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In India, the incidence of mucormycosis reached high levels during 2021–2022, coinciding with the COVID-19 pandemic. In response to this, we established a multicentric ambispective cohort of patients hospitalised with mucormycosis across India. In this paper, we report their baseline profile, clinical characteristics and outcomes at discharge. Patients hospitalized for mucormycosis during March–July 2021 were included. Mucormycosis was diagnosed based on mycological confirmation on direct microscopy (KOH/Calcofluor white stain), culture, histopathology, or supportive evidence from endoscopy or imaging. After consent, trained data collectors used medical records and telephonic interviews to capture data in a pre-tested structured questionnaire. At baseline, we recruited 686 patients from 26 study hospitals, of whom 72.3% were males, 78% had a prior history of diabetes, 53.2% had a history of corticosteroid treatment, and 80% were associated with COVID-19. Pain, numbness or swelling of the face were the commonest symptoms (73.3%). Liposomal Amphotericin B was the commonest drug formulation used (67.1%), and endoscopic sinus surgery was the most common surgical procedure (73.6%). At discharge, the disease was stable in 43.3%, in regression for 29.9% but 9.6% died during hospitalization. Among survivors, commonly reported disabilities included facial disfigurement (18.4%) and difficulties in chewing/swallowing (17.8%). Though the risk of mortality was only 1 in 10, the disability due to the disease was very high. This cohort study could enhance our understanding of the disease’s clinical progression and help frame standard treatment guidelines.

Simulation as a teaching strategy aims to achieve learning objectives without exposing the learner and the patient to the risk of the activity. The simulation takes away the stress of the actual event and what is left is the joy of learning. Simulation can also be used in both formative and summative assignments. The simulation also provides a comfortable space where learners can cross their plateau phase and progress towards mastery. To understand more about the simulation experience, simulation activities are divided into three parts: brief, immersion and debrief. Brief is akin to the introductory or preparatory phase. During this phase keeping in mind the learner's expectation, information is given to the participants and objectives are framed to provide the participants with a self-determined sense of development. An educator must create an ideal learning environment free from stress and filled with trust and mutual respect to facilitate learning. Immersion in clinical simulation is comparable to a theatrical production, and it is defined as a subjective experience one gain when a learner participates in the event. In relation to simulation in healthcare, there is a concept of realism and meaningfulness. Both are individual perceptions but are different concepts. In healthcare, simulation meaningfulness is more relevant. Debrief is the final event and communication type that makes the participant sense of the action. Debrief helps the candidate reflect on his learning in terms of predetermined objectives. Debrief is further broken into the reaction phase, analysis phase and summarisation phase. In this phase, the instructor keeps the learner-centred approach, tries to explore the learner's mental frame, and can help reframe the learner's internal assumptions and feelings. Simulation can be one of the best teaching methods in populous and low-resource settings.

Background and Purpose: The healthcare system in India collapsed during the secondwave of the COVID-19 pandemic. A fungal epidemic was announced amid the pandemic with several cases of COVID-associated mucormycosis and pulmonary aspergillosis being reported. However, there is limited data regarding mixed fungal infections in COVID-19 patients. Therefore, we present a series of ten consecutive COVID-19 patients with mixed invasive fungal infections (MIFIs).Materials and Methods: Among COVID-19 patients hospitalized in May 2021 at atertiary care center in North India, 10 cases of microbiologically confirmed COVID-19-associated mucormycosis-aspergillosis (CAMA) were evaluated.Results: All patients had diabetes and the majority of them were infected with severeCOVID-19 pneumonia (6/10, 60%) either on admission or in the past month while twowere each of moderate (20%) and mild (20%) categories of COVID-19; and were treatedwith steroid and cocktail therapy. The patients were managed with amphotericin-B along with surgical intervention. In total, 70% of all CAMA patients (Rhizopus arrhizus with Aspergillus flavus in seven and Aspergillus fumigatus complex in three patients)survived.Conclusion: The study findings reflected the critical importance of a high index ofclinical suspicion and accurate microbiological diagnosis in managing invasive dualmolds and better understanding of the risk and progression of MIFIs among COVID-19patients. Careful scrutiny and identification of MIFIs play a key role in theimplementation of effective management strategies.

