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High-speed PLL is highly demanding with the advancement in the VLSI market. PLL performance gets affected due to bandwidth limitation. This paper presents third-order configurable transconductance capacitance ([Formula: see text]-[Formula: see text])-based loop filter for high-speed PLL. Operational transconductance amplifier (OTA) serves as a basic cell of the [Formula: see text]-[Formula: see text] filter. Quasi-floating gate (QFG) and Bulk-driven qausi-floating gate (BD-QFG) MOS-based differential input folded cascode (FC) OTAs are proposed for low-voltage operation. Here, DC gain of the BD-QFG FC OTA enhanced 5.18% than QFG FC OTA. The proposed OTAs enhanced DC gain, CMRR, UGB and FOM along with reduction in the power consumption in comparison to the state-of-art work. Further, third-order [Formula: see text]-[Formula: see text] filters are designed using both QFG and BD-QFG MOS-based OTAs and achieved [Formula: see text]3[Formula: see text]dB cut-off frequency of 16.51[Formula: see text]MHz and 17.22[Formula: see text]MHz, respectively. The proposed QFG and BD-QFG MOS-based filters achieved 22.42% and 21.53% reduction in power than the reported result, respectively. The locking time of integer-N PLL is calculated as 0.33[Formula: see text][Formula: see text]s and 0.32[Formula: see text][Formula: see text]s, respectively, through an analytical approach. The transistor-level simulation has been done in 0.18[Formula: see text][Formula: see text]m CMOS process.

The present article presents the load forecasting for a power system (substation) load demands using techniques based on fuzzy time series (FTS), artificial neural network (ANN), and wavelet transform (WT). The mean absolute percentage error (MAPE), integral absolute error (IAE), integral of time multiplied error (ITAE), integral square error (ISE) along with integral time multiplied square error (ITSE) criteria are used for determining the performance indices and minimizing the error. From the investigations of the results obtained in the study, it is inferred that forecasting of electric load based on WT and ANN offers less error as compared to FTS. The suggested integrated model captures the useful properties of artificial neural networks and wavelet transforms in time series and is found to be accurate for real-time data.

This paper will provide an outline of the dissolved pollutants and their removal techniques from water and wastewater. Dissolved impurities are omnipresent in all kinds of water like ground water, surface water and other industrial sewage. Many methods are available for the treatment of dissolved pollutants. Rather than the conventional methods such as membrane technology, coagulation- flocculation method, electro dialysis, and ion exchange method for removing dissolved impurities from a different kind of water, the applicability of the adsorption technique is a simple, economical and the most potential one. Adsorbents may be conventional and non-conventional. Activated carbon and silica gel are included in conventional materials. Activated carbon is preferred material for removing pharmaceutical waste, heavy metals, and dyes from an aqueous medium. They can remove larger and smaller particles from water and wastewater due to their porosity. Among non-conventional methods, clay minerals and zeolites are used in both natural and modified forms as potential adsorbents. Bio-sorbents like industrial waste, agro waste, and chitosan have unique properties to be used as adsorbents to remove dissolved impurities from an aqueous medium. It also outlines mechanism of adsorption and complex relation between adsorbents and adsorbates. Considering the applicability of different adsorbents discussed here for the removal of heavy metals, pharmaceutical waste, dyes, and organic waste, it is expected that this technique can be helpful in further treatment in variety of water and wastewater.

The use of polyelectrolytes in the treatment of water/wastewater has been studied with special emphasis on the characteristic impurities, which should be removed and the types of polyelectrolytes commonly available. Much attention is being on using polyelectrolyte as primary coagulation, their application as a coagulant aid, including the use of dual polyelectrolytes in the treatment of complex industrial wastewater. The optimum dosage of polyelectrolytes in all kinds of water and wastewater is very low when they are used as coagulant aids in conjunction with inorganic polyelectrolytes. Hence, the quantification of remaining polyelectrolytes in the water after their treatment is ruled out in this case. Polymer toxicity in aquatic animals has been assessed and the presence of residual polyelectrolytes in the treated water has been discussed. Keeping in view the applicability of these polyelectrolytes for the removal of contaminants, it is expected that this technique can be applied for further investigation in various types of water from different origins.

Blockchain provides innovative ideas for storing information, executing transactions, performing functions, creating trust in an open environment, etc. Even though cryptographers, mathematicians, and coders have been trying to bring the most trustable protocols to get authentication guarantee over various systems, blockchain technology is secure with no central authority in an open network system because of a large distributed network of independent users. If anyone tries to change the blockchain database, the current hash will also change, which does not match with the previous hash. In this way, blockchain creates privacy and trust in digital data by removing malleability attacks. In this chapter, security and privacy on the blockchain has been focused. The safety and privacy of blockchain are mainly engrossed on two things: firstly, uncovering few attacks suffered by blockchain systems and, secondly, putting specific and advanced proposals against such attacks.

The influence of the underlying nucleation layer on the properties of semipolar $$(11{\bar{2}}2)$$ GaN grown on m-plane sapphire by metalorganic vapor-phase epitaxy has been investigated. $$(11{\bar{2}}2)$$ GaN epilayers of ~ 1 μm thickness were grown using four different initiating sequences: low-temperature AlN and GaN, and high-temperature AlN buffer layers, and directly (high-temperature GaN). The choice of nucleation layer had a pronounced effect on the surface morphology and crystal quality of the overlying GaN epilayer. In comparison, direct growth of $$(11{\bar{2}}2)$$ GaN without any buffer layer provided the best crystal quality with a rocking-curve $$\omega $$ full-width at half-maximum (FWHM) value of 720 arcsec along the $$[11{\bar{2}}{\bar{3}}]$$ direction and relatively enhanced near-band-edge photoluminescence emission, thus showing this direct growth process to be a simple route for synthesis of semipolar $$(11{\bar{2}}2)$$ GaN layers.

