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Federated Learning (FL) is a distributed machine learning approach in which clients contribute to learning a global model in a privacy preserved manner. Effective aggregation of client models is essential to create a generalised global model. To what extent a client is generalisable and contributing to this aggregation can be ascertained by analysing inter-client relationships. We use similarity between clients to model such relationships. We explore how similarity knowledge can be inferred from comparing client gradients, instead of inferring similarity on the basis of client data which violates the privacy-preserving constraint in FL. The similarity-guided FedSim algorithm, introduced in this paper, decomposes FL aggregation into local and global steps. Clients with similar gradients are clustered to provide local aggregations, which thereafter can be globally aggregated to ensure better coverage whilst reducing variance. Our comparative study also investigates the applicability of FedSim in both real-world datasets and on synthetic datasets where statistical heterogeneity can be controlled and studied systematically. A comparative study of FedSim with state-of-the-art FL baselines, FedAvg and FedProx, clearly shows significant performance gains. Our findings confirm that by exploiting latent inter-client similarities, FedSim’s performance is significantly better and more stable compared to both these baselines.

BackgroundThis systematic review and meta-analysis was aimed to evaluate the efficacy and safety of tocilizumab (TCZ) in treating severe coronavirus disease 2019 (COVID-19).MethodsThe electronic search was performed using PubMed, Scopus, CENTRAL, and Google scholar to identify the retrospective observational reports. The studies published from 01 January 2020 to 30th September 2020. Participants were hospitalized COVID-19 patients. Interventions included tocilizumab versus placebo/standard of care. The comparison will be between TCZ versus standard of care (SOC)/placebo. Inconsistency between the studies was evaluated with I2 and quality of the evidences were evaluated by Newcastle-Ottawa scale.ResultsBased on the inclusion criteria there were 24 retrospective studies involving 5686 subjects were included. The outcomes of the meta-analysis have revealed that the TCZ has reduced the mortality (M-H,RE-OR −0.11(−0.18 to −0.04) 95% CI, p =0.001, I2 =88%) and increased the incidences of super-infections (M-H, RE-OR 1.49(1.13 to 1.96) 95% CI, p=0.004, I2=47%). However, there is no significant difference in ICU admissions rate (M-H, RE-OR −0.06(−0.23 to 0.12), I2=93%), need of MV (M-H, RE-OR of 0.00(−0.06 to 0.07), I = 74%), LOS (IV −2.86(−0.91 to 3.38), I2=100%), LOS-ICU (IV: −3.93(−12.35 to 4.48), I2=100%), and incidences of pulmonary thrombosis (M-H, RE-OR 1.01 (0.45 to 2.26), I2=0%) compared to SOC/control.ConclusionBased on cumulative low to moderate certainty evidence shows that TCZ could reduce the risk of mortality in hospitalized patients. However, there is no statistically significant difference observed between the TCZ and SOC/control groups in other parameters.

An integrated generator–rectifier system is a promising architecture to harvest energy in offshore wind turbines. The system processes the majority of the incoming power using reliable, efficient, and inexpensive passive diodes operating at the generator line frequency. Elimination of capacitors at the diode rectifiers’ output by appropriately phase shifting the voltages of a multiport generator further improves the reliability of the overall architecture. This article creates a generalized framework to evaluate the interactions among different generator ports, diode-bridge rectifiers, and the active rectifier that is used to control the power flow. The framework enables quantifying the effect of integration on the dc bus power ripple and power imbalance among different generator ports. An exemplary winding layout is proposed that ensures theoretically zero interaction between the passive ports, although all the ports are mounted on a magnetic structure. A 10-MW integrated generator–rectifier design and simulation proves the accuracy of the framework using coupled circuit and finite-element simulation. Finally, a laboratory prototype shows the realization of the winding layout. The proposed inductance-matrix-based framework can be used to evaluate other winding layouts to estimate the effect of magnetic coupling on the performance of the system.

Background Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to over 170?million cases worldwide with over 33.2?million cases and 594,000 deaths in the US alone as of May 31st, 2021. The pandemic has also created severe shortages of personal protective equipment, particularly of filtering facepiece respirators (FFRs). The Centers for Disease Control and Prevention (CDC) has issued recommendations to help conserve FFRs, as well as crisis standards, including four criteria required for decontamination of the traditionally single use respirators. This review is designed to provide an overview of the current literature on vaporized hydrogen peroxide (vHP), hydrogen peroxide gas plasma (HPGP), and aerosolized hydrogen peroxide (aHP) with respect to each of the four CDC decontamination criteria. Methods PubMed and Medrxiv were queried for relevant articles. All articles underwent a title and abstract screen as well as subsequent full text screen by two blinded reviewers if indicated. Results Searches yielded 195 papers, of which, 79 were found to be relevant. Of those, 23 papers presented unique findings and 8 additional articles and technical papers were added to provide a comprehensive review. Overall, while there are potential concerns for all 3 decontamination methods, we found that vHP has the most evidence supporting its use in FFR decontamination consistent with CDC recommendation. Conclusions Future research is recommended to evaluate biological inactivation and real world fit failures after FFR reuse.

Objective To compare the clinical profile of long-term survivors and non-survivors with T1D(T1D) in India. Research design and methods This is a retrospective study of 76 individuals with T1D who had survived for at least 40 years ('survivors') and 51 individuals with T1D who had died with shorter duration of diabetes ('non-survivors'), from diabetes clinics in different cities of India. Prevalence of complications in both groups and causes of death of the non-survivors were analyzed. Retinopathy was diagnosed by retinal photography; chronic kidney disease (CKD) by urinary albumin excretion (micro- or macroalbuminuria) and estimated glomerular filtration rate; peripheral vascular disease (PVD) by Doppler measurement of ankle-brachial pressure index; coronary artery disease (CAD) based on history of myocardial infarction or coronary revascularization and neuropathy by biothesiometry. Results Mean glycated hemoglobin (8.4±1.5 vs 10.7±2.2%, p

Multiple myeloma (MM) measurable residual disease (MRD) persisting after treatment is an adverse prognostic factor for progression free survival (PFS) and overall survival.1Genomic mutations occurred in the remaining clonal aberrant plasma cells (A-PCs) are linked to the development of drug resistance and disease relapse.2 Thus, personalised treatment based on the genomic profile of MRD could be highly beneficial and ultimately increase patients’ survival. However, while large-scale sequencing studies have characterised the genome of many malignancies including MM,3–8 the genomic mutations present in MM MRD are at the beginning of investigation.9 Here, we set up an exome sequencing analysis to identify genomic mutations characteristic for MM MRD and explore if they could mediate drug response, resistance or disease progression.

