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Abstract Climate change is the greatest challenge to developing countries, especially where rain-fed agriculture is the main source of livelihood and revenue. Agroforestry provides an opportunity for farmers to adapt and reduce the carbon footprint. We conducted an exploratory review on the role of cocoa agroforestry for climate change mitigation and adaptation of smallholders by applying combinations of keywords that include climate change, agroforestry, stakeholders, Paris agreement, INDCs/NDCs, mitigation and adaptation. The paper combined data sources covering reports on past and on-going cocoa sustainability projects and policy interventions in Ghana as well as the output of exploratory review that utilized relevant key words to identify appropriate literature for investigation and analysis. We established that, there is low adoption of pro-environmental interventions introduced by both Government and NGOs in the cocoa sector. In addition, there is a shift in cocoa farming from expansion into forest areas to adoption of intensive cocoa monoculture. Despite the importance of shaded trees in cocoa production such as the benefits gained from agroforestry system, cocoa farmers have low appreciation of their environmental, soil, nutrients and other ecological benefits. We recommend that cocoa farmers should be involved in the formulation and implementation of pro-environmental interventions that affect their cocoa production practices. This will make farmers take ownership of the innovation instead of it being introduced to them. In addition, since our review of the literature established that the surge in yield is the impetus for cocoa monoculture adoption, there is the need to introduce cocoa varieties with higher yields under agroforestry system. Finally, there should be monetary valuation of shade trees used in cocoa agroforestry systems for payment to farmers to help improve agroforestry adoption. We argue that cocoa agroforestry though considered an old practice, remains one of the most appropriate land-use systems that is climate-smart with great potential to contribute to sustainable cocoa production.

Abstract Background Disability stigma in low- and middle-income countries is one of the most persistent and complex barriers limiting persons with disabilities (PwDs) from enjoying their rights and opportunities. Perceived stigma among PwDs and its impact on participation restriction is rarely assessed in Nepal. Objective This study aimed to measure the extent of perceived stigma by PwDs, identify its relationships with specific demographic factors, and assess the impact on social participation. Methods A cross-sectional survey was conducted between May and July 2022 among PwDs in Nepal, with a sample of 371. The Explanatory Model Interview Catalog (EMIC) stigma scale and P-scale suitable for people affected by stigmatized conditions were used, and the generated scores were analyzed. One-way ANOVA was performed to determine group differences for sociodemographic variables, and linear regression and correlational analysis were used to identify their association and measure the strength and direction of the relationship. Results The mean stigma score was 16.9 (SD 13.8). 42% of respondents scored higher than the mean. The scores differed significantly by disability type, caste and ethnicity, education, occupation, and household wealth. Over 56% reported participation restriction, and 38% had severe/extreme restriction. Approximately 65% of participants with intellectual disabilities, 53% with multiple disabilities, and 48.5% of persons with severe or profound disabilities experienced severe or extreme restrictions. Perceived stigma had a positive correlation with Disability type (r = 0.17, P 0.05). Conclusion All participants exhibited stigma in general; however, the severity varied based on disability type, level of education, and sociocultural circumstances. A large proportion of participants reported facing a high degree of restrictions in participation; however, no association was detected between perceived stigma and participation restriction. A significant negative linear correlation was observed between education and participation restriction. Stigma reduction programs focusing on education and empowerment would be especially important for overcoming internalized stigma and increasing the participation of PwDs.

Context: Emphasis on grossing to reporting for the assessment of histopathological parameters predicting outcomes in Wilms tumor. Aims: To analyze various clinicopathological parameters that effect outcomes in treatment naïve and post chemotherapy Wilms tumor specimens. Settings and Design: This was a retrospective observational study. Subjects and Methods: All patients diagnosed with Wilms tumor between 2012 and 2018 at our institute will be included with their clinical findings, laboratory reports, and radiological findings. The patients will be categorized into two groups based on treatment protocol (Society of Pediatric Oncology (SIOP) or the National Wilms Tumor Study Group/Children's Oncology Group (COG) guidelines) used. Details of Grossing and reporting protocols used for the in pre treatment and post treatment specimens will be analyzed. Follow-up till December 2020 will be analyzed. Statistical Analysis Used: Chi-square and Fisher's exact tests were used for statistical analysis. Results: A total of 36 patients with the diagnosis of Wilms tumor were included in the present study. The mean age of presentation was 3.9 ± 0.7 years, and males were more common than females. Most of them presented as abdominal mass and few with isolated hematuria. Twenty-six (72%) patients were treated under SIOP protocol with preoperative neoadjuvant chemotherapy. Ten patients underwent upfront surgery as per COG protocol. In SIOP group patients, the mean tumor size was 9.3cm. Forty percent (n = 10) we mixed histological type followed by blastemal type constituting (32%, n = 8). Regressive and epithelial histological types constituted 16% (n = 4) and 12% (n = 3), respectively. In the SIOP group 72% (n = 19) had no anaplasia and 28% (n = 7) had anaplasia. Fifty seven percent (n = 15) cases were Stage I, followed by 26.9% n = 7) and 11.5% (n = 3) being Stage II and Stage III, respectively. Ten patients underwent upfront surgery as per COG protocol. The mean tumor size among this group was 8 cm ranging from 7 cm to 11 cm. Eight (80%) cases had favorable histology and two cases showed focal anaplasia. Heterologous differentiation is seen in 3 (70%). Out of the 10 cases, one case was Stage I, six were Stage 2, one was Stage III, and two were clinical Stage IV. None of the cases showed either vessel or lymph node metastasis. All the patients received adjuvant chemotherapy postsurgery and were followed up till December 2020 for (at least 3 years). Of 25 patients in the SIOP group, 18 (72%) had complete remission with no radiological evidence of residual disease. Of the 10 patients in the COG group, 6 (70%) had complete remission. Conclusions: Histopathological evaluation of Wilms tumor is a critical aspect in the management of Wilms tumor, as tumor characteristics are different in the tumors treated under SIOP and COG protocols, which will ultimately affect the prognostic risk stratification. This necessitates the knowledge of the important grossing and reporting of these tumors under the two protocols.

