Prevalence and etiology of hearing impairment in urban area of Shimla, Himachal Pradesh, India: a cross sectional observational study

Background: The ear is a marvelously complex and sensitive organ. Disease of the ear have profound effect on the health and quality of life of millions of people around the globe. Data regarding the magnitude of hearing impairment in our country is limited and the literature search revealed that no such studies have been conducted in this region.Methods: A community based cross sectional observational study was carried out among the 306 individuals in urban area of Shimla, Himachal Pradesh, India. Information was obtained by a structured questionnaire, clinical ENT examination and audiological tests after obtaining informed consent.Results: The study group had 48.4% males and 51.6% females. Maximum 29.4% of individuals were in the age group of 31-45 years. Mean age was 32.22±20.15. The prevalence of hearing impairment was 13.1%. Among individuals with hearing loss, maximum 57.5% were in the age group of ≥60 years. Sensorineural hearing loss was found in 70%, maximum 55% had mild hearing loss. Among majority of individuals with hearing loss cause was presbyacusis 57.5% followed by infectious ear disease 27.5%. Among majority of individuals with hearing loss 37.5% required no further action at the time of study.Conclusions: In the present study, prevalence of hearing loss was found to be 13.1% and predominantly mild sensorineural or conductive type of hearing loss. An early intervention and quality patient education was necessary for prevention of hearing impairment in majority of cases

Evaluation of Lung Volume and Effect of Vital Staining as Motivation to Quit Tobacco among Nicotine Dependents of Kanpur, India

Objective: To quantify and compare respiratory functions and further screen the oral mucosa of tobacco and non-tobacco users. Material and Methods: First control group, non-tobacco users (n=55); Second group, smokers’ group (n=168) who currently smoked cigarettes; Third group smokeless/chewing type, tobacco group (n=81); Fourth group, both smokeless and smoking type tobacco users (n=46). Fagerstrom Test for Nicotine Dependences (FTND) and Fagerström Test for Nicotine Dependence-Smokeless Tobacco (FTND-ST) instruments were used to assess nicotine dependence. Subsequently, spirometry and Toluidine Blue (TB) vital staining were performed. Chi-squared and one-way analysis of variance (ANOVA) were used for statistical analysis. Results: Fagerstrom test resulted in 48.8% of subjects with low dependency, followed by an increase in nicotine dependency from low to moderate (29.2%), moderate (15.6%), and highly dependent (6.4%) groups. All respiratory function tests and oral screening confirmed significant changes amongst tobacco and non-tobacco users. The forced vital capacity of non-smoker group was significantly different from other tobacco users’ group (p<0.05). Conclusion: Early effects of tobacco use can lead to complications with the respiratory system and oral cavity. Such data can be used to delineate the harm of tobacco and should be used to urge individuals to evade the utilization of tobacco

Cyto-histological correlation of salivary gland lesions- a prospective study in a tertiary care institute

Background: Fine needle aspiration cytology (FNAC) has an essential proven role in diagnosing most of the common and benign salivary gland lesions. However, limited cellularity and morphological heterogeneity of the lesion can pose diagnostic challenges. The present study was conducted in a tertiary care centre over a period of one year with an objective to study the cyto-morphological features of salivary gland lesions and correlate cytological findings with histopathology.Methods: The study was carried out over a period of one year from January 2014 to December 2014. FNA specimens obtained from 78 patients were analyzed. Of these, only 51 patients underwent biopsy or surgery and their specimens were subjected to histopathological examination. Validation of cytological diagnosis was done on the basis of histopathological diagnosis.Results: A total 78 patients with salivary gland lesions were subjected to FNAC. Non neoplastic lesions constituted 19 cases (25%) and benign lesions constituted 46 cases (80.70%).  Malignant lesions constituted 11 cases (19.30%). Two cases were inconclusive due to inadequate aspirated material. Overall sensitivity, specificity and diagnostic accuracy were 95.98%, 99.20% and 98.09% respectively.Conclusions: FNAC continues to be an accurate diagnostic technique in the hands of an experienced cytopathologist. It is a highly sensitive and specific technique for rapid diagnosis of most of the salivary gland swellings

