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Zinc deficiency, a common malnutrition in children and women is a global public health problem.Burden of zinc deficiencyis more in countries with low meat and high cereal food consumption like Nepal. Nationally representative data on zinc status in Nepal is lacking at present. This study analysed the data from the recent Nepal National Micronutrient status survey 2016(NNMSS-2016) to determinethe prevalence of zinc deficiency and associated risk factors among children aged 6-59 months (n=1462) and non-pregnant women aged 15-49 years(n=1923) from three ecological zones, Hill, Terai, and Mountainof the country. Venous blood was collected from the participants to measure micronutrients such as zinc, markers of anaemia, vitamin A, and markers of inflammation. Stool was collected to assessthe soil-transmitted helminths (STHs) and Helicobacterpylori infection. Socio-demographic, household and other relevant information were collected by a structured questionnaire. Logistic regression was used to examine the predictors of zinc deficiency among the participants.The overall zinc deficiency in children was found to be 22.9% while it was higher in non-pregnant women (24.7%). Predictors associated with zinc deficiency among enrolled children in the study were,living in rural areas (AOR=2.25, 95% CI, [1.13, 4.49]),occurrence of diarrhoea during the two weeks preceding the survey (AOR=1.57, 95% CI, [1.07, 2.30]), household wealth quintile (AOR= 0.48, 95% CI,[0.25, 0.92]) and vitamin A status (AOR=0.49, 95% CI,[0.28, 0.85]. Risk factors associated with zinc deficiency among the non-pregnant women were being underweight (AOR=1.60, 95% CI,[1.15, 2.23]), fever occurrence during two weeks preceding the survey (AOR=1.45, 95% CI,[ 1.06, 1.99]), H. pylori in the stool (AOR=1.32, 95% CI, [1.03, 1.70]), being rich (AOR=0.64, 95% CI,[0.42, 0.98]) and being in the risk of folate deficiency (AOR=0.60, 95% CI,[0.37, 0.96]). We conclude that community focused intervention programs including health and nutrition counselling and livelihood opportunities focusing groups at high-risk may improve the zinc status in Nepal.

The yeast mating pathway regulates haploid cell fusion in response to pheromone signaling via a mitogen-activated protein kinase (MAPK) cascade that controls directional growth (chemotropism). However, the regulators of chemotropic morphogenesis are ill-defined. By using a non-biased genome-wide screen, we identified hundreds of genes that affect mating. An additional screens identified and validated >20 novel positive and negative regulators of pheromone gradient sensing, chemotropism, shmoo development, and mating. Aside from known regulators of exocytosis and endocytosis, genes involved in translational control downstream of the G-protein-regulated pheromone and filamentous growth MAPK pathways were identified. These include the Scp160 RNA-binding protein and the Asc1, Rpl12b, and Rpl19b ribosomal proteins (RPs). Importantly, we demonstrate that pheromone treatment and Gα (Gpa1) activation stimulate Scp160 binding to (and inhibition of) Asc1, which acts downstream of glucose-activated Gα (Gpa2) on the filamentous growth pathway. Moreover, we identify both Rpl12b and Rpl19b as RP paralog-specific positive regulators of translation of mating components, including Scp160. Thus, opposing MAPK pathways may converge at the level of translational control to regulate signaling output.Abstract Figure

Over the past decade, we have witnessed the Internet becoming increasingly centralized in the hands of a small number of giant technology firms, that control many of the most popular applications and the content they host on their platforms. In addition, in the majority of instances today, access to the Internet is usually provided through local internet service providers (ISPs) in each country. Governments in different jurisdictions can exert pressure on these technology firms and ISPs to enforce restrictions on Internet usage by their citizens, such as the blocking access to certain sites and/or content. In this paper, we present a promising new approach to circumventing some of these issues. Our decentralized web (DWeb) proposal makes use of a mesh network to connect community based routers. In addition, objects on the DWeb are indexed using Bblockchain technology, which allows for secure storage of immutable object references, and integrity checking of the data being served to users. Our DWeb design is also capable of operating during network partitions, and is able to quickly re-synchronize with the larger network once connectivity has been restored., 7 pages

