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Early dementia diagnosis in low and middle-income countries (LMIC) is challenging due to limited availability of brief, culturally appropriate, and psychometrically validated tests. Montreal Cognitive Assessment (MoCA) is one of the most widely used cognitive screening tests in primary and secondary care globally. In the current study, we adapted and validated MoCA in five Indian languages (Hindi, Bengali, Telugu, Kannada, and Malayalam) and determined the optimal cut-off points that correspond to screening for clinical diagnosis of dementia and MCI.A systematic process of adaptation and modifications of MoCA was fulfilled. A total of 446 participants: 214 controls, 102 dementia, and 130 MCI were recruited across six centers.Across five languages, the area under the curve for diagnosis of dementia varied from 0.89 to 0.98 and MCI varied from 0.73 to 0.96. The sensitivity, specificity and optimum cut-off scores were established separately for five Indian languages.The Indian adapted MoCA is standardized and validated in five Indian languages for early diagnosis of dementia and MCI in a linguistically and culturally diverse population.

The science of motion, i.e. dynamics, forms the foundation for most branches of physical and engineering sciences. It is not only the first branch of Natural Philosophy that attracted the attention of giant intellectuals of the past but also took more than two millennia to reach its final form. This article is a brief exposition to the beautiful thought process and intuition supported by back-breaking research by these philosophers and scientists. It is not a history of mechanics.

Background/Aims: In a linguistically diverse country such as India, challenges remain with regard to diagnosis of early cognitive decline among the elderly, with no prior attempts made to simultaneously validate a comprehensive battery of tests across domains in multiple languages. This study aimed to determine the utility of the Indian Council of Medical Research-Neurocognitive Tool Box (ICMR-NCTB) in the diagnosis of mild cognitive impairment (MCI) and its vascular subtype (VaMCI) in 5 Indian languages. Methods: Literate subjects from 5 centers across the country were recruited using a uniform process, and all subjects were classified based on clinical evaluations and a gold standard test protocol into normal cognition, MCI, and VaMCI. Following adaptation and harmonization of the ICMR-NCTB across 5 different Indian languages into a composite Z score, its test performance against standards, including sensitivity and specificity of the instrument as well as of its subcomponents in diagnosis of MCI, was evaluated in age and education unmatched and matched groups. Results: Variability in sensitivity-specificity estimates was noted between languages when a total of 991 controls and 205 patients with MCI (157 MCI and 48 VaMCI) were compared due to a significant impact of age, education, and language. Data from a total of 506 controls, 144 patients with MCI, and 46 patients with VaMCI who were age- and education-matched were compared. Post hoc analysis after correction for multiple comparisons revealed better performance in controls relative to all-cause MCI. An optimum composite Z-score of −0.541 achieved a sensitivity of 81.1% and a specificity of 88.8% for diagnosis of all-cause MCI, with a high specificity for diagnosis of VaMCI. Using combinations of multiple-domain 2 test subcomponents retained a sensitivity and specificity of >80% for diagnosis of MCI. Conclusions: The ICMR-NCTB is a “first of its kind” approach at harmonizing neuropsychological tests across 5 Indian languages for the diagnosis of MCI due to vascular and other etiologies. Utilizing multiple-domain subcomponents also retains the validity of this instrument, making it a valuable tool in MCI research in multilingual settings.

Objectives:While the burden of dementia is increasing in low- and middle-income countries, there is a low rate of diagnosis and paucity of research in these regions. A major challenge to study dementia is the limited availability of standardised diagnostic tools for use in populations with linguistic and educational diversity. The objectives of the study were to develop a standardised and comprehensive neurocognitive test battery to diagnose dementia and mild cognitive impairment (MCI) due to varied etiologies, across different languages and educational levels in India, to facilitate research efforts in diverse settings.Methods:A multidisciplinary expert group formed by Indian Council of Medical Research (ICMR) collaborated towards adapting and validating a neurocognitive test battery, that is, the ICMR Neurocognitive Tool Box (ICMR-NCTB) in five Indian languages (Hindi, Bengali, Telugu, Kannada, and Malayalam), for illiterates and literates, to standardise diagnosis of dementia and MCI in India.Results:Following a review of existing international and national efforts at standardising dementia diagnosis, the ICMR-NCTB was developed and adapted to the Indian setting of sociolinguistic diversity. The battery consisted of tests of cognition, behaviour, and functional activities. A uniform protocol for diagnosis of normal cognition, MCI, and dementia due to neurodegenerative diseases and stroke was followed in six centres. A systematic plan for validating the ICMR-NCTB and establishing cut-off values in a diverse multicentric cohort was developed.Conclusions:A key outcome was the development of a comprehensive diagnostic tool for diagnosis of dementia and MCI due to varied etiologies, in the diverse socio-demographic setting of India.