This paper introduces a new divergence measure for a fuzzy matrix with proof of its validity. In addition, the properties are proved for the new fuzzy divergence measure. A method to solve decision making problem is developed by using the proposed fuzzy divergence measure. Finally, the application of this fuzzy divergence measure to decision making is shown using real-life example

Information theory is a tool to measure uncertainty; these days, it is used to solve various challenging problems that involve hybridization of information theory with the fuzzy set, rough sets, vague sets, etc. In order to solve challenging problems in scientific data analysis and visualization recently, various authors are working on hybrid measures of information theory. In this paper, using the relation between information measures, some measures are proposed for the fuzzy rough set. Firstly, an entropy measure is derived using the fuzzy rough similarity measure, and then corresponding to this entropy measure, some other measures like mutual information measure, joint entropy measure, and conditional entropy measure are also proposed. Some properties of these measures are also studied. Later, the proposed measure is compared with some existing measures to prove its efficiency. Further, the proposed measures are applied to pattern recognition, medical diagnoses, and a real-life decision-making problem for incorporating software in the curriculum at the Department of Statistics.

The electroluminescence of UVB light-emitting diodes emitting at 310 nm before and after 1000 h of operation is studied in the temperature range from 20 to 340 K. Before operation, the external quantum efficiency (EQE) at 10 mA gradually increases with decreasing temperature from 0.8% at 340 K to 1.8% at 150 K and then levels off. This trend is attributed to a reduction of non-radiative recombination and finally the domination of radiative recombination at low temperatures. After 1000 h of operation, the EQE has dropped to 0.45% at 340 K with a maximum EQE of 1.4% at 80 K, followed by a drop for temperatures below 80 K. These findings suggest a stress-induced reduction of both the radiative recombination efficiency and the carrier injection efficiency.

Thin layer chromatography (TLC) is considered as an efficient analytical technique used for the monitoring and identification of the adsorption behaviour of different amino acids through soil as a stationary phase amended with polyvinyl acetate at different concentration. The study gives complete idea about the mobility of four different uncharged amino acids namely glycine, alanine, tryptophan and glutamine in terms of retention factor by thin layer chromatography. Among four amino acids, highest mobility was found in case of glycine. The order of mobility was found to be in order of glycine > alanine > tryptophan > glutamine in which distilled water has been used as a mobile phase. It has been observed from the results that pH and electrical conductivity also influence mobility of amino acids. The influence of activation temperature and particle size of soil on the mobility of amino acids was also studied.

Pain is the most common reason for prehospital transport. As emergency wait times increase, timely pain management is essential. In children, there is abundant evidence that prehospital pharmacologic analgesia is suboptimal, but little is known about non-pharmacologic therapies. We sought to characterize documentation by paramedics of non-pharmacologic (immobilization and ice) and pharmacologic analgesia in children with musculoskeletal injuries.We reviewed all ambulance call reports for children 0-17 years transported to Southwestern Ontario regional hospitals from January 1, 2017, to December 31, 2019, with a musculoskeletal injury (Ontario Ministry of Health and Long-Term Care problem codes 66 and 67). Primary and secondary outcomes were documented immobilization or ice and pharmacologic analgesia, respectively. In a multivariable analysis, we explored the relationship between immobilization or ice and the following a priori covariates: age, sex, visible deformity, crew type, pain severity, and analgesia.Of 40,692 ambulance call reports reviewed, 4445 met inclusion criteria. There were 2584/4441 (58.2%) males, with a median (IQR) age of 14 (10, 16) years. In ambulance call reports with documented pain scores, 2106/3048 (69.1%) ambulance call reports reported "moderate or severe" pain. Immobilization or ice were documented in 1605/4445 (36.1%) and 385/4445 (8.7%) of ambulance call reports. Pharmacologic analgesia was documented in 275/1983 (13.9%) and 125/991 (12.6%) of ambulance call reports for primary care paramedics and advanced care paramedics, respectively. An increased odds of documented immobilization or ice was associated with moderate or severe pain [OR: 2.4; 95% CI 1.84-3.17; p 0.01] and visible deformity [OR: 2.5; 95% CI 1.97-3.12; p 0.01].Documented immobilization and ice and pharmacologic analgesia to children by paramedics is suboptimal. Our findings underscore an important need for enhanced education surrounding the benefits of non-pharmacologic options for children with musculoskeletal injuries.RéSUMé: OBJECTIFS: La douleur est le motif le plus fréquent de transport préhospitalier. À mesure que les temps d'attente aux urgences augmentent, la gestion de la douleur en temps opportun est essentielle. Chez les enfants, il existe de nombreuses preuves que l'analgésie pharmacologique préhospitalière est sous-optimale, mais on sait peu de choses sur les thérapies non pharmacologiques. Nous avons cherché à caractériser la documentation par les ambulanciers paramédicaux de l'analgésie non pharmacologique (immobilisation et glace) et pharmacologique chez les enfants souffrant de lésions musculo-squelettiques. MéTHODES: Nous avons examiné tous les rapports d'appels d'ambulance pour les enfants de 0 à 17 ans transportés vers les hôpitaux régionaux du Sud-Ouest de l'Ontario du 1

