Search

In order to build a more flourishing, identical and secure world by 2030 Seventeen Global Goals has been put forwarded by the United Nations in the year 2015. Among these 17 goals one of the goals is focused on poverty eradication from global society. This is very crucial for society as various socio-economic problems are directly or indirectly linked up with this social phenomenon. In the particular case of India, during the last two decades, the national authorities have implemented several poverty alleviation programs among the poor. The objective of these programs is to improve their standard of living. For this purpose, constitutionally sanctioned local govt. system i.e. Panchayati Raj Institution (PRI) is a crucial driving force for visioning, planning, developing implementation and monitoring the various govt. welfare schemes at the grassroots level. The current study is focused on the roles that play by PRI in achieving the first goal of SDGs in a village from the influence zone of Assam’s capital city Guwahati through case study. For that both primary and secondary data base are used to draw the conclusion. Along with the govt.’s efforts it’s the duty of local people also to cooperate in implementing and proper maintenance of the various poverty alleviation schemes in the study area.

Chatbots have experienced significant growth over the past decade, with a proliferation of new applications across various domains. Previous studies also demonstrate the trend of new technologies, especially artificial intelligence, being adopted in libraries. The purpose of this study is to determine the current research priorities and findings in the field of chatbots in libraries. A systematic literature review was performed utilising the PRISMA checklist and the databases Scopus and Web of Science, identifying 5734 records. Upon conducting the first screening, abstract screening, full-text assessment, and quality assessments guided by the CASP appraisal checklist, 19 papers were deemed suitable for inclusion in the review. The results of the review indicate that the majority of the existing studies were empirical in nature (primarily adopting qualitative methods) and technology reviews with a focus on reviewing the implementation and maintenance, design, evaluation, characteristics, and application of chatbots. The chatbots of interest were mainly text-based and guided chatbots, with closed-source tools with access portals mostly built on library web pages or integrated with social software. The research findings primarily concerned the development models and necessary tools and technologies, the application of chatbots in libraries. Our systematic review also suggests that studies on chatbots in libraries are still in the early stages.

Purpose: The absence of culture- and language-specific aphasia assessment in Bangla underscores a critical problem in communication sciences and disorders. Aphasia occurs in ~41% of Bangla-speaking stroke survivors. In the past 40 years, stroke incidence has doubled in low- and middle-income countries, such as Bangladesh and India, where there are ~250 million native Bangla speakers. This study aims to initiate the first step toward identifying an appropriate picture stimulus for the Bangla picture description task (PDT) intended for inclusion in a Bangla aphasia assessment. Researchers have reported the importance of cultural relevance and three visuographic variables of a picture (high-context, color, and photograph vs. black-and-white line drawing) for faster comprehension and comprehensive language production in people with aphasia and neurologically healthy adults. Method: Ninety-six neurologically healthy native Bangla speakers of three age groups (young 19–30, middle age 40–55, and older 65–89 years) were recruited to compare spontaneous language production for four selected culturally related and nonrelated picture stimuli with and without the three visuographic variables. Five linguistic variables were used to analyze the language samples. Results: The results demonstrated a significant (a) picture type effect for moving-average type–token ratio, words per minute (WPM), and mean length of utterance in morphemes (MLU) and (b) age group effect for WPM, MLU, and complexity index. Conclusions: This study suggests that a culturally related high-context color photograph is the optimal choice for the Bangla PDT. This study also indicates reduced fluency, grammatical complexity, and syntactic complexity in healthy Bangla-speaking adults aged 65 years and above. Supplemental Material: https://doi.org/10.23641/asha.22233664

BACKGROUND: No studies have examined how health care mergers and acquisitions affected the hospital supply chain and its employees since the passing of the Patient Protection and Affordable Care Act. OBJECTIVE: To describe the barriers and facilitators of digital transformation in a hospital supply chain from the employee perspective. METHODS: We conducted two rounds of interviews, one year apart, with supply chain employees at an urban academic health system preparing to adopt an enterprise resource planning (ERP) software (N = 11 in Round I and N = 8 in Round II). Two researchers coded transcripts for themes using NVivo 11. RESULTS: We identified the following barriers to technology integration: silos between supply chain groups (e.g. Purchasing, Information Management, Strategic Sourcing), between employees and management, and resulting from prior mergers; focus on short-term problems and fear of change; and lack of transparent communication about upcoming changes. Facilitators of technology integration included motivation to work in supply chain; long-term vision that allowed tolerance of change and positive outlook; and transparent communication. CONCLUSION: Desire for shared leadership among employees emerged as a major theme, indicating the need for active involvement of employees during transition to new integrative technology.

