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Above-Ground Biomass (AGB) is an important parameter in the conservation of mangrove ecosystem owing to their ecological and economic benefits. LiDAR technologies in forest studies have become popular, due to its highly accurate 3D spatial data acquisition. In this study, we propose an end-to-end framework for estimating AGB of mangroves from Terrestrial Laser Scanner (TLS) point clouds. The framework includes pre-processing of data, segmenting the wood and foliage at tree level using Weighted Random Forest (WRF) classifier and constructing Quantitative Structure Model (QSM) of the wooden components to estimate its biomass. The flow was extended to AGB estimation of 33 x 33 m plot by integrating tree level framework. The study also finds a unique solution to estimate the contribution of pneumatophores in the AGB. Segmentation of wood/foliage of tree point cloud using WRF yielded better results with an increment of 15.27 % in Balanced accuracy, 0.2 of Cohen’s Kappa coefficient, and 7.45 % in F1score than RF classifier. AGB estimation of mangroves using our approach using TLS data is 47.54 T/ha which has a mean bias of 0.0044 T/ha and RMS variation of 0.026 T/ ha when compared with the allometric methods. A Breadth-first graph-search segmentation approach was used to count the pneumatophores, aerial roots seen in few mangrove species (R2 = 0.94 with manual counting) and estimate its contribution to AGB of mangroves which is first of its kind using TLS point cloud. This outcome could also aid future studies in modeling the underlying root network and estimating the below-ground biomass.

Background: Blood loss is often a major complication of neurosurgery; and adversely impacts postoperative outcomes. Primary objective of our study was to assess the effect of tranexamic acid (TXA) on total perioperative blood loss and the need for packed red blood cell (PRBC) transfusion in patients. Secondary objective was to assess and compare the effect of TXA on haemoglobin (Hb) , packed cell volume (PCV), coagulation profile, crystalloid and PRBC requirement, neurological outcomes; and the quality of surgical field peri-operatively. Materials and Methods: 60 adult patients, undergoing elective craniotomy for tumor resection were recruited. 30 patients each, received either a bolus of TXA , followed by an infusion (TXA group); or normal saline in the same dose (Placebo group). Crystalloid and PRBC transfusion, blood loss, Hb, PCV, platelet count, fibrinogen levels, international normalized ratio were recorded. Mean intensive care unit (ICU) stay and Glasgow Outcome Extended (GOSE) score were also measured. Results: There was no significant difference in blood loss, PRBC requirement, Hb, PCV, fibrinogen levels , INR, duration of ICU stay or the quality of the operative field; between the TXA and placebo groups. GOSE scores were better and platelet count decrease was significantly higher in the TXA group. Conclusion: Low-dose TXA did not significantly reduce blood loss or improve outcomes in patients undergoing intracranial tumor resection. GOSE score was better; and the platelet decrease post- operatively was significantly higher in the TXA group. Keywords: Intracranial Tumours, Tranexamic Acid ( TXA), Glasgow Outcome Extended (GOSE) Score

Purpose: The current study was aimed to find correlation of glycosylated hemoglobin with retinal nerve fiber layer thickness (RNFLT) and central macular thickness (CMT) in the diabetic population in North India. Methods: This was a cross-sectional observational study of 300 diabetic patients divided equally in two groups with and without retinopathy, and 150 people were included as control. The study was conducted from October 2020 to August 2022. All patients underwent slitlamp fundoscopy with a +78 D lens, and spectral-domain (SD) optical coherence tomography was performed to measure the RNFLT and CMT, and the staging of retinopathy was done as per the ETDRS classification. Along with that, blood investigations were ordered, including fasting (FBS) and post-prandial (PPBS) blood sugar and glycosylated hemoglobin (HbA1c). Quantitative variables were compared using one-way analysis of variance, or Kruskal–Wallis test was applied for inter-group comparison, followed by a Student Newman Keuls Test. Results: The mean age of the patients in the diabetic group with retinopathy was 52.62 ± 9.38 years. The overall male: female ratio was 3:2. The mean FBS in the diabetic group with retinopathy was 146.54 ± 45.40mg/dl; the PPBS and HbA1c in the same were 210.39 ± 63.71mg/dl and 7.85 ± 1.33%, respectively. RNFL thinning was found in all four quadrants in diabetics irrespective of the status of retinopathy (P-value = 0.000) with a significant weak negative (r 0.05). Conclusion: The study concluded that neurodegeneration occurs in diabetic retinopathy as evident with nerve fiber layer thinning, and it is negatively correlated with glycosylated hemoglobin (HbA1c).

Cross-modality person re-identification is the process of matching person instances across different modalities, which poses a challenge in surveillance systems. These models encounter high intra-modality differences and a very high modality gap. In order to address the modality gap, numerous studies have employed generative models to produce image pairs as a means of augmenting the dataset. Nevertheless, the presence of artifacts in the generated images could potentially impact the model’s prediction. In order to tackle these problems, we adopt a two-stage network. In the initial stage, we will extract features from cross-modality images and employ adversarial learning to produce prototype features that encompass essential features from both the RGB and IR modalities. The prototype features are utilized to construct a compensating feature set, which is then employed to train the re-identification model. The prototype features are derived from the extracted features, ensuring that only key components are utilized in the generation process. In the second phase, we employ a combination of integral probability metrics to align the identities through discrimination learning. Subsequently, we map the modalities to diminish the gap between them. At this stage, we propose to use modality-specific loss functions and modality-shared loss functions, which ensure that features relating to each modality are preserved during training. In addition, rather than identifying point-to-point differences between the feature distributions, the study focuses on the process of transporting one distribution to another, which contributes to the incorporation of perceptual learning in the model. The extensive evaluation of the proposed model demonstrates enhanced re-identification outcomes, affirming the model’s ability to align modalities and augment the feature space.

Abstract Classification tasks today, especially for the medical domain, use datasets which are often hierarchical. These tasks are approached using methods that consider the class taxonomy for predicting a label. The classifiers are gradually becoming increasingly accurate over the complex datasets. While increasing accuracy is a good way to judge a model, in high-risk applications, it needs to be ensured that even if the model makes a mistake, it does not bear a severe consequence. This work explores the concept of severity of an error and extends it to the medical domain. Further, it aims to point out that accuracy or AUROC alone are not sufficient metrics to decide the performance of a model in a setting where a misclassification will incur a severe cost. Various approaches to reduce severity for classification models are compared and evaluated in this work, which indicate that while many of them might be suited for a traditional image classification setting, there is a need for techniques tailored toward tasks and settings of medical domain to push artificial intelligence in healthcare to a deployable state.