Trajectory planning in the field of mobile robotics involves the generation of a trajectory to navigate a robot from a start state to a goal state. One widely employed technique involves a two-step approach: a path planner generates a path made up of piecewise linear segments with sharp turns, which are then smoothed in the trajectory generation step. In contrast, this work formulates trajectory generation as an optimization problem based on the Bézier curve, denoted as ‘BTP’, to generate the robot’s trajectory in one step. It uses a weighted objective function of trajectory length and navigation time to suit different optimization strategies while considering the robot’s kinematics and dynamics limitations. BTP adopts matrix-based formulations for all mathematical operations to enable dynamic adjustment of the degree of the Bézier curve during the optimization process, if convergence is not obtained with the current degree. Additionally, BTP guarantees that the robot’s trajectory is always within the open space identified by the robot’s sensors. The efficacy of BTP has been evaluated through simulations and real-world experimentation, including soccer games and cluttered environment scenarios. Finally, the performance is benchmarked against some of the existing trajectory planners. BTP reduced the robot’s navigation time by a minimum of 11% up to 55% compared to other tested trajectory planners, ensuring $C^{2}$ continuity rather than just $C^{1}$ continuity. Furthermore, it consistently achieved precise goal configuration, unlike the tested trajectory planners, which exhibited deviations of up to 0.6 meters.

Background: Seborrheic keratosis (SK) is a skin condition affecting the keratinocytes. Although various treatment options are available, the need for a simpler topical treatment approach is unmet. Hydrogen peroxide (HP) acts by forming free radicals and initiates apoptosis in cells. Aims and Objectives: The aim of this study was to evaluate the safety and efficacy of 30% HP in SK. Materials and Methods: This study was conducted on patients attending the Dermatology, Venereology, and Leprology at MGM Hospital attached to Kakatiya Medical College, Warangal and Government Medical College Mahabubabad, Telangana, during the period from December 2019 to May 2021. In total, 80 adult patients with SKs were enrolled. The study was approved by the Research Ethics Committee of the MGM Hospital attached to Kakatiya Medical College. This is a prospective and interventional study. Eighty patients will be treated with 30% of HP topically. A photographic record of the pre- and post-treatment appearance of lesions was maintained. Physician’s lesion assessment (PLA) score was evaluated on day 15th and 106th day after treatment. Local skin reactions (LSRs) were divided into mild, moderate, and severe categories. LSR was observed immediately after 2 weeks and 106 days of treatment. Results: Most of the patients were of middle to elderly age group. SK lesions were most common seen over the head and trunk. The dermatosis papulosa nigra variant was the most common. PLA 0 was observed by day 15 in some patients after application. Of 30% HP, faster healing rates were observed in lesions over the face, and middle aged. Conclusion: About 30% HP is a promising option for the treatment of SK.

Anemia is a common and serious health problem, nearly universally diagnosed in preterm infants, and is associated with increased morbidity and mortality worldwide. Red blood cell (RBC) transfusion is a lifesaving and mainstay therapy; however, it has critical adverse effects. One consequence is necrotizing enterocolitis (NEC), an inflammatory bowel necrosis disease in preterm infants. The murine model of phlebotomy-induced anemia and RBC transfusion–associated NEC enables a detailed study of the molecular mechanisms underlying these morbidities and the evaluation of potential new therapeutic strategies. This protocol describes a detailed procedure for obtaining murine pups with phlebotomy-induced anemia and delivering an RBC transfusion that develops NEC.

The wireless charging for electric vehicle is getting popular due to the absence of sophisticated cable connection and associated issues with the actuators in field for connected charging. The major challenges in inductive power transfer (IPT) systems are the control of the resonance converter and synchronisation in communications with the vehicle and power supply. In IPT system, the dynamic nature of load as well as system demands extra care for the existing charging architectures. This work proposes a unique control algorithm to charge the Li-ion battery under coupling coefficient and load variations. The developed control algorithm is validated in MATLAB simscape platform. Further, the control logic is validated using the Texas C2000 Delfino controller in 1 kW IPT system. The developed control logic would ensure proper frequency of operation as well as the constant voltage and constant current control.

