgery over long term. Pretransplant nonadherence to prescribed therapy, medications, investigations, and clinical visits, is recognized as a relative or an absolute contraindication by transplant programs. For example, the Canadian Society of Transplantation states, given the use of immunosuppressive agents with a narrow therapeutic window, the impact of nonadherence to therapy on the risk of acute rejection and premature graft loss, and the scarcity of donor organs, nonadherence is a contraindication to kidney transplantation.2 This echoes the recommendations of some of the other major transplantation societies as summarized in Table 1.2-8 Most recommend delaying transplant surgery until patients have demonstrated adherence to therapy for 6 months. Table 1. Current Guidelines in the Assessment of Transplant Candidates With a History of Nonadherence.

Tumors of the ocular surface include a wide spectrum of epithelial, stromal, and vascular lesions that may be congenital or acquired. Acquired lesions are categorized as melanotic or non-melanotic. Ocular surface tumors require careful and meticulous assessment as it can mimic common inflammatory and non-neoplastic conditions. Surgical excision is the gold standard management modality. Newer treatment alternatives including topical chemotherapy/immunotherapy have shown encouraging results. Malignant tumors like conjunctival melanoma can be lethal. Systemic association of malignant tumors mandates thorough evaluation. Protocol-based management in ocular surface tumors has improved the outcome.

Tumors arising from the eyelid can be benign or malignant and are classified according to the tissue of origin. Malignant eyelid tumors can potentially be life threatening. A detailed evaluation is required to differentiate benign from malignant tumors depending on the characteristic clinical features. The standard of care involves surgical excision. Malignant eyelid tumors require complete surgical clearance with histopathologically proven negative margins. This prevents recurrences and reduces morbidity and mortality. Adjuvant therapy is indicated in selected case scenarios. The newer development of targeted therapy in malignant eyelid tumors seems promising.

Rationale: New-onset psychosis in an immunosuppressed patient post-kidney transplantation (KT) is a diagnostic challenge. A broad differential diagnosis merits consideration; however, an approach to this differential diagnosis remains to be outlined in the literature. Also, when and how to modify the maintenance immunosuppressive regimen remains a significant area of controversy. Presenting concerns: A 23-year-old male, known for X-linked Alport syndrome for which he had undergone KT 1 year prior, presented with a 1-week history of disorganized speech, bizarre behavior, religious delusions, and visual hallucinations. Diagnoses: After ruling out infectious, metabolic, autoimmune, and structural causes, immunosuppressant medications were changed from tacrolimus to cyclosporine. The patient did not improve after this change, and a second opinion consultation with a transplant psychiatrist led to a diagnosis of primary first-episode psychosis, later refined to bipolar disorder type I. Interventions: The patient was started on risperidone, which led to a significant improvement in his symptoms. Outcomes: Twelve months after discharge, his mood and behavior had returned to baseline on aripiprazole, bupropion, and citalopram. However, he developed acute allograft rejection, prompting a change from cyclosporine back to tacrolimus, with stability of his mental state and graft function. Teaching points: This report offers learners an extensive and organized differential diagnosis to the work up of psychosis post kidney transplantation. A complete history, with input from collateral sources, and a systematic approach to the differential diagnosis, are crucial and should not be overshadowed by the risk of immunosuppressant-related neurotoxicity. We underscore the importance of multi-disciplinary management and comprehensive psychosocial assessment and re-assessment to refine the diagnosis. We also report the successful re-introduction of tacrolimus once the diagnosis of a primary psychiatric disorder is confirmed. Finally, we offer a simplified approach that can aid in distinguishing between a primary psychiatric diagnosis versus tacrolimus-associated psychosis.

