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Over the recent years, deep learning has been considered as one of the primary choices for handling huge amounts of data. Having deeper hidden layers, it surpasses classical methods for detection of outliers in wireless sensor networks. The convolutional neural network (CNN) is a biologically-inspired computational model which is one of the most popular deep learning approaches. It comprises neurons that self-optimize through learning. EEG generally known as electroencephalography is a tool used for investigation of brain function, and EEG signal gives time-series data as output. In this paper, the authors propose a state-of-the-art technique designed by processing the time-series data generated by the sensor nodes stored in a large dataset into discrete one-second frames, and these frames are projected onto 2D map images. A convolutional neural network (CNN) is then trained to classify these frames. The result improves detection accuracy.

The identification and mitigation of nonline-of-sight (NLOS) paths play crucial roles in effectively localizing sensor nodes deployed in both indoor and urban outdoor environments. In this work, the NLOS identification and mitigation tasks are performed using the bagging-based ensembled classifier. The proposed method is compared to other state-of-the-art approaches, and promising results, such as higher classification accuracy, are obtained. The received signal waveform is used as raw data, and further statistical features are extracted from the channel impulse response (CIR). The classification performances are analyzed over varying feature subsets, and associated hyperparameters are validated on three datasets. The obtained results strongly suggest implementing the bagging classifier with a proper selection of features and hyperparameters.

The aim of this article was to study the spectrum of scrub typhus meningitis/meningoencephalitis (STM) cases in children. Children ≤14 years of age with acute undifferentiated febrile illness were included. Immunoglobulin M (IgM) enzyme-linked immunosorbent assay was done in blood and cerebrospinal fluid (CSF) of children with suspected STM. Demographic, clinical, and laboratory details were expressed as descriptive statistics. Factors associated with neurological involvement were identified on univariate analysis. A total of 76 children had ST during the study period (meningitis/meningoencephalitis = 8 [10.5%], of which 5 [62.5%] had detectable ST IgM antibodies in CSF). The included children were 4 to 12 years of age with boys > girls. Headache and vomiting were common in those with STM, whereas hyponatremia and thrombocytopenia were common in those without STM. All children with STM recovered with sequelae in one child (right lateral rectus palsy). There was no mortality. STM has an incidence of 10.5% in children with ST from Eastern India. Headache and vomiting were significant predictors of STM, whereas hyponatremia and thrombocytopenia were significant predictor of non-STM.

Cognitive radio network (CRN) has been recognized by researchers to solve the spectrum shortage problem, where the unlicensed users opportunistically exploit the idle licensed channels for data transmission. Prior to the data transmission, the SUs should rendezvous on an available idle licensed channel to establish a link or to exchange control information without causing interference to the co-located licensed channels. However, the dynamic behavior of channels and its availability make the rendezvous more challenging. A blind rendezvous on the available channels without any centralized unit, or a common control channel is preferable to address issues like long-time blocking, control channel saturation, and scalability in a congested network. In this paper, a blind rendezvous for a specific CRN is proposed, where a Role-Based Channel Hopping is introduced to achieve guaranteed rendezvous in an asynchronous environment. Analytical study shows that for N available channels, the maximum time to rendezvous is $$N+\lfloor \frac{N}{2}\rfloor$$ , degree of rendezvous is N, maximum conditional time to rendezvous is $$N^2$$ and Channel loading is $$\frac{1}{N}$$ .

Emotion recognition based on facial expression is an intriguing research field, which has been presented and applied in various spheres such as safety, health and in human machine interfaces. Researchers in this field are keen in developing techniques that can prove to be an aid to interpret, decode facial expressions and then extract these features in order to achieve a better prediction by the computer. With advancements in deep learning, the different types of prospects of this technique are exploited to achieve a better performance. We spotlight these contributions, the architecture and the databases used and present the progress made by comparing the proposed methods and the results obtained. The interest of this paper is to guide the technology enthusiasts by reviewing recent works and providing insights to make improvements to this field.

BACKGROUND Traumatic cataract is one of the common sequelae following ocular injury. It is one of the leading causes of preventable blindness. Ocular trauma leading to traumatic cataract, if managed early gives good visual outcome. Associated ocular structure involvement has much bearing on the management and prognosis of traumatic cataract. We wanted to study the visual outcome of cataract surgery in traumatic cataract. METHODS All patients included in this prospective study were subjected complete ocular examination, intra ocular lens (IOL) power calculation and small incision cataract surgery (SICS) with IOL implantation. Visual outcome was assessed after 1st week, 2 nd week, 6th week and 6 months. Postoperative visual outcome and post-operative complications were assessed. RESULTS Out of 50 cases studied, 56 % of cases were in the age group of less than 20 years. Male: Female ratio was 2.57 : 1. Traumatic cataract was higher in patients of rural background as compared to urban background (64 % vs 32 %). In 58 % of cases, penetrating injury was the type of trauma. 60 % of patients had visual acuity of less than 3/60 at presentation. Corneal injuries (34 %), scleral tear in (22 %) and iris related problems (18 %) were the most common associated findings. All the patients were treated with SICS with IOL implantation. Most common intra-operative complication was posterior capsule rupture seen in 14 % of cases, 34 % of patients had anterior uveitis as early post-operative complication and 24 % of patients developed PCO as late post-operative complication; 68 % of the patients achieved visual acuity of above 6/18. CONCLUSIONS Timely management and involvement of other structures in traumatic cataract determines the visual prognosis of cataract surgery in traumatic cataract. Thus, our study showed that traumatic cataract can be successfully managed surgically with intraocular lens implantation with good visual outcome, unless there is associated corneal opacity or posterior segment involvement. More emphasis should be laid on the preventive measures like mass health education and awareness about risk of ocular trauma, and need to adopt safety measures should be focused, especially during playground, and at workplace. KEYWORDS Traumatic Cataract, Small Incision Cataract Surgery, IOL, Visual Acuity