Abstract A COVID-19 patient often presents with multiple comorbidities and is associated with adverse outcomes. A comprehensive assessment of the prevalence of comorbidities in patients with COVID-19 is essential. This study aimed to assess the prevalence of comorbidities, severity and mortality with regard to geographic region, age, gender and smoking status in patients with COVID-19. A systematic review and multistage meta-analyses were reported using PRISMA guidelines. PubMed/MEDLINE, SCOPUS, Google Scholar and EMBASE were searched from January 2020 to October 2022. Cross-sectional studies, cohort studies, case series studies, and case–control studies on comorbidities reporting among the COVID-19 populations that were published in English were included. The pooled prevalence of various medical conditions in COVID-19 patients was calculated based on regional population size weights. Stratified analyses were performed to understand the variations in the medical conditions based on age, gender, and geographic region. A total of 190 studies comprising 105 million COVID-19 patients were included. Statistical analyses were performed using STATA software, version 16 MP (StataCorp, College Station, TX). Meta-analysis of proportion was performed to obtain pooled values of the prevalence of medical comorbidities: hypertension (39%, 95% CI 36–42, n = 170 studies), obesity (27%, 95% CI 25–30%, n = 169 studies), diabetes (27%, 95% CI 25–30%, n = 175), and asthma (8%, 95% CI 7–9%, n = 112). Moreover, the prevalence of hospitalization was 35% (95% CI 29–41%, n = 61), intensive care admissions 17% (95% CI 14–21, n = 106), and mortality 18% (95% CI 16–21%, n = 145). The prevalence of hypertension was highest in Europe at 44% (95% CI 39–47%, n = 68), obesity and diabetes at 30% (95% CI, 26–34, n = 79) and 27% (95%CI, 24–30, n = 80) in North America, and asthma in Europe at 9% (95% CI 8–11, n = 41). Obesity was high among the ≥ 50 years (30%, n = 112) age group, diabetes among Men (26%, n = 124) and observational studies reported higher mortality than case–control studies (19% vs. 14%). Random effects meta-regression found a significant association between age and diabetes (p

The phenomenon of local knowledge of the fishing community about fish ethology and conservation of existing natural resources are investigated in this article. It explores the inextricably intertwined aspects and long-lasting constructive dependence of marine resources with a symbiotic relationship as critical components for integration with marine ecology. Lastly, the paper emphasizes the significance of local knowledge beliefs and systems which promote natural marine conservation methods for increased economic prosperity. The study focuses on the Telugu marine fishing community in South India. [ABSTRACT FROM AUTHOR]

Diabetes mellitus is a chronic disease that poses a serious global health problem, due to its associated effects on obesity and aging. Therapeutic strategies for targeting diabetes include the downregulation and/or inhibition of enzymes such as a-amylase and a-glucosidase, hydrolyzing the dietary carbohydrates in intestine. There is increasing interest for a-amylase inhibitors from natural sources. Our objective was to undertake the phytochemical screening of bark extracts of Diospyros melanoxylon for potential a-amylase inhibitory activity and further identification of the active principle and the underlying mechanisms of inhibition. Enzyme-assay guided fractionation of the Diospyros melanoxylon bark extract led to the isolation of a triterpene, Lupenone as a potential inhibitor of a-amylase, with a non-competitive inhibition and inhibitor constant = 30 mM. Lupenone-mediated inhibition of a-amylase responsible for the breakdown of dietary sugar may be effective in preventing postprandial hyperglycemia in the diabetic subjects.

Growth in renewable energy systems, direct current (DC) microgrids, and the adoption of electric vehicles (EVs) will substantially increase the demand for bi-directional converters. Precise control mechanisms are essential to ensure optimal performance and better efficiency of these converters. This paper proposes a deep neural network (DNN)-based controller designed to precisely control bi-directional converters for vehicle-to-vehicle (V2V) and vehicle-to-grid (V2G) applications. This control technique allows the converter to quickly attain new reference values, enhancing performance and efficiency by significantly reducing the overshoot duration. To train the DNN controller, large synthetic data are used by performing simulations for various sets of conditions, and the results are validated with a hardware setup. The real-time performance of the DNN controller is compared with a conventional proportional–integral (PI)-based controller through simulated results using MATLAB Simulink (version 2023a) and with a real-time setup. The converter attains a new reference of about 975 μs with the proposed control technique. In contrast, the PI controller takes about 220 ms, which shows that the proposed control technique is far better than the PI controller.

To avoid risking the lives of rescue team personnel in the event of disasters like earthquakes, volcanic eruptions, hurricanes, etc., Search and Rescue (SAR) robots are increasingly incorporated into the operation. One of the major challenges in integrating SAR robots into rescue operations is the potentially severely damaged infrastructure within the disaster site. A functional communication system is critical for exchanging real-time information between the robots and the base station. Given the limited coverage or absence of communication systems in a severely affected disaster site, a novel communication architecture for search & rescue missions based on Long Range (LoRa) Low Power Wide Area Network (LPWAN) and a SAR robot called Rescuer are proposed. Rescuer is a SAR robot that can operate in worst-case disaster sites where all communication infrastructure has been wiped out. It has been tested in a Gazebo simulated environment as well as an actual test setup inside the University of Detroit Mercy’s lab facility and showed great promise. In this test, the Rescuer robot was monitored and controlled from a remote base station.

