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A common conversion factor of 6.25 has been used worldwide to estimate crude protein content. However, many researchers especially Jones (1931) has extensively researched and did not agree with using the same factor for every food ingredient as it resulted in misleading estimation of crude protein content. ICMR/NIN and FAO/WHO/UNU recommendations over decades for protein and amino acid requirements using various techniques are used to state Estimated Average Requirement (EAR) and Recommended Daily Allowance (RDA) as accurate as possible. In the present manuscript, nitrogen: protein conversion factor has been reworked using NDpCal%.

Reduced precision computation is a key enabling factor for energy-efficient acceleration of deep learning (DL) applications. This article presents a 7-nm four-core mixed-precision artificial intelligence (AI) chip that supports four compute precisions--FP16, Hybrid-FP8 (HFP8), INT4, and INT2--to support diverse application demands for training and inference. The chip leverages cutting-edge algorithmic advances to demonstrate leading-edge power efficiency for 8-bit floating-point (FP8) training and INT4 inference without model accuracy degradation. A new HFP8 format combined with separation of the floating- and fixed-point pipelines and aggressive circuit/architecture optimization enables performance improvements while maintaining high compute utilization. A high-bandwidth ring protocol enables efficient data communication, while power management using workload-aware clock throttling maximizes performance within a given power budget. The AI chip demonstrates 3.58-TFLOPS/W peak energy efficiency and 26.2-TFLOPS peak performance for HFP8 iso-accuracy training, and 16.9-TOPS/W peak energy efficiency and 104.9-TOPS peak performance for INT4 iso-accuracy inference.

Lymphomas are the second most common malignancy in the oral cavity after squamous cell carcinoma. Non-specific clinical presentation of lymphoma mimics the other common oral pathologies thereby; delaying its diagnosis, ensuing definitive treatment, and leading to a guarded prognosis. The present clinical review and accompanying case report highlights the clinical presentation, diagnostic challenges, progression, manifestations, and holistic management of a rare extra-nodal, nasal variant of Natural Killer T-cell lymphoma and underscores the importance of interdisciplinary coordination in the overall management of this aggressive tumor.

India's COVID-19 lockdown, one of the most severe in the world, is widely believed to have disrupted critical non-COVID health services. However, linking these disruptions to effects on health outcomes has been difficult due to the lack of reliable, up-to-date health outcomes data. We identified all dialysis patients under a statewide health insurance program in Rajasthan, India (N = 2110), and conducted surveys to examine the effects of the lockdown on non-COVID care access and health outcomes. Post-lockdown mortality was our primary outcome and morbidity and hospitalization were secondary outcomes. 63% of patients experienced a disruption to their care. Transport barriers, hospital service disruptions, and difficulty obtaining medicines were the most common causes. We compared monthly mortality in the four months after the lockdown with pre-lockdown mortality trends, as well as with mortality trends for a similar cohort in the previous year. Mortality in May 2020, after a month of exposure to the lockdown, was 1.70 percentage points (95% CI 0.01-0.03) or 64% higher than in March 2020 and total excess mortality between April and July was estimated to be 22%. A 1SD increase in an index of care disruptions was associated with a 0.17SD (95% CI 0.13-0.22) increase in a morbidity index, a 3.1 percentage point (95% CI 0.012-0.051) increase in hospitalization, and a 2.1 percentage point (95% CI 0.00-0.04) increase in probability of death between May and July. Females, socioeconomically disadvantaged groups, and patients living far from the health system faced worse outcomes. The results highlight the unintended consequences of the lockdown on critical, life-saving non-COVID health services that must be taken into account in the implementation of future policy efforts to control the spread of pandemics.

Background Data on the cost-effectiveness of lifestyle-based diabetes prevention programs are mostly from high-income countries, which cannot be extrapolated to low- and middle-income countries. We performed a trial-based cost-effectiveness analysis of a lifestyle intervention targeted at preventing diabetes in India. Methods The Kerala Diabetes Prevention Program was a cluster-randomized controlled trial of 1007 individuals conducted in 60 polling areas (electoral divisions) in Kerala state. Participants (30–60 years) were those with a high diabetes risk score and without diabetes on an oral glucose tolerance test. The intervention group received a 12-month peer-support lifestyle intervention involving 15 group sessions delivered in community settings by trained lay peer leaders. There were also linked community activities to sustain behavior change. The control group received a booklet on lifestyle change. Costs were estimated from the health system and societal perspectives, with 2018 as the reference year. Effectiveness was measured in terms of the number of diabetes cases prevented and quality-adjusted life years (QALYs). Three times India’s gross domestic product per capita (US$6108) was used as the cost-effectiveness threshold. The analyses were conducted with a 2-year time horizon. Costs and effects were discounted at 3% per annum. One-way and multi-way sensitivity analyses were performed. Results Baseline characteristics were similar in the two study groups. Over 2 years, the intervention resulted in an incremental health system cost of US$2.0 (intervention group: US$303.6; control group: US$301.6), incremental societal cost of US$6.2 (intervention group: US$367.8; control group: US$361.5), absolute risk reduction of 2.1%, and incremental QALYs of 0.04 per person. From a health system perspective, the cost per diabetes case prevented was US$95.2, and the cost per QALY gained was US$50.0. From a societal perspective, the corresponding figures were US$295.1 and US$155.0. For the number of diabetes cases prevented, the probability for the intervention to be cost-effective was 84.0% and 83.1% from the health system and societal perspectives, respectively. The corresponding figures for QALY gained were 99.1% and 97.8%. The results were robust to discounting and sensitivity analyses. Conclusions A community-based peer-support lifestyle intervention was cost-effective in individuals at high risk of developing diabetes in India over 2 years. Trial registration The trial was registered with Australia and New Zealand Clinical Trials Registry (ACTRN12611000262909). Registered 10 March 2011.