The rapid expansion of the Industrial Internet-of-Things (IIoT) has spurred significant research interest due to the growth of security-aware, vehicular, and time-sensitive applications. Unmanned aerial vehicles (UAVs) are widely deployed within wireless communication systems to establish rapid and reliable links between users and devices, attributed to their high flexibility and maneuverability. Leveraging UAVs provides a promising solution to enhance communication system performance and effectiveness while overcoming the unprecedented challenges of stringent spectrum limitations and demanding data traffic. However, due to the dramatic increase in the number of vehicles and devices in the industrial wireless networks and limitations on UAVs’ battery storage and computing resources, the adoption of energy-efficient techniques is essential to ensure sustainable system implementation and to prolong the lifetime of the network. This paper provides a comprehensive review of various disruptive methodologies for addressing energy-efficient issues in UAV-assisted industrial wireless networks. We begin by introducing the background of recent research areas from different aspects, including security-enhanced industrial networks, industrial vehicular networks, machine learning for industrial communications, and time-sensitive networks. Our review identifies key challenges from an energy efficiency perspective and evaluates relevant techniques, including resource allocation, UAV trajectory design and wireless power transfer (WPT), across various applications and scenarios. This paper thoroughly discusses the features, strengths, weaknesses, and potential of existing works. Finally, we highlight open research issues and gaps and present promising potential directions for future investigation.

Recently, to address the multiple object tracking (MOT) problem, we harnessed the power of deep learning-based methods. The tracking-by-detection approach to multiple object tracking (MOT) involves two primary steps: object detection and data association. In the first step, objects of interest are detected in each frame of a video. The second step establishes the correspondence between these detected objects across different frames to track their trajectories. This paper proposes an efficient and unified data association method that utilizes a deep feature association network (deepFAN) to learn the associations. Additionally, the Structural Similarity Index Metric (SSIM) is employed to address uncertainties in the data association, complementing the deep feature association network. These combined association computations effectively link the current detections with the previous tracks, enhancing the overall tracking performance. To evaluate the efficiency of the proposed MOT framework, we conducted a comprehensive analysis of the popular MOT datasets, such as the MOT challenge and UA-DETRAC. The results showed that our technique performed substantially better than the current state-of-the-art methods in terms of standard MOT metrics.

Pediatric corneal transplant is a highly demanding and technically challenging procedure for the cornea surgeon in today’s era. These cases pose unique challenges in clinical and surgical management. The indications of pediatric corneal transplant can be therapeutic, tectonic, optical, and cosmetic. Pediatric patients undergoing corneal transplants are at a high risk of graft infection, failure, rejection, dehiscence, and amblyopia due to young age, robust immune system, increased incidence of trauma, and compliance issues. The other factors contributing to graft failure can be allograft rejection, secondary glaucoma, corneal vascularization, multiple surgeries, vitreous prolapse, and lack of treatment compliance. A successful corneal transplant in children depends on meticulous preoperative evaluation, uneventful surgery, the expertise of a corneal surgeon, and regular and timely postoperative follow-up. Therapeutic and optical penetrating keratoplasty are the most commonly performed transplants in children. However, with the advancements in surgical technique and management protocol, the current focus has shifted toward lamellar keratoplasty. Lamellar keratoplasty offers early visual recovery and potentially fewer complications. Visual rehabilitation through corneal transplant in otherwise blind eyes can be a boon for the children. Recently, keratoprostheses have been promising in children with multiple graft failures. The current review gives insights into epidemiology, etiology, indications, clinical characteristics, investigations, management options, recent advances, and the future of pediatric corneal transplants. As surgical techniques continue to grow and comprehension of pediatric corneal transplants is improving, we can safeguard these eyes with the best possible anatomical and functional outcomes.

Abstract This work introduces a novel method to construct Schottky junctions to boost the output performance of triboelectric nanogenerators (TENGs). Perovskite barium zirconium titanate (BZT) core/metal silver shell nanoparticles are synthesized to be embedded into electrospun polyvinylidene fluoride‐co‐hexafluoropropylene (PVDF‐HFP) nanofibers before they are used as tribo‐negative layers. The output power of TENGs with composite fiber mat exhibited >600% increase compared to that with neat polymer fiber mat. The best TENG achieved 1339 V in open‐circuit voltage, 40 µA in short‐circuit current and 47.9 W m−2 in power density. The Schottky junctions increased charge carrier density in tribo‐layers, ensuring a high charge transfer rate while keeping the content of conductive fillers low, thus avoiding charge loss and improving performance. These TENGs are utilized to power radio frequency identification (RFID) tags for backscatter communication (BackCom) systems, enabling ultra‐massive connectivity in the 6G wireless networks and reducing information communications technology systems’ carbon footprint. Specifically, TENGs are used to provide an additional energy source to the passive tags. Results show that TENGs can boost power for BackCom and increase the communication range by 386%. This timely contribution offers a novel route for sustainable 6G applications by exploiting the expanded communication range of BackCom tags.

This study aimed to develop an automatic diagnostic scheme for bruxism, a sleep-related disorder characterized by teeth grinding and clenching. The aim was to improve on existing methods, which have been proven to be inefficient and challenging. We utilized a novel hybrid machine learning classifier, facilitated by the Weka tool, to diagnose bruxism from biological signals. The study processed and examined these biological signals by calculating the power spectral density. Data were categorized into normal or bruxism categories based on the EEG channel (C4-A1), and the sleeping phases were classified into wake (w) and rapid eye movement (REM) stages using the ECG channel (ECG1-ECG2). The classification resulted in a maximum specificity of 93% and an accuracy of 95% for the EEG-based diagnosis. The ECG-based classification yielded a supreme specificity of 87% and an accuracy of 96%. Furthermore, combining these phases using the EMG channel (EMG1-EMG2) achieved the highest specificity of 95% and accuracy of 98%. The ensemble Weka tool combined all three physiological signals EMG, ECG, and EEG, to classify the sleep stages and subjects. This integration increased the specificity and accuracy to 97% and 99%, respectively. This indicates that a more precise bruxism diagnosis can be obtained by including all three biological signals. The proposed method significantly improves bruxism diagnosis accuracy, potentially enhancing automatic home monitoring systems for this disorder. Future studies may expand this work by applying it to patients for practical use.

Purpose: To assess the current trends in use of perioperative antibiotic prophylaxis, especially intracameral antibiotics (ICAB), for cataract surgery in India. Methods: This was an E-survey using a previously validated questionnaire carried out by the All India Ophthalmological Society (AIOS) in August 2022. An E-mail invitation to complete an online 40-point survey was sent to all members of the AIOS using a digital E-mail service (Survey Monkey) and social media platforms. Results: Out of 1804 total respondents, 58% (n = 1022) reported using routine ICAB prophylaxis. Of those using ICAB, 89% (n = 909) reported using it for all cases, whereas the rest used it for specific indications such as post-PC rent (n = 43), one eyed patient (n = 19), and high-risk cases (n = 50). Commercially available moxifloxacin was by far the commonest agent used for ICAB (n = 686, 67%). Eighty respondents (8%) reported noticing occasional toxic reactions and nontoxic corneal edema (n = 64, 6%) with ICAB. Surgeons with >10 years' experience especially practicing in medical colleges used fewer ICAB (OR = 0.52, 95%CI = 0.38 – 0.72, P < 0,001) compared to younger surgeons (