The recent mass production and usage of the Internet of Things (IoT) have posed serious concerns due to the unavoidable security complications. The firmware of IoT systems is a critical component of IoT security. Although multiple organizations have released security guidelines, few IoT vendors are following these guidelines properly, either due to a lack of accountability or the availability of appropriate resources. Some tools for this purpose can use static, dynamic, or fuzzing techniques to test the security of IoT firmware, which may result in false positives or failure to discover vulnerabilities. Furthermore, the vast majority of resources are devoted to a single subject, such as networking protocols, web interfaces, or Internet of Things computer applications. This paper aims to present a novel method for conducting compliance testing and vulnerability evaluation on IoT system firmware, communication interfaces, and networking services using static and dynamic analysis. The proposed system detects a broad range of security bugs across a wide range of platforms and hardware architectures. To test and validate our prototype, we ran tests on 4300 firmware images and discovered 13,000+ compliance issues. This work, we believe, will be the first step toward developing a reliable automated compliance testing framework for the IoT manufacturing industry and other stakeholders.

The aim of this study is to study the two cases of acute lymphoblastic leukemia (ALL) who relapsed as acute myeloid leukemia (AML). Presented here are reports of two cases of pediatric ALL who developed change of lineage to AML at relapse. This change in phenotype, which involves the conversion of one phenotype to other phenotype during the course of disease or at relapse is a rare phenomenon rarely described in literature. The immunophenotypic and molecular findings are described. The present study emphasizes the need of immunophenotyping and molecular workup at relapse. Also adds to the repertoire of the published literature on this rare entity.

The evaluation of performance and emission of Common Rail Direct Injection (CRDI) engine fuelled by various biodiesel at different operating conditions is time consuming and expensive. This can be overcome by using prediction techniques like GRNN. The GRNN model is developed using ‘newgrnn’ function in Matlab R2019b software to predict the performance and emission responses of CRDI engine for simarouba biodiesel. A total of 27 experimental dataset of each biodiesel is used for development of model. Out of 27 experimental dataset, 21 datasets are selected randomly for training the model. The remaining 6 datasets are utilized for testing the GRNN model. In this study, 20 different values of spread parameters within the range 0.05 to 1 with step increment of 0.05 are chosen. As a result, 20 simulations are performed and the best predicted results are chosen based on least mean error. The optimum spread parameter for simarouba, pongamia and composite biodiesel GRNN model was found to be 0.1, 0.1 and 0.05 respectively. The Root Mean Square Error (RMSE) values of different responses are found to be acceptable. The results indicated that GRNN model for the prediction of engine responses yields good correlation with experimental values and are acceptable for new predictions.

In this study, biologically active chitooligosaccharides (COS) D3–7 (D-deacetylated unit) and A5 (A-acetylated unit) were assessed for their suitability to reduce the viability of human breast cancer cell lines, BT-474 and SUM-159. The treatment with COS resulted in a significant decrease in the viability of breast cancer cells, in a dose-dependent manner. The long-term proliferative potential of breast cancer cells decreased upon COS treatment, suggesting that COS significantly inhibited colony formation in breast cancer cells. The COS-treated cell population significantly underwent apoptosis, confirmed by flow cytometry. Further, the increased expression of BAX, cleaved PARP, and cleaved caspase 3, with increased concentration of COS, conformed that COS-D3–7 and A5 induce apoptosis in BT474 cells through apoptotic signaling. We further investigated the mechanism by which COS promotes apoptosis. The marked inhibition of phosphorylation of EGFR and its downstream signaling molecules FAK, AKT, and MAPKpromote apoptosis.

Tuberculosis (TB) remains a global health problem and the emergence of HIV has further worsened it. Long chemotherapy and the emergence of drug-resistance strains of Mycobacterium tuberculosis as well as HIV has aggravated the problem. This demands urgent the need to develop new anti-tuberculosis and antiretrovirals to treat TB and HIV. The lack of diversity in drugs designed using traditional approaches is a major disadvantage and limits the treatment options. Therefore, new technologies and approaches are required to solve the current issues and enhance the production of drugs. Interestingly, fragment-based drug discovery (FBDD) has gained an advantage over high-throughput screenings as FBDD has enabled rapid and efficient progress to develop potent small molecule compounds that specifically bind to the target. Several potent inhibitor compounds of various targets have been developed using FBDD approach and some of them are under progression to clinical trials. In this review, we emphasize some of the important targets of mycobacteria and HIV. We also discussed about the target-based druggable molecules that are identified using the FBDD approach, use of these druggable molecules to identify novel binding sites on the target and assays used to evaluate inhibitory activities of these identified druggable molecules on the biological activity of the targets.

Abstract Background Pulmonary alveolar proteinosis (PAP) poses a risk of opportunistic infections with a variety of organisms with Nocardia being the most common pathogen followed by mycobacteria and fungi. Case presentation A 7-year-old female child, presented with headache and multiple episodes of vomiting. There was no fever or altered sensorium. On examination, there were no focal deficits or cranial nerve palsies. An MRI brain showed a small T2 hyperintense lesion in the left superior parietal lobe suggestive of an abscess. She was diagnosed as PAP based on CT chest and bronchioloalveolar lavage 7 months earlier and treated with corticosteroids. A left parieto-occipital craniotomy was done with drainage of abscess and abscess wall excision. Histopathology revealed a suppurative lesion with slender septate acute angle branching hyphae which were positive on fungal stains. Culture done on the pus was positive for Aspergillus fumigatus. The patient was treated with voriconazole and stable at 1 year follow-up. Conclusion Opportunistic infections are common in patients diagnosed with PAP. High index of clinical suspicion and early diagnosis are important for favorable outcome.