Author(s): Dupas, Pascaline; Jain, Radhika | Abstract: Using administrative data on over 4 million hospital visits, we document striking gender disparities within a government health insurance program that entitles 46 million poor individuals to free hospital care in Rajasthan, India. Females account for only 33% of hospital visits among children and 43% among the elderly. These shares are lower for more expensive types of care, and far lower than sex differences in illness prevalence can explain. Almost two-thirds of non-childbirth spending is on males. We combine these data with patient survey, census, and electoral data to show that 1) the program is unable to fully offset the costs of care-seeking, which results in disparities in hospital utilization because some households are willing to allocate more resources to male than female health; 2) lowering costs does not reduce disparities, because males benefit as much as females do; and 3) long-term exposure to village-level female leaders reduces the gender gap in utilization, but effects are modest and limited to girls and young women. In the presence of gender bias, increasing access to and subsidizing social services may increase levels of female utilization but fail to address gender inequalities without actions that specifically target females.

Low-precision computation is the key enabling factor to achieve high compute densities (T0PS/W and T0PS/mm2) in AI hardware accelerators across cloud and edge platforms. However, robust deep learning (DL) model accuracy equivalent to high-precision computation must be maintained. Improvements in bandwidth, architecture, and power management are also required to harness the benefit of reduced precision by feeding and supporting more parallel engines to achieve high sustained utilization and optimize performance within a given product power envelope. In this work, we present a 4-core AI chip in 7nm EUV technology that exploits cutting-edge algorithmic advances for iso-accurate models in low-precision training and inference [1, 2] and aggressive circuit/architecture optimization to achieve leading-edge power-performance. The chip supports fp16 (DLFIoat16 [8]) and hybrid-fp8(hfp8) [1] formats for training and inference of DL models, as well as int4 and int2 formats for highly scaled inference.

IntroductionGovernments around the world suspended immunization outreach to control COVID-19 spread. Many have since resumed services with an emphasis on catch-up vaccinations to reach children with missed vaccinations. This paper evaluated immunization disruptions during India’s March-May 2020 lockdown and the extent to which subsequent catch-up efforts reversed them in Rajasthan, India.MethodsIn this retrospective observational study, we conducted phone surveys to collect immunization details for 2,144 children that turned one year old between January and October 2020. We used logistic regressions to compare differences in immunization timeliness and completed first-year immunization status among children that were due immunizations just before (unexposed), during (heavily exposed), and after (post-exposure) the lockdown.ResultsRelative to unexposed children, heavily exposed children were significantly less likely to be immunized at or before 9 months (OR 0.550; 95%CI 0.367-0.824; p=0.004), but more likely to be immunized at 10-12 months (OR 1.761; 95%CI 1.196-2.591; p=0.004). They were also less likely to have completed their key first-year immunizations (OR 0.624; 95%CI 0.478-0.816; p=0.001) by the time of survey. In contrast, post-exposure children showed no difference in timeliness or completed first-year immunizations relative to unexposed children, and their immunization coverage was 6.9pp above heavily exposed children despite their younger age. Declines in immunization coverage were larger among children in households that were poorer, less educated, lower caste, and residing in COVID red zones, although subgroup comparisons were not statistically significant.ConclusionDisruptions to immunization services resulted in children missing immunization during the lockdown, but catch-up efforts after it was eased ensured many children were reached at later ages. Nevertheless, catch-up was incomplete and children due their immunizations during the lockdown remained less likely to be fully immunized 4-5 months after it lifted, even as younger cohorts due immunizations in June or later returned to pre-lockdown schedules.

India’s COVID-19 lockdown, one of the most severe in the world, is widely believed to have disrupted critical non-COVID health services. However, linking these disruptions to effects on health outcomes has been difficult due to the lack of reliable, up-to-date health outcomes data. We identified all dialysis patients under a statewide health insurance program in Rajasthan, India, and conducted surveys to examine the effects of the lockdown on care access, morbidity, and mortality. 63% of patients experienced a disruption to their care. Transport barriers, hospital service disruptions, and difficulty obtaining medicines were the most common causes. We compared monthly mortality in the four months after the lockdown with pre-lockdown mortality trends, as well as with mortality trends for a similar cohort in the previous year. Mortality in May 2020, after a month of exposure to the lockdown, was 1.70 percentage points or 64% (p=0.01) higher than in March 2020 and total excess mortality between April and July was estimated to be 22%. Morbidity, hospitalization, and mortality between May and July were strongly positively associated with lockdown-related disruptions to care, providing further evidence that the uptick in mortality was driven by the lockdown. Females, socioeconomically disadvantaged groups, and patients living far from the health system faced worse outcomes. The results highlight the unintended consequences of the lockdown on critical, life-saving non-COVID health services that must be taken into account in the implementation of future policy efforts to control the spread of pandemics.