BACKGROUND: Less than two-thirds of children with abdominal pain in the emergency department receive analgesia. We sought to determine whether hyoscine butylbromide was superior to acetaminophen for children with nonspecific colicky abdominal pain. METHODS: We randomly allocated children aged 8–17 years with nonspecific colicky abdominal pain who presented to the pediatric emergency department of London Health Sciences Centre, London, Ontario to receive hyoscine butylbromide, 10 mg given orally, or acetaminophen, 15 mg/kg given orally (maximum 975 mg). We considered the minimal clinically important difference for the primary outcome (self-reported pain at 80 min) to be 13 mm on a 100 mm visual analogue scale. Secondary outcomes included administration of rescue analgesia, adverse effects and pain score less than 30 mm at 80 minutes. RESULTS: A total of 236 participants (120 in the hyoscine butylbromide group and 116 in the acetaminophen group) were included in the trial. The mean visual analogue scale scores at 80 minutes were 29 mm (standard deviation [SD] 26 mm) and 30 mm (SD 29 mm) with hyoscine butylbromide and acetaminophen, respectively (adjusted difference 1, 95% confidence interval −7 to 7). Rescue analgesia was administered to 4 participants (3.3%) in the hyoscine butylbromide group and 1 participant (0.9%) in the acetaminophen groups (p = 0.2). We found no significant differences in rates of adverse effects between hyoscine butylbromide (32/116 [27.6%]) and acetaminophen (28/115 [24.3]) (p = 0.5); no serious adverse effects were observed. The proportion with a pain score less than 30 mm at 80 minutes was 66 (55.0%) with hyoscine butylbromide and 63 (54.3%) with acetaminophen (p = 0.9). INTERPRETATION: Hyoscine butylbromide was not superior to acetaminophen in this setting. Both agents were associated with clinically important pain reduction, and either can be considered for children presenting to the emergency department with nonspecific colicky abdominal pain. Trial registration:Clinicaltrials.gov, no. NCT02582307

Decision-making is a critical problem in various circumstances where some vagueness and ambiguity is found in information. To handle these types of problems, entropy is an important measure of information theory which is exploited to evaluate the uncertain degree of any data. There are two methodologies to determine the entropy, one is probabilistic in nature and other is non-probabilistic. It is shown that for every probabilistic measure there is a corresponding non-probabilistic measure. In this article, some logarithmic non-probabilistic entropy measures have been proposed for the fuzzy rough set corresponding to existing probabilistic entropy measures. The proposed measures are employed in a decision-making problem, which is related to the agriculture. Finally, these proposed measures are compared with the existing trigonometric entropy measures for fuzzy rough sets.

Judgments of facial attractiveness invariably accompany our perception of faces. Even neonates appear to be capable of making such judgments in a manner consistent with adults. This suggests that the processes supporting facial attractiveness require little, if any, visual experience to manifest. Here we investigate the resilience of these processes to several years of early-onset visual deprivation. Specifically, we study whether congenitally blind children treated several years after birth possess the ability to rate facial attractiveness in a manner congruent to normally sighted individuals. The data reveal significant individual variability in the way each newly sighted child perceives attractiveness. This is in marked contrast to data from normally sighted controls who exhibit strong across-subject agreement in facial attractiveness ratings. This variability may be attributable, in part, to atypical facial encoding strategies used by the newly sighted children. Overall, our results suggest that the development of facial attractiveness perception is likely to be vulnerable to early visual deprivation, pointing to the existence of a possible sensitive period early in the developmental trajectory.

In this article, we describe experimental study designs and focus on randomized controlled trials. Experimental studies are intervention studies in which the investigator tests a new treatment on a selected group of patients. In a controlled design, the effects of an intervention (new treatment) are measured by comparing the outcome in the experimental group with that in a control group. Experimental studies are similar to cohort studies except that the exposure is a deliberate change (intervention) made by the researcher in one group of participants and it overcomes confounding because the treatment is assigned randomly. Further, we discuss various types of randomization (random sequence allocation) and importance of allocation concealment and blinding for proper assessment of outcomes in randomized trials.

Osteoporosis is a common secondary complication in patients with systemic lupus erythematosus (SLE). Current osteoporosis treatment with bisphosphonates has some negative side effects and there is a lack of data regarding newer treatments options for SLE associated osteoporosis. The tissue-selective estrogen complex (TSEC) containing conjugated estrogens and the selective estrogen receptor modulator bazedoxifene (Bza) is approved for treatment of postmenopausal vasomotor symptoms and prevention of osteoporosis. However, it has not been evaluated for treatment of osteoporosis in postmenopausal SLE patients. Ovariectomized MRL/ lpr mice constitute a model for postmenopausal lupus that can be used for osteoporosis studies. We used this model in a set of experiments where the mice were treated with different doses of 17β-estradiol-3-benzoate (E2), Bza, or TSEC (E2 plus Bza), administered in the early or late phases of disease development. The skeleton was analyzed by dual-energy X-ray absorptiometry, peripheral quantitative computed tomography, and high-resolution microcomputed tomography. The lupus disease was assessed by determination of proteinuria, hematuria, and lupus disease markers in serum. Treatment with medium dose TSEC administered in early disease protected ovariectomized MRL/ lpr mice from trabecular bone loss, while there were no differences in lupus disease parameters between treatments. This is the first experimental study to investigate TSEC as a potential new therapy for osteoporosis in postmenopausal SLE.