It is becoming more difficult to protect the authentication of our data in today's world of smart living. On the one hand, we are able to live in smart homes and smart cities with ease. Even if we use the most complicated passwords, we can't be sure that the Internet of Things and the Internet of Everything are safe. One way to make sure people and things are safe is to use Multi-Factor Authentication. Also, a big and complicated system needs more efficient and robust solutions for real, and strong, security, so this is important. There are a lot of smart ways to solve problems today. For this reason, the internet of things is being used in every possible field or application. This new ecosystem, which is called Cyber Physical Systems, was built by IoTs. Cyber-Physical Systems use computing, communication, and control to make new technology or the next generation of engineered systems. In the last decade, there has been a lot of work done on cyber physical systems that we didn't expect. There have been a lot of threats, challenges, and important issues in the last decade. We have a big problem with the security of CPS because the basic blocks used to make them are very different. Even if we're talking about natural gas systems or transportation systems or other automated systems, they all have something to do with CPS, no matter what. These days, CPSs systems are used for energy, transportation, the environment, and health care, among other things. This article talks about a number of problems that need to be solved by researchers and scientists (working related to respective area, i.e., CPS). As a result, this article also talks about a partial survey of important research issues, and an overview of several research projects that have been done in the last decade by a number of different people to improve CPS.

The vehicle business has accomplished extraordinary outcomes in creating dependable, sheltered and reasonable vehicles throughout the only remaining century. Autonomous Vehicles (AV) are turning into a reality due to generous late improvements in Internet of Things (IoTs), Programmable Logic Controller (PLC) and correspondence innovations in computing filed. Notice that self-sufficient vehicles here are for vehicles just including transports, light vehicles, and so forth Model models have now voyaged a huge number of miles in test driving for self-ruling vehicles (under self-sufficient vehicles). This isn't a final attempt to self-governing vehicles; we have to plan Autonomous Intelligent Vehicles (AIV) that can make a compelling (for example, without hurting people) choice over the street organization. Later on, self-governing vehicles will be a reality, in any event, for commercialization, as by and by. In AIV, we face various specialized and non-specialized issues, for example, programming multifaceted nature, constant information examination and testing and confirmation. Handling these issues requires viable and prompt arrangements that meet the prerequisites, guidelines and strategies of clients, industry and government. The analysis of this work will help numerous research analysts who work in Autonomous Vehicles or Intelligent Transport Systems today and so on in near future to get better solution.

The enhancement (in the past decade) in electronics devices/technology, a rise in most of the accidents concerning security and surveillance intruding the private lives of the users question the existing systems being used to combat this challenge wherein, the third-parties gather and handle large amounts of individual details. As part of the constant evolution of the cyber physical system architecture, one of the goals of our system is to reduce the latency time for enrollment of new information. Generally, the efficiency and benefit of a Cyber Physical Systems (CPS) depends heavily on interconnection of individual devices or nodes. Exchange of data and information relevant to an overall task or functionality is the key to many applications such as smart grids, smart cities, and many others. Trustworthiness of data is needed to make such systems (especially in MCPS systems) successful. To be able to fulfill policies to guarantee the safety of all entities within a Medical Cyber Physical Systems (MCPS) and to provide security measures to enforce these cryptographic solutions have to be embedded. This paper describes a decentralized e-healthcare application framework for personal data management that ensures that users own and access their data. This work proposes a novel mechanism to secure Medical Cyber Physical Systems (MCPS), i.e., as an automated access-control manager (including building trust in a third party). This work also integrates some features in security building blocks in ultra-small devices to provide essential properties to secure embedded systems.

Today, blockchain is becoming more popular in academia and industry because it is a distributed, decentralised technology which is changing many industries in terms of security, building trust, etc. A few blockchain applications are banking, insurance, logistics, transportation, etc. Many insurance companies have been thinking about how blockchain could help them be more efficient. There is still a lot of hype about this immutable technology, even though it has not been utilised to its full potential. Insurers have to decide whether or not to use blockchain, just like many other businesses do. This technology keeps a distributed ledger on each blockchain node, making it more secure and transparent. The blockchain network can operate smart contracts and convince others to agree, so criminals cannot make mistakes. On another side, the Internet of Things (IoT) might make a real-time application work faster through its automation. With the integration of blockchain and IoT, there will always be a problem with technology regarding IoT devices and mining the blockchain. This paper gives a real-time view of blockchain—IoT-based applications for Industry 4.0 and Society 5.0. The last few sections discuss essential topics such as open issues, challenges, and research opportunities for future researchers to expand research in blockchain—IoT-based applications.

Soft tissue tumors are not uncommon in childhood and comprise entities that range from common to very rare malignancies. Infantile fibrosarcoma (IFS) is a rare pediatric malignancy mainly seen in the first two years of life. The data about the incidence of infantile fibrosarcoma occurring in the neck in the Indian subcontinent is scarce. To the best of our knowledge, only one case of infant cervical IFS has been reported previously in the Indian subcontinent. We present another case of an eight-year-old male patient with a rapidly growing mass on the left side of the neck. He was successfully treated with a combined modality of surgery and chemotherapy with a good outcome. Among the soft tissue tumors of childhood, IFS is a rare entity. It has a good prognosis and lesser chance of distant metastasis as compared to adult fibrosarcoma. Though surgical excision is the mainstay of treatment, chemotherapy also has a significant role in the treatment of primary tumor and metastasis. We discuss the stated case to bring to the notice this uncommon cause, which can be considered as a differential diagnosis of upper cervical swellings. A better understanding of this entity would help in early diagnosis and aggressive treatment, reducing the overall morbidity and mortality.

