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There are some factors that play a crucial role in deciding the image quality during the optical as well as the micrographic association with the technique of the shadow casting in which contrast of the image has influenced with obliquely depositing of a thin layer of the metal during the process of the microscopic preparations. Further castingadvantages of the using shadow technique are to be observed during the process if shadow casting itself. Shadow casting posses’ number of the advantages over the other casting methods. The most prominent advantage is that if the height and thickness of an object is not completely flat that can be easily notice by the shadow of that object. The lengths of the shadow of the uneven part are so differentiate from other part that can be easily determined. Shadow casting uses the scattering power or even the optical efficiency to bring out the specimens contours and will easily get notice in order to check the flatness of the surfaces.

Conventional fuels have been continuous in use from a long time. These are petroleum based fuels and are obtained by the refining process of the crude oil obtained from the deep under sea and under the surface of the earth mining of the fossil fuels which takes about millions of years for their generation. As these resources are used by the man in very high amount from a long time, so they are now at the verge of exploitation and also these are the major source of the pollution. So there is need to find a substitute of these fossil fuels which can just replace these fossil having similar properties. So in this research paper the study has been focused on the biodiesel to study it for the purpose of using it as the alternative fuel for the fossil fuels. This study will be helpful for the researchers doing their study in the biodiesel, students who want to gain knowledge in this alternative fuel and also to industrialists to discuss the merits and demerits of the biodiesel or the biofuels.

Poisoning is a significant health problem around the world. In India being an agriculture based economy, Pesticide Poisoning contributes largest sum in poisoning cases. The study was conducted in Emergency Department of S.N. Medical College and Hospital, Agra from Sept 2018 to Sept 2019 to investigate Acute Pesticide Poisoning (APP) cases in the region. Majority of cases in our study were from age group of 21-30 yrs with mean age of 28.10 ± 11.38 yrs with male predominance. In This study we found out that APP is 61% of all poisoning cases, out of them maximum cases belongs to OP poisoning which clinically presented with Dyspnea/Tachypnea, Sweating, Vomiting, Abdominal pain. Mortality in APP cases was found to be 10.5%. Although case fatality ratio is highest in cases of celphos (AlP) which most commonly presented with symptoms of Paresthesias, Diarrhea, and Abdominal pain.

We examine a crowdfunding platform that connects artists with funders. Although the Internet reduces many distance-related frictions, local and distant funders exhibit different funding patterns. Local funders appear less responsive to information about the cumulative funds raised by an artist. However, this distance effect appears to proxy for a social effect: it is largely explained by funders who likely have an offline social relationship with the artist (“friends and family”). Yet, this social effect does not persist past the first investment, suggesting that it may be driven by an activity like search but not monitoring. Thus, although the platform seems to diminish many distance-sensitive costs, it does not eliminate all of them. These findings provide a deeper understanding of the abilities and limitations of online markets to facilitate transactions and convey information between buyers and sellers with varying degrees of social connectedness.

Hypothyroidism may manifest as large ovarian cyst formation with precocious puberty in young prepubertal girls, which frequently regress upon starting thyroxin suplemntation. We present a case report of 10 year old girl who had undergone unnecessary laparoscopic cystectomy for bilateral large ovarian cyst as the diagnosis of hypothyroidism was missed. She again had recurrence of bilateral ovarian cyst which regressed upon thyroxin supplementation.

A self-driving car is a machine that can really hear and function without the need for human intervention. A human rider is never needed to maintain control of the vehicle or to be in the vehicle at the same time. A self-employed vehicle should be able to do all of the duties that a competent human driver can. A standard vehicle should be capable of traveling to any place. Thousands of hours have been recorded on US highways by self-driving vehicles, such as Google's robotic vehicle prototype, but they are not yet commercially accessible. Self-sufficient vehicles use a range of technologies. It may be developed to assist navigation using GPS sensor data. Sensors and other equipment should be used to avoid accidents. And also use a variety of technologies, such as extended truth, in which a vehicle delivers data to drivers in novel and innovative ways. Many people think that substantial autonomous vehicle development will aggravate current man-made car insurance and traffic regulations. Extensive research on autonomous cars is taking place not just in the United States, but also in Europe and other areas of the world. According to industry analysts, it will only be a matter of time until individuals are able to use a device on a regular basis as a result of such advances. The construction and device design of an autonomous vehicle, as well as the control system module that enables the vehicle to travel independently, are covered in this article. The CaRINA I model was used to test and validate the team's autonomous navigation and driver assistance technologies. Our technology covers modifications to mechanical vehicles as well as the creation and implementation of an integrated computer architecture.