Creutzfeldt–Jakob disease (CJD) is one of the subtypes of prion diseases, classified as hereditary, infectious, and sporadic disorders. Magnetic resonance imaging (MRI), particularly diffusion-weighted imaging, has become an important tool for the diagnosis of CJD due to its peculiar findings of cortical ribboning and hyperintense basal ganglia structures. In our case series, we described clinical details and MRI findings of four patients admitted to a tertiary center of North India, diagnosed as sporadic sCJD. Among these, three patients were female and one was male. The age ranged from 42 to 65 years, with a mean age of 55.5 years. Investigations, including MRI, electroencephalogram, and viral markers, were done for all four patients. The clinical features, neuroimaging characteristics, and outcomes were discussed with a review of the literature. The patients were treated with anti-epileptics and supportive drugs, but despite it, all the four patients died within one year of onset of illness. Our report may impress the treating physicians about the role of MRI as even now, it is underdiagnosed due to rare occurrence.

COVID-19, although primarily a respiratory illness, has myriad cardiovascular manifestations. Underlying comorbidities like hypertension, diabetes, and underlying cardiovascular disease are associated with higher mortality. Diabetes confers greater risk in women than men. Myocardial injury is seen in 17 to 36% of patients and is associated with higher mortality. Acute coronary syndromes (ACS) pose diagnostic and therapeutic challenges in the setting of the COVID-19 pandemic. Case reports of myocarditis have been documented. The sex differences in these common presentations have not been disaggregated and such evaluation is warranted to elucidate future interventions.

In this present investigation, four important process parameters of catalyst concentration, molar ratio, reaction time, and reaction temperature were studied and optimized using Box Behnken assisted response surface method (RSM) and Genetic Algorithm (GA) to achieve the maximum mahua oil biodiesel yield. For this purpose, 27 experiments were conducted randomly based on the design matrix using statistical software MiniTab®2019. A maximum yield of 91.32 % is achieved in RSM, catalyst concentration and reaction time are identified as influence parameters in biodiesel yield. GA modelling show an improvement of 4.96 % in biodiesel yield compared to RSM approach. Both techniques are successfully tested in prediction and modelling the biodiesel yield from mahua oil. The obtained biodiesel from the transesterification process is blended with standard diesel fuel at various proportions (B10 to B90) and tested for different fuel properties. All the biodiesel blends are observed within the limits of international standards of ASTMD-6751 and EN-14214. The results indicate that the chosen models are highly accurate in achieving maximum biodiesel yield and mahua biodiesel is recommended as the best alternative fuel to diesel engines without any major modifications in the engine design.

The present research is focused on the gasification study of a lab-scale pressurized circulating fluidized bed (PCFB) gasifier considering low-grade Indian coal and biomass such as sawdust and rice husk with a mean particle size of 600 μ m as feed materials. Syngas composition, lower heating value (LHV), dry gas yield (Y), carbon conversion efficiency (CCE), and cold gas efficiency (CGE) are evaluated based on the experiments in the range of pressure 1–4 bar. It is observed that the concentration of CH4 increases with pressure for all the three feed materials. The concentration of CH4 is found to be increasing from (3.65–4.86 vol%) and (2.98–3.46 vol%) for sawdust and rice husk, respectively. Similarly, the LHV is found to be increasing with pressure for coal and sawdust. There is a significant increase of 12% in LHV with an increase in pressure from 1 to 4 bar for both coal and sawdust. The CGE is found to increase by 34, 51, and 61% for rice husk, coal and sawdust, respectively with the increase in pressure from 1 to 4 bar.

Tuberculous meningitis (TBM) is the most severe form of tuberculosis. As reported in various studies, stroke is common among patients with TBM, with a prevalence of 17–54%. The present study assessed platelet dysfunction and coagulation abnormality in patients with TBM. This was a prospective observational study that included 123 consecutive patients with TBM. In addition to clinical and radiological parameters, the complete platelet function and coagulation function were studied. The patients were followed up to 6 months. A significant correlation between platelet abnormality and stroke in patients with TBM was reported in this study. Results of the univariate analysis revealed that haematological parameters such as mean platelet volume (MPV) (p

Despite renewed policy priorities to universalise health coverage, unmet need for healthcare is long-standing concern in India. The recent data suggests the unmet healthcare need amounts to a notable share of twelve per cent. While studies have examined inequalities in healthcare utilisation in single axes of social power, there was no consensus on the role of the intersectionality between class, caste and gender in shaping the unmet health need. Utilising data from National Sample survey 75th round (2017–18), this paper identifies the factors contributing to such unmet need and investigate the intersectionality of class with caste and gender in determining unmet need. The contribution of socioeconomic factors was assessed by the decomposition method & multivariate logistic regression was used to measure inter and intra-class differentials in unmet need. The analysis informs that class inequality is fundamental to having unmet need with limited role of gender and caste. Economic class however, interacting with caste and gender unfolds wider gaps in access to healthcare. While inter-class differences in unmet need are observed across caste as well as gender, intra-class differences intensify more by caste inequalities. The findings indicate the significance of the intersectional approach in identifying the sources of health inequity and special recognition to the income-poor and socially marginalised in policy agenda. Eliminating the barriers to health care access therefore needs a multidimensional construct of identifying combination of attributes to be focused towards realization of universal health coverage. These observations should aid in formulation and restructuring of the existing healthcare interventions to achieve equity in healthcare provision.

