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1. Objectives: Ÿ To prove that there is a role of IOTA ADNEX model in preoperative evaluation of adnexal masses. 2. Conclusion And Results: Ÿ In our study, out of 65 patients, most of the patients were ≤50 years of age. Age was statistically signicant with HPE (p0.032). Ÿ We found that, most of the patients had family history in Malignant group compared to Benign group but this was not statistically signicant (p-0.951). Ÿ Our study showed that, a greater number of patients had more than 10 locules in Malignant group compared to Benign group though it was not statistically signicant (p-0.87). Ÿ Higher number of patients had Ascites in Malignant group compared to Benign group which was statistically signicant (p

Objectives: Ÿ To grade the severity of Diffuse Parenchymal Lung Diseases by HRCT and Correlate the HRCT Severity with Spirometry indices. Ÿ To predict the performance of carbon monoxide diffusion capacity (DLCO) for associated HRCT ndings in the detection of diffuse parenchymal lung diseases. Conclusion And Results A Cross sectional study was conducted at radiology department of tertiary healthcare hospital in Central India for 2 years study period in patients suffering from diffuse lung disease. The results are summarised below: Ÿ The highest frequency of age was 50-60 years (36.7%) followed by 60-70 years age (33.3%) and 40-50 years age (13.3%). Mean age was 57.83 year. Ÿ Maximum patients were male (70%). Ÿ Maximum patients had breathlessness (86.7%), cough (76.7%) and chest pain (56.7%). Ÿ Only few patients had fever (20%), history of smoking (30%), h/o infection (13.3%) and systemic disease (16.7%) Ÿ Maximum patients had UIP (46.7%) followed by NSIP (23.3%) and RB ILD (13.3%). Ÿ Mean FVC was 66.13 l, mean FEV1 was 56.47 %, mean FEV1/FVC was 0.81% and mean DLCO was 49.67 mL/min/mm Hg. Ÿ Maximum patients had restrictive (76.7%) followed by normal (20%) and obstructive (3.3%). Ÿ Normal interpretation (6) was seen in DSIP (1), SCLERODERMA-ILD (2) and UIP (3). Obstructive interpretation (1) was seen only in RB ILD (1). Restrictive interpretation was seen higher in NSIP (7), RB ILD (3) and UIP (11). Comparison between interpretation and diagnosis was showed statistically signicant results. Ÿ Total score was higher in restrictive (30.87) followed by obstructive (20) and normal (19.5). Comparison between interpretation and total score was showed statistically signicant results. Ÿ Comparison between interpretation and spirometry prole (every parameter) showed statistically signicant results. Ÿ Higher total score was showed in POST COVID FIBROSIS NSIP (36), SARCOIDOSIS (32), NSIP (31) and UIP (29.86). Comparison between interpretation and total score was showed statistically signicant results. INFERENCE: The patients included in the study were distinguished patients with diffuse parenchymal lung diseases from those with normal lungs, correlated closely with both 2D analysis and visual quantitation. This study shows that cough, restrictive, FVC, DLCO have statistically signicant correlation with total HRCT score in patients with diffuse parenchymal lung diseases. FCV correlated the best with HRCT. DLCO also showed correlation with HRCT in patients with diffuse parenchymal lung diseases.

Purpose This study aims to review the presentation of substance use disorders in older adults, how addiction intertwines with neurocognitive disorders and how to approach this vulnerable population. Design/methodology/approach Electronic data searches of PubMed, Medline and the Cochrane Library (years 2000–2021) were performed using the keywords “neurocognitive,” “dementia,” “substance use,” “addiction,” “older adults” and “elderly.” The authors, in consensus, selected pivotal studies and conducted a narrative synthesis of the findings. Findings Research about substance use disorders in older adults is limited, especially in those with superimposed neurocognitive disorders. Having dual diagnoses can make the identification and treatment of either condition challenging. Management should use a holistic multidisciplinary approach that involves medical professionals and caregivers. Originality/value This review highlights some of the intertwining aspects between substance use disorders and neurocognitive disorders in older adults. It provides a comprehensive summary of the available evidence on treatment in this population.