In recent years, usage of advanced analytical as well as computational modeling in operational production has expanded significantly. An essential component of models is a thorough description of stressstrain behavior of material. The current article is about creating uniform act on equations for full stress-strain reply of hot-rolled carbon steels. The theoretical models imply a flexible until yield point, shadowed to a yield besides toughening till ultimate stress, giving different options for interpretation of strain hardening component. The engineer usually finds Young's modulus E, yield stress fy and ultimate stress fu readily accessible, but certain critical limitations, including stresses at start of straining hardening as well as at ultimate stress, are not, thus require predictive terminology. The phrases were industrialized here every day in addition to standardized against facts produced from literary works on stress-strain. Unlike usually ECCS model that has a persistent strain toughening slope, optional models feature a yield duration besides strain hardening characteristics that vary with yield ratio to ultimate stress.

Introduction: Cesarean sectionis on the rising trend,so WHO proposes that health care facilities uses the Robson's 10 group classification system to audit their Cesarean section rates. This classification will helpto developstrategies to reduce these rates. Objective: The objective of this study was to classify the women coming for delivery into the 10 Robson’s group,to interpret the 10 group classification and to know the highest rate of cesarean section in the group. Methodology: This was a hospital basedcross sectional study carried out in the Department of Obstetrics and Gynaecology, for a period of 6months. All women undergoing deliverywere recruited for study .Based onthe patient’s obstetric parameters, women were assigned to one of 10 groups as per Robson’s 10-group classification system.The relative size of each group, the cesarean section rate in each group, and the absolute and relative contributions to the overall cesarean section rate was then reported. Results: During the study period, the overall Cesarean Section rate was 33.40%.Highest contribution was by Robson's Group 2(Nulliparous, single cephalic, ≥ 37 weeks, induced or CS before labor(9.84%) followed by Group 1(Nulliparous, single cephalic, ≥ 37 weeks, in spontaneous labor)(7.73%) and Group 5(Previous CS, single cephalic, ≥ 37 weeks) (5.75%). Least contribution was by Groups 8(All multiple pregnancies (including previous CS)and 9[All abnormal lies (including previous CS)]0.20% and 0.27% respectively. All women in group 9(all abnormal lies including previous CS)had 100% Cesarean rate. Conclusions: With reductions in the primary cesarean section rates and encouragingpatients forVBACcould reduce the contribution of Robson's groups towards the absolute Cesarean Section rates.

In 2004, Canada changed the eligibility rules for its Scientific Research and Experimental Development (SRED) tax credit, which provides tax incentives for R&D conducted by small private firms. Difference-in-difference estimates show a 17 percent increase in total R&D among eligible firms. The impact was larger for firms that took the tax credits as refunds because they had no current tax liability. Contract R&D expenditures were more elastic than the R&D wage bill. The response was also greater for firms that invested in R&D capital before the policy change. (JEL D22, G32, H25, L25, O32, O38)

Introduction: Evolution of laparoscopy has revolutionised the field of gynaecological surgery for more than 40 years.Owing to the long learning curve, added expenses and lack of awareness among patients and surgeons, its introduction and development in Nepal is not upto the timeline. Gynaecologic laparoscopy (GL) seems to be introduced at BP Koirala institute of Health Sciences, Dharan,Nepal (BPKIHS) since 2002. It remained in latency because of widespread lack of equipment and skilled personnel. Some laparoscopic procedures like diagnostic laparoscopy, laparoscopic tubal ligation and very few laparoscopic assisted vaginal hysterectomy (LAVH) were done from 2002 - 2012 (10 years). Since then more gynecologists have been trained in GL which has contributed to expansion of GL. Objective: The objective of this study is to study and share trends of gynaecological laparoscopic surgeries performed at BPKIHS. Methodology: All the patients undergoing GL surgeries have been analyzed for the indication, type of procedure, conversion and its complications. We took data from operation theatre register and patient case sheet from July 2004 to May 2018. We divided this period into two phase viz Phase 1: July 2004-June 2013 and Phase 2: July 2013- till May 2018. Results: Total number of GL done in this period was 427. Out of which 102 cases were from phase one and rest of the cases were done in five years of phase II. Number of operative laparoscopy has increased in phase 2 compared to phase 1. In last five years there was155 (47.6%) cases of adnexal surgery, 77 (23.6%) cases of diagnostic laparoscopy.Total laparoscopic hysterectomy was done in 25 (7.6%) cases. Conversion to laparotomy was done in4.6% (n=15) cases. Overall 12(3.7%) patient had major complications. Oral diet started at 4-6th hour post-operatively, and mobilization started after 24 hours. Seventy percent of patient had a hospital stay of 2days and rest stayed for 3 days. Conclusions: There is rising trend in operative GL at BPKIHS. We are facing less complication with expanding experience. There has been good learning from each case. GL has well demonstrated its advantages of reducing postoperative pain and morbidity, short hospital stay, and less postoperative recovery time. We have plans to get new gadgets and expand services in GL.