This paper used Our World data for coronavirus disease-2019 (COVID-19) death count, test data, stringency, and transmission count and prepared a path model for COVID-19 deaths. We augmented the model with age structure-related variables and comorbidity via non-communicable diseases for 117 countries of the world for September 23, 2021, on a cross-section basis. A broad-based global quantitative study incorporating these two prominent channels with regional variation was unavailable in the existing literature. Old age and comorbidity were identified as two prime determinants of COVID-19 mortality. The path model showed that after controlling for these factors, one SD increase in the proportion of persons above 65, above 70, or of median age raised COVID-19 mortality by more than 0.12 SDs for 117 countries. The regional intensity of death is alarmingly high in South America, Europe, and North America compared with Oceania. After controlling for regions, the figure was raised to 0.213, which was even higher. For old age, the incremental coefficient was the highest for South America (0.564), and Europe (0.314), which were substantially higher than in Oceania. The comorbidity channel via non-communicable diseases illustrated that one SD increase in non-communicable disease intensity increased COVID-19 mortality by 0.132 for the whole sample. The regional figure for the non-communicable disease was 0.594 for South America and 0.358 for Europe compared with the benchmark region Oceania. The results were statistically significant at a 10% level of significance or above. This suggested that we should prioritize vaccinations for the elderly and people with comorbidity via non-communicable diseases like heart disease, cancer, chronic respiratory disease, and diabetes. Further attention should be given to South America and Europe, which are the worst affected regions of the world.

This paper presents Zika Virus Analysis. Zika virus infection during pregnancy causes neurological disorder, Guillain-Barre syndrome, and birth defects in newborns. No cure or vaccine is available. The study of genome replication will bring some insight into the Zika virus. One of the important tasks in the cell is Genome replication. The daughter cells inherit its own copy of the genome, and then the cell divides in the process of genome replication. Ori is the position in the genome where the genome replicates. Finding the position of ori is a complicated task even for biologists. This task can be performed using Genome analysis. This paper presents the Genome analysis of Zika virus using innovative programming techniques instead of using a laboratory. Identifying the position ori will help the biologist in finding the position where the genome replication occurs.

Rendezvous is a critical step in Cognitive Radio Network (CRN) prior to transmission for establishing communication links between secondary users (SUs). Due to the long-term blocking, channel saturation, and scalability issues encountered by dedicated common control channels (CCC) in a distributed CRN, rendezvous is preferable on the available idle channels of the primary users (PUs). In fact, each SU is unaware of the other SUs’ available channel sets, and the blind rendezvous is performed through the channel hopping (CH) process. As a result, ensuring a rendezvous between two SUs in a finite period in an asynchronous environment remains a challenging problem. In this work, a disjoint difference set based CH (DDSCH) method is developed that ensures the highest degree of rendezvous in comparatively less time.

Vehicular Ad hoc Networks (VANETs) provide an extensive number of services through a collection of applications for intelligent transportation. It mainly reduces the difficulties for the drivers of vehicles by generating alerts for any unforeseen road accidents, warnings and road congestions in real time. Wireless Body Area Network (WBAN) facilitates remote health monitoring for patients and elderly people in healthcare sector. This paper proposes an architecture which combines WBAN and VANET — WBAN is used for patient monitoring while travelling and VANET takes the charge of delivering the alert message generated from abnormal physiological data of the patient to its destination. A Road Side Unit (RSU) allocates distinct channels to the On Board Units (OBU) of vehicles that ask for it. However, allocation scheme taking the priority of the OBUs into account allocates the channels. An OBU will send the emergency messages using the assigned channel. In this work, we develop a novel technique to compute the priority of vehicles using three important criteria such as severity of the message, vehicle speed, and channel occupancy time. The technique utilized two multi-criteria based decision making schemes — Analytic Hierarchy Process (AHP) for finding a weight for individual criterion, and Technique for Order of Preference by Similarity to an Ideal Solution (TOPSIS) for computing normalized priority values of vehicles. The main aim of this work is to minimize the End-to-End delay of alert messages. Our simulation study shows that our proposed scheme provides better results as compared to the standard scheme.

Infertility is a major concern for couples wanting to have progeny. Despite recent advances in the field of IVF, success rates still need improvement. Understanding the patient’s variability and addressing it with personalized interventions may improve the success rate of fertilization and live births. This study examined the impact of a personalized pharmacogenomic approach on LH supplementation on the pregnancy and live birth rate outcomes in comparison with the traditional approaches. 193 patients undergoing a second IVF cycle in Krishna IVF Clinic received LH supplementation either as per the conventional methods or based on N312S (rs2293275) LHCGR gene polymorphism. Results showed a significant increase in pregnancy rate (P-value: 0.049) and a trend showing improvement in live birth rates (P-value: 0.082) when r-hLH supplementation protocol was decided as per the genotypes A/A, A/G, and G/G of the N312S variant in the respective patients. This stimulation regimen helped in providing optimum levels of r-hLH supplementation to patients with impaired hormone-receptor interacting activity, to achieve higher success in pregnancy and live birth rates.

In heterogeneous networks, vertical handover plays a major role in providing seamless connectivity to the mobile users that are passing through different network access technologies and connecting to different point of network attachments. A mobile node scans all of its interfaces to find a suitable network with which it can connect. However, scanning of a large number of networks requires a huge amount of energy thereby the mobile node drains the battery very fast. The Media Independent Handover (MIH), which was introduced by IEEE, to facilitate seamless and energy efficient handover of mobile nodes across heterogeneous networks. The MIH Information Service (MIIS) offers a variety of criteria and services that can be used to avoid network scanning. But sometimes scanning avoidance leads to inconsistent handover, that is, increased handover failure rates. Thus, an optimal network scanning procedure, which can maintain a consistent handover and should consume the energy as least as possible is required. Our proposed work incorporates two additional functional units into MIH - one is responsible for making an optimal network scanning decision (it could be either full scanning, partial scanning, or avoid scanning) and other one is responsible for computing handover decisions by taking both network conditions and user preferences into account. In the second functional unit, we have introduced a utility function based TOPSIS algorithm that computes the handover decisions. Whereas, in principle, MIH users make the handover decision. Almost all of these existing methods suffer from severe ping-pong effect, unnecessary handovers, handover failures, and excess energy consumption due to inaccurate scanning method and ineffective network choice, whereas the performance analysis of our proposed work indicates that the suggested scheme performs better and consumes less amount of energy than existing works.

