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Cotton detection is the localization and identification of the cotton in an image. It has a wide application in robot harvesting. Various modern algorithms use deep learning techniques for detection of fruits/flowers. As per the survey, the topics travelled include numerous algorithms used, and accuracy obtained on using those algorithms on their data set. The limitations and the advantages in each paper, are also discussed. This paper focuses on various fruit detection algorithms- the Faster RCNN, the RCNN, YOLO. Ultimately, a rigorous survey of many papers related to the detection of objects like fruits/flowers, analysis of the assets and faintness of each paper leads us to understanding the techniques and purpose of algorithms.

In several fields of application, data science plays an important role. Fraud discovery has historically been a repetitive manual. Popular approaches to discover and deter fraud are analysis and computer assistance. Computers can use very simple means in the alert, for example, to flag all statements exceeding a previously defined threshold. The obvious intention is to prevent major losses by concentrating on the larger claims. Financial fraud is rapidly advanced and strategies for combating such attacks must also develop. Big data also created a new insight in terms of fraud detection and prevention strategies such as behavioural analysis and real-time detection. Even though technology made consumer banking much more convenient, new avenues for fraud have been developed. Financial fraud figures show that the annual losses of institutions and customers are millions of dollars in account fraud, credit card fraud, insurance fraud, fraud and other criminal activities. In this work we concentrate on Big data is the use for the collection of very broad sets of knowledge of advanced techniques and technologies. These data sets are often so broad and complex that using on-line database management software is difficult to process.

Biomechanical investigation is a multidisciplinary branch which joins biological-science and the mechanical engineering in order to understand the behaviour of organic materials. A finite element examination is comprehensively used to depict the mechanical conduct of the bones. Femur bone is perhaps the strongest and longest bone in the entire human body that is situated in thigh region and furthermore it is most prone to break during mishaps because of static loads or impact loads. In the current examination the finite element model is created by utilizing MRI information and modelling software to analyse the location of maximum stress in bone for different conditions using finite element analysing software to select the alternative composite material for Human Femur bone.

Landing gear is the most valued element in an airplane framework and it was also noted from a survey that an airplane structure failure occurs because of fracture in its landing gear. In the present study, a prototype of a classic nose landing gear of a Boeing 737 is created in a 3-D modelling tool, and is considered for analysis using an analysing software, the materials selected for landing gear are Aluminium 7075, Titanium 6Al-4 V, and Alloy Steel 4340. The design load is calculated by keeping Factor of Safety constant for all three materials, while comparing the results from analysis performed, the maximum weight is considered for load on landing gear, and then it is analysed for Stress, Deformation, and Fatigue analysis is performed to find failure point in the landing gear.

Public Key Cryptosystem (PKC) completely relies under the assumption that user’s private key is absolutely secure. Exposure of private key may lead to disastrous situations in the communication network. To diminish the damage of private key exposure in PKC, key-insulation mechanism was introduced. In key-insulated cryptosystems, a user can update his private key with the help of a physically secure device from time to time. Identity-based cryptosystem alleviates the heavy certificate management problems in traditional PKC. Recently, many Identity-based key insulated signature schemes have been proposed in literature; however, most of the Identity-based schemes are designed based on the expensive bilinear pairing operation over elliptic curves. Due to the heavy computational cost of a pairing, the pairing based schemes are less efficient in practice. In order to improve the computational and communicational efficiency and to resist the problem of private key exposure in Identity-based signature schemes, we present a pairing-free key insulated signature scheme in identity based setting. We show that this scheme is unforgeable and achieves strong key insulation property with secure key updates, under the hardness of the Elliptic Curve Discrete Logarithm Problem (ECDLP). The performance analysis shows that our scheme is more efficient than the existing schemes.

Late urethral strictures (US) presenting in adults after childhood hypospadias repair (hypospadias associated urethral strictures, HAUS) present a difficult problem that is being increasingly recognized. The best treatment option is not clear. In this systematic review and meta-analysis, we analysed the incidence of HAUS presenting to the adult urologist, and compared single-stage (SS) and 2-stage (TS) oral mucosal graft (OMG) repairs. Studies on adult US reporting the proportion of HAUS were identified by searching Pubmed (Medline), Publon, Index Medicus, and Embase, using a combination of “urethral” [OR] “urethra” [All Fields], AND “stricture” in “etiology,” “aetiology” [MESH] and “hypospadias” [MESH], and “adult” [All Fields], along with cross-citations and “related articles” search. Incidence of HAUS and commonest treatment option was analysed; meta-analysis of single-stage and 2-stage OMG repairs was performed. Thirty-two studies were included; proportion of HAUS was 9.8% and 30.6% of total US and anterior US (AUS). Commonest management of HAUS was using OMG in 94% cases. SS repair was performed in 25.4% cases and TS repair in 74.6% cases. In pooled data analysis, both SS and TS repairs had comparable success (88.2% versus 84.4%, p = 0.263) and comparable urethrocutaneous fistula rate (5.5% versus 6.9%, p = 0.590). Stricture length was shorter in SS than TS (4.5 cm versus 6.5 cm, p = 0.001), and SS had longer follow-up (50.9 mo versus 38.4 mo, p = 0.001). HAUS accounted for about 10% of total US and 30% of AUS in adults. Most cases require 2-stage OMG repair, and is best performed in specialized centres for reconstructive urethral surgery. HAUS

Although, cancer is considered as a localized disease in its premature stages, in certain types of cells, it results in metastasis, which accounts for over 90% of the total cancer deaths in the wor...

OBJECTIVE: T-Flex registry was designed to investigate the safety and clinical performance of the ultrathin (60 μm) strut biodegradable polymer-coated sirolimus-eluting stent (SES) with a unique long dual Z (LDZ) link design on a cobalt-chromium stent platform (Sahajanand Medical Technologies Pvt. Ltd., Surat, India) in a real-world all-comer population including high-risk subgroups. METHODS: This was an observational, multicenter, single-arm, and investigator-initiated retrospective registry. A total of 1,203 patients treated with an ultrathin biodegradable polymer-coated SES, irrespective of lesion complexity, comorbidities, and acute presentation were analyzed from May 2016 to January 2017. The primary endpoint was the one-year incidence of target lesion failure (TLF), a composite of cardiac death, target-vessel myocardial infarction (TV-MI), and clinically-indicated target lesion revascularization (CI-TLR). Stent thrombosis was assessed as an additional safety endpoint. RESULTS: At the one-year follow-up, TLF was observed in 3.8% [95% confidence interval (CI) 2.9–5.1] patients, composed of 0.6% (95% CI: 0.3–1.3) cardiac death, 1.3% (95% CI: 0.8–2.2) TV-MI, and 1.9% (95% CI: 1.3–2.9) CI-TLR. In the high-risk subgroups, TLF at one-year was 6.8% (95% CI: 4.6–9.8) in patients with diabetes, 5.2% (95% CI: 3.4–8) in patients with small-vessel disease, 6.1% (95% CI: 3.9–9.6) in patients with ST-elevation myocardial infarction, and 4.5% (95% CI: 2.4–8.3) in patients with total occlusion. During follow-up, stent thrombosis was reported in 0.8% (95% CI: 0.4–1.5) patients in the overall population. CONCLUSION: Low event rates of TLF and stent thrombosis at one-year follow-up indicate that this ultrathin biodegradable polymer-coated SES has encouraging safety and clinical performance in real-world all-comer populations as well as in high-risk subgroups.