In this paper, we address the challenge of establishing secure communication within a symbiotic radio (SR) network. This network comprises a primary transmitter (PT), a primary receiver (PR), a passive backscatter device (BD), and an eavesdropper (ED) attempting to intercept the BD’s transmitted information signal. The PT simultaneously transmits an information-bearing signal to the PR and artificial noise (AN) to confound the ED. The objective is that the BD conveys confidential information to the PR by leveraging the PT’s signal. The PR performs joint decoding of both the symbols transmitted by the PT and the BD. In this system configuration, we derive a closed-form expression for the ergodic secrecy rate of the BD, providing an analytical framework for evaluating its security performance. Furthermore, we derive an expression for the secrecy rate in the asymptotic regime characterized by a large number of transmit antennas. These derived expressions allow us to optimize both the reflection coefficient and power allocation factor, enabling the maximization of the BD’s ergodic secrecy rate while considering the quality of service (QoS) requirements of the primary system. The derived analytical results provide valuable insights into the influence of key system parameters on the secrecy performance. Notably, the derived analytical results quantify the effect of key system parameters on the secrecy performance. In particular, we show that the using AN can always improve the secrecy rate given the QoS constraints of the primary user. Moreover, we show that the secrecy rate can be improved by increasing the reflection coefficient at the BD even with better channel condition for the ED than the legitimate link.

Corneal cross-linking (CXL), a corneal strengthening procedure, is known to alter anterior stroma swelling behavior and is one of the treatment modalities of bullous keratopathy (BK). There are multiple studies published on the role of CXL in the treatment of BK. These articles had heterogeneous study population, different protocols used, and variable conclusions. This systematic review aimed to determine the role of CXL in the treatment of BK. The primary outcomes considered were changes in central corneal thickness (CCT) after 1, 3, and 6 months of CXL. The secondary outcome measures were changes in visual acuity, corneal clarity, subjective symptoms, and complications after CXL. We included randomized control trials (RCTs), observational and interventional studies, and case series with reports of more than 10 cases in this review. In RCTs, the mean pre-CXL CCT (794.0 ± 178.5 μm) in the intervention group (n = 37), decreased at 1 month (750.9 ± 154.3 μm) followed by a subsequent increase, but this difference was not significant during the 6-month follow-up (P- value 0.28, 0.82, and 0.82 at 1, 3, and 6 months, respectively). In noncomparative clinical studies (n = 188), the mean pre-CXL CCT (794.0 ± 178.5 μm) decreased at 1 month (710.9 ± 127.2 μm, P < 0.0001). Seven of the 11 articles included in the review reported no significant improvement in vision with CXL. The initial improvement in corneal clarity and clinical symptoms was not sustained. Current evidence suggests that CXL has short-term efficacy in the treatment of BK. More RCTs with high-quality evidence are needed.

Purpose: To study the corelation between outer retinal layer thickness (ORL), outer photoreceptor segment thickness (PROS), and central macular thickness (CMT) with best-corrected visual acuity (BCVA) in patients having clinically significant macular edema (CSME) and compare these parameters with normal patients. Methods: This was a prospective, nonrandomized, observational, comparative study done during the period of January to May 2019. The study included 60 eyes of 36 patients. The patient population was segregated into two Groups: Group I (30 normal eyes of 15 normal patients) and Group II (30 eyes of 21 diabetic patients) with CSME. The comparison between ORL, PROS, and CMT was made between both the groups, and the correlation between ORL thickness, PROS thickness, and CMT with BCVA in Group II was studied. Results: The mean age in Group I was 52.6+10.66 years, and 53.42+8.15 years in Group II. The male/female ratio was 1.1:1 in Group I and 4:3 in Group II. The mean CMT was greater in Group II (330.13 ± 37.01) than in Group I (222.20 ± 12.30). The mean ORL thickness was greater in Group I (97.73 ± 6.92) than in Group II (80.63 ± 9.03). The PROS thickness was statistically significant in Group I (35.05 ± 3.4) than in Group II (28.57 ± 3.53). There was a strong correlation between BCVA and ORL thickness (r = −0.580, P < 0.001) and more strong correlation between BCVA and PROS thickness in Group II (r = −0.611, P < 0.000). There was a moderate correlation between BCVA and CMT (r = 0.410, P < 0.025), and all results were statistically significant. Conclusion: Both ORL and PROS thickness were greater in healthy normal eyes than in eyes with CSME. BCVA was strongly correlated with PROS and ORL thickness and moderately associated with CMT.

Cataract is the leading cause of blindness worldwide. There is an increased incidence of cataract formation in the diabetic population due to several factors. Diabetes mellitus accelerates the development of cataract. Oxidative stress results in most of the diabetic complications including diabetic cataract. Oxidative stress leading to the expression of various enzymes has also been proven as crucial for cataractous changes in the lens in old age. A narrative review was undertaken to investigate the expression of different biochemical parameters as well as enzymes in diabetic and senile cataracts. Identification of these parameters is crucial for the prevention and treatment of blindness. Combinations of MeSH terms and key words were used to do literature search in PubMed. The search resulted 35 articles and among them, 13 were relevant to the topic and were included in synthesis of results. Seventeen different types of enzymes were identified in the senile and diabetic cataracts. Seven biochemical parameters were also identified. Alteration in biochemical parameters and expression of enzymes were comparable. Majority of the parameters were raised or altered in diabetic cataract compared to senile cataract.

Recently, Polarization Depolarization current (PDC) measurement is widely accepted time domain spectroscopy-based method for assessing the insulation condition. Various performance parameters like Dissipation factor (%tan $\delta $ ), Paper Moisture (%pm), Dielectric Adsorption Ratio (DAR), Polarization index (PI) etc. can be estimated by analyzing the PDC data. During field measurement various factors influences the recorded PDC data. As per existing literature, presence of low frequency noise, effect of temperature variation and influence of residual charge are common during field measurement. These factors significantly affect recorded polarization current and hence estimated performance parameters. Hence, analysis using recorded polarization current data may provide misleading information regarding insulation condition. Under such practical situation where polarization current is affected by above mentioned factors that generally observed during field measurement, depolarization current should be used for analysis of insulation condition. The depolarization current does not influence by such external factors. The present work shows the importance of depolarization current where polarization current is influenced by external low frequency noise and residual charge. The analysis firstly applied on sample prepared in the laboratory and then on data collected from real life in-situ transformers. The results obtained from the analysis shows that the data obtained from depolarization current is more reliable.