Extreme-mass-ratio inspirals are one of the most exciting and promising target sources for space-based interferometers (such as LISA, TianQin). The observation of their emitted gravitational waves will offer stringent tests on general theory of relativity, and provide a wealth of information about the dense environment in galactic centers. To unlock such potential, it is necessary to correctly characterize EMRI signals. However, resonances are a phenomena that occurs in EMRI systems and can impact parameter inference, and therefore the science outcome, if not properly modeled. Here, we explore how to model resonances and develop an efficient implementation. Our previous work has demonstrated that tidal resonances induced by the tidal field of a nearby astrophysical object alters the orbital evolution, leading to a significant dephasing across observable parameter space. Here, we extensively explore a more generic model for the tidal perturber with additional resonance combinations, to study the dependence of resonance strength on the intrinsic orbital and tidal parameters. To analyze the resonant signals, accurate templates that correctly incorporate the effects of the tidal field are required. The evolution through resonances is obtained using a step function, whose amplitude is calculated using an analytic interpolation of the resonance jumps. We benchmark this procedure by comparing our approximate method to a numerical evolution. We find that there is no significant error caused by this simplified prescription, as far as the astronomically reasonable range in the parameter space is concerned. Further, we use Fisher matrices to study both the measurement precision of parameters and the systematic bias due to inaccurate modeling. Modeling of self-force resonances can also be carried out using the implementation presented in this study, which will be crucial for EMRI waveform modeling., Comment: 18 pages, 14 figures

Background The growing burden of hypertension and diabetes is one of the major public health challenges being faced by the health system in India. Clinical Decision Support Systems (CDSS) that assist with tailoring evidence-based management approaches combined with task-shifting from more specialized to less specialized providers may together enhance the impact of a program. We sought to integrate a technology “CDSS” and a strategy “Task-shifting” within the Government of India’s (GoI) Non-Communicable Diseases (NCD) System under the Comprehensive Primary Health Care (CPHC) initiative to enhance the program’s impact to address the growing burden of hypertension and diabetes in India. Methods We developed a model of care “I-TREC” entirely calibrated for implementation within the current health system across all facility types (Primary Health Centre, Community Health Centre, and District Hospital) in a block in Shaheed Bhagat Singh (SBS) Nagar district of Punjab, India. We undertook an academic-community partnership to incorporate the combination of a CDSS with task-shifting into the GoI CPHC-NCD system, a platform that assists healthcare providers to record patient information for routine NCD care. Academic partners developed clinical algorithms, a revised clinic workflow, and provider training modules with iterative collaboration and consultation with government and technology partners to incorporate CDSS within the existing system. Discussion The CDSS-enabled GoI CPHC-NCD system provides evidence-based recommendations for hypertension and diabetes; threshold-based prompts to assure referral mechanism across health facilities; integrated patient database, and care coordination through workflow management and dashboard alerts. To enable efficient implementation, modifications were made in the patient workflow and the fulcrum of the use of technology shifted from physician to nurse. Conclusion Designed to be applicable nationwide, the I-TREC model of care is being piloted in a block in the state of Punjab, India. Learnings from I-TREC will provide a roadmap to other public health experts to integrate and adapt their interventions at the national level. Trial registration CTRI/2020/01/022723.

Objectives: The objectives of this study were: 1) to describe the socio demographics and classify chief complaints and reason to visit facilities of patients presenting to public healthcare facilities; 2) To explore difference in these complaints and ICPC-3 groups across socio-demographic and health system level.Design: Cross sectional studySettings: This study was conducted in three districts of Odisha, India. Within each district, the District hospital, one SDH (if available), two CHCs and two PHCs were selected. Thus a total of three DHHs, three SDHs, six CHCs and six PHCs were covered. Two tertiary health care facilities were also be included. Patients aged 18 years and above, attending the Outpatient Departments (OPD) of sampled health facilities were chosen as study participants through systematic random sampling. Results: In total 3044 patients were interviewed. In general, 65% of the sample reported symptoms as their chief complain for reason of encounter whereas 35% reported for disease and diagnosis. Most common reasons to encounter health facilities are fever, hypertension, abdominal pain, chest pain, arthritis, skin disease, cough, diabetes, and injury. Among symptoms categories, highest patients reported for general category (29%) followed by digestive system (16%). In the disease category circulatory system has the highest proportion followed by musculatory system. In symptom categories general, digestive and musculatory system were the key systems for reason of encounter in outpatient department irrespective of different groups of population. In terms of different tiers of health system, the top three reasons to visit OPD were dominated by circulatory system, respiratory system, musculatory system. Conclusion: This is the first Indian study using ICPC-3 classification for all the three levels of health care. Irrespective of age, socio economic variables and tiers of healthcare top three groups to visit public health facility according to ICPC-3 classification were consistent i.e., general, digestive, and circulatory. Implementation of standard management and referral guidelines for common diseases under these group will improve the quality and burden at public health facilities in India.

