Adaptive And Reliable GPS Uncertain Position Estimation an Insightful Oceanography and Geography Applications

Location evaluation applications are one of the most imperative services in GPS position applications. The Global Positioning Systems (GPS) is a versatile and legacy technology has been providing a reliable and accurate position of objects on Earth. The uncertain GPS position is considered an initialization parameter for many inherent systems in today’s world. This initialization position estimate has a wide variety of applications such as Coast line maps, understanding the geo-dynamical phenomena such as volcanic eruptions, earthquakes and subsequent originating source mechanisms, Mean Sea level estimation for contours of land surfaces, Oceanic en-route as well as in mobile and Vehicular technologies etc. The validation and reliability of the results of all those applications is dependent on the accuracy of the position estimate given by GPS. In this work an attempt is made to retrieve accurate and reliable position parameters from GPS by correcting the measurement errors for all the visible satellites at every epoch. The maximum and minimum pseudo ranges in L2 signal observed are 2437404.2 meters and -76295.22 meters

GEOTEXTILE USING IN ROAD PAVEMENT DESIGNS AND CONSTRUCTION

Geotextiles are the enterable fabrics that, when used together with soil has the proficiency to independent, dribble, boost, cushion, or sap. Typically in regard to polypropylene or polyester, geotextile fabrics reach triple essential forms: wreathed, bedevil stamped, or heat manacled. The imaginative and nevertheless constantly used term for geotextiles is dribble fabrics. Geotextiles have many applications and directly relief many courteous architecture applications not to mention roads, airstrip, embankments, hiring structures, reservoirs and system site. Geotextiles have a crucial role in the system of paved roads over areas having high dirt aquifer. There are specific key applications, the system of concretes, in blacktop dried overlays and for package systems, and that helps in enhancing the dance and spreading the serviceable life of roads. Drainage of spray from asphalts has ever been a prominent evidence infiltration invent. When just as a sap, geo-textiles perform a pipeline for the flow of splashing or gases in the airplane of geo-textile. Some of the geo-textiles used for diminishing are wicked diminishes and carpet diminish. In this report, different options applicable to the local engineers in the use of geo-textile in the sidewalk diminishing systems have been highlighted

A RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED, PARALLEL GROUP CLINICAL STUDY TO EVALUATE THE ANALGESIC EFFECT OF AQUEOUS EXTRACT OF TERMINALIA CHEBULA, A PROPRIETARY CHROMIUM COMPLEX, AND THEIR COMBINATION IN SUBJECTS WITH JOINT DISCOMFORT

Objective: To evaluate the analgesic effect of an aqueous extract of Terminalia chebula (TCE), a proprietary chromium complex (PCC), and theircombination in subjects with joint discomfort.Methods: A total of 100 patients with knee joint discomfort were randomized into five treatment groups - TCE 500 mg BID, TCE 500 mg BID+PCC400 µg OD, PCC 400 µg OD alone, placebo, and TCE 250 mg BID, for 12 weeks in a double-blinded manner. Assessment of symptoms of knee joint painand discomfort was done by modified Western Ontario and McMaster Universities Arthritis Index (mWOMAC) and knee swelling index (KSI); visualanalog scale (VAS) was used for subjective assessment of pain, stiffness, and disability. Statistical analysis was done with GraphPad Prism 6.Results: Absolute reduction in mWOMAC score in TCE 500 mg (19.82±8.35), TCE 500 mg+PCC 400 µg (13.10±5.69), PCC 400 µg (8.30±3.81), placebo(2.45±3.07), and TCE 250 mg (10.47±4.43), respectively, at the end of 12 weeks as compared to the baseline values. Absolute reduction in KSI inTCE 500 mg (28.95±16.82), TCE 500 mg+PCC 400 µg (19.14±9.50), PCC 400 µg (12.7±4.86), placebo (10.03±3.8), and TCE 250 mg (18.24±6.86),respectively, at the end of 12 weeks as compared to the baseline values (p<0.001). Similar results were seen with VAS assessments for pain, stiffness,and disability. All the treatments were well tolerated.Conclusion: TCE and PCC reduce joint discomfort.Keywords: Terminalia chebula extract, Proprietary chromium complex, Western Ontario and McMaster Universities Arthritis Index

Evaluation Of The Complications Associated With ORIF In The Management Of Mandibular Fractures- A 7 Years Retrospective Study

Aim: This study is intended to evaluate the incidence of post-operative complications associated with ORIF in the management of mandibular fracturesMaterials and Method: A total of 224 patients who were diagnosed clinically and radiographically to have sustained mandibular fractures and were managed with ORIF between the period of June 2012 to May 2019 were included. Patient’s records were analysed to evaluate the incidence of post-operative complications that are associated with ORIF in the management of mandibular fractures.Results: It was observed that patients who underwent ORIF for the management of condylar fractures reported with relatively higher number of complications when compared to mandibular angle / body / parasymphysis fractures. Wound dehiscence, occlusal disturbance, paresthesia and infection leading to the removal of miniplates in general are the notable complications following ORIF.Conclusion: It can be concluded that the most common complications associated with ORIF in the management of mandibular fractures were majorly due to the surgical approach used than the type of fixation devices/techniques

