Mobile Audiometry Application

The Mobile Audiometry Application hopes to utilize the ubiquity of the mobile device by providing a means of healthcare focused on audiometry. This application enables a mobile device to perform audiometric testing to detect a user\u27s hearing range, and notify the user whether he or she is suffering from hearing loss. This project seeks to fulfill a social need for increased access to hearing testing by providing a portable, affordable, and reliable screening tool that is accurate. The result was sleek application that provided a calibration method, executed an audiometry test using accurate and calibrated files, displayed the results graphically, and notified the user of hearing loss. The application also let the user save their test results under created profiles, using local storage, and peruse the saved results at a later time

Airborne LiDAR and high resolution satellite data for rapid 3D feature extraction

This work uses the canopy height model (CHM) based workflow for individual tree crown delineation and 3D feature extraction approach (Overwatch Geospatial's proprietary algorithm) for building feature delineation from high-density light detection and ranging (LiDAR) point cloud data in an urban environment and evaluates its accuracy by using very high-resolution panchromatic (PAN) (spatial) and 8-band (multispectral) WorldView-2 (WV-2) imagery. LiDAR point cloud data over San Francisco, California, USA, recorded in June 2010, was used to detect tree and building features by classifying point elevation values. The workflow employed includes resampling of LiDAR point cloud to generate a raster surface or digital terrain model (DTM), generation of a hill-shade image and an intensity image, extraction of digital surface model, generation of bare earth digital elevation model (DEM) and extraction of tree and building features. First, the optical WV-2 data and the LiDAR intensity image were co-registered using ground control points (GCPs). The WV-2 rational polynomial coefficients model (RPC) was executed in ERDAS Leica Photogrammetry Suite (LPS) using supplementary?.RPB file. In the second stage, ortho-rectification was carried out using ERDAS LPS by incorporating well-distributed GCPs. The root mean square error (RMSE) for the WV-2 was estimated to be 0.25 m by using more than 10 well-distributed GCPs. In the second stage, we generated the bare earth DEM from LiDAR point cloud data. In most of the cases, bare earth DEM does not represent true ground elevation. Hence, the model was edited to get the most accurate DEM/ DTM possible and normalized the LiDAR point cloud data based on DTM in order to reduce the effect of undulating terrain. We normalized the vegetation point cloud values by subtracting the ground points (DEM) from the LiDAR point cloud. A normalized digital surface model (nDSM) or CHM was calculated from the LiDAR data by subtracting the DEM from the DSM. The CHM or the normalized DSM represents the absolute height of all aboveground urban features relative to the ground. After normalization, the elevation value of a point indicates the height from the ground to the point. The above-ground points were used for tree feature and building footprint extraction. In individual tree extraction, first and last return point clouds were used along with the bare earth and building footprint models discussed above. In this study, scene dependent extraction criteria were employed to improve the 3D feature extraction process. LiDAR-based refining/ filtering techniques used for bare earth layer extraction were crucial for improving the subsequent 3D features (tree and building) feature extraction. The PAN-sharpened WV-2 image (with 0.5 m spatial resolution) was used to assess the accuracy of LiDAR-based 3D feature extraction. Our analysis provided an accuracy of 98% for tree feature extraction and 96% for building feature extraction from LiDAR data. This study could extract total of 15143 tree features using CHM method, out of which total of 14841 were visually interpreted on PAN-sharpened WV-2 image data. The extracted tree features included both shadowed (total 13830) and non-shadowed (total 1011). We note that CHM method could overestimate total of 302 tree features, which were not observed on the WV-2 image. One of the potential sources for tree feature overestimation was observed in case of those tree features which were adjacent to buildings. In case of building feature extraction, the algorithm could extract total of 6117 building features which were interpreted on WV-2 image, even capturing buildings under the trees (total 605) and buildings under shadow (total 112). Overestimation of tree and building features was observed to be limiting factor in 3D feature extraction process. This is due to the incorrect filtering of point cloud in these areas. One of the potential sources of overestimation was the man-made structures, including skyscrapers and bridges, which were confounded and extracted as buildings. This can be attributed to low point density at building edges and on flat roofs or occlusions due to which LiDAR cannot give as much precise planimetric accuracy as photogrammetric techniques (in segmentation) and lack of optimum use of textural information as well as contextual information (especially at walls which are away from roof) in automatic extraction algorithm. In addition, there were no separate classes for bridges or the features lying inside the water and multiple water height levels were also not considered. Based on these inferences, we conclude that the LiDAR-based 3D feature extraction supplemented by high resolution satellite data is a potential application which can be used for understanding and characterization of urban setup

Enhanced urban landcover classification for operational change detection study using very high resolution remote sensing data