Early visual deprivation is known to have profound consequences on the subsequent development of spatial visual processing. However, its impact on temporal processing is not well characterized. We have examined spatial and temporal contrast sensitivity functions following treatment for early and extended bilateral visual deprivation in fifteen children born with congenital cataracts in rural India. The results reveal a marked difference in post-treatment spatial and temporal sensitivities. Whereas spatial processing in newly sighted children is significantly impaired relative to age-matched controls, temporal processing exhibits remarkable resilience and is comparable to that in the control group. This difference in spatial and temporal outcomes is especially surprising given our computational analyses of video sequences which indicate a strong linkage between the spatial and temporal spectral content of natural visual inputs. We consider possible explanations for this discrepancy.

Extreme-mass-ratio inspirals (EMRIs) are promising target sources for space-based interferometers such as LISA, Taiji, and Tianqin. Depending on the astrophysical environment, such as close perturbers or an accretion disk, EMRI orbital evolution may deviate from the predictions of general relativity in vacuum. In particular, we focus on the resonance jumps, i.e., the changes of the conserved quantities induced by a stationary perturbation to the background Kerr geometry. Using Hamiltonian formulation, we provide a closed relation between the jump in Carter constant and that in the axial component of angular momentum. It is also shown that the obtained relation is consistent with the fitting formulae computed for the tidal resonance in previous works., Comment: 9 pages, 1 figure, submitted to Class. Quantum Grav

Exercise can lower the risk of developing pancreatic cancer and has the potential to improve physical fitness and quality of life in patients with the disease. Yet, the effects of exercise training during pancreatic cancer treatment remain poorly characterized. This hampers the development of evidence-based disease-specific exercise recommendations.The purpose of this review was to describe and interpret the effect of exercise on physiological, QoL, and cancer-specific outcomes reported in clinical trials among pancreatic cancer patients during treatment.We conducted a scoping review of the literature according to the framework proposed by Arksey and O'Malley. Articles published prior to December 2021 were retrieved from PubMed, EMBASE, and Scopus. We only included studies that prescribed structured cardiorespiratory and/or resistance exercise in pancreatic cancer patients undergoing treatment.A total of 662 references were retrieved, of which 24 are included in the review. Twelve articles were randomized controlled trials and 12 were single-arm trials. Overlap in the trials from which data were reported occurred in 16 articles. Moderate intensity exercise was most commonly prescribed, reported feasible for most patients, with potential to enhance physical fitness and QoL. However, exercise adherence and beneficial effects may diminish with disease progression. Limited evidence suggests exercise may benefit cancer-specific outcomes.The results of this review indicate that exercise is feasible during pancreatic cancer treatment. Exercise can also improve physical fitness and QoL. However, its beneficial effects may fall with advanced disease and more rigorous research is needed to develop precise exercise protocols for this population.

The study aims to identify recurrent multimorbidity pattern among individuals in the age-group 15-64 years. Further, the study examines the association of these identified patterns with sociodemographic variables and selected health outcomes.The study utilized data on 2912 individuals in the age-group 15-64 years collected under the burden of diseases study among patients attending public health care settings of Odisha. A latent class analysis was used to identify commonly occurring disease clusters.The findings suggested that 2.4% of the individuals were multimorbid. Two latent disease clusters were identified, low co-morbidity and Hypertension-Diabetes-Arthritis. Findings highlighted that age, belonging to a non-aboriginal ethnicity and urban area increased the risk of being in the 'Hypertension-Diabetes-Arthritis' group. Furthermore, 50% of the individual in the 'Hypertension-Diabetes-Arthritis' group reported poor quality of life, whereas 30% reported poor self-rated health compared to only 11% by their counterparts. Additionally, the mean health score reported by the individuals in the 'Hypertension-Diabetes-Arthritis' group was 39.9 compared to 46.9 by their counterparts.The study findings hint towards increasing burden of multimorbidity among the working age population, which depicts a shift in causation of diseases as a result of which preventive measures also need to be taken much prior.

Extreme mass ratio inspirals (EMRIs) will be important sources for future space-based gravitational-wave detectors. In recent work, tidal resonances in binary orbital evolution induced by the tidal field of nearby stars or black holes have been identified as being potentially significant in the context of extreme mass-ratio inspirals. These resonances occur when the three orbital frequencies describing the orbit are commensurate. During the resonance, the orbital parameters of the small body experience a jump leading to a shift in the phase of the gravitational waveform. In this paper, we treat the tidal perturber as stationary and restricted to the equatorial plane, and present a first study of how common and important such resonances are over the entire orbital parameter space. We find that a large proportion of inspirals encounter a low-order resonance in the observationally important regime. While the instantaneous effect of a tidal resonance is small, its effect on the accumulated phase of the gravitational waveform of an EMRI system can be significant due to its many cycles in band; we estimate that the effect is detectable for a significant fraction of sources. We also provide fitting formulae for the induced change in the constants of motion of the orbit due to the tidal resonance for several low-order resonances., Comment: 19 pages, 14 figures

