Search

ABSTRACT Background Procalcitonin may be increased in active ulcerative colitis (UC). We investigated the role of procalcitonin in predicting response in acute severe UC (ASUC). Methods Consecutive patients with ASUC diagnosed on basis of Truelove and Witts criteria were enrolled. Serum procalcitonin levels for consecutive patients were measured at admission and day 3. We assessed role of procalcitonin values at presentation and at day 3 in assessing response on day 3 (Oxford’s criteria) and need for second line therapy (day 28). Results Of fifty patients (23 males, mean age: 35.98±13.8 years), 16 did not respond (day 3). Ten (20%) patients required second-line therapy. Baseline procalcitonin was significantly associated with response on day 3 (P=0.016). There was no association between day 1 or day 3 procalcitonin and need for second-line rescue therapy. Conclusion Serial procalcitonin is not an effective biomarker for predicting outcomes or need for second line therapy in ASUC.

Abstract Background First Nations (FN) people of Canada experience health, social, and systemic inequities due to colonization. Consequently, COVID-19 has placed further mental health stress on people related to personal finances, employment security and worry over infection, resulting in exacerbated effects of unresolved past medical and physical traumas. This study aims to understand the experiences related to mental health in an Alberta FN community during the early stages of the pandemic. Methods In partnership with FN leadership, the study implemented an online cross-sectional survey. Adults from a large FN community in Alberta, Canada, were asked to complete a survey, including two mental health-related screening questionnaires: (1) Generalized Anxiety Disorder-2 item; and (2) Patient Health Questionnaire-2 item. In addition, respondents could provide responses to open-ended questions about their experiences. Results Among 106 respondents, 95 (89.6%) finished the survey; 18% of adults screened positive for depressive symptoms (score of 3 or greater) and reported difficulty following public health advice for using hand sanitizer, maintaining social distancing, or self-isolating. 21% of adults screened positive for symptoms of anxiety (score of 3 or greater) and reported difficulty maintaining social distance, self-isolating, obtaining food and clothing, or meeting other basic living requirements. Conclusions FN communities may be disproportionately affected by COVID-19, and may experience exacerbated symptoms of anxiety, depression and overall poor mental health and well-being. Additional supports and services, including for mental health, should be considered for FN in the context of COVID-19 public health measures. Highlights The COVID-19 pandemic has brought upon increased stress and accompanying symptoms of anxiety and depression for a First Nations community in Alberta. Studies, such as this one, that characterize the influence of the COVID-19 pandemic on mental health among First Nations people, are urgently needed because of increasing demands on healthcare systems due to the pandemic and potential delays in the care of patients living with pre-existing mental health conditions. There is an opportunity to capitalize on First Nations people’s experiences of post-traumatic growth proactively supporting/maintaining their well-being and possibly the development of community-based mental health interventions and supports.

It is challenging to differentiate between tuberculous peritonitis and peritoneal carcinomatosis due to their insidious nature and intersecting symptoms. Computed tomography (CT) is the modality of choice in evaluating diffuse peritoneal disease. We conducted an ambispective analysis of patients suspected as having tuberculous peritonitis or peritoneal tuberculosis between Jan 2020 to Dec 2021. The study aimed to identify the clinical and radiological features differentiating the two entities. We included 44 cases of tuberculous peritonitis and 45 cases of peritoneal carcinomatosis, with a median age of 31.5 (23.5–40) and 52 (46–61) years, respectively (p ≤ 0.001). Fever, past history of tuberculosis, and loss of weight were significantly associated with tuberculous peritonitis (p ≤ 0.001, p = 0.038 and p = 0.001). Pain in the abdomen and history of malignancy were significantly associated with peritoneal carcinomatosis (p = 0.038 and p ≤ 0.001). Ascites was the most common radiological finding. Loculated ascites, splenomegaly and conglomeration of lymph nodes predicted tuberculous peritonitis significantly (p ≤ 0.001, p = 0.010, p = 0.038). Focal liver lesion(s) and nodular omental involvement were significantly associated with peritoneal carcinomatosis (p = 0.011, p = 0.029). The use of clinical features in conjunction with radiological findings provide better diagnostic yields because of overlapping imaging findings.

Abstract Introduction Stricturing gastrointestinal tuberculosis (GITB) may result in persistent symptoms even after antitubercular therapy (ATT) and may require surgical intervention. Data on efficacy and safety of endoscopic dilatation for management GITB related strictures is scarce. Methods A retrospective analysis of database of patients who underwent endoscopic balloon dilatation for suspected or proven gastrointestinal tuberculosis was performed. The analysis included the site of involvement, technical success, clinical success (response), relapse and requirement of surgery in these patients. Results Out of 34 patients (47.1% males, mean age 31.9 ± 12.9 years), eventually four patients were diagnosed to have Crohn’s disease while the rest had GITB. Initial technical success was achieved in 30 (88.2%) patients. Initial clinical success was achieved in 28 (82.3%) patients. Median number of dilatation sessions required to obtain symptomatic relief were 2.5 (1–5) per patient. Two patients with initial clinical success had recurrence of symptoms over follow up of 1 year, out of which one patient was managed with repeat endoscopic balloon dilatation successfully. Of 30 patients with technical success, 16 (53.4%) were on ATT when they underwent dilatation while two were in intestinal obstruction. Eventually 7 patients required surgical intervention for various reasons. Conclusion Non-fluoroscopic endoscopic balloon dilatation is an acceptable and fairly safe modality for symptomatic tuberculous strictures of gastrointestinal tract.

The design of an efficient and scalable Wireless Sensor Network (WSN) to accommodate the fluctuations in topology, node-mobility, node-density, and network-size is an exigent task. A meticulous investigation is necessitated to implement the sensor nodes in an appropriate topology at optimum node-mobility in ZigBee incorporated WSN networks to offer optimum Quality of Services (QoS). Subsequently, an attempt to compute the comprehensive recital of a non-beacon mode based 802.15.4/ZigBee integrated WSN network is demonstrated. An analytical model is designed using parameters such as back-off number, retransmission limit, and back-off exponent considering the impact of node-mobility which has not reported earlier. Further, the investigation is carried out experimentally by evaluating the different QoS metrics, for instance, throughput, network load, bit error rate (BER), received power, signal to noise ratio (SNR) and end-to-end delay for diverse node-density and network-size of a mobile Wireless Sensor Network. Based on the measurements obtained, the authors recommend implementing the mobile sensor nodes in a cluster-tree fashion to afford the best possible QoS services.

Background: Several phyto-chemicals have been identified and suggested as potential therapeutic options for hepatotoxicity management. Objective: To assess the hepatoprotective effect of scopoletin, a pure phyto-chemical, in carbon tetrachloride (CCl4)-induced hepatotoxicity model in Wistar rats. Methods: Thirty-six rats in total, six in each group, were utilized in this study. Animals in group 1 received normal saline; those in group 2 received carbon tetrachloride in olive oil (0.5 ml/kg, i.p. in ratio 1:1); those in groups 3, 4, and 5 received oral scopoletin (1 mg/kg, 5 mg/kg, 10 mg/kg dose-wise groups); and those in group 6 received N-acetyl cysteine (NAC) 150 mg/kg. Blood sampling was performed on day -3, day 1, and day 7 of the CCl4 administration. Rats were sacrificed on day 7 of the experiment for histological examination and oxidative stress measurement of the liver. Results: The 5 mg/kg scopoletin group showed a maximum reduction in AST levels [727.33 ± 29.15 in medium dose (MD) group vs 1526.66 ± 60.72 in the experimental control (EC) group (P < 0.001) and ALT levels of 532.66 ± 24.23 in MD group vs 894.83 ± 52.47 in EC (P < 0.01)]. The dose-dependent action was not observed with scopoletin doses. The protective effect of scopoletin was confirmed by MDA and GSH levels (P < 0.05) coupled with histo-pathological findings. In the present study, a reversible model of CCl4-induced hepatotoxicity was observed to get normalized in a week's time. Conclusion: The study confirms the hepatoprotective action of scopoletin in an acute model of hepatic injury with the putative anti-oxidant mechanism.

