Performance of Public-Private-Partnership Model of Veterinary Services in West Bengal

ABSTRAC

Climate change awareness among the livestock rearers of east coast of India

The phenomenon of global climate change is directly affecting the livestock production system world overall. Therefore, understanding the changing climatic scenario by the millions of resource poor livestock rearers across the east coast of India found to be imperative to get information for strategic planning to improve the livelihoods of rural people. But, systematic methodology to assess climatic change awareness among the livestock rearers is currently not available. Therefore, a psychometric scale entitled “Climate Change Awareness Scale” was developed and applied among the randomly selected 480 livestock rearers of eastern coastal region of India. Results reflected majority of the population exhibit their strong level of awareness towards changing climatic scenario in general and particularly towards broad spectrum of climate change like causes, features, effects and impacts. It was also found that 37.188% of livestock rearers of coastal region were having higher level of awareness followed by 31.973% and 30.839% were having lower and medium level of awareness. Comparisons of state of awareness with the factual climatic data validated farmers’ claim and established the authenticity of the psychometric tool. Hence, this study will provide a significant tool for researchers and policy makers to assess state of climate change awareness among the end users and to develop appropriate adaptation strategies to minimize the risk of livestock sector to climate change

Combination of finasteride and flutamide as potency-sparing hormone ablation therapy in management of advanced carcinoma of prostate

Complete androgen blockade by LHRH agonist /Orchiectomy plus antiandrogen results in androgen deficiency amongst males (ADAM). We treated advanced cancer prostate with finasteride and flutamide with an aim of potency sparing in relatively younger males with the disease. 45 sexually active males between the age of 48 to 65 having advanced cancer of prostate were treated, for 1 year with Flutamide (750mg) and Finasteride (5mg) daily and followed up for 18 months. Results showed 89% having low PSA and 80% maintained their sexual potency. Side effects were mild: 20% of patients developing diarrhoea, gynaecomastia and hot flushes with good drug compliance. This combination is ideal as potency sparing androgen ablation therapy for advanced cancer of prostate among young & sexually active males

Adapting to climate change: Traditional coping mechanism followed by the <i>Brokpa </i>pastoral nomads of Arunachal Pradesh, India

752-761Transhumance system of livelihood of the Brokpa pastoral nomads inhabiting in the yak tracts of Arunachal Pradesh with special emphasis on climate change adaptation was assessed in the present study. A representative sample of the 240 Brokpa pastoral nomads from all the yak rearing tracts of Arunachal Pradesh was selected randomly. The Brokpa pastoral nomads mainly depend upon livestock, like yak, yak-cattle hybrid etc, rearing for their livelihood. They perceived that season cycle has been changed in lower and mid altitude. They also perceived that onset of summer is getting started 1-2 month(s) earlier than before and also extended by 2-3 months. Therefore, Brokpa pastoral nomads of Arunachal Pradesh have expanded their migration duration by 2-3 months in searching of congenial environment for their livestock specially yak and yak-cattle hybrid. They adopted 10 coping mechanisms to cope up with negative impact of climate change. Among the coping mechanisms, ‘duration of migration has expanded by 2-3 months’ and ‘change in pasture utilization practice’ were found to be mostly adopted

Machine learning driven intelligent and self adaptive system for traffic management in smart cities

Traffic congestion is becoming a serious problem with the large number of vehicle on the roads. In the traditional traffic control system, the timing of the green light is adjusted regardless of the average traffic rate at the junction. Many strategies have been introduced to solve and improve vehicle management. However, in order to handle road traffic issues, an intelligent traffic management solution is required. This article represents a self adaptive real-time traffic light control algorithm based on the traffic flow. We present a machine learning approach coupled with image processing to manage the traffic clearance at the signal junction. The proposed system utilizes single image processing via neural network and You Only Look Once (YOLOv3) framework to establish traffic clearance at the signal. We employed YOLO architectures because it is accurate in terms of mean average precision (mAP), interaction over union (IOU) values and fast in object detection tasks as well. It runs significantly faster than other detection methods with comparable performance. The average processing time of single image was estimated to be 1.3 s. Further based on the input from YOLO we estimated the ‘on’ time period green light for effective traffic clearance. Several real time parameters like number of vehicles (two wheelers, four wheelers), road width and junction crossing time are considered to estimate the ‘on’time of green light. Moreover, we used the real traffic images to test the performance and trained the system with different dataset. Our experiments investigation reveals that the predicted vehicle counts were well matched with the actual vehicle count and proposed method apprehended an average accuracy of 81.1%. The reported strategy is self adaptive, highly accurate, fast and has the potential to be implemented in the traffic clearance at the junctions.Scopu