We propose a new formulation to non-rigid structure-from-motion that only requires the deforming surface to preserve its differential structure. This is a much weaker assumption than the traditional ones of isometry or conformality. We show that it is nevertheless sufficient to establish local correspondences between the surface in two different images and therefore to perform point-wise reconstruction using only first-order derivatives. To this end, we formulate differential constraints and solve them algebraically using the theory of resultants. We will demonstrate that our approach is more widely applicable, more stable in noisy and sparse imaging conditions and much faster than earlier ones, while delivering similar accuracy. The code is available at https://github.com/cvlab-epfl/diff-nrsfm/.

Generative models that produce point clouds have emerged as a powerful tool to represent 3D surfaces, and the best current ones rely on learning an ensemble of parametric representations. Unfortunately, they offer no control over the deformations of the surface patches that form the ensemble and thus fail to prevent them from either overlapping or collapsing into single points or lines. As a consequence, computing shape properties such as surface normals and curvatures becomes difficult and unreliable. In this paper, we show that we can exploit the inherent differentiability of deep networks to leverage differential surface properties during training so as to prevent patch collapse and strongly reduce patch overlap. Furthermore, this lets us reliably compute quantities such as surface normals and curvatures. We will demonstrate on several tasks that this yields more accurate surface reconstructions than the state-of-the-art methods in terms of normals estimation and amount of collapsed and overlapped patches., 14 pages

Smart cards have gained popularity in many domains by providing different facilities in every domain. Such cards are beneficial for storing credentials and access information. The cards are easy to carry and provides easy and fast computations. The cards have certain limitations due to the possible attacks on them. This chapter gives an overview of the smartcards including its history, physical design, life cycle. It also provides an overview of the possible threats on smartcards and its application area.

The article critically analyzes how historical narrative redesigns the past to serve the needs of present and construct a palimpsest that is subject to constant erasure and revision. The study choo...

As the technology node is shrinking from micron to sub-micron and to deep sub-micron, the device size of semiconductor components is getting smaller and smaller to achieve greater functionality. It has been established that the power consumption in the technology >100 nm is largely dominated by the active power dissipation. The technology

Most companies develop their strategy around key strengths or core competencies, especially how to coordinate diverse production skills and integrate multiple streams of technologies. But leadership often is credited for the success or failure of international operations. Effective leadership styles and practices in one culture are not necessarily effective in others. For examples, the leadership approach used by effective US managers would not necessarily be the same as that employed in other parts of the world even within the same country. Effective leadership tends to be very situation specific.However, certain leadership styles and practices transcend international boundaries. This paper gives a bird’s eye view of Japanese versus U.S. Leadership styles.Keywords: Leadership, strategy, worldwide.

Background The use of machine perfusion (MP) in kidney transplantation lowers delayed graft function (DGF) and improves 1-year graft survival in some, but not all, grafts. These associations have not been explored in grafts stratified by the Kidney Donor Profile index (KDPI). Methods We analyzed 78 207 deceased-donor recipients using the Scientific Registry of Transplant Recipients data from 2006 to 2013. The cohort was stratified using the standard criteria donor/expanded criteria donor (ECD)/donation after cardiac death (DCD)/donation after brain death (DBD) classification and the KDPI scores. In each subgroup, MP use was compared with cold storage. Results The overall DGF rate was 25.4% and MP use was associated with significantly lower DGF in all but the ECD-DCD donor subgroup. Using the donor source classification, the use of MP did not decrease death-censored graft failure (DCGF), except in the ECD-DCD subgroup from 0 to 1 year {adjusted hazard ratio [aHR] 0.56 [95% confidence interval (CI) 0.32-0.98]}. In the ECD-DBD subgroup, higher DCGF from 1 to 5 years was noted [aHR 1.15 (95% CI 1.01-1.31)]. Also, MP did not lower all-cause graft failure except in the ECD-DCD subgroup from 0 to 1 year [aHR = 0.59 (95% CI 0.38-0.91)]. Using the KDPI classification, MP did not lower DCGF or all-cause graft failure, but in the ≤70 subgroup, higher DCGF [aHR 1.16 (95% CI 1.05-1.27)] and higher all-cause graft failure [aHR 1.10 (95% CI 1.02-1.18)] was noted. Lastly, MP was not associated with mortality in any subgroup. Conclusions Overall, MP did not lower DCGF. Neither classification better risk-stratified kidneys that have superior graft survival with MP. We question their widespread use in all allografts as an ideal approach to organ preservation.