Antimicrobial stewardship (AMS) has emerged as a systematic approach to optimize antimicrobial use and reduce antimicrobial resistance. To support the implementation of AMS programs, the World Health Organization developed a draft toolkit for health care facility AMS programs in low- and middle-income countries. A feasibility study was conducted in Bhutan, the Federated States of Micronesia, Malawi, and Nepal to obtain local input on toolkit content and implementation of AMS programs. This descriptive qualitative study included semi-structured interviews with national- and facility-level stakeholders. Respondents identified AMS as a priority and perceived the draft toolkit as a much-needed document to further AMS program implementation. Facilitators for implementing AMS included strong national and facility leadership and clinical staff engagement. Barriers included lack of human and financial resources, inadequate regulations for prescription antibiotic sales, and insufficient AMS training. Action items for AMS implementation included improved laboratory surveillance, establishment of a stepwise approach for implementation, and mechanisms for reporting and feedback. Recommendations to improve the AMS toolkit&rsquo, s content included additional guidance on defining the responsibilities of the committees and how to prioritize AMS programming based on local context. The AMS toolkit was perceived to be an important asset as countries and health care facilities move forward to implement AMS programs.

Rozen’s reagent (hypofluorous acid–acetonitrile complex, HOF·MeCN) is a robust nonspecific oxygen-transfer reagent and became a proven tool for the oxidation of difficult-to-oxidize molecules. It has been applied to instant oxygen transfers to functional groups such as alkenes, alkynes, and aromatic hydrocarbons, epoxidation, oxidation of alcohols, amines, and alkynes, oxygen-transfer reactions with nitrogen, phosphorus, and sulfur-containing substrates, and α-hydroxylation of carbonyl groups. Apart from being a potential green oxidizing agent, the complex has applications in 18O-labeling and C–H functionalization strategies. Recent uses of Rozen’s reagent in developing nanomaterials and oxidized expanded graphite indicate the enormous potential of the reagent. These aspects are discussed in this review.1 Introduction2 Synthesis and Physical Properties3 Safety and Handling4 Oxygen-Transfer Reactions4.1 General Mechanism of Oxygen Transfer4.2 Epoxidation4.3 Oxidation of Alkynes4.4 Oxidation of Aromatic Alcohols and Phenols4.5 Oxidation of Nitrogen-Containing Compounds4.6 Conversion of Aldehydes into Nitriles4.7 Oxidation of Alcohols and Ethers4.8 Oxidation of Sulfur-Containing Compounds4.9 Oxygen-Transfer Reaction with Phosphine, Phosphite, and Phosphinite Compounds5 C–H Activation Reactions5.1 Hydroxylation of Nonactivated Tertiary Saturated Carbon Center5.2 Hydroxylation of Aromatic Carbon Center5.3 α-Hydroxylation of Carbonyl Group5.4 Activation of α-Hydrogens of α-Amino Acids6 Other Uses7 Green Chemistry and Rozen’s Reagent8 Experimental Problems9 Further Applications10 Conclusions

The cold spray process is governed by the impact of high velocity feedstock particles onto a substrate without melting. Hence, the bulk material properties are retained. However, it is challenging to achieve good adhesion strength. The adhesion strength depends on factors such as the cold spray process parameters, substrate conditions, coating/substrate interactions at the interface and feedstock material properties. This review examines fundamental studies concerning the adhesion mechanisms of cold spray technology and considers the effect of cold spray input parameters such as temperature, stand-off-distance, pressure, process gas, spray angle, and traverse speed of the cold spray torch on the bonding mechanism and adhesion strength. Furthermore, the effects of substrate conditions such as temperature, hardness, roughness and material on the adhesion mechanism are highlighted. The effect of feedstock properties, such as feed rate, shape and size are summarized. Understanding the effect of these parameters is necessary to obtain the optimal input parameters that enable the best interfacial properties for a range of coating/substrate material combinations. It is expected that feedstock of spherical morphology and small particle size (

A dedicated key server cannot be instituted to manage keys for MANETs since they are dynamic and unstable. The Lagrange's polynomial and curve fitting are being used to implement hierarchical key management for Mobile Ad hoc Networks (MANETs). The polynomial interpolation by Lagrange and curve fitting requires high computational efforts for higher order polynomials and moreover they are susceptible to Runge's phenomenon. The Chebyshev polynomials are secure, accurate, and stable and there is no limit to the degree of the polynomials. The distributed key management is a big challenge in these time varying networks. In this work, the Chebyshev polynomials are used to perform key management and tested in various conditions. The secret key shares generation, symmetric key construction and key distribution by using Chebyshev polynomials are the main elements of this projected work. The significance property of Chebyshev polynomials is its recursive nature. The mobile nodes usually have less computational power and less memory, the key management by using Chebyshev polynomials reduces the burden of mobile nodes to implement the overall system.