The study was conducted to evaluate the outcomes of transverse cancellous lag screw (TCLS) fixation in pauwels type 3 fracture neck of femur (NOF). 29 patients with pauwels type 3 fracture neck of femur were operated with transverse cancellous lag screws. Functional outcome was evaluated using Harris hip score while RUSH score was used to evaluate radiological outcome. The follow up period was 6 months. Quantitative variables were compared using unpaired t- test/Mann- Whitney test. Qualitative variables were compared using Chi-Square test /Fisher’s exact test. Pearson correlation coefficient/Spearman rank correlation coefficient was used to find out the correlation between quantitative variables. A p value of Mean Harris hip score was 84.86 with excellent outcomes in 44.82% of patients. Mean RUSH score was 26.55 at the end of 6 month follow up. The mean time to union was 4 months and the union rate was 93.10%. Over all TCLS fixation technique had good results in our study. This construction not only improves the compression pressure across the fracture site, also offer a multi-plane structure to lock the fracture ends. The addition of the transverse lag screw (inserted perpendicularly to the fracture line) allows optimum control of shear forces in the fracture ends. The transverse screw also provides rigid cortical support by transferring the bending moments from the femoral head and neck to the enhanced posterior lateral cortical support, which harmonized the function of the calcar femorale.

Background: Breast cancer is the most commonly diagnosed non-cutaneous malignancy in American women and one of the leading causes of cancer deaths. Breast cancer can be divided into several subtypes, the most aggressive of which is Triple-Negative Breast Cancer (TNBC), a disease with few targeted therapies. TP53 mutations are found in 80% or more of TNBCs. However, direct targeting of mutant TP53 has been difficult. To identify drugs that can specifically induce the death of TP53-mutant breast cancers, we conducted a drug screen in TP53-mutant and TP53-wild type breast cancer cells. Through this combined in silico and in vitro drug screen, we discovered that TP53 mutant TNBC cells have an increased sensitivity to KIF11 inhibition as compared to TP53 wild-type cells. Hypothesis: We hypothesize that TP53 mutational status confers sensitivity of triple-negative breast cancer cells to KIF11 inhibition. Methods: We obtained data on TP53 mutational status, KIF11 mRNA expression levels, and clinical characteristics from publicly-available TCGA, METABRIC, and CCLE datasets. To demonstrate the effect of KIF11 inhibition on cell growth, we treated TP53 mutant and wild-type breast cancer cell lines with the small molecule KIF11 inhibitor SB-743921 and KIF11 siRNAs. Cell counts were obtained through staining with DAPI or Hoechst nuclear stains and imaging on the MetaXPress PICO instrument. To determine protein expression of p53 and Kif11 across various cell lines, western blotting was performed. We then investigated the biological mechanisms of growth inhibition by DRAQ7 staining and flow cytometry analysis following Annexin V-PI staining. Results: Using cell growth assays we demonstrated that TP53 mutant cells are more sensitive to KIF11 inhibition. We next utilized cell lines in which TP53 mutations had been introduced into TP53 wild-type cells to show that overexpression of a TP53 mutant gene can sensitize cells to KIF11 inhibition. Using assays of proliferation and apoptosis, we showed that TP53 mutant breast cancer cells treated with a KIF11 inhibitor undergo cell death. Using publicly-available datasets of breast cancers, we showed that KIF11 is upregulated in TNBCs and TP53 mutant cancers, and that high expression of KIF11 in breast cancer is correlated with poorer clinical prognosis. Conclusions: Our results show that the Kif11 protein is essential for the survival of TP53 mutant TNBC cells. Inhibitors of Kif11 induce death of TP53 mutant TNBCs and thus, this kinesin-like protein involved in cell spindle mechanics is a potential target for the treatment of these aggressive cancers. Research reported in this publication was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Numbers TL1TR003169 and UL1TR003167. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This work was also supported by the John Charles Cain Endowment. Citation Format: Amanda Lanier, Abhijit Mazumdar, William Tahaney, Powel Brown. The Kinesin-like protein Kif11 is essential for the Survival of TP53-mutant Triple Negative Breast Cancer Cells [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P2-16-01.