A peer-reviewed publication is a culmination of the scientific process, which involves various stages, including planning and executing a research project. Publications, apart from being evidence of research productivity, have become the chief measure of assessment of a researcher for selection and promotion. This has increased the pressure on academicians to have more publications. Moreover, with advances in peer review and an increasing number of journals that want to publish “impactful research” with a bias toward positive results, the process of getting a publication has become more difficult and complex. There is a lack of awareness about ethical practices known as good publication practices (GPPs). Reporting any research in a standard manner, preregistration of clinical trials, obtaining a proper ethical clearance, maintaining patient anonymity, and getting proper consent are some of the components of GPP. Misconducts in the publication process at the author's front include data fraud, plagiarism, copyright violations, nondisclosure of conflicts of interest, and duplicate publications. The peer reviewers and editors are also prone to misconduct, either knowingly or unknowingly. Ethical misconduct should be handled appropriately at the institutional, editorial, or journal level. The custodians of these ethical pillars are largely the editors and peer reviewers who must base their decisions on suggestions and advice from the organizations standardizing the practices, such as the Committee on Publication Ethics and the International Committee of Medical Journal Editors.

Artificial intelligence (AI) is often being touted as the means to bring about the fourth industrial revolution and its role in almost all sectors of our society is almost certain. This brings about an urgent need for evaluating the benefits and limitations of AI and machine learning (ML) across various sectors. Pharmaceutical industry has pioneered in embracing the use of AI in all its core areas but the success as of now seems very limited. The major advantage of AI is that it reduces the time that is needed for drug development, and in turn, it reduces the costs that are associated with drug development, enhances the returns on investment, and may even cause a decrease in cost for the end user along with improved drug safety. Hence, in this article, we will review the scope and limitations of AI in the pharmaceutical industry along with the brief review of how AI/ML can impact geriatric health care.

Background: Gastrointestinal tuberculosis (GITB) and Crohn's disease (CD) are close mimickers and difficult to discriminate. Recent work has focused on the immunological differences between GITB and CD based on cytokines related to T-regulatory cells and Th17 cells. In the present cross-sectional study, suspected cases of GITB or CD underwent extensive clinical, radiological, endoscopic, histological, and microbiological assessment. The diagnosis was based on standard criteria and response to antitubercular therapy endoscopically. Methods: Interleukin (IL)-10, transforming growth factor-β (TGF-β), and IL-17 were measured and compared between GITB and CD along with other parameters. Fisher's exact test and Mann–Whitney U test were used as per the data type. Results: Of the 27 patients, 11 had CD, 9 had GITB, and 7 had other conditions. Chronic diarrhea, involvement of left and long segments of the colon, and aphthous ulcers were significantly more frequent in CD; however, transverse ulcers were in GITB. IL-10 was reduced in both GITB (median-interquartile range [IQR] 9.54 [3.65–24.04]) and CD (median-IQR 13.28 [6.91–22.50]) compared to control (median-IQR 26.72 [10.34–35.43]). TGF-β showed little variation, but IL-17 was below the detection limit in most cases. None of these cytokines were significantly different between CD and GITB. The sensitivity and specificity of multiplex Mycobacterium tuberculosis-polymerase chain reaction were 44.44% and 100%, respectively. Conclusion: Serum cytokine profiling (IL-10, IL-17, and TGF-β) could not significantly differentiate GITB and CD. Moreover, extensive molecular, transcriptomic, chemokines, and cytokine analyses may shed light on these aspects.

The concept of digital twin (DT) is constantly revealing as a key enabling technology for the deployment of mobile communication services envisaged for the sixth-generation (6G) Internet-of-Things (IoT). This paper aims at providing a comprehensive review of the current state-of-the-art DT-enabled 6G oriented network services. The main characteristics of this new key enabling technology and its critical aspects are highlighted. An overview of the 6G network requirements for the deployment of its innovative envisioned services is firstly provided, emphasizing how the DT concept represents a complementary key enabling technology for them. This is followed by a brief introduction of the DT technology. Subsequently, a comprehensive classification and analysis of the research advancements on DT-enabled 6G services currently available in literature is provided. This paper is concluded by highlighting the most representative challenges and future directions necessary for the deployment of this promising and innovative technology.

Quantum computing is envisaged as an evolving paradigm for solving computationally complex optimization problems with a large-number factorization and exhaustive search. Recently, there has been a proliferating growth of the size of multi-dimensional datasets, the input-output space dimensionality, and data structures. Hence, the conventional machine learning approaches in data training and processing have exhibited their limited computing capabilities to support the sixth-generation (6G) networks with highly dynamic applications and services. In this regard, the fast developing quantum computing with machine learning for 6G networks is investigated. Quantum machine learning algorithm can significantly enhance the processing efficiency and exponentially computational speed-up for effective quantum data representation and superposition framework, highly capable of guaranteeing high data storage and secured communications. We present the state-of-the-art in quantum computing and provide a comprehensive overview of its potential, via machine learning approaches. Furthermore, we introduce quantum-inspired machine learning applications for 6G networks in terms of resource allocation and network security, considering their enabling technologies and potential challenges. Finally, some dominating research issues and future research directions for the quantum-inspired machine learning in 6G networks are elaborated.

Wind turbines are one of the primary sources of renewable energy, which leads to a sustainable and efficient energy solution. It does not release any carbon emissions to pollute our planet. The wind farms monitoring and power generation prediction is a complex problem due to the unpredictability of wind speed. Consequently, it limits the decision power of the management team to plan the energy consumption in an effective way. Our proposed model solves this challenge by utilizing a 5G-Next Generation-Radio Access Network (5G-NG-RAN) assisted cloud-based digital twins’ framework to virtually monitor wind turbines and form a predictive model to forecast wind speed and predict the generated power. The developed model is based on Microsoft Azure digital twins infrastructure as a 5-dimensional digital twins platform. The predictive modeling is based on a deep learning approach, temporal convolution network (TCN) followed by a non-parametric k-nearest neighbor (kNN) regression. Predictive modeling has two components. First, it processes the univariate time series data of wind to predict its speed. Secondly, it estimates the power generation for each quarter of the year ranges from one week to a whole month (i.e., medium-term prediction) To evaluate the framework the experiments are performed on onshore wind turbines publicly available datasets. The obtained results confirm the applicability of the proposed framework. Furthermore, the comparative analysis with the existing classical prediction models shows that our designed approach obtained better results. The model can assist the management team to monitor the wind farms remotely as well as estimate the power generation in advance.