Prostate cancer is the most common cancer that affects elderly men. The conventional non-imaging screening test for prostate cancer like prostate antigen (PSA) and digital rectal examination (DRE) tests generally lack specificity. Ultrasound is the most commonly available, inexpensive, non-invasive, and radiation-free imaging modality among all the screening imaging modalities available for prostate cancer diagnosis. The precise segmentation of prostate contours in ultrasound images is crucial in applications such as the exact placement of needles during biopsies, computing the prostate gland volume, and to localize the prostate cancer. Moreover, the low-dose-rate (LDR) brachytherapy treatment in which radioactive seeds are implanted in the prostate region requires accurate contouring of the prostate gland in ultrasound images. Therefore, it is very important to segment the prostrate region accurately for the diagnosis and treatment. This paper aims to present the analysis of existing approaches used for the segmentation of prostate in transrectal ultrasound (TRUS) images. In this survey, different segmentation methods used to extract the prostrate using criteria such as mean absolute distance, Hausdorff distance and time are discussed in detail and compared.

Purpose The paper addresses various cyber threats and their effects on the internet. A review of the literature on intrusion detection systems (IDSs) as a means of mitigating internet attacks is presented, and gaps in the research are identified. The purpose of this paper is to identify the limitations of the current research and presents future directions for intrusion/malware detection research. Design/methodology/approach The paper presents a review of the research literature on IDSs, prior to identifying research gaps and limitations and suggesting future directions. Findings The popularity of the internet makes it vulnerable against various cyber-attacks. Ongoing research on intrusion detection methods aims to overcome the limitations of earlier approaches to internet security. However, findings from the literature review indicate a number of different limitations of existing techniques: poor accuracy, high detection time, and low flexibility in detecting zero-day attacks. Originality/value This paper provides a review of major issues in intrusion detection approaches. On the basis of a systematic and detailed review of the literature, various research limitations are discovered. Clear and concise directions for future research are provided.

A convenient and efficient synthesis of new triazole β-lactam conjugates using click chemistry is described. β-lactam 15 and 16 were prepared using cycloaddition strategy and propargylated at N-1 to afford compounds 17 and 18. Cu-catalyzed click reaction of these β-lactams 17 and 18 with different aryl azides provided 1,2,3-triazole conjugates 6 and 7, respectively. The products were fully characterized spectroscopically and tested against Gram-(+) and Gram-(-) bacteria. Compound 7a and 7c were found to be most active., Pharmaceutical chemistry; Microbiology, Triazole; Beta-lactam; Conjugates; Antibacterial assay.

The Internet of Things (IoT) represents the physical world of devices and objects connected over the network using wireless sensors. This chapter gives detailed study about the different applications of IoT with the integration of WSN (wireless sensor networks) with Internet connectivity. This allows applications to communicate among themselves and users on a global scale. A large number of IoT applications, like smart home, buildings, transport, water management, healthcare, agriculture, environment and industries, together form the smart city. Along with this, various challenges in the implementation of applications are discussed related to the reliability, sustainability, and efficiency. An open architecture looking into current need of IoT is also proposed and discussed.

Increasing awareness among the masses, environment, and the depleting natural oil reservoirs, a replacement for the fossil fuels is urgently required. Presently, biofuels are having increased scientific and societal attention, due to factors such as the need for high energy security, foreign exchange savings, oil price fluctuation, and concern over greenhouse gas (GHG) emissions arising from fossil fuels. Conventional fuel generated severe environmental impacts across the globe. Thus, increasing drastic greenhouse gas emission levels and decreasing crude oil depletion need to arise to study toward an alternative for fuel. Biodiesel and bioethanol are primary biofuels, yet they have limitations toward the feedstock and production process. Synthetic biofuel can be produced from any type of biomass. So they have the diversity of feedstocks and pathways. It may be sustainable, renewable alternative fuel over fossil fuels. It may be boon in GHG mitigation, especially world level carbon dioxide (CO2) reduction problem.