Purpose: To assess the quantum of cataract surgical training opportunities for trainees enrolled in ophthalmology residency programs in India. Methods: An anonymous online survey was sent across to resident ophthalmologists across India through various social media platforms. The results were tabulated and analyzed. Results: A total of 740 resident ophthalmologists participated in the survey. In all, 40.1% (297/740) were independently performing cataract surgeries. Of those who were not performing independent cataract surgeries, 62.5% (277/443) were in the third year of residency. A significantly higher proportion of trainees who were not operating independent cataract surgeries were enrolled in MD/MS programs as compared with DNB courses (65.6% vs. 43.7%; P < 0.0001). Of those who were operating independent cases; 97.1% had exposure to manual small incision cataract surgery (MSICS), whereas only 14.1% performed phacoemulsification. It was noted that 31.3% of residents reported that on an average a trainee in their training program performed less than 100 independent cataract surgeries throughout the residency. Apart from cataract surgery, the most performed surgeries by residents were pterygium excision (85.3%), followed by enucleation/evisceration (68.1%). When it came to training aids, 47.2% (349/740) of the respondents reported no access to wet lab, animal/cadaver eyes, or surgical simulators for training. Conclusion: The amount of surgical exposure in terms of cataract surgery across residency programs in India is low with most of the ophthalmology residents who participated in this survey not operating cataracts independently; even in their final year of residency. Exposure to phacoemulsification in residency programs is very limited across the country. Although some programs do provide well-rounded surgical exposure to trainees, such centers are scarce; the stark variations in infrastructure, training opportunities, and surgical numbers warrant an overhaul in the structure and curriculum of residency programs in India.

Wireless-based sensing of physical environments has garnered tremendous attention recently, and its applications range from intruder detection to environmental occupancy monitoring. Wi-Fi is positioned as a particularly advantageous sensing medium, due to the ubiquity of Wi-Fi-enabled devices in a more connected world. Although Wi-Fi-based sensing using Channel State Information (CSI) has shown promise, existing sensing systems commonly configure dedicated transmitters to generate packets for sensing. These dedicated transmitters substantially increase the energy requirements of Wi-Fi sensing systems, and hence there is a need for understanding how ambient transmissions from nearby Wi-Fi devices can be leveraged instead. This paper explores the potential of Wi-Fi-based sensing using CSI derived from ambient transmissions of Wi-Fi devices. We demonstrate that CSI sensing accuracy is dependent on the underlying traffic type and the Wi-Fi transceiver architecture, and that control packets yield more robust CSI than payload packets. We also show that traffic containing upload data is more suitable for human occupancy counting, using the Probability Mass Function (PMF) of CSI. We further demonstrate that multiple spatially diverse streams of Wi-Fi CSI can be combined for sensing to an accuracy of 99%. The experimental study highlights the importance of training Wi-Fi sensing systems for multiple transmission sources to improve accuracy. This research has significant implications for the development of energy-efficient Wi-Fi sensing solutions for a range of applications.

Wireless energy harvesting (EH) communication has long been considered a sustainable networking solution. However, it has been limited in efficiency, which has been a major obstacle. Recently, strategies such as energy relaying and borrowing have been explored to overcome these difficulties and provide long-range wireless sensor connectivity. In this article, we examine the reliability of a wireless-powered communication network by maximizing the net bit rate. To accomplish our goal, we focus on enhancing the performance of hybrid access points and information sources by optimizing their transmit power. Additionally, we aim to maximize the use of harvested energy, by using energy-harvesting relays for both information transmission and energy relaying. However, this optimization problem is complex, as it involves non-convex variables and requires combinatorial relay selection indicator optimization for decode and forward (DF) relaying. To simplify this problem, we utilize the Markov decision process and deep reinforcement learning framework based on the deep deterministic policy gradient algorithm. This approach enables us to tackle this non-tractable problem, which conventional convex optimization techniques would have difficulty solving in complex problem environments. The proposed algorithm significantly improved the end-to-end net bit rate of the smart energy borrowing and relaying EH system by 13.22%, 27.57%, and 14.12% compared to the benchmark algorithm based on borrowing energy with an adaptive reward for Quadrature Phase Shift Keying, 8-PSK, and 16-Quadrature amplitude modulation schemes, respectively.

Purpose: The current study was aimed at assessment of optic disk by disk damage likelihood scale (DDLS) staging using slit-lamp biomicroscopy and optical coherence tomography (OCT) in diagnosing primary open-angle glaucoma (POAG) patients. Methods: This was a cross-sectional observational study of 106 POAG patients, which was conducted from April 2017 to April 2018. All patients underwent slit-lamp fundoscopy with a +78 D lens and high-definition (HD)-OCT, and the vertical cup disk ratios (VCDRs) were recorded. Disk size and neuroretinal rim assessment were done, and the disk was then staged using the recent version, which stages the optic nerve head (ONH) from 1 to 10 as read from the DDLS nomogram table. DDLS scores >5 indicate glaucomatous damage. Pearson coefficient was used to correlate the DDLS staging by slit-lamp biomicroscopy with best-corrected visual acuity (BCVA), intraocular pressure (IOP), disk size, and VCDR and VCDR, mean deviation, and DDLS staging by HD-OCT. Results: The mean age of the patients was 59.54 ± 6.61 years. The male: female ratio was 2:1. The mean IOP was 16.04 ± 1.97 mmHg, and BCVA was 0.72 ± 0.13 LogMAR units. The mean VCDR on 78 D slit-lamp biomicroscopy was 0.76 ± 0.09 (standard deviation [SD]) (range 0.1–0.77), whereas on HD-OCT, the mean VCDR was 0.81 ± 0.09 (SD) (range 0.07–0.81). The mean deviation on visual field testing in decibels was −14.43 ± 3.31 (SD). The correlation coefficient between DDLS staging by slit-lamp biomicroscopy and DDLS staging by HD-OCT parameters was r = 0.96. Conclusion: There is a positive correlation between the DDLS system of optic disk evaluation on slit-lamp biomicroscopy and most of the HD-OCT evaluation parameters.

Purpose: The purpose of this study was to compare and analyze the endothelial cell loss during manual small-incision cataract surgery (MSICS) using the viscoelastic-assisted nucleus removal versus basal salt solution plus technique. Methods: This was a prospective randomized trial of 204 patients who underwent MSICS using viscoelastic-assisted nucleus removal (Group 1- OVD) versus basal salt solution plus technique (Group 2- BSS) at a tertiary eye care hospital in North India from January 2018 to 2021. Of these 204 patients, 103 (50.5%) and 101 (49.5%) were allocated to Group 1 and 2, respectively. The parameters assessed were detailed history, demographics, and anterior and posterior segment details. Visual acuity, intraocular pressure (IOP), keratometry, pachymetry, and endothelial cell density were evaluated preoperatively and postoperatively on day 1 and 30. Results: The mean age of the patients was 64.5 ± 8.2 years (range 48–82 years). There were 129 (63.2%) males and 75 (36.8%) females. The mean LogMAR visual acuity for both groups on day 1 (Group 1- 0.3 ± 0.1, Group 2- 0.5 ± 0.2) and day 30 (Group 1- 0.1 ± 0.2, Group 2- 0.1 ± 0.1) was statistically significant (P < 0.001), and the mean IOP value showed a statistically significant value (P < 0.009) on day 1 in Group 2 (15.0 ± 2.4 mmHg) and on day 30 (P < 0.001) in both the groups (Group 1- 13.6 ± 1.8 mmHg, Group 2- 13.5 ± 2 mmHg). The horizontal and vertical k values also showed a statistically significant difference on day 1 and day 30 (P < 0.001). The mean percentage change of central corneal thickness (CCT) in Group 1 was 17.7% and in Group 2 was 17.4% on day 1, and it was 1.1% on day 30 in both the groups, which was statistically significant (P < 0.001) compared to preoperative values. The percentage change in endothelial cell density on day 1 was 9% in Group 1 and 4.6% in Group 2, which was statistically significant (P < 0.001). On day 30, it was 9.7% and 4.8%, respectively, which was statistically significant (P < 0.001). Conclusion: Our study highlights statistically significant endothelial cell loss with viscoelastic-assisted nuclear delivery compared to BSS-assisted nuclear delivery during MSICS in a short follow-up of 1 month. The CCT values showed a slight increase, and the keratometry and IOP were unaffected compared to the preoperative parameters in both the groups.