Background: The pioneer transcription factor (TF) GATA4 (GATA Binding Protein 4) is expressed in multiple cardiovascular lineages and is essential for heart development. GATA4 lineage-specific occupancy in the developing heart underlies its lineage specific activities. Here, we characterized GATA4 chromatin occupancy in cardiomyocyte and endocardial lineages, dissected mechanisms that control lineage specific occupancy, and analyzed GATA4 regulation of endocardial gene expression. Methods: We mapped GATA4 chromatin occupancy in cardiomyocyte and endocardial cells of embryonic day 12.5 (E12.5) mouse heart using lineage specific, Cre-activated biotinylation of GATA4. Regulation of GATA4 pioneering activity was studied in cell lines stably overexpressing GATA4. GATA4 regulation of endocardial gene expression was analyzed using single cell RNA sequencing and luciferase reporter assays. Results: Cardiomyocyte-selective and endothelial-selective GATA4 occupied genomic regions had features of lineage specific enhancers. Footprints within cardiomyocyte- and endothelial-selective GATA4 regions were enriched for NKX2-5 (NK2 homeobox 5) and ETS1 (ETS Proto-Oncogene 1) motifs, respectively, and both of these TFs interacted with GATA4 in co-immunoprecipitation assays. In stable NIH3T3 cell lines expressing GATA4 with or without NKX2-5 or ETS1, the partner TFs re-directed GATA4 pioneer binding and augmented its ability to open previously inaccessible regions, with ETS1 displaying greater potency as a pioneer partner than NKX2-5. Single-cell RNA sequencing of embryonic hearts with endothelial cell–specific Gata4 inactivation identified Gata4 -regulated endocardial genes, which were adjacent to GATA4-bound, endothelial regions enriched for both GATA4 and ETS1 motifs. In reporter assays, GATA4 and ETS1 cooperatively stimulated endothelial cell enhancer activity. Conclusions: Lineage selective non-pioneer TFs NKX2-5 and ETS1 guide the activity of pioneer TF GATA4 to bind and open chromatin and create active enhancers and mechanistically link ETS1 interaction to GATA4 regulation of endocardial development.

Soil fertility is one of the most promising factors that directly impact sustainable crop production. Therefore, a pot experiment was conducted in net house on capsicum (Capsicum annuum L.) in the agricultural soil to study the effects of vermicompost (VC) and inorganic fertilizers (NPK) on growth, yield and nutrient content in capsicum plants. The growth parameters and nutritional values were observed during the experiment under eleven treatments. The treatments variables are T1 (control, -VC & -NPK), T2 (VC 5 ton/ha), T3 (VC 10 ton/ha), T4 (VC 15 ton/ha), T5 (N60P35K60 kg/ha), T6 (VC 5 ton/ha +N48P28K48 kg/ha), T7 (VC 10 ton/ha + N48P28K48 kg/ha), T8 (VC 15 ton/ha + N48P28K48 kg/ha), T9 (VC 5 ton/ha + N36P21K36 kg/ ha), T10 (VC 10 ton/ha + N36P21K36 kg/ha), T11 (VC 15 ton/ha + N36P21K36 kg/ha) which were arranged in a completely randomized design (CRD) with three replications. There were statistically significant differences in each treatment for growth and yield parameters. The highest plant height (45 cm), the highest number of leaves (44 no/plant), and the highest leaf area index (90 cm2) were found in the treatments T6, T5 and T9 respectively. The lowest values for all of the above parameters were found in the treatment T1 (control). Then the highest yield parameters fruit no/ plant (3), total fresh weight (39.60 g/plant), and total dry weight (2.38 g/plant) were observed under the treatment T11. The results of the growth and yield parameters varied significantly (p

Background: Measurement of glycosylated hemoglobin (HbA1c) is considered the gold standard for monitoring chronic glycemic level of diabetes patients. HbA1c is a form of hemoglobin that is measured primarily to identify the average plasma glucose concentration over prolonged periods of time. Levels of HbA1C represent the average blood glucose levels of diabetic patients over the previous 120 days. The objective of this study was to see the correlation between HbA1c levels and glucose levels. Methods: This cross-sectional study included 60 randomly selected subjects with known diabetes. Both fasting and post prandial blood glucose levels were measured by using venous blood samples. HbA1c levels were measured in venous blood by immunoturbidimetric method. Data were recorded on a proforma in MS-excel sheet. Pearson's coefficient of correlation was applied to find out any significant correlation between the HbA1c levels and the both fasting and postprandial blood glucose levels. Results: Results were obtained by statistical calculation and plotted with respect to scatter and bar diagram was done and a p

Work-life balance is highly desirable and involves maintaining equilibrium between professional and personal work. With the onset of a novel coronavirus pandemic, the workforce has seen unprecedented changes. Instead of the COVID-19 pandemic, the Government of India implemented a nationwide lockdown and several isolation policies. IT industry has seen a massive increase in work from home policy. Many companies permanently shift working patterns to embrace remote working. Because of this lockdown, many employees working in this sector have experienced psychological distress. With companies expecting their employees to perform with the same productivity, worklife balance has taken a toll. It becomes imperative to identify the factors that most influence the balance. The responses are collected from employees across the IT industry in various regions of India. Factor analysis is employed to identify the most and least important factors that affect work-life balance during COVID-19 lockdown.

