247 results on '"Sinhal A."'
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2. YouTube: Spam Comments Filtration Using Hybrid Ensemble Machine Learning Models
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Dr. Amit Sinhal
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General Engineering ,General Earth and Planetary Sciences - Abstract
In today’s era most of the YouTuber’s are facing the major problem with electronic spam as troublesome Internet phenomenon. This work proposes a methodology for the detection of spam comments on the video-sharing website - YouTube. YouTube is running its own spam blocking system but continues to fail to block them properly. In this work, we examined several top- performance classification techniques for spam comment screening and proposed a novel methodology. In this work, we have analyzed such comments by applying conventional machine learning algorithms such as Naive Bayes, Random Forest, Support Vector Machine, Logistic regression, Decision Tree and will construct another model utilizing ensemble and hybrid approach. This paper proposed the YouTube spam comments detection framework, examined, and validated by using data collected from the YouTube using Naïve Bayes multinomial, Gradient Boosting, Random Forest and tested in Weka and Python data mining tools.
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- 2022
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3. An Extensive Review on Contemporary Analysis of Comment Filtration of YouTube Videos Using Machine Learning Techniques
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Dr. Amit Sinhal
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General Engineering ,General Earth and Planetary Sciences - Abstract
Recently, social media platforms like LinkedIn, Twitter, Facebook, YouTube, etc., are immensely popular, especially in the pandemic era. This is because they provide connection and interaction between people by posting images, comments, or videos.YouTube has become a very popular video-sharing platform, and because of this, it has also attracted several types of spammers or malicious users whose aim is to distribute viruses or promote their videos. Spammers also want to spread phishing, malware, or advertisements in the comment section of the videos. Spam is generally related to unsought content or irrelevant comments with low-grade information. They are usually found as images, texts, or videos, clogging the visualization of interesting content. Users spend a lot of time eradicating spam since it causes a variety of issues that could lead to traffic and financial losses. To filter spam, several techniques have been developed. Automatic comment spam filtering on YouTube is not a simple task even for well-known classification methods since comments are very short and often contain slang, symbols and abbreviations. However, typical machine learning classification algorithms have been confirmed to be fairly effective, but there is still space for improved accuracy with new methods. In this paper, we will evaluate several topperformance classification techniques (such as Naive Bayes, Random Forest, and Support Vector Machine) of Machine Learning classification algorithms to detect such comments as spam or ham with the help of text classification, feature extraction and text pre-processing. It will work after posting the comments. This paper provides a comparative analysis of various ML techniques implemented by various researchers and authors in their work. The dataset would be used with reference to the UCI machine learning repository for future implementations of this related work.
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- 2022
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4. Do Chest Pain Characteristics in Patients with Acute Myocardial Infarction Differ between Those with and without Obstructive Coronary Artery Disease?
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Beltrame, Sivabaskari Pasupathy, Sarena La, Rosanna Tavella, Christopher Zeitz, Matthew Worthley, Ajay Sinhal, Margaret Arstall, and John F.
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myocardial infarction ,coronary angiography ,MINOCA ,chest pain ,myocardial infarction with non-obstructive coronary arteries - Abstract
The universal definition of acute myocardial infarction (MI) requires both evidence of myocardial injury and myocardial ischaemia. In MINOCA (MI with non-obstructive coronary arteries), patients must fulfil this MI criteria, but is their chest pain similar to those who have MI with obstructive CAD (MICAD)? This study compares prospectively collected chest pain features between patients with MINOCA and MICAD. Utilising the Coronary Angiogram Database of South Australia (CADOSA), consecutive MI patients were categorized as MINOCA or MICAD based on angiographic findings. Chest pain data were collected via direct patient interviews by trained staff members. Of 6811 consecutive patients fulfilling a clinical MI diagnosis, 411 (6.0%) were MINOCA, and 5948 MICAD. The MINOCA patients were younger, more often female and had less cardiovascular risk factors than those with MICAD. There were no significant differences in chest pain characteristics between the MINOCA and MICAD cohorts in relation to pain location, quality, associated symptoms, or duration. In conclusion, MINOCA patients have chest pain characteristics that are indistinguishable from MICAD patients, suggesting that their pain is ischaemic in nature. Thus, in the presence of positive myocardial injury markers, ischaemic chest pain fulfils the universal criteria for MI, despite the absence of obstructive coronary artery disease.
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- 2023
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5. A RECENT UPDATES IN TOPICAL APPLICATIONS OF ANTIFUNGAL AGENTS: A REFERENCE TO LIPID- BASED FORMULATIONS
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Mr. Amit P. Sinhal, Dr. R. D. Wagh.
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Clinically available antifungals have a restricted range of efficacy, substantial toxicity, and emerging resistance. Because fungi and the humans who host them are both eukaryotic, it has been difficult to identify precise targets for antifungals. Novel antifungals include first-in-class compounds, new structures for a known target, formulation changes to antifungals already on the market, and repurposed medications. The authorized antifungal drugs, and 39; mechanisms of action, pharmacological profiles, and susceptibility to certain fungi were assessed. The field is paying more and more attention to membrane-interacting peptides and aromatherapy. Antifungal antibodies are making progress in clinical studies, making immunotherapy another intriguing therapeutic approach. New antifungal therapeutic targets are also being found, enabling the development of innovative, potentially effective drugs that could solve the resistance problem. Due to their unique structural and functional characteristics, advanced topical carriers get beyond biopharmaceutical issues with traditional drug delivery vehicles, such as poor retention and low bioavailability. Topical nanocarriers containing anti-fungal pills have improved healing responses with little toxicity, in line with literature evidence. Topical antifungal medications are frequently delivered via nanocarriers such as solid- lipid nanoparticles, microemulsions, liposomes, niosomes, microsponges, nano gel, nanoemulsions, micelles, and so on. This review offers an overview of modern-day tendencies in new topical providers used to enhance the therapeutic efficacy of antifungal medicines. Keywords: antifungal, strong-lipid nanoparticles, microemulsions, liposomes, niosomes, microsponge, nanogel, nanoemulsions, micelles, and many others.
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- 2023
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6. Tunable Q-Factor Wavelet Transform-Based Robust Image Watermarking Scheme Using Logistic Mapping and Antlion Optimization
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Rishi Sinhal and Irshad Ahmad Ansari
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Applied Mathematics ,Signal Processing - Published
- 2022
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7. An Improved Auto Categorical PSO with ML for Heart Disease Prediction
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A. K. Dubey, A. K. Sinhal, and R. Sharma
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Cardiovascular or heart diseases consist a global major health concern. Cardiovascular diseases have the highest mortality rate worldwide, and the death rate increases with age, but an accurate prognosis at an early stage may increase the chances of surviving. In this paper, a combined approach, based on Machine Learning (ML) with an optimization method for the prediction of heart diseases is proposed. For this, the Improved Auto Categorical Particle Swarm Optimization (IACPSO) method was utilized to pick an optimum set of features, while ML methods were used for data categorization. Three heart disease datasets were taken from the UCI ML library for testing: Cleveland, Statlog, and Hungarian. The proposed model was assessed for different performance parameters. The results indicated that, with 98% accuracy, Logistic Regression (LR) and Support Vector Machine by Grid Search (SVMGS) performed better for the Statlog, SVMGS outperformed on the Cleveland, while the LR, Random Forest (RF), Support Vector Machine (SVM), and SVMGS performed better with 97% accuracy on the Hungarian dataset. The outcomes were improved by 3 to 33% in terms of performance parameters when ML was applied with IACPSO.
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- 2022
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8. Use of Color Channels to Extract Heart Beat Rate Remotely from Videos
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R. A. Sinhal
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General Medicine - Abstract
Since last decades, photoplythesmography (PPG) signals that are extracted from the optical absorption in the tissues are increasingly being used for health diagnosis. Despite a good literature, there are different claims about the use of color channels as red, green and blue for extraction of PPG signal, i.e., pulse rate from the videos captured through high resolution cameras. In this article, we present the technique for extracting the heart beat rate (pulse rate) from the videos captured through the mobile cameras for all three color channels and thier analysis. Experiments were performed on a DMIMS database comprising 720 videos, out of which we used 25 videos for the analysis. The pulse rate estimated from the blue channel, was in good agreement with reference data extracted using an MP20 monitor, used as the gold standard. The findings of the present study demonstrated the non-invasive color intensity method for detection of pulse rate from the pre-recorded video of 30 seconds. The algorithm is tested on the DMIMS dataset which we have captured in uncontrolled setting. The green channel is proven to be statistically significant for the video recorded followed by red and then blue channel. The accuracy of the pulse extracted is still low because of low signal to noise ratio.We therefore conclude that the presented technique is best for pulse rate extraction through a blue channel followed by red and green channels respectively.