Previous cross-sectional studies reported positive effects of meditation on the brain areas related to attention and executive function in the healthy elderly population. Effects of long-term regular meditation in persons with mild cognitive impairment (MCI) and Alzheimer’s disease dementia (AD) have rarely been studied. In this study, we explored changes in cortical thickness and gray matter volume in meditation-naïve persons with MCI or mild AD after long-term meditation intervention. MCI or mild AD patients underwent detailed clinical and neuropsychological assessment and were assigned into meditation or non-meditation groups. High resolution T1-weighted magnetic resonance images (MRI) were acquired at baseline and after 6 months. Longitudinal symmetrized percentage changes (SPC) in cortical thickness and gray matter volume were estimated. Left caudal middle frontal, left rostral middle frontal, left superior parietal, right lateral orbitofrontal, and right superior frontal cortices showed changes in both cortical thickness and gray matter volume; the left paracentral cortex showed changes in cortical thickness; the left lateral occipital, left superior frontal, left banks of the superior temporal sulcus (bankssts), and left medial orbitofrontal cortices showed changes in gray matter volume. All these areas exhibited significantly higher SPC values in meditators as compared to non-meditators. Conversely, the left lateral occipital, and right posterior cingulate cortices showed significantly lower SPC values for cortical thickness in the meditators. In hippocampal subfields analysis, we observed significantly higher SPC in gray matter volume of the left CA1, molecular layer HP, and CA3 with a trend for increased gray matter volume in most other areas. No significant changes were found for the hippocampal subfields in the right hemisphere. Analysis of the subcortical structures revealed significantly increased volume in the right thalamus in the meditation group. The results of the study point out that long-term meditation practice in persons with MCI or mild AD leads to salutary changes in cortical thickness and gray matter volumes. Most of these changes were observed in the brain areas related to executive control and memory that are prominently at risk in neurodegenerative diseases.

Objectives: The growing prevalence of dementia, especially in low- and middle-income countries (LMICs), has raised the need for a unified cognitive screening tool that can aid its early detection. The linguistically and educationally diverse population in India contributes to challenges in diagnosis. The present study aimed to assess the validity and diagnostic accuracy of the Indian Council of Medical Research-Neurocognitive Toolbox (ICMR-NCTB), a comprehensive neuropsychological test battery adapted in five languages, for the diagnosis of dementia.Methods: A multidisciplinary group of experts developed the ICMR-NCTB based on reviewing the existing tools and incorporation of culturally appropriate modifications. The finalized tests of the major cognitive domains of attention, executive functions, memory, language, and visuospatial skills were then adapted and translated into five Indian languages: Hindi, Bengali, Telugu, Kannada, and Malayalam. Three hundred fifty-four participants were recruited, including 222 controls and 132 dementia patients. The sensitivity and specificity of the adapted tests were established for the diagnosis of dementia.Results: A significant difference in the mean (median) performance scores between healthy controls and patients with dementia was observed on all tests of ICMR-NCTB. The area under the curve for majority of the tests included in the ICMR-NCTB ranged from 0.73 to 1.00, and the sensitivity and specificity of the ICMR-NCTB tests ranged from 70 to 100% and 70.7 to 100%, respectively, to identify dementia across all five languages.Conclusions: The ICMR-NCTB is a valid instrument to diagnose dementia across five Indian languages, with good diagnostic accuracy. The toolbox was effective in overcoming the challenge of linguistic diversity. The study has wide implications to address the problem of a high disease burden and low diagnostic rate of dementia in LMICs like India.