Retinoblastoma (RB) is the most common intraocular childhood malignancy, and it is considered potentially fatal if untreated. The management of RB has undergone a tremendous leap in the past four decades, with a global effort to save life along with eye and vision. Despite the on-going genetic and clinical research, there is a lack of clinical expertise and understanding of optimal management as it is customized and has to be tailored individually depending on various factors. In this review, we explore the management of RB and various chemotherapeutic alternatives using intravenous chemotherapy and the newer modalities such as intra-arterial and intravitreal chemotherapy in combating this deadly but curable disease. The strategy of management is challenging and mainly depends on the stage of the disease and tumor laterality.

The rapid increase in usage of personal computers, internet and digital multimedia technology leads to easily sharing of digital data/ media. However, availability of numerous image processing tools facilitate unauthorized use of such data. Unauthorized users/ attackers can easily copy, delete or modify digital data. This problem of illegal modification/ reproduction of digital data, leads to innovation of some techniques which can protect intellectual property rights of digital data/ media. Recently, watermarking has been identified as a major tool to attain copyright protection/ authentication. A digital watermark can be embedded in host data in spatial domain as well as in frequency domain. In this work a hybridized technique incorporating Discrete Wavelet Transform (DWT) and Singular Value Decomposition (SVD) has been presented.

Objectives: To assess the incidence and rates of hypoglycaemia in patients with type 1 diabetes mellitus (T1DM) or type 2 diabetes mellitus (T2DM) in the South African cohort of the International Operations Hypoglycaemia Assessment Tool (IO HAT) study.Methods: Patients diagnosed with either T1DM or T2DM, aged ≥ 18 years and treated with insulin for > 12 months, completed self-assessment questionnaires to record demography, treatment information and hypoglycaemia during a 6-month retrospective and 4-week prospective periods (ClinicalTrials.gov: NCT02306681).Results: In T1DM 76.2% (95% confidence interval [CI] 69.1%, 82.3%) of patients reported hypoglycaemia in the retrospective period and 98.2% (95% CI 94.7%, 99.6%) in the prospective period. The corresponding figures for patients with T2DM were 52.2% (95% CI 48.6%, 55.9%) and 90.1% (95% CI 87.7%, 92.3%), respectively. Rates of any and severe hypoglycaemia, respectively were T1DM 90.7 events per patient year (PPY) (95% CI 85.5, 96.1) and 8.8 events PPY (95...

In recent years, the enhancement in technology has been envisioning for people to complete tasks in an easier way. Every manufacturing industry requires heavy machinery to accomplish tasks in a symmetric and systematic way, which is much easier with the help of advancement in the technology. The technological advancement directly affects human life as a result. It is found that humans are now fully dependent on it. The online game industry is one example of technology breakthrough. It is now a prominent industry to develop online games at world level. In this paper, our main objective is to analyze major factors which encourage mobile games industry to expand. Analyzing the system and symmetric relations inside can be done into two phases. The first phase is through a TAM Model, which is a very efficient way to solve statistical problems, and the second phase is with machine learning (ML) techniques, such as SVM, logistic regression, etc. Both strategies are popular and efficient in analyzing a system while maintaining the symmetry in a better way. Therefore, according to results from both the TAM model and ML approach, it is clear that perceived usefulness, attitude, and symmetric flow are important factors for game industry. The analytics provide a clear insight that perceived usefulness is an important parameter over behavior intention for the online mobile game industry.