In this study, we report mineralogical features of post-metamorphic K-metasomatic assemblage of high-grade metapelites from Guwahati, the northern extension of the central part of the Shillong Plateau, NE India. Several reaction textures of metasomatic metapelites are shown and they offer clues for relevant reactions for metasomatic modification of pre-metasomatic metapelites. Two sets of mineral reactions are recognized, which include, the alteration of high-temperature of all kinds of aluminium-silicate phases of pre-metasomatic metapelites into low-grade minerals and the replacement of coexisting metamorphic plagioclase and quartz by K-feldspar due to the involvement of K-rich fluids at the end of all deformational events. Our structural study indicates the rocks of the area are intensely deformed with multiple folding events and post-kinematic shearing and faulting which cross-cut the dominant foliation of the rocks. The deep-seated K-rich metasomatic fluids moved into shear zones and migrated along the foliation plane, grain boundaries of minerals transforming the parent metapelites into metasomatic rocks. As a result of metasomatic changes, all pre-existing features disappear and metapelites turn into K-feldspar -rich granitic rock.

Tea gardens are facing water scarcity; moreover, their irrigation utilises overhead sprinklers, which lack uniformities and controlled irrigation methods. Evaluating the performance of drip irrigation is an important research area for better water resources management. To address these issues different drip irrigation methods have been experimented with having different combinations of drippers. Two plots are online drip systems while the other two are inline systems operated at the same pressure on water application uniformity while other conditions remain similar. Earlier studies witnessed experimentation of drip irrigation with only the same emitter flow. While in this research, the uniformity coefficient, emission uniformity and performance index are calculated. It is found that due to various dripper discharges and systems the water application significantly changes. Extreme values of discharge variation of the emitters were observed during field operations under the same pressure and length of laterals. From the evaluation of the uniformities and investment cost, the performance of an inline system with a 4 lph dripper at 60 cm with 1-m lateral spacing is found to be the best model for tea irrigation under the specified conditions. Later stage and further research efforts should be aimed at the findings of the efficiencies and yield response of tea under the four drip systems.

Arsenic (As) is a broadly distributed toxic metalloid that accumulates in the environment through natural and anthropogenic sources. Numerous techniques were evolved for arsenic remediation from water including adsorption, flocculation, ion exchange and reverse osmosis. Due to the excessive affinity between iron and inorganic arsenic species, iron-based adsorption is an emerging technique for the remediation of arsenic-contaminated water and soil. Whereas iron (Fe) and nickel (Ni) belong to the same chemical group (VIIIB) in the periodic table, it is expected to get similar interaction of Ni with As. An in vitro incubation study and pot experiment were conducted to evaluate the effect of Nickel on mineral release patterns in soil and growth yield of kalmi (Ipomoea aquatica), red amaranth (Amaranthus sp.) and Spinach (Spinacia oleracea L.). Nickel was applied as different doses of Nickel of 10, 40 and 160 mg/kg respectively where As was applied with irrigation water at the rates of 1 mg/L and incubated at field moisture condition for 10, 20 and 30 days individually in different pots. Total organic carbon (C), total nitrogen (N), phosphorus (P), sulfur (S), potassium (K) and 0.1N HCl extractable arsenic (As), iron (Fe) contents were determined at 10, 20 and 30 days of incubation. The pot experiment was carried out in triplicates for 45 days till the plants were grown to maturity. The growth performance of plants and the remedial effect of Ni on As toxicity in soil and plant was examined. Nickel showed a significant impact on fresh and dry yield of three plants and an antagonistic relationship between Ni and As was also observed i.e., Ni in soil was found to lessen the availability of As in soil likewise its accumulation in plants. J. Biodivers. Conserv. Bioresour. Manag. 2022, 8(2): 79-88

Osteoarthritis(OA) is the most common chronic condition of the knee joints that takes place when the cartilage or a low friction surface between joints breaks down which leads to pain, stiffness and swelling. Total 56 patients with osteoarthritis of knee, randomized to receive intra articular hyaluronic acid injection and were followed up for 3 months. Patients were evaluated with the Western Ontario and Mc Master University Osteoarthritis Index(WOMAC), Knee injury and Osteoarthritis Outcome Score (KOOS) and the visual analog scale. This study was done for the evaluation of the therapeutic effect of intra articular injection of hyaluronic acid (HA) in knee osteoarthritis. Patients mean age were57 ±9 years. WOMAC score shows that stiffness did not improved after intervention, (P> 0.05). KOOS score shows that after intervention, symptoms were improved (P< 0.05).