Stroke is the second most common cause of death worldwide. It occurs due to the insufficient supply of oxygen-rich blood to the brain. It is a complex disease with multiple associated risk factors, including smoking, alcoholism, age, sex, ethnicity, etc. Calcium ions are known to play a vital role in cell death pathways, which is a ubiquitous intracellular messenger during and immediately after an ischemic period. Disruption in normal calcium homeostasis is known to be a major initiator and activator of the ischemic cell death pathway. Under ischemic stroke conditions, glutamate is released from the neurons and glia, which further activates the N-methyl-D-aspartate (NMDA) receptor and triggers the rapid translocation of Ca2+ from extracellular to intracellular spaces in cerebral tissues and vice versa. Various studies indicated that Ca2+ could have harmful effects on neurons under acute ischemic conditions. Mitochondrial dysfunction also contributes to delayed neuronal death, and it was established decades ago that massive calcium accumulation triggers mitochondrial damage. Elevated Ca2+ levels cause mitochondria to swell and release their contents. As a result, oxidative stress and mitochondrial calcium accumulation activate mitochondrial permeability transition and lead to depolarization-coupled production of reactive oxygen species. This association between calcium levels and mitochondrial death suggests that elevated calcium levels might have a role in the neurological outcome in ischemic stroke. Previous studies have also reported that elevated Ca2+ levels play a role in the determination of infarct size, outcome, and recurrence of ischemic stroke. The current review has been compiled to understand the multidimensional role of altered Ca2+ levels in the initiation and alteration of neuronal death after an ischemic attack. The underlying mechanisms understood to date have also been discussed.

Gestational diabetes mellitus (GDM) diagnosed during the first trimester of pregnancy is called 'early pregnancy Gestational Diabetes Mellitus' (eGDM). The burden of eGDM has only been studied sporadically. This review aims to understand the global burden of eGDM in terms of prevalence, risk factors, pregnancy outcomes, treatment and postpartum dysglycemia. METHODS: A review of epidemiologic studies reporting on early GDM screening as per Joanna Briggs Institute (JBI) methodology for prevalence reviews was conducted. A customized search strategy was used to search electronic databases namely, PubMed, CINAHL, EMBASE, Cochrane Library, Scopus, MEDLINE, Ovid, ScienceDirect, and Google Scholar. Three independent reviewers reviewed studies using Covidence software. Observational studies irrespective of study design and regardless of diagnostic criteria were included. Quality of evidence was appraised, and findings were synthesized.Of 58 included studies, 41 reported a prevalence of eGDM, ranging from 0.7 to 36.8%. Body mass index (BMI), previous history of GDM, family history of diabetes and multiparity were reported as eGDM risk factors. Adverse pregnancy outcomes associated with eGDM were macrosomia, caesarean delivery, induction of labour, hypertension, preterm delivery, and shoulder dystocia. The incidence of postpartum dysglycemia and the need for insulin was higher in women with eGDM. The risk of bias was moderate. Heterogeneity of studies is a limitation. Meta-analysis was not performed.There is heterogeneity in the prevalence of eGDM and intrapartum and postpartum ill effects for the mother and the offspring. There is a need to develop a universal screening protocol for eGDM.

As agriculture seems to be a crucial part in food security as well as economic development of a country, selecting crops for cultivation is a most important aspect in an agricultural planning. It relies on variety of parameters which includes weather condition, soil property and government policies. The suggested system helps the farmers to select suitable crop based on season and region of sowing. It will in-turn help the farmers by improving the net profit to them. By considering different datasets with respect to five parameters such as rainfall, temperature, slope, humidity and soil moisture of horticulture data, the system builds a model or method using which can suggest list of crops which is mainly helpful for the farmers in his/her decision making.

We previously created a mandatory, inpatient, hepatology resident curriculum that immediately improved comfort, knowledge, and career interest in chronic liver disease (CLD). The durability of these effects needs to be known to use this intervention to address the hepatologist shortage. Thus, we aimed to assess this curriculum’s long‐term outcomes on internal medicine (IM) residents’ CLD comfort, knowledge, and career interest. From 2015 to 2019 at a single institution, one IM resident was always assigned to the rotation. Similar anonymous assessments were administered to incoming postgraduate year (PGY)‐1 residents and graduating PGY‐3 residents, including a historic control cohort that graduated in June 2015. At residency completion, the intervention cohort (n = 61) had significantly higher comfort (1, not at all comfortable/strongly disagree; 5, very comfortable/strongly agree) with both hepatology (e.g., hepatitis C, 2.5 vs. 3.3, P

Aims/hypothesis We aimed to estimate the lifetime risk of diabetes and diabetes-free life expectancy in metropolitan cities in India among the population aged 20 years or more, and their variation by sex, age and BMI. Methods A Markov simulation model was adopted to estimate age-, sex- and BMI-specific lifetime risk of developing diabetes and diabetes-free life expectancy. The main data inputs used were as follows: age-, sex- and BMI-specific incidence rates of diabetes in urban India taken from the Centre for Cardiometabolic Risk Reduction in South Asia (2010–2018); age-, sex- and urban-specific rates of mortality from period lifetables reported by the Government of India (2014); and prevalence of diabetes from the Indian Council for Medical Research INdia DIABetes study (2008–2015). Results Lifetime risk (95% CI) of diabetes in 20-year-old men and women was 55.5 (51.6, 59.7)% and 64.6 (60.0, 69.5)%, respectively. Women generally had a higher lifetime risk across the lifespan. Remaining lifetime risk (95% CI) declined with age to 37.7 (30.1, 46.7)% at age 60 years among women and 27.5 (23.1, 32.4)% in men. Lifetime risk (95% CI) was highest among obese Indians: 86.0 (76.6, 91.5)% among 20-year-old women and 86.9 (75.4, 93.8)% among men. We identified considerably higher diabetes-free life expectancy at lower levels of BMI. Conclusions/interpretation Lifetime risk of diabetes in metropolitan cities in India is alarming across the spectrum of weight and rises dramatically with higher BMI. Prevention of diabetes among metropolitan Indians of all ages is an urgent national priority, particularly given the rapid increase in urban obesogenic environments across the country.

Chimeric antigen receptor (CAR) T cell-based immunotherapy, approved by the US Food and Drug Administration, has shown curative potential in patients with haematological malignancies. However, owing to the lack of control over the location and duration of the anti-tumour immune response, CAR T cell therapy still faces safety challenges arising from cytokine release syndrome and on-target, off-tumour toxicity. Herein, we present the design of light-switchable CAR (designated LiCAR) T cells that allow real-time phototunable activation of therapeutic T cells to precisely induce tumour cell killing. When coupled with imaging-guided, surgically removable upconversion nanoplates that have enhanced near-infrared-to-blue upconversion luminescence as miniature deep-tissue photon transducers, LiCAR T cells enable both spatial and temporal control over T cell-mediated anti-tumour therapeutic activity in vivo with greatly mitigated side effects. Our nano-optogenetic immunomodulation platform not only provides a unique approach to interrogate CAR-mediated anti-tumour immunity, but also sets the stage for developing precision medicine to deliver personalized anticancer therapy. While chimeric antigen receptor (CAR) T cell-based therapy has been approved for clinical use for certain types of blood cancers, it remains difficult to achieve precise spatiotemporal control of the elicited anti-tumour response. Here, the authors propose light-switchable CAR T cells that can be remotely activated by a nano-optogenetic approach, reducing unwanted side effects.