Summary Background Despite many technical advances the debate continues on single versus staged procedures for proximal hypospadias. In this systematic review and meta-analysis we have compared the contemporary outcomes of proximal hypospadias repair: single stage foreskin pedicle tube (FPT) versus two stage foreskin free graft (FFG) and two-stage foreskin pedicled flap (FPF) over the last decade. Methods A systematic literature review of publications in English of the following electronic databases was conducted: Cochrane Database, PUBMED, MEDLINE and EMBASE. The following keywords were used: (proximal) AND (hypospadias) AND (repair OR urethroplasty) AND (outcomes OR complications). The publication date range for studies was from January 2010 to December 2020. Outcomes analyzed were complications like urethro-cutaneous fistula (UCF), glans dehiscence (GD), meatal stenosis (MS), urethral stricture (US), urethral diverticulum (UD), recurrent curvature or residual chordee (RC), buried penis (BP) and poor cosmesis (PC) as per objective assessment scores, or poor graft uptake (PGF) during first stage. We also divided the papers based on case load into two groups: 5 cases operated per year and compared the post-operative outcomes. Results The I 2 statistics for prevalence of total complications showed high heterogeneity with I 2 of 88% for one stage repair and 92% & 98% for two stage repairs. The pooled data from 26 articles covered a total of 2664 patients; mean follow-up of 4.5 years (1.8–14 years). One stage repair (FPT) was used in 680 (25%) patients while two stage repair was used in 1984 (75%) patients. Complications were encountered in 285/680 (42%) of those who underwent single stage repair (FPT) and this was significantly higher (Fishers; p = 0.001) than 414/1984 (21%) complication rate seen in two stage repair. Among the two different techniques of two stage operations over-all complication rate was not significantly different (Fisher's; p = 0.1) between FFG (155/674; 23%) and FPF (259/1310; 20%). FFG was superior to FPF in terms of individual complications UCF, MS, GD and UD. For two-stage FPT and FPF repairs the complication rate significantly reduced (p = 0.01) with increasing case load. For single stage repairs the complication rate remained high despite the increasing case load. Conclusions Two-stage repair of proximal hypospadias had significantly less complications compared to single stage repair. Among two-stage repairs specific complications were significantly less for FFG, although total complications were not significantly different from that seen with FPF. The results of two-stage repairs improved with higher case load supporting the concept of dedicated hypospadias centres.

Introduction: Mucormycosis is a aggressive and most dangerous type of oppurtunistic Fungal infection. This disease starts commonly from Nose and Para nasal Sinuses. Many a times Middle Turbinate alone and some time both Middle and Inferior Turbinate are affected. This Fungi invades the Arteries more than the Veins and produce Thrombus and further reduces blood supply to concerned region and later on resulting in Necrosis of soft and Hard tissues , which was seen clinically as Black coloured “ Eschar”, the characteristic Endoscopic nding of Mucormycosis. Objectives: To Study about the effects Mucormycosis in the Turbinate, Septum and Floor of Nasal Cavity and to know the Effect of Septal Deviation in development of Sinusitis and further development of Mucormycosis. Study Design: Analytical Study, Retrospective Study. Materials And Method: This study was conducted in Govt Thanjavur Medical College, in Department of E.N.T and Head and Neck Surgery, from May 2021 to July 2021. Total Number of cases taken for study was 81 cases. Cases with Orbital and Pterygo Palatine Fossae and Infra Temporal Fossae involvement and Intra cranial involvement are excluded from the study. All cases are subjected to DNE and classied according to ndings. All cases under went Endoscopic Sinus Surgery and tissues sent for HPE and Fungal culture, followed by Systemic Amphotericin and Regular Post Operative Follow up for 4-6 weeks. Results: Males are involved more in numbers (48) than Females. Commonest age group involved are 21 to 40years. Strong Positive association present between Post Covid-19 status and Diabetes. Middle Turbinate involved in more number (34cases), followed by Inferior Turbinate (21 cases) and Septum (18 cases). Most common Anatomical factor present are High Septal Deviation (60 cases) and Osteo Meatal Complex (OMC) crowding (56 cases). Discussion: Mucormycosis is a Fulminant Fungal infection, which is common in Immunodecient individuals. Patients with Uncontrolled Diabetes Mellitus, on Prolonged Steroid therapy and Post COVID_19 status are very much prone for this infections. Angio invasion to Arteries and the resultant formation of Thrombi and Gangrene of involved areas is characteristic of Mucor. Black coloured dead tissue is called as ESCHAR. Depending upon the Arterial involvement Anterior half of Middle Turbinate or Posterior half of Middle Turbinate is involved, Posterior half of septum or entire septum is also involved. High septal deviation gives indirect disturbances to Osteo Meatal Complex functions resulting in development of Sinusitis and further chances of developing Mucormycosis. Early Surgical debridement of dead tissues followed by Inj.Amphotericin is very important in restriction of Disease spread. Proper management of predisposing factors and Postoperative Regular Weekly follow up and Endo Cleaning reduces the Recurrences. Conclusion:In our Study Males are affected more in numbers. 21-40 years are affected more. High Septal Deviation and OMC crowding are present in more number of patients which was responsible for the development of Acute Sinusitis. Post Covid status and Uncontrolled Diabetes was the commonest Predisposing factor the development of Mucormycosis. Middle Turbinate was involved more in numbers followed by Inferior Turbinate and Septum. Routine Examination followed by Nasal Septal Correction plays a major preventive role in development of sinusitis and further dreaded complications like Mucormycosis. Adequate Glycemic Control and Inj Amphotericin plays important role in the management of Mycormycosis. Regular Follow up with Endo Cleaning is reduces the chances of Recurrence.

An increase in demand for natural fiber has created a good opportunity for the – new emerging fiber like bhindi, the ‘fiber from waste plant,’ into the production of value-added textiles and in dif...