This study presents an operational case of advancements in urban land cover classification and change detection by using very high resolution spatial and multispectral information from 4-band QuickBird (QB) and 8-band WorldView-2 (WV-2) image sequence. Our study accentuates quantitative, pixel based, image difference approach for operational change detection using very high resolution pansharpened QB and WV-2 images captured over San Francisco city, California, USA (37° 44" 30N', 122° 31" 30' W and 37° 41" 30'N,122° 20" 30' W). In addition to standard QB image, we compiled three multiband images from eight pansharpened WV-2 bands: (1) multiband image from four traditional spectral bands, i.e., Blue, Green, Red and near-infrared 1 (NIR1) (henceforth referred as "QB equivalent WV-2"), (2) multiband image from four new spectral bands, i.e., Coastal, Yellow, Red Edge and NIR2 (henceforth referred as "new band WV-2"), and (3) multiband image consisting of four traditional and four new bands (henceforth referred as "standard WV-2"). All the four multiband images were classified using support vector machine (SVM) classifier into four most abundant land cover classes, viz, hard surface, vegetation, water and shadow. The assessment of classification accuracy was performed using random selection of 356 test points. Land cover classifications on "standard QB" image (kappa coeffiecient, κ = 0.93), "QB equivalent WV-2" image (κ = 0.97), and "new band WV-2" image (κ = 0.97) yielded overall accuracies of 96.31, 98.03 and 98.31, respectively, while "standard WV-2" image (κ = 0.99) yielded an improved overall accuracy of 99.18. It is concluded that the addition of four new spectral bands to the existing four traditional bands improved the discrimination of land cover targets, due to increase in the spectral characteristics of WV-2 satellite. Consequently, to test the validity of improvement in classification process for implementation in operational change detection application, comparative assessment of transition of various landcover classes in three WV-2 images with respect to "standard QB" image was carried out using image difference method. As far as waterbody class is concerned, there was no significant transition observed in all the three WorldView-2 Images, whereas, hard surface class showed lowest transition in "standard WV-2" image and highest in case of "new band WV-2". The most significant transition was occurred in vegetation class in all of the three images, showing positive change (increase) in standard WV-2 image (0.31 Sq. Km) and negative change (decrease) in other two images (-0.12 Sq. Km for "QB equivalent WV-2" image and -31.15 Sq. Km in "new band WV-2" image) with considerable amount. Similar case was observed with the shadow class, but the difference is, transition from shadow to other classes was negative in all the three WV-2 images which can be attributed to the fact that, "standard QB" image had more shadow area (based on acquisition time and sun position) than WV-2, that means all the band combinations of WV-2 succeeded in extracting the features hidden below the shadow in "standard QB" image. These trends indicate that the overall bandwise transition in landcover classes in case of "standard WV-2" is more precise than other two images. We note that "QB equivalent WV-2" image had narrower band widths than those of "standard QB" image but the observed vegetation change is not prominent as in case of other two images, but at the same time, transition in hard surface and waterbody was discerned more efficiently than "new band WV-2" image. The addition of new bands in WV-2 enabled more effective vegetation analysis, so the vegetation transition results shown by "new band WV-2" image were at par with the "standard WV-2" image, showing the importance of these newly added bands in the WV-2 imagery, with comparatively lower transitions in other classes. In a nutshell, it can be claimed that incorporation of new bands along with even narrower Red, Green, Blue and Near Infrared-1 bands in WV-2 image holds remarkable importance which leads to enhancement in the potential of WV-2 imagery in change detection and other feature extraction studies

Prevalence of elderly patients who refuse to get discharge from coronary intensive care unit in a tertiary care hospital of North India: a pilot study

Background: The elderly population ≥60 years is increasing as the life span is increasing. So is the number of elderly patients who are refusing to get discharge from the hospital is also increasing. Authors are conducting this study in the elderly population who want to stay against medical advice.The aim to find the prevalence of elderly patients who refuse to get discharge from Coronary Care Unit (CCU) in a Tertiary care hospital of North IndiaMethods: A retrospective, observational study conducted in patients of age ≥60 years admitted to the coronary intensive care unit of a tertiary health care centre who refused discharge from the unit, were included in the study. Results: Of the 575 patients 44(7.65%) were willing to stay against medical advice. Of these 24(54.5%) were males and 20(45.5%) females. 6(13.6%) patients were terminally ill suffering from malignancies. Among all the patients who were willing to stay against medical advice, 8(18.2%) were covered by some health insurance scheme of either State or Central Government. 3(6.8%) patients were discharged after 24 hours, 22(50%) patients after 48 hours, 14(31.9%) patients after 72 hours and 5(11.3%) patients after 96 hours of advising discharge from hospital.Conclusions: As the intensive care beds at tertiary healthcare level are limited, the treatment of other salvageable sick patients who need the intensive care is affected by the unnecessary stay in hospital. Apart from the worsened nurse to patient ratio this increases the cost of treatment. This is need of hour to provide safe environment for the elderly outside the hospital settings and increase resources to provide better homecare