Background: Many flaps have been described and used for coverage of various soft tissue defects of hand, which can be regional or distant. Objective: In this study main goal is to evaluate the assessment of flap viability and post-operative hand function by Total Active Motion (TAM) and Hand grip strength. Method: This was a comparative observational study, conducted at department of Orthopaedic Surgery and Burn and Plastic surgery in Sylhet MAG Osmani Medical College Hospital (SOMCH) from January 2018 to October, 2019. A total of 16 patients with acute hand injury or pathology in the palm which may create surgical wound, admitted in the study place during the study period were the study population. Where those who had Acute wound in palm with exposed tendon, nerve and bones or degloving hand injury were included in the study. Patient were divided into two group namely Group-A and Group-B. Patient chosen for groin flap were allocated in group-A and for reverse pedicled radial forearm flap were in group-B. Results: During the study, complete flap survival was 100% in both group A and B. At all the follow-ups hand grip strength was more in group B and the difference was statistically significant (p

This is a survey paper on refrigeration monitoring systems designed using PIC microcontroller and FT811 display driver. PIC (Peripheral Interface Controllers) are a family of microcontrollers developed and produced by Microchip Technology. They are generally 8-bit or 16-bit controllers and feature a wide range of peripherals like ADCs, DACs, timers and communication interfaces. The FT811 is a graphic controller or an embedded video engine manufactured by FTDI chips. It generates images to be displayed on graphic TFT displays based on display list commands sent to it via a microcontroller through an SPI (Serial Peripheral Interface) channel. These commands can perform functions ranging from drawing lines, rectangles, displaying text and numbers, designing buttons, to loading images onto the chip’s RAM and display them on the screen. We are doing this as a part of our project as final year students belonging to the Electronics and Telecommunication branch from Pune Institute of Computer Technology.

In the current day, information and communication technologies are tightly linked to provide ultimate business solutions. Cloud computing is one of these topics that has recently been hotly contested and carefully explored, but still has a lot of room for further research and growth. Technology-assisted learning is becoming more common, with most educational institutions across the globe using learning management systems, content management systems, virtual networks, and virtual machines to enhance student learning. In this day and age, educational institutions are even using private clouds to improve the student experience. Despite the fact that many educational institutions, colleges, and universities have effectively implemented and incorporated instructional technology, many of them still fall short in a variety of areas. The purpose of this research is to investigate the influence of cloud computing technology on educational institutions and corporate management.

In today's complex Internet platform, online users need help to protect their online identity. Only sometimes, websites are very transparent about how user data will be collected, stored and processed by them. Sometimes Internet entities collect more online user information than required. These entities often share user identity-related data with third parties without consent. Existing traditional identity schemes need to be improved to stop and counter new ways of digital identity theft and fraud. Blockchain is a promising technology to strengthen the preservation of online users' digital identity due to its decentralised nature and robust data security features. In this paper, we proposed and implemented a generic blockchain- IoT-based self-sovereign identity management framework called ChainDiscipline. We have demonstrated the framework's oper- ability and functionality by implementing healthcare and smart home data management-based use cases.

The present study was mainly aimed at exploring the causal association of the atherogenic (ApoB) and antiatherogenic apolipoproteins (ApoA1) and their ratio in the basic defects of pancreatic β cell dysfunction and insulin resistance in type 2 Diabetes Mellitus (T2DM). An intermediate stage towards diabetes, the prediabetic stage, was chosen to explore the association. Following a standardized selection process, 131 subjects were purposefully recruited for the study, including 18 with impaired fasting glucose (IFG), 56 with impaired glucose tolerance (IGT), and 57 with type 2 diabetes (T2DM). Fifty-nine healthy subjects served as controls. Glucose, lipid and insulin were estimated by glucose-oxidase, enzymatic colorimetric assay and enzyme linked immunosorbent assay (ELISA) respectively. Serum ApoB and ApoA1 were estimated by immuno-nephelometric method. Appropriate statistical tools were used to calculate statistical differences using Statistical Package for Social studies (SPSS) for Windows V12. Absolute insulin (mIU) levels were significantly higher in the IGT and T2DM groups compared to controls (p 0.001 and p = 0.001, respectively). HOMA%B (meanSD) was significantly lower in T2DM groups (p=