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- 2022
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9. Machine learning based multipurpose medical image watermarking
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Rishi Sinhal and Irshad Ahmad Ansari
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Artificial Intelligence ,Software - Published
- 2023
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10. Multipurpose medical image watermarking for effective security solutions
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Rishi Sinhal, Sachin Sharma, Irshad Ahmad Ansari, and Varun Bajaj
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Computer Networks and Communications ,Hardware and Architecture ,Media Technology ,Software - Abstract
Digital medical images contain important information regarding patient's health and very useful for diagnosis. Even a small change in medical images (especially in the region of interest (ROI)) can mislead the doctors/practitioners for deciding further treatment. Therefore, the protection of the images against intentional/unintentional tampering, forgery, filtering, compression and other common signal processing attacks are mandatory. This manuscript presents a multipurpose medical image watermarking scheme to offer copyright/ownership protection, tamper detection/localization (for ROI (region of interest) and different segments of RONI (region of non-interest)), and self-recovery of the ROI with 100% reversibility. Initially, the recovery information of the host image's ROI is compressed using LZW (Lempel-Ziv-Welch) algorithm. Afterwards, the robust watermark is embedded into the host image using a transform domain based embedding mechanism. Further, the 256-bit hash keys are generated using SHA-256 algorithm for the ROI and eight RONI regions (i.e. RONI-1 to RONI-8) of the robust watermarked image. The compressed recovery data and hash keys are combined and then embedded into the segmented RONI region of the robust watermarked image using an LSB replacement based fragile watermarking approach. Experimental results show high imperceptibility, high robustness, perfect tamper detection, significant tamper localization, and perfect recovery of the ROI (100% reversibility). The scheme doesn't need original host or watermark information for the extraction process due to the blind nature. The relative analysis demonstrates the superiority of the proposed scheme over existing schemes.
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- 2022
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11. Multipurpose Image Watermarking: Ownership Check, Tamper Detection and Self-recovery
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Rishi Sinhal and Irshad Ahmad Ansari
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Applied Mathematics ,Signal Processing - Published
- 2022
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12. SUSTAINABILITY: A CHALLENGE FOR FOOD CONSUMPTION HABITS OF MILLENNIALS
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Ms. Preeti Sinhal and Dr. Honey Vikalp Tyagi
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Sustainable development, economic growth, social inclusion and environmental protection - Abstract
Sustainable development has been defined as development that meets the needs of the present without compromising the ability of future generations to meet their own needs. Sustainable development calls for concerted efforts towards building an inclusive, sustainable and resilient future for people and planet. For sustainable development to be achieved, it is crucial to harmonize three core elements: economic growth, social inclusion and environmental protection. These elements are interconnected and all are crucial for the well-be The unsustainability of current arrangements arises from the industrialization and globalization of agriculture and food processing, the shift of consumption patterns toward more dietary animal protein, the emergence of modern food styles that entail heavily processed products. For food consumption to be sustainable it has to be safe and healthy in amount and quality, and it has to be realized through means that are economically, socially, culturally and environmentally sustainable – minimizing waste and pollution and not jeopardizing the needs of others. Researcher, understands that there is no research been carried out about the millennials habit of sustainable food consumption and practices the importance of in India. More of research is be carried out in environmentally sustainable food consumption sector. so researcher tries to understand the importance of this in her mind and carried out research.
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- 2023
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13. A review of digital watermarking approaches for forensic applications
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Irshad Ahmad Ansari, Rishi Sinhal, and Om Prakash Verma
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General Medicine - Abstract
Abstract: There has been remarkable growth in the digital domain. This has led to the production of a huge amount of digital data in the form of text messages, documents, audio/speech signals, digital images, videos, etc. In forensics, digital information (i.e., images of crime scenes, etc.) is very important to examine cases and collect the proof regarding the incident. This further leads to judge the victims and culprits by the court for appropriate actions. So, even a slight change (intentional/unintentional) may lead to the wrong judgement. Several digital signal processing tools are easily available to process this type of digital data, which means data may get disrupted, altered, or deform in such a way that the authenticity gets compromised. In such cases, it can be difficult to recognize the source information as well as to check the originality/intactness of the digital data. In the recent past, several techniques have come into existence to protect digital data against security issues. Steganography, cryptography, and watermarking are examples of security techniques, which have been widely used for data security and forensic applications for a long time. Specifically, digital watermarking techniques provide many useful features to help users regarding data security and authentication without affecting other data characteristics. This work is an attempt to provide a review of recent digital image watermarking approaches for forensic applications.
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- 2023
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14. Improvement and evaluation of a unique natural gel formula of curcumin for wound restoration pastime
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null Jitendra Devchand More, null Chandrakant Punamchand Suryawanshi, null Amit Pravin Sinhal, null Shailesh Bhausaheb Patil, and null Chhaya Hemraj Gadgoli
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Pulmonary and Respiratory Medicine ,Pediatrics, Perinatology and Child Health ,Curcumin ,Curcumin-Gelucire®44/14 novel gel ,Penetration ,Gelucire®44/14 ,Carbopol 940 ,Wound recovery ,ORS without dextrose ,many others - Abstract
Curcuminoids are one of the main active ingredients in the roots or rhizomes of Safran from India. Its miles observed that the roots have medicinal price, Safran from India. Its miles determined that the roots have beneficial for the medicinal drugs. Chemically, Curcuminoids are (1E, 6E)-1, 7-bis (4-hydroxy- three-methoxyphenyl) -1, 6- heptadiene-3, 5-dione has a high metabolism and negative pores and skin permeation and is poorly soluble in water. With this background, the present observes pursues to improve pores and skin permeation by way of utilizing the polymers Gelucire®44/14 and carbopol 940. In this work, the capability of novel gels, particularly gel-middle Gelucire®44/14, to beautify Curcuminoids delivery to wound websites, decorate recovery price, and decrease scar formation was evaluated. Curcuminoids - Gelucire®44/14 gels have organized the use of an easy approach and evaluated concerning size, entrapment efficiency (% EE), and in vitro launch. The formation of novel gel Curcuminoids and Gelucire®44/14 became confirmed the use of toes-IR and DSC-TG evaluation. They have a look at also aimed to comprise the unconventional gel into the gel base and evaluate whether or not the topical novel gel training finished higher in phrases of wound restoration compared to unprocessed Curcuminoids. It became the simplest device showing marked improvement at days 18–21, and the performance of the novel gel turned into evaluated and handled on excision wounds inflicted on rat skin in the subsequent 12–15 days. The institution of animals handled with the Carbopol 940 gel base couldn't heal the wound, as the mean percent contraction of the wound was discovered to be the lowest. The organizations dealt with the obvious Curcuminoids gel and Curcuminoids - Gelucire®44/14 topical novel gel showed drastically (P
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- 2023
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15. E) -420024, Maharashtra Nation
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Jitendra Devchand More, Punamchand Suryawanshi, Sinhal, Amit Pravin, Shailesh Bhausaheb Patil, and Gadgoli, Chhaya Hemraj
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- 2023
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16. Obesity-induced vena cava compression syndrome: a case report of a rare precipitant of a type 2 myocardial infarction in a patient with critical aortic stenosis
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Alexander M Sellers, Ferdous Alam, Jayme S Bennetts, Sam J Lehman, and Ajay R Sinhal
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Cardiology and Cardiovascular Medicine - Abstract
Background Obesity is a global health problem of increasing prevalence with a broad range of multisystem complications. An under-recognized complication of severe obesity is the potential haemodynamic compromise that may arise due to pathological external compression of the inferior vena cava whilst lying in the supine position, a phenomenon known as obesity-induced vena cava compression syndrome. Case summary A 56-year-old independent woman presented to a rural Australian hospital for routine dressing care for bilateral lymphoedema on a background of class III morbid obesity (weight 197 kg, body mass index 68.55 kg/m3) and aortic stenosis. Whilst laid in the supine position with both legs elevated to aid lower limb venous return, the patient developed angina with associated troponin rise (15 to 75 to 332 ng/L) and inferolateral territory ischaemic changes on electrocardiogram. The pain then resolved shortly after restoring the patient to the upright position. A transthoracic echocardiogram showed critical bicuspid aortic stenosis. Computerized tomography coronary angiogram showed no significant coronary artery disease. Following multidisciplinary discussions, a transcatheter aortic valve insertion was performed via a transfemoral approach. Post-procedure, she went into atrial fibrillation, she was cardioverted into a sinus rhythm with new left bundle branch block. There were no complications otherwise, and the patient was discharged home following a brief period of convalescence. Discussion We describe a case of suspected obesity-induced vena cava compression syndrome precipitating a type 2 myocardial infarction in a pre-load dependent patient with critical bicuspid valve aortic stenosis. This case highlights a potential haemodynamic consequence of morbid obesity in the supine position.
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- 2022
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17. Frequency stabilisation and SI tracing of mid-infrared quantum-cascade lasers for precision molecular spectroscopy
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Mudit Sinhal, Anatoly Johnson, and Stefan Willitsch
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Physics - Instrumentation and Detectors ,Biophysics ,FOS: Physical sciences ,Instrumentation and Detectors (physics.ins-det) ,Physical and Theoretical Chemistry ,Condensed Matter Physics ,Molecular Biology ,Physics - Optics ,Optics (physics.optics) - Abstract
The advancement of technologies for the precise interrogation of molecules offers exciting possibilities for new studies in the realms of precision spectroscopy and quantum technologies. Experiments in these domains often address molecular vibrations in the mid-infrared (MIR) spectral region, thus generating the need for spectrally pure and accurate MIR laser sources. Quantum-cascade lasers (QCLs) have emerged as flexible sources of coherent radiation available over a wide range of MIR frequencies. Here, we demonstrate a robust approach for the simultaneous linewidth narrowing, frequency stabilisation, and absolute frequency referencing of MIR QCLs all of which are prerequisites for precise spectroscopic experiments. Following upconversion of its radiation to the visible domain, we implement a phase lock of the QCL to a linewidth-narrowed optical frequency comb which is referenced to a remote SI-traceable primary frequency standard via a fibre link for absolute frequency calibration. To achieve a reliable frequency counting of the beat note between the QCL and the OFC, we employ redundant tracking oscillators and demonstrate a frequency instability of $5\times10^{-13}$ at 1 s and $2\times10^{-14}$ at 1000 s integration time, limited by the accuracy of our remote reference.
