Optimal response and covariate-adaptive biased-coin designs for clinical trials with continuous multivariate or longitudinal responses

Adaptive randomization of the sequential construction of optimum experimental designs is used to derive biased-coin designs for longitudinal clinical trials with continuous responses. The designs, coming from a very general rule, target pre-specified allocation proportions for the ranked treatment effects. Many of the properties of the designs are similar to those of well understood designs for univariate responses. A numerical study illustrates this similarity in a comparison of four designs for longitudinal trials. Designs for multivariate responses can likewise be found, requiring only the appropriate information matrix. Some new results in the theory of optimum experimental design for multivariate responses are presented

An observational study to compare Muhtaseb's and Habib's scoring systems in patients undergoing phacoemulsification to predict risk in cataract at a tertiary centre in West Bengal

Background: Cataract is derived from the Latin ‘cataracta’, meaning ‘waterfall’ as rapidly running water turns white, so term may have been used metaphorically to describe similar appearance of mature ocular opacities.1 Methods: This observational study with prospective study design has been conducted in the college of medicine and JNM hospital, department of ophthalmology, COMJNMH, Kalyani-741235, Nadia District, West Bengal which catering mostly the rural and also urban population. The study was done spread over a period of 18 months starting from July 2018 to December 2019, i.e., 1 year for research and 6 months for analysis. It included all patients, irrespective of age, undergoing Phacoemulsification surgery for cataract admitted in our hospital fulfilling the laid criteria for the study. Results: The study consisted of total 147 cases in these 14 (9.52%) cases complicated with PCR, 10 (6.80%) striate keratopathy and 4 (2.72%) cases complicated with both PCR and striate keratopathy. Though sample size derived was 126 cases, 147 cases were studied during the research period of 1 year. Out of 10.89% cases of miscellaneous risk (ex: poor position of the eye/patient) risk factor, posterior capsule rupture (12.5%), striate keratopathy (12.5%), cases having both complication (00.0%) and total complicated cases (25%) which is 1.36%, 1.36%, 0% and 2.72% of total cases respectively. Out of 8.84% cases of unable to lie flat risk factor, posterior capsule rupture (15.38%), striate keratopathy (7.69%), and total complicated cases (23.07%) which is 1.36%, 0.68% and 2.04% of total cases respectively. Conclusions: The current study tries to validate two scoring systems to predict complications during phacoemulsification surgerylike risk of posterior capsule rupture and striate keratopathy and to predict the potential difficulty of a case

Effects of Storage Conditions on Chemistry and Technological Properties of Different Cultivars of Chickpea

The impact of storage conditions, such as 40 °C, high humidities (55% and 65%), and storage (360 days), on the nutritional value, pasting, and functional properties, color differences, and quality of protein and starch in five Chickpea (Cicer arietinum) cultivars (Crown, Royal, Sierra, Orion, and Frontier) was determined. The Sierra cultivar had the highest initial moisture content (MC, 7.7 ± 0.01%), and MC increased over time for all samples stored at 55% and 65% RH and 21 °C. Protein (PC), total starch (TSC), and fat (FC) contents changed in all cultivars during storage. Under the same storage conditions (65% RH and 40 °C treatment), the Frontier variety had significantly higher PC at day zero (24.0 ± 0% dwb) and 360 (23.9 ± 0.2% dwb) compared to other cultivars, while no significant differences existed between other cultivars. A general upward trend in the pasting data was observed for all cultivars of the 360-day stored samples. In contrast, the gel firmness of the gels formed during Rapid Visco Analysis (RVA) was lower for the 360-day samples. Emulsion capacity (EC) and Foaming capacity (FC) changed significantly in all samples over time under the effects of different variables. Color analysis revealed reduced yellowness in all samples during storage. Also, lightness values decreased over time, indicating seed darkening during storage. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) showed the disappearance of major protein bands around 37 and 55 kDa after 360 days, indicating protein aggregation and structural alterations. Fourier transform infrared spectroscopy (FTIR) of amide II structures indicated interactions and differences in the secondary structure of proteins in the samples stored for 360 days. Starch analysis via SEM revealed protein-coated starch granules, indicating protein-starch interactions occurred during storage. Harsh storage conditions (65% RH and 40 °C) significantly affected nutritional quality, functional and pasting properties, and protein chemistry of chickpeas and should be avoided for extended storage

A qualitative study on diversity of psychological stress between the suburban & metropolitan field level health workers.