Summary Objective While there are several reports confirming the safety and efficacy of laparoscopic pyeloplasty (LP) and robot-assisted laparoscopic pyeloplasty (RALP) in children there have been none comparing LP and RALP specifically in infants. In this meta-analysis, we have compared the outcomes of LP and RALP in infants. Methods Pubmed (Medline), Publon, Index Medicus and Embase were searched using the search terms: pyeloplasty (laparoscopic OR robot-assisted) AND (infant), to identify all papers pertaining to LP and RALP. Systematic review was performed to identify information regarding number of patients/renal units, age, body weight, operating time, hospital stay, success and complications. Meta-analysis of heterogeneity was reported with I2statistics. Once heterogeneity was found low, the pooled outcomes were compared with student's t test and Fishers exact test, wherever appropriate. Results After screening a total of 267 articles, 18 articles were included (10 articles on LP, 7 on RALP, 1 reporting both), comprising 323 renal units for LP and 173 renal units for RALP. With low heterogeneity (I2: 0%) both groups were considered to have been conducted under similar conditions for fixed effect model. There was no significant difference between the success rates of LP or RALP (97.5% vs 94.8%; p = 0.21). The mean age at operation was significantly lower for LP (5.6 ± 1.8 months) than RALP (7.2 ± 1.2 months, P = 0.0001). The duration of surgery was 137 ± 45 min for LP while significantly higher at 179 ± 49 min for RALP (p = 0.0001). The mean (s.d) time to discharge was 2.0 (1.9) days for LP while 1.3 (0.4) days for RALP. The overall complication rate was significantly higher (summary table) for RALP than LP (p = 0.03), mainly due to more port-site hernias in RALP. Discussion In the present study, we found that the success of LP and RALP in infants was similar. RALP in infants had longer duration of surgery, similar hospital stay and higher Clavien-3 complications than LP. While several studies have reported favorable outcomes for RALP over LP in children, this was not the case in infants. The smaller workspace, in an infant, can significantly limit the mobility of robotic instruments and increase the chance of port-site conflicts or trocar collisions. The use of larger robotic ports and instruments in the small space of infant abdomen might have been responsible for higher complications in RALP, including significantly larger number of port-site hernias. This meta-analysis represents the early experience of most RALP in infants, and it is possible that with experience RALP outcomes in infants also will catch up with LP. Miniaturization of robotic instruments might render RALP the future standard of care for pyeloplasty in infants. Summary table . Meta-analysis comparing pooled outcomes of infant LP & RALP Summary LP (n = 323) RALP (n = 173) Difference (p value) Age in months Mean (s.d) 5.6 (1.8) 7.2 (1.1) 0.0001 Surgery duration (min) Mean (s.d) 137 (45) 179 (49) 0.0001 Time to discharge (days) Mean (s.d) 2.0 (1.9) 1.3 (0.4) 0.0001 Success rate 315 (97.5%) 164 (94.8%) 0.12 Complication rate Clavien 1–2 25 (7.6%) 18 (10.2%) 0.32 Complication rate Clavien 3–4 5 (1.5%), 1 port site hernia 10 (5.7%), 4 port site hernias 0.01 All complications 30 (9%) 28 (16%) 0.03

Background Segond fractures (avulsion fractures of the proximal lateral tibia) are highly associated with anterior cruciate ligament (ACL) tears in adult patients. This large case series of pediatric Segond fractures describes the associated intra-articular knee injuries to determine if these fractures have a high incidence of ACL tears or its equivalent injury in young patients. Methods Institutional review board approved retrospective study at a tertiary children's hospital of patients under 19 years who were diagnosed with a Segond fracture between 2009 and 2019 was conducted. Demographics, clinical data, imaging features, associated injuries, and treatment information were collected. Results Fifty-three patients (44 males and 9 females) with median age 15.4 (11.8 to 19) years with Segond fractures of the proximal tibia on radiographic imaging were included. Diagnosis of associated injuries was established based on clinical examination, radiology report, and arthroscopic findings. Median Segond fracture size was 2.0×9.0 mm measured on standard anteroposterior knee radiographs. Magnetic resonance imaging (MRI) was obtained in 49/53 (92.5%) patients. Associated injuries included ACL tears (39 patients, 73.6%), tibial spine fractures (9, 17.0%), and other injuries (5, 9.4%). 37/53 (69.8%) patients had meniscal injury. Three (5.7%) patients sustained multiligament injuries. All associated injuries were confirmed by either MRI/computerized tomography or direct operative examination. Among Segond fractures found with ACL tears, 12 (30.8%) were contact injuries, 30 (76.9%) were sports injuries. In associated tibial spine fractures, 7 (78%) injuries were contact in nature and were sports related. There was a statistically significant difference (P=0.013) in age, patients with tibial spine fractures (median 13.6 y) being younger than those with ACL tears (median 15.4 y). 12/53 (22.6%) had associated articular cartilaginous injuries, 3 of which were treated surgically. Overall, 81.1% of patients were treated operatively for associated intra-articular injuries. Conclusions This large case series of Pediatric Segond fractures suggests a high association with intra-articular injuries, specifically, ACL tears and its equivalent injury, that is, tibial spine fractures, the later more common in the younger patient population. An MRI is recommended in patients with a Segond fracture for characterizing the exact intra-articular injury to help plan the appropriate management. Level of evidence Level IV-prognostic.

While laparoscopic heminephrectomy is performed for poorly functioning moieties, laparoscopic reconstruction with renal preservation is feasible when the affected moiety is functioning. Laparoscopic pyelopyelostomy at the level of pelvic brim can offer an alternative solution. We retrospectively reviewed the records of patients treated between 2017 and 2019 with renal duplication anomalies, and a preserved function. Five patients were identified, who underwent laparoscopic high internal diversion after placing a retrograde double J stenting in the receiving moiety. Stents were removed 8 weeks after surgery. All patients had uneventful post-operative recovery and showed clinical and radiological improvement at 1-year follow-up with no further episodes of urinary tract infection (UTI). The mean operative time was 155 min (range 130–170) and mean time to discharge was 4 days (range 2–5). The management of the duplex renal systems should be individualized for every patient. In the presence of a functioning moiety, laparoscopic reconstruction can be accomplished by pyelopyelostomy. This approach gives wider anastomosis, is easier to perform and gives better drainage than laparoscopic uretero-ureterostomy where the receiving ureter is often narrow potentially risking the normal moiety.

Objectives Vascular malformation (VM) of the tongue can cause true macroglossia in children. Reduction glossectomy provides primary relief when sclerotherapy has failed or is not possible. In this study, we evaluated the surgical role in functional outcome of reduction glossectomy performed for VM of the tongue. Patients and methods : We evaluated the functional and surgical outcomes of seven children who were treated at a tertiary care centre in Southern India between 2013 and 2018. Results : Six children underwent median glossectomy, while one child underwent lateral glossectomy. Functional assessment was performed at least 2 years after the date of surgery. At the time of assessment, speech was comprehensible for three children and was occasionally unintelligible in four children. Taste and swallowing were normal in all seven children. Six children exhibited a minimal residual lesion after surgery, of which only one was symptomatic. Residual lesions were managed with sclerotherapy (n=3), observation (n=2), or repeat surgery (n=1). Conclusion Reduction glossectomy in children with macroglossia secondary to VMs has acceptable outcomes in terms of cosmesis and speech, with no gastronomic restriction.