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- 2022
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18. A multiple transform based approach for robust and blind image copyright protection
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Rishi Sinhal and Irshad Ahmad Ansari
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Computational Theory and Mathematics ,Computer Networks and Communications ,Software ,Computer Science Applications ,Theoretical Computer Science - Published
- 2022
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19. Assessing the Impact of Colchicine on Coronary Plaque Phenotype After Myocardial Infarction with Optical Coherence Tomography: Rationale and Design of the COCOMO-ACS Study
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Peter Barlis, Sanjay Patel, Thalia Salagaras, Giuseppe Di Giovanni, Stephen J. Nicholls, Nitesh Nerlekar, Peter L. Thompson, Kuljit Singh, Rustem Dautov, Dennis T.L. Wong, Sharmalar Rajendran, Stefan M. Nidorf, R. Alcock, Peter J. Psaltis, Ajay Sinhal, Nicholas J. Montarello, Juanita L Ottaway, and Julie Butters
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medicine.medical_specialty ,Acute coronary syndrome ,Trial Designs ,Myocardial Infarction ,Coronary Artery Disease ,Coronary Angiography ,Placebo ,chemistry.chemical_compound ,Double-Blind Method ,Internal medicine ,Clinical endpoint ,medicine ,Humans ,Colchicine ,Pharmacology (medical) ,Myocardial infarction ,Acute Coronary Syndrome ,Inflammation ,Pharmacology ,Optical coherence tomography ,business.industry ,Fibrous cap ,General Medicine ,Guideline ,medicine.disease ,Coronary Vessels ,Lipids ,Plaque, Atherosclerotic ,Phenotype ,medicine.anatomical_structure ,chemistry ,Cardiology ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,Cardiology and Cardiovascular Medicine ,business ,Coronary plaque ,Tomography, Optical Coherence ,Artery - Abstract
Introduction Recurrent event rates after myocardial infarction (MI) remain unacceptably high, in part because of the continued growth and destabilization of residual coronary atherosclerotic plaques, which may occur despite lipid-lowering therapy. Inflammation is an important contributor to this ongoing risk. Recent studies have shown that the broad-acting anti-inflammatory agent, colchicine, may reduce adverse cardiovascular events in patients post-MI, although the mechanistic basis for this remains unclear. Advances in endovascular arterial wall imaging have allowed detailed characterization of the burden and compositional phenotype of coronary plaque, along with its natural history and responsiveness to treatment. One such example has been the use of optical coherence tomography (OCT) to demonstrate the plaque-stabilizing effects of statins on both fibrous cap thickness and the size of lipid pools within plaque. Methods The Phase 2, multi-centre, double-blind colchicine for coronary plaque modification in acute coronary syndrome (COCOMO-ACS) study will evaluate the effect of colchicine 0.5 mg daily on coronary plaque features using serial OCT imaging in patients following MI. Recruitment for the trial has been completed with 64 participants with non-ST elevation MI randomized 1:1 to colchicine or placebo in addition to guideline recommended therapies, including high-intensity statins. The primary endpoint is the effect of colchicine on the minimal fibrous cap thickness of non-culprit plaque over an 18-month period. Summary The COCOMO-ACS study will determine whether addition of colchicine 0.5 mg daily to standard post-MI treatment has incremental benefits on high-risk features of coronary artery plaques. If confirmed, this will provide new mechanistic insights into how colchicine may confer clinical benefits in patients with atherosclerotic cardiovascular disease. Trial Registration ANZCTR trial registration number: ACTRN12618000809235. Date of trial registration: 11th of May 2018.
- Published
- 2021
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20. Machine learning based blind color image watermarking scheme for copyright protection
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Rishi Sinhal, Irshad Ahmad Ansari, and Deepak Kumar Jain
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Artificial neural network ,Channel (digital image) ,business.industry ,Computer science ,Pattern recognition ,Watermark ,02 engineering and technology ,Filter (signal processing) ,01 natural sciences ,Artificial Intelligence ,Computer Science::Multimedia ,0103 physical sciences ,Signal Processing ,0202 electrical engineering, electronic engineering, information engineering ,Discrete cosine transform ,Embedding ,020201 artificial intelligence & image processing ,Computer Vision and Pattern Recognition ,Artificial intelligence ,010306 general physics ,business ,Digital watermarking ,Software ,Computer Science::Cryptography and Security - Abstract
This work presents a blind and robust scheme using YCbCr color space, IWT (integer wavelet transform) and DCT (discrete cosine transform) for color image watermarking. During watermark insertion, Y channel is divided into blocks and Mersenne Twister random number generator is used to select the blocks for embedding. This randomized selection of blocks required a secret key, thus improving the security of the scheme. To reduce the computational complexity, the artificial neural network architecture is developed for watermark embedding. To check the robustness, several signal processing attacks such as JPEG compression, filtering attacks, noise attacks, cropping, resizing and other common attacks are applied on the watermarked images. The proposed work is tested on different images to verify the similarity in watermarking results. The scheme provides similar results (having little variation) for different test images. Experimental results demonstrate the superior performance in terms of imperceptibility and robustness. Further, the ANN framework provides faster embedding with approximately similar parametric results. The performance comparison with existing schemes demonstrates better performance for different attacks. The proposed work can be used in robust applications (i.e. copyright protection) for efficient results and less computational time.
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- 2021
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21. Non-destructive State Detection and Spectroscopy of Single Molecules
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Ziv Meir, Stefan Willitsch, and Mudit Sinhal
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Materials science ,ion traps ,Polyatomic ion ,cold molecular ions ,n+2 ,General Medicine ,General Chemistry ,State (functional analysis) ,Molecular physics ,Ion ,Physical Concepts ,Chemistry ,Quantum state ,Non destructive ,Molecule ,quantum-logic spectroscopy ,Spectroscopy ,QD1-999 ,precision spectroscopy - Abstract
We review our recent experimental results on the non-destructive quantum-state detection and spectroscopy of single trapped molecules. At the heart of our scheme, a single atomic ion is used to probe the state of a single molecular ion without destroying the molecule or even perturbing its quantum state. This method opens up perspectives for new research directions in precision spectroscopy, for the development of new frequency standards, for tests of fundamental physical concepts and for the precise study of chemical reactions and molecular collisions with full control over the molecular quantum state.
- Published
- 2021
22. Sign language recognition (SLR) system for hearing-impaired people and those with speech disability: a review
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Amit Sinhal and Surbhi Maheshwari
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- 2022
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23. Transcatheter mitral valve-in-valve: treatment of rheumatic heart disease in young patients
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Abbey Knox, Jayme S. Bennetts, Damian Gimpel, Richard F. Newland, Robert A. Baker, Majo X. Joseph, Gregory D. Rice, Nadarajah Kangaharan, and Ajay Sinhal
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Adult ,Male ,Heart Valve Prosthesis Implantation ,Bioprosthesis ,Adolescent ,Rheumatic Heart Disease ,Mitral Valve Insufficiency ,General Medicine ,Prosthesis Design ,Prosthesis Failure ,Treatment Outcome ,Heart Valve Prosthesis ,Humans ,Mitral Valve ,Surgery ,Female - Abstract
Rheumatic heart disease (RHD) in young people presents a complex management problem. In Australia a significant proportion of those affected are Aboriginal and Torres Strait Islanders. Transcatheter mitral valve-in-valve (TMViV) replacement has emerged as an alternative to redo surgery in high-risk patients with degenerated mitral bioprostheses. The aim of this study is to review outcomes of TMViV replacement in young patients with RHD.A single-centre, retrospective review of prospectively collected data on patients undergoing TMViV from December 2017 to June 2021. Primary outcome was major adverse cardiovascular events. Secondary outcome was post-operative trans-thoracic echocardiogram (TTE) results.There were seven patients with a mean age of 33 years and predominantly female (n = 5). Pre-operative comorbidities included diabetes (29%), chronic obstructive pulmonary disease (43%), left ventricular dysfunction (43%) and current smoking status (80%). Post-operative median length of hospital stay was 4 days with no post-operative renal failure, stroke, return to theatre, valve embolization or in hospital mortality. Post-operative TTE showed either nil or trivial central mitral regurgitation, no paravalvular leak and a median gradient of 5 mmHg (IQR 4.5, 7) across the new bioprosthesis; sustained at median follow-up of 22 months.Current literature of TMViV replacement is focused on an older population with concurrent comorbidities. This study provides a unique insight into TMViV replacement in a young cohort of patients with complex social and geographical factors which sometimes prohibits the use of a mechanical valve. The prevalence of RHD remains high for Aboriginal and Torres Strait Islanders, planning for future repeat valve operations should be considered from the outset. We consider TMViV as a part of a staged procedural journey for young patients with RHD.