The transmission of coronavirus disease 2019 (COVID-19) in workplaces has been a persistent issue throughout the pandemic. In response, a not-for-profit initiative emerged to mitigate COVID-19 workplace transmission in Canada. We report the process for establishing a workplace frequent rapid antigen test (RAT) program. The screening program identified 473 asymptomatic individuals who tested positive on the RAT and confirmed positive by a nasopharyngeal polymerase chain reaction (PCR) diagnostic test. One in 4300 RATs was presumptive positive but later tested PCR negative, and thus, false positives did not meaningfully disrupt workplace operations. Most employers rated the program highly and felt strongly that the program contributed to workplace and community safety. The findings describe a sustained and scalable implementation plan for establishing a frequent workplace testing program. High-frequency testing programs offer the potential to break chains of transmission and act as an extra layer of protection in a comprehensive public health response.

Objective: Second uterine carcinosarcoma (UCS) occurs in 5 years of treatment with concurrent chemoradiotherapy (CCRT) for cervical cancer. Surgical staging with lymphadenect...

Background The maternal mortality ratio is a significant public health indicator that reflects the quality of health care services. The prevalence is still high in developing countries than in the developed countries. This study aimed to determine the MMR and identify the various risk factors and causes of maternal mortality. Methods This is a retrospective study conducted in a tertiary care center in Eastern Nepal from 16th July 2015 to 15th July 2020. The maternal mortality ratio was calculated per 100,000 live-births over five year’s study period. The causes of death, delays of maternal mortality and, different sociodemographic profiles were analyzed using descriptive statistics. Results There was a total of 55,667 deliveries conducted during the study period. The calculated maternal mortality ratio is 129.34 per 100,000 live-births in the year 2015 to 2020. The mean age and gestational age of women with maternal deaths were 24.69 ± 5.99 years and 36.15 ± 4.38 weeks of gestation. Obstetric hemorrhage, hypertensive disorder of pregnancy and sepsis were the leading causes of maternal death. The prime contributory factors were delay in seeking health care and reaching health care facility (type I delay:40.9%). Conclusions Despite the availability of comprehensive emergency obstetric care at our center, maternal mortality is still high and almost 75% of deaths were avoidable. The leading contributory factors of maternal mortality are delay in seeking care and delayed referral from other health facilities. The avoidable causes of maternal mortality are preventable through combined safe motherhood strategies, prompt referral, active management of labor and, puerperium.

Background: Genitourinary tract actinomycosis is the second most frequent clinical form of actinomycosis. Although it has been recognized for over a century, owing of its infrequent and invasive na...

Background: A large percentage of cases of hysterectomy involves symptomatic myomas. It can be challenging to retrieve a large uterus after laparoscopic hysterectomy through the natural orifice of ...

Background: Insulin therapy is often started if medical nutritional therapy (MNT) fails to manage Gestational diabetes mellitus (GDM) which is associated with multiple injections and demands more patient compliance. So use of safe and effective oral agents may offer advantages over insulin. Objectives: To evaluate glycaemic control in women receiving metformin versus insulin for GDM, and to identify factors predicting the need for supplemental insulin in women initially treated with metformin. Methods: Women, 18 – 45 years at 20 –33 weeks of gestation with singleton pregnancy with GDM without satisfactory glycemic control on MNT for a minimum period of 1 week were randomised to receive either insulin or metformin. Results: There was no significant difference in mean pre-treatment glucose levels between two groups (P = 0.890). After randomizing, women received their respective intervention. Mean glucose level measured after glycaemic control showed, lower levels in the metformin group (P= .034). Also women under metformin presented less weight gain (P=.02) and a lower frequency of neonatal hypoglycaemia (P= .032). Thirteen women in the metformin group (31.7%) required supplemental insulin. Early gestational age at diagnosis and high BMI were identified as predictors of the need for supplemental insulin. Conclusions: Metformin appears to constitute safe and effective treatment option for GDM who do not have satisfactory glycemic control. It was found to provide adequate glycemic control with lower mean glucose level, less weight gain and a lower frequency of neonatal hypoglycaemia. Early gestational age at diagnosis and high BMI were predictors of the need for supplemental insulin therapy in women initially treated with metformin.