Melanins play a crucial role in defending organisms against external stressors. In several pathogenic fungi, including the human pathogen Aspergillus fumigatus, melanin production was shown to contribute to virulence. A. fumigatus produces two different types of melanins, i.e., pyomelanin and dihydroxynaphthalene (DHN)-melanin. DHN-melanin forms the gray-green pigment characteristic for conidia, playing an important role in immune evasion of conidia and thus for fungal virulence. The DHN-melanin biosynthesis pathway is encoded by six genes organized in a cluster with the polyketide synthase gene pksP as a core element. Here, cross-species promoter analysis identified specific DNA binding sites in the DHN-melanin biosynthesis genes pksP-arp1 intergenic region that can be recognized by bHLH and MADS-box transcriptional regulators. Independent deletion of two genes coding for the transcription factors DevR (bHLH) and RlmA (MADS-box) interfered with sporulation and reduced the expression of the DHN-melanin gene cluster. In vitro and in vivo experiments proved that these transcription factors cooperatively regulate pksP expression acting both as repressors and activators in a mutually exclusive manner. The dual role executed by each regulator depends on specific DNA motifs recognized in the pksP promoter region.

With congeneric mergers, which involve firms with interrelated but not identical business lines that develop diverse products and services, a major challenge for organizations is the development of a common platform that fulfills similar business functions across multiple divisions. Through a field study of a post-merger common platform development initiative, we develop a framework that highlights how environmental and organizational contexts shape the process of common platform development (CPD). Our study provides an account of how the focal organization transitioned to a platform-based approach by achieving a balance between stable and flexible aspects of the common platform through negotiations among the divisions acquired through mergers and acquisitions. These negotiations were enabled through various boundary-spanning activities and the guided successive enrichment of boundary objects used in CPD process.

In the present study an attempt has been made to re-engineer traditional wadi into wholesome ready-to-use cereal-pulse-based chunks rich in protein quality and fibre content. Chunks were made using extrusion-dehydration combination. Two formulations i.e., whole green gram dhal with instant oats and washed green gram dhal with whole oats were formulated. These chunks are versatile in nature as they can be easily incorporated in day-to-day home-made preparations such as pulao, potato curry and kadhi. Cereal-pulse ratio was calculated using NDpCal%. Limiting amino acids such as lysine, tryptophan, methionine, cysteine and threonine were calculated for maximum amino acid profile in cereal-pulse combination. Time-temperature combination for extrusion at 130oC and dehydration at 65oC for 7 hours and 15 minutes were standardized to obtain maximum protein and fibre content. Proximate analysis such as moisture, fat and ash content were analyzed. Protein content of formulation was 62.10% and 68.50% respectively. Fibre content of formulations was 2.99% and 2.45%, respectively. Using a 5-point hedonic scale, consumer preference trials of 102 consumers were conducted and analyzed. Evaluation of chunks prepared in potato curry, kadi and pulao showed preferences for colour 82%, 87%, 86%, texture and consistency 80%, 81%, 88%, flavour and aroma 74%, 82%, 86%, after taste 70%, 75%, 86% and overall acceptability 77%, 75%, 88% respectively. High temperature inactivates antinutritional compounds such as trypsin inhibitors, lectins, saponins etc. Hence, availability of protein content was increased. Developed products were palatable and easy to prepare., {"references":["BIS IS 9487:1980, \"Specification for 'Ready-to-eat' Protein-rich Extruded Foods\" (FAD 16: Foodgrains, Starches and Ready to Eat Foods), 1980.","Doughty J, Walker A, \"Legumes in human nutrition\" FAO food and nutrition, Paper 20, FAO, Rome, pp. 46, 1982.","Fabriani G, Lintas C, Quaglia GB, \"Chemistry of lipids in processing and technology of pasta products\", Cereal Chemistry, vol, 45, pp. 454-463, 1968.","FAO, \"Protein quality evaluation in human diets\", Report of a joint FAO/WHO expert consultation. Rome, Food and Agriculture Organization of the United Nations (FAO Food and Nutrition Paper No. 51, 1991.","Gopalan C, Rama Sastri BV, Balasubramanian SC, 2011, \"Nutritive value of Indian foods\", 2010.","Satyanarayan and Chakrapani, \"The book on Biochemistry\", 2007.","Zhang M, Zhang Z, \"Extrusion process improves the functionality of soluble dietary fibre in oat bran\", Journal of Cereal Science, vol 54, pp. 98-103, 2011."]}