A Novel Fog Computing Approach for Minimization of Latency in Healthcare using Machine Learning

In the recent scenario, the most challenging requirements are to handle the massive generation of multimedia data from the Internet of Things (IoT) devices which becomes very difficult to handle only through the cloud. Fog computing technology emerges as an intelligent solution and uses a distributed environment to operate. The objective of the paper is latency minimization in e-healthcare through fog computing. Therefore, in IoT multimedia data transmission, the parameters such as transmission delay, network delay, and computation delay must be reduced as there is a high demand for healthcare multimedia analytics. Fog computing provides processing, storage, and analyze the data nearer to IoT and end-users to overcome the latency. In this paper, the novel Intelligent Multimedia Data Segregation (IMDS) scheme using Machine learning (k-fold random forest) is proposed in the fog computing environment that segregates the multimedia data and the model used to calculate total latency (transmission, computation, and network). With the simulated results, we achieved 92% as the classification accuracy of the model, an approximately 95% reduction in latency as compared with the pre-existing model, and improved the quality of services in e-healthcare

A comparative study of effect of phenytoin, topiramate, and zonisamide in learning and memory of albino rats

Background: Epilepsy is one of the non-communicable neurologic diseases leading to significant morbidity and mortality. Complaints of impaired learning and memory are common in patients of epilepsy. Antiepileptic drugs (AEDs) may further enhance this impairment. So, the present study was carried out on albino rats to evaluate the effect of AEDs on learning and memory.Methods: Albino rats of about 150 -200 gm of either sex were treated with drugs for 15 days and assessed for effect on learning behavior and again treated for next 15 days after which they were assessed for retention behavior on Morris water maze and Elevated plus maze. The data was statistically analyzed by ANOVA and Tukey HSD.Results: Phenytoin and topiramate causes significant delay in learning and memory whereas zonisamide doesn’t causes significant delay in learning and memory.Conclusions: Impairment in learning and memory occurs in treatment with phenytoin and topiramate but not with zonisamide in low therapeutic doses

Nimesulide induced toxic epidermal necrolysis: a rare case report

Adverse drug reactions to the prescribed medicines are the major obstacles in continuation of drug treatment. Nimesulide, a selective cyclo-oxygenase (COX-2) inhibitor was first launched in Italy in 1985 and subsequently marketed in more than 50 countries including India. Due to its better and faster antipyretic action, it has gained popularity among physicians and paediatricians. Here, we report a case of 60 years old male patient who developed toxic epidermal necrolysis (TEN) following ingestion of tablet nimesulide. The patient was managed with parenteral corticosteroids, antibiotics, emollients, anti-fungal and supportive care. This case highlights the importance of nimesulide and other NSAIDs as possible cause of TEN. Nimesulide has never been approved in countries like USA, Canada, Britain, New Zealand, Australia. But in India it is available as over the counter drug and is used for various indications like fever, myalgia, arthralgia. Therefore, the drugs which are banned outside India should be used with caution and medical practitioners should report all the adverse drug reactions to such drugs.

Evaluation of prescribing pattern of antidiabetic drugs in medicine outpatient clinic of a tertiary care teaching hospital

Background: Diabetes is rapidly gaining the status of a potential epidemic in India with more than 62 million diabetics currently diagnosed with the disease. Drug utilization studies are of paramount importance for the optimization of drug therapy and promote rational drug use among health care providers. The aim of this study was to investigate the drug utilization pattern in type-2 diabetic patients. The objective of the study was to analyse the prescribing pattern of anti-diabetic drugs in a tertiary care hospital.Methods: A prospective, cross-sectional study was carried out in medicine outpatient clinic of tertiary care hospital, RIMS Ranchi for a period of 7 months. The data was analysed using WHO core indicators and Microsoft Excel 2013.Results: The total number of encounters surveyed was 94. Avg no of drugs per prescription was 3.04. Percentage of drugs prescribed by generic name was found to be 34.2%. Percentage of prescriptions was a) with antibiotics was 27.6%, b) with insulin was 14.89%, c) from essential drugs list 44.05%. Most common co morbid disease was found to be hypertension present in 27.6% cases.Most commonly use drug was found to be metformin followed by glimepiride.Conclusions: Implementation of WHO core prescribing indicators by the prescribers would help us to reduce the cost, to recognize and prevent potentially dangerous drug- drug interaction and antibiotic resistance

The global, regional, and national burden of adult lip, oral, and pharyngeal cancer in 204 countries and territories:A systematic analysis for the Global Burden of Disease Study 2019