Basal cell adenoma is a benign basaloid cell tumor involving salivary glands. It requires biopsy and histopathology to distinguish from pleomorphic adenoma, adenoid cystic carcinoma and basal cell adenocarcinoma. Present manuscript reports a case of an adult female with nasal mass, which was clinically and cytologically mimicking benign lesion and adenoid cystic carcinoma was confirmed only on surgical biopsy. The possible clinical dilemma between Basal cell adenoma and Adenoid cystic carcinoma is discussed in this case report

Human Activity Recognition (HAR) has become an active field of research in the computer vision community. Recognizing the basic activities of human beings with the help of computers and mobile sensors can be beneficial for numerous real-life applications. The main objective of this paper is to recognize six basic human activities, viz., jogging, sitting, standing, walking and whether a person is going upstairs or downstairs. This paper focuses on predicting the activities using a deep learning technique called Convolutional Neural Network (CNN) and the accelerometer present in smartphones. Furthermore, the methodology proposed in this paper focuses on grouping the data in the form of nodes and dividing the nodes into three major layers of the CNN after which the outcome is predicted in the output layer. This work also supports the evaluation of testing and training of the two-dimensional CNN model. Finally, it was observed that the model was able to give a good prediction of the activities with an average accuracy of 89.67%. Considering that the dataset used in this research work was built with the aid of smartphones, coming up with an efficient model for such datasets and some futuristic ideas pose open challenges in the research community.

Introduction: Solitary fibrous tumours (SFTs) of the nose and paranasal sinuses are extremely rare.These were originally described as neoplasms of the pleura originating from spindle cells. It is further sub-classified as a benign type of mesothelial tumour. Its occurrence in many extra pleural sites have been reported earlier, mainly in the liver, parapharyngeal space, sublingual glands, tongue, parotid gland, thyroid, periorbital region, and very occasionally in the nose and paranasal sinus area. Case Report: A 28-year-old man with a 6 month history of persistent progressive left nasal obstruction and watering of the left eye is reported. Further imaging by CT and MRI revealed a large, left-sided, highly vascular, nasal cavity mass (Fig 1,2,3,4) pushing laterally on the medial wall of the maxilla. The patient underwent a lateral rhinotomy, which proceeded with the excision of the mass. Histopathological analysis of the specimen was consistent with SFT. Conclusion: This case is reported to develop insights regarding diagnosis and management of such rare tumours.

The aqueous leaf extract of Jatropha curcas was used for the synthesis of silver nanoparticles (Jc-AgNps) which were further evaluated for its antibacterial potential against food borne pathogens. J. curcas leaf extract could synthesize stable silver nanoparticles (Zeta potential: -23.4 mV) with absorption band at 430 nm. Fourier transform infrared spectroscopy (FTIR) indicated various biological compounds responsible for capping and stabilizing Jc-AgNps in suspension, while the presence of silver was authenticated by scanning electron microscopy (SEM) equipped with energy-dispersive X-ray (EDX). Jc-AgNps were confirmed to be uniform in shape, size and behaviour through dynamic light scattering (DLS), transmission electron microscopy (TEM), X-ray diffraction (XRD), SEM, and atomic force microscopy (AFM) analysis. To investigate the antibacterial activity, disc diffusion and microplate dilution assays were performed and zone of inhibition (ZOI) as well as minimum inhibitory/bactericidal concentrations (MIC/MBCs) were evaluated against selected bacterial strains. Overall results showed that Escherichia coli (ZOI: 23 mm, MBC: 0.010 mg/ml) was the most sensitive organism, whereas Staphylococcus aureus (ZOI: 14.66 mm, MBC: 0.041 mg/ml) and Salmonella enterica (ZOI: 16.66 mm, MBC: 0.041 mg/ml) were the least sensitive against Jc-AgNps. The detailed microscopic investigations using SEM, TEM and AFM were performed to understand the antibacterial impacts of Jc-AgNps against Listeria monocytogenes. SEM and TEM analysis showed the clear deformation and disintegration of treated L. monocytogenes cells, whereas AFM established a decrease in the height and cell surface roughness (RMS value) in the treated L. monocytogenes.

Spices have been used since ancient times. Although they have been employed mainly as flavouring and colouring agents, their role in food safety and preservation have also been studied in vitro and in vivo. Spices have exhibited numerous health benefits in preventing and treating a wide variety of diseases such as cancer, aging, metabolic, neurological, cardiovascular and inflammatory diseases. The present review aims to provide a comprehensive summary of the most relevant and recent findings on spices and their active compounds in terms of targets and mode of action; in particular, their potential use in food preservation and enhancement of shelf life as a natural bioingredient.