Performance Evaluation of Manhattan Mobility Model in Mobile Ad-hoc Networks

Mobility model is the foundation of the simulation study of various routing protocols in Mobile Ad-hoc Network (MANET). A Mobile Ad Hoc Network (MANET) is a continuously self-configuring network without infrastructure, where every node functions as a transmitter, router, and data sink. A high mobility of MANET nodes reduces the reliability of network communication. In dynamic networks, high mobility of the nodes makes it very difficult to predict the dynamic network topology and hence route/link failures. NS2 network simulator is used to implement MANET by using Destination-Sequenced Distance Vector (DSDV), Ad Hoc Demand Vector (AODV), and Dynamic Source Routing (DSR) by using mobility generator tool, Bonnmotion-3.0.1 in this paper. This paper compares mobility model on AODV, DSDV, and DSR routing protocols with QoS performance metrics throughput, packet delivery ratio, end to end delay, packet overhead and packet dropping rate

Tools Used in Big Data Analytics

Big data is the current state of the art topic creating its unique place in the research and industry minds to look into depth of topic to get valuable results needed to meet the future data mining and analysis needs. Big data refers to enormous amounts of unstructured data created as a result of high performance applications ranging from scientific to social networks, from e-government to medical information system and so on. So, there also prevails the need of to analyze the data to get valuable data results from it. This paper deals with analytic emphasis on big data and what are the different tools used for big data analysis In this paper, different sections through an overlook on different aspects on big data such as big data analysis, big data storage techniques and tools used for big data analysis

Prevalence of thyroid autoimmunity in sporadic idiopathic hypoparathyroidism in comparison to type 1 diabetes and premature ovarian failure

Context: Thyroid autoimmunity is the most common coexistent endocrinopathy in type 1 diabetes (T1D), Addison's disease, and premature ovarian failure (POF). Although the role of autoimmunity is being investigated in patients with sporadic idiopathic hypoparathyroidism (SIH), there is little information on coexistent thyroid autoimmunity. Objective: Our objective was to assess the prevalence of thyroid peroxidase autoantibodies (TPOAb) and thyroid dysfunction in patients with SIH and its comparison with that in T1D, POF, and Hashimoto's thyroiditis (HT) and age- and sex-matched healthy controls (for SIH). Design and Setting: We conducted a case control study in a tertiary care setting. Patients and Methods: Subjects were consecutive patients with SIH (n = 87), T1D (n = 100), POF (n = 58), and HT (n = 47) and healthy controls (100 females and 64 males). Serum free T3, free T4, TSH, and TPOAb (normal ≤ 34 IU/ml) were measured by electrochemiluminescence assay. Subjects with 1) serum TSH at least 5 μ U/ml along with TPOAb more than 34 IU/ml; 2) TSH at least 10 μ U/ml but normal TPOAb titers; or 3) Graves' disease were considered to have thyroid dysfunction. Results: TPOAb positivity (>34 IU/ml) in females was 14.6% in SIH, 24.1% in POF, and 42.1% in T1D compared with 76.6% in HT and 9% in healthy controls. The frequencies of TPOAb positivity and thyroid dysfunction in patients with SIH were comparable to those in control and POF groups, but significantly less than in T1D and HT groups. Conclusion: The frequencies of TPOAb and thyroid dysfunction were not significantly higher in patients with SIH than in healthy controls, unlike in patients with T1D and POF

Molnupiravir plus usual care versus usual care alone as early treatment for adults with COVID-19 at increased risk of adverse outcomes (PANORAMIC): an open-label, platform-adaptive randomised controlled trial