Background: Limited data are available for insulin resistance (IR) in over-weight/obese children from the Indian subcontinent. Identifying predictors of IR in this population is important, as they may be used as a screening tool for future metabolic complications.Materials and Methods: This school-based cross-sectional study was conducted in an Eastern Indian city. Anthropometry and blood pressure measurements were carried out as per the published guidelines. Venous blood samples were taken in a fasting state to measure plasma glucose, insulin, and lipid profile. IR was measured quantitatively by a homeostatic model of assessment (HOMA-IR).Results: A total of 545 (28.2%) children who were overweight or obese were included. The male:female ratio was 1:1.27. The overall prevalence of metabolic syndrome (MS) in these children was 21.8%. Around 32.3% of children had HOMA-IR of ≥2.5, and 22.2% had HOMA-IR of ≥3.16. The mean HOMA-IR in children with MS was 5.46 compared to 2.18 in those without MS. An increased risk of IR with low HDL, high triglyceride, increased waist circumference, and increased BP (both systolic and diastolic) was found. This means that insulin resistance was more common in children who were overweight or obesity and had underlying MS.Conclusions: The present school-based study found a high prevalence of insulin resistance among children who were overweight or obese. This could predict an increased risk of future adverse cardio-vascular events in the studied children. The findings of this study would help in planning and implementing primary prevention programs targeting weight management and lifestyle change in schoolchildren.

Fear and anxiety are factors strongly associated with the pandemic and exacerbate the pre-existing rate of domestic violence Drawing evidence from popular media and existing literature, it is possible to study domestic violence in present-day society and try to analyze the cycle of violence During the lockdown, on-screen media such as cinema and streaming platforms have become popular Archaic remnants of patriarchal ethos may leave the father as a passive observer and creates barriers for the involvement of the father Inculcating a sense of moral pride in the father regarding the daughter and daughter in law will improve family dynamics and reduce the rates of violence As times are changing, paradigm shifts in policy and program regarding the interventions are necessary for a more fluid and suitable response by the government and community-based organizations to cater to modern society © 2021 John Wiley & Sons, Ltd

The evolution of wireless communication from fourth generation (4G) to fifth generation (5G) is envisioning massive growth in application of vehicular ad hoc network (VANET) based on cognitive radio (CR) technology. In this VANET, fast and efficient spectrum sensing techniques are required to co-exist with heterogenous network. Most of the current applications are done with assuming perfect carrier sensing, but in actual practice, channel sensing is imperfect. We have investigated the performance under imperfect sensing, so as to exactly analyse the key concern of co-existence, i.e. the average/peak transmission power constraints of secondary user (SU) and average interference power constraints of primary user (PU). However, to alleviate these concerns, we need to have optimum resource allocation, to improve the capacity and energy efficiency of this VANET. To solve the resource allocation and power distribution problem, we have investigated two popular cooperative relay transmission schemes such as Decode-and-Forward (DF) and Amplify-and-Forward (AF). Moreover, we have analytically derived the required transmission rates for both AF and DF schemes. In addition to this, we have also develop the new optimal resource allocation strategies for the CR based co-operative relay protocol to improve the capacity and energy efficiency (EE) of the VANET. The MATLAB simulation results are incorporated to validate the correctness of the analysis.

Background India has the largest burden of drug‑resistant organisms compared with other countries around the world, including multiresistant and extremely drug‑resistant tuberculosis and resistant Gram‑negative and Gram‑positive bacteria. Antibiotic resistant bacteria are found in all living hosts and in the environment and move between hosts and ecosystems. An intricate interplay of infections, exposure to antibiotics, and disinfectants at individual and community levels among humans, animals, birds, and fishes triggers evolution and spread of resistance. The One Health framework proposes addressing antibiotic resistance as a complex multidisciplinary problem. However, the evidence base in the Indian context is limited. Objective This multisectoral, trans-species surveillance project aims to document the infection and resistance patterns of 7 resistant-priority bacteria and the risk factors for resistance following the One Health framework and geospatial epidemiology. Methods This hospital- and community-based surveillance adopts a cross-sectional design with mixed methodology (quantitative, qualitative, and spatial) data collection. This study is being conducted at 6 microbiology laboratories and communities in Khurda district, Odisha, India. The laboratory surveillance collects data on bacteria isolates from different hosts and their resistance patterns. The hosts for infection surveillance include humans, animals (livestock, food chain, and pet animals), birds (poultry), and freshwater fishes (not crustaceans). For eligible patients, animals, birds and fishes, detailed data from their households or farms on health care seeking (for animals, birds and fishes, the illness, and care seeking of the caretakers), antibiotic use, disinfection practices, and neighborhood exposure to infection risks will be collected. Antibiotic prescription and use patterns at hospitals and clinics, and therapeutic and nontherapeutic antibiotic and disinfectant use in farms will also be collected. Interviews with key informants from animal breeding, agriculture, and food processing will explore the perceptions, attitudes, and practices related to antibiotic use. The data analysis will follow quantitative (descriptive and analytical), qualitative, and geospatial epidemiology principles. Results The study was funded in May 2019 and approved by Institute Ethics Committees in March 2019. The data collection started in September 2019 and shall continue till March 2021. As of June 2020, data for 56 humans, 30 animals and birds, and fishes from 10 ponds have been collected. Data analysis is yet to be done. Conclusions This study will inform about the bacterial infection and resistance epidemiology among different hosts, the risk factors for infection, and resistance transmission. In addition, it will identify the potential triggers and levers for further exploration and action. International Registered Report Identifier (IRRID) DERR1-10.2196/23241