The information technology plays an important role as an enabler in retail industry to automate the business processes. The companies had identified that without the involvement of information technology the businesses cannot move forward with smooth running of business operations. With the advent of latest technologies in the field of information technology, companies are managing the business processes in more effective and efficient way. It is important to identify the importance of technological trends that had enabled the business processes to smoothen the operations such as technological enabler of the retail industry and its overall contribution to the sector as a whole. Enterprise Resource Planning, as the concept suggests, it can play a vital role in dealing with daily processes of the company. The importance of the Enterprise Resource Planning can deal with more challenging factors that a company faces and how well they can automate the processes is an advantage to the company at large Methodology: The first step is to identify the technological tools of the retailer and finding out the detailed analysis in terms of system requirements such as the network capabilities and the software tools in usage, whether the technology is been used by the company at large. Finding out the training gaps also is an important aspect; the objective of the company is to make sure the resources are equipped with sufficient knowledge of the tools in the organization. The GAP analysis can be done by the company in terms of infrastructural requirements, by setting the benchmark at large. The analysis and integration are to be done to find out the possibility of the company scaling up in terms of infrastructure. The analysis of the data and time taken to implement the software needs a detailed study and must get approval from top management at every stage of the implementation. The conclusion is the signoff document between the client and the company who is a technology partner, once he is satisfied with the services provided by the implanters. Conclusion: “By the research, we can suggest to the company who is in retail that there has to be a more effective way in dealing with business by using proper automotive techniques. The trends can give potential to the startup company and can take leverage on the existing infrastructure at large. We can say that with the proper use of the technologies we can change the customer perspective towards purchasing a product or a service at large. Enterprise Resource Planning software can have a significant impact on the overall prospects of the company when dealing in business.

With the majority of parents choosing laparoscopic approach for their children due to its inherent cosmetic benefits, it is essential that the surgeon aims for the best scar. In this study, we hypothesized that smooth profile port instead of a screw profile port, along with subcuticular/adhesive closure provides a superior cosmetic appearance. Scars of patients who underwent laparoscopic pediatric urology procedures were analysed based on: Group 1- screw profile port and trans cuticular closure and Group 2- smooth profile port and subcuticular/sealant closure. Junior doctors were asked to rate the overall cosmetic result of scar photographs on a Likert scale of 1 to 5, where 1 = poor, 2 = prominent, 3 = acceptable, 4 = good, and 5 = excellent. In Group 1, 89/112 (79%) scars could be identified while in Group 2, only 32/122 (26%) scars could be identified (p=0.001). Among all the scars analysed (n=234), the umbilical scars were the least noticeable (8/234; 3%), followed by right/left lower quadrant scars (42/234; 18%). Among the scars correctly identified, the cosmetic result was rated poor/ prominent in 53/89 (60%) in Group 1 versus none in Group 2; acceptable in 34/89 (38%) Group 1 versus 2/32 (6%) in Group 2 and good/ excellent in 2/89 (2%) Group 1 versus 30/32 (94%) in Group 2. The cosmetic outcomes were significantly superior in Group 2 compared to Group 1 (p=0.001). Using a smooth profile port unlike the screw profile port during laparoscopic pediatric urology procedures provides an inconspicuous scar.

Laparoscopic pyeloplasty (LP) is less popular and considered less successful in infants compared to older children. There are few reports analyzing the functional results of LP in relation to age of surgery. The aim of this paper is to compare the functional results of LP in infants (group 1) with children over 1 year of age (group 2). The data of all children undergoing LP between August 2016 and July 2019 were retrospectively analyzed for patient details and follow-up. Only children (n = 135) with at least 1-year follow-up and completed post-operative ultrasound and diuretic renogram were included. All children underwent pre-operative and post-operative ultrasound and diuretic renogram; pre-operative, operative and post-operative parameters were compared between both groups. Statistical analysis was done using software; Mann–Whitney U test, Student t test, and Fisher’s exact test were applied. There were 71 infants (group 1) and 64 children > 1 year (group 2). Pre-operatively, all kidneys had SFU grade 3 or 4 HDN and 131/135 kidneys had a renal pelvic APD > 20 mm; all kidneys had unequivocal obstruction on DR. At surgery, the preferred drainage method was intra-operative antegrade placement of a JJ stent in 68 (96%) group 1 and 63 (98%) group 2 children. The remaining 4 cases (3 group 1, 1 group 2) had a nephrostomy with trans-anastomotic external stent placement, because the JJ stent could not be negotiated into the bladder. The demographic data and comparison of pre- and post-operative parameters between both groups are summarized in Tables 1 and 2, respectively. Group 1 had significantly more children with antenatal diagnosis of HDN (87% vs 56%, p = 0.0005). The 36 children with antenatal diagnosis in group 2 were initially followed expectantly; the indication for pyeloplasty was deterioration of SRF on serial DR, urinary infection, and pain, in 13, 14, and 9 children, respectively. The operating time was significantly longer in group 2 (p = 0.0001). There was no difference in the success of LP or complication rate in both groups. Group 2 had significantly more children with extrinsic obstruction (1.4% vs 17%, p = 0.001). All children underwent post-operative US and DR; a significant reduction in hydronephrosis (APD) on follow-up was noted in both groups (p = 0.0001). The mean pre-operative SRF in both groups was comparable (p = 0.088). The mean SRF in both groups improved significantly after LP; however, the mean post-operative SRF was significantly higher in group 1 when compared to group 2 (p = 0.0001). Furthermore, group 1 had significantly more kidneys demonstrating > 10% increase in SRF after LP (53% vs 26%, p = 0.0003). The safety profile and success of LP in infants was comparable to older children. Infant LP took shorter time to perform, while older children had increased incidence of extrinsic obstruction. Infant kidneys demonstrated better functional improvement than older children after LP. These findings should encourage more surgeons to utilize LP for pyeloplasty even in infants.

This paper investigates quantum mechanical effects on surface potential and threshold voltage in a two-dimensional molybdenum disulfide (MoS $$_{2}$$ ) based transistor. Drain current improvement occurs as a result of the low work function for metal Ti and electron affinity of MoS $$_{2}$$ , thereby reducing the Schottky barrier height (SBH). The titanium (Ti) contact introduced into the mono-layer MoS $$_{2}$$ helps in obtaining lower contact resistance and improved drain current due to the lowering of SBH. An analytical model is proposed for evaluating various device parameters such as surface potential, threshold voltage, contact resistance, mobility, and drain current. This model provides useful aspects for understanding the physics of quantum mechanical effects. Compared to other conventional devices, this transistor incorporates Ti, a low work function metal, in the contact region, producing better current drive and lower contact resistance values. A positive Schottky barrier is noticed between the mono-layer MoS $$_{2}$$ and the Ti metal. Compared to other high function metals, the proposed device displayed about 11% improvement in current drive and 8% less contact resistance. By attaining an enhanced carrier injection and decreased contact resistance, this device serves as a suitable prospect for low-power applications.