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- 2022
24. Transcatheter Transseptal Mitral Valve-in-Valve Replacement: An Early Australian Case Series and Literature Review
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Niamh M. Keenan, Andrew D. McGavigan, Majo X. Joseph, Jayme Bennetts, Robert A. Baker, Gregory D. Rice, and Ajay Sinhal
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Reoperation ,Pulmonary and Respiratory Medicine ,Cardiac Catheterization ,medicine.medical_specialty ,Mitral Valve Annuloplasty ,medicine.medical_treatment ,Population ,Ventricular outflow tract obstruction ,030204 cardiovascular system & hematology ,Prosthesis Design ,Prosthesis ,03 medical and health sciences ,0302 clinical medicine ,Valve replacement ,Mitral valve ,medicine ,Humans ,030212 general & internal medicine ,education ,Heart Valve Prosthesis Implantation ,education.field_of_study ,Mitral regurgitation ,business.industry ,Australia ,Mitral Valve Insufficiency ,Surgery ,Cardiac surgery ,medicine.anatomical_structure ,Ventricle ,Heart Valve Prosthesis ,Mitral Valve ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Transcatheter mitral valve implantation for degenerated bioprostheses has recently emerged as an alternative to redo mitral valve surgery, particularly in patients at high risk for reoperative cardiac surgery. We sought to examine our early experience of transcatheter transseptal mitral valve-in-valve procedures. Methods Prospectively collected data was retrospectively reviewed in patients undergoing transcatheter transseptal mitral valve-in-valve implantation using the Edwards Sapien 3 balloon expandable bioprosthesis (Edwards Lifesciences, Irvine, CA, USA). Results Seven (7) patients underwent the procedure between December 2017 and November 2018. Three (3) patients were young Indigenous Australians (age range 33–41years) who were not suitable for mechanical prostheses; four patients were elderly (age range 82–92 years) and considered high risk for reoperative surgery. The median (maximum, minimum) EuroSCORE II of the group was 7.32 (4.81, 19.89). Procedural success was obtained in six of the seven patients; these six patients had no significant complications and had a median hospital stay of 3 days. In one patient, the device displaced towards the left ventricle on inflation, resulting in left ventricular outflow tract obstruction and haemodynamic instability. Urgent redo mitral valve surgery and explantation of the transcatheter prosthesis was undertaken, however, this patient died postoperatively of multi-organ failure. Of the successfully deployed valves, the median (maximum, minimum) gradient across the new mitral prosthesis was 5.5 mmHg (4, 7) and only one patient had mild mitral regurgitation, all others had no or trivial regurgitation. At 30 days, these six patients are well and all are in New York Heart Association (NYHA) Class I. Conclusions Our early experience with transcatheter transseptal mitral valve-in-valve implantation demonstrates this procedure to be feasible in our institution with acceptable early results. Further follow-up is necessary to determine the longevity of valves implanted in this manner, especially in the younger population.
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- 2020
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25. Key Aggregation Cryptosystem and Double Encryption Method for Cloud-Based Intelligent Machine Learning Techniques-Based Health Monitoring Systems
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Khalid K. Almuzaini, Amit Kumar Sinhal, Raju Ranjan, Vikas Goel, Rajeev Shrivastava, and Awal Halifa
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Machine Learning ,General Computer Science ,Article Subject ,Research Design ,General Mathematics ,General Neuroscience ,Intelligence ,Commerce ,Humans ,General Medicine ,Cloud Computing - Abstract
Cloud technology is a business strategy that aims to provide the necessary material to customers depending on their needs. Individuals and cloud businesses alike have embraced the cloud storage service, which has become the most widely used service. The industries outsource their data to cloud storage space to relieve themselves of the load of dealing with redundant data contents. This must be protected to prevent the theft of personal belongings, and privacy must be improved as well. Different research projects have been suggested to ensure the safe management of the information included within the data content. The security of current research projects, on the contrary, still needs improvement. As a result, this method has been suggested to address the security concerns associated with cloud computing. The primary goal of this study effort is to offer a safe environment for cloud users while also increasing the profit of cloud resource providers by managing and securely delivering data contents to the cloud users. The bulk of sectors, including business, finance, military, and healthcare industry, do not store data in cloud-based storage systems. This technique is used to attract these kinds of customers. Increasing public acceptance, medical researchers are drawn to cloud computing because it allows them to store their study material in a centralized location and distribute and access it in a more flexible manner. They were collected from numerous individuals who were being evaluated for medical care at the time. Scalable and enhanced key aggregate cryptosystem is a protected data protection method that provides highly effective security in the healthcare industry. When parties interested in a dispute disagree on the outflow of sensitive information, this technique manages the disputes and ensures the data security deployment of a cloud-based intelligent health monitoring system for the parties involved. The encrypted data structure of medical and healthcare prescriptions is recorded as they move through the hands of patients and healthcare facilities, according to the technique recommended. The double encryption approach is used in order to raise the overall degree of security. An encryption class is created by referring to the Ciphertext ID during the encryption procedure. The keyholder is a master secret key that facilitates in the recovery of the secret keys of various monsters and creatures by acting as a conduit between them. It is transferred and stored as a single aggregate for the benefit of the patient or customer in order to make decryption more convenient and efficient. A safe connection between cloud-based intelligent health monitoring systems and healthcare organizations and their patients may be established via the use of a key aggregation cryptosystem and a double encryption approach, according to the researchers. Because of this, when compared to earlier techniques, the findings reveal that the research methodology provides high levels of security in terms of confidentiality and integrity, in addition to excellent scalability.
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- 2022
26. Molecular-ion quantum technologies
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Sinhal, Mudit and Willitsch, Stefan
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Chemical Physics (physics.chem-ph) ,Quantum Physics ,Atomic Physics (physics.atom-ph) ,Physics - Chemical Physics ,FOS: Physical sciences ,Quantum Physics (quant-ph) ,Physics - Atomic Physics - Abstract
Quantum-logic techniques for state preparation, manipulation, and non-destructive interrogation are increasingly being adopted for experiments on single molecular ions confined in traps. The ability to control molecular ions on the quantum level via a co-trapped atomic ion offers intriguing possibilities for new experiments in the realms of precision spectroscopy, quantum information processing, cold chemistry, and quantum technologies with molecules. The present article gives an overview of the basic experimental methods, recent developments and prospects in this field.
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- 2022
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27. Color Intensity: A Study of RPPG Algorithm for Heart Rate Estimation
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Ruchika Sinhal, Kavita R. Singh, and K. O. Gupta
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- 2021
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28. Effects of delayed versus immediate umbilical cord clamping in reducing death or major disability at 2 years corrected age among very preterm infants (APTS): a multicentre, randomised clinical trial
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Kristy P Robledo, William O Tarnow-Mordi, Ingrid Rieger, Preeti Suresh, Andrew Martin, Carbo Yeung, Alpana Ghadge, Helen G Liley, David Osborn, Jonathan Morris, Wendy Hague, Martin Kluckow, Kei Lui, Roger Soll, Melinda Cruz, Anthony Keech, Adrienne Kirby, John Simes, Himanshu Popat, Shelley Reid, Adrienne Gordon, Koert De Waal, Ian M Wright, Anne Wright, Jane Buchan, Michelle Stubbs, John Newnham, Karen Simmer, Cherry Young, Diane Loh, Yen Kok, Andy Gill, Tobias Strunk, Michele Jeffery, Yan Chen, Scott Morris, Sanjay Sinhal, Kathryn Cornthwaite, Sue P Walker, Andrew M Watkins, Clare L Collins, James R Holberton, Elizabeth J Noble, Arvind Sehgal, Emma Yeomans, Kristy Elsayed, Abdel-Latif Mohamed, Margaret Broom, Guan Koh, Annemarie Lawrence, Glen Gardener, Jane Fox, David W Cartwright, Pieter Koorts, Margo A Pritchard, Lisa McKeown, Anne Lainchbury, Antonia W Shand, Joanna Michalowski, John P Smyth, Srinivas Bolisetty, Alan Adno, Gaksoo Lee, Anna L Seidler, Lisa M Askie, Katie M Groom, Deborah A Eaglen, Ella C Baker, Harshad Patel, Natalie Wilkes, Joanna E Gullam, Nicola Austin, Dianne E Leishman, Phil Weston, Nicola White, Nadia A Cooper, Roland Broadbent, Michael Stitely, Pauline Dawson, Walid El-Naggar, Marlene Furlong, Tara Hatfield, Daniele de Luca, Alexandra Benachi, Emmanuelle Letamendia-Richard, Guillaume Escourrou, Valentina Dell'Orto, David Sweet, Muriel Millar, Shilpa Shah, Lumaan Sheikh, Shabina Ariff, Erin A Morris, Leslie Young, Shannon K Evans, Michael Belfort, Kjersti Aagaard, Mohan Pammi, George Mandy, Manisha Gandhi, Jane Davey, Emma Shenton, Jennifer Middleton, Roslyn Black, Annie Cheng, Jamie Murdoch, Claire Jacobs, Lizzie Meyer, Kathryn Medlin, Heather Woods, Kerry-Ann O'Connor, Caitlin Bice, Katherine Scott, Marie Hayes, Debbie Cruickshank, Mekha Sam, Susan Ireland, Corrine Dickinson, Leith Poulsen, Andreja Fucek, Jo Hegarty, Jenny Rogers, Dorothy Sanchez, Veronique Zupan Simunek, Bakhtawar Hanif, Adrienne Pahl, Jerilyn Metayer, Lelia Duley, Neil Marlow, Deborah Schofield, and Jennifer Bowen
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Male ,Developmental Disabilities ,Infant, Newborn ,Infant ,Child, Preschool ,Infant, Extremely Premature ,Pediatrics, Perinatology and Child Health ,Infant Mortality ,Umbilical Cord Clamping ,Developmental and Educational Psychology ,Humans ,Female ,Infant, Premature ,Follow-Up Studies - Abstract
Very preterm infants are at increased risk of adverse outcomes in early childhood. We assessed whether delayed clamping of the umbilical cord reduces mortality or major disability at 2 years in the APTS Childhood Follow Up Study.In this long-term follow-up analysis of the multicentre, randomised APTS trial in 25 centres in seven countries, infants (30 weeks gestation) were randomly assigned before birth (1:1) to have clinicians aim to delay clamping for 60 s or more or clamp within 10 s of birth, both without cord milking. The primary outcome was death or major disability (cerebral palsy, severe visual loss, deafness requiring a hearing aid or cochlear implants, major language or speech problems, or cognitive delay) at 2 years corrected age, analysed in the intention-to-treat population. This trial is registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12610000633088).Between Oct 21, 2009, and Jan 6, 2017, consent was obtained for follow-up for 1531 infants, of whom 767 were randomly assigned to delayed clamping and 764 to immediate clamping. 384 (25%) of 1531 infants were multiple births, 862 (56%) infants were male, and 505 (33%) were born before 27 weeks gestation. 564 (74%) of 767 infants assigned to delayed clamping and 726 (96%) of 764 infants assigned to immediate clamping received treatment that fully adhered to the protocol. Death or major disability was determined in 1419 (93%) infants and occurred in 204 (29%) of 709 infants who were assigned to delayed clamping versus 240 (34%) of 710 assigned to immediate clamping, (relative risk [RR]) 0·83, 95% CI 0·72-0·95; p=0·010). 60 (8%) of 725 infants in the delayed clamping group and 81 (11%) of 720 infants in the immediate clamping group died by 2 years of age (RR 0·70, 95% CI 0·52-0·95); among those who survived, major disability at 2 years occurred in 23% (144/627) versus 26% (159/603) of infants, respectively (RR 0·88, 0·74-1·04).Clamping the umbilical cord at least 60 s after birth reduced the risk of death or major disability at 2 years by 17%, reflecting a 30% reduction in relative mortality with no difference in major disability.Australian National Health and Medical Research Council.
