Diagnostic Accuracy Of Lachman Test For Diagnosis Of Anterior Cruciate Ligament Tear In Adults With Knee Injuries Using Arthroscopy As Gold Standard

Abstract Objective: To evaluate the Lachman test's ability to identify an ACL rupture using arthroscopy as the gold standard. Methods: This cross-sectional (validation) study was done from September 2022 to March 2023. Individuals presenting with a knee injury were enrolled and underwent Lachman test and later on arthroscopy and findings will be recorded. SPSS version 25 was used to analyze the collected data. Results: 150 patients were enrolled with a mean age of 39.95 ± 11.46 years. There were 80 (53.3%) male patients and 70 (46.7%) were females. In this study, we observed that the Lachman test had 81.8% sensitivity, 95.2% specificity, PPV & NPV were 93.1% and 87.0%, respectively and diagnostic accuracy of 89.3%. Conclusion: Thus, the Lachman test is a reliable test for the diagnosis of anterior cruciate ligament tear in knee injuries, which can replace arthroscopy and other invasive or expensive modalities.

Security and Privacy Issues in IoT

Internet of Things (IoT) is a global network of physical and virtual ‘things’ connected to the internet. Each object has unique ID which is used for identification. IoT is the emerging technology which will change the way we interact with devices. In future almost every electronic device will be a smart device which can compute and communicate with hand-held and other infrastructure devices. As most of the devices may be battery operated, due to less processing power the security and privacy is a major issue in IoT. Authentication, Identification and device heterogeneity are the major security and privacy concerns in IoT. Major challenges include integration, scalability, ethics communication mechanism, business models and surveillance. In this paper major issues related to security and privacy of IoT are focused

Semi-automatic lexical functional grammar development

Abstract We are presenting a semi-automatic Lexical Functional Grammar (LFG

Comparative Analysis of Shear Strength Prediction Models for Reinforced Concrete Slab-Column Connections

This research aims at comparative analysis of shear strength prediction at slab-column connection, unifying machine learning, design codes and Finite Element Analysis. Current design codes (CDCs) of ACI 318-19 (ACI), Eurocode 2 (EC2), Compressive Force Path (CFP) method, Feed Forward Neural Network (FNN) based Artificial Neural Network (ANN), PSO-based FNN (PSOFNN), and BAT algorithm-based BATFNN are used. The study is complemented with FEA of slab for validating the experimental results and machine learning predictions.In the case of hybrid models of PSOFNN and BATFNN, mean square error is used as an objective function to obtain the optimized values of the weights, that are used by Feed Forward Neural Network to perform predictions on the slab data. Seven different models of PSOFNN, BATFNN, and FNN are trained on this data and the results exhibited that PSOFNN is the best model overall. PSOFNN has the best results for SCS=1 with highest value of R as 99.37% and lowest of MSE, and MAE values of 0.0275%, and 1.214% respectively which are better than the best FNN model for SCS=4 having the values of R, MSE, and MAE as 97.464%, 0.0492%, and 1.43%, respectively.Comment: 34 Pages,25 Figure

Efficacy Of Tranexamic Acid in Reducing Blood Loss in Primary Total Knee Replacement

Objective: To determine the efficacy of tranexamic acid in reducing blood loss in primary total knee replacement. Material and Methods: A total of 96 patients having a diagnosis of primary knee osteoarthritis made up the population sample. The Total Knee Replacement patients were separated into two groups. Patients in Group B used Intra venous tranexamic acid, but those in Group A did not use tranexamic acid during the course of the operation or afterwards. Results: Mean age of the patients recorded in group A 63.79±6.60 (years) and in group B 62.96±7.89 (years). The majority of the patients in both groups were females. After surgery, Group B patients who received tranexamic acid reported less blood loss and less haemoglobin reduction as compared to the control group. Conclusion: From our study, we conclude that Tranexamic acid used intravenously during total knee arthroplasty considerably lowers postoperative blood loss

Can home visits for early child development be implemented with sufficient coverage and quality at scale? Evidence from the SPRING program in India and Pakistan