Picture-naming tests (PNTs) evaluate linguistic impairment in dementia due to semantic memory impairment, impaired lexical retrieval or perceptual deficits. They also assess the decline in naming impairment at various stages of dementia and mild cognitive impairment (MCI) that occurs due to progressive cognitive impairment. With the increasing numbers of people with dementia globally, it is necessary to have validated naming tests and norms that are culturally and linguistically appropriate.In this cross-sectional study we harmonized a set of 30 images applicable to the Indian context across five languages and investigated the picture-naming performance in patients with MCI and dementia.A multidisciplinary expert group formed by the Indian Council of Medical Research (ICMR) collaborated towards developing and adapting a picture naming test (PNT) known as the ICMR-PNT in five Indian languages: Hindi, Bengali, Telugu, Kannada and Malayalam. Based on cross-cultural adaptation guidelines and item-wise factor analysis and correlations established separately across five languages, the final version of the ICMR-PNT test was developed. A total of 368 controls, 123 dementia and 128 MCI patients were recruited for the study. Psychometric properties of the adapted version of the ICMR-PNT were examined, and sensitivity and specificity were examined.The ICMR-PNT scores in all languages combined were higher in controls compared with patients with dementia and MCI (FThe ICMR-PNT was developed by following cross-cultural adaptation guidelines and establishing correlations using item-wise factor analysis across five languages. This adapted PNT was found to be a reliable tool when assessing naming abilities effectively in mild to moderate dementia in a linguistically diverse context.What is already known on this subject Picture-naming evaluates language impairment linked to naming difficulties due to semantic memory, lexical retrieval or perceptual disturbances. As a result, picture naming tests (PNTs) play an important role in the diagnosis of dementia. In a heterogeneous population such as India, there is a need for a common PNT that can be used across the wide range of languages. What this study adds to existing knowledge PNTs such as the Boston Naming Test (BNT) were developed for the educated, mostly English-speaking, Western populations and are not appropriate for use in an Indian context. To overcome this challenge, a PNT was harmonized in five Indian languages (Hindi, Bengali, Telugu, Kannada and Malayalam) and we report the patterns of naming difficulty in patients with MCI and dementia. The ICMR-PNT demonstrated good diagnostic accuracy when distinguishing patients with mild to moderate dementia from cognitively normal individuals. What are the potential or actual clinical implications of this work? With the growing number of persons suffering from Alzheimer's disease and other forms of dementia around the world, its critical to have culturally and linguistically relevant naming tests and diagnosis. This validated ICMR-PNT can be used widely as a clinical tool to diagnose dementia and harmonize research efforts across diverse populations.

The 5G System is being developed and enhanced to provide unparalleled connectivity to connect everyone and everything, everywhere. The first version of the 5G System, based on the Release 15 (“Rel-15”) version of the specifications developed by 3GPP, comprising the 5G Core (5GC) and 5G New Radio (NR) with 5G User Equipment (UE), is currently being deployed commercially throughout the world both at sub-6 GHz and at mmWave frequencies. Concurrently, the second phase of 5G is being standardized by 3GPP in the Release 16 (“Rel-16”) version of the specifications which will be completed by March 2020. While the main focus of Rel-15 was on enhanced mobile broadband services, the focus of Rel-16 is on new features for URLLC (Ultra-Reliable Low Latency Communication) and Industrial IoT, including Time Sensitive Communication (TSC), enhanced Location Services, and support for Non-Public Networks (NPNs). In addition, some crucial new features, such as NR on unlicensed bands (NR-U), Integrated Access & Backhaul (IAB) and NR Vehicle-to-X (V2X), are also being introduced as part of Rel-16, as well as enhancements for massive MIMO, wireless and wireline convergence, the Service Based Architecture (SBA) and Network Slicing. Finally, the number of use cases, types of connectivity and users, and applications running on top of 5G networks, are all expected to increase dramatically, thus motivating additional security features to counter security threats which are expected to increase in number, scale and variety. In this paper, we discuss the Rel-16 features and provide an outlook towards Rel-17 and beyond, covering both new features and enhancements of existing features. 5G Evolution will focus on three main areas: enhancements to features introduced in Rel-15 and Rel-16, features that are needed for operational enhancements, and new features to further expand the applicability of the 5G System to new markets and use cases.