Systematic review of public health research on prevention of mother-to-child transmission of HIV in India with focus on provision and utilization of cascade of PMTCT services

BACKGROUND: In spite of effective strategies to eliminate mother-to-child-transmission of HIV, the implementation of such strategies remains a major challenge in developing countries. In India, programs for the prevention of mother-to-child transmission (PMTCT) have been scaled up widely since 2005. However, these programs reach only a small percentage of pregnant women, and their overall effectiveness is low. Evidence-based program planning and implementation could significantly improve their effectiveness. This study sought to systematically retrieve, thematically categorize and review published research on PMTCT of HIV in India, focusing on research related to the provision and/or utilization of the cascade of services provided in a PMTCT program, in order to direct further research to enhance program implementation and effectiveness. METHODS: A systematic search using MEDLINE, US National Library of Medicine Gateway system (PubMed) and ISI Web of Knowledge resulted in 1,944 abstracts, of which 167 met our inclusion criteria. RESULTS: A huge share of the empirical literature on PMTCT in India (N = 134) deals with epidemiological studies (N = 60). The 46 papers related to utilization/provision of the cascade of PMTCT services were mostly from the four high HIV prevalence states in southern India and from the public sector. Studies on experiences of implementing a PMTCT program (N = 20) show high rates of drop out of women in the cascade particularly prior to receiving ARV. Studies on individual components of the cascade (N = 26) show that HIV counseling and testing is acceptable and feasible. Literature on other components of the cascade - such as pregnant women’s access to ANC care, HIV infected women’s immunological assessment using CD4 testing, repeat HIV testing among pregnant women, early infant diagnosis and factors related to linking HIV infected women and children to postnatal care – is lacking. CONCLUSIONS: While the scale of the Indian PMTCT program is large, comprehensive understanding of the context-driven factors affecting its efficiency is lacking. Systematic and more focused public health research output is needed on the issues related to reduction of drop outs of women in the cascade, role of PMTCT programs in improving maternal and child health indicators and role of private sector in delivering PMTCT services

Food Processing: Policy for Rice and Oil Technology in South Asia

RESUMEN Elaboración de alimentos: política tecnológica para el arroz y el aceite en el Sur de Asia Este artículo se refiere a la política seguida al nivel nacional para modernizar la tecnología en la elaboración de alimentos. Se refiere al arroz y al aceite de cacahuete en el Sur de Asia en general, pero con mayor énfasis en la India. En el caso del arroz se examinan críticamente los argumentos que informaron la decisión de asignar recursos públicos al moderno molino arrocero, junto con las consecuencias de esto. Pasa a examinar entonces la modernización de la industria de tratamiento de cacahuetes, que está retrasada una década en relación a la del arroz. Por esta comparación se sacan las conclusiones de la política a seguir para el sector. SUMMARY This article is concerned with public policy for the modernisation of technology in food processing. It focuses on rice and edible groundnut oil in South Asia as a whole, but with most emphasis on India. In the case of rice it looks critically at the arguments which informed the decision to allocate public resources to the modern rice mill, and the consequences of this. It then examines the modernisation of the groundnut processing industry, which is behind that of rice by about a decade. Policy conclusions for the sector are drawn from this comparison. RÉSUMÉ L'industrie alimentaire: la politique de la technologie du riz et des huiles en Asie Méridionale L'article traite de la politique publique de modernisation de la technologie de l'industrie alimentaire. II se concentre sur le riz et l'huile d'arachide comestible en Asie Méridionale généralement, mais le plus fort accent se porte sur l'Inde. Dans le cas du riz, il jette un regard critique sur les arguments à la base de la décision d'allouer des ressources publiques à la Rizerie Moderne, et à ses conséquences. II examine ensuite la modernisation de l'industrie de l'arachide, qui est en arrière de celle du riz d'environ une décennie. Des conclusions de politique pour le domaine sont tirées de cette comparaison

Human B-cell Ontogeny in Humanized NOD/SCID γcnull^{null} Mice Generates a Diverse Yet Auto/Poly- and HIV-1 Reactive Antibody Repertoire