Intubation Practices and Adverse Peri-intubation Events in Critically Ill Patients from 29 Countries

Importance: Tracheal intubation is one of the most commonly performed and high-risk interventions in critically ill patients. Limited information is available on adverse peri-intubation events. Objective: To evaluate the incidence and nature of adverse peri-intubation events and to assess current practice of intubation in critically ill patients. Design, Setting, and Participants: The International Observational Study to Understand the Impact and Best Practices of Airway Management in Critically Ill Patients (INTUBE) study was an international, multicenter, prospective cohort study involving consecutive critically ill patients undergoing tracheal intubation in the intensive care units (ICUs), emergency departments, and wards, from October 1, 2018, to July 31, 2019 (August 28, 2019, was the final follow-up) in a convenience sample of 197 sites from 29 countries across 5 continents. Exposures: Tracheal intubation. Main Outcomes and Measures: The primary outcome was the incidence of major adverse peri-intubation events defined as at least 1 of the following events occurring within 30 minutes from the start of the intubation procedure: cardiovascular instability (either: systolic pressure &lt;65 mm Hg at least once, &lt;90 mm Hg for &gt;30 minutes, new or increase need of vasopressors or fluid bolus &gt;15 mL/kg), severe hypoxemia (peripheral oxygen saturation &lt;80%) or cardiac arrest. The secondary outcomes included intensive care unit mortality. Results: Of 3659 patients screened, 2964 (median age, 63 years; interquartile range [IQR], 49-74 years; 62.6% men) from 197 sites across 5 continents were included. The main reason for intubation was respiratory failure in 52.3% of patients, followed by neurological impairment in 30.5%, and cardiovascular instability in 9.4%. Primary outcome data were available for all patients. Among the study patients, 45.2% experienced at least 1 major adverse peri-intubation event. The predominant event was cardiovascular instability, observed in 42.6% of all patients undergoing emergency intubation, followed by severe hypoxemia (9.3%) and cardiac arrest (3.1%). Overall ICU mortality was 32.8%. Conclusions and Relevance: In this observational study of intubation practices in critically ill patients from a convenience sample of 197 sites across 29 countries, major adverse peri-intubation events - in particular cardiovascular instability - were observed frequently

Rationale, design, and baseline characteristics in Evaluation of LIXisenatide in Acute Coronary Syndrome, a long-term cardiovascular end point trial of lixisenatide versus placebo

BACKGROUND: Cardiovascular (CV) disease is the leading cause of morbidity and mortality in patients with type 2 diabetes mellitus (T2DM). Furthermore, patients with T2DM and acute coronary syndrome (ACS) have a particularly high risk of CV events. The glucagon-like peptide 1 receptor agonist, lixisenatide, improves glycemia, but its effects on CV events have not been thoroughly evaluated. METHODS: ELIXA (www.clinicaltrials.gov no. NCT01147250) is a randomized, double-blind, placebo-controlled, parallel-group, multicenter study of lixisenatide in patients with T2DM and a recent ACS event. The primary aim is to evaluate the effects of lixisenatide on CV morbidity and mortality in a population at high CV risk. The primary efficacy end point is a composite of time to CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for unstable angina. Data are systematically collected for safety outcomes, including hypoglycemia, pancreatitis, and malignancy. RESULTS: Enrollment began in July 2010 and ended in August 2013; 6,068 patients from 49 countries were randomized. Of these, 69% are men and 75% are white; at baseline, the mean ± SD age was 60.3 ± 9.7 years, body mass index was 30.2 ± 5.7 kg/m(2), and duration of T2DM was 9.3 ± 8.2 years. The qualifying ACS was a myocardial infarction in 83% and unstable angina in 17%. The study will continue until the positive adjudication of the protocol-specified number of primary CV events. CONCLUSION: ELIXA will be the first trial to report the safety and efficacy of a glucagon-like peptide 1 receptor agonist in people with T2DM and high CV event risk