Objective In the background of a large population of bilinguals globally, the study aimed to develop standards of neuropsychological testing in the context of bilingualism. Because bilingualism is known to affect cognitive processes, bilinguals and monolinguals were compared on their performance on cognitive tests, to investigate the possibility of the need for separate normative data for the two groups. Method A comprehensive neuropsychological test battery, standardized across five Indian languages: the Indian Council of Medical Research-Neuro Cognitive Tool Box (ICMR-NCTB) was administered to 530 participants (267 monolingual and 263 bilinguals matched for age and education). A systematic method of testing cognition in bilinguals was developed; to identify the appropriate language for testing, ensure language proficiency of examiner, and to interpret the bilingual responses. Additionally, the performance of bilinguals on the ICMR-NCTB was compared with monolinguals. Results Cognitive testing in the bilingual context was performed in the most proficient language of the participants, by examiners well versed with the language. Results from the language-based tests suggested that the frequent occurrence of borrowed- and language-mixed words required consideration while scoring. The reported bilingual effect on cognitive processes did not reflect as differences in the performance between bilinguals and monolinguals. Conclusions Observations from the study provide robust recommendations for neuropsychological testing in the context of bilingualism. Results indicate that separate normative data may not be required for bilinguals and monolinguals. The study will be relevant and provide a reference framework to address similar issues in the large population of bilinguals in other societies.

One of the major brownfields in offshore India was producing for three decades from main carbonate reservoirs of the Eocene and Oligocene age. Average production of this brownfield is approximately 11,000 barrels of oil per day (BOPD). To maintain the declining reservoir pressure, the field has been under active water injection for more than two decades. However, being a complex carbonate reservoir with high textural heterogeneity, the water-front movement is not very well understood and monitored. To increase the oil production, the operator started drilling horizontal drain-holes from the platforms and has adopted a conventional perforated and blind tubing combination as a completion strategy. However, it was found that wells were performing poorly with very high water cut. An integrated and comprehensive petrophysical workflow was applied that used data analysis and the added value of advanced 3D acoustic data in combination with nuclear magnetic resonance (NMR) data to provide a rapid realistic solution to avoid such high watercut through optimizing the completion strategy. This led to a production gain in this offshore field, which was underperforming as per earlier predictions and expectations. Conventional well-log based qualitative evaluation for horizontal segmentation strategy was rejected in favor of an integrated approach for lateral reservoir facies delineation. Lateral petrophysical property characterization was carried out through quick integration of NMR pore-size driven facies analysis, advanced acoustic radial profiling, anisotropy, and Stoneley analysis. Permeability profiling along the horizontal drain-hole section using NMR and acoustics provided critical insight. Those were integrated to avoid potential high permeability conduits of thief zones for water breakthrough. A rock-quality index was derived to optimize the completion strategy soon after the logging, even preceding the rig-down of the acquisition runs and lowering of the completion. Zones with higher skin, deeper formation damage, and lower rock-mechanical properties were avoided for efficient swell-packer placements. The well started producing and continued production with only 10% water cut along with 450 barrels of oil compared to an average 90% watercut and 100 barrels of oil from the other wells of the same platform, which used the older nonoptimized completion strategy. Based on the promising result for the first well, the same workflow was used for two similar wells of other two different platforms inthe same field, which also resulted in similar production with enhanced oil production and reduced water cut. The study using the rapid integrated evaluation workflow established efficient zonal isolation of high permeability thief zones with accuracy for timely optimization of horizontal well segmentation, which assisted in pulling higher production in this brownfield by reducing unwanted water production.

Introduction GBA mutations have been reported in PD, PDD and DLB - but not associated with cognitive impairment for example in PSP, AD or MSA. However, frequencies of GBA mutations are ethnicity dependent. The present study aims to identify commonly reported GBA mutations (mostly from Asia), among eastern Indian patients with neurodegenerative disorders. Methods The patient cohort consisting of 198 classical PD cases, 136 PD cases with cognitive impairment, 184 cases with Parkinson Plus syndrome, 46 AD and 241 unrelated controls, from eastern India. Subjects were analyzed for IVS2 + 1A > G, p.Arg120Trp, p.His255Gln, p.Arg257Gln, p.Glu326Lys, p.Asn370Ser, p.Asp409His, p.Leu444Pro, & RecNciI by PCR-RFLP techniques and confirmed by Sanger sequencing method. Results We have identified only p.Leu444Pro variant among nine cases; three PDD, one DLB, two PD, two PSP and one AD patients in heterozygous condition. The highest frequency for p.Leu444Pro variant was found among PDD subgroup (3.95 %, P = 0.0134). An overall significant overrepresentation of positive family history (P = 0.000049), impaired recent memory (P = 0.0123) was observed among p.Leu444Pro carriers. Further, subgroup analysis for PD, PD-MCI and PDD, revealed statistically significant higher frequency of early age at onset (P = 0.0455), positive family history (P = 0.0025), higher UPDRS III score (off state) (P = 0.006), advanced H&Y stage (P = 0.045) and anxious behaviour (P = 0.0124) among p.Leu444Pro positive patients. Conclusion The p.Leu444Pro mutation of GBA was found in patients with PD, PDD, DLB, PSP and AD. An Overall higher frequency of positive family history and impaired recent memory are significantly associated with for p.Leu444Pro carriers from eastern India. Our study also ascertains contribution of p.Leu444Pro to an earlier onset of PD, PD-MCI and PDD, higher UPDRS III score (off state) against positive family history background. Furthermore, taking into consideration other Indian studies, we can conclude that p.Leu444Pro mutation plays a limited role in PD and other neurodegenerative disorders.