This data article presents a description of a benchmark dataset for the multiple depot vehicle scheduling problem (MDVSP). The MDVSP is to assign vehicles from different depots to timetabled trips to minimize the total cost of empty travel and waiting. The dataset has been developed to evaluate the heuristics of the MDVSP that are presented in “A new formulation and a column generation-based heuristic for the multiple depot vehicle scheduling problem” (Kulkarni et al., 2018). The dataset contains 60 problem instances of varying size. Researchers can use the dataset to evaluate the future algorithms for the MDVSP and compare the performance with the existing algorithms. The dataset includes a program that can be used to generate new problem instances of the MDVSP.

The original concept of the artificial potential field in robot path planning has spawned a variety of extensions to address its main weakness, namely the formation of local minima in which the robot may be trapped. In this paper, a smooth navigation function combining the Dijkstra-based discrete static potential field evaluation with bilinear interpolation is proposed. The necessary modifications of the bilinear interpolation method are developed to make it applicable to the path-planning application. The effect is that the strategy makes it possible to solve the problem of the local minima, to generate smooth paths with moderate computational complexity, and at the same time, to largely preserve the product of the computationally intensive static plan. To cope with detected changes in the environment, a simple planning strategy is applied, bypassing the static plan with the solution of the A* algorithm to cope with dynamic discoveries. Results from several test environments are presented to illustrate the advantages of the developed navigation model.

IPT (inductive power transfer) charging is a highly flexible concept that allows for charging at any possible opportunity and is highly versatile for vehicles of all sizes. IPT wireless charging technology employs high-power inductive energy transfer between the components embedded into streets and the receiving equipment mounted below the vehicle. When the vehicle moves over the charging point, the contactless charging process is initiated between the components and the vehicle. In this work, the role of power converter topologies in IPT systems are studied for electric vehicle (EV) charging applications. Further, the predominant topologies are compared and analyzed in detail. The contingency in misalignment, loading and frequency shift are discussed for various converter topologies. The tolerance in misalignment poses serious challenges for wireless chargers in EVs. Therefore, there is currently a need to design a symmetric IPT system with multiple decoupled receiving coils. The significance of power inverter topologies for achieving resonance, as well as the generation of high-frequency supply, has been studied in detail. Experimental waveforms that are related to the explanations in this work are provided to substantiate the advantages regarding the converters.

The purpose of smart grid architecture as compared to the conventional grid is to ensure more stability, reliability and bi-directional communication between the utility and the consumer. The deployment of the same has succeeded in improving the efficiency of the distribution systems and effective co-ordination and interoperability among the different components of the grid. Smart inverters play a major role in seamless grid integration, control and conversion of power when the renewable energy sources are present. However, they come with several security challenges as well, which are of considerable concern. Certain cyber threats include physical and cyber attacks, natural phenomena which in turn can lead to grid failure, blackouts, commercial energy losses, privacy and safety issues, etc. Therefore, there is a need for critical examination of all these issues which must be considered for designing cyber secure smart inverters at the distribution level. In this comprehensive review, keeping the technological perspective in mind, the existing gaps and the necessity for the same are highlighted. The various topologies, IEEE protocols and the control strategy are presented in detail. This will enable prospective researchers to address the design issues of smart inverters with greater focus on security and reliability aspects.

Abstract Humans have exploited natural resources for a variety of applications. Chitin and its derivative chitin oligosaccharides (CHOS) have potential biomedical and agricultural applications. Availability of CHOS with the desired length has been a major limitation in the optimum use of such natural resources. Here, we report a single domain hyper-transglycosylating chitinase, which generates longer CHOS, from Enterobacter cloacae subsp. cloacae 13047 (EcChi1). EcChi1 was optimally active at pH 5.0 and 40 °C with a Km of 15.2 mg ml−1, and k cat/Km of 0.011× 102 mg−1 ml min−1 on colloidal chitin. The profile of the hydrolytic products, major product being chitobiose, released from CHOS indicated that EcChi1 was an endo-acting enzyme. Transglycosylation (TG) by EcChi1 on trimeric to hexameric CHOS resulted in the formation of longer CHOS for a prolonged duration. EcChi1 showed both chitobiase and TG activities, in addition to hydrolytic activity. The TG by EcChi1 was dependent, to some extent, on the length of the CHOS substrate and concentration of the enzyme. Homology modeling and docking with CHOS suggested that EcChi1 has a deep substrate-binding groove lined with aromatic amino acids, which is a characteristic feature of a processive enzyme.

Tracking performance and stability play a major role in observer design for speed estimation purpose in motor drives used in vehicles. It is all the more prevalent at lower speed ranges. There was a need to have a tradeoff between these parameters ensuring the speed bandwidth remains as wide as possible. This work demonstrates an improved static and dynamic performance of a sliding mode state observer used for speed sensorless 3 phase induction motor drive employed in electric vehicles (EVs). The estimated torque is treated as a model disturbance and integrated into the state observer while the error is constrained in the sliding hyperplane. Two state observers with different disturbance handling mechanisms have been designed. Depending on, how they reject disturbances, based on their structure, their performance is studied and analyzed with respect to speed bandwidth, tracking and disturbance handling capability. The proposed observer with superior disturbance handling capabilities is able to provide a wider speed range, which is a main issue in EV. Here, a new dimension of model based design strategy is employed namely the Processor-in-Loop. The concept is validated in a real-time model based design test bench powered by RT-lab. The plant and the controller are built in a Simulink environment and made compatible with real-time blocksets and the system is executed in real-time targets OP4500/OP5600 (Opal-RT). Additionally, the Processor-in-Loop hardware verification is performed by using two adapters, which are used to loop-back analog and digital input and outputs. It is done to include a real-world signal routing between the plant and the controller thereby, ensuring a real-time interaction between the plant and the controller. Results validated portray better disturbance handling, steady state and a dynamic tracking profile, higher speed bandwidth and lesser torque pulsations compared to the conventional observer.