The main purpose of this paper is to focus on the design of Viterbi Decoder (VD) with low power, which is significant for receiver section of data communication applications such as Radar, Satellite, Telephone and Automatic speech recognition. The Viterbi decoder algorithm consists of three most important blocks – Branch Metric Unit (BMU), Add Compare and Select (ACS) Unit and Survivor Memory Unit (SMU). BMU computes the metrics between the input and output state transitions. ACS unit include the Path Metric Unit (PMU), which computes the metrics with the sequence to a next state of a path and selects the lower metric value as a survivor path. SMU stores the data bits which utilizes the trace back method to fetch the likelihood path from the current state to a previous state. An ACS unit is an essential block for VD. The basic recursive ACSU design consists of Ripple Carry Adder (RCA), Comparator and a Selector block, which consume more area, power and operates with high junction temperature. To overcome these drawbacks, a modified ACSU design is implemented with recursive cancellation technique. ACS unit is modified by including a trace back mechanism to obtain a low latency and high speed in VD. It is designed with low complexity multiplexers, adders, logical AND gate and comparator block. This breaking recursive ACSU design utilizes less power, high throughput, low latency and also operates at low temperature. This analysis and simulation process are accomplished using Vivado Design Suite.

In this case series (n = 7) on prostatic utricles (PU), retention of urine was seen in 5 of 7, urinary tract infection (4 of 7), recurrent epidydymo-orchitis (3 of 7), and scrotal sinus (1 of 7). Voiding cystourethrogram established diagnosis in 3 of 7 patients while CT/MRI in 4 of 7 patients. Four patients were primarily managed by cystoscopic widening of mouth of PU. Three with large PU underwent initial open (2) or laparoscopic (1) excision but later warranted cystoscopic widening for residual PU. Excision (open/laparoscopic) has risk of damage to adjacent structures (nerves/vas/seminal vesicles) or leaving behind a residual PU. Cystoscopic management (primary/salvage) has less morbidity and relieves recurrent symptoms due to stasis of urine in PU.

One dimensional (1D) metal organic framework (MOF) micro/nanostructural arrays are highly promising candidates for their potential applications in energy related areas. These exceptional behaviors ...

Background: osseointegration of dental implants refers to direct structural and functional link between living bone and the surface of non-natural implants. It follows bonding up of an implant into jaw bone when bone cells fasten themselves directly onto the titanium surface.it is the most investigated area in implantology in recent times. Evidence based data revels that osseointegrated implants are predictable and highly successful. This process is relatively complex and is influenced by various factors in formation of bone neighbouring implant surface. Keywords: Osseointegration, Implant, Bone.

Synchronization of 4-D nonlinear fractional order hyperchaotic system with external disturbance is important models for encryption and decryption technique. In this paper, the fractional order 0 < α ≤ 1 is consider to establish finite-time control for synchronization of sender and receiver system. An audio encryption and decryption algorithms are investigated based on converting an audio data samples into image data. A random mask generated from chaotic mask is used to encrypt and decrypt the audio signals. The path of error system of fractional order hyperchaotic system is shown to be highly better than the classical one. Further, high level security of the proposed work is entrusted or assured by analyzing various metrics including MSE, PSNR, SSIM, NPCR and SNR along with numerical simulations.

To describe the first “arcuate sign” case series in the pediatric population, radiologic features of the associated injuries, management, and how they compare with the adult population. Retrospective study included patients under 18 years of age with a classic “arcuate sign” on radiographs. Data collected included patient demographics, mechanism of injury, and management. Radiographs and advanced imaging (MRI, CT) were reviewed by two musculoskeletal radiologists in a blinded fashion and findings recorded. Seven patients (4 males, 3 females) with mean age 15 years (range 14–17 years) were included in the study. All 7 injuries were related to sports, 5/7 (71%) being non-contact injuries. Five patients had MRI done-1 LCL injury, MPFL sprain, and MCL sprain were reported; 3 popliteofibular ligament and popliteus sprains were seen; and 3 bone contusions were present on imaging. None of the patients had meniscus or cruciate ligament tears. One patient had an additional fracture of the lateral tibial plateau at the ilio-tibial band attachment and an associated peroneal nerve injury. Five out of seven (71.4%) were treated non-operatively and were able to return back to activity at a mean of 7.2 weeks from injury. Two out of seven (28.6%) needed operative intervention for the fracture but not arthroscopic repair. Pediatric patients with a radiographic arcuate sign tend not to have ACL, PCL, or meniscal injuries, and treatment is predominantly non-operative in contrast to literature reported in adults.

Word related Health and Safety estimates are unavoidable to any association where laborers are included. It is an organizations duty to gracefully to its laborers past the installment of wages for their administrations. The laborers wellbeing and security on all the activity inside the organizations is the imperative discussion of the business. The working environment all through an industry antagonistically influences the representative wellbeing and security because of the exorbitant warmth or cold, commotion, smells, exhaust and absence of sanitation and unadulterated air and so forth, that wraps up in mishap or injury or disablement or death toll to the worker. Giving a wellbeing and more secure condition may be a pre-essential for any beneficial exertion. These simply be kept under tight restraints by giving customary wellbeing registration, defensive gadgets and compensatory advantages to the laborers. This exploration manages the investigation on the wellbeing and security measures gave to the laborers at a material manufacturing industry.

In this paper, for sensing and monitoring the biochemical analyte dissolved in liquid, antigen-antibody interaction or protein-DNA/RNA binding process, we design a surface plasmon resonance refractive index based biosensor by using a dual core D-shaped six-fold photonic crystal fibre which is embedded with silver nanowires for multi-detection. We numerically analyze both the dispersion relations and the loss spectra for various analytes by finite element method. This optical fibre bio-sensor monitors the changes of the refractive index for different analytes by measuring the spectral shifts of the fibre loss peaks at their resonance wavelengths. With the wavelength interrogation method, we find that the proposed biosensor with two sensing channels exhibits a maximum refractive index sensitivity of 3400 nm/RIU and a resolution of $2.94\times 10^{-5}$ RIU for a large sensing range from 1.35 to 1.50, which covers most known analytes of proteins, viruses or DNA/RNA. By utilizing 200 nm silver nanowires in the sensing channels, the sensitivity can be enhanced up to 4000 nm/RIU. Due to its special two-channel design for multi-sensing, it is possible to distinguish/study the binding possibility/capability of unknown analyte with two different target proteins simultaneously. Further, by introducing another critical channel, the confinement loss for either channel I or channel II can be greatly enhanced for high accurate result and more reliable sensing. Moreover, we numerically prove that the diameter of nano silver wires has great influences on the sensing peaks and sensitivity of the proposed biosensor.

The current trend in the automobile industry is to use composite materials, which are lightweight and non-corrosive to atmospheric conditions. The present work explores the feasibility of using a pultruded composite structure for the Rear Under run Protection Device (RUPD) of a truck. Numerical simulations have been performed for analysing the impact behaviour of the RUPD which is made of composite. Impact simulations are carried out for moderately high velocity impacts of 20 km/h and 40 km/h. The impact energy absorption, peak reaction loads and displacements are compared for different pultruded composites. Results indicate that RUPD structure consisting of carbon-epoxy bidirectional mat at outer layers and unidirectional mat as inner core layer provides more specific energy absorption and less reaction loads. The simulation results presented in this study will provide guidelines for designing the composite RUPD structure.