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- 2021
29. Blind image watermarking with efficient dual restoration feature
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Varun Bajaj, Tarun Kumar Sharma, Rishi Sinhal, and Irshad Ahmad Ansari
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Feature (computer vision) ,Computer science ,business.industry ,Computer vision ,Artificial intelligence ,DUAL (cognitive architecture) ,business ,Digital watermarking ,Image (mathematics) - Published
- 2021
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30. Real-time watermark reconstruction for the identification of source information based on deep neural network
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Rishi Sinhal, Irshad Ahmad Ansari, and Deepak Kumar Jain
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Artificial neural network ,business.industry ,Computer science ,Digital data ,020207 software engineering ,Pattern recognition ,Watermark ,02 engineering and technology ,Computer graphics ,Watermark embedding ,Robustness (computer science) ,0202 electrical engineering, electronic engineering, information engineering ,020201 artificial intelligence & image processing ,The Internet ,Artificial intelligence ,business ,Digital watermarking ,Information Systems - Abstract
A novel deep neural network-based image watermarking method is presented to identify the source of digital data that is shared/forwarded on the internet using various messenger apps. The app that is used to share/communicate the image at the very first time is also identified in the proposed method. The ten-digit mobile number of the source (user) and identification data of particular messenger app (i.e. WhatsApp, Snapchat, Kik, Facebook messenger, etc.) is combined to get the text watermark signal. The part of the watermark signal representing specific mobile-based messenger application is obtained by randomizing the Walsh orthogonal codes using secret keys. To embed the watermark, the host image (shared/forwarded) is divided into blocks of equal size and then, slantlet transform is applied on each block. To get high reliability, three copies of the source information (user and app) are embedded during watermark embedding. Watermark extraction is performed using trained multilayer deep neural network. Furthermore, an optimal block selection logic is used to get improved results for real-time applications. The method is examined against various signal-processing attacks and high robustness with significant imperceptibility is attained. The method is also found to be fast enough for real-time applications. The prime objective of identifying the first user (source) and the shared/forwarded status (app detection) is successfully accomplished.
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- 2019
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31. A multipurpose image watermarking scheme for digital image protection
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Irshad Ahmad Ansari and Rishi Sinhal
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Signal processing ,Cover (telecommunications) ,Computer science ,business.industry ,Strategy and Management ,ComputingMilieux_LEGALASPECTSOFCOMPUTING ,020207 software engineering ,Watermark ,02 engineering and technology ,Digital image ,Least significant bit ,Robustness (computer science) ,0202 electrical engineering, electronic engineering, information engineering ,020201 artificial intelligence & image processing ,Computer vision ,Artificial intelligence ,Time domain ,Safety, Risk, Reliability and Quality ,business ,Digital watermarking - Abstract
A multipurpose digital image watermarking scheme is proposed based on the multiple LSB bit substitution method. Fragile and robust watermarks are embedded into the host image for tamper and ownership detection respectively. Randomized insertion is used to insert a fragile watermark pattern to get better tamper detection. Secret keys are used in this scheme to secure data from forged/unauthorized access, which must be known to the end user to extract the watermark from the host. Tampering is done at random locations to cover most of the watermarked image’s area during testing of proposed scheme. Due to blind nature and randomized watermark insertion, high security is obtained. Experimental outcomes represent that the proposed method is able to achieve significant tamper detection. Proposed scheme exhibits robust nature towards common signal processing attacks and provides distortion-less robust watermark in case of no attack. This method also exhibits less execution time due to its time domain insertion methodology. A comparative analysis with the existing schemes shows that the proposed scheme has many features simultaneously such as blind extraction, high embedding capacity, low execution time, significant robustness, acceptable imperceptibility, and multipurpose nature. The proposed scheme can be utilized in fields where rapid response, ownership protection, and tamper detection are prime concerns.
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- 2019
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32. Heart Rate Measurement Based on Color Signal Extraction
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Ruchika Sinhal, Mukesh Raghuwanshi, and Kavita Singh
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General Computer Science ,Mechanics of Materials ,Electrical and Electronic Engineering ,Civil and Structural Engineering - Abstract
Photoplethysmography measures vital signs through to extraction of signals from the body. The paper explains the technique for extraction of pulse rate from the videos for three color channels namely; red, green and blue. The DMIMS database is used for experimentation which consists of total 720 videos out of which 25 videos are used for analysis. The results presented in this paper depict that our algorithm works best for blue channel followed by green and then red channel. The main focus of paper is to extract pulse rate from the recorded video and compare the output for different channels and find the best channel for heart rate extraction.
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- 2019
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33. Initial Feasibility Study of a New Transcatheter Mitral Prosthesis
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Gaetano Paone, Lowell F. Satler, Philipp Blanke, Thomas Modine, Darren L. Walters, David G. Rizik, Jeffrey J. Popma, Richard Bae, Neil Moat, Vinay Badhwar, Gry Dahle, Samir R. Kapadia, Vinod H. Thourani, Michael L Chuang, Jonathon Leipsic, Paul A. Grayburn, Paolo Denti, Vasilis C. Babaliaros, Paul Sorajja, Mubashir Mumtaz, David W.M. Muller, Brian Bethea, Francesco Bedogni, Mayra Guerrero, Nicolas Dumonteil, and Ajay Sinhal
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medicine.medical_specialty ,Mitral regurgitation ,Ejection fraction ,business.industry ,medicine.medical_treatment ,Mitral valve replacement ,medicine.disease ,Prosthesis ,Surgery ,Heart failure ,Cohort ,Risk of mortality ,Medicine ,Cardiology and Cardiovascular Medicine ,business ,Stroke - Abstract
Background Transcatheter mitral valve replacement (TMVR) is a rapidly evolving therapy. Follow-up of TMVR patients remains limited in duration and number treated. Objectives The purpose of this study was to examine outcomes with expanded follow-up for the first 100 patients who underwent TMVR with the prosthesis. Methods The Global Feasibility Study enrolled symptomatic patients with either primary or secondary mitral regurgitation (MR) who were at high or prohibitive surgical risk. The present investigation examines the first 100 patients treated in this study. Clinical outcomes through last clinical follow-up were adjudicated independently. Results In the cohort (mean age 75.4 ± 8.1 years; 69% men), there was a high prevalence of severe heart failure symptoms (66%), left ventricular dysfunction (mean ejection fraction 46.4 ± 9.6%), and morbidities (Society of Thoracic Surgeons Predicted Risk of Mortality, 7.8 ± 5.7%). There were no intraprocedural deaths, 1 instance of major apical bleeding, and no acute conversion to surgery or need for cardiopulmonary bypass. Technical success was 96%. The 30-day rates of mortality and stroke were 6% and 2%, respectively. The 1-year survival free of all-cause mortality was 72.4% (95% confidence interval: 62.1% to 80.4%), with 84.6% of deaths due to cardiac causes. Among survivors at 1 year, 88.5% were New York Heart Association function class I/II, and improvements in 6-min walk distance (p Conclusions In this study of TMVR, which is the largest experience to date, the prosthesis was highly effective in relieving MR and improving symptoms, with an acceptable safety profile. Further study to optimize the impact on long-term survival is needed.
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- 2019
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34. Unplanned Removal of a Patent Foramen Ovale Closure Device During Retrieval of an Inferior Vena Cava Filter
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Ajay Sinhal and Marc Agzarian
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medicine.medical_specialty ,stomatognathic system ,business.industry ,cardiovascular system ,Closure (topology) ,Patent foramen ovale ,Medicine ,Inferior vena cava filter ,cardiovascular diseases ,business ,medicine.disease ,Surgery - Abstract
This brief communication reports what appears to be the first case of an interaction between an inferior vena cava filter and a patent foramen ovale closure device. During removal of the inferior vena cava filter, the patent foramen ovale closure device was unintentionally removed. This case report serves to highlight the possible interaction of these two devices.