An MBSE Approach for Development of Resilient Automated Automotive Systems

Advanced driver assistance and automated driving systems must operate in complex environments and make safety-critical decisions. Resilient behavior of these systems in their targeted operation design domain is essential. In this paper, we describe developments in our Model-Based Systems Engineering (MBSE) approach to develop resilient safety-critical automated systems. An MBSE approach provides the ability to provide guarantees about system behavior and potentially reduces dependence on in-vehicle testing through the use of rigorous models and extensive simulation. We are applying MBSE methods to two key aspects of developing resilient systems: (1) ensuring resilient behavior through the use of Resilience Contracts for system decision making; and (2) applying simulation-based testing methods to verify the system handles all known scenarios and to validate the system against potential unknown scenarios. Resilience Contracts make use of contract-based design methods and Partially Observable Markov Decision Processes (POMDP), which allow the system to model potential uncertainty in the sensed environment and thus make more resilient decisions. The simulation-based testing methodology provides a structured approach to evaluate the operation of the target system in a wide variety of operating conditions and thus confirm that the expected resilient behavior has indeed been achieved. This paper provides details on the development of a utility function to support Resilience Contracts and outlines the specific test methods used to evaluate known and unknown operating scenarios. Document type: Articl

The Importance of Research on the Origin of SARS-CoV-2

The origin of the severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) virus causing the COVID-19 pandemic has not yet been fully determined. Despite the consensus about the SARS-CoV-2 origin from bat CoV RaTG13, discrepancy to host tropism to other human Coronaviruses exist. SARS-CoV-2 also possesses some differences in its S protein receptor-binding domain, glycan-binding N-terminal domain and the surface of the sialic acid-binding domain. Despite similarities based on cryo-EM and biochemical studies, the SARS-CoV-2 shows higher stability and binding affinity to the ACE2 receptor. The SARS-CoV-2 does not appear to present a mutational “hot spot” as only the D614G mutation has been identified from clinical isolates. As laboratory manipulation is highly unlikely for the origin of SARS-CoV-2, the current possibilities comprise either natural selection in animal host before zoonotic transfer or natural selection in humans following zoonotic transfer. In the former case, despite SARS-CoV-2 and bat RaTG13 showing 96% identity some pangolin Coronaviruses exhibit very high similarity to particularly the receptor-binding domain of SARS-CoV-2. In the latter case, it can be hypothesized that the SARS-CoV-2 genome has adapted during human-to-human transmission and based on available data, the isolated SARS-CoV-2 genomes derive from a common origin. Before the origin of SARS-CoV-2 can be confirmed additional research is required

Urgent Need for Field Surveys of Coronaviruses in Southeast Asia to Understand the SARS-CoV-2 Phylogeny and Risk Assessment for Future Outbreaks

Phylogenetic analysis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is focused on a single isolate of bat coronaviruses (bat CoVs) which does not adequately represent genetically related coronaviruses (CoVs) [...

The structural basis of accelerated host cell entry by SARS-CoV-2 dagger

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of the pandemic coronavirus disease 2019 (COVID-19) that exhibits an overwhelming contagious capacity over other human coronaviruses (HCoVs). This structural snapshot describes the structural bases underlying the pandemic capacity of SARS-CoV-2 and explains its fast motion over respiratory epithelia that allow its rapid cellular entry. Based on notable viral spike (S) protein features, we propose that the flat sialic acid-binding domain at the N-terminal domain (NTD) of the S1 subunit leads to more effective first contact and interaction with the sialic acid layer over the epithelium, and this, in turn, allows faster viral ‘surfing’ of the epithelium and receptor scanning by SARS-CoV-2. Angiotensin-converting enzyme 2 (ACE-2) protein on the epithelial surface is the primary entry receptor for SARS-CoV-2, and protein–protein interaction assays demonstrate high-affinity binding of the spike protein (S protein) to ACE-2. To date, no high-frequency mutations were detected at the C-terminal domain of the S1 subunit in the S protein, where the receptor-binding domain (RBD) is located. Tight binding to ACE-2 by a conserved viral RBD suggests the ACE2-RBD interaction is likely optimal. Moreover, the viral S subunit contains a cleavage site for furin and other proteases, which accelerates cell entry by SARS-CoV-2. The model proposed here describes a structural basis for the accelerated host cell entry by SARS-CoV-2 relative to other HCoVs and also discusses emerging hypotheses that are likely to contribute to the development of antiviral strategies to combat the pandemic capacity of SARS-CoV-2