In current year the waste created from industry is the colossal worry for different climate, wellbeing, and used for land filling. Reusing of squanders and utilizing industrial waste in development elements has all the earmarks of being reasonable arrangement not exclusively to the contamination issue yet additionally a conservative choice in development. There are numerous decisions concerning choice of materials in developments. Because of developing interest in supportable development, specialists and planners are spurred to pick the elements are supplementary realistic. Geo polymer concrete competent economical development is portrayed by use of mechanical squanders to decrease utilization of common assets and energy and contamination of the climate. Substitution of materials over ostensible cement is the thing that makes more environmental friendly concrete as Geo polymer concrete. It restrains fly ash, alkaline solution arrangement as restricting element. Considering usage of mechanical desecrates in Geo polymer Concrete, the current journal surveys different Industrial desecrate materials at various steps in Geo polymer Concrete. Compressive strength of Geo polymer Concrete fusing distinctive desecrate resources is looked into and proposals are recommended at the result of the investigation. The evaluated move toward for improvement of innovative development fabric utilizing mechanical desecrate is valuable to give a likely economical resource. The principle intention of this examination expand the potency of Geo polymer cement and Geo polymer concrete by supplanting characteristic assets with different modern waste materials such as fly ash, GGBS, Copper Slag, M−Sand, Silica Flume etc., reintegrated by natural revenue in Geo polymer concrete. Cost of geopolymer concrete is low similar higher grade strength cement concrete cost. This paper gives an audit of examination period in the region of Geo polymer concrete.

The aim of this study is to analyze various ways to increase the performance of Thermoelectric (TEG) by using Computational Fluid Dynamics (CFD) techniques. For this study a three-dimensional model of TEG is developed using design modeling software SOLIDWORKS and the developed geometry is exported to CFD package which is ANSYS-FLUENT for further analysis. Mass flow rate of exhaust gas is 0.279 kg/s at a temperature of 800 K and mass flow rate of the coolant is 0.26Kg/s at a temperature 350 K are taken as boundary conditions. For this analysis various parameters are investigated such as heat exchanger material, inclination and exit gap of heat deflector and use of baffles. The effect of heat exchanger material on the performance of TEG is investigated. For this investigation pure copper, pure aluminum, aluminum alloy and low-carbon steel are chosen as heat exchanger material. Results show that pure copper has given better performance than others with 184.98 K of temperature difference. To study the effect of exit gap between heat deflector and exhaust pipe on TEG performance, exit gap is varied from 10 mm to 15 mm with an increment of 2.5 mm. The inclination angle of heat deflector is varied from 1° to 3.5° with an increment of 0.5°. Results show that 2°inclination angle of deflector with 10 mm exit gap has given better performance than other inclinations and exit gaps. The influence of baffles on TEG performance is also studied. Introducing a baffle in inclined position directs the flow direction of exhaust gas effectively to achieve better heat distribution. Finally, it can be concluded TEG has good performance with copper material as heat exchanger material, 2° inclination angle of deflector and 10 mm exit gap between heat deflector to the exhaust pipe.

In this paper, we mainly investigate the sensing performance of a fabricable 6-fold D-shaped photonic crystal fibre sensor based on the surface plasmon resonance (SPR). Its resonance couplings between fundamental core mode and three surface plasmonic modes which have different electric filed distributions for analytes of various refractive indices have been studied in detail. We firstly observe two different types of SPRs, namely, ‘dielectric like’ resonance with low-loss peak and ‘plasmon like’ resonance with high-loss peak, by analysing the electric field distribution of the fibre modes. Then, we discuss the influence of the secondary SPR over the main SPR which is directly related to the limitation on the detection sensing range of the proposed sensor. In order to mitigate the adverse effect of the sub-peak of the secondary SPR on the sensor’s sensing performance, we reduce the thickness of analyte’s binding layer from 1500 nm to 500 nm. Thus, the sensing range of the proposed sensor can be tuned from 1.33 – 1.41 to 1.33 – 1.45 at the cost of a reduced maximum sensitivity from 7900 nm/RIU to 5300 nm/RIU. Owning to the simple structure design of the proposed sensor, we envisage that this highly sensitive D-shaped PCF-SPR sensor could be developed as a versatile and competitive instrument with a large and flexible refractive index detection range.

Numerical anomalies of renal arteries are frequently encountered at radiological investigations. Origin of main renal artery from abdominal aorta above the level of origin of celiac trunk and supplying normally positioned kidney is encountered occasionally. But ectopic supradiaphragmatic thoracic origin of main renal artery supplying a normally positioned kidney is extremely rare and reported only as case reports and till recently only ten such cases have been reported. Incidentally all cases reporting thoracic origin are right renal arteries. The present case report is an incidental observation of origin of main right renal artery from thoracic aorta at the level of upper part of body of T-12 vertebra in a male patient undergoing contrast enhanced CT for suspected lung pathology. The normally positioned right kidney was supplied by an accessory renal artery arising just below the level of origin of superior mesenteric artery. Our literature search has yielded 23 cases (excluding the present case) out of which 19 were thoracic right renal arteries and 4 thoracic left renal arteries. Additionally the present case was associated with the presence of variations of celiac and superior mesenteric arteries in the form of gastrosplenic and hepatomesenteric trunks. This association of variant gastrosplenic and hepatomesenteric trunks with thoracic origin of main renal artery is reported for the first time. Knowledge of such rare variations is crucial for radiologists, surgeons and urologists for better outcome of surgical and interventional procedures. KEY WORDS: Thoracic renal artery, Supradiaphragmatic renal artery, Ectopic renal artery origin, Hepatomesenteric trunk, Gastrosplenic trunk.