Introduction Nepal has pledged to substantially reduce maternal and newborn death by 2030. Improving quality of intrapartum health services will be vital to reduce these deaths. This paper examines quality of delivery and newborn services in health facilities of Nepal. Methods Data were sourced from the Nepal Health Facility Survey 2015, which covered a national representative sample of health facilities. The datasets were analysed to assess service readiness, availability and quality of delivery and newborn care in a sample of 992 health facilities. Results Of the 992 facilities in the sample, 623 provided delivery and newborn care services. Of the 623 facilities offering delivery and newborn care services, 13.3% offered comprehensive emergency obstetric care (CEmONC), 19.6% provided basic emergency obstetric care (BEmONC) and 53.9% provided basic delivery and newborn service. The availability of essential equipment for delivery and newborn care was more than 80% in health facilities. Except for the coverage of vitamin K injection, the coverage of immediate newborn care was more than 85% in all health facilities. The coverage of use of chlorhexidine ointment to all newborns was more than 70% in government hospitals and primary health care centers (PHCCs) and only 32.3% in private hospitals. Conclusions These findings show gaps in equipment and drugs, especially in PHCCs and private health facilities. Improving readiness and availability of equipment and drugs in PHCCs and private health facility will help improve the quality of care to further reduce maternal and newborn mortality in Nepal.

Lead-free double perovskite materials, A

Sampurna Kakchapati,1 Dipendra Raman Singh,2 Bir Bahadhur Rawal,2 Apiradee Lim1 1Department of Mathematics and Computer Science, Prince of Songkla University, Pattani, Thailand; 2National Centre for AIDS and STD Control, Kathmandu, Nepal Purpose: Female sex workers (FSWs) are a key-affected population susceptible to acquiring HIV and sexually transmitted infections (STIs), as well as transmitting the virus to others. The aim of the study was to assess HIV and syphilis prevalence among FSWs in Nepal and to examine factors associated with it. Materials and methods: The study was based on Integrated Biological and Behavioral Surveillance (IBBS) surveys among FSWs in Nepal from 2004 to 2015. Statistical analysis used chi-squared test to assess statistically significant risk factors for HIV and syphilis. Logistic regression models were used to identify the most important determinants for each outcome. Results: A total of 5,958 FSWs were tested, and among them, 100 (1.7%) were HIV positive and 230 (3.9%) were syphilis positive. The multivariate analysis revealed that syphilis was higher among those street-based, aged ≥35 years, illiterate, and with a duration of sex work of >3 years. HIV was higher among those aged ≥35 years, illiterate, street-based, and with a duration of sex work >3 years. Syphilis was strongly correlated with HIV. Conclusion: HIV epidemic among FSWs in Nepal appears in the stagnant trend, whereas STI epidemic has increased in recent years. The high influencing factors for HIV and syphilis prevalence were advanced age, street-based, lower education, and longer duration of sex work. Urgent efforts, as part of routine HIV/STI prevention and intervention, are required to reduce the high burden of syphilis among FSWs. Keywords: IBBS, sex workers, sexual behaviors, surveillance

This paper presents an experimental investigation on mechanical and associated properties of seawater and sea sand concrete (SWSSC) filled glass fibre reinforced polymer (GFRP) and stainless steel (SS) circular tubes. A proper SWSSC mix was developed to achieve the target strength and desirable workability. A total of 24 stub columns, including hollow sections and SWSSC fully filled tubes or double-skin tubes, were tested under axial compression with the load applied to concrete and tubes simultaneously. The stress-strain curves of the core concrete indicate that concrete strength and ductility is enhanced due to the confinement effect. Discussion focuses on the influence of tube diameter-to-thickness ratio, outer tube types and inner tube types on concrete confinement. Capacity formulae are proposed to estimate the load carrying capacity of SWSSC fully filled SS or GFRP tubes, and that of double skin tubes with four combinations of inner and outer tubes, i.e. SS and SS, SS and GFRP, GFRP and GFRP and GFRP and SS.

Researchers active in clinical, epidemiological, or translational research have the aim to publish their outcomes so that they can generalize their findings to the population. The sample size decision should be based on the difference in the result between the two groups analyzed as in an analytical subject field. It should also be based on the acceptable P value for statistical significance and the expected statistical power to test a hypothesis. Therefore, the purpose of sample size planning is to calculate an appropriate number of subjects for a specified survey design. This article accounts the concepts in calculating the sample size.