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- 2021
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35. Case report describing balloon dilatation as a treatment for acute intraprosthetic regurgitation immediately following implantation of a SAPIEN‐3 transcatheter aortic valve
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Ajay Sinhal, Nikhil Pal, and Derek P. Chew
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Medicine (General) ,medicine.medical_specialty ,Transcatheter aortic ,business.industry ,aortic stenosis ,General Medicine ,Regurgitation (circulation) ,Balloon dilatation ,Surgery ,TAVI ,R5-920 ,valvular leak ,medicine ,case report ,Medicine ,business ,balloon dilatation of aortic valve - Abstract
Acute intraprosthetic regurgitation is a rare but potentially devastating complication following the transcatheter aortic valve implantation; here, balloon dilatation could provide a potential treatment option for these patients.
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- 2021
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36. Diagnostic and Therapeutic Approach in ANOCA Patients: Insights From the CADOSA Registry
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S. La, R. Tavella, J. Wu, M. Arstall, A. Sinhal, M. Worthley, C. Zeitz, and J. Beltrame
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Pulmonary and Respiratory Medicine ,Cardiology and Cardiovascular Medicine - Published
- 2022
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37. ANOCA: An Under-Recognised and Undertreated Disorder. Insights From the CADOSA Registry
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S. La, R. Tavella, J. Wu, M. Arstall, A. Sinhal, M. Worthley, C. Zeitz, and J. Beltrame
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Pulmonary and Respiratory Medicine ,Cardiology and Cardiovascular Medicine - Published
- 2022
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38. Predictors of Obstructive Sleep Apnoea (OSA) Population in the Coronary Angiogram Database of South Australia (CADOSA)
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Sharmalar Rajendran, Eng Lee Ooi, John F. Beltrame, Matthew I. Worthley, Rosanna Tavella, Christopher Zeitz, Tracy Air, Gnanadevan Mahadavan, Ajay Sinhal, and Margaret Arstall
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Male ,Population ,MEDLINE ,Coronary Artery Disease ,Disease ,030204 cardiovascular system & hematology ,Coronary angiogram ,Coronary Angiography ,computer.software_genre ,Chest pain ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,South Australia ,Prevalence ,Humans ,Medicine ,In patient ,Angina, Stable ,030212 general & internal medicine ,Risk factor ,education ,Male gender ,Sleep Apnea, Obstructive ,education.field_of_study ,Database ,business.industry ,Australia ,General Medicine ,respiratory tract diseases ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,computer - Abstract
Obstructive sleep apnoea (OSA) is increasingly recognized to be a risk factor for cardiovascular disease. This study assessed the prevalence and clinical predictors of OSA in patients undergoing coronary angiography. Consecutive patients undergoing coronary angiography in South Australian public hospitals from 2015 to 2018 were included. Clinical details for consecutive patients undergoing coronary angiography in South Australian public hospitals were captured by the Coronary Angiogram Database of South Australia (CADOSA) registry staff, with OSA identified by patient report. Among the 9,885 patients undergoing coronary angiography for the investigation of chest pain, 11% (n = 1,089) were documented as having OSA. Independent clinical predictors of OSA included male gender (OR 2.22, 1.86-2.65, P0.001), diabetes mellitus (OR 1.84, 1.58-2.14, P0.001), depression (OR 1.81, 1.55-2.12, P0.001), prior heart failure (OR 1.63, 1.22-2.18, P = 0.001), hypertension (OR 1.61, 1.32-1.95, P ≤ 0.001), asthma (OR 1.61, 1.34-1.93, P0.001), not a current smoker (OR 1.60, 1.30-1.96, P0.001), dyslipidaemia (OR 1.46, 1.22-1.76, P0.001), non-acute coronary syndrome presentation (OR 1.45, 1.25-1.69, P0.001), chronic lung disease (OR 1.40, 1.12-1.73, P = 0.003), cerebrovascular disease (OR 1.36, 1.07-1.73, P = 0.012), non-obstructive coronary artery disease (NOCAD) (OR 1.30, 1.10-1.55, P = 0.003) and atrial fibrillation/flutter (OR 1.30, 1.06-1.60, P = 0.012). Finally, stable angina (32.1% vs 22.7%) and NOCAD (29.1% vs 26.3%, P = 0.051) were trended more common in patients with OSA versus no OSA. In addition to established risk factors for OSA, this study found NOCAD to be independent predictor of OSA; especially in those presenting with a stable angina presentation. This suggests that coronary vasomotor disorders may be associated with OSA, although further detailed studies are required.
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- 2022
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39. Managing asymptomatic severe rheumatic mitral stenosis in pregnancy: a case report
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Edwina Wing-Lun, Ajay Sinhal, Joanne Eng-Frost, and Marcus Ilton
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Balloon valvuloplasty ,medicine.medical_specialty ,Heart disease ,Heart failure ,030204 cardiovascular system & hematology ,Asymptomatic ,Pulmonary hypertension ,03 medical and health sciences ,0302 clinical medicine ,Mitral valve stenosis ,Pregnancy ,Mitral valve ,Internal medicine ,Case report ,medicine ,AcademicSubjects/MED00200 ,030212 general & internal medicine ,Rheumatic heart disease ,Mitral stenosis ,business.industry ,Atrial fibrillation ,medicine.disease ,medicine.anatomical_structure ,Cardiology ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Postpartum period - Abstract
Background Rheumatic heart disease (RHD) is a disease of disparity most prevalent in developing countries and among immigrant populations. Mitral stenosis (MS) is a common sequalae of RHD and affects females disproportionately more than males. Rheumatic MS remains a significant management challenge as severe MS is usually poorly tolerated in pregnancy due to haemodynamic changes and increased cardiovascular demands of progressing pregnancy. Pregnancy remains contraindicated in current management guidelines based on expert consensus, due to a paucity of evidence-based literature. Case summary A 28-year-old aboriginal woman with known severe MS was found to be pregnant during routine health review, despite contraceptive efforts. Echocardiography demonstrated mean mitral valve (MV) gradient 14 mmHg; stress echocardiography demonstrated increased MV gradient 28–32 mmHg at peak exercise and post-exercise pulmonary artery pressure 56 + 3 mmHg with marked dynamic D-shaped septal flattening. Left ventricular systolic function remained preserved. She remained remarkably asymptomatic and underwent successful elective induction of labour at 34 weeks. Postpartum, she remained euvolaemic despite worsening MV gradients and new atrial fibrillation (AF). She subsequently underwent balloon mitral valvuloplasty with good result. Discussion Severe rheumatic MS in pregnancy carries significant morbidity and mortality, due to an already fragile predisposition towards heart failure development compounded by altered haemodynamics. Pregnancy avoidance and valvular intervention prior to conception or in the second trimester remain the mainstay of MS management; however, we present an encouraging case of successful near-term pregnancy with minimal complications in a medically managed asymptomatic patient with critical MS, who subsequently underwent valvular intervention post-partum.
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- 2021
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40. Impact of increased augmentation index and valvuloarterial impedance on symptom recovery after aortic valve replacement for severe aortic stenosis
- Author
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Carmine G. De Pasquale, Majo X. Joseph, Ajay Sinhal, Derek P. Chew, Sam J. Lehman, Jayme Bennetts, A. E. Russell, D. Jones, Robert A. Baker, Matthew Horsfall, and Joseph B. Selvanayagam
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Aortic valve ,medicine.medical_specialty ,lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_treatment ,Population ,030204 cardiovascular system & hematology ,TAVR ,Valvuloarterial impedance ,03 medical and health sciences ,0302 clinical medicine ,Afterload ,Valve replacement ,Aortic valve replacement ,Internal medicine ,medicine ,030212 general & internal medicine ,education ,education.field_of_study ,Original Paper ,business.industry ,Aortic stenosis ,Augmentation index ,medicine.disease ,Stenosis ,medicine.anatomical_structure ,Quartile ,lcsh:RC666-701 ,Symptoms ,Arterial stiffness ,Cardiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Aortic stenosis (AS) is a common valvular disorder with a large symptomatic burden resulting from increased myocardial workload due to valvular obstruction. The contribution of increased afterload from arterial stiffness on symptoms is uncertain. The purpose of this analysis was to determine the symptomatic impact of arterial stiffness as determined by Applanation Tonometry. Methods Eighty-eight patients with severe AS undergoing intervention with transcatheter aortic valve replacement (TAVR) (n = 65) or surgical aortic valve replacement (SAVR) (n = 23) were prospectively enrolled. Symptoms were recorded using the NYHA Class, Kansas City Cardiomyopathy Questionnaire (KCCQ) and a 6 min walk test (6MWT) at baseline, and 1- and 6-months post intervention. Pulse Wave Analysis (PWA) using Applanation Tonometry was performed at all reviews, including the augmentation index (AIx). Results Patients undergoing TAVR were older, with worse renal function and lower aortic valve areas, but were otherwise similar. There was no significant difference between the augmentation index of our AS population compared with an age matched reference population (p = 0.89). Symptoms significantly improved after intervention according to NYHA Class, KCCQ and 6MWT. Additionally, with adjustment, the initial augmentation index correlated with the final KCCQ (Coeff. = −0.383, p = 0.02) and NYHA Class (Coeff. = 0.012, p = 0.03) and a baseline AIx value in the top quartile resulted in a significantly worse final KCCQ (95.1 v 85.2, p = 0.048) relative to the bottom 3 quartiles. Conclusions According to our analysis, an elevated baseline AIx is associated with a poorer symptomatic recovery after aortic valve intervention and so is worthy of consideration when assessing potential symptomatic benefit.