Cataract is the most common cause of reversible blindness worldwide, accounting for approximately 50% of blindness worldwide. Cataract surgery is the most common surgical procedure performed in routine ophthalmic practice. It has undergone tremendous evolution, and the incision size has progressively reduced from 10–12 mm in extracapsular cataract surgery (ECCE) to 6–8 mm for manual small-incision cataract surgery (MSICS) and 2.2–2.8 mm in phacoemulsification. In a developing country like India, with a massive backlog of cataract, everyone cannot afford private surgery like phacoemulsification. Moreover, annual maintenance of the machine, cost of foldable IOLs, need for greater skill, learning curve, and difficulty in performing the surgery in mature and brown cataracts are other barriers. Due to these factors, MSICS is the surgery of choice in the developing world, with profound societal and economic benefits and similar visual recovery compared to phacoemulsification. During the last two decades, MSICS gained popularity in developing countries and has undergone tremendous advances. This article aims to review the various techniques of MSICS and how the surgery has evolved over the years, particularly focusing on the current technique of 2-mm MSICS.

Cataract causes bilateral blindness in 20 million people globally, the vast majority of whom live in developing countries. Manual small-incision cataract surgery (MSICS) has emerged as an efficient and economical alternative to phacoemulsification, giving comparable results in terms of final visual gain. One of the important determinants of postoperative visual gain is the status of the corneal endothelium. Multiple factors such as corneal distortion, irrigation solution turbulence, mechanical trauma by instruments, nuclear fragments, intraocular lens contact, and free oxygen radicals, all have been implicated in causing corneal damage during cataract surgery. MSICS with posterior chamber intraocular lens implantation has been reported to cause an endothelial cell loss of 15.83%, which is comparable with other modes of cataract surgery like extracapsular cataract extraction and phacoemulsification. Thorough preoperative assessment of endothelial status and taking necessary steps for endothelial protection during surgery can decrease the endothelial cell loss and overall burden of pseudophakic bullous keratopathy. In addition to surgical techniques, the type of irrigating solutions, ocular viscoelastic devices, intracameral dyes, and drugs all affect the endothelial cell status. This review presents a summary of available literature on the protection of endothelial cells during different steps of MSICS. This is especially relevant for developing countries where large-scale MSICS cataract surgeries are performed to decrease the cataract blindness burden.

Co-infection of coronavirus disease 2019 (COVID-19) patients with life-threatening mucormycosis was seen as a major health crisis during the recent surge of coronavirus disease cases. We have taken 14 affected patients who were operated on at our centre and noted associated risk factors, intraoperative courses and surgical outcome in immediate peri-operative course. Out of 14 patients, 8 were people with diabetes while 2 were freshly detected/had corticosteroid-induced hyperglycaemia. Although our sample size is small, it is evident that patients who had diabetes, who were treated with steroids and who received supplemental oxygen support are more prone to contract mucormycosis infection. Also, patients who have the more severe form of COVID-19 pneumonia and those who need to be operated on early (within 20 days of COVID-19 infection) are likely to have turbulent intraoperative and postoperative courses. Therefore, optimization before surgery is of paramount importance.

Purpose: India's cataract surgery rate has been hovering around a creditable 6000 per million population but the coverage is variable across the geography and demography with sharp urban rural divide. Smaller incisions in manual small incision cataract surgery (MSICS) with phacofracture have been credited with lower astigmatism and faster recovery, which is especially useful for patients traveling for surgeries. Methods: In this retrospective chart analysis based observational study of 66 eyes, we describe the early postoperative results with 2 mm MSICS with phacofracture. Results: The mean spherical equivalent of the autorefractor measured astigmatic error changed marginally to −0.51 diopters (SD = 0.58) from −0.44 diopters (SD = 0.42) (t = −8.410, P = 0.0) translating to mean change in astigmatism of 0.14 DCyl when the axis was ignored. The keratometric difference between steepest and flattest axis of the anterior surface of the central 3 mm zone of the cornea changed from a mean of 0.89 diopters (SD = 0.55) to 1.39 diopters (SD = 1.03). The visual acuity improved to mean logarithm of the minimum angle of resolution (logMAR) score of 0.27 (SD = 0.33) at 1 week and 0.007 (SD = 0.04) which corresponds to 6/6P on Snellen's acuity at 1 month or more. Conclusion: A 2 mm MSICS with phacofracture can deliver low astigmatism and good visual recovery in cataract surgery. The study underlines the need for considering the refraction at anterior and posterior corneal interfaces when the triplanar incision with separate interfaces is used.

The prevalence of blindness in India is 14.9 per 1000. Cataract causes 80% of this blindness. Most of these blinds are in the rural areas while the surgical service delivery channels are concentrated in the urban areas. This situation has many social impacts like loss of productivity, breakdown of interpersonal relationships, depressive manifestations, loss of self-esteem, and isolated humiliating life. Manual small-incision cataract surgery (MSICS; also SICS) is a low-cost, small-incision, high-valued cataract surgery that is principally employed in the developing world. In poor settings, MSICS also has several distinct advantages over phacoemulsification, including shorter operative time, less need for technology, and lower cost. Ranjan MSICS Marker is a tool which enables MSICS to be done under topical anesthesia easily with more precise and safe incision making along with more control on surgery induced astigmatism.

Manual small-incision cataract surgery (MSICS) preserves its utility as a cost-effective and efficient strategy for mitigating cataract-associated blindness. Numerous techniques of nucleus delivery in MSICS have been described in the literature. The fish hook technique of nucleus extraction was advocated in 1997 and has been popular for high-volume surgery in limited pockets of the world. This article describes in detail the steps involved in the construction of a fish hook, tips of nucleus extraction with the help of a fish hook, and the pros and cons of fish hook-based MSICS through text, diagram, and video supplement.