Aim To estimate the prevalence, socio-demographic determinants, common disease combinations, and health impact of multimorbidity among a young rural population. Methods We conducted a cross-sectional survey among participants aged ≥30 years in rural Punjab, North India, from Jan 2019 to April 2019. Multimorbidity was defined as the coexistence of ≥two conditions using a 14-condition tool validated in India. We also calculated a multimorbidity-weighted index (MWI), which provides a weight to each disease based on its impact on physical functioning. Logistic regression was conducted to evaluate the association with sociodemographic variables, mental health (PHQ-9), physical functioning (ADL scale), and self-rated health (SRH). Results We analyzed data from 3213 adults [Mean age 51.5 (±13), 54% women]. Prevalence of single chronic condition, multimorbidity, and MWI was 28.6, 18% and − 1.9 respectively. Age, higher wealth index and ever use alcohol were significantly associated with multimorbidity. Overall, 2.8% of respondents had limited physical functioning, 2.1% had depression, and 61.5% reported low SRH. Poorer health outcomes were more prevalent among the elderly, women, less educated, and those having lower wealth index and multimorbidity, were found to be significantly associated with poor health outcomes. Conclusions The burden of multimorbidity was high in this young rural population, which portends significant adverse effects on their health and quality of life. The Indian health system should be reconfigured to address this emerging health priority holistically, by adopting a more integrated and sustainable model of care.

Background: High dietary salt intake is an avoidable cause of hypertension and associated cardiovascular diseases (CVDs). Thus, salt reduction is recommended as one of the most cost-effective interventions for CVD prevention and for achieving the World Health Organization’s (WHO) 25% reduction in premature non-communicable disease (NCD) mortality by 2025. However, current and comprehensive information about national salt reduction policies and related actions across different regions are difficult to access and impede progress and monitoring. Objectives: As an initial step to developing an online repository of salt reduction policies and related actions, and to track nation-wise progress towards the WHO’s 25 by 25 goal, we aimed to identify and assess salt reduction policies and actions in select countries from two of the top five most populous regions of the world- the South-East Asia and Latin America. Methods: We conducted a literature review to identify national and regional salt reduction policies in the selected South-East Asian and Latin American countries, from January 1990–August 2020, available in English and Spanish. We also contacted selected WHO country offices (South-East Asian region) or relevant national authorities (Latin America) to gain access to unpublished documents. Results: In both regions, we found only a few dedicated stand-alone salt reduction policies: Bhutan, Sri-Lanka and Thailand from South East Asia and Costa Rica from Latin America. Available polices were either embedded in other national health/nutritional policy documents/overall NCD policies or were unpublished and had to be accessed via personal communication. Conclusions: Salt reduction policies are limited and often embedded with other policies which may impede their implementation and utility for tracking national and international progress towards the global salt reduction target associated with the 25 by 25 goal. Developing an online repository could help countries address this gap and assist researchers/policymakers to monitor national progress towards achieving the salt reduction target.

Entropy is a significant measure of information theory used as to measure the uncertainty or quantities the information’s contained in data or information in any experiment or process. Thus keeping...

We study a hierarchical triple system with the Kozai-Lidov mechanism, and analyse the cumulative shift of periastron time of a binary pulsar by the emission of gravitational waves. Time evolution of the osculating orbital elements of the triple system is calculated by directly integrating the first-order post-Newtonian equations of motion. The Kozai-Lidov mechanism will bend the evolution curve of the cumulative shift when the eccentricity becomes large. We also investigate the parameter range of mass and semi-major axis of the third companion with which the bending of the cumulative-shift curve could occur within 100 years., Comment: 6 pages, 3 figures, accepted by MNRAS letters

Background: The burden of noncommunicable diseases and their risk factors has rapidly increased worldwide, including in India. Innovative management strategies with electronic decision support and task sharing have been assessed for hypertension, diabetes mellitus, and depression individually, but an integrated package for multiple chronic condition management in primary care has not been evaluated. Methods: In a prospective, multicenter, open-label, cluster-randomized controlled trial involving 40 community health centers, using hypertension and diabetes mellitus as entry points, we evaluated the effectiveness of mWellcare, an mHealth system consisting of electronic health record storage and an electronic decision support for the integrated management of 5 chronic conditions (hypertension, diabetes mellitus, current tobacco and alcohol use, and depression) versus enhanced usual care among patients with hypertension and diabetes mellitus in India. At trial end (12-month follow-up), using intention-to-treat analysis, we examined the mean difference between arms in change in systolic blood pressure and glycated hemoglobin as primary outcomes and fasting blood glucose, total cholesterol, predicted 10-year risk of cardiovascular disease, depression score, and proportions reporting tobacco and alcohol use as secondary outcomes. Mixed-effects regression models were used to account for clustering and other confounding variables. Results: Among 3698 enrolled participants across 40 clusters (mean age, 55.1 years; SD, 11 years; 55.2% men), 3324 completed the trial. There was no evidence of difference between the 2 arms for systolic blood pressure (Δ=−0.98; 95% CI, −4.64 to 2.67) and glycated hemoglobin (Δ=0.11; 95% CI, −0.24 to 0.45) even after adjustment of several key variables (adjusted differences for systolic blood pressure: – 0.31 [95% CI, −3.91 to 3.29]; for glycated hemoglobin: 0.08 [95% CI, −0.27 to 0.44]). The mean within-group changes in systolic blood pressure in mWellcare and enhanced usual care were −13.65 mm Hg versus −12.66 mm Hg, respectively, and for glycated hemoglobin were −0.48% and −0.58%, respectively. Similarly, there were no differences in the changes between the 2 groups for tobacco and alcohol use or other secondary outcomes. Conclusions: We did not find an incremental benefit of mWellcare over enhanced usual care in the management of the chronic conditions studied. Clinical Trial Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT02480062.