Resistance to thyroid hormone syndrome (RTH) is a rare disorder and is usually inherited as dominantly negative autosomal trait. RTH is caused by mutations in the thyroid hormone receptor beta. Patients with RTH usually do not have signs and symptoms of thyrotoxicosis, but the thyroid function test shows an elevated T3 and T4, which get misinterpreted as hyperthyroidism, resulting in unnecessary treatment.

Visual axis opacification (VAO) occurs in up to 40% of pediatric patients after cataract surgery withintraocular lens implantation(IOL) even with a primary posterior capsulotomy (PPC). In both children and adult group, opacification does obscure the visual axis. However, in children after PPC, there is no capsule. Hence, the terminology VAO is used in children rather than posterior capsular opacification. This opacification is caused by a proliferation of epithelial cells on the posterior capsule or anterior vitreous face and can hinder the optical image quality needed for normal visual development. The rate of epithelial mitotic activity is higher in children compared to adult. It can be managed by Yag laser or surgical membranectomy, the latter is preferable. International and national published articles were systematically reviewed on aetio-pathogenesis, surgical techniques and equipment, type and material of IOL, and management of VAO in children operated for cataract. Author's experience was also included to write manuscript. VAO is frequent complication following cataract surgery in pediatric patients. Age of cataract patients, surgical technique and type and materials of IOL are most common influencing factor for VAO. Immediate management with advance equipment of VAO reduces the incidence for development of irreversible stimulation deprivation amblyopia. Keywords: pediatric cataract; pediatric cataract surgery; visual axis opacification.

Introduction: Provisional restoration is an analytical component of fixed prosthodontics serving as a ground plan for the design of fixed dental prosthesis. Flexural strength is critical in case of long standing fixed dental prosthesis, to appreciate success of full mouth rehabilitation cases and temporomandibular joint dysfunction therapies. Aim: The present study was to evaluate the flexural strength of different provisional restorative resins used for prosthetic rehabilitation. Materials and Methods: Forty identical samples (n=10 for each material) measuring 25mm×2mm×2mm according to ADA/ANSI specification no. 27 were fabricated using autopolymerizing Poly Methyl Methacrylate (PMMA) (Group A); heat activated PMMA (Group B); autopolymerizing Bis-GMA composite resin (Group C) and light activated Urethane Dimethacrylate Resin (UDMA) (Group D). For 14 days all these samples were stored in artificial saliva. Ten samples from each material were subjected to thermal cycling for 2500 cycles (5°C to 55°C). Later, a standard three point bending test was conducted on all the specimens with a universal testing machine at a crosshead speed of 0.75mm/min. Statistical analysis used included Kruskal-Wallis and Mann-Whitney U test. Results: The mean flexural strength of specimens confirmed higher flexural strength for Group C (102.98 Mpa) followed by Group B (91.86 Mpa), Group A (79.13 Mpa) and Group D (60.01 Mpa). There were significant differences between any two materials tested (p

The purpose of this work is to present an adaptive sliding mode Luenberger state observer with improved disturbance rejection capability and better tracking performance under dynamic conditions. The sliding hyperplane is altered by incorporating the estimated disturbance torque with the stator currents. In addition, the effects of parameter detuning on the speed convergence are observed and compared with the conventional disturbance rejection mechanism. The entire drive system is first built in the Simulink environment. Then, the Simulink model is integrated with real-time (RT)-Lab blocksets and implemented in a relatively new real-time environment using OP4500 real-time simulator. Real-time simulation and testing platforms have succeeded offline simulation and testing tools due to their reduced development time. The real-time results validate the improvement in the proposed state observer and also correspond to the performance of the actual physical model.

Here we have identified HIV-1 B clade Envelope (Env) amino acid signatures from early in infection that may be favored at transmission, as well as patterns of recurrent mutation in chronic infection that may reflect common pathways of immune evasion. To accomplish this, we compared thousands of sequences derived by single genome amplification from several hundred individuals that were sampled either early in infection or were chronically infected. Samples were divided at the outset into hypothesis-forming and validation sets, and we used phylogenetically corrected statistical strategies to identify signatures, systematically scanning all of Env. Signatures included single amino acids, glycosylation motifs, and multi-site patterns based on functional or structural groupings of amino acids. We identified signatures near the CCR5 co-receptor-binding region, near the CD4 binding site, and in the signal peptide and cytoplasmic domain, which may influence Env expression and processing. Two signatures patterns associated with transmission were particularly interesting. The first was the most statistically robust signature, located in position 12 in the signal peptide. The second was the loss of an N-linked glycosylation site at positions 413-415; the presence of this site has been recently found to be associated with escape from potent and broad neutralizing antibodies, consistent with enabling a common pathway for immune escape during chronic infection. Its recurrent loss in early infection suggests it may impact fitness at the time of transmission or during early viral expansion. The signature patterns we identified implicate Env expression levels in selection at viral transmission or in early expansion, and suggest that immune evasion patterns that recur in many individuals during chronic infection when antibodies are present can be selected against when the infection is being established prior to the adaptive immune response.