Scleral-fixated intraocular lens implantation in an important tool in the armamentarium of an ophthalmologist for managing aphakia. Various techniques have been described in the literature with variable learning curves. Herein, we describe an easy, fast, reproducible technique; the “MYX” technique, which utilizes the advantages of both the Yamane and the X-NIT technique, where the handshaking of the prolene haptic of a 3-piece PMMA IOL into the lumen of a 26-gauge needle is done externally (like in X-NIT technique), and the exteriorized haptic is cauterized to form a flange transconjunctivally, thereby avoiding the scleral pocket tucking (like Yamane technique), to achieve excellent surgical outcomes.

Wet labs are an extremely important training tool, especially in times of a global COVID-19 pandemic, where surgical training can be minimal. They help the trainee learn and practice in a risk-free environment, without an imminent of a complication or failure, also allowing them the chance to execute the steps of a surgery repeatedly. We summarize all the key ingredients required from setting up a wet lab to improve the surgical skill of the trainees. The review also discusses various eyeball fixating devices, preparation of the eye for various types of ocular surgeries, and the role of simulation-based training in today's scenario.

Purpose: The purpose of this study is to evaluate the post-lockdown challenges during Coronavirus disease 2019 (COVID-19) pandemic amongst the ophthalmologists in India. Methods: An online survey was sent to the practicing ophthalmologists across India. Data were collected from the responding ophthalmologists and analysed using Medcalc 16.4 software. Results: A total of 794 responses were obtained. Most respondents (51%) were in the age group 30–50 years and were in independent practice (40.05%). Almost three-fourth of ophthalmologists resumed their surgical services after a gap of more than a month post-lockdown. Almost a third of the respondents had significant reduction in their surgical workload during this period. Significant fear of contracting COVID-19 infection in the operation theatres was reported while moderate difficulty was found in procuring protective gear during immediate post-national lockdown period. Conclusion: The pandemic has changed the ophthalmic practice significantly, with patient and staff safety becoming areas of major concern. Both financial and psychological concerns affecting healthcare workers need addressing for continued patient care.

Background and Aims: Postanesthesia shivering (PAS) is a common, distressing experience. Ondansetron, the classical 5HT3 antagonist has been in use for its prevention since long. Palonosetron, a newly introduced potent antiemetic drug with better pharmacodynamics is currently in use by clinicians. Hence, a study was conducted to compare the efficacy of ondansetron and palonosetron in preventing PAS in patients undergoing elective lower segment caesarean section (LSCS) under spinal anaesthesia. Material and Methods: A total of 84 patients scheduled for elective LSCS under spinal anesthesia were randomly allocated to one of the two study groups (Group O & P). Accordingly, 8 mg of ondansetron or 0.075 mg palonosetron was administered in the same volume intravenously 30 min preoperatively. Sublingual temperature was recorded regularly. All patients were observed for 90 min postspinal for PAS. Observations were analyzed statiscally. Results: No statistically significant intergroup difference was observed in the duration of surgery, and sublingual temperature. However, statistically significant difference was recorded for PAS (23.8% in ondansetron group, 9.5% in palonosetron group). Conclusion: Prophylactic administration of palonosetron significantly reduced incidence of PAS compared to ondansetron. However, further studies with larger sample size and more heterogeneous groups are suggested.

OBJECTIVE: The objective of the study was to assess the perceived utility and the impact of web-based teaching programs being conducted following the COVID-19 pandemic. METHODS: An online survey was sent to trainee ophthalmologists across India through various social media platforms. The responses were tabulated and analyzed. RESULTS: A total of 768 valid responses were recorded. Majority of respondents (52.2%) felt that the ideal duration for webinars was 1 hour or less. Factors that helped trainees in choosing a webinar were the topic (95.1%), the timing (53.6%), and the speaker list (42.4%). Residents indicated a preference for webinars to attend aimed at postgraduate residency training, more specifically clinical problem-solving. Further questions were answered using a 1-10 Likert scale (1: least useful and 10: extremely useful). The median score when asked for overall usefulness of the webinars in general was 8 (interquartile range/IQR: 2). The median response when asked about utility of webinars in enhancing theoretical knowledge was 8 (IQR: 2) and the median for utility of webinar-based teaching programs in enhancing practical knowledge/surgical learning was also 8 (IQR: 2). The median score when asked about the utility of the webinar programs in acquiring skills for writing research papers/thesis was 7 (IQR: 3). Connectivity issues, audio/voice issues, and the long duration of webinars were some of the problems faced while attending webinars. CONCLUSIONS: Ophthalmology trainees in India found online teaching programs and webinars to be useful in enhancing their theoretical knowledge and practical skills/surgical learning. Administrators and educational institutes should tailor online teaching programs as per the needs and preferences of the residents.

Purpose: A survey was conducted by the All India Ophthalmological Society (AIOS) to document the initial coronavirus disease 2019 (COVID-19)-related financial impact on ophthalmology practice in India. It also assessed various measures taken by ophthalmologists and the possible role of AIOS in mitigating the economic crisis. Methods: An online questionnaire-based cross-sectional survey was conducted among its registered members from July to August 2020. The prevalidated questionnaire contained 25 items related to the impact of COVID-19 on patient volume, the extent of financial distress faced by the ophthalmologists, and various proactive measures taken by them. All valid responses were tabulated and analyzed. Results: Out of 1,026 respondents, more than 90% ophthalmologists faced a 25% or more reduction in outpatient and surgical volume. Nearly 59% reported that they can suffer from serious financial distress in near future due to COVID-19 pandemic-related losses. Those who are young (P < 0.0005), salaried (P < 0.0005), and practicing in private sector (P < 0.0005) and Tier 1 cities (P < 0.0005) are reported to be more vulnerable to become financially unstable. The major concerns were revenue losses (70%), preexisting debts (39%), and increased operating costs (27%). The majority (90%) believed that AIOS can help in alleviating the distress. There was also hesitancy regarding the adoption of teleophthalmology and home-based care. Conclusion: COVID-19 has significantly affected the financial sustainability of ophthalmologists practicing in India. Identification of vulnerable groups and timely advocacy efforts by AIOS can help in mitigating this financial crisis.

Background Combination of dabrafenib–trametinib is one of the standard treatments in patients with BRAF-mutated advanced malignant melanoma (MM). Real-world data on the usage of this combination is scarce, especially from India. Here, we are reporting our early experience with the usage of this combination therapy. Materials and Methods This is a single institutional data assessment of patients with BRAF-mutated MM registered and treated with BRAF–MEK inhibitors in our hospital. Clinico-pathological features and treatment details were reviewed for all patients. Results A total of seven patients with BRAF-mutated MM treated with this combination therapy with a median age of 66.5 years (range: 49–72 years) and a male:female ratio of 3:4. Six (85.7%) patients had metastatic disease at presentation. In total, 80% of our patient population had two or less than two sites of metastasis at presentation. The initial response rate of the study population was 71%. The drug was well tolerated with fever being the most common side effect which was seen in two (28.5%) of the patients. Conclusion Combination of dabrafenib–trametinib is effective in patients with BRAF-mutated MM with good tolerability. Further studies are required to look for improvement in outcome in this group of patients.