Interval-valued intuitionistic fuzzy environment is appropriate for the most of the practical scenarios involving uncertainty, vagueness and insufficient information such as pattern recognition, medical diagnoses and decision making, etc. Entropy, similarity, distance, inclusion and cross entropy measures are few methods used for the measuring uncertainty and classifying interval-valued intuitionistic fuzzy sets. This paper presents the generalised entropy measure for the interval-valued intuitionistic fuzzy sets and relation is established that is used to define the generalised similarity measures using the proposed entropy measure. Further, the proposed entropy measure is compared with some existing measure of entropy with the help of an illustrative example and lastly we have demonstrated how the proposed measure can be used in decision making.

This paper deals with the designing of low-power transconductance–capacitance-based loop filter. The folded cascode-based operational transconductance amplifier (OTA) is designed in this paper with the help of quasi-floating bulk MOSFET that achieved the DC gain of 88.61[Formula: see text]dB, unity gain frequency of 97.86[Formula: see text]MHz and power consumption of 430.62[Formula: see text][Formula: see text]W. The proposed OTA is compared with the exiting OTA structure which showed 19.50% increase in DC gain and 15.11% reduction in power consumption. Further, the proposed OTA is used for the designing of transconductance–capacitance-based loop filter that has been operated at [Formula: see text]3[Formula: see text]dB cut-off frequency of 30.12[Formula: see text]MHz with the power consumption of 860.90[Formula: see text][Formula: see text]W at the supply voltage of [Formula: see text][Formula: see text]V. The transistor-level simulation has been done in 0.18[Formula: see text][Formula: see text]m CMOS process.

The study utilized data on 2912 individuals in the age-group 15-64 years collected under the burden of diseases study among patients attending public health care settings of Odisha, India. The findings suggested that 2.4% of the individuals in the working age-group were affected with multimorbidity. We utilized a latent class analysis (LCA) to identify commonly occurring disease clusters. Based on the LCA model fits, i.e., lowest AIC and BIC values, two latent disease classes were identified. These classes were named low co-morbidity and Hypertension-Diabetes-Arthritis; based on the item responseprobabilities. Binary logistic regression adjusted for age, sex, ethnicity, educationlevel, marital status, socio-economic status, residence, and health insurance, highlighted thatage, belonging to a non-aboriginal ethnicity and urban area increased the risk of being in the‘Hypertension-Diabetes-Arthritis’group compared to ‘low-comorbidity’ group. Furthermore, 50% of the individual in the ‘Hypertension-Diabetes-Arthritis’ group reportedpoor quality of life, whereas 30% reported poor self-rated health (SRH) compared to only11% reporting poor SRH in the ‘low-comorbidity’ group. Additionally, the mean healthscore reported by the individuals in the ‘Hypertension-Diabetes-Arthritis’ group was 39.9(scale 0-100) compared to 46.9 by their counterparts.

With the increasing demand of low-power integrated circuit for the RF transreceiver, it is always desirable to design the low-power phase lock loop. Nowadays, the demand of ultra-low-power PLL is increasing rapidly. Loop filter is one of the power consuming building block that takes large amount of power. This paper deals with the designing of the low-power transconductance-capacitance based loop filter with the help of dynamic threshold MOS technique. The simulation results show transconductance-capacitance loop filter operating at −3 dB frequency of 39.9 MHz with the power consumption of 252.78 µW along with the supply voltage of 1 V.

Tissue engineering and regenerative medicine is an area of life science which employs not only engineering but biological principles as well in creating new tissues and organs to promote the regeneration of damaged tissues and organs. It aims in developing different biomaterials which can restore the function of living tissues by delivering the biological factors and stimulating the cells. Over the past few decades, nanotechnology has also gained due importance for creating nanoscale particles, which have made a significant contribution to the mankind. The chapter introduces different bionanocomposites that are being used in the field of tissue engineering and regenerative medicine for the development of biological substitutes. Hard tissues and soft tissues are identified by their specific characteristics and utility in the human body. Skin substitutes, scaffolds, hydrogels, implants, etc. are all different examples where tissue engineering and regenerative medicines play a significant role to mankind and are being studied in detail.

ImportanceThere is substantial interest in leveraging digital health technology to support hypertension management in low- and middle-income countries such as India. The potential for healthcare infrastructure and broader context to support such initiatives in the public healthcare system in India has not been examined.ObjectiveWe evaluated existing healthcare infrastructure to support digital health interventions and examined epidemiologic, socioeconomic, and geographical contextual correlates of healthcare infrastructure in 544 districts covering 29 states and union territories across India.DesignCross-sectional analysis of India’s Fourth District Level Household and Facility Survey (DLHS-4; 2012-2014), the most up-to-date district-level healthcare infrastructure data. Facilities were the unit of analysis and analyses accounted for clustering within states.SettingNationally representative data of health facilities across India.ParticipantsThe target sample was all health facilities within the government healthcare system.ExposuresEpidemiologic, socioeconomic, and geographical context.Main Outcome(s) and Measure(s)Healthcare system infrastructural context to implement hypertension management programs. Domains included diagnostics (functional BP instrument) medications (anti-hypertensive medication in stock), essential clinical staff (e.g., staff nurse, medical officer, pharmacist), and IT specific infrastructure (regular power supply, internet connection, computer availability). Infrastructure indicators were based on the Indian Public Health Standards.ResultsData from 32,215 government facilities were analyzed. Among lowest-tier subcenters, 30% had some IT infrastructure, while at the highest-tier district hospitals, 92% possessed IT infrastructure. At mid-tier primary health centres and community health centres, IT infrastructure availability was 29% and 51%, respectively. For all but sub-centres, the availability of essential staff was lower than the availability of IT infrastructure. For all but district hospitals, higher levels of blood pressure, body mass index, and urban residents were correlated with more favorable infrastructure. By region, districts in Western India tended towards having the best prepared health facilities.Conclusions and RelevanceIT infrastructure to support digital health interventions is more frequently lacking at lower and mid-tier healthcare facilities compared with apex facilities in India. Gaps were generally larger for staffing than physical infrastructure, suggesting that beyond IT infrastructure, shortages in essential staff pose as significant constraints to the adoption of digital health interventions. These data provide early benchmarks for state- and district level planning.