Part 2 of Encountering Berlant amplifies the promise of Lauren Berlant's influential concept of ‘cruel optimism’. Cruel optimism names a double-bind in which attachment to an ‘object’ holds out the promise of sustaining/flourishing, whilst simultaneously harming. The lines between harming, sustaining, damaging and flourishing blur, sometimes collapsing entirely. By holding together opposites the concept exemplifies and performs the centrality of ambivalence to Berlant's thought, as well as their orientation to overdetermination and incoherence. Geographers and others have found in the concept a way of understanding the intersection between affective and political economies in the crisis-present following the 2008 financial crisis. Together with Berlant's linked concepts such as ‘crisis ordinariness’ and ‘impasse’, cruel optimism has offered a way of understanding why detachment can be so difficult and how damaging conditions endure. Contributors begin from these starting points, amplifying the concept's promise: a new way of researching and writing about the reproduction of ordinary damage and harm. By writing from diverse encounters with Berlant's work, they move the concept in multiple directions, juxtaposing it with other optimisms across a variety of empirical scenes and locations. The result is a repository of what cruel optimism, and Berlant's mode of thinking-feeling more broadly, offer geographers and others. publishedVersion Non

To compare resection and survival outcomes of neoadjuvant chemoradiotherapy (CRT) and immediate surgery in patients with resectable pancreatic cancer (RPC) or borderline resectable pancreatic cancer (BRPC).In compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement standards, a systematic review of randomized controlled trials (RCTs) was conducted. Random effects modeling was applied to calculate pooled outcome data. Likelihood of type 1 or 2 errors in the meta-analysis model was assessed by trial sequential analysis.A total of 400 patients from four RCTs were included. When RPC and BRPC were analyzed together, neoadjuvant CRT resulted in a higher R0 resection rate (risk ratio [RR]: 1.55,Neoadjuvant CRT might be beneficial for patients with BRPC, but not for patients with RPC. Nevertheless, the best available evidence does not include contemporary chemotherapy regimens. Patients with RPC and those with BRPC should not be combined in the same cohort in future studies.

Evaluation of success rate of manual DSEK in terms of central corneal thickness and BSCVA in patients of PBK. : Prospective, non-comparative, interventional study of 18 patients of PBK, who underwent manual DSEK between June 2021 to May 2022 with minimum six months to maximum 15 months post-operative follow up. DSEK lenticule was prepared by manual dissection. Push in technique with 26 G needle was used for graft insertion. Preoperative and post-operative CCT and BSCVA were measured and compared. : Preoperative central pachymetry in patients (n=18) was (832±162) μm which significantly reduced in the post operative period. The mean thickness of lenticule on day 1 post op was 203±93.5μm which became 156±76 μm (p =.0436) at 6 months and remained almost same till last follow up. Pre operative BSCVA ranged from HM to 2/60 in these 18 patients which was improved in 16/18 eyes post DSEK. Eighty eight percent (15/17) patients had regained BSCVA of 6/60 to 6/12. In early post operative period, complications noted were, partial detachment of lenticule and pupillary block glaucoma which were managed accordingly.: Manual DSEK is feasible, low-cost widely accessible alternative to DSAEK/DMEK for patients of PBK with good visual outcome in resource limited settings.: Manual DSEK has short learning curve and it’s training should be imparted to corneal surgeons for better outcome in PBK and other causes of endothelial decompensation.

Several low- and middle-income countries are considering health financing system reforms to accelerate progress toward universal health coverage (UHC). However, empirical evidence of the effect of health financing systems on health system outcomes is scarce, partly because it is difficult to quantitatively capture the 'health financing system'. We assign country-year observations to one of three health financing systems (i.e., predominantly out-of-pocket, social health insurance (SHI) or government-financed), using clustering based on out-of-pocket, contributory SHI and non-contributory government expenditure, as a percentage of total health expenditures. We then estimate the effect of these different systems on health system outcomes, using fixed effects regressions. We find that transitions from OOP-dominant to government-financed systems improved most outcomes more than did transitions to SHI systems. Transitions to government financing increases life expectancy (+1.3 years, p 0.05) and reduces under-5 mortality (-8.7%, p 0.05) and catastrophic health expenditure incidence (-3.3 percentage points, p 0.05). Results are robust to several sensitivity tests. It is more likely that increases in non-contributory government financing rather than SHI financing improve health system outcomes. Notable reasons include SHI's higher implementation costs and more limited coverage. These results may raise a warning for policymakers considering SHI reforms to reach UHC.