Summary Objective When considering treatment for vesico ureteric reflux via inimally invasive surgery there is a dilemma to choose between laparoscopic extravesical (LEVUR) and transvesicoscopic (TVUR) ureteric reimplantation. In this systematic review and meta-analysis we have analyzed the articles on LEVUR and TVUR and compared the outcomes. Methods We searched the databases to identify all papers pertaining to TVUR and LEVUR in the pediatric population. Duplicate publications, review articles, incomplete articles and robotic assistance were excluded. Systematic review was performed to identify patient data, reflux grades, laterality, duration of surgery, time to discharge, success rate and complications. Meta-analysis of heterogeneity was reported with I 2 statistics. Once heterogeneity was found low, the pooled outcomes were compared with students t test and Fishers exact test, wherever appropriate. Results After screening a total of 45 articles, 23 articles were included (13 articles on TVUR and 10 articles on LEVUR). The I 2 statistics for TVUR and LEVUR showed low heterogeneity with I 2 of 0% (95% C.I 0–37%) and 25% (95% C.I 0–64%) respectively. With low heterogeneity both were suitable to be considered to have been conducted under similar conditions with possibility of using fixed effect model. The percentage of Grade 5 VUR was significantly higher (p = 0.001; X 2) in TVUR (11.9%) compared to LEVUR (2.2%). The proportion of bilateral reimplantation was significantly higher (p = 0.001; X 2) in TVUR compared to LEVUR (summary table). The success rate of LEVUR was significantly higher at 96.7% compared to TVUR at 93.7% (p = 0.007 X 2). Unilateral/Bilateral TVUR took significantly longer duration of surgery (155/194 min vs 107/161 min) compared to LEVUR (p = 0.001; Fishers). The mean (s.d) time to discharge was longer at 3.2 (1.6) days for TVUR compared to 1.6 (0.4) days for LEVUR (p = 0.001; Fishers). The complication rate was comparable, 7.35% for TVUR and 5.35% for LEVUR (p = 0.167; X 2). Discussion In this meta-analysis we found that LEVUR had shorter operating time, higher success, and shorter hospital stay compared to TVUR. A probable explanation could be higher number unilateral VURs and lower number of grade 5 VUR cases in LEVUR group. Both the techniques had comparable overall complication rate: LEVUR had more post-operative urinary retention while TVUR had more port-related problems. Summary table . Meta analysis comparing all outcomes between TVUR & LEVUR Summary TVUR (530 patients; 873 ureters) LEVUR (523 patients; 696 ureters) Difference (p value) Mean (s.d) age in years 5.5 (1.8) 5.6 (2.9) 0.501 Bilateral cases 360/530 (67.9%) 173/523 (33.1%) 0.001 % of Grade 5 VUR (among papers that provided grade) 77/643 (11.9%) 12/552 (2.2%) 0.001 Surgery Duration (minutes)Mean (s.d) Unilateral Bilateral Unilateral Bilateral 154 (53.1) 194 (54.4) 107 (30.1) 161 (35.8) 0.001 0.001 Time to discharge (days)Mean (s.d) 3.2 (1.6) 1.6 (0.4) 0.001 Success rate 818 (93.7%) 673 (96.7%) 0.007 Complication rate 39/530 (7.35%) 21 port related 28/523 (5.35%) 9 retention, 9 leak 0.167

To describe the largest case series of lower extremity traumatic internal degloving injury, i.e. Morel-Lavallée lesion (MLL) in the pediatric and adolescent population, its treatment and outcomes.Retrospective review of patients under 18 years who presented with MLL to a tertiary children's hospital. Demographic, clinical, radiographic, treatment and outcomes data were collected. Descriptive statistical analysis was conducted.38 patients having MLL with mean age 14.6 years were classified into two groups: hip/thigh MLL (nine patients) and lower leg MLL (29). Most common cause of lower leg and hip/thigh MLL was sports injury (79.3%) and motor vehicle accident (MVA) (33%) respectively. Most implicated sports were football and baseball. Primary care physicians/pediatricians were the initial treating providers for 63% of patients. Imaging modality of choice was magnetic resonance imaging (MRI) for lower leg MLLs (72.4%) and ultrasonography (US) for hip/thigh MLL (66.7%). Twenty-five (65.8%) patients were treated with conservative management, 12 (31.6%) with minimally invasive methods and 1 (2.6%) needed surgical management. Average return to normal activities took 14.3 and 9.1 weeks for hip/thigh and lower leg MLL, respectively. Twenty-four patients with adequate documentation demonstrated lower extremity functional score (LEFS) and pain level of 74/80 (92.5%) and 0.7/10, respectively, at mean 12.5 months follow-up.In contrast to adult injury literature, pediatric MLLs are more common in the leg/knee than hip/thigh region and caused mostly by sports injuries. Primary care physicians are the initial treating providers for the majority of the patients. Intervention is more often needed in the hip/thigh MLLs as opposed to non-operative management for lower leg injuries. This large case series on MLL in the pediatric population demonstrates differences in the management of hip and thigh lesions when compared to the management of the knee and leg lesions in the majority of these patients. Non-operative management in the majority of these lesions provided overall satisfactory outcomes.

In many resource-limited devices, ZigBee tree routing is widely utilised as it does not need any route discovery and routing table overhead through send a packet of destination. Therefore, packet f...

To perform a systematic review and meta-analysis comparing the outcomes of robotic-assisted laparoscopic extravesical ureteric reimplantation (RALUR) with conventional laparoscopic extravesical ureteric reimplantation (LEVUR) for primary vesicoureteric reflux in children. We searched the databases to identify all papers of RALUR and LEVUR between 2001 and 2020. Systematic review was performed to identify patient data, age, reflux grades, laterality, duration of surgery, time to discharge, success rate and complications. Heterogeneity was reported with I2 statistics and publication bias was assessed by Doi curve and Luis Furuya-Kanamori index. Pooled data from both groups were compared with Student’s t test and Fisher’s exact test, wherever appropriate. From a total of 43 articles screened, 28 articles were included (18 RALUR and 10 LEVUR). The I2 statistics for RALUR and LEVUR showed heterogeneity of 86% and 25%, respectively. Both groups had comparable minor publication bias. RALUR had higher proportion of grade 5 VUR (p

The descriptive observational study was conducted over six months among inpatients of the orthopaedics department. The aim is to observe the prescribing pattern of drugs, to find out the percentage of analgesics given and most commonly prescribed analgesic, to compare the prescribed drugs whether they are in NLEM, WHO list and calculate DDD/100 Bed-days and to analyze the drugs for WHO prescribing drugs. A total of 250 patients were included in the study. Out of this, 168 were male, and 82 were female. Most of the patients were in the age group of 31-40[45 in number with 18%]. The most common condition was found to fracture [113 in number with 95.2%]. Commonly prescribed drugs were analgesics 447 with 26.76%. Among all the NSAID's, PCM was most commonly prescribed analgesic with 34.4%. The highest no, of drugs was found to be 4drugs/prescription with 24%. Monthly one analgesic was prescribed per prescription with 38.8%. Utilization of analgesics in term of DDD/100 Bed-days was 55.26; Drugs will be evaluated per prescription as per prescribing indicators of WHO was done, the average no. of drugs per prescription was found to be 0.45, percentage of drugs prescribed by generic name was found to be 13.3%, percentage of encounters with antibiotics prescribed were found to be 94.4%, In ratio percentage of drugs prescribed from the national list of essential medicine was found to be 92.6%. This study would help to facilitate better health care delivery.

Purpose Diabetes mellitus (DM)-induced brain damage is characterized by cellular, molecular and functional changes. The mechanisms include oxidative stress, neuroinflammation, reduction of neurotrophic factors, insulin resistance, excessive amyloid beta (Aβ) deposition and Tau phosphorylation. Both antidiabetic and neuroprotective effects of the phytoestrogen genistein have been reported. However, the beneficial effect of genistein in brain of the ob/ob mouse model of severe obesity and diabetes remains to be determined. Methods In this study, female ob/ob mice and lean control mice were fed with either a standard diet or a diet containing genistein (600mg/kg) for a period of 4 weeks. Body weight was monitored weekly. Blood was collected for the measurement of glucose, insulin and common cytokines. Mice brains were isolated for Western immunoblotting analyses. Results Treatment with genistein reduced weight gain of ob/ob mice and decreased hyperglycemia compared to ob/ob mice fed the standard diet. The main findings show that genistein treatment increased insulin sensitivity and the expression levels of the neurotrophic factors nerve growth factor (NGF) and brain-derived neurotrophic factors (BDNF). In these mice, genistein also reduced Aβ deposition and the level of hyper-phosphorylated Tau protein. Conclusion The results of our study indicate the beneficial effects of genistein in the obese diabetic mouse brain, including improving brain insulin signaling, increasing neurotrophic support, and alleviating Alzheimer's disease-related pathology.