INTRODUCTION: There is limited evidence from low and middle-income settings on the effectiveness of early child development interventions at scale. To bridge this knowledge-gap we implemented the SPRING home visiting program where we tested integrating home visits into an existing government program (Pakistan) and employing a new cadre of intervention workers (India). We report the findings of the process evaluation which aimed to understand implementation. METHODS AND MATERIALS: We collected qualitative data on acceptability and barriers and facilitators for change through 24 in-depth interviews with mothers; eight focus group discussions with mothers, 12 with grandmothers, and 12 with fathers; and 12 focus group discussions and five in-depth interviews with the community-based agents and their supervisors. RESULTS: Implementation was sub-optimal in both settings. In Pakistan issues were low field-supervision coverage and poor visit quality related to issues scheduling supervision, a lack of skill development, high workloads and competing priorities. In India, issues were low visit coverage - in part due to employing new workers and an empowerment approach to visit scheduling. Coaching caregivers to improve their skills was sub-optimal in both sites, and is likely to have contributed to caregiver perceptions that the intervention content was not new and was focused on play activities rather than interaction and responsivity - which was a focus of the coaching. In both sites caregiver time pressures was a key reason for low uptake among families who received visits. DISCUSSION: Programs need feasible strategies to maximize quality, coverage and supervision including identifying and managing problems through monitoring and feedback loops. Where existing community-based agents are overstretched and system strengthening is unlikely, alternative implementation strategies should be considered such as group delivery. Core intervention ingredients such as coaching should be prioritized and supported during training and implementation. Given that time and resource constraints were a key barrier for families a greater focus on communication, responsivity and interaction during daily activities could have improved feasibility

Maternal time investment in caregiving activities to promote early childhood development: evidence from rural India

INTRODUCTION: Intervention strategies that seek to improve early childhood development outcomes are often targeted at the primary caregivers of children, usually mothers. The interventions require mothers to assimilate new information and then act upon it by allocating sufficient physical resources and time to adopt and perform development promoting behaviours. However, women face many competing demands on their resources and time, returning to familiar habits and behaviours. In this study, we explore mothers' allocation of time for caregiving activities for children under the age of 2, nested within a cluster randomised controlled trial of a nutrition and care for development intervention in rural Haryana, India. METHODS: We collected quantitative maternal time use data at two time points in rural Haryana, India, using a bespoke survey instrument. Data were collected from 704 mothers when their child was 12 months old, and 603 mothers when their child was 18 months old. We tested for significant differences in time spent by mothers on different activities when children are 12 months of age vs. 18 months of age between arms as well as over time, using linear regression. As these data were collected within a randomised controlled trial, we adjusted for clusters using random effects when testing for significant differences between the two time points. RESULTS: At both time points, no statistically significant difference in maternal time use was found between arms. On average, mothers spent most of their waking time on household chores (over 6 h and 30 min) at both time points. When children were aged 12 months, approximately three and a half hours were spent on childcare activities for children under the age of 2 years. When children were 18 months old, mothers spent more time on income generating activities (30 min) than when the children were 12 years old, and on leisure (approximately 4 h and 30 min). When children were 18 months old, less time was spent on feeding/breastfeeding children (30 min less) and playing with children (15 min). However, mothers spent more time talking or reading to children at 18 months than at 12 months. CONCLUSION: We find that within a relatively short period of time in early childhood, maternal (or caregiver) time use can change, with time allocation being diverted away from childcare activities to others. This suggests that changing maternal time allocation in resource poor households may be quite challenging, and not allow the uptake of new and/or optimal behaviours

Maternal time investment in caregiving activities to promote early childhood development: evidence from rural India