In the tracking‐by‐detection approach of online multiple object tracking (MOT), a major challenge is how to associate object detections on the new video frame with previously tracked objects. Two important aspects that directly influence the performance of MOT are quality of detection and accuracy in data association. The authors propose an efficient and unified MOT framework for improved object detection, followed by enhanced object tracking. The object detection and tracking are considered as two independent functions in the tracking‐by‐detection paradigm. In this study, object detection accuracy has been increased by employing a faster region‐based convolutional neural network (Faster R‐CNN) modified with the feedback region proposals from the tracker. Target association is performed by the correlation filter‐based Siamese CNN model, which finds the similarity score between the input image patches. The Siamese CNN is trained using a supervised hard sample mining strategy. An optical flow‐based motion model is employed to predict the next probable location of the targets from the tracker and these region proposals are fed back to the classifier module of Faster R‐CNN. The authors’ extensive analysis of publicly available MOT benchmark datasets and comparison with the state‐of‐the‐art tracking methods demonstrate competitive tracking performance of the proposed MOT framework.

Purpose: In 2020, in response to the emergence and global spread of the disease COVID-19, caused by a new variant of coronavirus 2019-nCoV, the government of India ordered a nationwide lockdown for 21 days, which was then extended to a total of over 50 days. The aim of this study is to assess the effect of the lockdown on ophthalmic training programs across India. Methods: An online survey was sent across to trainee ophthalmologists across India through various social media platforms. Results: In all, 716 trainees responded; the average age was 29.1 years. Results showed that majority of the respondents were enrolled in residency programs (95.6%; 685/716) and the others were in fellowship programs. About 24.6% (176/716) of the trainees had been deployed on 'COVID-19 screening' duties. Nearly 80.7% (578/716) of the trainees felt that the COVID-19 lockdown had negatively impacted their surgical training. Furthermore, 54.8% (392/716) of the trainees perceived an increase in stress levels during the COVID-19 lockdown and 77.4% (554/716) reported that their family members had expressed an increased concern for their safety and wellbeing since the lockdown began. In all, 75.7% (542/716) of the respondents felt that online classes and webinars were useful during the lockdown period. Conclusion: Our survey showed that majority ophthalmology trainees across the country felt that the COVID-19 lockdown adversely affected their learning, especially surgical training. While most found online classes and webinars useful, the trainees' perceived stress levels were higher than normal during the lockdown. Training hospitals should take cognizance of this and reassure trainees; formulate guidelines to augment training to compensate for the lost time as well as mitigate the stress levels upon resumption of regular hospital services and training. Going ahead, permanent changes such as virtual classrooms and simulation-based training should be considered.

On March 11, 2020, WHO announced that a novel coronavirus disease 2019 (COVID-19) had transformed into pandemic. Since then, it has challenged health systems and tested the governance of every country. In India, national and sub-national governments have responded by proposing new policies to stop the advance COVID-19 through a slew of measures. Among these was prohibiting smoking and spitting, especially that induced by the use of smokeless tobacco in public places, which could potentially spread the infection further. States and districts were first to propose strict orders, which was followed by advisories and orders at the national level, which supported sub-national implementation. It is premature to estimate the impact of restricting tobacco trade, sale, and use on COVID-19 transmission; however, this early review assesses efforts made which national and sub-national commitment (or lack of it) towards tobacco control.

Depth computation from an image is useful for many robotic systems like obstacle recognition, autonomous navigation, and 3D measurements. The estimation is best solved with Deep Neural Networks (DNN) as these are non-linear and ill-posed problems. The network takes single-color images with corresponding ground truth to predict depth-map after training. The depth accuracy, here, is dependent on the quality of ground truth and training images. Images have inherent blurs, which impact depth prediction and accuracy. In our work, we study different combinations of loss functions involving various edge functions to improve the depth of images. We use DenseNet and transfer learning method for learning and prediction of depth. Our analysis shows improvement in performance parameters as well as in the visual depth-map. We achieve 85% δ1 accuracy and improve log10error using NYU Depth V2 dataset.

PURPOSEThere are limited reports of quality metrics in glioblastoma. We audited our adherence to quality indicators as proposed in the PRIME Quality Improvement study.METHODSThis is a retrospective audit of patients treated between 2017 and 2020. After postsurgical integrated diagnosis, patients received radiotherapy (RT) with concurrent and adjuvant temozolomide (TMZ). Multiparametric magnetic resonance imaging at predefined times guided management. Numbers with proportions for indices were calculated. Survival was estimated using the Kaplan-Meier method.RESULTSOne hundred six patients were consecutively treated. The median age was 55 years (interquartile range of 47-61 years) with a male preponderance (68%). Ninety-six (90.6%) patients underwent subtotal resection, and 10 (9.4%) biopsy alone. Isocitrate dehydrogenase was wild-type in 96 (91%), and O6-methylguanine-DNA methyltransferase was unmethylated in 70 (66.0%) patients. Telomerase reverse transcriptase promoter was mutated in 64 (60.4%), and TP53 was mutated in 22 (20.8%). Concurrent radiation and TMZ were planned for 104 (98.1%), and radiation alone for 2 (1.9%). The median time to concurrent RT-TMZ was 36 days (interquartile range 30-44 days). All patients planned for RT-TMZ completed treatment, but only 81 (76%) completed adjuvant TMZ. Sixty-three (59%) completed six cycles, 18 (17%) received less than six cycles, and 25 (24%) did not receive adjuvant TMZ. At a median follow-up of 24 months (range 21-31 months), the median (95% CI) progression-free survival and overall survival were 11 (95% CI, 9.4 to 13.0) and 20.0 (95% CI, 15 to 26) months, respectively.CONCLUSIONOur patients met quality indices in most domains; outcomes are comparable with global results. Metrics will be periodically evaluated to include new standards and assess continuous service appropriateness.

Applications such as medical diagnosis, navigation, robotics, etc., require 3D images. Recently, deep learning networks have been extensively applied to estimate depth. Depth prediction from 2D images poses a problem that is both ill–posed and non–linear. Such networks are computationally and time–wise expensive as they have dense configurations. Further, the network performance depends on the trained model configuration, the loss functions used, and the dataset applied for training. We propose a moderately dense encoder–decoder network based on discrete wavelet decomposition and trainable coefficients (LL, LH, HL, HH). Our Nested Wavelet–Net (NDWTN) preserves the high–frequency information that is otherwise lost during the downsampling process in the encoder. Furthermore, we study the effect of activation functions, batch normalization, convolution layers, skip, etc., in our models. The network is trained with NYU datasets. Our network trains faster with good results.