Pleural tuberculosis (pTB) is a grave form of extrapulmonary tuberculosis. Microbiological tests are usually found to be inadequate for pTB diagnosis. The absence of a uniform ‘composite reference standard’ is challenging; therefore, diagnosis is usually performed using a combination of diversified criteria. Nucleic acid tests vary in diagnostic accuracy and have not yet been integrated into clinical decision making. This review assesses the varied criteria used for pTB classification and the challenges afflicting pleural fluid-based DNA diagnostic tests, namely, PCR and Xpert® MTB/RIF. In the 58 studies (PCR: n = 33; Xpert: n = 25) analyzed, reference standards were heterogeneous and PCR/Xpert pooled sensitivity values (range: 0–100%) were inadequate. However, the consistent high specificity of Xpert (range: 90–100%) indicated its utility as a ‘rule-in’ test. There is an urgent need to evaluate existing and new molecular tests in well-designed studies to accurately assess their utility for pTB diagnosis. To conclude, rapid and accurate tests are warranted for pTB diagnosis.

ObjectiveThe aims of the present study were to determine the prevalence of hypothyroidism, both subclinical hypothyroidism (SH) and overt hypothyroidism (OH), its correlation with dyslipidemia, and whether replacement therapy with levothyroxine has an effect on plasma lipid profile, i.e., total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL) of hypothyroid patients.Materials and methodsA prospective, open-label, observational, clinical study was conducted by the Department of Pharmacology in collaboration with the Department of Medicine, Rohilkhand Medical College & Hospital, for a period of 10 months. A total of 50 patients, age 18 to 65 years, of both genders, who were newly diagnosed cases of hypothyroidism with dyslipidemia (Adult Treatment Panel III National Cholesterol Education Program guidelines) were recruited for the study. Levothyroxine replacement therapy was administered and the patients were reassessed at 6 and 36 weeks for an effect on lipid profile and body mass index.ResultsIn cases of OH, baseline TC, TG, LDL, and HDL were 231.01 ± 27.84, 148.18 ± 10.72, 149.07 ± 12.38, and 35.42 ± 6.73 mg/dL, which was reduced to 177.33 ± 23.17, 123.15 ± 29.50, 118.44 ± 29.85, and 47.86 ± 8.53 mg/dL after 36 weeks of levothyroxine therapy (p < 0.05).ConclusionIn cases of OH associated with dyslipidemia, levothyroxine therapy achieved a favorable lipid profile in significant number of cases.How to cite this articleShekhar A, Singh HK, Chandra S, Shaifali I, Mehra D. Effect of Levothyroxine Therapy on Hypothyroidism-induced Dyslipidemia. Int J Adv Integ Med Sci 2017;2(3):107-110.

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate ≥25 mL/min/1.73 m2 and albuminuria (urinary albumin-to-creatinine ratio ≥30 to ≤5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level α = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049.

Background Only few retrospective studies have looked into the ability of PET-CT to diagnose distant metastases in gall bladder cancer (GBC) patients with variable results. This study aims to determine the utility of PET –CT in potentially resectable GBC. Methods All GBC patients with resectable disease on CECT chest, abdomen & pelvis were subjected to FDG- PET-CT scan. Incidental GBC was excluded. All additional findings and change in management plan was recorded. Results Out of 149 patients, 99 (66.4%) were females and the mean age was 56.7 ± 11.0 years,. After PET scan, additional findings were seen in 46/149 (30.9%) patients and it lead to change in management plan in 35 (23.4%) patients due to the presence of distant metastases. Impact of PET scan in changing the stage was higher in patients having node positive disease on CECT (26/96, 27%) as compared to node negative patients (9/53, 16.9%), but this difference was not statistically significant (p = 0.233). After assessment on CECT, 76 patients were planned for NACT in view of locally advanced disease but after PET-CT in these patients, the management plan changed to palliative chemotherapy in 26 (34.2%) cases whereas it changed in only 9 out of 73 (12.3%) patients who were planned for upfront surgery (p = 0.003). Conclusion Our results show that preoperative staging workup for GBC should include PET-CT as it changed the management plan in approximately one-fourth of all resectable GBC patients and in one-third of locally advanced cases.