Background: Neonates at risk of hypoglycemia are often roomed in with mothers, but there is paucity of literature on the occurrence of hypoglycemia in these exclusively breastfed high-risk neonates. The primary objective was to estimate the incidence of hypoglycaemia in high-risk neonates on exclusive breastfeeding. The secondary objectives were to study the time of presentation, symptoms of hypoglycaemia, and the various maternal and neonatal risk factors., Methods: This prospective observational study was carried out in a tertiary care teaching hospital of eastern India between January 2017 and June 2018. All neonates roomed in with mothers with high-risk factors such as low birth weight, preterm, small for gestational age, large for gestational age and infants of diabetic mothers were included. All included neonates were exclusive breastfed and underwent blood glucose monitoring at 2, 6, 12, 24, 48 and 72 h of life using glucometer strips and also whenever clinical features suggested hypoglycaemia. Hypoglycemia was defined as the blood glucose level ≤46 mg/dL., Results: Of a total of 250 neonates studied, 52 (20.8%) developed hypoglycaemia in first 72 h. Hypoglycaemia was detected in most at 2 h with the second peak at 48 h of age. Only 8 (3.2%) neonates had symptomatic hypoglycaemia with jitteriness being the commonest symptom, followed by lethargy and poor feeding., Conclusion: There is a need to closely monitor the blood glucose levels for at least first 48 h in high-risk neonates roomed in with mothers on exclusive breastfeeding., Competing Interests: The authors have none to declare., (© 2020 Director General, Armed Forces Medical Services. Published by Elsevier, a division of RELX India Pvt. Ltd.)

Dentinogenesis imperfecta type 2, also referred to as Capdepont teeth and hereditary opalescent dentin, is a rare hereditary dysplasia affecting the dentin that occurs during the histodifferentiation stage of tooth development. The resulting brownish gray opalescent hue creates an unesthetic appearance. This form of dentin anomaly occurs in approximately 1 in 8000 individuals in the United States. Teeth affected by hereditary dentin dysplasia chip easily, even under normal masticatory forces; however, as a result of underlying sclerotic dentin formation and obliteration of pulp chambers in response to attrition, these teeth are not hypersensitive. This case report describes this rare anomaly in a 27-year-old woman, whose discolored teeth were restored with ceramic laminate veneers.

Purpose: To ascertain the benefits of practicing shunt pumping test on a validated experimental model., Methods: A validated experimental model of shunt was used and 25 medical professionals were asked to assess the block in the model where artificial blocks were created. The assessment was repeated after the participants had practiced on the same model. The performance of participants before and after practice was compared and statistically evaluated., Results: The ability to predict the status of shunt showed an improvement in all scenarios after practice. The odds ratio for predicting a blocked shunt before and after practice was 7.25 (95% credible interval: 1.50-21.01). The odds ratio for predicting a functional shunt before and after practice was 8.81 (95% credible interval of 1.64 to 13.65)., Conclusion: Practicing on the experimental model significantly improves the ability to predict the status of shunt. Training of primary caregivers on similar shunt models based on the shunts used in respective centers can improve an early detection of shunt block and reduce reliance on more invasive and expensive evaluation modalities., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Purpose: Shunt pumping test has often been used clinically to detect functional status of ventriculoperitoneal (VP) shunt. Its ability to correctly predict the status is not reliably known. Ethical dilemmas make it difficult to perform any studies in patients with blocked shunts, and hence, a requirement of devising an experimental model was felt., Method: An experimental model was devised using a Chhabra Slit N Spring shunt. The pressures were maintained in the proximal and distal chamber by real-time monitoring and maintained similar to intra-ventricular and intra-abdominal pressures. Three such models with scenarios of proximal block (PB), distal block (DB), and a functional shunt (BO) were created. Twenty-five participants were tested using these models to assess the efficacy of shunt pumping test., Results: The experimental model could be used successfully to perform the test. The sensitivity of the test to detect a shunt with block on any side (AB) was found to be 0.79 (95% confidence interval 0.72-0.85) and specificity to be 0.69 (95% confidence interval 0.59-0.80). Its ability to detect the side of block was also evaluated. Absolute correctness value, odds ratio, and interpersonal heterogeneity were also evaluated. Pressure changes in proximal and distal catheter on compressing the chamber in various scenarios were recorded., Conclusion: The shunt pumping test has moderate ability to predict a blocked shunt and can aid clinical assessment of shunt block. It has only limited ability to detect the side of block. Pressure changes in the proximal and distal catheters on chamber compression are commensurate with the rationale of "shunt pumping test."