Struma ovarii is a rare ovarian teratoma characterised by the unusual presence of thyroid tissue. Even though usually benign, malignant transformation is sometimes detected. We report such a case of malignant struma ovarii in a 29-year-old nulliparous woman who was managed systematically with fertility preservation and followed up to have a successful delivery. The patient was diagnosed to have bilateral complex ovarian cyst when evaluated for pain abdomen. She underwent bilateral ovarian cystectomy with frozen section biopsy as initial management. On diagnosing as malignant epithelial ovarian tumour in frozen, definitive treatment was planned after final histopathology report and fertility preservation. Her histopathology showed stage 3 malignant struma ovarii. Multidisciplinary team was convened. After further detailed evaluation, she had embryo freezing by controlled ovarian stimulation with antagonist protocol. Two good quality embryos were vitrified on day 2 post-intra-cytoplasmic sperm insemination (ICSI). She underwent staging laparotomy that included uterus conserving surgery with bilateral oophorectomy, omentectomy, peritonectomy, appendicectomy with total thyroidectomy and iodine ablation. After 1 year of follow-up, embryo transfer was done which resulted in a successful delivery. This is, to our knowledge, the first case of fertility preservation after stimulation with gonadotropins in a case of malignant struma ovarii. Poor ovarian reserve due to bilateral ovarian cystectomy, time constraint as she had to undergo a definitive surgery and residual complex ovarian cystic lesions made this a challenging case.

Amelogenesis imperfecta (AI) refers to a group of rare genetic disorders that involve tooth development and that are passed down through families as a dominant trait. This condition is characterized by abnormal enamel formation caused by gene mutations that alter the quality and/or quantity of enamel. This dental problem can impact both primary and permanent dentition, varies among affected individuals, and results in esthetic and functional problems. The treatment planning for patients with AI is related to many factors, including the age of the patient, the type and severity of the disorder, intraoral conditions, and the socioeconomic status of the patient. It is crucial to plan a proper remedy, which requires collaboration among dental specialties to execute comprehensive dental treatment in order to provide a long-term solution with adequate esthetics. This clinical case study looks at three different types of amelogenesis imperfecta patients. Keywords: Amelogenesis imperfecta, Hypoplastic amelogenesis imperfecta, Hypomaturation hypoplasia with taurodontism

Objectives Literature from stroke and cardiac hospital admissions demonstrate a higher prevalence of undiagnosed type 2 diabetes compared with the general population. Fewer diabetes screening studies exist in the general medicine population, none of which have been based in Canada. Our primary objective in this study was to determine the prevalence of probable undiagnosed diabetes (glycated hemoglobin [A1C]≥6.5%) in hospitalized medicine patients. Secondary objectives were to identify the prevalence of undiagnosed dysglycemia (A1C≥6.0%) and the subsequent management of emergent cases. Methods In this prospective cohort study, adult patients admitted to internal medicine at a tertiary hospital in Ontario were screened for diabetes using an A1C test over a 3-month period. Baseline demographics and outcomes were compared using t tests, chi-square tests and Fisher’s exact tests for normoglycemia, undiagnosed dysglycemia and probable undiagnosed diabetes. A regression analysis was performed to identify any relationships between various cardiovascular-related risk factors and A1C. Results A total of 53 adult patients were enrolled. The prevalence of probable undiagnosed diabetes and undiagnosed dysglycemia was 7.5% (n=4) and 30.2% (n=16), respectively. Implementation of diabetes management strategies and/or documentation of the finding occurred in 4 of 16 patients. Regression analysis showed no relationship between either cardiovascular-related risk factors or admission glucose with A1C. Conclusions A broader screening approach may capture previously undiagnosed cases of diabetes that do not belong to traditionally at-risk populations. Future studies should focus on identifying risk factors for undiagnosed dysglycemia in hospitalized patients, including ethnicity and barriers to community access, so that appropriate screening programs can be developed.

Background and Rationale: Immune checkpoint inhibitor (ICI) therapy is an expanding therapeutic option for hepatocellular carcinoma (HCC). Antibiotics (ATB) taken prior to or early during ICI therapy can impact immunotherapy efficacy across indications; however, the effect of ATB is undefined in HCC. Methods: In a large international cohort of 450 ICI recipients from Europe, North America, and Asia, we categorized patients according to timing of ATB focusing on exposure within −30 to +30 days from ICI (early immunotherapy period [EIOP]). EIOP was evaluated in association with overall survival (OS), progression-free survival (PFS), and best radiologic response using RECIST 1.1 criteria. Results: Our study comprised mostly cirrhotic (329, 73.3%) males (355, 79.1%) with a Child-Turcotte Pugh class of A (332, 73.9%), receiving ICI after 1 therapy line (251, 55.9%) for HCC of Barcelona clinic liver cancer stage C (325, 72.4%). EIOP (n = 170, 37.9%) was independent of baseline clinicopathologic features of HCC and correlated with longer PFS (6.1 vs. 3.7 months, log-rank p = 0.0135). EIOP+ patients had similar OS, overall response, and disease control rates (DCRs) compared to EIOP. The effect of EIOP persisted in landmark time analyses and in multivariable models, confirming the independent predictive role of EIOP in influencing PFS following adjustment for covariates reflective of tumor burden, liver function, and ICI regimen administered. In patients receiving programmed cell death-1 receptor/ligand inhibitors monotherapy, EIOP was also associated with higher DCRs (61.4% vs. 50.9%, p = 0.0494). Conclusions: Unlike other oncological indications, ATB in the 30 days before or after ICI initiation is associated with improved benefit from immunotherapy, independent of disease and treatment-related features. Evaluation of the immune microbiologic determinants of response to ICI in HCC warrants further investigation.

Children with ASD receive a multitude of educational, medical, and therapeutic services. At the onset of the COVID‐19 pandemic, all of these services came to a complete halt following strict lockdowns. Many services have resumed in a hybrid format using face to face and virtual modes of delivery. This study describes findings from the COVID‐19 impact survey administered at the onset of the pandemic in a subgroup of families from the SPARK cohort (N = 6393), one of the largest ASD cohorts in the US. The differential early impact of COVID‐19 on various subgroups of children with ASD and their families was examined. Caregivers of children and adolescents with ASD between 19 months and 18 years completed an online survey inquiring about the impact of COVID‐19 pandemic on access to services, parent concerns about the same, impact on child's ASD‐related behaviors, child, and parent mental health, and the benefits/potential benefits of online/future online services. Analysis revealed that certain demographic (age, income/SES) and child‐related factors (repetitive behaviors, language, functional, cognitive, and motor impairments, and child's understanding), as well as parent's past mental health were associated with/predicted greater service disruptions, greater ASD‐related behaviors, and greater negative impact on parent mental health. In conclusion, younger children, children from low‐income families, and children with greater impairment severity (more severe repetitive behaviors, language, cognitive, function, language, and motor impairments) were more negatively impacted by the pandemic through service disruptions, increased ASD‐related behaviors, parent health/family impact, and found online interactions to be less beneficial. Lay Summary The SPARK study impact survey shows that at the onset of the COVID‐19 pandemic, parents reported significant service disruptions, negative impact on their child's ASD‐related behaviors as well as their own mental health; which was greater in families with younger children, children with greater ASD severity, and children from low‐income families. Majority of families did not report significant benefits of online services whereas some families did. Low‐income families were hopeful about receiving benefits through future online services. Overall, these findings have important implications for future clinical care delivery and healthcare policies to ensure that healthcare services are not interrupted during a potential resurgence of COVID‐19 or other pandemics. A combination of in‐person and online healthcare and family support services must be implemented to prevent negative health impacts in the future.