Background/Aims Coronavirus disease 2019 (COVID-19) is recognized to have variable clinical manifestations. The clinical presentation of patients with inflammatory bowel disease (IBD) having COVID-19 is unclear. Methods We identified articles reporting about the clinical presentation of COVID-19 in those with underlying IBD from PubMed and Embase. The studies, irrespective of design or language, were included. The overall pooled frequency of various symptoms was estimated. Joanna Briggs Institute Critical appraisal checklist was used to assess the quality of studies. Results Eleven studies, including 1,325 patients, were included in the pooled analysis. The pooled estimates for clinical presentation were; fever: 67.53% (95% confidence interval [CI], 45.38–83.88), cough: 59.58% (95% CI, 45.01–72.63), diarrhea: 27.26% (95% CI, 19.51–36.69), running nose: 27% (95% CI, 15.26–43.19) and dyspnea: 25.29% (95% CI, 18.52–33.52). The pooled prevalence rates for abdominal pain, nausea and vomiting were 13.08% (95% CI, 9.24–18.19), 10.08% (95% CI, 5.84–16.85) and 8.80% (95% CI, 4.43–16.70) per 100 population, respectively. Conclusions The clinical presentation of COVID-19 in IBD patients is similar to the general population.

Introduction: Real time Reverse Transcription-Polymerase Chain Reaction (RT-PCR) test, the gold standard test for Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) detection, is a tedious process and requires proficient workforce. Accurate and fast test results may permit more efficient use of protective and isolation resources and allow rapid therapeutic interventions. Aim: To evaluate the analytical performance characteristics of the Cepheid Xpert Xpress SARS-CoV-2 test, a rapid, automated molecular test for SARS-CoV-2 with gold standard RT-PCR test. Materials and Methods: This retrospective cohort study was conducted in Virus Research and Diagnostic Laboratory (VRDL) in Department of Microbiology at GGS Medical College, Faridkot from January 2021-June 2021. A total of 100 nasopharyngeal samples, collected from clinically suspected Coronavirus Diseae-2019 (COVID-19) cases admitted at GGSMC during 1st January-30th June 2021 were tested both by Xpert assay and RT-PCR test simultaneously, taking RT-PCR as the gold standard test. The data was analysed by MedCalc® statistical software version 19.6.4., and sensitivity, specificity, predictive values, likelihood ratios and the agreement between the two tests were calculated. Results: The mean age of the study participants was 46 years. Of these, 55 were males and 45 were females. The overall sample sensitivity and specificity of the Xpert assay were both 100% and there was perfect agreement across specimens, if authors, set a cut-off Cycle threshold-value (Ct-value) at 40 cycles for Xpert. Of 100 samples, 32 were positive for SARS-CoV-2 by either of the tests and 68 were negative. Xpert assay could detect 100% positive cases and RT-PCR test could detect 84.37% positive cases. Out of the 32 samples which were positive by Xpert assay, 5 (15.62%) samples had a Ct-value greater than 40. Conclusion: The Xpert assay found to be useful as a point-of-care test in acute scenario, where rapid and authentic diagnosis is essential, but do not have expertise and infrastructure to perform RT-PCR.

In recent years, beta-casomorphin peptides (BCM7/BCM9) derived from the digestion of cow milk have drawn a lot of attention world over because of their proposed impact on human health. In order to evaluate the transcriptional modulation of target genes through RT-qPCR in response to these peptides, availability of appropriate reference or internal control genes (ICGs) will be the key. The present study was planned to identify a panel of stable ICGs in the liver tissue of C57BL/6 mice injected with BCM7/BCM9 cow milk peptides for 3 weeks. A total of ten candidate genes were evaluated as potential ICGs by assessing their expression stability using software suites; geNorm, NormFinder and BestKeeper. The suitability of the identified ICGs was validated by assessing the relative expression levels of target genes, HP and Cu/Zn SOD. Based on geNorm, PPIA and SDHA gene pair was identified to be most stably expressed in liver tissue during the animal trials. Similarly, NormFinder analysis also identified PPIA as the most stable gene. BestKeeper analysis showed crossing point SD value for all the genes in the acceptable range that is closer to 1. Overall, the study identified a panel of stable ICGs for reliable normalization of target genes expression data in mice liver tissues during BCM7/9 peptides trial.

China and India interactions are dominated by strategic and business concerns. Despite the massive growth of bilateral trade between China and India, tensions over territorial and political issues have also grown, particularly in the last years. These effects are mediated and often inflamed by media depictions and perceptions of these tensions. India and China are both aware that peace and cooperation are essential. But it seems some media are more intent on fanning the flames than focusing on the ties that bind the two ancient civilizations. The media can play a constructive role in promoting mutual understanding. This paper deals with different areas of bilateral competition and convergence covered by the media as well as discusses the key differences between the Indian medias coverage of China and the Chinese medias reporting on India of the last years and especially in 2020. The article proposes to discover the problems and perspectives of the Indian media in India-China relations today.

ABSTRACT BACKGROUND: Traditionally peptic ulcer disease was the most common cause of upper gastrointestinal (UGI) bleed but with the changing epidemiology; other etiologies of UGI bleed are emerging. Many scores have been described for predicting outcomes and the need for intervention in UGI bleed but prospective comparison among them is scarce. OBJECTIVE: This study was planned to determine the etiological pattern of UGI bleed and to compare Glasgow Blatchford score, Pre-Endoscopy Rockall score, AIMS65, and Modified Early Warning Score (MEWS) as predictors of outcome. METHODS: In this prospective cohort study 268 patients of UGI bleed were enrolled and followed up for 8 weeks. Glasgow Blatchford score, Endoscopy Rockall score, AIMS65, and MEWS were calculated for each patient, and the area under the receiver operating characteristic (AUC-ROC) curve for each score was compared. RESULTS: The most common etiology for UGI bleed were gastroesophageal varices 150 (63.55%) followed by peptic ulcer disease 29 (12.28%) and mucosal erosive disease 27 (11.44%). Total 38 (15.26%) patients had re-bleed and 71 (28.5%) patients died. Overall, 126 (47%) patients required blood component transfusion, 25 (9.3%) patients required mechanical ventilation and 2 (0.74%) patients required surgical intervention. Glasgow Blatchford score was the best in predicting the need for transfusion (cut off - 10, AUC-ROC= 0.678). Whereas AIMS65 with a score of ≥2 was best in predicting re-bleed (AUC-ROC=0.626) and mortality (AUC-ROC=0.725). CONCLUSION: Gastrointestinal bleed was most commonly of variceal origin at our tertiary referral center in Northern India. AIMS65 was the best & simplest score with a score of ≥2 for predicting re-bleed and mortality.

Security and trust are the entangled role players in the future generation of wireless networks. Security in 5G networks is currently supported using several functions. Given the advantages of such a system, this article explores the functional security and trust for the 6G ecosystem with ultra-connectivity. Several associated challenges, application-specific domains, and consumer issues related to 6G security are discussed. The article highlights the network security-by-design and trust-by-design principles and performance expectations from the security protocols in supporting handover in an ultra-connected scenario. Finally, potential research directions are presented for a road towards the 6G ecosystem.

Esophageal Intramural Haematoma (EIH) is a rare entity usually caused by repeated emesis or trauma. It is diagnosed on the basis of upper gastrointestinal endoscopy and radiology.Treatment is conservative unless hemodynamic instability prevails. Use of anticoagulation or thrombolytic therapy is believed to be a risk factor rather than a causative etiology. However,a review of literature shows only few cases occurring post-thrombolysis. We report about a patient of myocardial infarction who was thrombolyzed with streptokinase. He developed hematemesis and dysphagia a few hours after thrombolysis despite ECG resolution of his ST elevation. He was diagnosed to have EIH on basis of endoscopic and computed tomographic findings. His symptoms improved within two weeks, and a repeat UGIE showed resolution of the hematoma.