Introduction: Urban front-level surveillance workers (HCWs) visited door-to-door to find out whether any residents had any symptoms of Covid 19 in both slums and non-slums of West Bengal.  This study aims to discover what type of problems HCWs face; their perception about why people are not responding or hiding their symptoms; what type of stigma they face & what type of response they get from their family members & neighbours. Materials and methods: Three Focus Group Discussions (FGD) were conducted with 8 participants each, the sample size being 24. They were asked about their perception of different aspects per one FGD guide. The discussion was on local languages (Bengali and Hindi) which were audio recorded transcribed and translated into English. Data saturation was reached after 3 interviews. Result: From inductive analysis, themes like ‘job responsibility’, ‘difficulty faced’ and ‘stigmatisation of community’, ‘response about symptoms’, and ‘stigma to HCW from neighbour & Family Member’. In theme 1, making the community aware of the Government\u27s health system was uttered mostly. Health workers thought that most of the beneficiaries were hiding symptoms mainly due to the stigma faced by the neighbours. Human-to-human transmission probability is the reason behind stigma. Hostility faced in the community due to many grievances towards the authority was the main difficulty of HCWs. Conclusion: Stigma regarding disease and grievances towards authority were the main causes of hostility faced by the health workers.

More assistance of entanglement, less rounds of classical communication

Classical communication plays a crucial role to distinguish locally a class of quantum states. Despite considerable advances, we have very little knowledge about the number of measurement and communication rounds needed to implement a discrimination task by local quantum operations and classical communications (in short, LOCC). In this letter, we are able to show the relation between round numbers with the local discrimination of a set of pure bipartite orthogonal quantum states. To demonstrate the possible strong dependence on the round numbers, we consider a class of orthogonal product states in $d\otimes d$, which require at least $2d-2$ round of classical communications. Curiously the round number can be reduced to $d$ by the assistance of one-ebit of entanglement as resource and can be reduced further by assistance of more entanglement. We are also able to show that the number of LOCC rounds needed for a discrimination task may depend on the amount of entanglement assistances.Comment: 11 pages, 3 figures, revtex, comments welcom

Irreversible Hemichorea–Hemiballism in a Case of Nonketotic Hyperglycemia Presenting as the Initial Manifestation of Diabetes Mellitus

Background: Hemichorea–hemiballism (HCHB) is a hyperkinetic movement disorder with features of both chorea and ballism occurring on the same side. Case report: We present a case of HCHB due to nonketotic hyperglycemia (NKH) that was the initial presentation of diabetes and was irreversible clinically even after 6 months of optimal blood sugar control. Discussion: Although HCHB due to hyperglycemia is a potentially reversible condition in the majority of patients, prolonged uncontrolled hyperglycemia may cause ischemic insult and persistent symptoms. Hyperglycemia should always be kept in the list of differentials while dealing with patients who are newly diagnosed with HCHB

Analysis Of Deletion Mutation In SMN I Gene For Spinal Muscular Atrophy In A Tertiary Care Centre, Kolkata