Heart diseases are the one of the primary reasons of human death today. There are many recent technologies are used to assist the medical professionals and doctors in the prediction of heart disease in the early stage. Prediction of heart disease is a critical challenge in the area of clinical data analysis. This paper introduces a technique to detect arrhythmia, which is a representative type of cardio vascular diseases. Arrhythmia refers to any irregular change from the normal heart rhythms, means that your heart beats too quickly, too slowly, or with an irregular pattern. The Electro Cardiogram (ECG) is used as an input for the arrhythmia detection. It displays the rhythm and status of the heart. This paper propose an effective ECG arrhythmia classification approach based on a deep convolutional neural network (CNN), which has lately demonstrated remarkable performance in the field of machine learning. It perform the classification without any manual pre-processing of the ECG signals such as noise filtering, feature extraction, and feature reduction. Keywords: Arrhythmia, ECG, deep learning, CNN, ResNet

The goal of this survey is to review the state-of-the art Reversible Data Hiding (RDH) methods, classify these methods into different classes, and list out new trends in this field. RDH, in general, is a challenging problem and has potential applications in the today’s digital world. Reversible data hiding methods not only securely transfer secret data but also recover the cover media faithfully. Recently, RDH methods are mainly focused on obtaining high capacity along with tuneable quality. Although, extensive investigations in the field of reversible data hiding was carried out in the recent past, a comprehensive review of existing literature for listing out research gap and future directions has not yet been reported. In this survey, we have classified the reversible data hiding methods mainly into a) Plain domain b) Encrypted domain and also examine their pro and cons. Tabular comparison of various RDH methods has been provided considering various design and analysis aspects. Moreover, we discuss important issues related to reversible data hiding and use of benchmarked datasets along with performance metrics for evaluation of RDH methods.

Purpose Advanced bibliometric methods have emerged as key tools in mapping the history and trends of a discipline. This paper aims to demonstrate on applying various bibliometric methods to track a journal’s impact and review its knowledge contribution. In doing so, the authors take the case of IIMB Management Review (IMR) journal focused on management discipline, in consideration of its 10 years of publication presence. Design/methodology/approach Using bibliometric and Scopus metric methods, the authors map and analyze the productivity of IMR Journal and map its knowledge contributions. Findings The authors identify the IMR journal’s impact, its growth, the most prolific authors/affiliations, key research hotspots, cross-country collaboration and emerging trends over the past decade. Originality/value A 10-year longitudinal review helps the target group identify the main themes. It also provides key empirical insights to the journal editorial board and library managers for future planning and growth of the journal.

Variations in topogeographical features causes immense miscellany of widely used medicinal plants (MPs) in Indian Himalayan Region (IHR), thus an ethnobotanical approach was adopted to file the undocumented indigenous wealth of the communities against different corporeal ailments. 370 households of 31 villages were surveyed during the summer seasons of 2015 and 2016 to explore the traditional folkloric practices of the inhabitants using a semi structured questionnaire. The data set was documented in Microsoft Office Excel and statistically analyzed for Use Value (UV), Informants' Consensus Factor (ICF), Fidelity Level (FL), Relative Importance (RI), Cultural Importance Index (CI), Index of Agreement on Remedies (IAR) and Cultural Agreement Index (CAI). The MPs were classified and analyzed for altitudinal distribution, nativity, endemism and threat categories. Total 292 MPs belonging to 95 families were reported to be used against major 15 types of substantial corporeal disorders. The richness of MPs decreased with an increasing altitude. Asteraceae (27 species) was found to be dominant family, followed by Rosaceae (17 species), Lamiaceae (16 species) and Ranunculaceae (15 species) used to cure such ailments. Five MPs were endemic to the IHR and 8 MPs were found to be critically endangered (CR) in the study region. Traditional healers had a detailed and wide range of folkloric therapeutic wisdom to treat different types of human diseases. Folkloric practice provides an alternative preference from conventional healthcare centers for the needy rural ethnic people of this distant area. But unfortunately rapid loss in biodiversity elements, urbanization and considerable anthropogenic stress causes significant decrease in the ethnic knowledge as well as the MPs. Thus, awareness among the people and proper conservation measures is readily needed.

BACKGROUND The standard conventional radiation schedule for early laryngeal cancer is 64 - 70 Gy in 2 Gy per fraction over 6.5 - 7 weeks. Hypofractionated radiotherapy in early laryngeal cancer allows delivery of larger dose per fraction (fraction size) in decreased overall treatment time with improved local control and similar survival rates. Reduction in treatment time also optimizes the usage of radiotherapy resources. The purpose of this study was to estimate the local control rates, survival rates and toxicity profile of hypofractionated radiotherapy of 52.5 Gy in 15 fractions for early glottic cancer. METHODS Twenty-eight patients with early glottic squamous cell carcinoma (SCC) treated with hypofractionated definitive radiotherapy from June 2015 to December 2019 were analyzed. The median age was 61 years. Total dose of 52.5 Gy in 15 fractions was delivered over three-four weeks with a fraction size of 3.5 Gy. The median follow-up period was 23.8 months. RESULTS The 5-year local control rates were 96.4 % with one recurrence. The 5-year overall survival rate was 100 % and cause specific survival at 5 years was 100 %. There was no association of T1 sub staging, T2 (P - 0.40) and no significant association of anterior commissure involvement (P = 0.408, chi square value = 3.982) and pretreatment haemoglobin (P - 0.480) on local control. Late complications include laryngeal oedema (21.5 %), altered thyroid function (3.6 %), cardiac complication (3.6 %) and altered voice quality (14.3 %).There was no association of local control with field size (FS) (P = 0.812), beam energy (P = 0.098 ) overall treatment time of less than thirty days (P - 0.747). CONCLUSIONS Local control with hypofractionated radiotherapy for early laryngeal glottis squamous cell carcinoma is excellent with no severe complications. The short overall treatment time enables channelling of radiotherapy resources in low budget countries with long wait list for radiation. KEYWORDS Early Laryngeal Cancer, Glottic Cancer, Hypofractionated Radiotherapy, Overall Treatment Time.