The recruitment of foreign-trained scientists enhances US science through an expanded workforce but could also cause harm by displacing better connected domestically-trained scientists, thereby reducing localized knowledge spillovers. We develop a model in which a sufficient condition for the absence of overall harm is that foreign-trained scientists generate at least the same level of localized spillovers as the domestically-trained scientists they displace. To test this condition, we conduct a hypothetical experiment in which each foreign-trained displaces an appropriately matched domestically-trained scientist. Overall, we do not find evidence that foreign-trained scientists harm US science by crowding out better-connected domestically-trained scientists, measured by citations by the US scientific community to their publications.

Based on recent developments in the field of artificial intelligence (AI), we examine what type of human labor will be a substitute versus a complement to emerging technologies. We argue that these recent developments reduce the costs of providing a particular set of tasks – prediction tasks. Prediction about uncertain states of the world is an input into decision-making. We show that prediction allows riskier decisions to be taken and this is its impact on observed productivity although it could also increase the variance of outcomes as well. We consider the role of human judgment in decision-making as prediction technology improves. Judgment is exercised when the objective function for a particular set of decisions cannot be described (i.e., coded). However, we demonstrate that better prediction impacts the returns to different types of judgment in opposite ways. Hence, not all human judgment will be a complement to AI. Finally, we show that humans will delegate some decisions to machines even when the decision would be superior with human input.

Recent advances in artificial intelligence are primarily driven by machine learning, a prediction technology. Prediction is useful because it is an input into decision-making. In order to appreciate the impact of artificial intelligence on jobs, it is important to understand the relative roles of prediction and decision tasks. We describe and provide examples of how artificial intelligence will affect labor, emphasizing differences between when the automation of prediction leads to automating decisions versus enhancing decision-making by humans.

Background: Intrauterine fetal death is a traumatic event. Stillbirth rate is an important indicator to assess the quality of antenatal care. The objective of the study was to identify the risk factors related to intrauterine fetal death in patients admitted with intrauterine fetal death.Methods: It was a descriptive study conducted in the department of Obstetrics and Gynaecology at B. P. Koirala Institute of Health Sciences from January to December 2014. Patients admitted with singleton pregnancy with intrauterine fetal death after 28 weeks gestation were included. Results: There were 11,006 obstetric admissions. Of them, 152 women had intrauterine fetal death. There were 128(84.2%) women between 20-35 years of age. Out of 152, 81(53.3%) women were preterm and 39(2.1%) women were postterm. Primigravida were 77(50.7%) followed by 35(23%) of second gravida. Hypertension was the commonest identified risk factor in 30(26.78%) women. Out of 152 women, 49(32.2%) had not received formal education. Ten (6.6%) women had a past history of fetal death. Four (2.6%) women had medical disorder before pregnancy. One hundred and twenty five (82.2%) women had vaginal delivery, 21(13.8%) had caesarean section and 6(3.9%) had laparotomy for rupture uterus. The commonest indication for caesarean section was placenta previa for 7(33.33%) women. Four (2.6%) women had diabetes. Ninety five (62.5%) were male and 57(37.5%) were female babies. Five (3.3%) babies had malformations. Conclusions: Hypertension in pregnancy was found to be the most common identified risk factor for intrauterine fetal death. Keywords: Fetal death; pregnancy; risk factors.

Executive SummaryRecent progress in artificial intelligence (AI)—a general purpose technology affecting many industries—has been focused on advances in machine learning, which we recast as a qualit...

Analyses of AI adoption focus on its adoption at the individual task level. What has received significantly less attention is how AI adoption is shaped by the fact that organisations are composed of many interacting tasks. AI adoption may, therefore, require system-wide change which is both a constraint and an opportunity. We provide the first formal analysis where multiple tasks may be part of a modular or non-modular system. We find that reliance on AI, a prediction tool, increases decision variation which, in turn, raises challenges if decisions across the organisation interact. Modularity, which leads to task independence rather than system-level inter-dependencies, softens that impact. Thus, modularity can facilitate AI adoption. However, it does this at the expense of synergies. By contrast, when there are mechanisms for inter-decision coordination, AI adoption is enhanced when there is a non-modular environment. Consequently, we show that there are important cases where AI adoption will be enhanced when it can be adopted beyond tasks but as part of a designed organisational system.