SUMMARYExcitability—the ability to fire action potentials—is a signature feature of neurons. How neurons become excitable during development, and whether excitability is an intrinsic property of neurons or requires signaling from glial cells, remain unclear. Here we demonstrate that Schwann cells, the most abundant glia in the peripheral nervous system, promote somatosensory neuron excitability during development. We find that Schwann cells secrete prostaglandin E2, which is necessary and sufficient to induce developing somatosensory neurons to express normal levels of voltage-gated sodium channels and fire action potential trains. Inactivating this signaling pathway specifically in Schwann cells selectively impairs the maturation of nociceptor and proprioceptor somatosensory neuron subtypes, leading to corresponding sensory defects in thermoception, inflammatory pain, and proprioception. Our studies thus reveal a cell non-autonomous mechanism by which glia regulate neuronal excitability to enable the development of normal sensory functions.

Sub-lethal baculoviral infections are associated with several developmental and reproductive defects but the mechanism behind these defects is not well understood. Here, we investigated the reproductive defects induced by sub-lethal infection of Spodoptera frugiperda nucleopolyhedrovirus (SfNPV) in Spodoptera frugiperda (J.E.Smith) adults. We observed significantly less oviposition, loss of fecundity and egg hatchability in surviving adults after SfNPV infection. Reciprocal crosses with both the genders suggested that the infection of either sex could result in the fertility defects. An investigation of anatomy of reproductive of the surviving females suggested minor defects but confirmed reduced mating with infected males. Oviposition defects were observed in the infected group in spite of successful mating. Differential transcriptome analysis of infertile females from sub-lethally infected group revealed alteration of reproductive, developmental and behavioural pathway genes in comparison to control. We have also investigated the involvement of hormonal genes and piRNAs in their contribution to reproductive defects post sub-lethal baculoviral infection. This study will shed some light on the molecular mechanisms behind the sub-lethal effects observed in the surviving adults post baculovirus infection and will be useful to understand the infertility pathways in insects.

This study presents a non-orthogonal multiple access (NOMA) solution for 5G that unifies communication betweenmacro-cells via the S-R NOMA link and communication between small cells via the R-D NOMA link. S-R NOMA isused to decode own signal by respective relay. Separate studies of outage performance in S-R and R-D connectionsmay formerly be used to get an accurate definition of system outage likelihood. Our mathematical analysis issupported by simulation findings, which indicate that NOMA-assisted relaying systems outperform OrthogonalMultiple Access systems in terms of lower outage probability and better cumulative capacities (OMA).

Several studies have established the two-way relationship between the sporadic and familial forms of Alzheimer's disease (AD) and epilepsy. However, a more robust connection exists between epilepsy and early onset familial AD (EOFAD). Still, the mechanisms underlying the same are not yet fully understood. Aging is also known to be associated with both AD and seizures. Seizures of any type can occur at any stage of AD and are six to 10 times more likely in patients with AD than in controls of a similar age group. Seizures can quicken cognitive decline and increase mortality, amplifying the medical and economic burden. It is, therefore, clinically essential to recognize and treat seizures early in these patients. However, diagnosis of seizures in AD is complicated by the difficulty in identifying non-motor focal seizures in patients with cognitive decline, problems with obtaining histories, low sensitivity of standard scalp electroencephalogram (EEG) methods, nonspecific cerebrospinal fluid (CSF) and radiological findings. This article has reviewed and summarised the existing literature on the association between AD and epilepsy pertaining to epidemiology, pathophysiological links, risk factors, modalities for diagnosis, and treatment strategies.

Detection of lane region under the road boundary is an imperative module for intelligent vehicle system. Lane markings provide separate regions on the road for the vehicles to avoid the possibility of accidents. Existing methods in lane detection have limited performance using various sensor-based approaches such as Radar and LiDAR and have high operational costs. To achieve a steady and optimal lane detection, the vision-based lane region detection scheme VLDNet is proposed which utilizes a encoder-decoder network using semantic segmentation architecture. In this direction, a hybrid model using UNet and ResNet has been adopted, where UNet is used as a segmentation model and ResNet-50 is used for down-sampling the image and identifying the required features. These identified features have been then applied into UNet for up-sampling and decoding the segments of the images. The publicly available KITTI dataset have been accessed for experiments and validation of the proposed network. The method outperforms the existing state-of-the-art methods in lane region detection. The network achieves better performance using standard evaluation measures such as accuracy of 98.87%, the precision of 98.24%, recall of 96.55%, frequency weighted IoU of 97.78%, and MaxF score of 97.77%.