The embryonal sarcoma of the liver is an extremely malignant, aggressive and infrequent condition of the liver, predominantly affecting children in the age groups of four to ten. The disease manifests with fever, abdominal pain or mass, nausea and laboratory findings suggestive of liver cell injury. The diagnosis can be made using tumor markers, imaging, immunohistochemistry and histopathology. The multimodal management protocol focuses the use of surgical resection, chemotherapy and radiation to significantly improved survival rates and quality of life in these patients.

Crack formation in concrete is one of the main reasons for concrete degradation. Calcium alginate capsules containing biological self-healing agents for cementitious materials were studied for the self-healing of cement paste and mortars through in vitro characterizations such as healing agent survivability and retention, material stability, and biomineralization, followed by in situ self-healing observation in pre-cracked cement paste and mortar specimens. Our results showed that bacterial spores fully survived the encapsulation process and would not leach out during cement mixing. Encapsulated bacteria precipitated CaCO3 when exposed to water, oxygen, and calcium under alkaline conditions by releasing CO32&minus, ions into the cement environment. Capsule rupture is not required for the initiation of the healing process, but exposure to the right conditions are. After 56 days of wet&ndash, dry cycles, the capsules resulted in flexural strength regain as high as 39.6% for the cement mortar and 32.5% for the cement paste specimens. Full crack closure was observed at 28 days for cement mortars with the healing agents. The self-healing system acted as a biological CO32&minus, pump that can keep the bio-agents retained, protected, and active for up to 56 days of wet-dry incubation. This promising self-healing strategy requires further research and optimization.

Subacute sclerosing panencephalitis (SSPE) is a chronic debilitating condition that occurs in children affected with measles. SSPE is broadly distinguished as typical SSPE, the more rampant form, occurring over a period of years following primary measles infection, while the atypical has a more rapidly progressive course over weeks to months. SSPE can present with cognitive, epileptic, autonomic, pyramidal and ophthalmologic manifestations with scholastic decline being the primary feature. The management of SSPE focuses on improvement of quality of life and prolongation of survival which can be achieved with the use of supportive care modalities and immunomodulators respectively. This is a comprehensive review which discusses several parameters of SSPE such as epidemiology, pathophysiology, clinical presentations, and detailed management protocol for this condition. As part of this review, we also discuss a case of rapidly progressive, fulminant and atypical SSPE in a five-year-old male presenting clinically with myoclonic jerks of lower extremities.

Objective. To assess the periodontal status among the leather factory workers in Dewas and to provide a baseline data for the oral health care and promotion programs. Materials and Methods. A total of 850 study population was considered for examination, and the age ranged from 20 to 60 years. All those factory workers with low socioeconomic status and poor background were considered. The data were collected by means modified World Health Organization (WHO) Oral Health Assessment 1997 Performa and clinical examination with the use of the Community Periodontal Index (CPI). Statistical analyses were used: chi-squared test, Mann–Whitney U test, and Kruskal–Wallis test. Results. The sociodemographic characteristics were found to be significantly associated with the periodontal status in the study population (p≤0.05). Mean number of loss of attachment (LOA) 0 sextants was 3.55 ± 2.35, LOA 1 was 0.935 ± 1.3, LOA 2 was 0.414 ± 0.8, LOA 3 was 0.529 ± 0.94, and LOA 4 was 1.24 ± 0.04; all the parameters showed statistically significant difference (p=0.001) except LOA 1 and LOA 2. Conclusion. The periodontal health status of the factory workers is poor. Factors associated with high prevalence of periodontal disease could be the following: a high rate of tobacco consumption and not cleaning their teeth at all along with other associated factors like stress, poor oral hygiene, etc.

Physical evidence in case of services refers to something associated with service, which can be seen, touched or experienced by the customer. In case of online shopping of goods, which basically involves dominance of services, there are few areas where physical evidence is involved like suitable packaging of the product at the time of delivery or physical stores of such online service providers. Recent scholars have classified physical evidence related to e-tail industry under two categories- traditional physical evidence and virtual physical evidence. In the present research work physical evidence related four factors have been selected and consumer preferences regarding such evidences have been collected. It is analysed that among those four factors which factor/s have been preferred by consumers. Consumer’s actual online purchase related data has also been collected and its relationship with consumer’s preferences towards physical evidence related factors has been analysed in the research work. For analysis purposes reliability analysis, central tendencies, correlation and regression analysis have been applied in the related data.