Mechanical engineering is one of the three most important engineering branches that have played the primary role in bringing the First Industrial Revolution that is responsible for the present-day human civilization. However, whether this branch of engineering is a result of gradual evolution over the millennia or it was almost ‘born’ during a relatively short period of time is a point that has been discussed in this article. The article also attempts to provide a very brief account of the possible current and future trends of development. How the different branches of engineering have evolved and the possible course that will be followed by the futuristic engineering have also been discussed in brief.

Mechanical logic gates, whose embodiments were demonstrated in the past with rigid bodies connected with kinematic joints, are revisited in this work using compliant mechanisms. In particular, an OR gate is designed using pinned-pinned bistable arches. The compliant OR gate consists of five bistable arches arranged in such a way that a central arch acts as the output with 0 and 1 stable states while two pairs of arches, with their own 0 and 1 states, act as inputs. The arch-profiles of all arches are designed so that the forces of switching and switching back between the two stable states and the travel between the two stable configurations are as per the desired functionality. An analytical method, which is based on linear superposition of buckling mode shapes of a straight pinned-pinned column, was used to design the arch-profiles. Finite element analysis was used to validate the OR logic behaviour of the entire setup. A macroscale prototype was made using 3D printing to demonstrate the working of the OR logic. Since mechanical gates are useful at the micro-scale, using fixed-fixed arches instead of pinned-pinned arches is beneficial from the viewpoint of microfabrication.

As has been emphasized earlier, it is very important to check the approximate consistency of the astronomically derived chronology with other available information from different sources. In this respect, there are three major sources which can indicate the antiquity of the ancient chronology of protohistoric India. These are (i) geological and climatological, (ii) archaeological and (iii) genealogical evidences.

A brief description of the basic principles involved in descriptive archaeoastronomy was given in Sect. 2.4.2. In this chapter the principles are going to be elaborated that can help better the understanding of their application for dating purpose. As mentioned earlier, in descriptive archaeoastronomy only the descriptions of past stellar and planetary alignments are used.

Many consider the vedas to be the oldest texts of the world. The root of the word ‘Veda’ is ‘Vid’ meaning ‘to know’. Thus, ‘veda’ implies ‘knowledge’ or book of knowledge. The vedic corpus is vast and is divided into the following four vedas—‘Rigk’, ‘Sam’, ‘Yajur’ and ‘Atharva’. Each veda has the original hymns called ‘Samhita’ followed by a commentary portion called ‘Brāhmana’ which guide people to perform sacrificial rites.

To understand the basic principles behind the techniques of archaeoastronomy, it is essential to have some idea about positional astronomy.

Investigating the chronological history of ancient India is a difficult task. The difficulties arise not only because of natural reasons but the major obstacles are framed by the historians and archaeologists themselves. So, a major problem is the presence of dogmatic theories which were developed in the nineteenth-century colonial India based on presumptive hypotheses in the absence of any archaeological evidence of any ancient civilization in the soil of this subcontinent. With more and more new evidences of ancient settlements, the old dogmatic theory is being given only cosmetic uplifts keeping the basic foundation intact.

To apply the principles of descriptive archaeoastronomy for investigating the chronology of ancient India before the historical period, it is imperative that one understands the astronomical system followed by ancient Indian astronomers.