The 2019 novel coronavirus (SARS-CoV-2), officially named as COVID-19 by the WHO, has spread to more than 180 countries and the confirmed coronavirus cases have reached around 10 million with 0.6 million deaths by end of June 2020. Moreover, there is no sign of a sustained decline in any country till date. Continuous rise of positive cases has instilled fear in people, society and even health professionals. According to WHO’s daily situation report, 22,073 COVID-19 cases of healthcare professionals have been reported to the WHO as of Wednesday, 8 April 2020 by Jin (Mil Med Res 7:24, 2020). Infection to health professionals is a serious concern not only because they are a valuable frontline worker but also because of the risk of spread to co-workers and non-Covid patients. This project was undertaken to develop a solution to minimize the chance of infection to the health care professionals by providing them isolation from a potential source of Covid-19 and similar highly contagious diseases. The two models of Chitra swab collection booth were developed to: (1) protect health professionals from the risk of infection (2) to provide technical know-how to manufacturers to produce booths using locally available materials while meeting international regulations and (3) reduce the consumption of personal protective equipment. The prototypes developed were tested for safety and efficacy in accordance with the guidelines of the Centers for Disease Control and Prevention, Atlanta, USA. The device received the registration for commercialisation from the Central Drugs Control Standard Organization, Ministry of Health, Government of India, as a non-notified medical device.

To compare the immunogenicity and safety of an investigational typhoid Vi conjugate vaccine (Test TCV) with a marketed typhoid Vi conjugate vaccine (Comparator TCV).Randomized, controlled trial.Tertiary care and multispecialty hospitals.240 healthy subjects of 6 months to 45 years. Pediatric (18 years) subjects were enrolled after day 21 safety assessment of adult subjects.Participants received a single-dose of test TCV or comparator TCV at baseline and were followed up for 6 weeks post-vaccination.Primary variable was to demonstrate non-inferiority of the test TCV with the comparator TCV for seroconversion post-vaccination (³4-fold rise in antibody titre). Secondary variables were seroconversion in the adult and pediatric cohorts, and geometric mean titre of antibodies while the safety was based on reported adverse events.A total of 117 subjects (Adult-58, Pediatric-59) and 119 subjects (Adult-60, Pediatric-59) in test and comparator group, respectively completed the study. The seroconversion rate with test TCV (overall-94.8%, adult-96.6% and pediatric-93.1%) was non-inferior to comparator TCV (overall-91.6%, adult-91.7% and pediatric-91.5%). The geometric mean titres of antibodies (EU/mL) at baseline (test TCV: overall-7.6, adult-10.0, and pediatric-5.7; and comparator TCV: overall-8.0, adult-12.0, and pediatric-5.3) and at end of study (test TCV: overall-1121.0, adult-1411.0 and pediatric-891.1; and comparator TCV: overall-1104.0, adult-1199.0 and pediatric-1014.0) were also comparable between the groups (P0.05 for all). The most common adverse event was injection-site pain followed by fever in both the groups.The immunogenicity and safety of test TCV is comparable to already marketed comparator TCV.

BACKGROUND Several trace elements are found to play a significant role in the evolution of febrile convulsions by co-enzyme activity. The aim of the study is to estimate the serum zinc levels in children with simple and complex febrile seizures and compare them with serum zinc levels in febrile children without seizures. METHODS This prospective comparative study was designed to have three groups – children with simple febrile seizures, complex febrile seizures and febrile children without seizures. RESULTS About 46% of children with simple febrile seizures were in the age group of 1 to 2 years. Complex febrile seizures were common (40%) between 6 months to 1 year of age. The mean serum zinc levels in the simple febrile seizures group, complex febrile seizures group and no seizures group were 57.69 mcg/dL, 60.66 mcg/dL and 73.12 mcg/dL respectively (p=0.002). About 66% and 80% of children with simple febrile seizures and complex febrile seizures respectively had low serum zinc levels compared to only 20% in no seizures group. The multivariate analysis of serum zinc levels with various age groups (P=0.441) and gender (P=0.462) did not demonstrate any significant association. CONCLUSIONS The present study has demonstrated significantly lower levels of serum zinc in children with simple and complex febrile seizures. Further research should be directed to test the hypothesis as to whether correction of zinc deficiency prevents febrile seizures in children.

Weigh-in-motion (WIM) data provide an excellent opportunity to study the effects of actual traffic loads on bridges. Here procedures are presented for using WIM data to quantify the fatigue damage accumulated in steel bridges. These procedures allow comparisons of the impacts of truck traffic on various routes beyond simple comparisons of the numbers and gross vehicles weights of trucks in the traffic streams. The fatigue damage accumulation procedures are demonstrated using WIM traffic data collected in the state of Alabama. The results of the analysis show that approximately 20% of trucks are overloaded, that is, permit loads and illegal loads, and those trucks create more than 50% of the total damage based on the combined data from all the WIM locations in the state. The contribution of overloaded trucks to the total fatigue damage varies so that their contribution is less significant along some routes. A typical steel bridge with bottom flange coverplates was evaluated using the WIM data from 1 year for a heavily traveled route. This analysis shows that the fatigue life of the bridge was consumed at an annual rate consistent with a mean life of 100 years. These procedures have applications in planning weight limit enforcement, budgeting, and maintenance, and they have the potential for future use in planning inspection intervals.

Background We have recently shown that the copy number of salivary amylase (AMY1) gene was significantly decreased, and the obesity-related salivary biomarkers resistin, MCP-1, TNF-α, IL-6, and CRP were significantly increased in overweight/obese children compared to normal weight. This study aimed to evaluate the association of AMY1 copy number variant (CNV) with obesity and inflammatory markers. Seventy-six participants aged between 6 and 10 years have participated, and the saliva samples were collected along with the anthropometric measurements. Methods AMY1 copy number was analyzed by 3D digital PCR, and obesity-related biomarkers were performed with a Bioplex multiplex analyzer. Results The mean AMY1 copy number was higher in normal weight (7.90 ± 0.38) compared to the overweight/obese group (6.20 ± 0.29). The association of AMY1 CNV with obesity and inflammatory markers showed significant negative correlation [CRP, β = -0.238 (p < 0.05); resistin, β = -0.25 (p < 0.05); MCP-1, β = -0.304 (p < 0.01)] except for complement factor D, TNF α and IL-6. The anti-inflammatory cytokine, IL-10 reported a positive correlation with AMY1 copy number with a β = 0.268 (p < 0.05). The multivariable model adjusted with age and gender depicted a similar correlation with obesity markers. Conclusion Our results report that AMY1 CNV is associated with obesity and inflammatory biomarkers in children's saliva sample.