Background: Increasing demand for shoulder arthroplasty and an aging population may increase the rate of complications associated with advanced age such as postoperative delirium, but little is known on its burden in this cohort. Purpose: We sought to answer the following questions: (1) What is the epidemiology of postoperative delirium after shoulder arthroplasty? (2) What modifiable risk factors can be identified for postoperative delirium after shoulder arthroplasty? (3) Do risk factors differ in those younger than and in those older than 70 years of age? Methods: In a retrospective nationwide cohort study, we extracted data from the Premier Healthcare database on inpatient total and reverse shoulder arthroplasties from 2006 to 2016. The primary outcome was postoperative delirium; modifiable risk factors of interest were perioperative opioid use (high, medium, or low), peripheral nerve block use, and perioperative prescription medications. Mixed-effects models assessed associations between risk factors and postoperative delirium. Odds ratios and confidence intervals are reported. We applied a cutoff of 70 years of age because it was the median age of the cohort, as well as the age at which we observed that delirium prevalence increased. Results: A total of 92,429 total and reverse shoulder arthroplasties were identified (age range: 14–89 years). Overall delirium prevalence was 3.1% ( n = 2909). Age-specific prevalence of postoperative delirium was lower in patients aged 50 to 70 years and higher in those aged 70 years and older, up to 8% among those older than 88 years. After adjusting for relevant covariates, only long-acting and combined short-acting and long-acting benzodiazepines (compared with no benzodiazepines) were associated with increased odds of postoperative delirium. Corticosteroids were associated with decreased odds of postoperative delirium. Conclusion: Our retrospective cohort study demonstrated that benzodiazepine use and older patient age were significantly associated with postoperative delirium in shoulder arthroplasty patients. The relationship between benzodiazepine use and delirium was particularly notable among those 70 years of age and older. Further investigation is indicated, given the known adverse effects of benzodiazepines in older adults and our findings of higher than expected use of these medications in this surgical cohort.

The unprecedented ballooning of network traffic flow, specifically, Internet of Things (IoT) network traffic, has big stressed of congestion on todays Internet. Non-recurring network traffic flow may be caused by temporary disruptions, such as packet drop, poor quality of services, delay, etc. Hence, the network traffic flow estimation is important in IoT networks to predict congestion. As the data in IoT networks is collected from a large number of diversified devices which have unlike format of data and also manifest complex correlations, so the generated data is heterogeneous and nonlinear in nature. Conventional machine learning approaches unable to deal with nonlinear datasets and suffer from misclassification of real network traffic due to overfitting. Therefore, it also becomes really hard for conventional machine learning tools like shallow neural networks to predict the congestion accurately. Accuracy of congestion prediction algorithms play an important role to control the congestion by regulating the send rate of the source. Various deeplearning methods (LSTM, CNN, GRU, etc.) are considered in designing network traffic flow predictors, which have shown promising results. In this work, we propose a novel congestion predictor for IoT, that uses Temporal Convolutional Network (TCN). Furthermore, we use Taguchi method to optimize the TCN model that reduces the number of runs of the experiments. We compare TCN with other four deep learning-based models concerning Mean Absolute Error (MAE) and Mean Relative Error (MRE). The experimental results show that TCN based deep learning framework achieves improved performance with 95.52% accuracy in predicting network congestion. Further, we design the Home IoT network testbed to capture the real network traffic flows as no standard dataset is available.

Walkability scores have been developed to measure how well the characteristics of the physical environment support walking. However, because pedestrian safety is not taken into account, areas that have higher Walk Scores could be associated with more walking and also more pedestrian-related injury. We aimed to explore the association between Walk Score and pedestrian-related injury in Sydney.Pedestrian-related injuries from 2010 to 2018 in Sydney were identified in the New South Wales Combined Admitted Patient Epidemiology Data. Walk Score was used to measure area-level walkability in Sydney statistical division. Regression models were used to examine the association between Walk Score, pedestrian-related injury, length of hospital stay (LOS) and injury severity.Among people aged ≤64 years, there was no significant association between walkability score and pedestrian-related injury. Among people aged ≥ 65 years, walkability score was significantly positively associated with pedestrian-related injury, which peaked at Somewhat Walkable. For most disadvantaged areas, the risk of pedestrian-related injury was highest for areas that were classified as Somewhat Walkable. For moderately disadvantaged areas, the risk of pedestrian-related injury was highest at Very Walkable to Walker's Paradise areas. For the least disadvantaged areas, there was no significant association between walkability score and pedestrian-related injury. For LOS among people aged ≥ 65 years or in the most disadvantaged areas, it peaked at Somewhat Walkable areas. For injury severity, the risk of serious pedestrian-related injury was highest at Very Walkable to Walker's Paradise areas among people aged 16-64 years.For the majority of the population, built environment characteristics that are considered to make walking attractive also make it safer, offsetting any exposure-related increase injury risk. However, this is not the case for people aged ≥ 19 years, and those living in socioeconomically disadvantaged areas. Incorporating measures of pedestrian safety in walkability scores may create an impetus to ensure that the built environment is designed to support the safety of pedestrians from these groups.