Owing to their suitable mechanical property and biocompatibility as well as the technological possibility of controlling their high corrosion rates, magnesium and its alloys have attracted significant attention as temporary bio-implants. Though the ability of magnesium to harmlessly biodegrade and its inherent biocompatibility make magnesium alloys a suitable choice for a temporary implant, their high corrosion rates limit their practical application, as the implants can potentially corrode away even before the healing process has completed. Different approaches, such as alloying, surface modification, and conversion coatings, have been explored to improve the corrosion resistance of various magnesium alloys. However, the corrosion behavior of magnesium implants with and without a surface modification has been generally investigated under in-vitro conditions, and studies under in-vivo conditions are limited, which has contributed to the lack of translation of magnesium implants in practical applications. This paper comprehensively reviews the prospects of magnesium alloy implants and the current challenges due to their rapid degradation in a physiological environment. This paper also provides a comprehensive review of the corrosion mitigation measures for these temporary implants.

International audience; Integrating care at the home and facility level is a critical yet neglected function of healthcare delivery systems. There are few examples in practice or in the academic literature of affordable, digitally-enabled integrated care approaches embedded within healthcare delivery systems in low- and middle-income countries. Simultaneous advances in affordable digital technologies and community healthcare workers offer an opportunity to address this challenge. We describe the development of an integrated care system involving community healthcare worker networks that utilize a home-to-facility electronic health record platform for rural municipalities in Nepal. Key aspects of our approach of relevance to a global audience include: community healthcare workers continuously engaging with populations through household visits every three months; community healthcare workers using digital tools during the routine course of clinical care; individual and population-level data generated routinely being utilized for program improvement; and being responsive to privacy, security, and human rights concerns. We discuss implementation, lessons learned, challenges, and opportunities for future directions in integrated care delivery systems.

Background There are different models for community-based health insurance (CBHI), and in Nepal, among them, the government and the local communities (co-ops) are responsible for operating the CBHI models that are in practice. Aims The aim of this study is to compare the outcomes in relation to benefit packages, population coverage, inclusiveness, healthcare utilization, and promptness of treatment for the two types of CBHI models in Nepal. Methods This study was an observational and interactive descriptive study using the concurrent mixed approach of data collection, framing, and compilation. Quantitative data were collected from records, and qualitative data were collected from key informants in all 12 CBHI groups. Unstructured questionnaires, observation checklists, and memo notepads were used for data collection. Descriptive statistics and the Mann–Whitney U test were used when appropriate. Ethically, written informed consent was obtained from the respondents who participated in the study, and they were told that they could withdraw from the study anytime. Results The study revealed the following: new enrolment did not increase in either group; however, the healthcare utilization rate did (Government 107% and co-ops 137%), while the benefit packages remained almost same for both groups. Overall, inclusiveness was higher for the government group. For the CBHI co-ops, enrollment among the religious minority and the discount negotiated with the hospitals for treatment were significantly higher, and the promptness in reaching a hospital was significantly faster (p

International audience; Background: Global health academic partnerships are centered around a core tension: they often mirror or reproduce the very cross-national inequities they seek to alleviate. On the one hand, they risk worsening power dynamics that perpetuate health disparities; on the other, they form an essential response to the need for healthcare resources to reach marginalized populations across the globe.Objectives: This study characterizes the broader landscape of global health academic partnerships, including challenges to developing ethical, equitable, and sustainable models. It then lays out guiding principles of the specific partnership approach, and considers how lessons learned might be applied in other resource-limited settings.Methods: The experience of a partnership between the Ministry of Health in Nepal, the non-profit healthcare provider Possible, and the Health Equity Action and Leadership Initiative at the University of California, San Francisco School of Medicine was reviewed. The quality and effectiveness of the partnership was assessed using the Tropical Health and Education Trust Principles of Partnership framework.Results: Various strategies can be taken by partnerships to better align the perspectives of patients and public sector providers with those of expatriate physicians. Actions can also be taken to bring greater equity to the wealth and power gaps inherent within global health academic partnerships.Conclusions: This study provides recommendations gleaned from the analysis, with an aim towards both future refinement of the partnership and broader applications of its lessons and principles. It specifically highlights the importance of targeted engagements with academic medical centers and the need for efficient organizational work-flow practices. It considers how to both prioritize national and host institution goals, and meet the career development needs of global health clinicians.