Background: Various inotropic agents/vasopressors combinations are used in patients of cardiogenic shock. We performed this study to observe hemodynamic effects of various inotrope/vasopressor combinations in patients with NSTEMI cardiogenic shock (CS) at tertiary cardiac centre Methods and materials: Of 3832 NSTEMI, we studied 59 consecutive such patients with CS who hadn't undergone revascularization in the first 24 h in a prospective, open label, observational study. Group 1 comprised of background Dopamine with Noradrenaline titration(N = 38), Group 2 had background Dobutamine and Noradrenaline titration(N = 15) and Group 3 comprised of triple combination of Dopamine, Noradrenaline & Adrenaline(N = 6). Results: The mean change in hemodynamic parameters between these groups from baseline to 24 h showed no statistical difference. Cardiac output(CO), mean arterial pressure(MAP), central venous pressure(CVP) and cardiac power output(CPO) in group 2 were favorable at 6 and 24 h compared to baseline but mean change was insignificant as compared to others. In group 3, the increase in MAP was significant. IABP use did not change CO, CPO or SVR in any group except lower dosages of Dobutamine (49%) in IABP group. Lower in-hospital mortality in group 2 compared to others (P = 0.004) may be reflective of sicker patients in group 1 and 3. Conclusion: The mean changes in hemodynamic parameters were not significant between all groups. All regimes of inotropes when selected as per clinical indication in CS with ACS resulted in similar hemodynamic effects. The mortality difference may not truly be reflective of regimes rather reflect sicker patients in the higher mortality group.

Introduction: Rosacea is a chronic inflammatory disease that affects the facial skin with eye involvement being underdiagnosed. Aim: To study the prevalence of ocular rosacea in patients of rosacea in a tertiary care centre. Materials and Methods: The present study was a cross-sectional study conducted at two tertiary level hospitals from January 2020 to December 2021. Cases of rosacea diagnosed were referred from the Departments of dermatology to the Departments of ophthalmology for ocular evaluation. A total of 400 patients were included in study in a multicentric setting. For ophthalmic evaluation, Ocular Surface Disease Index (OSDI) questionnaire was used. Results: Total 29 cases (7.25%) had ocular rosacea, out of 400 dermatological confirmed cases of rosacea. Amongst confirmed ocular rosacea, 12 (41.4%) were males and 17 (58.6%) were females. Most manifestations were noted in 41 to 60 years age with an average age of 52.2 years. Most of the cases presented with multiple symptoms and signs- 19 presented with features of dry eyes,16 had features of conjunctivitis, 6 had blepharitis, and 7 had recurrent chalazions. Conclusion: Ocular rosacea is a diagnostic enigma to clinicians as it is underdiagnosed because of overlapping sign and symptoms. This study emphasises ocular examination in all cases of rosacea.

The elderly population in developed countries has increased rapidly in recent years; the elderly may be at greater risk of protein deficiency due to dietary, socio-economic, dental, and physical restrictions. Therefore, to address the issue of protein deficiency in elderly people, the present study aimed to enhance the protein content of high-gluten flour noodles, an Asian staple food, by supplementing them with soybean protein isolate (SPI) powder. The effect of SPI addition (5–20%, w/w) on composition, quality, texture, physical and sensory properties, and glycemic index (GI) of high-gluten flour noodles was investigated. The noodles made only from high-gluten flour served as control. In comparison to control noodles, 20% SPI noodles showed a rise in protein and moisture content from 16.17% to 30.64% and 36.06 to 44.84%, respectively. The cooking yield and cooking loss increased with an increase in SPI concentration compared to control noodles. Color characteristics analysis revealed the decreasing trend in brightness and yellowness of SPI noodles with minimal L* and b* values at a 20% SPI concentration. The addition of SPI also resulted in a decrease in the hardness and tensile strength of the noodles. The sensory analysis showed that 5% SPI noodles were more similar to control noodles in terms of flavor, taste, and overall acceptability. Moreover, the addition of SPI to the noodles significantly decreased the GI of the noodles reaching the standard of low-GI food. The findings of the current study indicate that soy protein noodles, besides supplementing the desired nutrients, may also prevent the risk of diabetes in elderly people.

Abstract Background Polymorphisms in thiopurine methyltransferase (TPMT) and Nudix hydrolase-15 (NUDT15) have been implicated as the predominant cause of thiopurine induced leukopenia in the Western countries and East Asia respectively. Exact role of these polymorphisms in South Asian population with inflammatory bowel disease (IBD) is uncertain. Methods We included consecutive patients with IBD who were initiated on thiopurines at a center in North India. The dosage of thiopurines was titrated using regular monitoring of hemogram and liver function tests. Three TPMT polymorphisms (c.238 G > C, c.460 G > A, and c.719A > G) and one NUDT15 polymorphism (c.415 C > T) were assessed. Comparison regarding incidence of leukopenia and maximum tolerated thiopurine dosage was performed between those with wild polymorphism and those with TPMT and NUDT15 polymorphisms, respectively. Results Of the 119 patients (61 males, mean age 36.8 ± 13.5 years), 105 (88.2%) had ulcerative colitis and 14 (11.8%) had Crohn’s disease. Leukopenia was noted in 33 (27.7%), gastrointestinal intolerance in 5 (4.2%) and pancreatitis in 2 (1.6%). TPMT polymorphisms were detected amongst five patients of whom 1 developed leukopenia. NUDT15 polymorphism was noted in 13 patients of whom 7 had leukopenia. The odds of developing leukopenia in TPMT polymorphism were non-significant (0.77, 95% CI:0.0822 to 7.2134, P = 0.819) but were significantly higher in those with NUDT15 polymorphism (3.5933, 1.1041 to 11.6951, P value: = 0.0336). Conclusion NUDT15 polymorphism was more frequent than TPMT polymorphisms and was associated with thiopurine induced leukopenia. However, the tested polymorphisms account for only 24.2% of the risk of thiopurine induced leukopenia.

Previous studies have suggested favorable outcomes of hydrocortisone, ascorbic acid (vitamin C), and thiamine (HAT) therapy in patients with sepsis. However, similar results have not been duplicated in sequential studies. This meta-analysis aimed to reevaluate the value of HAT treatment in patients with sepsis. Electronic databases were searched up until October 2020 for any studies that compared the effect of HAT versus non-HAT use in patients with sepsis. Data from 15 studies (eight randomized controlled trials [RCTs] and seven cohort studies) involving 67,349 patients were included. The results from the RCTs show no significant benefit of triple therapy on hospital mortality (risk ratio [RR], 0.99; P=0.92; I2=0%); intensive care unit (ICU) mortality (RR, 0.77; P=0.20; I2=58%); ICU length of stay (weighted mean difference [WMD], 0.11; P=0.86; I2 =37%) or hospital length of stay (WMD: 0.57; P=0.49; I2=17%), and renal replacement therapy (RR, 0.64; P=0.44; I2=39%). The delta Sequential Organ Failure Assessment (SOFA) score favored treatment after a sensitivity analysis (WMD, –0.72; P=0.01; I2=32%). However, a significant effect was noted for the duration of vasopressor use (WMD, –25.49; P

Abstract Current Additive Manufacturing machines have limited techniques to observe process conditions and to decrease process errors. In order to overcome these limitations and increase the level and accuracy of machine intelligence, machine conditions need to be monitored more meticulously. A novel method for the condition monitoring of a 3D‐printer is proposed in this paper. Quantum support vector machine (QSVM) is compiled for recognizing the health condition of the 3D‐printer. The proposed quantum machine learning approach helps in monitoring the health state of the machine and classifies the same as healthy or aberrant. Classical machine learning approaches are inefficient to process the large amount of experimental data in real time. For better decision‐making on such big data, quantum machine learning approaches are deployed which are much more efficient due to their exponential speed and parallel operation on complex sensor data, they show speedups in both the dimensionality and number of experimental data deployed to train the algorithm. The simulation results show that the proposed method has higher accuracy in fault diagnosis than the traditional Support Vector Machine. All the numerical simulations and experiments have been carried out on a real quantum hardware provided by the IBM Quantum computing over the cloud.