Importance Lip, oral, and pharyngeal cancers are important contributors to cancer burden worldwide, and a comprehensive evaluation of their burden globally, regionally, and nationally is crucial for effective policy planning.Objective To analyze the total and risk-attributable burden of lip and oral cavity cancer (LOC) and other pharyngeal cancer (OPC) for 204 countries and territories and by Socio-demographic Index (SDI) using 2019 Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study estimates.Evidence Review The incidence, mortality, and disability-adjusted life years (DALYs) due to LOC and OPC from 1990 to 2019 were estimated using GBD 2019 methods. The GBD 2019 comparative risk assessment framework was used to estimate the proportion of deaths and DALYs for LOC and OPC attributable to smoking, tobacco, and alcohol consumption in 2019.Findings In 2019, 370 000 (95% uncertainty interval [UI], 338 000-401 000) cases and 199 000 (95% UI, 181 000-217 000) deaths for LOC and 167 000 (95% UI, 153 000-180 000) cases and 114 000 (95% UI, 103 000-126 000) deaths for OPC were estimated to occur globally, contributing 5.5 million (95% UI, 5.0-6.0 million) and 3.2 million (95% UI, 2.9-3.6 million) DALYs, respectively. From 1990 to 2019, low-middle and low SDI regions consistently showed the highest age-standardized mortality rates due to LOC and OPC, while the high SDI strata exhibited age-standardized incidence rates decreasing for LOC and increasing for OPC. Globally in 2019, smoking had the greatest contribution to risk-attributable OPC deaths for both sexes (55.8% [95% UI, 49.2%-62.0%] of all OPC deaths in male individuals and 17.4% [95% UI, 13.8%-21.2%] of all OPC deaths in female individuals). Smoking and alcohol both contributed to substantial LOC deaths globally among male individuals (42.3% [95% UI, 35.2%-48.6%] and 40.2% [95% UI, 33.3%-46.8%] of all risk-attributable cancer deaths, respectively), while chewing tobacco contributed to the greatest attributable LOC deaths among female individuals (27.6% [95% UI, 21.5%-33.8%]), driven by high risk-attributable burden in South and Southeast Asia.Conclusions and Relevance In this systematic analysis, disparities in LOC and OPC burden existed across the SDI spectrum, and a considerable percentage of burden was attributable to tobacco and alcohol use. These estimates can contribute to an understanding of the distribution and disparities in LOC and OPC burden globally and support cancer control planning efforts

The global burden of adolescent and young adult cancer in 2019 : a systematic analysis for the Global Burden of Disease Study 2019

Background In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15-39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults. Methods Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15-39 years to define adolescents and young adults. Findings There were 1.19 million (95% UI 1.11-1.28) incident cancer cases and 396 000 (370 000-425 000) deaths due to cancer among people aged 15-39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59.6 [54.5-65.7] per 100 000 person-years) and high-middle SDI countries (53.2 [48.8-57.9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14.2 [12.9-15.6] per 100 000 person-years) and middle SDI (13.6 [12.6-14.8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23.5 million (21.9-25.2) DALYs to the global burden of disease, of which 2.7% (1.9-3.6) came from YLDs and 97.3% (96.4-98.1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally. Interpretation Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Microstructure, stress and texture in sputter deposited TiN thin films: effect of substrate bias

Abstract: Titanium nitride thin films deposited by reactive dc magnetron sputtering under various substrate bias voltages have been investigated by X-ray diffraction. TiN thin films exhibits lattice parameter anisotropy for all bias voltages. Preferential entrapment of argon atoms in TiN lattice has been identified as the major cause of lattice parameter anisotropy. Bombardment of argon ions during film growth has produced stacking faults on {111} planes of TiN crystal. Stacking fault probability increases with increasing substrate bias voltages. X-ray diffraction line profile analysis indicates strain anisotropy in TiN thin films. Diffraction stress analysis by d-sin 2 ψ method reveals pronounced curvature in the plot of interplanar spacing (d) (or corresponding lattice parameter (a)) versus sin 2 ψ. Direction dependent elastic grain interaction has been considered as possible source of the observed anisotropic line broadening. Introduction Titanium nitride (TiN) thin films deposited by reactive magnetron sputtering is widely used for improving the hardness and wear resistance of materials surfaces Specimen preparation and characterization Polycrystalline titanium nitride thin films (thickness ~ 2µm for all films) were deposited on silicon ({100} Si) substrate by planer reactive dc magnetron (magnetron power ~ 270W) sputtering under various substrate bias voltages (0kV to -5kV) using a high voltage pulsed DC power supply. The sputter target was 99.99% pure titanium and argon gas of high purity (99.99%) was used as the sputtering gas for the magnetron targets. For the reactive deposition of titanium nitride, the reactive gas nitrogen was introduced. Operating pressure of the sputtering chamber was 3x1

Thickness-dependent fcc–hcp phase transformation in polycrystalline titanium thin films

Polycrystalline Ti thin films are shown to gradually transform from face-centered cubic (fcc) to hexagonal close-packed structure (hcp) with increasing film thickness. Diffraction stress analysis revealed that the fcc phase is formed in a highly compressive hcp matrix (⩾2 GPa), the magnitude of which decreases with increasing film thickness. A correlation between stress and crystallographic texture vis-à-vis the fcc–hcp phase transformation has been established. The total free energy change of the system upon phase transformation calculated using the experimental results shows that the fcc–hcp transformation is theoretically possible in the investigated film thickness regime (144–720 nm) and the hcp structure is stable for films thicker than 720 nm, whereas the fcc structure can be stabilized in Ti films much thinner than 144 nm

Stress, Texture and Phase Transformation in Titanium Thin Films

{111} fiber textured face centered cubic (fcc) titanium has been found to coexist with the {0002} fiber textured hexagonal close packed (hcp) titanium in polycrystalline titanium (Ti) thin films (thickness: 144 nm to 720 nm) deposited on Si (100) substrate by magnetron sputtering. X-ray diffraction investigation confirms that relative phase fraction of such metastable fcc Ti phase decreases with increasing film thickness indicating thickness dependent fcc-hcp phase transformation of titanium. Texture development in hcp Ti phase was due to film microstructure (thickness effect) rather than the phase transformation. Diffraction stress analysis (by d-sin(2)psi method) indicates that fcc to hcp phase transformation is also accompanied by the reduction of compressive stress in the hcp Ti phase with increasing film thickness. Strain energy calculations for both phases of titanium indicate that fcc Ti is a more stable phase compared to hcp Ti at relatively low film thickness (144 nm to 432 nm). It has been concluded that film stress favours fcc to hcp phase transformation towards the higher film thickness. Reverse transformation (hcp to fcc) occurs towards the lower film thickness