Corrosion is among the most common forms of materials degradation which poses enormous challenges across industries, and can even impact our health [...]

This research pertains to classification of the heart sound using digital Phonocardiogram (PCG) signals targeted to screen for heart ailments. In this study, an existing variant of the decision tree, i.e. XgBoost has been used with unsegmented heart sound signal. The dataset provided by PhysioNet Computing in Cardiology (CinC) Challenge 2016 has been used to validate the technique proposed in this research work. The said dataset comprises six databases (A–F) having 3240 heart sound recordings in all with the duration lasting from 5–120 s. The approach proposed in this paper has been compared with 18 existing methodologies. The proposed method is accurate with the mean score of 92.9, while sensitivity and specificity scores are 94.5 and 91.3, respectively. The timely prediction of heart health will support specialists to attain useful risk stratification of patients and also assist clinicians in effective decision-making. These predictive facts may serve as a guide to provide improved quality of care to the patients by way of effective treatment planning and monitoring.

BackgroundChronic obstructive pulmonary disease accounts for a significant portion of the world’s morbidity and mortality, and disproportionately affects low/middle-income countries. Chronic obstructive pulmonary disease management in low-resource settings is suboptimal with diagnostics, medications and high-quality, evidence-based care largely unavailable or unaffordable for most people. In early 2016, we aimed to improve the quality of chronic obstructive pulmonary disease management at Bayalpata Hospital in rural Achham, Nepal. Given that quality improvement infrastructure is limited in our setting, we also aimed to model the use of an electronic health record system for quality improvement, and to build local quality improvement capacity.DesignUsing international chronic obstructive pulmonary disease guidelines, the quality improvement team designed a locally adapted chronic obstructive pulmonary disease protocol which was subsequently converted into an electronic health record template. Over several Plan-Do-Study-Act cycles, the team rolled out a multifaceted intervention including educational sessions, reminders, as well as audits and feedback.ResultsThe rate of oral corticosteroid prescriptions for acute exacerbations of chronic obstructive pulmonary disease increased from 14% at baseline to >60% by month 7, with the mean monthly rate maintained above this level for the remainder of the initiative. The process measure of chronic obstructive pulmonary disease template completion rate increased from 44% at baseline to >60% by month 2 and remained between 50% and 70% for the remainder of the initiative.ConclusionThis case study demonstrates the feasibility of robust quality improvement programmes in rural settings and the essential role of capacity building in ensuring sustainability. It also highlights how individual quality improvement initiatives can catalyse systems-level improvements, which in turn create a stronger foundation for continuous quality improvement and healthcare system strengthening.

An LC–MS/MS-ESI method has been validated for simultaneous estimation of the three endocannabinoids; N-arachidonoylethanolamine (AEA), N-oleoylethanolamine (OEA) and palmitoylethanolamide (PEA), in surrogate matrix using AEA-d 4 as an internal standard with highest sensitivity over the existing methods. Simple precipitation was used to extract analytes and these were subsequently analyzed on a monolithic column. Linear response function was established over the concentration range 12.3 to 1225 pg/ml for AEA (r > 0.994); 0.70 to 641 ng/ml for OEA (r > 0.999) and 0.54 to 321 ng/ml (r > 0.998) for PEA. The intra- and inter-day precision values met the acceptance to criteria as per US FDA guidelines. Analytes were found to be stable in the battery of stability studies. The method was applied to quantify endogenous levels of analytes in rat plasma.

Intrusion Detection System (IDS) can be used to detect malware by its network activities or behavioral profiles. Common challenges for IDS are large amount of data to process, low detection rate and high rate of false alarms. Online Sequential Extreme Learning Machine (OS-ELM) based IDS with network traffic profiling is tested on Panjab University - Intrusion DataSet (PU-IDataSet). This IDS is known as alpha-FST-Beta IDS. The training connections are first categorized on the basis of protocol and service features. This categorization is named as alpha profiling. It increases the scalability and reduces the time complexity of IDS. Large feature set of network traffic dataset is reduced using ensemble of three feature selection techniques. Beta profiling is used to reduce the size of training dataset. Various parameters like accuracy, true positive rate, false positive rate, true negative rate, false negative rate, precision, F1-score and detection time is used to evaluate the performance. The results obtained encourage the integration of this system in intrusion detection models.