Objective Panic disorder (PD) is associated with changes in platelet and red blood cell (RBC) indices. However, the diagnostic or predictive value of these indices is unknown. This study assessed the diagnostic and discriminating value of platelet and RBC indices in patients with PD. Materials and Methods In this cross-sectional study including patients with PD (n = 98) and healthy controls (n = 102), we compared the following blood indices: mean platelet volume (MPV), platelet distribution width (PDW), and RBC distribution width (RDW). The receiver operating characteristic (ROC) curve was used to calculate the area under the ROC curve (AUC), sensitivity, specificity, and likelihood ratio for the platelet and RBC indices. Results Statistically significant increase in PDW (17.01 ± 0.91 vs. 14.8 ± 2.06; p < 0.0001) and RDW (16.56 ± 2.32 vs. 15.12 ± 2.43; p < 0.0001) levels were observed in patients with PD. PDW and mean corpuscular hemoglobin concentration had larger AUC (0.89 and 0.74, respectively) and Youden’s index (0.65 and 0.39, respectively), indicating their higher predictive capacity as well as higher sensitivity in discriminating patients with PD from healthy controls. Conclusion PDW can be considered a “good” diagnostic or predictive marker in patients with PD.

Background: Overweight and obesity are prevalent in schoolchildren due to dietary habits and lack of exercise. These children are prone to metabolic syndrome (MS) and future risk of type 2 diabetes mellitus and cardiovascular diseases. Materials and Methods: This cross-sectional study was conducted in Bhubaneswar City, Eastern India, among schoolchildren. Obesity and overweight were determined by the Indian Academy of Pediatrics guideline. Fasting venous blood samples were taken for insulin, blood glucose, and lipid levels measurement. Blood pressure was measured as per the protocol. The International Diabetic Federation (IDF) criteria for the definition of MS were followed. Insulin resistance was determined by a homeostatic model assessment (HOMA-IR). Results: A total of 1,930 children were screened, of which 545 (28.2%) were overweight and obese. The male to female ratio was 1.27. The overall prevalence of MS was 21.8% (11% in 6 to ≤10 years old and 30.6% in 11 to 16 years old). A history of cardiovascular disease, diabetes, obesity, and hypertension in the family was present in 42.7%. Acanthosis nigricans was present in 46.4%. A history of exclusive breast feeding for 6 months was present in 68.1%. The mean HOMA-IR in children with MS was 5.46 compared to 2.18 in those without MS (insulin resistance was more common in children with MS). Conclusions: The present study found a higher prevalence of MS and insulin resistance in schoolchildren from Eastern India who are overweight/obese.

A secure, portable and affordable IoT module, designed for control of electrical appliances and security surveillance has been discussed in this paper. The module development primarily focuses on increasing convenience and feasibility for remote control using the Internet Of Things (IoT) principles. It also incorporates multiple sensors within the module to provide a 24 hrs security monitoring solution. The objective of the work is to build a system for homes that is robust, reliable, affordable and dedicated to easing the lives of people through the use of recent advancements in IoT.

In a time of rising average population and complex illnesses, the healthcare system is strained and struggling to keep costs low. Wearable devices are a potential solution to detecting the onset of sickness allowing for early treatment as well as continuous monitoring to prevent readmittance. Utilization of sensors to monitor patients will allow them to return to the comfort of their home while still under physician supervision remotely in case treatment is necessary, freeing up hospital space and staff to treat those in need of direct care. Additionally, in the consumer market, wearable devices are utilized by millions of users to monitor their vital signs and general health. In this manuscript, various wearable device, biosensors, and their applications are presented, as well as methods such as surface engineering, a powerful tool to incorporate materials into devices to result in increased functionality. Current challenges and the future outlook of the wearables industry are also discussed.

This brief presents the design of 16-bit and 32-bit heterogeneous adders. For designing efficient adder architecture in terms of power, area and speed, a number of research works have been implemented to design an optimized architecture. This paper gives a comparative analysis of previously presented designs and the proposed heterogeneous adder architectures to validate a trade-off between power, area and delay. The proposed heterogeneous adder designs consist of cascading of ripple carry adder (RCA) and carry-lookahead adder (CLA) and are implemented in Xilinx Vivado 2017.1 design tool and FPGA-Kintex7 (xc7k70tfbv676-1) device without any constraints. These proposed adders are coded with VHDL language for obtaining better performance parameters in comparison with other reported adders for different application points of view.

BACKGROUND The rural citizens who constitute major portion of Indian population are underprivileged as they have very little or no access to tertiary eye care. In order to make eye care services accessible to everyone, the concept called teleophthalmology has come into existence. A mobile van with eye-care-experts and equipment regularly reconnoiters through the rural population in the district of Ganjam to carry out screening, offsite diagnosis, monitoring, providing treatment and distantly educate the paramedics. The whole gamut of activities of this initiative can be categorized into three broad aspects. The first one is to screen out patients with treatable ailments and advise them for future course for a better prognosis. The second one is to educate the paramedics and ophthalmic assistants of their locality and generate consciousness among the mass. The third one is smartphone-based transmission of information of patients to the Prof. & Head and to other senior faculty of Department of Ophthalmology for treatment on the spot or to store information for use subsequently. MATERIALS AND METHODS A mobile van (air conditioned) which has inhouse sterilization chemicals, betadine, spirit, sterilized drum, surgical instruments, surgical gloves & surgical masks, slit lamp, autorefractometer, fundus camera, streak retinoscope, ophthalmoscope, trial box, vision drum, tonometer, colour vision chart, magnifying lenses, smart phones, on-board computer etc. were deployed for the purpose. Ophthalmological experts and paramedics organized camps in villages. RESULTS 1541 rural patients were examined and treated at their doorsteps. Medical treatment was provided on the spot of examination. 44 camps were organized over a period starting from July 2016 to February 2018. CONCLUSION Vision centers provide access to permanent primary eye care and a comprehensive eye examination having a clear advantage over outreach camps. Consultation with professors at base hospital helps in diagnosis and patients’ satisfaction. It also saves cost for both provider and patient. Teleophthalmological mobile van services are a good, cost effective option in providing primary eye care in rural areas. Patients are immensely benefited. Smart phones are utilized for exchange of vital information between the camp sites and the base hospitals.