BackgroundThe safety, effectiveness, and cost-effectiveness of molnupiravir, an oral antiviral medication for SARS-CoV-2, has not been established in vaccinated patients in the community at increased risk of morbidity and mortality from COVID-19. We aimed to establish whether the addition of molnupiravir to usual care reduced hospital admissions and deaths associated with COVID-19 in this population.MethodsPANORAMIC was a UK-based, national, multicentre, open-label, multigroup, prospective, platform adaptive randomised controlled trial. Eligible participants were aged 50 years or older—or aged 18 years or older with relevant comorbidities—and had been unwell with confirmed COVID-19 for 5 days or fewer in the community. Participants were randomly assigned (1:1) to receive 800 mg molnupiravir twice daily for 5 days plus usual care or usual care only. A secure, web-based system (Spinnaker) was used for randomisation, which was stratified by age (<50 years vs ≥50 years) and vaccination status (yes vs no). COVID-19 outcomes were tracked via a self-completed online daily diary for 28 days after randomisation. The primary outcome was all-cause hospitalisation or death within 28 days of randomisation, which was analysed using Bayesian models in all eligible participants who were randomly assigned. This trial is registered with ISRCTN, number 30448031.FindingsBetween Dec 8, 2021, and April 27, 2022, 26 411 participants were randomly assigned, 12 821 to molnupiravir plus usual care, 12 962 to usual care alone, and 628 to other treatment groups (which will be reported separately). 12 529 participants from the molnupiravir plus usual care group, and 12 525 from the usual care group were included in the primary analysis population. The mean age of the population was 56·6 years (SD 12·6), and 24 290 (94%) of 25 708 participants had had at least three doses of a SARS-CoV-2 vaccine. Hospitalisations or deaths were recorded in 105 (1%) of 12 529 participants in the molnupiravir plus usual care group versus 98 (1%) of 12 525 in the usual care group (adjusted odds ratio 1·06 [95% Bayesian credible interval 0·81–1·41]; probability of superiority 0·33). There was no evidence of treatment interaction between subgroups. Serious adverse events were recorded for 50 (0·4%) of 12 774 participants in the molnupiravir plus usual care group and for 45 (0·3%) of 12 934 in the usual care group. None of these events were judged to be related to molnupiravir.InterpretationMolnupiravir did not reduce the frequency of COVID-19-associated hospitalisations or death among high-risk vaccinated adults in the community

Molnupiravir plus usual care versus usual care alone as early treatment for adults with COVID-19 at increased risk of adverse outcomes (PANORAMIC): an open-label, platform-adaptive randomised controlled trial

Background: The safety, effectiveness, and cost-effectiveness of molnupiravir, an oral antiviral medication for SARS-CoV-2, has not been established in vaccinated patients in the community at increased risk of morbidity and mortality from COVID-19. We aimed to establish whether the addition of molnupiravir to usual care reduced hospital admissions and deaths associated with COVID-19 in this population. Methods: PANORAMIC was a UK-based, national, multicentre, open-label, multigroup, prospective, platform adaptive randomised controlled trial. Eligible participants were aged 50 years or older—or aged 18 years or older with relevant comorbidities—and had been unwell with confirmed COVID-19 for 5 days or fewer in the community. Participants were randomly assigned (1:1) to receive 800 mg molnupiravir twice daily for 5 days plus usual care or usual care only. A secure, web-based system (Spinnaker) was used for randomisation, which was stratified by age (&lt;50 years vs ≥50 years) and vaccination status (yes vs no). COVID-19 outcomes were tracked via a self-completed online daily diary for 28 days after randomisation. The primary outcome was all-cause hospitalisation or death within 28 days of randomisation, which was analysed using Bayesian models in all eligible participants who were randomly assigned. This trial is registered with ISRCTN, number 30448031. Findings: Between Dec 8, 2021, and April 27, 2022, 26 411 participants were randomly assigned, 12 821 to molnupiravir plus usual care, 12 962 to usual care alone, and 628 to other treatment groups (which will be reported separately). 12 529 participants from the molnupiravir plus usual care group, and 12 525 from the usual care group were included in the primary analysis population. The mean age of the population was 56·6 years (SD 12·6), and 24 290 (94%) of 25 708 participants had had at least three doses of a SARS-CoV-2 vaccine. Hospitalisations or deaths were recorded in 105 (1%) of 12 529 participants in the molnupiravir plus usual care group versus 98 (1%) of 12 525 in the usual care group (adjusted odds ratio 1·06 [95% Bayesian credible interval 0·81–1·41]; probability of superiority 0·33). There was no evidence of treatment interaction between subgroups. Serious adverse events were recorded for 50 (0·4%) of 12 774 participants in the molnupiravir plus usual care group and for 45 (0·3%) of 12 934 in the usual care group. None of these events were judged to be related to molnupiravir. Interpretation: Molnupiravir did not reduce the frequency of COVID-19-associated hospitalisations or death among high-risk vaccinated adults in the community