Imbalanced dataset classification is challenging because of the severely skewed class distribution. The traditional machine learning algorithms show degraded performance for these skewed datasets. However, there are additional characteristics of a classification dataset that are not only challenging for the traditional machine learning algorithms but also increase the difficulty when constructing a model for imbalanced datasets. Data complexity metrics identify these intrinsic characteristics, which cause substantial deterioration of the learning algorithms’ performance. Though many research efforts have been made to deal with class noise, none of them focused on imbalanced datasets coupled with other intrinsic factors. This paper presents a novel hybrid pre-processing algorithm focusing on treating the class-label noise in the imbalanced dataset, which suffers from other intrinsic factors such as class overlapping, non-linear class boundaries, small disjuncts, and borderline examples. This algorithm uses the wCM complexity metric (proposed for imbalanced dataset) to identify noisy, borderline, and other difficult instances of the dataset and then intelligently handles these instances. Experiments on synthetic datasets and real-world datasets with different levels of imbalance, noise, small disjuncts, class overlapping, and borderline examples are conducted to check the effectiveness of the proposed algorithm. The experimental results show that the proposed algorithm offers an interesting alternative to popular state-of-the-art pre-processing algorithms for effectively handling imbalanced datasets along with noise and other difficulties.

Background This systematic review evaluated the efficacy of autologous skin cell suspensions (ASCS) on the re-epithelialization of partial thickness burn injuries and skin graft donor site wounds. Methods Four databases (EMBASE, Google Scholar, MEDLINE, Web of Science), grey literature and select journal hand-searching identified studies from 1975 - 2020. Randomized trials evaluating partial thickness burn management with non-cultured ASCS compared to any other intervention were included. Time to re-epithelialization (TTRE) was the primary outcome. Three independent researchers completed screening, data extraction and certainty of evidence assessment using Cochrane Risk of Bias Tool and Grading of Recommendations Assessment, Development and Evaluation. Results Five trials (n = 347) reported on adults (2 trials) and children (1 trial) with burn wounds, and adults with donor site wounds (2 trials). The effect of ASCS compared to control on TTRE in adult burn wounds was not estimable. TTRE was shorter in pediatric burn wounds (SMD -1.75 [95% CI: -3.45 to -0.05]) and adult donor site wounds (SMD-5.71 [95% CI: -10.61 to-0.81]) treated with ASCS. The certainty of evidence was very low. Conclusion Compared to standard care, ACSC may reduce pediatric partial thickness burn wound and adult split-thickness skin graft donor site TTRE. Registration PROSPERO CRD42019133171

Breast cancer (BC) is the most common cancer for females, and its incidence tends to increase year by year. Currently, the backbone of therapy for BC is mainly chemotherapy; however, its toxicity in normal cells and acquired tumor resistance to the drug users are considered the main barriers. Therefore, there is still an urgent need for the development of more effective and safer anti-BC agents. Based on previous reference documents in recent years, this review covers the work reported on the anti-BC compounds classified according to the structures. This review summarized significant anti-BC compounds organized by functional groups according to the animal model data, although there would be some limitations. This review highlights the properties of new compounds having promising anti-BC properties, which may be proven to be more effective and selective, and possibly free of unwanted side effects. The reviewed compounds represent an interesting possibility of overcoming BC and reducing the percentage of patients with an inadequate response to drug therapy.

Objective To examine the relationship of visual function as assessed by visual acuity, contrast sensitivity, and multifocal electroretinography (mfERG) to macular structural and microvascular measures on optical coherence tomography (OCT) and angiography (OCTA) in individuals with diabetes. Methods This is a prospective observational study conducted at a tertiary eye care centre in India. Right eyes of 121 adults with type 2 diabetes with no diabetic retinopathy (DR), mild or moderate nonproliferative DR (NPDR) were examined. Severe NPDR, proliferative DR and diabetic macular oedema were excluded. Participants underwent assessment of glycated haemoglobin (HbA1C), blood pressure, best corrected visual acuity (LogMAR), contrast sensitivity (CS), mfERG, ultrawide field fundus photography, OCT and OCTA. Correlations were assessed by Spearman's rank correlation (rho). Results Of the total of 121 eyes, 89 had No DR, 32 had mild to moderate NPDR. In the No DR group, the LogMAR acuity was significantly and negatively correlated to central subfoveal thickness (CST) (rho = -0.420), macular vessel density (rho = -0.270) and perfusion (rho = -0.270). (ii) Contrast sensitivity correlated to foveal avascular zone circularity (rho = 0.297); (iii) mfERG P1 response densities were better with higher macular perfusion index (rho = 0.240). In the NPDR group, the LogMAR acuity also showed a significant negative correlation to CST (rho = -0.379). Other correlations were not significant. Conclusion Retinal and visual functional changes are evident in diabetic patients with No DR and are correlated to subclinical retinal structural changes detectable using multimodal imaging.

A 50 years old woman was referred to hospital with complaints of bluish black discoloration of skin or multiple ecchymosis since 6 days and skin rashes, pink changes or petechiae changes since 1 week, dark color stools since 3 days. She had a history of COVID-19 positive on past ‘‘3 months’’ back and she received the corticosteroids, antiviral drugs, broad spectrum antibiotics, anticoagulants, and vitamin B and C supplements. Now patient is admitted and investigated for further management. Her bone marrow examination reveals marrow cytological features are compatible with immune thrombocytopenic Purpura and peripheral examination reveals red cells are microcytic hypochromic with elongation forms, platelets are markedly reduced and elevation of CRP, reduction of the Hb, PCV, MCH, MCV, MCHC, APTT, Serum vitamin B12, Lymphocytes and her HRCT-Chest shows CORADS 5, Rapid antigen test shows positive. A review on introduction of the disease, etiology, pathogenesis, pathophysiology, mechanism of thrombocytopenia in COVID-19 patients and grading is explained in literature review.

We report a novel transparent copper-based grid electrode fabricated by micro-contact printing, that offers high stability towards oxidation in air. Passivation is achieved using a 2.5 nm thick layer of nickel buried just below the surface of the copper film from which the grid is etched. This approach to electrode passivation retains the advantages associated with using microcontact printing lithography for grid fabrication, of very fast resist deposition and compatibility with the low cost, low toxicity etchant ammonium persulfate. The processes of patterned resist deposition and metal etching is complete within less than 1 minute. Using this approach a grid electrode with far-field transparency of 82% across the wavelength range 300-900 nm and sheet resistance of 6.8 Ohms square is demonstrated, which is shown to be a promising alternative to indium-tin oxide as the transparent electrode in perovskite photovoltaic devices.