The L-type calcium current (ICaL) plays a critical role in cardiac electrophysiology, and models of ICaL are vital tools to predict arrhythmogenicity of drugs and mutations. Five decades of measuring and modelling ICaL have resulted in several competing theories (encoded in mathematical equations). However, the introduction of new models has not typically been accompanied by a data-driven critical comparison with previous work, so that it is unclear which model is best suited for any particular application. In this review, we describe and compare 73 published mammalian ICaL models, and use simulated experiments to show that there is a large variability in their predictions, which is not substantially diminished when grouping by species or other categories. We provide model code for 60 models, list major data sources, and discuss experimental and modelling work that will be required to reduce this huge list of competing theories and ultimately develop a community consensus model of ICaL.

Maconellicoccus hirsutus is a destructive pest which causes severe losses of agricultural and horticultural crops. For the management of M. hirsutus, many insecticides have been used and it has been exposed to insufficient dosage or uneven spray coverage which resulted in the development of insecticide resistance. Xenobiotic metabolism can be better understood with the help of gene expression studies by unveiling the underlying molecular mechanisms. The qRT-PCR is the simplest method to analyse gene expression, however, it highly relies on suitable reference genes concerning the different experimental conditions.We evaluated the stability of five reference genes in two sets of experimental conditions viz. developmental stages (nymphs and adults) and agrochemical stress (GA3 and Buprofezin sprayed) against M. hirsutus, using different softwares-NormFinder, geNorm, BestKeeper, and RefFinder. The study revealed that ATP51a and GAPDH can be used as reference genes for gene expression studies when exposed to Gibberellic acid. Additionally, the study revealed that the ideal pair of reference genes for data validation in M. hirsutus treated with Buprofezin was GAPDH and β-tubulin. The ideal reference gene combination for various developmental stages was found to be 28S and Actin.According to the study, GAPDH can be utilized as a reliable reference gene in the agrochemical (GA3 and Buprofezin) exposure set. The genes can be utilized as a suitable reference for qRT-PCR gene expression studies of xenobiotic metabolism to understand the underlying molecular mechanism, which will help further to design suitable management strategies.

Background: Children comprise only 1–5% of COVID-19 cases. Recent studies have shown that COVID-19 associated multisystem inflammatory syndrome in children (MIS-C) can present with neurological signs and symptoms. In this systematic review and meta-analysis, we have reviewed neurological involvement in these patients. Methods: A comprehensive electronic literature search was done on PubMed, Google Scholar, Embase, Cochrane database, and SCOPUS for the published English language articles from December 1, 2019, to February 28, 2021. A meta-analysis of the proportion was expressed as a pooled proportion with a 95% confidence interval (CI). Representative forest plots showing individual studies and the combined effect size were generated to provide an overview of the results.Results: This systematic review and meta-analysis analyzed 15 published MIS-C studies with a total of 785 patients. Neurological manifestations in patients with MIS-C was found in 27.1%. We found that 27% developed headaches, 17.1% developed meningism/meningitis and 7.6 % developed encephalopathy. Other uncommon neurological manifestations of MIS-C includes anosmia, seizures, cerebellar ataxia, global proximal muscle weakness and bulbar palsy. In MIS-C patients with neurological feature, neuroimaging showed signal changes in the splenium of the corpus callosum. Electroencephalography showed slow wave pattern and nerve conduction studies and electromyography showed mild myopathic and neuropathic changes. Conclusions: Our study revealed that neurological manifestations are not uncommon in patients with MIS-C. Further large prospective studies are needed to better explore the disease spectrum and to unravel the underlying pathophysiology.Keywords: Children; COVID-19; kawasaki disease; MIS-C, neurology