IntroductionIntervention strategies that seek to improve early childhood development outcomes are often targeted at the primary caregivers of children, usually mothers. The interventions require mothers to assimilate new information and then act upon it by allocating sufficient physical resources and time to adopt and perform development promoting behaviours. However, women face many competing demands on their resources and time, returning to familiar habits and behaviours. In this study, we explore mothers' allocation of time for caregiving activities for children under the age of 2, nested within a cluster randomised controlled trial of a nutrition and care for development intervention in rural Haryana, India.MethodsWe collected quantitative maternal time use data at two time points in rural Haryana, India, using a bespoke survey instrument. Data were collected from 704 mothers when their child was 12 months old, and 603 mothers when their child was 18 months old. We tested for significant differences in time spent by mothers on different activities when children are 12 months of age vs. 18 months of age between arms as well as over time, using linear regression. As these data were collected within a randomised controlled trial, we adjusted for clusters using random effects when testing for significant differences between the two time points.ResultsAt both time points, no statistically significant difference in maternal time use was found between arms. On average, mothers spent most of their waking time on household chores (over 6 h and 30 min) at both time points. When children were aged 12 months, approximately three and a half hours were spent on childcare activities for children under the age of 2 years. When children were 18 months old, mothers spent more time on income generating activities (30 min) than when the children were 12 years old, and on leisure (approximately 4 h and 30 min). When children were 18 months old, less time was spent on feeding/breastfeeding children (30 min less) and playing with children (15 min). However, mothers spent more time talking or reading to children at 18 months than at 12 months.ConclusionWe find that within a relatively short period of time in early childhood, maternal (or caregiver) time use can change, with time allocation being diverted away from childcare activities to others. This suggests that changing maternal time allocation in resource poor households may be quite challenging, and not allow the uptake of new and/or optimal behaviours.</jats:sec

Can home visits for early child development be implemented with sufficient coverage and quality at scale? Evidence from the SPRING program in India and Pakistan

IntroductionThere is limited evidence from low and middle-income settings on the effectiveness of early child development interventions at scale. To bridge this knowledge-gap we implemented the SPRING home visiting program where we tested integrating home visits into an existing government program (Pakistan) and employing a new cadre of intervention workers (India). We report the findings of the process evaluation which aimed to understand implementation.Methods and materialsWe collected qualitative data on acceptability and barriers and facilitators for change through 24 in-depth interviews with mothers; eight focus group discussions with mothers, 12 with grandmothers, and 12 with fathers; and 12 focus group discussions and five in-depth interviews with the community-based agents and their supervisors.ResultsImplementation was sub-optimal in both settings. In Pakistan issues were low field-supervision coverage and poor visit quality related to issues scheduling supervision, a lack of skill development, high workloads and competing priorities. In India, issues were low visit coverage - in part due to employing new workers and an empowerment approach to visit scheduling. Coaching caregivers to improve their skills was sub-optimal in both sites, and is likely to have contributed to caregiver perceptions that the intervention content was not new and was focused on play activities rather than interaction and responsivity - which was a focus of the coaching. In both sites caregiver time pressures was a key reason for low uptake among families who received visits.DiscussionPrograms need feasible strategies to maximize quality, coverage and supervision including identifying and managing problems through monitoring and feedback loops. Where existing community-based agents are overstretched and system strengthening is unlikely, alternative implementation strategies should be considered such as group delivery. Core intervention ingredients such as coaching should be prioritized and supported during training and implementation. Given that time and resource constraints were a key barrier for families a greater focus on communication, responsivity and interaction during daily activities could have improved feasibility

Comparative Effects of Different Types of Biochar on Physical Properties of Soil And Growth of Maize

The current pot trial was conducted to estimate the impacts of different types of biochar on the growth and nutrients availability of maize (Zea mays) and their effects on the properties of soil. Treatments including four different feedstock based biochar i.e wheat straw, rice husk, corn cob and wood bark were applied to the soil in 10 kg pots @ 1.5% w/w. The experiment was carried out using complete randomized design (CRD). The crop was harvested after the plants have completed their vegetative growth. Physiological parameters of the crop (plant height, leaf area, chlorophyll content) were measured before harvesting while shoot mass (fresh and dry) and root mass (fresh and dry) were calculated after harvesting of the crop. The data showed a significant difference when compared with the control. Plant height was significantly increased from 140cm (control) to 159.9cm in T4 (wood bark biochar). Experimental soil was analyzed in the laboratory for NPK, water aggregate stability, organic matter and active carbon. Wet aggregate stability value of the soil was improved from 17.82% to 19.5%. Similarly soil active carbon was significantly improved from 259.33 ppm to 321.25 ppm. The data showed more significant results of wood bark biochar. Nutrient availability in the soil and plant nutrients uptake N (21.6%), P (31.25%) and K (45%) was increased as a results of biochar incorporation in the soil