Background: Prolonged symptoms after COVID-19 are an important concern due to the large numbers affected by the pandemic. Objectives: To ascertain the frequency of gastrointestinal (GI) manifestations as part of long GI COVID. Design: A systematic review and meta-analysis of studies reporting GI manifestations in long COVID was performed. Data Sources and Methods: Electronic databases (Medline, Scopus, Embase, Cochrane Central Register of Controlled Trials, and Web of Science) were searched till 21 December 2021 to identify studies reporting frequency of GI symptoms in long COVID. We included studies reporting overall GI manifestations or individual GI symptoms as part of long COVID. We excluded pediatric studies and those not providing relevant information. We calculated the pooled frequency of various symptoms in all patients with COVID-19 and also in those with long COVID using the inverse variance approach. All analysis was done using R version 4.1.1 using packages ‘meta’ and ‘metafor’. Results: A total of 50 studies were included. The frequencies of GI symptoms were 0.12 [95% confidence interval (CI), 0.06–0.22, I 2 = 99%] and 0.22 (95% CI, 0.10–0.41, I 2 = 97%) in patients with COVID-19 and those with long COVID, respectively. The frequencies of abdominal pain, nausea/vomiting, loss of appetite, and loss of taste were 0.14 (95% CI, 0.04–0.38, I 2 = 96%), 0.06 (95% CI, 0.03–0.11, I 2 = 98%), 0.20 (95% CI, 0.08–0.43, I 2 = 98%), and 0.17 (95% CI, 0.10–0.27, I 2 = 95%), respectively, after COVID-19. The frequencies of diarrhea, dyspepsia, and irritable bowel syndrome were 0.10 (95% CI, 0.04–0.23, I 2 = 98%), 0.20 (95% CI, 0.06–0.50, I 2 = 97%), and 0.17 (95% CI, 0.06–0.37, I 2 = 96%), respectively. Conclusion: GI symptoms in patients were seen in 12% after COVID-19 and 22% as part of long COVID. Loss of appetite, dyspepsia, irritable bowel syndrome, loss of taste, and abdominal pain were the five most common GI symptoms of long COVID. Significant heterogeneity and small number of studies for some of the analyses are limitations of the systematic review.

Objective We investigated whether a previously reported association of IFNGR expression with rheumatoid arthritis (RA) and its radiographic severity reflects differences in proximal interferon‐γ (IFN‐γ) signaling in T cells from patients with RA compared with healthy controls (HC). Methods Using phosphoflow cytometry, we compared IFN‐γ–stimulated signal transducer and activator of transcription 1 (STAT1) activation in CD4+ and CD8+ T‐cell populations from patients with RA and HC. Results Compared with controls, patients with RA had a higher proportion of CD4+ T cells, associated with expansion of the CD4+ effector memory subset. Several CD4+ T‐cell types exhibited reduced IFN‐γ–induced phosphoSTAT1Y701 (pSTAT1Y701) in patients with RA compared with HC. Engaging the T‐cell receptor (TCR) complex on CD4+ T cells during IFN‐γ stimulation abrogated the reduction in STAT1 activation in patients with RA but had no effect in HC. The phosphorylation of STAT1S727 was similar in CD4+ T cells from patients with RA and HC. In contrast to CD4+ T cells, IFN‐γ–induced pSTAT1Y701 levels in CD8+ T cells were equivalent or higher in patients with RA compared with HC. Total STAT1 levels (phosphorylated + unphosphorylated) were lower in CD4+ and CD8+ T cells from patients with RA compared with HC. Conclusion We report diminished IFN‐γ–induced pSTAT1Y701 levels in CD4+ T cells in patients with RA, which were restored by TCR engagement. There were lower levels of total STAT1 in patients with RA compared with HC, but this likely does not explain diminished IFN‐γ–induced pSTAT1Y701 levels in CD4+ T cells because activation in CD8+ T cells was higher or equivalent to that seen in HC. The enhanced IFNGR expression in patients with RA reported previously may reflect a compensatory mechanism to overcome deficiency in IFN‐γ responsiveness.

The rising climate change concerns over the excessive exploitation of non-renewable sources have necessitated the need for alternative renewable and eco-friendly resources for the production of innovative materials, achieving the targets of bioeconomy. Lignocellulosic biomass (LB) constituted by polymeric sugars and lignin is an abundantly available plant-based renewable material in the form of agro-industrial food waste and crop residues that can be exploited for the production of an array of value-added chemicals and bioproducts. Cellulose is the most abundant natural and biodegradable organic polymer on earth derived from LB, with wide scale applications in the lignocellulosic biorefineries and food industries. The negative effects of food waste from agro-industrial activities could be reduced through the recovery of cellulose from these wastes and converting it into valuable forms. However, the extraction of cellulose from LB is a difficult task owing to the recalcitrant nature of biomass that restricts the easy accessibility of cellulose for value addition. Therefore, a suitable cellulose extraction method through the fractionation of LB is necessary for a better cellulose yield. Furthermore, owing to the enormous potential of nanocellulose (NC), researchers are keenly interested in developing ecologically acceptable cellulose extraction methods. Cellulose nanofibrils and nanocrystals confer excellent mechanical properties, non-toxic characteristics and biodegradability, due to which they possess wide-scale applications in diverse industrial sectors. The current review emphasizes the potential role of cellulose extraction and NC production from agro-food waste. The different pretreatment methods for their extraction from LB are outlined. The applications of nanocellulose in different areas are also discussed. The review also highlights the recent trends, challenges and future directions in the development of cellulose and NC-based commercial products.

Bioactive peptides derived from fish the byproduct protein hydrolysate have wide potential as functional food ingredients. The preparation of bioactive peptides is commonly achieved via enzymatic hydrolysis; this is the most preferred method because it has high specificity, fewer residual organic solvents in the product, and it is usually carried out in mild conditions. The use of various enzymes such as proteases is widely practiced in the industry, yet there are various limitations as it is of high cost and there is a limited availability of food-grade enzymes in the market. Moreover, high-throughput purification and the identification analysis of these peptides are currently being studied to further understand the functionality and characterization of the bioactive peptides. This review mainly focuses on the novel bioactive peptides derived from fish protein hydrolysates from various fish wastes and byproducts. The hydrolysis conditions, source of hydrolysate, and amino acid sequence of these novel peptides are presented, along with their corresponding methods of analysis in purification and identification. The use of various enzymes yields novel peptides with potent bioactivities, such as antiproliferative, antimicrobial, antihypertensive, antiglycemic, antitumor, and antioxidative biological functions. The increasing interest in proteomics in marine and aquatic waste utilization continues due to these products’ bioactivity and sustainability.