Occupants of aircraft have reported an array of symptoms related to general discomfort and irritation. Volatile organic compounds (VOCs) have been suggested to contribute to the reported symptoms. VOCs are from products used, bioeffluents from people and oxidation reaction products. Thirty-six healthy, young female subjects rated symptoms and environmental quality during an eight-hour exposure to groups of compounds often present in aircraft: (i) long-chain carbonyls, (ii) simulated bioeffluents, and (iii) short-chain carbonyls/organic acids. Statistically more symptoms were identified for the simulated bioeffluents and, to a lesser extent, short-chain carbonyls/organic acids compared to a control condition, although they remained in the acceptable range. There were three temporal patterns in the environmental quality and symptom reports: (i) an adaptive response (immediate increases followed by a decline); (ii) an apparent physiological effect (increases one to three hours into the exposure that remained elevated); and (iii) no statistical differences in reported environmental quality or symptom severity compared to the control air conditions. Typical concentrations found in aircraft can cause transitory symptoms in healthy individuals questioning the adequacy of current standards. Understanding the effects on individuals sensitive to air pollutants and methods to remove the compounds causing the greatest symptom responses are needed., (© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Coronal incision is a popular and versatile surgical approach to the anterior cranial vault and upper and middle third facial skeleton. The flap itself permits widespread exposure of the fractures in this region. The bicoronal flap was first described by Hartley and Kenyon (neurosurgeons) to gain access to the anterior cranium in 1907. It extension as an access flap to the upper and lateral aspect of the face was pioneered by Tessier (1971). Esthetically, it is pleasing as the surgical scar is hidden within the hair., Aims: To evaluate the versatility of coronal incision using various modifications advocated in incision, exposure to fractured site, and closure of flap in treating the upper and middle third facial fractures., Materials and Methods: A total of ten patients diagnosed with upper and middle third facial fractures requiring open reduction and internal fixation/correction of contour defect were selected after preoperative clinical and radiographic (computed tomography scan) evaluation. All the cases were operated by coronal approach to gain the access to the fracture/defect site for reduction/correction of the defect. Advantages and complication are evaluated., Results: Excellent access and anatomical reduction by this approach with least number of complications; if it is performed with healthy knowledge of anatomy of the scalp and temporal region. Certain minimal complications have also been noted using various modifications used in the procedure., Conclusion: Despite of prolonged surgical time for the exposure, it is very advantages in treating upper and middle third facial fractures due to wide access and discreet scar (minimal)., Competing Interests: There are no conflicts of interest.

Industrially contaminated sites with hazardous materials are a priority and urgent problem all over the world. Appropriate risk assessment is required to determine health risks associated with contaminated sites. The present study was conducted to investigate distribution of potentially hazardous, heavy metal (As, Cd, Cr, Cu, Ni, Pb and Zn) concentrations in surface and groundwater samples collected during summer (pre-monsoon) and winter (post-monsoon) seasons from an industrially contaminated site, Hyderabad, India, with potential source of metal contamination because of industrial effluents and usage of pesticides in agriculture. Heavy metal (HM) concentrations were analysed by using inductively coupled plasma-mass spectrometer and were compared with permissible limits set by the World Health Organisation. Data obtained was treated using multivariate statistical approaches like R-mode factor analysis (FA), principal component analysis, cluster analysis, geoaccumulation index, enrichment factor, contamination factor and the degree of contamination. Health risk assessment like chronic daily intake (CDI) and hazard quotient (HQ) were also calculated. Relatively high levels were noted in surface water with average concentrations during summer and winter seasons showing 16.13 and 11.83 for As, 7.91 and 1.64 for Cd, 88.33 and 32.90 for Cr, 58.11 and 28.26 for Cu, 53.62 and 69.96 for Ni, 173.8 and 118.6 for Pb, and 2,943 and 1,889 μg/L for Zn. While in groundwater, the mean metal levels during two seasons were 18.18 and 3.76 for As, 1.67 and 0.40 for Cd, 29.40 and 5.15 for Cr, 17.03 and 4.19 for Cu, 25.4 and 6.09 for Ni, 81.7 and 2.87 for Pb and 953 and 989 μg/L for Zn, respectively. FA identified two factors with cumulative loadings of F1-60.82 % and F2-76.55 % for pre-monsoon surface water and F1-48.75 % and F2-67.55 % for groundwater. Whereas, three factors with cumulative loadings of F1-39.13 %, F2-66.60 % and F3-81.01 % for post-monsoon surface water and F1-50.31 %, F2-66.18 % and F3-81.54 % for groundwater. The health risk assessment like CDI and HQ indices with increased levels of hazardous elements in the surface and groundwater were safe for drinking purposes provided some water treatment methodologies are adopted.

The current research examines the possibility of using recirculation filters from aircraft to document the nature of air-quality incidents on aircraft. These filters are highly effective at collecting solid and liquid particulates. Identification of engine oil contaminants arriving through the bleed air system on the filter was chosen as the initial focus. A two-step study was undertaken. First, a compressor/bleed air simulator was developed to simulate an engine oil leak, and samples were analyzed with gas chromatograph-mass spectrometry. These samples provided a concrete link between tricresyl phosphates and a homologous series of synthetic pentaerythritol esters from oil and contaminants found on the sample paper. The second step was to test 184 used aircraft filters with the same gas chromatograph-mass spectrometry system; of that total, 107 were standard filters, and 77 were nonstandard. Four of the standard filters had both markers for oil, with the homologous series synthetic pentaerythritol esters being the less common marker. It was also found that 90% of the filters had some detectable level of tricresyl phosphates. Of the 77 nonstandard filters, 30 had both markers for oil, a significantly higher percent than the standard filters.