DKIFCM (Density Based Kernelized Intuitionistic Fuzzy C Means) is the new proposed clustering algorithm that is based on outlier identification, kernel functions, and intuitionist fuzzy approach. DKIFCM is an inspiration from Kernelized Intuitionistic Fuzzy C Means (KIFCM) algorithm and it addresses the performance issue in the presence of outliers. It first identifies outliers based on density of data and then clusters are computed accurately by mapping the data to high dimensional feature space. Performance and effectiveness of various algorithms are evaluated on synthetic 2D data sets such as Diamond data set (D10, D12, and D15), and noisy Dunn data set as well as on high dimension real-world data set such as Fisher-Iris, Wine, and Wisconsin Breast Cancer Data-set. Results of DKIFCM are compared with results of other algorithms such as Fuzzy-C-Means (FCM), Intuitionistic FCM (IFCM), Kernel-Intuitionistic FCM (KIFCM), and density-oriented FCM (DOFCM), and the performance of proposed algorithm is found to be superior even in the presence of outliers and noise. Key advantages of DKIFCM are outlier identification, robustness to noise, and accurate centroid computation.

Hyperlipidaemia is an condition that increases the chance of coronary heart disease (CHD) and atherosclerotic disease (ASHD) in blood vessels. Hyperlipidaemia occurs in response to smoking, obesity, sedentary lifestyle, and other risk factors to extend CHD. Cardiovascular disease (CVD) is the reason for death. Hyperlipidaemia is divided into two broad classifications: Primary (familial) and Secondary (acquired). Primary hyperlipidemia has been generated by hereditary defects and climatic factors or by undisclosed mechanisms. Secondary hyperlipidemia concern to the metabolic disorders linked with the diabetes mellitus, liver complication, thyroid, and kidney complications. Hyperlipidemia also refers to as elevated levels of lipids within the blood. Circulating lipid are carried in lipoproteins that transport the lipids to varied tissues for energy use, lipid deposition, hormone production, and steroid formation. The lipoprotein consists of esterified and unesterified cholesterol, triglycerides, phospholipids, and protein. The general public who have hyperlipidemia experience no symptoms. Hyperlipidemia is most oftenly correlated with high-fat diets, a stationary lifestyle, obesity and diabetes mellitus. Four different classes of cholesterol-lowering drugs namely, statins, niacin, resins, and fibrates are available to treat hyperlipidemia; however, statins are now considered to be the first line therapy. The preventable causes of hyperlipidemia can include: Smoking, Being overweight, Physical inactivity, Steroid use, Alcohol consumption & Diet high in saturated fat, & cholesterol such as cheese, meat, fried & processed foods and egg yolk. The treatment of hyperlipidemia includes statins, bile acid sequestrants, fibric acids, niacin, and cholesterol absorption inhibitors. There are some of the novel drugs which are selected for the treatment of hyperlipidemia which includes: Evolocumab, Alirocumab, Bempedoic acid, Lomitapide, Evinacumab, and Sebelipase alfa.

Medicinal plants are an integral part of traditional medicine systems all over the world. Nepal, rich in biodiversity and ethnic, linguistic, and cultural diversity, possesses different traditional and folk medicinal practices for thousands of years. These systems have been using many locally available medicinal plants as crude drugs, which are not always properly documented. Detailed documentation and research related to the conservation and cultivation of medicinal plants should be carried out. Scientific studies related to chemical analysis, standardization, evaluation of pharmacological activities, and safety should be carried out to strengthen these systems of traditional medicine. Adequately designed clinical studies are necessary to provide evidence for their therapeutic efficacy

The objective of this study was to assess the anti-stroke activity of acteoside isolated from methanolic root extract of C. oppositifolia Ischemia–reperfusion(I/R) brain injury was induced in Wistar rats to assess the anti-stroke activity of acteoside. Rats were pretreated with acteoside (10, 25 & 50 mg/kg, p.o.) before the induction of I/R injury. Parameters such as neurological, motor-cognitive functions were evaluated along with morphological (brain volume, infarct size), biochemical (SOD, Catalase, GSH, lipid peroxidation, TNF-α, IL-6, IL-10, ICAM-1, HIF-1α, VEGF, and NF-κB), histopathological, and gene expression studies (HIF-1α, VEGF) were performed to study the protective effect of acteoside against I/R induced brain injury. I/R injury caused significant deterioration of neurological (p

Scleroderma is a rare heterogenous group of autoimmune fibrosing disorder that mainly exists in two forms; localized scleroderma (LS) and systemic sclerosis (SSc). It involves thickening of the skin at fingers region extending from proximal to metacarpophalangeal joints. The diagnostic criteria of scleroderma include past history of patient, symptoms of patient, serology, and skin biopsy. The morbidity and mortality are much worse for SSc with the patients are at risk for life threatening lung, heart and other visceral organ fibrosis and vasculopathy. There is no drug that can cure or stop scleroderma over fibrosis, but certain drugs regulate the symptoms associated with it and boost the patient's quality of life, particularly steroidal creams that help alleviate swelling, joint pain, loosen tight skin; blood pressure drugs that dilate blood vessels; immunosuppressive agents. If the disease is severe amputation is necessary.

Objective: To evaluate the efficacy of intraperitoneal subdiaphragmatic instillation of ropivacaine on shoulder tip pain (STP) or upper abdominal pain postoperatively after gynecological laparoscop...

This paper presents a hybrid level shifted carrier‐based pulse width modulation (HLSC‐PWM) technique for modular multilevel converters (MMCs). The concept of the proposed HLSC‐PWM method is developed by combining the principles of phase disposition PWM (PD‐PWM), phase opposition disposition PWM (POD‐PWM), and alternate phase opposition disposition PWM (APOD‐PWM) methods. The main aim of the proposed HLSC‐PWM method is to generate an output voltage with half‐wave and quarter‐wave symmetries. The generated symmetrical PWM output voltage based on the proposed HLSC‐PWM method provides less total harmonic distortion (THD) and enhances the DC‐Link voltage utilization (DCLVU). A generalized mathematical model is formulated to develop a single HLSC for MMC with an N number of submodules (SMs) per arm. Theoretical analysis of DCLVU for the proposed method is described. The functionality and performance of the HLSC‐PWM method are carried out on a three‐phase five‐level MMC in MATLAB/Simulink. A hardware prototype of a single‐phase five‐level MMC is designed for experimental validation. The proposed HLSC‐PWM method is implemented on an Altera/Cyclone I series (EP1C12Q240C8N) field‐programmable gate array (FPGA), simulation and experimental results are presented.