Characterization of the human antibody (Ab) repertoire in mouse models of the human immune system is essential to establish their relevance in translational studies. Single human B-cells were sorted from bone marrow and periphery of humanized NOD/SCID γc$^{null}$ mice at 8–10 months post-engraftment with human cord blood-derived CD34$^+$ stem cells. Human immunoglobulin variable heavy (V$_H$) and kappa (V$_κ$) genes were amplified, cognate V$_H$-V$_κ$ gene-pairs assembled as single-chain variable fragment-Fc antibodies (scFvFcs) and functional studies performed. Although overall distribution of V$_H$ genes approximated the normal human Ab repertoire, analysis of the V$_H$-third complementarity determining regions (H-CDR3) in the mature B-cell subset demonstrated an increase in length and positive charges suggesting autoimmune characteristics. Additionally, >70% of Vκ sequences utilized V$_κ$4-1, a germline gene associated with autoimmunity. The mature B-cell subset-derived scFvFcs displayed the highest frequency of autoreactivity and polyspecificity, suggesting defects in checkpoint control mechanisms. Furthermore, these scFvFcs demonstrated binding to recombinant HIV envelope corroborating previous observations of poly/autoreactivity in anti-HIVgp140 antibodies. These data lend support to the hypothesis that anti-HIV BnAbs may be derived from auto/polyspecific Abs that escaped immune elimination and that the hNSG mouse could provide a new experimental platform for studying the origin of anti-HIV neutralizing Ab responses

Stability-indicating HPLC determination of pramipexole dihydrochloride in bulk drug and pharmaceutical dosage form

A novel stability-indicating high-performance liquid chromatographic assay method was developed and validated for quantitative determination of pramipexole dihydrochloride in bulk drugs and in pharmaceutical dosage form in the presence of degradation products. An isocratic, reversed phase HPLC method was developed to separate the drug from the degradation products, using an Ace5-C18 (250×4.6 mm, 5 µm) advance chromatography column, and 10 mmol L-1 ammonium acetate and acetonitrile (75:25 v/v) as a mobile phase. The detection was carried out at a wavelength of 260 nm. The pramipexole was subjected to stress conditions of hydrolysis (acid, base), oxidation, photolysis and thermal degradation. Degradation was observed for pramipexole in base, in acid and in 30% H2O2. The drug was found to be stable in the other stress conditions attempted. The degradation products were well resolved from the main peak. The percentage recovery of pramipexole was from (99.87 to 99.98%) in the pharmaceutical dosage form. The developed method was validated with respect to linearity, accuracy (recovery), precision, system suitability, specificity and robustness. The forced degradation studies prove the stability indicating power of the method

Retention and mortality outcomes from a community-supported public–private HIV treatment programme in Myanmar

Introduction: There is a growing interest in the potential contribution the private sector can make towards increasing access to antiretroviral therapy (ART) in low- and middle-income settings. This article describes a public–private partnership that was developed to expand HIV care capacity in Yangon, Myanmar. The partnership was between private sector general practitioners (GPs) and a community-based non-governmental organization (International HIV/AIDS Alliance). Methods: Retrospective analysis of 2119 patient records dating from March 2009 to April 2015 was conducted. Outcomes assessed were immunological response, loss to follow-up, all-cause mortality, and alive and retained in care. Follow-up time was calculated from the date of registration to the date of death, loss to follow-up, transfer out, or if still alive and known to be in care, until April 2015. Cox proportional hazards model was used to identify predictors of loss to follow-up and mortality. Kaplan–Meier survival analysis was used to estimate survival function of being alive and retained in care. Results: The median number of patients for each of the 16 GPs was 42 (interquartile range (IQR): 25–227), and the median follow-up period was 13 months. The median patient age was 35 years (IQR: 30–41); 56.6% were men, 62 and 11.8% were in WHO Stage III and Stage IV at registration, respectively; median CD4 count at registration was 177 cells/mm3; and 90.7% were on ART in April 2015. The median CD4 count at registration increased from 122 cells/mm3 in 2009 to 194 cells/mm3 in 2014. Among patients on ART, CD4 counts increased from a median of 187 cells/mm3 at registration to 436 cells/mm3 at 36 months. The median time to initiation of ART among eligible patients was 29 days, with 93.8% of eligible patients being initiated on ART within 90 days. Overall, 3.3% patients were lost to follow-up, 4.2% transferred out to other health facilities, and 8.3% died during the follow-up period. Crude mortality rate was 48.6/1000 person-years; 42% (n=74) of deaths occurred during the pre-ART period and 39.8% (n=70) occurred during the first six months of ART. Of those who died during the pre-ART period, 94.5% were eligible for ART. In multivariate regression, baseline CD4 count and ART status were independent predictors of mortality, whereas ART status, younger age and patient volumes per provider were predictors of loss to follow-up. Probability of being alive and retained in care at six months was 96.8% among those on ART, 38.5% among pre-ART but eligible patients, and 20.0% among ART-ineligible patients. Conclusions: Effectively supported private sector GPs successfully administered and monitored ART in Myanmar, suggesting that community-supported private sector partnerships can contribute to expansion of HIV treatment and care capacity. To further improve patient outcomes, early testing and initiation of ART, combined with close clinical monitoring and support during the initial periods of enrolling in treatment and care, are required