Arsenic crosses the placenta and accumulates in fetal tissues. In the United States, diet is the predominant route of arsenic exposure, but epidemiologic data are sparse regarding this exposure and development of birth defects. Using data from a large case-control study, we explored associations between maternal dietary arsenic exposure and congenital heart defects (CHDs), the most prevalent birth defects.We used maternal self-reported dietary assessments and arsenic concentration estimates in food items to estimate average daily exposure to dietary arsenic during the year before pregnancy for mothers of 10,446 unaffected control children and 6,483 case children diagnosed with CHDs. Using tertiles of dietary exposure to total arsenic (all species) and inorganic arsenic, we applied logistic regression analysis to estimate associations for middle and high tertiles, compared with the low tertile.Positive associations (odds ratio [OR] ≥ 1.2) for total arsenic were observed in both tertiles for perimembranous ventricular septal defect (VSD) and high tertile only for double outlet right ventricle-transposition of the great arteries (DORV-TGA), partial anomalous pulmonary venous return (PAPVR), and tricuspid atresia. Positive associations were also observed in both tertiles (tricuspid atresia) and high tertile only (DORV-TGA, conoventricular VSD, PAPVR, and pulmonary atresia) for inorganic arsenic. Most remaining associations were near or below unity.Exploration of maternal dietary exposure to total and inorganic arsenic and CHDs produced few positive associations but was limited by available food item concentrations. Future research requires expanded collection of dietary data, improved estimates of concentrations, and consideration of nondietary sources of arsenic exposure.

Smart living represents the hardware-software co-habiting with humans for better living standards and improved well being. Here, hardware monitors human activities (by collecting data) specific to a context. Such data can be processed to offer valuable context-specific insights. Such insights can be used for optimizing the well being, living experience, and energy cost of smart homes. This article proposes the Secure Embedded Living Framework (SELF), which enforces a privacy-preserving data control mechanism by integrating multiple technologies, such as the Internet of Things, cloud/fog platform, machine learning, and blockchain. The primary aim of SELF is to allow the user to retain more control of its data.

Background: Nephrotic syndrome is a very common yet perplexing kidney disease whose spectrum has undergone a gradual change globally over time. Within various Asian countries, the spectrum of adult nephrotic syndrome varies according to the place of origin. Aims and Objectives: The purpose of this study is to know the clinical presentation, laboratory abnormalities, histopathological spectrum of adult nephrotic syndrome, and its changing trends compared to previous studies. Materials and Methods: This observational cross-sectional study includes 50 cases of biopsy proven nephrotic syndrome admitted under general medicine department of a tertiary care hospital of Kolkata from March 2020 to February 2021. Proper history taking, clinical examination, and relevant laboratory investigations were done. Results: The mean age of presentation was 34.56±12.033 years with 27 males and 23 females. Oliguria was the most common presentation. Facial puffiness was the most predominant clinical finding closely followed by generalized swelling, pedal edema and ascites. 44 (88%) patients had serum albumin level ≤3 g/dl and all 50 (100%) patients had serum cholesterol values >200 mg/dl. 46 (92%) patients had a 24 h urinary protein level >3.5 g whereas 33 (66%) patients had 3+grade and 8 (16%) patients had 4+grade albuminuria. The most predominant renal biopsy variety was found to be focal segmental glomerulosclerosis (FSGS), seen in 27 (54%) patients followed by minimal change disease in 14 (28%) patients. 44 (88%) patients had primary glomerular disease (PGD) and 6 (12%) patients had secondary glomerular disease (SGD). The most common type of PGD and SGD was FSGS (59.09%) and lupus nephritis (4%), respectively. Conclusion: Widely varying etiology and clinical presentation makes early diagnosis by renal biopsy critical to properly categorize the disease and direct subsequent clinical approach in adults.