The study was carried out using the secondary data on income, expenditure, productive assets and indebtedness of agricultural households in Madhya Pradesh collected from the Situation Assessment Survey (SAS) conducted by the National Sample Survey Office (NSSO) in 70th round (2012-13). The household level data on various parameters was first extracted for Madhya Pradesh and brought into suitable form for carrying out analysis in SPSS. Tabular analysis was employed to analyze the potential economic benefits of livestock farming. The findings revealed that marginal and small farmers earned only 26-27 per cent of income of large farm households. Scheduled Caste and Scheduled Tribes who constitutes nearly 43.5 per cent of total farm households in Madhya Pradesh earns only 33.8 and 33.4 per cent, respectively of the income of OBC farmers. Among the regions, farmers in the northern and central regions of the state earn the highest income while those in the southern and vindhya regions earn the lowest income. in spite of farmers’ high satisfaction in selling milk to cooperatives (72-75%), the share of cooperatives and government agencies was very less in procuring milk from farm households (3-5.5%) in the state.

Introduction: The superficial fungal infection of the scalp caused by dermatophytes is called tinea capitis. It has a predilection for the pediatric age group. In developing countries like India factors such as overcrowding, inadequate hygiene, and low literacy rate contribute to its high incidence. Aims and Objective: This study aimed at identifying and grading the psychosocial impact of tinea capitis in children and correlating it with disease duration and socioeconomic status of patient's family. Materials and Methods: This was a cross-sectional study conducted in our skin outpatient department involving children aged 6–16 years with clinical diagnosis of tinea capitis. We used the children's dermatology life quality index (CDLQI) instrument to observe the psychological implications in these children. Results: The study included 134 patients, with a mean CDLQI score of 6.01 ± 4.17. There was a male preponderance in our study with 112 (68.3%) male patients and 52 (31.7%) female patients. The age group affected most commonly was 6–8 years (37.8%). The domains affected most severely were symptoms and feelings (Q1 and Q2) followed by sleep (Q 9). The psychological implications were higher in patients suffering from kerion, older children, and female patients. There was a statistically significant correlation between the impact on quality of life (QOL) and disease duration as well as disease severity; however, no correlation could be made between QOL and socioeconomic strata of family. Conclusion: The study brings into question the overlooked psychological implications of tinea capitis which are often overlooked by the dermatologist and parents as a mere dermatological disease. Instead a holistic approach including a complete psychological evaluation of children and appropriate counseling of both patients and their parents must be done.

The global pandemic of COVID-19 has created havoc worldwide with its high transmission rate. The vaccine and drugs are still under trial; thus, the only option is to break the chain of transmission of disease by imparting the knowledge and designing awareness campaigns to educate people about the risks and preventive measures of COVID-19. This study was conducted to explore the knowledge and perception on health behaviors related to prevention along with addressing several myths and practices for COVID-19. An online cross-sectional survey was carried out in the initial days of disease outbreak in Nepal. A structured questionnaire was used for the data collection and recruitment of participants was done using snowball sampling technique. A total of 358 participants from all over the country were recruited for the study. Output measures were portrayed through descriptive statistical analysis with the use of frequencies (n) and percentages (%). Most of the participants (94.1%) knew about the high-risk age group, 38.5% were unaware that SARS-CoV-2 can be transmitted even from objects. Participants had better knowledge on modes of transmission of disease (77.1%) while 49.2% thought that regular surgical mask is highly effective for the preventive measure. Findings of this study suggests that people of Nepal are required to be educated about false beliefs and misconceptions. The findings and concerns raised in the study would be beneficial to design awareness-raising campaigns tailored specifically to the need for and understanding of the Nepalese community. Int. J. Soc. Sc. Manage. Vol. 7, Issue-4: 183-190

In this letter, as early career psychiatrists we highlight the urgent need to address the mental health fallout of the COVID 19 pandemic. We advocate the reorientation of mental healthcare services cadre to provide proactive mental health care services. For this purpose, the focus with regard to the COVID 19 pandemic needs to shift from acute care for the infected persons to the medium and long term care for those who are affected by COVID 19. The latter category includes survivors with protracted symptoms and family members. We also recognize the need for mental health surveillance and support for those losing loved ones, and experiencing financial and emotional adversities. This will also aid provision of better mental health care services by trainee and early career professional who through redeployment have had challenges in achieving learning and training competencies. Redeployment has affected Low and Middle income countries worse and reorientation will benefit these settings the most.