The loss of lower motor neurons in the ventral horns of the spinal cord is the hallmark of spinal muscular atrophy (SMA), the second most prevalent autosomal recessive disorder in children. Some genes cause SMA. Among them, the mutation in the SMN1 gene is the most common, especially exon 7 and exon 8. SMN gene has at least one homologous but inverted copy in the chromosome. From newborns to adults, mutations in the SMN1 gene can impact people in a wide spectrum of severity. Types I, II, III, and IV are the four variations of SMA. The SMN2 gene can be found in each cell of certain individuals with SMA types II and III in three or more copies. The condition is less severe because of these numerous copies of the SMN2 gene. In our tertiary center, we have tried to find out the pattern of deletion and type in the patients. We investigated them depending on their clinical manifestation by PCR of exon 7 and exon 8 followed by RFLP with restriction enzymes DraI & DdeI respectively, for molecular diagnosis. Through molecular study, we have confirmed forty patients with deletions in the SMN1 gene. Among them twenty-five cases showed both deletions of exon 7 and exon 8, thirteen cases were detected with exon 7 deletion, and only two cases with deletion of exon 8.The patients with confirmed deletions were divided into three groups: 16 patients with type III, 19 patients with type II, and 5 patients with type I, based on the clinical symptoms and age of onset. It was commonly observed that the majority of the patient who showed both deletions had a severe phenotype, even if there was some overlap between the deletions detected and the type and severity of SMA

Prevalence and determinants of early neonatal morbidity among neonates born in a rural tertiary care hospital, West Bengal

Background: The first 7 days of life, known as the early neonatal period, is a crucial period where there is increased vulnerability to neonatal complications. Most (75%) of the neonatal deaths occur during the early neonatal period. About 1 million neonates die within the first 24 h of life worldwide. The leading causes of neonatal morbidity and mortality include premature births, low birth weight (LBW), birth complications, such as asphyxia, trauma, neonatal sepsis, and congenital anomalies. Aims and Objectives: The present study was conducted from July 2024, to December 2024, to estimate the prevalence of early neonatal morbidity of neonates born in Bankura Sammilani Medical College and to analyze the significance of the risk factors of early neonatal morbidity. Materials and Methods: An institution-based, observational study was conducted among 300 neonates born in Bankura Sammilani Medical College within the first 7 days. Mothers were interviewed face to face on the basis of a pre-designed, pre-tested, structured questionnaire, and all medical records were reviewed. Bivariate logistic regression analysis was performed to ascertain adjusted odds ratios of sociodemographic, maternal, and neonatal variables on early neonatal morbidities. Results: Early neonatal morbidity was evident among 21.3% of newborns born in Bankura Sammilani Medical College. Common morbidities found were respiratory distress (6.0%), asphyxia (5.0%), sepsis and jaundice (4.7%). LBW babies had 2.92 times higher odds (P<0.001) and babies who did not cry at birth had 22.61 times higher odds of early neonatal morbidities. Conclusion: Early neonatal morbidity is high in our setting, with LBW and absent cry being significant predictors. This study extensively assessed the role of various predictors affecting neonatal morbidity, including socio-demographic characteristics, maternal and neonatal factors. These variables need to be explored further in future studies or meta-analysis so that, right efforts are directed toward reducing early neonatal morbidities utilizing optimum resources

Comparative Performance Study for Closed Loop Operation of an Adjustable Speed Permanent Magnet Synchronous Motor Drive with Different Controllers

In this paper an extensive comparative study is carried out between PI and PID controlled closed loop model of an adjustable speed Permanent Magnet Synchronous Motor (PMSM) drive. The incorporation of Sinusoidal Pulse Width Modulation (SPWM) strategy establishes near sinusoidal armature phase currents and comparatively less torque ripples without sacrificing torque/weight ratio. In this closed loop model of PMSM drive, the information about reference speed is provided to a speed controller, to ensure that actual drive speed tracks the reference speed with ideally zero steady state speed error. The entire model of PMSM closed loop drive is divided into two loops, inner loop current and outer loop speed. By taking the different combinations of two classical controllers (PI &amp; PID) related with two loop control structure, different approximations are carried out.  Hence a typical comparative study is introduced to familiar with the different performance indices of the system corresponding to time domain and frequency domain specifications. Therefore overall performance of closed loop PMSM drive is tested and effectiveness of controllers will be determined for different combinations