Background Hypertension and diabetes are among the most common and deadly chronic conditions globally. In India, most adults with these conditions remain undiagnosed, untreated, or poorly treated and uncontrolled. Innovative and scalable approaches to deliver proven-effective strategies for medical and lifestyle management of these conditions are needed. Methods The overall goal of this implementation science study is to evaluate the Integrated Tracking, Referral, Electronic decision support, and Care coordination (I-TREC) program. I-TREC leverages information technology (IT) to manage hypertension and diabetes in adults aged ≥30 years across the hierarchy of Indian public healthcare facilities. The I-TREC program combines multiple evidence-based interventions: an electronic case record form (eCRF) to consolidate and track patient information and referrals across the publicly-funded healthcare system; an electronic clinical decision support system (CDSS) to assist clinicians to provide tailored guideline-based care to patients; a revised workflow to ensure coordinated care within and across facilities; and enhanced training for physicians and nurses regarding non-communicable disease (NCD) medical content and lifestyle management. The program will be implemented and evaluated in a predominantly rural district of Punjab, India. The evaluation will employ a quasi-experimental design with mixed methods data collection. Evaluation indicators assess changes in the continuum of care for hypertension and diabetes and are grounded in the Reach, Effectiveness, Adoption Implementation, and Maintenance (RE-AIM) framework. Data will be triangulated from multiple sources, including community surveys, health facility assessments, stakeholder interviews, and patient-level data from the I-TREC program’s electronic database. Discussion I-TREC consolidates previously proven strategies for improved management of hypertension and diabetes at single-levels of the healthcare system into a scalable model for coordinated care delivery across all levels of the healthcare system hierarchy. Findings have the potential to inform best practices to ultimately deliver quality public-sector hypertension and diabetes care across India. Trial registration The study is registered with Clinical Trials Registry of India (registration number CTRI/2020/01/022723). The study was registered prior to the launch of the intervention on 13 January 2020. The current version of protocol is version 2 dated 6 June 2018.

We study the Kozai-Lidov mechanism in a hierarchical triple system in detail by the direct integration of the first-order post Newtonian equations of motion. We analyse a variety of models with a pulsar to evaluate the cumulative shift of the periastron time of a binary pulsar caused by the gravitational wave emission in a hierarchical triple system with Kozai-Lidov mechanism. We compare our results with those by the double-averaging method. The deviation in the eccentricity, even if small, is important in the evaluation of the emission of the gravitational waves. We also calculate the cumulative shift of the periastron time by using obtained osculating orbital elements. If Kozai-Lidov oscillations occur, the cumulative shift curve will bend differently from that of the isolated binary. If such a bending is detected through the radio observation, it will be the first indirect observation of gravitational waves from a triple system., 22 pages, 24 figures, published by MNRAS

Thiazole based receptor 3, was designed and synthesized by condensation reaction of 5–chlorosalicylaldehyde with 4-(4-phenylthiazol-2-yl)semicarbazide for colorimetric and fluorimetric detection of fluoride ion. Receptor 3 was characterized by 1H NMR, 13C NMR, and HRMS, and shows absorption in 280–400 nm region with emission at 442 nm in tetrahydrofuran (THF). Addition of fluoride ion to the THF solution of receptor 3 results in color change from colorless to yellow with significant change in UV–Visible absorption. The receptor–anion interaction occurs via hydrogen bonding followed by deprotonation which results in large bathochromic shift in absorption spectra and naked-eye color change. The colorimetric changes show selective response for fluoride ions over other anions. Fluorescence studies exhibit remarkable enhancement in emission intensity upon addition of fluoride ion with a limit of detection (LOD) of 8.6 nM. The 1H NMR titration studies exhibit deprotonation of the –OH proton of the salicylaldimine moiety resulting significant colorimetric and fluorimetric changes.

Neurofibroma(NF) is one of the common well known autosomal dominant inheritable entity with a prevalence of one per 3000 people. Clinically, there are two types of NF:NF 1 with 90% occurrence along with 7 subtypes and NF2. It is a genetic disorder and benign peripheral nerve sheath tumor. It has a neural origin with presence of café –au-lait spots along with multiple nodules over the skin and all over the body. It might be associated with bone malformation and sometimes the central nervous systems is also involved. Diagnosis of neurofibroma is based on clinical criteria. The frequency of oral manifestations is debated in the literature. Some authors report a frequency of 4-7% of cases, whereas others suggest that these manifestations are present in up to 72% of cases. Here the purpose of this case report is to review the disease with intraoral clinical and radiological findings found in a patient having a bizzare radiographic finding of Intraoral Neurofibroma (NF).