AIMS: To identify profiles of type 2 diabetes from continuous glucose monitoring (CGM) data using ambulatory glucose profile (AGP) indicators and examine the association with prevalent complications. METHODS: Two weeks of CGM data, collected between 2015 and 2019, from 5901 adult type 2 diabetes patients were retrieved from a clinical database in Chennai, India. Non-negative matrix factorization was used to identify profiles as per AGP indicators. The association of profiles with existing complications was examined using multinomial and logistic regressions adjusted for glycated hemoglobin (HbA1c; %), sex, age at onset, and duration of diabetes. RESULTS: Three profiles of glycemic variability (GV) were identified based on CGM data—Profile 1 [“TIR Profile”] (n = 2271), Profile 2 [“Hypo”] (n = 1471), and Profile 3 [“Hyper”] (n = 2159). Compared with time in range (TIR) profile, those belonging to Hyper had higher mean fasting plasma glucose (202.9 vs. 167.1, mg/dL), 2-h postprandial plasma glucose (302.1 vs. 255.6, mg/dL), and HbA1c (9.7 vs. 8.6; %). Both “Hypo profile” and “Hyper profile” had higher odds of nonproliferative diabetic retinopathy (“Hypo”: 1.44, 1.20–1.73; “Hyper”: 1.33, 1.11–1.58), macroalbuminuria (“Hypo”: 1.58, 1.25–1.98; “Hyper”: 1.37, 1.10–1.71), and diabetic kidney disease (DKD; “Hypo”: 1.65, 1.18–2.31; “Hyper”: 1.88, 1.37–2.58), compared with “TIR profile.” Those in “Hypo profile” (vs. “TIR profile”) had higher odds of proliferative diabetic retinopathy (PDR; 2.84, 1.65–2.88). CONCLUSIONS: We have identified three profiles of GV from CGM data. While both “Hypo profile” and “Hyper profile” had higher odds of prevalent DKD compared with “TIR profile,” “Hypo profile” had higher odds of PDR. Our study emphasizes the clinical importance of recognizing and treating hypoglycemia (which is often unrecognized without CGM) in patients with type 2 Diabetes Mellitus.

Cancer is an uncontrolled malignant tumor growth taking place in any tissue of the body and attains complex diversity which makes it difficult for oncologists to choose therapeutics. The changes leading to formation of cancerous cells occur due to a series of molecular events. Now scientists are trying to understand the various molecular processes that are involved in the growth of cancers. This article presents a brief account of epigenetics with reference to DNA methylation and histone modification as an important contributor to the formation of cancer cells. Drug targeting the epigenetic regulators has been considered for various types of cancer. The enzymes in DNA methylation and histone modification, FDA approved clinical drugs along with the challenges associated with the development of anti-cancer target based therapeutics are summarized.

Aims and objectives Proximal contacts and their interdigitation through occlusal contact with opposing teeth play a major role in children, for the eruption of permanent teeth into normal position. Determining the ideal matrix band system for proximal restorations helps in the construction of contacts and contours. This study is designed to determine the most suitable matrix band system for proximal restorations. Materials and methods A total of 96 proximal cavities were selected among patients aged 5-9 years and were equally divided into three groups. Group I: T-band, group II: ProMatrix, and group III: FenderMate. Pre- and postoperative radiographs were taken to evaluate carious lesions and restorations. Class II cavity was prepared and glass ionomer restorations were done using matrix systems. The efficacy of matrix bands was evaluated through the operator's questionnaire and postoperative radiographs. Results No statistical significance was found between the three matrix bands but FenderMate showed few clinical drawbacks that were statistically significant (p Interpretation and conclusion Matrix systems used in this study showed good results in restoring proximal contacts and contours. FenderMate showed few drawbacks when compared with the other two matrix systems. None of the matrix systems used in the present study were able to create 100% accurate proximal contacts and contours. How to cite this article Dindukurthi MK, Setty JV, Srinivasan I, et al. Restoration of Proximal Contacts in Decayed Primary Molars Using Three Different Matrix Systems in Children Aged 5-9 Years: An In Vivo Study. Int J Clin Pediatr Dent 2021;14(1):70-74.

In this paper, thermo-economic optimization and comparative analysis of a cascade refrigeration system configured with flash gas removal in its high-temperature cycle (HTC) and flash intercooling with indirect subcooling in lower temperature cycle (LTC) using different natural refrigerant pairs is performed. Thermo-economic optimization is carried out to maximize the exergetic efficiency and minimize the overall cost rate. The optimization model involves six design variables which include subcooling and de-superheating parameters, LTC evaporation and condensation temperatures, HTC condenser temperature and cascade temperature difference. The comparative analysis of twenty-two natural refrigerant pairs based on the results of thermodynamic and economic optimizations reveals that R717-R290 is most efficient pair and R290-R1150 is least efficient refrigerant pair thermodynamically whereas R717-R1270 is the best and R600a-R290 is the worst pair economically. Seven potential refrigerant pairs are chosen via the thermodynamic and economic optimization results and they are further compared based on their performances obtained through multi-objective optimization (maximization of exergetic efficiency and minimization of total cost rate). Multi-objective genetic algorithm is used for optimization which results in seventy non-dominated Pareto optimal solutions where the TOPSIS method is used to select a unique solution for each refrigerant pair. A comparison of refrigerant pairs using these unique solutions shows that R717-R1270 is the best refrigerant pair for the cascade system under consideration. It is also found that R717-R1270 results in 7.77% rise in COP and 5.32% reduction in overall cost when compared with NH3–CO2 refrigerant pair working under identical operating conditions.

Purpose of Review For many children, the SARS-CoV-2 pandemic has impacted the experience and treatment of their pain. This narrative review draws from the pain literature and emerging findings from COVID-19 research to highlight potentially meaningful directions for clinical consideration and empirical inquiry in the months and years to come. Recent Findings COVID-19 has been linked to diffuse acute pains as well as chronic pain sequelae. Contextual factors known to increase vulnerability for pain and associated functional disability have been exacerbated during the pandemic. Beyond these salient concerns has been the remarkable resilience demonstrated by patients and providers as healthcare systems have sought to harness creativity and innovative digital solutions to support optimal child wellbeing throughout this crisis. Summary Ongoing research is needed to elucidate the short- and long-term effects of the pandemic on children’s pain and to consider how the delivery of treatment via digital technology has impacted existing paradigms of pain management.

In modern decades, an increase in environmental awareness has attracted the keen interest of researchers to investigate eco-sustainable, recyclable materials to minimize reliance on petroleum-based polymeric compounds. Poly (3-hydroxybutyrate) is amorphous, linear, and biodegradable bacterial polyesters that belong to the polyhydroxyalkanoates family with enormous applications in many fields. The present review provides comprehensive information on polyhydroxybutyrate production from different biomass feedstock. Various studies on PHB production by genetically engineered bacterial cells and optimization of parameters have been discussed. Recent technological innovation in processing polyhydroxybutyrate-based biocomposite through the different process has also been examined. Besides this, the potential applications of the derived competent biocomposites in the other fields have been depicted.

Oral cancer is common worldwide but lacks robust diagnostics and therapeutics. Lifestyle factors, such as tobacco chewing and smoking, are significantly associated with oral cancers. Mapping the changes in the global proteome, secretome and post-translational modifications (PTMs) during tobacco exposure of oral keratinocytes hold great potential for understanding the mechanisms of oral carcinogenesis, not to mention for innovation toward clinical interventions in the future. On the other hand, although advances in mass spectrometry (MS)-based techniques have enabled the deep mining of complex proteomes, a large portion of the mass spectrometric data remains unassigned. These unassigned spectral data can be researched for multiple post-translational modifications (multiPTMs). Using data mining of publicly available proteomics data, we report, in this study, a multiPTM analysis of high-resolution MS-derived datasets on cellular proteome and secretome of chronic tobacco-treated oral keratinocytes. We identified 800 PTM sites in 496 proteins. Among them, 43 PTM sites in 37 proteins were found to be differentially expressed, accounting for their protein-level expression. Enrichment analysis of the proteins with altered phosphosite expression and the known kinases of these phosphosites discovered the overrepresentation of certain biological processes such as splicing and hemidesmosome assembly. These findings contribute to a deeper understanding of omics level changes in chronic tobacco-treated oral keratinocytes, and by extension, pathophysiology of oral cancers.