The development of CRISPR-based barcoding methods creates an exciting opportunity to understand cellular phylogenies. We present a compact, tunable, high-capacity Cas12a barcoding system called dual acting inverted site array (DAISY). We combined high-throughput screening and machine learning to predict and optimize the 60-bp DAISY barcode sequences. After optimization, top-performing barcodes had ∼10-fold increased capacity relative to the best random-screened designs and performed reliably across diverse cell types. DAISY barcode arrays generated ∼12 bits of entropy and ∼66,000 unique barcodes. Thus, DAISY barcodes-at a fraction of the size of Cas9 barcodes-achieved high-capacity barcoding. We coupled DAISY barcoding with single-cell RNA-seq to recover lineages and gene expression profiles from ∼47,000 human melanoma cells. A single DAISY barcode recovered up to ∼700 lineages from one parental cell. This analysis revealed heritable single-cell gene expression and potential epigenetic modulation of memory gene transcription. Overall, Cas12a DAISY barcoding is an efficient tool for investigating cell-state dynamics.

India is a federation whose roots can be found in the colonial period. Indian federal setup is clearly divided between centre, state and local government and likewise, the sources of revenue and responsibilities are also divided between them. The decentralization process in India is asymmetrical in the sense that decentralization of expenditure has been much more than the revenue decentralization as provided by the Constitution, thereby creating an imbalance in states’ income and spending. When this mismatch between the two is measured at different levels of government, we call it Vertical Fiscal Imbalance. In this paper, I have presented various definitions and measures of VFI given by several economists over the years and tried to measure the extent of VFI that exist in India since 1990-91 to 2014-15. We have used twenty five years data to make an analysis based on the data available in Finance Commission reports and Indian Public Finance Statistics. Our results show that the amount of revenue that has been decentralized over the period of study falls much short of the expenditure requirements that are expected to be met by the state governments. The situation is so intense that the state governments are left with no option other than relying on central transfers for financing their needs and that where the central government enjoys an upper hand and an authoritative power over the internal matters of the states. KEYWORDS: Expenditure, Decentralization, Indian federation, Revenue, Vertical Fiscal Imbalance.

Background: Leprosy, an insidious infectious granulomatous disease, is diagnosed traditionally through clinical examination coupled with skin smears and histopathology. It has myriad clinical presentations that pose diagnostic challenges. Lately, dermoscopy has emerged as a rapid, noninvasive diagnostic modality for many dermatoses. Objectives: We evaluated the dermoscopic findings of various manifestations of leprosy and correlated them with clinical and histopathological features. Methods: This prospective, cross-sectional study was conducted in our skin outpatient department for a period of 1 year. Patients newly diagnosed as having leprosy or those undergoing leprosy treatment for less than 6 months were included. The most representative lesion was dermoscopically evaluated and later biopsied. Results: We included 73 patients in the study. Results indicated an obvious correlation between dermoscopic findings and histopathology. We noted orangish yellow and white structureless areas, steadily throughout the spectrum, depicting dermal granuloma. Additionally, we observed focal vascular structures such as branching, linear, and crown vessels that result from the pressure of granuloma pushing the dilated vessels upwards. The relative absence of skin appendages aided in differentiating leprosy from other granulomatous disorders. Novel findings of our study were the detection of a branch-like pattern of clofazimine-induced pigmentation on dermoscopy and orange globules on onychoscopy. Other unique findings included violaceous structureless areas, characteristic large telangiectatic vessels, follicular plugging, star-shaped silvery-white scaling, and white globules in type 1 reaction; white shiny steaks were observed in patients with borderline lepromatous leprosy, and central white dots and keratotic plugs were observed in patients with histoid leprosy. Conclusions: Dermoscopy, as a noninvasive modality, could aid in the quick diagnosis of leprosy and should be used as a handy tool to complement other investigative tools for this disease.