Correlation between endothelial dysfunction, inflammatory status, oxidative stress and total (nitrite/ nitrate) in subjects with diabetes mellitus type 2

Background: Diabetes Mellitus is a systemic metabolic disorder associated with Endothelial dysfunction and increased systemic inflammatory state with oxidative stress leading to increased Cardiovascular risk. This study planned to correlate the level of Endothelial dysfunction with oxidative stress and inflammatory status.Methods: Study was conducted in 60 Diabetes Mellitus subjects of both genders with duration of more than two years. Endothelial dysfunction assessed as Augmentation Pressure and Augmentation Index generated from Radial artery waveforms by tonometer using Spygmocor PWA system. Plasma Total Nitrite/ Nitrate, High sensitive C - Reactive Protein, Malondialdehyde and Glutathione were measured.Results: Out of total 60 Diabetes Mellitus subjects 16 subjects were with Coronary Artery Disease. There was no significant difference in High sensitive C - Reactive Protein, Glutathione, Malondialdehyde and Total Nitrite/ Nitrate between Diabetes Mellitus with Coronary Artery Disease and without Coronary Artery Disease, however significant difference (p=0.02) was observed Augmentation Pressure between Diabetic alone (12.8±5.19 mm of Mercury) and diabetics with Coronary Artery Disease (16.13±33.47 mm of Mercury) and Augmentation Index (p=0.04) between Diabetic alone (29.8±5.68 mm of Mercury) and diabetics with Coronary Artery Disease (40.01±5.74). As endothelial function is age dependent the subjects were divided into three age groups (20-40 years, 40-60 years and more than 60 years). High sensitive C - Reactive Protein, Glutathione, Malondialdehyde, Total Nitrite/ Nitrate and Augmentation Index did not differ in the three age groups while Augmentation Pressure (p=0.0096) showed significant difference between age group 20-40 years (10.59±3.24) and age group more than 60 years (15.83±3.92).Conclusions: There is significant endothelial dysfunction observed in Diabetes Mellitus subjects and Diabetes Mellitus with coronary artery disease showed greater endothelial dyfunction. Thereby concluding that Diabetes Mellitus subjects were at higher risk for development of coronary artery disease and as endothelial dysfunction is an early event, it may have some prognostic value

Thioridazine: a potential adjuvant in pharmacotherapy of drug resistant tuberculosis Ki

Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis. Despite advances in control strategies, inadequate treatment and failure to comply with drug regimens have resulted in TB to emerge as one of the most common and deadly infectious diseases worldwide. The emergence of drug-resistant TBhas evolved as a formidable obstacle for comprehensive TB control. Drug-resistant TB can be classified as multi-drug-resistant TB, extensively drug-resistant TB and totally drug resistant TB (TDR-TB). There is a paucity in the development of new drugs against drug-resistant mycobacteria. The focus has shifted to the exploration of anti-mycobacterial properties of drugs approved for other indications. Thioridazine, a drug approved for use in schizophrenia is one such potential agent, which has shown anti-mycobacterial activity. There is evidence of anti-mycobacterial action of Thioridazine in in-vitro and mouse models. There is a compelling need for new anti-mycobacterial drugs that are more effective and have less toxicity. Further clinical trials are advocated favoring the use of thioridazine as an adjuvant in the treatment of TB, especially TDR-TB

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Randomized Clinical Trial of High-Dose Rifampicin With or Without Levofloxacin Versus Standard of Care for Pediatric Tuberculous Meningitis: The TBM-KIDS Trial

Background. Pediatric tuberculous meningitis (TBM) commonly causes death or disability. In adults, high-dose rifampicin may reduce mortality. The role of fluoroquinolones remains unclear. There have been no antimicrobial treatment trials for pediatric TBM. Methods. TBM-KIDS was a phase 2 open-label randomized trial among children with TBM in India and Malawi. Participants received isoniazid and pyrazinamide plus: (i) high-dose rifampicin (30 mg/kg) and ethambutol (R30HZE, arm 1); (ii) high-dose rifampicin and levofloxacin (R30HZL, arm 2); or (iii) standard-dose rifampicin and ethambutol (R15HZE, arm 3) for 8 weeks, followed by 10 months of standard treatment. Functional and neurocognitive outcomes were measured longitudinally using Modified Rankin Scale (MRS) and Mullen Scales of Early Learning (MSEL). Results. Of 2487 children prescreened, 79 were screened and 37 enrolled. Median age was 72 months; 49%, 43%, and 8% had stage I, II, and III disease, respectively. Grade 3 or higher adverse events occurred in 58%, 55%, and 36% of children in arms 1, 2, and 3, with 1 death (arm 1) and 6 early treatment discontinuations (4 in arm 1, 1 each in arms 2 and 3). By week 8, all children recovered to MRS score of 0 or 1. Average MSEL scores were significantly better in arm 1 than arm 3 in fine motor, receptive language, and expressive language domains (P < .01). Conclusions. In a pediatric TBM trial, functional outcomes were excellent overall. The trend toward higher frequency of adverse events but better neurocognitive outcomes in children receiving high-dose rifampicin requires confirmation in a larger trial. Clinical Trials Registration. NCT02958709