Background India is one of the most privatised health systems with high OOP payment for health care in the world. The financial burden of OOP payment has an iniquitous effect on access to health care as it restricts health care accessibility among poor. To provide universal health care access to all its citizen government has launched health insurance programs in the recent past. Objective The study attempts to understand the impact of health insurance schemes on tackling the economic burden of out of pocket expenditure and its effectiveness in reducing economic inequalities in health care spending. Method The study utilises National Sample Survey 2014 data to fulfill the objectives. Bi-variate analysis and two-part model were used to examine the association of health insurance with the level of health expenditure and financial burden. Results The paper shows that health insurance schemes are effective in reducing the burden of OOP expenditure but economic disparities in the financial burden of OOP expenditure exist where the poor with less income spends a greater share of household income than the rich. Conclusion An increasing coverage of poor under health insurance no doubt protects against health care impoverishment, but mere provision health care does not address the issue of equity in health spending as the burden of health spending was more among poor. The major implication of the findings is that there is a need for analysing the efficiency and equity implication of the health insurance schemes in providing financial protection

BACKGROUND A large section of the society is pursuing occupations in the outdoors which exposes the eyes to the ultraviolet radiations. The UV exposure leads to primary pterygium which in turn may lead to loss of vision. Persons with sedentary occupations in the indoors also have reported with primary pterygium although they are less in number. Prognosis of surgical treatment is encouraging. Therefore, the authors are motivated to incorporate two safer methods of surgeries. They are Conjunctival autograft and Conjunctival rotation flap techniques in primary pterygium surgery. The objectives of this study were to evaluate the complications and recurrence rate after primary pterygium excision with conjunctival autograft and conjunctival rotation flap techniques over a span of 18 months and to compare the two aforesaid methods as they are safer techniques in the treatment of primary pterygium. MATERIALS AND METHODS It is a prospective study conducted at P. G. Department of Ophthalmology, MKCG Medical College and Hospital, Berhampur from April 2016 to Sep 2017 (18 months). 40 patients were operated upon. Following primary pterygium excision, autoconjunctival graft was employed in 21 cases and conjunctival rotation flap was utilised in 19 cases. 36 patients were in the age group 32 to 60 years and 4 patients were more than 60 years old. RESULTS High prevalence of pterygium was seen in age group of 40 to 49 years (18 eyes - 45%). There is high incidence (80%) of pterygium in patients who have their occupation in outdoors which exposes persons to ultraviolet radiations. Patients of pterygium were less in number (20%) who have indoor occupations. All the pterygium were nasally located with mean corneal encroachment of 3mm X 3mm. 55% of surgeries were carried out on the right eyes and 45% of surgeries were carried out on left eyes. During the follow up period of this study, progressive pterygium recurred in 2 patients. The average duration of recurrence was 5.5 months. The mean age of patients with recurrence was 46 years. Mean surgical time spans in conjunctival rotation flap and conjunctival autograft group were 18 minutes and 25 minutes respectively. The recurrence in conjunctival autograft and conjunctival rotation flap groups were 4.76% and 5.26% respectively. CONCLUSION Both conjunctival rotation flap and conjunctival autograft techniques have almost same results in terms of pterygium recurrence and surgical complications in the treatment of primary pterygium, surgical time span in conjunctival rotation flap technique is significantly shorter. So, the conjunctival rotation flap technique may be a good alternative method for primary pterygium surgery.

The bipolar resistive switching (BRS) between a metallic low resistance state (LRS) and an insulating high resistance state (HRS) is demonstrated for annealed graphene oxide (GO) thin film-based device structures with aluminum (Al) as one of the contact electrodes. An optimal switching of ∼104 order is recorded for Al/GO (200 °C)/indium tin oxide (ITO) among the device structures in metal (M2)/GO (T)/metal (M1) configurations (M1 = Al, Au, or ITO and M2 = Au or Al), fabricated using GO (T)/metal (M1), annealed at different temperatures, T = 100, 200, 300, and 400 °C. The initial Ohmic conduction for electronic transport and the presence of metal contents through GO thin films in the X-ray photoelectron spectroscopy support the physical evidence of Al filament formation between the two electrodes as imaged by the high-resolution transmission electron microscopy. The speculated mechanism for BRS in repeated voltage sweep cycles is attributed to the current triggered breaking of metal filaments because of th...

BACKGROUND Cataract is the principal cause of blindness in India accounting for 62.6%. This problem can be tackled, and the backlog of cataract blind can be reduced by large scale cataract operations in reach in camps at Base Hospital approach for good visual outcome with lesser complications. MATERIALS AND METHODS In this retrospective study, 2400 cataract patients with vision less than 6/60 underwent uncomplicated sutureless small incision cataract surgery with intraocular lens implantation. Postoperative complication and visual acuity was recorded. RESULTS The most common operative complications were Descemet detachment (0.75%), posterior capsule rent with IOL implant (0.58%) and premature entry (0.25%). Immediate postoperative complications were mainly corneal oedema (1.16%), severe iritis (1.5%) and hyphema (0.5%). Late postoperative complications were iritis (0.69%), persistent corneal oedema (0.43%) and papillary capture (0.17%). Majority (48.71%) had visual acuity 6/9 on first followup in 45th day followed by visual acuity of 6/12 on 38.44% of cases. 71.23% of cases had astigmatism below -1.5 D cylinder at 90 degrees. CONCLUSION The overall vision-threatening complications after cataract surgery in the Base Hospital are low. Our study reflects the efficacy of Base Hospital approach in terms of visual and surgical outcome as an important aspect from the public health point of view, which can help in clearing the cataract backlog in developing countries like India.