QoS Improvement using Enhanced Manhattan Mobility Model on Proposed Ant Colony Optimization Technique in MANETs

616-628In the current Mobile Ad-hoc Network (MANET) route discovery procedure, traffic overflow and overhead may pose a major challenge for a path finding between communicating nodes. Swarm intelligence technique has been applied for various routing problems. We suggest an ant-based bottleneck routing method for MANET to identify weak links in the chosen route for routing overhead and delay issues. During data exchange, it selects the route using a swarm based technique called Ant Colony Optimization (ACO). Initially, we have created node movements by Enhanced Manhattan Mobility Model (EMMM) and then a bottleneck value based ant colony optimization technique is applied. The simulation results show the improvement over existing ACO technique in terms of mobility and pause time. The Quality of Service (QoS) performance metrics showed improvement of 66% in drop rate, 141% in the packet delivery ratio, 42% in packet overhead, 171% in throughput, and 34% in the average end-to-end delay for mobility experiment. There is an improvement of 82% in drop rate, 108% in the packet delivery ratio, 45% in packet overhead, 171% in throughput, and 49% in the average end-to-end delay for a pause time experiment

Effect of Head and Neck Positions on Oropharyngeal Seal Pressure with Baska Mask Versus I- Gel: A Prospective Randomized Interventional Study

Introduction: Airway management is a crucial skill for clinical anaesthesiologists. It is an integral part of general anesthesia, allowing ventilation and oxygenation as well as a mode of anesthetic gas delivery. This study was aimed to compare oropharyngeal seal pressure, peak inspiratory pressure, and exhaled tidal volume in different head and neck positions between two different groups using Baska mask and I-gel in paralyzed adult patients. Methodology: The study population (n=100) was randomly divided into two groups by opaque sealed envelope technique. Group A (n=50) received Baska mask and group B (n=50) received I-gel. Calculated volume of intravenous fluids was started through intravenous line secured with 18G cannula at 8 ml/kg body weight. Anaesthesia was induced in supine position with the patient's head in neutral position, resting on a roll sheet under shoulder. Oropharyngeal seal pressure (OSP) was measured by closing the expiratory valve of the circle system at a fixed gas flow of 3 L/minutes and noting the airway pressure at which equilibrium was reached. Results: Mean oropharyngeal seal pressure at different head and neck position among cases of Baska mask group was higher than cases of I-gel group and this difference in mean oropharyngeal seal pressure at different head and neck position was found to be statistically significant (p value <0.05). Conclusion: Baska mask and I-gel have comparable insertion success rates, insertion time, number of attempts for insertion, ease of insertion, and stable haemodynamic parameters. Hence, both I-gel and Baska mask can be used as ventilatory devices in anesthetized and paralyzed patients

Effect of head rotation on visualisation of carotid artery and jugular vein in ijv cannulation: an observational analytical study

Background: The relationship between the common carotid artery (CCA) and the internal jugular vein (IJV) plays a crucial role in the process of internal jugular vein (IJV) cannulation, and this relationship often undergoes changes with head rotation. Methods: In this analytical, observational study, we aimed to compare the effect of 15-degree and 45-degree head rotation on the visualization of the IJV and CCA among 30 patients undergoing IJV cannulation for central venous access. Ultrasound guidance was used during the cannulation procedure. Results: Our findings revealed that greater overlapping of the IJV, specifically at the 12 o'clock position, was observed in cases with a 45-degree head rotation, whereas a lesser degree of overlapping (IJV at the 10 o'clock position) was observed with head in the neutral position. Conclusion: Based on our observations, we conclude that maintaining a head neutral position during IJV central line insertion under ultrasound guidance is safer compared to a 45-degree neck rotation. This information can contribute to improved safety and efficacy during IJV cannulation procedures