Background: Upper GI endoscopy is an established procedure for investigating a wide range of upper GI conditions especially inflammatory and malignant diseases of stomach and esophagus. A good correlation in diagnosis can be achieved by complementing endoscopic findings with histopathology of biopsy specimens. Methods: Both retrospective and prospective study of upper GI endoscopic biopsy was carried out at department of pathology, KIMS, Hubli during January 2016 to December 2018. Samples were received in 10% formalin; routine processing was followed with H & E staining. Special stain like Giemsa was done for detection of H. Pylori. 396 endoscopic mucosal biopsies were analyzed and evaluated. Result: Out of 396 cases, 250 cases were esophageal biopsies, 104 cases were gastric biopsies & 42 cases were duodenal biopsies. The male: female ratio was 1:9:1. The highest number of cases was seen between 61 to 70 years. Dyspepsia was the common symptom seen in 61.3%. The most common lesions encountered in the esophagus were carcinomas (67%) followed by esophagitis (16%). The commonly encountered gastric lesion was chronic gastritis in 54.8% with H. pylori gastritis being positive in 38.18%. Among the duodenal biopsies, non-neoplastic lesions were most common (59.5%) followed by neoplastic lesions (26%). Conclusion: Upper GI endoscopy is an effective and appropriate preliminary investigation to assess patients with dysphagia, dyspepsia, vomiting. Endoscopy without biopsy is incomplete and that the combination of methods offers a strong diagnostic tool for better patient care.

A removable appliance is a device that modifies mandibular posture and transmits the resultant forces created by muscles and soft tissues to underlying and surrounding anatomical structures in a controlled manner. The resulting variation of the neuromuscular environment thus produces the required tooth movement along with the needed advancements in growing patterns. The necessity and requirement of early treatment is to modify the existing and developing malocclusions and muscular derangements before the attainment of growth completion of permanent dentition. Frankel Function Regulator (FR) is a device which functions on the principle of functional orthopedics in unity with muscle gymnastics (muscle exercises) and thereby results in morphological changes in both the jaws hence re-establishing the desirable normal occlusion.

This paper aims to discusses the extraction of urban features from airborne NISAR (NASA-ISRO SAR) data using deep learning algorithm for a part of Ahmedabad City. NISAR data is acquired in two wavelength bands (L and S) in hybrid polarization i.e., RH and RV. This study has used level two data viz., amplitude data. Pre-processing of NISAR data in L and S wavelength bands was carried out by using MIDAS, software developed and provided by the Space Applications Centre. Pre-processing viz., Speckle suppression using different filters in varying window sizes, radiometric and geometric calibration was performed. Variation of backscattering coefficient (Sigma- nought) in different wavelengths and polarizations for different land use features were analysed. NISAR data in conjunction with LISS 4 (5.8 m resolution) data is subjected to different fusion techniques. Qualitative and Quantitative analysis was carried out and Gram Schmidt technique was chosen for further analysis. Segmentation was performed to achieve better analysis of the fused image and the amplitude image. Lastly, a deep learning architecture was developed for the automatic classification of the image, and the Convolution Neural Network model was designed using mobile net and the regularization techniques. Deep learning architecture in conjunction with e-cognition developer was used for extracting urban features.

Optical communication uses light signals for transmitting information from source to destination. Optical fiber communication has been more popular for long-distance data transfer in recent years due to various benefits such as low loss, low cost, simple amplification, minimal interference, and lightweight. A simple optical telecommunication system consists of a transmitter, a medium, and a receiver. Wavelength Division Multiplexing (WDM) is a significant improvement in optical communication. WDM is basically used for improving spectral efficiency and to handle more data from several clients. Normal WDM, CWDM, and DWDM are three types of WDM technology. DWDM uses the most denser optical channels in optical networking. Complete detail about all types of WDM is given. The optical spectrum used in the transmission of light signals is also discussed.

Aims: To compare the sensitivity of 2 microscopic methods for the diagnosis of Mycobacterium tuberculosis (M.tb) along with culture and drug susceptibility testing to first line drugs. Settings and design: The cross-sectional study comprises 200 suspected cases of pulmonary tuberculosis both clinically and radiologically in KIMS, Bangalore over a period of 2 years. Materials and Methods: Samples (sputum/BAL fluid) were collected, processed and stained by Ziehl Neelson (ZN) and Fluorescent methods. Culture and drug susceptibilty testing was done for Streptomycin, Isoniazid, Rifampicin and Ethambutol by Mycobacterium growth indicator tube (MGIT) method after decontamination. Statistical analysis: Fischer’s test Results: 1. Out of 200 samples: 1.120 were male and 80 were female; 2. 18 were positive by Ziehl Neelson, 21 by Fluorescent and 28 by culture; 3. Majority of the patients belonged to age group 41-50 years (23%); 4. InMGIT, 26 were M.tb and 2 were Non-tubercular mycobacteria; 5. Out of 26 M.tb isolates, 4 were resistant to streptomycin, 6 to isoniazid, 2 to rifampicin and 9 to ethambutol. Conclusion: 1. The sensitivity of Fluorescent staining (64.28%) is higher than that of Ziehl-Neelson (51.7%); 2. In MGIT, 26 were M.tb and 2 were Non tubercular mycobacteria; 3. 2 were Multi-drug resistant- tuberculosis (MDR-TB) Key Messages: This study made us aware of the need for prompt detection, identification and appropriate treatment of Tuberculosis due to the rising incidence of MDR-TB. Keywords: Mycobacterium tuberculosis, Mycobacterium growth indicator tube, ZiehlNeelson, Fluorescent.

The advent of cloud infrastructure in which third-party cloud services may retain sensitive consumer and company data in storage environments underlines the need to advocate for encryption and multi-tenant shared processing as a primary security mechanism. Digital information movement, storage, and processing are widely defined in terms of "Data in Motion,” "Data at Rest," and "Data in Usage," respectively. The implementation of security methods for each of these states can be viewed similarly. Transit data applies to data when being moved from one source of data to another. Transit data contains data sent across the network from back-end clients, programs, and repositories. There could be two data centers inside the same organizational network in the cloud, as a member of completely separate networks. This paper presents a novel architecture data-in-transit defender (DiTD), to protect data in transit; DiTD provides a novel security framework based on high-performance cloud computing. This protocol enables more efficient use of the key strength and time of symmetric block encrypted data, public-key cryptography (PUKC), cryptographic hash, and brief key exchange function.