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- 2021
41. Call for Paper Springer International Conference on Sustainable Computing and Intelligent Systems Tracks: Intelligent Systems Robotics Computing and Modelling Computing for Sustainability
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Dr. Amit Sinhal
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- 2021
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42. SI-traceable frequency dissemination at 1572.06 nm in a stabilized fiber network with ring topology
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Frédéric Merkt, Gloria Clausen, Jacques Morel, Hansjürg Schmutz, Giacomo Scalari, Ziv Meir, Laurent-Guy Bernier, Mudit Sinhal, Anatoly Johnson, Stefan Willitsch, Dominik Husmann, Davide Calonico, Konstantinos Chaloulos, Mathieu Bertrand, Fabian Mauchle, U. Hollenstein, Alberto Mura, Ernst Heiri, Jérôme Faist, Cecilia Clivati, and Simon Scheidegger
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Time delay and integration ,Physics - Instrumentation and Detectors ,Optical fiber ,business.industry ,Computer science ,FOS: Physical sciences ,Ring network ,Instrumentation and Detectors (physics.ins-det) ,Laser ,01 natural sciences ,Atomic and Molecular Physics, and Optics ,law.invention ,Metrology ,010309 optics ,Optics ,law ,0103 physical sciences ,Phase noise ,Electronic engineering ,Satellite ,010306 general physics ,business ,Remote laboratory ,Physics - Optics ,Optics (physics.optics) - Abstract
Frequency dissemination in phase-stabilized optical fiber networks for metrological frequency comparisons and precision measurements are promising candidates to overcome the limitations imposed by satellite techniques. However, in an architecture shared with telecommunication data traffic, network constraints restrict the availability of dedicated channels in the commonly-used C-band. Here, we demonstrate the dissemination of an SI-traceable ultrastable optical frequency in the L-band over a 456 km fiber network with ring topology, in which data traffic occupies the full C-band. We characterize the optical phase noise and evaluate a link instability of 4.7 × 10-16 at 1 s and 3.8 × 10-19 at 2000 s integration time, and a link accuracy of 2 × 10-18. We demonstrate the application of the disseminated frequency by establishing the SI-traceability of a laser in a remote laboratory. Finally, we show that our metrological frequency does not interfere with data traffic in the telecommunication channels. Our approach combines an unconventional spectral choice in the telecommunication L-band with established frequency-stabilization techniques, providing a novel, cost-effective solution for ultrastable frequency-comparison and dissemination, and may contribute to a foundation of a world-wide metrological network., Optics Express, 29 (16), ISSN:1094-4087
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- 2021
43. Quantum Control of Single Molecular Ions
- Author
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Sinhal, Mudit, Willitsch, Stefan, Treutlein, Philipp, and Koelemeij, Jeroen
- Subjects
Physics::Atomic Physics - Abstract
Trapped atoms and ions are among the best-controlled quantum systems which find widespread applications in quantum sciences. For molecules, a similar degree of control is currently lacking owing to their complex energy-level structure. Quantum-logic protocols in which atomic ions serve as probes for molecular ions are a promising route for achieving this level of control, especially for homonuclear species that decouple from blackbody radiation. In this thesis, we report experimental progress in the quantum state control of single trapped N2+ molecules. N2+ is a homonuclear diatomic molecule with no permanent dipole moment. Thus all rotational-vibrational (rovibrational) transitions are rendered dipole- forbidden in its electronic ground state. Therefore, N2+ is an ideal test bed for precision spectroscopic studies, for tests of fundamental physics, for the realization of mid-IR frequency standards and clocks, and for implementation of molecular qubits for quantum information and computation applications. Here, a single N2+ ion is produced selectively in the ground rovibronic state and trapped in a radiofrequency ion trap together with one Ca+ ion. In a first step, the Ca+ ion is used to cool the N2+ to the ground state of the trapping potential. A quantum-nondemolition protocol is then implemented on the Ca+ – N2+ two-ion string in order to detect the rotational state of the N2+ ion. The protocol maps the internal state of the N2+ ion onto the external motion which is then detected by the Ca+ ion. The employed state-detection scheme is non-invasive and does not destroy the molecule or the molecular state. The spin-rovibronic state of the molecule is detected with fidelities exceeding 99%. Furthermore, as an application of the state-detection scheme, the transition frequency and the vibronic Einstein-A coefficient of an electric-dipole transition of the molecular ion is measured. In an effort to develop a complete and conscientious understanding of the mechanism exploited in the rovibronic-state detection of the molecule, this thesis theoretically investigates electric-dipole transitions between molecular states best described by different Hund’s coupling cases. The Hamiltonians for specific states are presented and subtle effects due to the molecular-hyperfine structure and mixing of rotational states are discussed. This thesis also discusses our setup of a system of narrow linewidth lasers for coherent manipulations of the atomic and the molecular ions. For the Ca+ ion, a cavity stabilized, 729 nm, ECDL is first stabilized to a high finesse cavity for linewidth narrowing and im- proved short term stability. In order to detect and compensate the long term drifts of the cavity, the 729 nm laser frequency is then compared to an UTC-referenced ultrastable laser at 1572 nm via an optical frequency comb. A stability of ~ 1×10−13 is demonstrated in 1 s. For experiments on the N2+ ion, a mid-IR quantum-cascade laser at 4574 nm is stabilized to the optical frequency comb. A sum-frequency generation process, with the cavity stabilized 729 nm laser, is employed in order to bridge the gap between the mid-IR laser and the near-IR comb. A tight lock with a signal-to-noise ratio of ~ 30 dB is demonstrated. The experimental and theoretical developments in this thesis lay the foundations for new approaches to precision spectroscopy and coherent control experiments on molecules.
- Published
- 2021
44. Development of Android Chat Application to Verify First Sender of the Image
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Rishi Sinhal, Megha Moondra, and Irshad Ahmad Ansari
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Development (topology) ,End-to-end encryption ,Multimedia ,Hadamard code ,Computer science ,Social media ,Communication source ,Android (operating system) ,computer.software_genre ,Digital watermarking ,computer ,Image (mathematics) - Abstract
Nowadays, people are shifting from web-based applications to android-based applications to connect people socially. It is important to identify ownership of the messages in android-based applications. Generally, the android-based social media apps (e.g., WhatsApp, etc.) provide end to end encryption to provide security. Therefore, one can never know about the origin of the forwarded information effortlessly. To know the source user, the tracking of each user who forwarded the data is required by the authorized people. But in the presented work, it is possible to know the source/origin of the information without keeping the track record of the people forwarded that data (i.e., image). It saves time and memory. In this proposed work, an image watermarking approach is implemented on the android platform to identify users and apps. The user is identified using the mobile number which is authenticated using OTP verification by Google firebase. The android-based applications (e.g., WhatsApp, etc.) is identified by using orthogonal Walsh codes as application-specific watermarks. Two different approaches are used for watermarking for performance evaluation and experimental results prove the significance of the proposed work.
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- 2021
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45. Troponin elevation pattern and subsequent cardiac and non-cardiac outcomes: Implementing the Fourth Universal Definition of Myocardial Infarction and high-sensitivity troponin at a population level
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Ajay Sinhal, Nathaniel R. Smilowitz, Matthew Horsfall, J. Vaile, Derek P. Chew, D. Jones, Martin Than, Sam J. Lehman, Anthony Chuang, Kristina Lambrakis, Mau T Nguyen, Ehsan Khan, and John K. French
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Male ,Population level ,Myocardial Infarction ,Cardiovascular Medicine ,Vascular Medicine ,Biochemistry ,Coronary artery disease ,Medical Conditions ,Risk Factors ,Medicine and Health Sciences ,Cardiac Arrest ,Coronary Heart Disease ,Myocardial infarction ,Aged, 80 and over ,Multidisciplinary ,biology ,Middle Aged ,Troponin ,Survival Rate ,Cardiovascular Diseases ,High sensitivity troponin ,Cardiology ,Medicine ,Female ,Diagnosis code ,Arrhythmia ,Research Article ,Adult ,Acute coronary syndrome ,medicine.medical_specialty ,Science ,Disease-Free Survival ,Troponin T ,Diagnostic Medicine ,Internal medicine ,medicine ,Humans ,cardiovascular diseases ,Acute Coronary Syndrome ,Aged ,Heart Failure ,business.industry ,Biology and Life Sciences ,Proteins ,Arrhythmias, Cardiac ,Cardiovascular Disease Risk ,medicine.disease ,Cytoskeletal Proteins ,Heart failure ,Chronic Disease ,biology.protein ,business ,Follow-Up Studies - Abstract
Background The Fourth Universal Definition of Myocardial Infarction (MI) differentiates MI from myocardial injury. We characterised the temporal course of cardiac and non-cardiac outcomes associated with MI, acute and chronic myocardial injury. Methods We included all patients presenting to public emergency departments in South Australia between June 2011–Sept 2019. Episodes of care (EOCs) were classified into 5 groups based on high-sensitivity troponin-T (hs-cTnT) and diagnostic codes: 1) Acute MI [rise/fall in hs-cTnT and primary diagnosis of acute coronary syndrome], 2) Acute myocardial injury with coronary artery disease (CAD) [rise/fall in hs-cTnT and diagnosis of CAD], 3) Acute myocardial injury without CAD [rise/fall in hs-cTnT without diagnosis of CAD], 4) Chronic myocardial injury [elevated hs-cTnT without rise/fall], and 5) No myocardial injury. Multivariable flexible parametric models were used to characterize the temporal hazard of death, MI, heart failure (HF), and ventricular arrhythmia. Results 372,310 EOCs (218,878 individuals) were included: acute MI (19,052 [5.12%]), acute myocardial injury with CAD (6,928 [1.86%]), acute myocardial injury without CAD (32,231 [8.66%]), chronic myocardial injury (55,056 [14.79%]), and no myocardial injury (259,043 [69.58%]). We observed an early hazard of MI and HF after acute MI and acute myocardial injury with CAD. In contrast, subsequent MI risk was lower and more constant in patients with acute injury without CAD or chronic injury. All patterns of myocardial injury were associated with significantly higher risk of all-cause mortality and ventricular arrhythmia. Conclusions Different patterns of myocardial injury were associated with divergent profiles of subsequent cardiac and non-cardiac risk. The therapeutic approach and modifiability of such excess risks require further research.