Gastrointestinal tuberculosis (GITB) and Crohn’s disease (CD) are close mimics. This prospective study aimed to evaluate the diagnostic performance of perfusion computed tomography (CT) in differentiating GITB from CD. Consecutive patients with ileocaecal thickening underwent perfusion CT of the ileocaecal region between January 2019 and July 2020. Two radiologists (blinded to the final diagnosis) independently assessed blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability at perfusion CT. These parameters were compared among the patients with GITB as well as active and inactive CD. Receiver operating characteristic curves were utilized for determining the diagnostic performance of perfusion CT. Interclass correlation coefficient and Bland–Altman analysis were performed to compare the observations of the two radiologists. During the study period, 34 patients underwent perfusion CT. Eight patients had diagnoses other than intestinal tuberculosis or CD. Thus, 26 patients (mean age 36 ± 14 years, 18 males) with GITB (n = 11), active CD (n = 6), and inactive CD (n = 9) were evaluated. BF, MTT, and permeability showed significant differences among the groups, while BV did not differ significantly among the groups. BF and permeability had 100% sensitivity and 100% specificity, while MTT had 61.5–100% sensitivity and 70–100% specificity for differentiating GITB from active CD and active from inactive CD. The interclass correlation coefficient for perfusion CT parameters was 0.88–1. Perfusion CT is a novel imaging technique that can improve the diagnostic performance of differentiating tuberculosis from CD.

Energy and electricity are critical prerequisites for every nation and critical components of social and economic growth. The monetary policy economist has been debating the issue of relying on core inflation or headline inflation, which includes energy, because the energy price is so volatile that it obscures the trend in inflation and dilutes the objectives of monetary policy. This paper aims at analyzing the impact of the twin deficit on energy inflation within a linear and nonlinear framework in India using time series data covering the period from 1971 to 2021. ARDL and NARDL approaches are employed to investigate the linear/symmetric response of energy inflation due to the twin-deficit in India. Estimates show a negative relationship between the twin-deficit and energy inflation in a symmetric model. The results of the asymmetric model reveal that the response of energy inflation due to expansionary fiscal policy (increment in CFD) and contractionary fiscal policy (decline in CFD) is diverse, in terms of size of the coefficient. Further, estimates of NARDL show the distinct impact of increases and decreases in CAD on energy inflation. The study offers several implications for policymakers and energy economists.

Introduction: Quantitative analysis of cardiac biomarkers, troponin I and CPK-MB, estimates the extent of myocardial injury while extent of benefit from coronary collateral circulation (CCC) to protect myocardium during acute myocardial infarction (AMI) needs validation. We analysed if the extent of collaterals had impact on baseline biomarkers at the time of coronary angiogram. Methods: We analysed 3616 consecutive patients who presented with AMI and underwent invasive coronary angiography (CAG) with intent to revascularisation with biomarkers assessment at the time of CAG. CCC to Infarct related artery (IRA) were graded as per Rentrop grading viz. poorly-developed CCC (Grade 0/1 as Group A) and well-developed CCC (Grade 2/3 as Group B). Results: Both groups (A and B) were matched for demographics, traditional risk factors, SYNTAX 1 Score, time to CAG from onset of angina and eGFR. 36.59% of patients had Non-ST segment elevation myocardial infarction (NSTEMI) as compared to 63.41% ST -segment elevation infarction (STEMI). Overall Troponin I (P=0.01, P=0.01) and CPK MB (P=0.00, P=0.002) values were lower in group B in both NSTEMI and STEMI groups respectively. Troponin I and CPK-MB were significantly lower in group B [with NSTEMI for SVD (Single vessel disease) (P=0.05) and DVD (Double vessel disease) (P=0.04),but not for TVD (Triple vessel disease) and with STEMI in SVD (P=0.01), DVD (P=0.01) and TVD (P=0.001)]. Conclusion: Patients with well-developed coronary collaterals had a lower rise in biomarkers in AMI as compared to those with poor collaterals amongst both NSTEMI and STEMI groups.

Background and Objectives: Stress is an indispensable part of modern-day living. The study deals with coping strategies by the participants and their perception toward drugs, electronic gadgets, and media as stress creators, busters, or relievers. Materials and Methods: A cross-sectional study was conducted among 400 community dwellers in a suburban area of Delhi. A structured questionnaire with Likert scale was used to assess coping strategies to stress and perception of use of electronic gadgets, media, and substance abuse as stress creators, busters, and relievers. Results: For coping strategies, 52.8% (95% confidence interval: 47.73–57.73) of the participants wanted to discuss problems with their families, but others considered mobile phones (51.5%, 46.48, 56.50), television (70.5%, 65.77, 74.93), and social networking sites (33.5%, 28.89, 38.36) to be their stress busters than creators. An age-associated statistically significant difference in perception about stress creator and buster scores between younger versus older was observed (P = 0.000), whereas gender-wise males perceived substance abuse to be a stress reliever in contrast to females (P = 0.000). Conclusion: Family plays an important role in the mitigation of stress. However, excess reliance on social media by younger people and substance abuse by males in stressful situations need to be addressed adequately.

Purpose Intraabdominal hypertension (IAH) in acute pancreatitis (AP) may reduce tissue perfusion and impair organ function and has been shown to portend poor prognosis. We investigated the computed tomography (CT) findings in patients with AP with IAH. Methods This retrospective study comprised of consecutive patients with AP from June 2016 to June 2018 in whom intraabdominal pressure (IAP) was measured. The patients who underwent a contrast-enhanced CT within 7 days of IAP measurement were included. Using a cutoff of 12 mm Hg for IAP, the patients were divided into IAH and non-IAH groups. Measures of severity and clinical outcome were evaluated. CT parameters were compared between the groups. Results The IAH group comprised of 41 patients, while there were 20 patients in the non-IAH group. The IAH group was characterized by severe disease, increased incidence of organ failure, increased requirement for drainage and surgery, prolonged hospital and intensive care unit stay. The mortality was not significantly different between the two groups. On univariate analysis, the CT features that were found to be significantly different between the two groups were the presence of collection (p = 0.036), the maximum dimension of collection (p = 0.004), volume of collection (p = 0.019), biliary dilatation (p = 0.011), and the presence of moderate-to-severe pleural effusion (p = 0.009). On multivariate analysis, all these parameters except biliary dilatation were found to be statistically significant. Conclusion CT findings in patients with AP may suggest IAH. This can be used as an additional marker for severity of AP.

Cellular technology has evolved over the decades for mobile network operators to accommodate the ever-growing demands of services for connecting Vehicle-to-Everything (V2X). The 5G infrastructure facilitates V2X communications, where a small-cell base station operating at ultra-high radio frequency with limited coverage becomes pervasive. These small-cell base stations in 5G-V2X must be strategically deployed near the consumers to realize several use cases. More recently, the architectural split solutions in Next Generation Radio Access Network (NG-RAN) are introduced, in which the gNB is divided into the distributed unit (gNB-DU) and control unit (gNB-CU). This functional split intends to improve scalability, performance, and network orchestration optimization. In this case, frequent user equipment (UE) handover between gNB-DUs is inevitable. However, the current 5G standard did not consider securing the path between these two entities. Hence, the NG-RAN could likely experience various security threats if the current handover procedure standard is employed without changes. Consequently, this paper introduces potential threats like resource depletion at NG-RAN caused by the useless execution of resource-demanding procedures to complete the transfer of attachment of UE to target gNB-DU. Another is UE being denied from accessing services caused by unsuccessful uplink and downlink synchronization during random access procedure execution, requiring establishing security and mutual authentication between the entities. Motivated by this, we proposed a security protocol composed of two phases, namely initial and handover. While the former phase assists in mutual authentication and key agreement between UE and serving gNB-DU, the latter secures UE’s mobility in inter-gNB-DU handover. This protocol aims to preserve the existing quality of service and support essential security requirements, including confidentiality, integrity, mutual authentication, secure key exchange, and perfect forward secrecy. The security requirements are formally verified using BAN logic and Scyther, and the proposed protocol demonstrated lower handover latency than EAP-AKA’, AKA, EAP-TLS, and EAP-IKEv2.