Purpose: External dacryocystorhinostomy (DCR) surgeries are cost-effective with excellent success rates. The present study was designed to compare the safety and efficacy of conventional external DCR versus external DCR using Pawar silicone implant in chronic dacryocystitis. Methods: This is a prospective, comparative, interventional case series over a period of 18 months with patients managed by external DCR surgery with and without Pawar implant. Institutional review board approval was obtained before the study. The success of the surgery was objectively measured by sac patency on syringing at the last follow up. Results: A total of 65 patients with chronic dacryocystitis were included in the study. The mean age of patients in the series was 41.43 years (median, 41 years; range, 12 years-60 years). All patients presented with epiphora (100%) and underwent external DCR and were chosen for conventional surgery (n = 33, 51%, group 1) or Pawar silicone implant surgery (n = 32, 49%, group 2) on a random basis. The mean duration of the surgery from the time of skin incision to skin closure for group 1 was 27.7 minutes (median, 26 minutes; range, 21-30 minutes) while in group 2, it was 75.5 minutes (median, 75 minutes; range, 60-88 minutes), which was statistically significant (P < 0.01). The success rate of the procedure done in group 1 was 90% which increased to 97% after the management of failed cases as compared to the success rate in group 2 of 91% and 94%, before and after the management of failed cases, respectively. Conclusion: External DCR using Pawar implant is a safe surgery which is faster than conventional external DCR with almost equal success rates between both the procedures

Researchers have shown that the value of charge carriers, de-trapped from the oil–paper interface of power transformer insulation, is useful in carrying out the diagnosis. However, the evaluation of the de-trapped charge requires the analysis of polarisation–depolarisation currents. Being an off-line time-consuming process, the measurement and analysis of polarisation and depolarisation current (PDC) data are not practically advantageous. The study presents a detrended fluctuation analysis-based technique to estimate the magnitude of normalised de-trapped charge using the polarisation current measured for a short duration. Using the proposed technique, the requirement of measuring the complete PDC data, for diagnosis purposes, can be eliminated. Further, the technique also eliminates the requirement of depolarisation current which in turn facilitates a reduction in equipment shutdown time. The applicability of the proposed technique is tested on the data obtained from several real-life power transformers.

Integrated circuits may be vulnerable to hardware Trojan attacks during its design or fabrication phases. This article is a case study of the design of a Viterbi decoder and the effect of hardware Trojans on a coded communication system employing the Viterbi decoder. Design of a Viterbi decoder and possible hardware Trojan models for the same are proposed. An FPGA-based implementation of the decoder and the associated Trojan circuits have been discussed. The noise-added encoded input data stream is stored in the block RAM of the FPGA and the decoded data stream is monitored on the PC through an universal asynchronous receiver transmitter interface. The implementation results show that there is barely any change in the LUTs used (0.5%) and power dissipation (3%) due to the insertion of the proposed Trojan circuits, thus establishing the surreptitious nature of the Trojan. In spite of the fact that the Trojans cause negligible changes in the circuit parameters, there are significant changes in the bit error rate (BER) due to the presence of Trojans. In the absence of Trojans, BER drops down to zero for signal to noise rations (SNRs) higher than 6 dB, but with the presence of Trojans, BER doesn’t reduce to zero even at a very high SNRs. This is true even with the Trojan being activated only once during the entire duration of the transmission.

Background: Several studies have been carried out regarding the epidemiology of presbyopia at or after 40 years of age. Now a day we find the need of presbyopic glasses before the age of 40 years, so we plan this study in pre-presbyopic age group. Aim: To find out epidemiology of presbyopia in a pre-presbyopic age group (age 34-40 years). Settings and Design: A prospective clinical study was done on two thousand two hundred and ninety-six patients at two tertiary care centres in India. Duration of study was three years and eight months. Materials and Methods: The degree of presbyopia was determined as minimum amount of plus lens needed to achieve maximum improvement in lines read to the end point (N8). Patients were divided in 3 groups, group 1 (age 34-36), group 2 (age 36-38) and in group 3 (age 38-< 40). A detailed epidemiological profile and systemic history were noted in the prescribed Performa. Statistical Analysis Used: Data was analyzed by SPSS software 16. Results: Maximum (43.7%) number of patients was in group 3.In the study females predominated over males and maximum (51.9%) patients were from middle socioeconomic status. We found that 53.6 % were from urban area. 39.6 % patients had accepted that near vision problem affected their daily work efficiency and quality of life. Conclusion: This study shows occurrence of presbyopia in pre-presbyopic age group. So we recommend patients should be screened and treated before the age of 40 years for presbyopia to reduce burden of avoidable visual impairments and for improvement in quality of life.

Green perpetual sensor network operation is the need of the hour for critical applications, such as surveillance, military, and environment monitoring. Mobile integrated data collection and recharging is a promising approach to meet this requirement by routinely visiting the field nodes for collecting the sensed data and supplying energy via radio frequency (RF) energy transfer. Practical constraints, such as self-discharge and aging effects of the energy storage element (supercapacitor), significantly impact the renewable energy cycle (REC) and, hence, strongly influence the performance of RF energy harvesting networks. To account for the nonidealities in practical supercapacitors, in this paper, a circuit model for REC is proposed, and corresponding RF charging time and node lifetime expressions are derived. Hardware experiments are performed to validate the proposed REC model. REC for complicated supercapacitor models is characterized using duality principle and a generic simulation model. Using the developed analytical models for practical supercapacitors, the size of network for perpetual operation is estimated, which is demonstrated to be significantly less than that predicted by considering ideal supercapacitor behavior. For example, with three-branch supercapacitor model, the estimated sustainable network size is shown to be nearly 52% less than that offered by the ideal supercapacitor model.

Background and challenges to implementation According to GATS 2009-10 prevalence of tobacco use in Bihar among adults is 53.5% ( n =30.8 million) much higher than the national average i.e. 34.6%. In 2008-09, Indian government rolled-out National Tobacco Control Programme (NTCP) including 02 districts of Bihar. With inclusion of another 06 and 11 districts in 2014 and 2015 respectively, currently 19 out of 38 districts of Bihar are covered under NTCP. Main key activities under NTCP are India's tobacco control law's enforcement, training, awareness generation, school health programs and cessation. Intervention or response To establish and initiate tobacco control programme in all 38 districts, Government of Bihar in collaboration with SEEDS-Bihar (an NGO) and The Union implemented a Bloomberg Initiative project on tobacco control. Through planned interventions, NTCP has been rolled-out in entire states as an institutional framework. Broadly three pronged strategies were adopted i.e. establishing NTCP implementation mechanism , intensive capacity building of government officials, robust reporting and monitoring from districts. Systematic efforts were made at both state and district level to engage for other stakeholder especially media . Additionally nodal officers were identified in all concerned department at state level and three district nodal officers in Health, Police and General Administration were appointed to develop synergy through better coordinated efforts. Results and lessons learnt Awareness and commitment of program managers, law-enforcers and media have noticeably increased for tobacco control. Following were the distinctive outcomes: Enforcement mechanism was established in all 38 districts (both NTCP and non-NTCP) Periodic programme review by top bureaucrats of concerned departments quarterly at state level and monthly at district level Enforcement status review in monthly crime review meeting by police department Conclusions and key recommendations Through intensive advocacy, capacity building and robust monitoring mechanism an efficient model for implementation of National Tobacco Control Programme can be institutionalised within existing system. Multi-stakeholder engagement especially media is very important for better monitoring and sustainability.