The prevalence of type 2 diabetes mellitus (T2DM) is increasing in an alarming way in India as well as across the globe. In order to minimize complications, there is a need to maintain good glycemic control in patients with T2DM and long-term durable glycemic control remains a challenge. Clinically, this challenge was addressed by step-wise intensification of therapy with additional antidiabetic drugs to maintain glycemic control. Various disease and patient-related factors as well as different antidiabetic agents influenced the durability of glycemic control differently. While understanding of the factors that influenced therapeutic outcomes had evolved, there was paucity of information about the durability of glycemic control and the role of oral antidiabetic drugs (OADs) in achieving it. With an objective to understand the role of durability of glycemic response in the management of Indian patients with T2DM, 4 advisory board meetings attended by 48 physicians from across the country were conducted in Mumbai, Delhi, Kolkata and Bengaluru. There was consensus to consider durability of glycemic control as an important goal in the management of T2DM. Personalized approach in T2DM management along with early initiation of dual combination therapy were recommended to achieve durability. Age group of patients, body mass index, glycated hemoglobin levels at diagnosis, presence or absence of comorbidities and complications are important factors that need to be considered before initiating dual combination therapy for patients with T2DM.

The temperature dependent electronic conduction through GO thin films sandwitched between indium tin oxide (ITO) substrates and top thermally deposited Al electrode (Al/GO/ITO) is explained. The cu...

In the last two decades, rise of community-based qualitative health research (CBQHR) has given impetus to deliberations on ethics, primarily on inequality between the researcher and the researched, and the principles of flexible and non-deductive field design adopted in CBQHR. The paper attempts to understand ethics as a process of negotiation at various stages in the field after the Research Ethical Board’s (REB’s) approval. The paper identifies three vulnerable stages of ethical negotiations: consent at commencement stage; data-collection stage (interview, observations, and ethnography); and data analysis at the collation stage in the context of a developing economy. Analysis suggests that REBs need to graduate from a product certification to ethical governance process to address the inherent flexibility and inequality that exists between the researcher and researched in developing countries like India.

Purpose Changing demographic trends in India have resulted in a growing ageing population, and this poses many health challenges for older people. Lack of formal care institutions and social security nets further aggravate the situation. Living arrangements are, thus, expected to play a significant role in determining the healthcare needs of older people. The purpose of this paper is to examine the association of living arrangements with health among older people in India. Design/methodology/approach Data for the study were drawn from the Building Knowledge Base on Population Ageing in India (2011). The health status of older people was measured by assessing chronic illness, self-rated health and limitations in activities of daily living. Logistic regression was used to examine the influence of living arrangements on health outcomes. Further, a structural equation model was employed to observe whether poor health preceded co-residence. Findings Older people living in co-residential arrangements report more health disadvantages and older people with poor health prefer co-residence with their offspring. Perhaps the support, care and health awareness in co-residential arrangements helps older people obtain the healthcare interventions they require for the various illnesses they have had, and enable them to improve their ongoing health status. Originality/value The present study has extended the research on the relationship between health and living arrangements, and has also addressed the case of older people with poor health who prefer to stay in co-residential arrangements which has been taken up by limited studies.

This phase III clinical trial was conducted to evaluate the immunogenicity and safety of the single-dose and multi-dose formulations of a novel MMR vaccine (live, freeze-dried) developed by M/s Cadila Healthcare Limited, India (Cadila MMR vaccine), containing the Hoshino mumps strain, compared to that of an existing MMR vaccine (live, freeze-dried) developed by M/s Serum Institute of India Limited, India (Serum MMR vaccine). These two vaccines have similar measles and rubella strains, but different mumps strains (Hoshino in Cadila MMR vaccine, and L-Zagreb in Serum MMR vaccine). Three hundred and twenty-eight subjects of either sex, aged 15–18 months, were randomized in a 2:1 ratio to receive either the Cadila or Serum MMR vaccine. Immunogenicity assessments (IgG antibodies against measles, mumps, and rubella viruses) were done at baseline and 42 d after vaccination. Solicited (local and systemic) and unsolicited adverse events were recorded for up to 42 d following vaccination. The Cadila MMR vaccine was found to be non-inferior to the Serum MMR vaccine in terms of end-of-study proportion of subjects seropositive for anti-measles antibodies (100.0% in both groups), anti-mumps antibodies (94.5% vs. 94.0%), and anti-rubella antibodies (95.5% vs. 91.0%). Both vaccines were well tolerated by all study participants; the most common adverse event reported in both groups was fever, followed by rash. The results of this phase III clinical trial show that the novel Cadila MMR vaccine is non-inferior to the Serum MMR vaccine.

In this status paper, impact of termites as serious structural insect-pests is highlighted with relevant information in Indian context. Worldwide, more than $40 billion was estimated towards the termite damage. Study revealed at least thirteen species of termites belonging to three families are closely associated with structural damage in India. Heterotermes indicola (Rhinotermitidae: Isoptera) was discussed as the key termite species causing structural damage with substantial impact (even with astounding cases of abandoning houses by victimized villagers). Swarming, the most important sign of termite infestation in and around buildings/structures is discussed. A nation-wide scenario of termite damage in various buildings, public places, dams and dykes, agri-horticultural constructions and timber-in-service are presented. Sustainable termite control in the light of present and upcoming eco-technologies is identified as the major focal point. Use of termiticides as recognized and recommended by Indian Standards, Insecticide Act (1968) and United Nation Environment Program for management of termites in pre- and post-construction stages of various buildings and other structures are recorded with relevance of application and dose. Termite management technologies like use of borate, bait and barrier (3B) are briefed; with pest-control industry-invented devices such as termatrac are brought into focus along with indigenous traditional knowledge of termite control. Status of termite R&D in India is discussed in various institutional and web-based levels along with recognizing research gaps. The present study is a pioneer approach in its kind which can be a platform to formulate compact eco-friendly, environmentally sustainable and economic module of termite control interventions indoor.