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- 2021
46. A Review on Cybersecurity of Internet of Things
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Abhinav Jaishanker, M. Rajeshkumar, S. Balaji, Sarthak Gokhale, and Sakshi Sinhal
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Smart meter ,business.industry ,Home automation ,Big data ,Cyber-physical system ,Confidentiality ,The Internet ,Business ,Data breach ,Computer security ,computer.software_genre ,computer ,Authentication (law) - Abstract
Internet of things (IOT) is the fastest growing technology in today’s world and has changed the world completely. It has become an integral part of our lives and from smart home to smart cities everything is connected to the internet which has reduced the human effort and made our lives easier. As it is all about the internet, so with it comes some repercussion which are the cyber threats. These threats need to be dealt with in a proper and a phased manner so that it won’t lead to any device failure or data breaches. As there have been a lot of attacks in the past so the issue of cybersecurity in IOT is of huge importance and needs to get much more attention. This paper discusses about the ways in which the important sectors like smart cities, healthcare and industries, apply IOT on day-to-day basis and the different ways in which these sectors deal with the cybersecurity issues. This paper deeply analyses the various kinds of cyber threats as well as the consequences the system has to face because of these attacks and what preventive measures can be taken to avoid the attacks.
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- 2021
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47. Color Intensity: A Study of RPPG Algorithm for Heart Rate Estimation
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Ruchika Sinhal, T-Mobile, Reston, Virginia, Usa., Kavita R. Singh, Ravi Wasalwar, and Gupta Dr. K. O
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Estimation ,business.industry ,Heart rate ,General Engineering ,Color intensity ,Pattern recognition ,Artificial intelligence ,business ,Mathematics - Abstract
With the growing advancements and development in the field of digital image processing and computer vision, an individual’s heart pulse can be extracted from the human skin surfaces. This method is termed as remote photoplethysmography (rPPG). The method can be applied from the video recorded from the consumer-based mobile camera also. In this paper, the work presented has mainly twofold goals. Firstly to develop a fruitful yet simple rPPG algorithm that should be simple for any individual to understand and implement that will increase the understanding of the rPPG subject. Secondly, to compare the algorithm designed for the RGB color model with the state-of-art rPPG algorithms developed and presented in the literature. And finally, we present the comparative analysis of rPPG algorithms reported in the literature with our proposed rPPG algorithm which is simple and has demonstrated comparably high performance for the green channel as compared to other algorithms.
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- 2020
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48. Surgical and percutaneous management of Aboriginal Australians with rheumatic heart disease: Timeliness and concordance between practice and guidelines
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Nadarajah Kangaharan, Libby Culgan, Ross L. Roberts-Thomson, Marcus Ilton, Alex Kaethner, Jayme Bennetts, Ajay Sinhal, H. Tayeb, Derek P. Chew, Angus A.W. Baumann, Peter J. Psaltis, Stephen J. Nicholls, Julie Reade, and Alex Brown
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Adult ,Male ,medicine.medical_specialty ,Percutaneous ,Native Hawaiian or Other Pacific Islander ,Referral ,Heart disease ,Concordance ,Psychological intervention ,Heart Valve Diseases ,030204 cardiovascular system & hematology ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Internal medicine ,Mitral valve ,medicine ,Humans ,030212 general & internal medicine ,business.industry ,Australia ,Rheumatic Heart Disease ,Atrial fibrillation ,Guideline ,Middle Aged ,medicine.disease ,medicine.anatomical_structure ,Mitral Valve ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Rheumatic heart disease (RHD) affects over 40 million people globally who are predominantly young and from impoverished communities. The barriers to valvular intervention are complex and contribute to the high morbidity and mortality associated with RHD. The rates of guideline indicated intervention in patients with significant RHD have not yet been reported. Methods From 2007 to 2017, we used the Australian Northern Territory Cardiac Database to identify patients with RHD who fulfilled at least one ESC/EACTS guideline indication for mitral valve intervention. Baseline clinical status, comorbidities, echocardiographic parameters, indication for intervention, referral and any interventions were recorded. Results 154 patients (mean age 38.5 ± 14.6, 66.1% female) were identified as having a class I or IIa indication for invasive management. Symptoms, atrial fibrillation and pulmonary hypertension were the most common indications for surgery (74.5%, 48.1%, 40.9%). From the onset of a guideline indication the actuarial rates of accepted referral and intervention within two-years were 66.0% ± 4.0% and 53.1% ± 4.4% respectively. Of those who were referred and accepted for intervention, 86% received it within 2 years. The rates of accepted referral for patients with class I indications were 72.5% ± 4.2% while class IIa indications were 42.5% ± 9.0% (p Conclusions Approximately half of Aboriginal patients with significant rheumatic mitral valve disease who met ESC/EACTS guideline indications for intervention received surgery or valvuloplasty within two-years. A significant difference in referral rates was found between Class I and Class IIa indications for valvular intervention.
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- 2020
49. Understanding the Role of Artificial Neural Networks in the Prediction of Mental Health Diseases
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Suchita Sinhal and Ruchi Nanda
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Helping hand ,Artificial neural network ,Computer science ,business.industry ,media_common.quotation_subject ,Context (language use) ,Disease ,Mental health ,Patient safety ,Risk analysis (engineering) ,Health care ,Quality (business) ,business ,media_common - Abstract
The healthcare organizations and life sciences are increasingly leveraging machine learning techniques such as Artificial Neural Networks (ANN) due to their potentiality. A considerable issue being faced by the healthcare organizations is to provide quality services at costs that can be easily afforded. Throughout the entire course of health care, many patients develop serious problems that can lead to severe discomfort, expensive treatment, disabilities and more. Early prediction of disease is one of the most important requirements in medical field. It allows the healthcare professionals to undertake preventive measures thereby lending a helping hand in improving patient safety, quality of care as well as reducing the medical costs too. Many prognostic methods focus on ANN to provide new and deep insights into the patient’s health condition. This paper provides the description of working and learning of predictive machine learning technique ANN, for solving many real-world decision modelling problems in context to health care. It throws light on the factors responsible for different mental diseases which are then perceived and mathematically modelled.
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- 2020
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50. Impact of Young Age and Gender on Outcomes of Transradial Versus Transfemoral Access Coronary Angiography
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Margaret Arstall, Matthew I. Worthley, John F. Beltrame, Tracy Air, Christopher Zeitz, Kuljit Singh, Ajay Sinhal, and Rosanna Tavella
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Coronary angiography ,Male ,medicine.medical_specialty ,Cardiac Catheterization ,Databases, Factual ,Hemorrhage ,Punctures ,030204 cardiovascular system & hematology ,Logistic regression ,Lower risk ,Coronary Angiography ,Risk Assessment ,03 medical and health sciences ,0302 clinical medicine ,Sex Factors ,Risk Factors ,Internal medicine ,Catheterization, Peripheral ,South Australia ,Medicine ,Humans ,030212 general & internal medicine ,Registries ,reproductive and urinary physiology ,Differential impact ,Aged ,business.industry ,Age Factors ,Odds ratio ,Middle Aged ,Femoral Artery ,Young age ,embryonic structures ,Cohort ,Radial Artery ,Observational study ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
The differential impact of young age and female gender on transradial access (TRA) outcomes remains to be confirmed. The primary objective was to assess the impact of young age and female gender on in-hospital net adverse cardiovascular events (NACE). Among 12 346 patients from the Coronary Angiogram Database of South Australia (CADOSA) Registry, the impact of gender; men (transfemoral access [TFA] 1995, TRA 6168) and women (TFA 1249, TRA 2934), and a median split of age, ≤63 years (TFA 1617, TRA 4727) and >63 years (TFA 1627, TRA 4375) were analyzed on in-hospital outcomes by creating 5 separate propensity-matched cohorts (entire cohort, men, women, ≤63 and > 63 years). Net adverse cardiovascular event reduction with TRA was limited to the >63 years old cohort (odds ratio [OR] = 0.56, 95% CI: 0.34-0.93, P = .02) and women (OR = 0.37, 95% CI: 0.18-0.76, P = .007). In both the age groups and genders, TRA was associated with a lower risk of bleeding and all-cause mortality. On multivariate logistic regression, TRA was associated with a significant reduction in NACE, major bleeding, and mortality in the overall cohort. In conclusion, a reduction in bleeding and mortality was noted with TRA in all the subgroups in this observational study.
- Published
- 2020
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