The fifth-generation (5G) of cellular technology is currently being deployed over the world. In the next decade of mobile networks, beyond 5G (B5G) cellular networks with the under-development advanced technology enablers are expected to be a fully developed system that could offer tremendous opportunities for both enterprises and society at large. B5G in more ambitious scenarios will be capable to facilitate much-improved performance with the significant upgrade of the key parameters such as massive connectivity, ultra-reliable and low latency (URLL), spectral efficiency (SE) and energy efficiency (EE). Equipping non-orthogonal multiple access (NOMA) with other key drivers will help to explore systems’ applicability to cover a wide variety of applications to forge a path for future networks. NOMA empowers the networks with seamless connectivity and can provide a secure transmission strategy for the industrial internet of things (IIoT) anywhere and anytime. Despite being a promising candidate for B5G networks a comprehensive study that covers operating principles, fundamental features and technological feasibility of NOMA at mmWave massive MIMO communications is not available. To address this, a simulation-based comparative study between NOMA and orthogonal multiple access (OMA) techniques for mmWave massive multiple-input and multiple-output (MIMO) communications is presented with performance discussions and identifying technology gaps. Throughout the paper, aspects of operating principles, fundamental features and technological feasibility of NOMA are discussed. Also, it is demonstrated that NOMA not only has good adaptability but also can outperform other OMA techniques for mmWave massive MIMO communications. Some foreseeable challenges and future directions on applying NOMA to B5G networks are also provided

Context: In patients with rheumatic heart disease (RHD), left atrial appendage (LAA) dilation and thrombus formation is widely known. LAA thrombus formation is a risk factor for stroke even in patients with sinus rhythm. The aim of this study was to determine an association between LAA structure and function with respect to thrombus formation and differences in LAA size and velocity between patients with sinus rhythm and those with atrial fibrillation (AF). Materials and Methods: We prospectively studied LAA structure and function in 120 patients with RHD by transthoracic echocardiography and/or transesophageal echocardiography by measuring left atrial (LA) dimension, LA area, LAAmax/min, LAA ejection fraction (EF), and LAA emptying velocity. Results: Four out of 48 patients with sinus rhythm had LAA thrombus. In 72 patients with AF, 32 had LAA thrombus. Patients with LAA thrombus had lower mean LAA EF and emptying velocity both variables P-value is same (P

Context: To study the demographics and clinical profile of patients with acute pulmonary embolism (PE) and impact of management as per risk stratification on outcome of patients with acute PE. Materials and Methods: Prospective observational study of demographics, clinical profile, risk stratification, management, and outcome of patients presenting with acute PE from August 2016 to July 2017. Results: One hundred and fifty patients who were detected to have acute pulmonary thromboembolism with a mean age of 45.08 years, with 70% being males, were included in the study. There were 6 (4%) patients in high-risk group, 69 (46%) patients in intermediate-high subgroup, 39 (26%) patients in intermediate-low subgroup and 36 (24%) patients in low-risk group as per the ESC 2019 guidelines using sPESI score, shock/hypotension, right ventricle (RV) dysfunction and cardiac marker elevation. 72 patients (52%) had antecedent deep vein thrombosis (DVT) of which 60 patients has proximal, whereas 12 patients had distal DVT. One hundred and forty-seven patients (98%) had moderate-to-severe TR, 117 patients (78%) had evidence of right atrium/RV dysfunction and 27 patients (18%) had evidence of thrombus in the heart. Computed tomography pulmonary angiogram showed middle pulmonary artery thrombus/dilatation in 63 patients (42%), saddle thrombus in 18 patients (12%), partial thrombus in the left pulmonary artery (LPA) and right pulmonary artery (RPA) in 84 (56%) and 75 (50%) patients, respectively. Majority (86%) of patients with tenecteplase; 9 (10.3%) patients with streptokinase and 3 (3.4%) was thrmobolysed with alteplase. Conclusion: PE can present with unexplained dyspnea and atypical chest pain, among other signs and symptoms. Early diagnosis, risk stratification, and guideline-directed prompt management can lead to favorable outcome.

Abdominal tuberculosis and its protean manifestations still create a diagnostic challenge for clinicians and remain an important concern in the developing world. Crohn’s disease, which is being increasingly recognised in countries where intestinal tuberculosis is prevalent, needs to be differentiated as the two diseases resemble each other in their clinical presentation, and in their radiological, endoscopic, and histological findings. New diagnostic modalities and scoring systems have facilitated the differentiation of Crohn’s disease from intestinal tuberculosis with good accuracy. Randomised trials have shown 6 months of therapy to be equivalent to longer durations of treatment for patients with abdominal tuberculosis. This review focusses on the recent advances in diagnosis and management of abdominal tuberculosis.

Abstract Background and Aim The main clinical relevance of hepatic osteodystrophy is the increased risk of fractures. Dual‐energy X ray absorptiometry (DEXA)‐based assessment of bone mineral density, the current gold standard for diagnosing osteoporosis, is not the sole determinant of fracture risk. Other clinical risk factors also play an important role. This study was carried out to assess the prevalence and risk factors of hepatic osteodystrophy and estimate the entailed fracture risk by using the FRAX tool in a cohort of Indian cirrhotics. Methods Consecutive patients with cirrhosis (n = 120) were recruited. Etiologic workup, liver function tests, serum calcium, phosphate, 25(OH)D, HbA1c, and DEXA scan were performed. Hepatic osteodystrophy was defined as a T score of < −1. FRAX scores were calculated using the Indian calculator. Results The study cohort was predominantly male (86.7%) with a median age of 49 (40–65) years. Alcohol was the most common etiology (80%). All patients had Child‐Turcotte‐Pugh class B (63.3%) or class B (36.7%) cirrhosis. Hepatic osteodystrophy was present in 83.3% patients. On multivariate analysis, smoking (odds ratio [OR]: 3.1 [1.76–4.7], P

Background The Mayo endoscopic score (MES) remains the most commonly used index in clinical practice, as well as in various clinical trials. Recently, two validated histological indices (Nancy Index [NI] and Robert Histological Index [RHI]) have been developed for ulcerative colitis (UC). We aim to study the relationship between MES with NI, RHI, and the established Geboes Index (GI) in patients with UC. Methods This was a prospective single‐center study. MES was documented from the most involved area. Biopsy was taken from the same area and reported by a single gastrointestinal histopathologist who was blinded to the endoscopic score. Histological activity was reported using GI, NI, and RHI. Statistical analysis was performed using Spearman's correlation coefficient and Cohen's kappa coefficient using SPSS version 23. Results Median age of patients with UC (n = 96) was 36 years. Seventeen patients were in endoscopic remission (MES 0/1). Correlation coefficient between MES and GI/NI/RHI was only weak to moderate (rho = 0.381/0.389/0.442, respectively; P