Qualitative data is now increasingly used within public health research, and domestic violence widely is recognized as a serious public health problem. India is one of the most socio-economically diverse nations in the world, where language, culture and customs differ from place to place within the country. In order to carry out research on domestic violence in a multi-centre cross-cultural environment, it is imperative to pay attention to methodological issues. This paper aims to understand how domestic violence is addressed in research and identifies lessons from the methodological gaps in understanding health research. These gaps are analyzed at four levels; conceptualization, setting, ethics and cross-cultural adaptation of research instruments. The research was a multicentre study covering 18 states of India. A wide range of methods were used to narrow the methodological gaps. Despite the inherent difficulties in defining domestic violence in a cross cultural set up, the paper reflects the cumulative efforts of investigators to recognize and systematically deal with the methodological gap in addressing multi-centre research.

Using the nationally representative data drawn from NSSO 64th round, this paper investigates the impact of remittances both internal and international on the expenditure patterns of households in India, with special focus on Uttar Pradesh and Kerala and Karnataka. To control for selectivity bias and to assess the average impact of remittances on household expenditure items, the present paper applies propensity score matching technique. The estimates reveal that compared to non-recipient households, households receiving remittances spend less on food and more on education and health care. Increasing expenditure with remittance flow on these critical variables signifies the positive impact of remittances on household development. The impact of international remittances on these indicators weighs more than internal. In line with the optimistic view, the findings of the present study show that remittances enhance household well-being.

Internet of Things (IoT) [1] is defined as connecting and interacting with things using Internet. In the context of IoT enabled Wireless Body Area Network (WBAN), WBAN [2] is a wireless networking paradigm of wearable sensors which can be referred as things. The sensors collect patients’ vital sign parameters such as Electrocardiogram (ECG) and body temperature, and then send this vital information to Hub or Coordinator over wireless medium. In turn, the coordinator relays the information gathered from the sensors to the Border Router, and thereafter the information is posted on to the doctor’s console for monitoring and analyzing the patient data. In this paper, we study the performance of IoT enabled WBAN in Contiki platform using Cooja simulator. We used the metrics for performance study are Average Delay and Power Consumptions which is in terms of percentage of Radio Transmissions, Receptions and ON. Our study shows that the average delay taken to deliver a packet for highest priority sensors is near to 450 milliseconds, which is about 14% less delay as compared to the lowest priority sensors. Also, our study shows that the average power consumed by highest priority sensors is near to 4.1% which is about 3% more as compared to the lowest priority sensors. It has also been observed that around 50% more packets of the highest priority nodes are delivered as compared to the percentage of packets delivered by the lowest priority nodes.

Sensor Networks are very much vulnerable and prone to faults and external attacks. Sensor networks used for Healthcare Monitoring are termed as Wireless Body Area Networks (WBAN), which is used for collecting various vital physiological parameters of patients from remote locations. However, WBAN sensors are prone to failures because of noise, hardware misplacement, patient‘s sweating. Sensed data from these sensors are sent from the Local Processing Unit to Medical Professionals. It would be very difficult for the Medical Professionals to diagnose correctly if the sensed data from these sensors are faulty or effected by the malicious third party. At times, even faulty data might lead to misdiagnosis or death of a patient. It motivated us to address this challenge by proposing a Machine Learning Paradigm to distinguish this anomalous data from the genuine sensed data. Firstly, we classify the health parameters as normal records or abnormal record. After the classification, we propose to apply regression technique for identifying the anomalous data and actual critical data. We use real patient‘s vital physiological parameters for validating the robustness and reliability of our proposed approach.

Wireless Body Area Network(WBAN) is an emerging technology in telemedicine used for continuous monitoring of the health conditions of a patient in a cost and energy effective manner. The low-powered sensors access the channel using CSMA/CA MAC protocol as part of IEEE 802.15.6 standard. However, the radio duty cycling mechanism can be used along with the MAC protocol for saving the power consumption of sensors. Although duty-cycling protocols help in reducing the power consumption of a sensor, it attracts a delay when applied in real life. This delay incurred due to the use of duty-cycling protocols is often ignored in most, if not all cases, in spite of it being significant in the field of telemedicine. In this paper, we propose to analyze the delay resulted due to use of a duty-cycling protocols. Furthermore, we compare the delay incurred due to use of ContikiMAC with the delay of XMAC for the nodes having different priorities. Our simulation study shows that the delay of XMAC is about 9.51% more as to that of ContikiMAC when the priority is set to low and is about 9.89% when the priority is set to high. Furthermore, the difference between power consumption of ContikiMAC and XMAC is analyzed. We observe that the power consumption for ContikiMAC is relatively higher than XMAC by 6.1% and 8.3% when the priority of the nodes are set to low or high respectively.

Heat dissipation during magnetization reversal processes in magnetic nanoparticles (MNP), upon exposure to alternating magnetic fields (AMF), has been extensively studied in relation to applications in magnetic fluid hyperthermia (MFH). This current paper demonstrates the design, fabrication, and evaluation of an efficient instrument, operating on this principle, for use as (i) a non-contact, in vitro, real-time temperature monitor; (ii) a drug release analysis system (DRAS); (iii) a high flux density module for AMF-mediated MNP studies; and (iv) an in vivo coil setup for real-time, whole body thermal imaging. The proposed DRAS is demonstrated by an AMF-mediated drug release proof-of-principle experiment. Also, the technique described facilitates non-contact temperature measurements of specific absorption rate (SAR) as accurately as temperature measurements using a probe in contact with the sample. Numerical calculations estimating the absolute and root mean squared flux densities, and other MNP-AMF studies suggest that the proposed stacked planar coil module could be employed for calorimetry. Even though the proposed in vivo coil setup could be used for real-time, whole body thermal imaging (within the limitations due to issues of penetration depth), further design effort is required in order to enhance the energy transfer efficiency.