Purpose: To assess the perspective and practice patterns of Indian surgeons concerning OBS and compare urban and rural areas. Patients and methods: A thirteen-question survey was distributed through the social media platform WhatsApp (WhatsApp Inc, California, US) to various Indian surgical society groups across India from 5th May 2020 to 19th May 2020. The questions focused on the surgeons' experience, surgical management technique of choice in breast cancer patients, acceptance and practice of OBS, knowledge of type 1 and type 2 OBS, and axilla management. Results: Two hundred ninety surgeons responded to the survey out of about 1000, with a response rate of 29%. 17.99% of the surgeons (n=52) practiced in a rural region, while 82.01% (n=237) practiced in an urban region. 94.12% (n=272) of the surgeons reported awareness about oncoplastic breast surgery (OBS), whereas only 5.88% (n= 17) were unaware of the existence of this procedure. 62.97% (n=182) surgeons offered OBS to their breast cancer patients, while 37.02% (n=107) did not offer OBS. 49.37% of surgeons in the urban areas do not perform OBS, whereas 78.85% do not perform it in the rural regions. It also highlights that the percentage of surgeons performing OBS with a plastic surgeon (29.41%) is higher than those who carry out the procedure by themselves (15.92%). Conclusion: Most of the Indian surgeons are aware of OBS. In the rural areas, OBS's rate is minimal due to various reasons such as poverty, illiteracy, inaccessible radiotherapy centers, and the absence of training of surgeons in OBS. Few urban surgeons perform OBS themselves while most of them do it with the help of plastic surgeons. Mastectomy is the most commonly performed surgical intervention for breast cancer in rural regions. The practice of OBS should increase in India to improve the postoperative quality of life of breast cancer patients. Keywords: Oncoplastic Breast Surgery, Mastectomy, Breast-conserving surgery, Indian surgeons, Oncoplasty

Traffic flow is regulated and controlled with the aid of traffic signals implemented at all major intersections in urban areas. With the increase in vehicles, the traditional control strategies are incapable of clearing heavy traffic which leads to long traffic queues and prolonged waiting time at intersections. Smart cities are increasingly adopting solutions by developing smart traffic lights to improve the flow of vehicles. A major demand arises to increase the efficiency of traffic controllers with the objective to minimize traffic congestion, prioritize emergency transit and give way to pedestrians to cross the lanes at an intersection. This requires leveraging the existing techniques that identify the best solutions at the lowest possible cost. This paper proposes Fuzzy Adaptive Control System (FACS) that uses fuzzy logic to decide the phase sequence and green-time for each lane based on sensed input parameters. It is designed with an aim to improve traffic clearance at isolated intersection especially in peak traffic hours of the day along with giving precedence to emergency vehicle as soon as it is detected and also assist pedestrian passage thus reducing their waiting time at the intersection. Performance of the proposed Fuzzy Adaptive Control System (FACS) is evaluated through simulations and compared with Pre-Timed Control System (PTCS) and Traffic Density-based Control System (TDCS) at a busy intersection with lanes leading to offices, schools and hospitals. Simulation results show significant improvement over PTCS and TDCS in terms of traffic clearance, immediate addressing of the emergency vehicle and giving preference to pedestrian passage at the intersection.

Introduction: Surgical simulator is a computer based technology used to educate and train medical students and practitioners without the need for a patient, cadaver or an animal model. Touch surgeryTM(TS) is a free of cost smartphone based application used for teaching surgical procedures. The participants in this study were specifically assessed on the increase of their knowledge in the key steps of laparoscopic cholecystectomy after practicing on the smartphone simulator, TS.Methods: A non-randomized controlled trial (uncontrolled longitudinal study) was carried out among 20 final year medical students. Their knowledge on surgical procedure was assessed through a questionnaire prepared regarding the steps of laparoscopic cholecystectomy before and after exposure to TS. Study Variable was the scores to a questionnaire before and after exposure to the surgical simulation.Results: Mean pre-practice score was 25.85 ± 11.05 and mean post practice score was 80 ± 10.62 (p