Due to high peak-to-average-power ratio (PAPR) and low spectral-efficiency, the conventional Fast Fourier Transform based orthogonal frequency division multiplexing (OFDM) is losing its place to the other multicarrier modulation schemes. Alternatively, the wavelet treated multiple-input multiple-output (MIMO)-OFDM is gaining its popularity in realization of futuristic 5G networks due to proffering high spectral-efficiency, low-cost and low phase-noise. Subsequently, this work demonstrates a RF transmission system in S-band employing 2×2 MIMO-OFDM using orthogonaland biorthogonal-wavelets with diverse phase shift keying modulation (PSK) schemes. Among the available MIMO configurations, the authors implement spatial diversity as it promises good reliability in noisy links [11]. However, the distribution of Wavelet-OFDM (W-OFDM) signals over a radio over fibre (RoF) link is critically affected by the optical sub-system non-linearity. So, the simplest 2×2 Alamouti's space-time block code (STBC) is implemented in this work to overcome this non-linearity and to realize a less-complex detection. The work is further extended to realize an adaptive MIMO-RoF system employing W-OFDM scheme to adjust itself to a suitable available phase shift keying strategy as per the link-situation to retain an optimal balance of link-quality and spectral-efficiency.

Major depressive disorder (MDD) is a persistent psychiatric mood disorder that is prevalent from a few weeks to a few months, even for years in the worst cases. It causes sadness, hopelessness in the individuals; sometimes, it forces them to hurt themselves. In severe cases, MDD can even lead to the death of the individual. It is challenging to diagnose MDD as it co-occurs with many other disorders (Co-Morbid) and many other reasons such as mobility, lack of motivation, and cost. The way to diagnose MDD is usually high ended that is challenging for the regular clinicians to diagnose. Therefore, to make their work more comfortable, and to predict MDD at the early stages, we have developed an ensemble-based machine learning model. The data collected has been cleaned with a preprocessing technique, and feature selection are performed using wrapper based methods; moreover, in the final step, a stacking based ensemble learning model is implemented to classify the MDD patients. Furthermore, KNN Imputation is implemented for preprocessing, Random Forest-Based Backward Elimination for feature selection and multi-layer perceptron, SVM and Random Forest as low-level learners in stacking generalization model. The results show that the prediction accuracy of the stacking generalization model is superior to the individual classifiers.

With an enormous range of applications, the Internet of Things (IoT) has magnetized industries and academicians from everywhere. IoT facilitates operations through ubiquitous connectivity by providing Internet access to all the devices with computing capabilities. With the evolution of wireless infrastructure, the focus from simple IoT has been shifted to smart, connected and mobile IoT (M-IoT) devices and platforms, which can enable low-complexity, low-cost and efficient computing through sensors, machines, and even crowdsourcing. All these devices can be grouped under a common term of M-IoT. Even though the positive impact on applications has been tremendous, security, privacy and trust are still the major concerns for such networks and insufficient enforcement of these requirements introduces non-negligible threats to M-IoT devices and platforms. Thus, it is important to understand the range of solutions which are available for providing a secure, privacy-compliant, and trustworthy mechanism for M-IoT. There is no direct survey available, which focuses on security, privacy, trust, secure protocols, physical layer security and handover protections in M-IoT. This paper covers such requisites and presents comparisons of state-the-art solutions for IoT which are applicable to security, privacy, and trust in smart and connected M-IoT networks. Apart from these, various challenges, applications, advantages, technologies, standards, open issues, and roadmap for security, privacy and trust are also discussed in this paper.

Smart farming is rapidly revolutionizing the agricultural sector where embedded Internet of Things (IoT) devices are integrated into the field to maintain or improve the quality of products as well as increase food production. Despite the tremendous benefits, various cybersecurity threats of IoT can also be inherited by the sector. In this paper, we propose a lightweight specification-based distributed detection to identify the misbehavior of heterogeneous embedded IoT nodes efficiently and effectively in a closed-loop smart greenhouse farming system. To expand the monitoring space of a node, we exploited the Kalman-filter algorithm and simple statistical operations to obtain estimates of data. Accordingly, this enables a monitoring node to assess a target node that has distinct physical characteristics and access to natural phenomena. Along with this, we derive the behavior-rules that are specific to the target system and carefully translate these rules into a state machine diagram. Besides, we formally verify the functional correctness of the monitoring processes as well as ensure that the behavior specifications are completely covered by using the model checker tool UPPAAL. Through extensive experimental simulation using Proteus, we verify its applicability to resource-constrained embedded devices, e.g., Arduino-Uno, as well as show high accuracy in detecting misbehaving nodes while having low false alarms.

Recent developments in the state-of-the-art Intelligent Transportation Systems enable autonomous vehicles to offer significant safety services to take appropriate and prompt actions to avoid any probable unfortunate road-hazard. As the utmost functions of the advanced driving assistance system-equipped autonomous vehicles governed by the equipped radar, therefore, the radar system should have the ability to track multiple-targets accurately with high radar-resolutions. Unlike the microwave-radar, the photonic-radar comes out as an attractive candidate owing to provide wide-spectra to attain improved and precise radar-resolutions at low-power requirements along with extended target-range even under severe atmospheric fluctuations. Therefore, a linear frequency-modulated continuous-wave photonic-radar is developed in this work to carry out a radar cross-section-based tracking of multiple mobile-targets in the presence of fog, cloud, and rain. Besides it, some complex real-time traffic-scenarios consisting of multiple mobile-targets make the target-detection, data-association, and classification processes more complicated. Therefore, this work is tested for different multiple-mobile targets in different complicated traffic-scenarios modeled by using MATLAB™ software. The performance of the demonstrated photonic-radar is assessed through the power spectral density and range-Doppler mapping measurements. Furthermore, a comparison of the developed photonic-radar is also established with conventional microwave-radar to present a comparative analysis.

Context: The main aim of the study is to find out efficacy, outcomes, and complications of thrombolytic therapy and surgery for obstructive prosthetic heart valve thrombosis (PHVT). Materials and Methods: This was a prospective, observational study done on 130 patients with PHVT, from January 2016 to December 2017. Baseline details, clinical investigations, echocardiography, and fluoroscopy were done. In fibrinolytic therapy, group agents used were streptokinase and urokinase. Out of 130, 115 patients were followed for up to 6 months after the discharge. Results: Majority of the patients were females (66.9%). Sixty-five (50%) patients were in the New York Heart Association Class III, whereas 55 (42.3%) and 10 (7.7%) patients were in Class IV and II, respectively. Nearly 34.6% patients had AF, and remaining 63.1% had sinus rhythm. Out of 130 patients, 26 (20%) patients had single-leaflet valve and 103 (79.2%) patients had bileaflet valve, and only one patient had ball and cage type of the valve. Out of 130 patients, 81 (62.3%) patients received fibrinolytic therapy as the first-line therapy and 49 (37.7%) patients underwent surgery initially. In fibrinolytic therapy group, three patients underwent surgery due to failed fibrinolytic therapy. Fifty-three patients (65.5%) had complete hemodynamic and clinical success without any complications; 28 patients (34.5%) had failure. Of 130 patients, 49 patients underwent surgery as the initial treatment. In the surgical group, three patients died out of 52 patients; mortality rate was 5.80%. Conclusion: Surgery should be offered to patients with contraindications for fibrinolytic therapy as in case of recurrent PHVT surgery offers better outcome with lesser recurrences when compared with fibrinolytic therapy.