Compact rover surveying and laser scanning for BIM development

This paper presents a custom made small rover based surveying, mapping and building information modeling solution. Majority of the commercially available mobile surveying systems are larger in size which restricts their maneuverability in the targeted indoor vicinities. Furthermore their functional cost is unaffordable for low budget projects belonging to developing markets. Keeping in view these challenges, an economical indigenous rover based scanning and mapping system has developed using orthogonal integration of two low cost RPLidar A1 laser scanners. All the instrumentation of the rover has been interfaced with Robot Operating System (ROS) for online processing and recording of all sensorial data. The ROS based pose and map estimations of the rover have performed using Simultaneous Localization and Mapping (SLAM) technique. The perceived class 1 laser scans data belonging to distinct vicinities with variable reflective properties have been successfully tested and validated for required structural modeling. Systematically the recorded scans have been used in offline mode to generate the 3D point cloud map of the surveyed environment. Later the structural planes extraction from the point cloud data has been done using Random Sampling and Consensus (RANSAC) technique. Finally the 2D floor plan and 3D building model have been developed using point cloud processing in appropriate software. Multiple interiors of existing buildings and under construction indoor sites have been scanned, mapped and modelled as presented in this paper. In addition, the validation of the as-built models have been performed by comparing with the actual architecture design of the surveyed buildings. In comparison to available surveying solutions present in the local market, the developed system has been found faster, accurate and user friendly to produce more enhanced structural results with minute details

Kashmiri refugees at the verge of hepatitis B and C epidemic in the State of Azad Jammu and Kashmir, Pakistan

OBJECTIVE: To determine the seroprevalence of hepatitis B and C among immigrants residing refugee camps in Muzaffarabad, Azad Kashmir, Pakistan, and to identify possible risk factors for HBV and HCV transmission. METHODS: Around 1,225 individuals inhabiting Muzaffarabad refugee camps, participated in the study. A qualitative Immuno-Chromatographic Technique was used for initial screening and PCR test was used for detection of HBV and HCV in participants. The major risk factors for HBV and HCV transmission were assessed using a questionnaire approach. RESULTS: Around 86 (7.0%) individuals were observed for HBsAg presence, and 215 (17.5%) individuals were found positive for Anti-HCV. Only 32 (2.6%) individuals were confirmed for HBV DNA and 126 (10.3%) individuals were positive for HCV RNA after PCR. Demographically, both HBsAg and Anti-HCV were found more prevalent in female (4.4% HBsAg and 10.8% Anti-HCV) population as compared to male (2.6% HBsAg and 6.7% Anti-HCV) population. Surprisingly, the HBsAg (23.5%) and Anti-HCV (41.1%) appeared to be more frequent in the age group 62–75 years. Previous history of hepatitis in the family (p < 0.0001), blood transfusion (p = 0.0197) dental treatment (p < 0.0001) and tattooing or piercing on any part of the body (p = 0.0028) were assessed as significant risk factors in HBV and HCV transmission. CONCLUSIONS: Presence of 7.0% HBsAg and 17.5% Anti-HCV in a small fragment of the migrant population cannot be overlooked. Lack of awareness among people and negligence of health department could escalate the situation

Skeletal Traction Followed by Plaster of Paris vs Open Reduction and Internal Fixation – Comparison of the Functional and Radiological Outcome of the Two Treatment Modalities in Schatzker Type V and VI Tibial Fractures

Objective: To compare the functional and radiological outcomes of Schatzker type V and VI tibialfractures for the two currently employed treatment modalities.Methodology: It was a quasi-experimental study conducted at Orthopedics department. Patientswere admitted through ER and OPD of Mayo hospital Lahore over a period of 1 year. Total 84 patientswere included in the study. Patients were divided into two groups. Patients in Group A weremanaged with skeletal traction for 2 weeks followed by plaster of Paris back splint applied for next 2weeks followed by plaster of Paris casting for stabilization of the fracture for another next 4 weeks.Patients in Group B were managed with ORIF by wires, screws or plates. Functional andRadiographic evaluations were performed to assess pain, range of motion weight bearing andfracture union in each follow-up visitResults: In this study functional outcome of patients was significantly better and higher in patientswho were treated with ORIF techniqueConclusion: ORIF is more effective for treating Schatzker type V and VI tibial fracture in terms offunctional and radiological outcome as that skeletal traction followed by plaster of Paris casting.Keywords: Skeletal Traction; ORIF; Schatzker type V; Schatzker type VI; Tibial Fractur

Security concepts in emerging 6G communication: threats, countermeasures, authentication techniques and research directions

Challenges faced in network security have significantly steered the deployment timeline of Fifth Generation (5G) communication at a global level; therefore, research in Sixth Generation (6G) security analysis is profoundly necessitated. The prerogative of this paper is to present a survey on the emerging 6G cellular communication paradigm to highlight symmetry with legacy security concepts along with asymmetric innovative aspects such Artificial Intelligence (AI), Quantum Computing, Federated Learning, etc. We present a taxonomy of the threat model in 6G communication in five security legacy concepts, including Confidentiality, Integrity, Availability, Authentication and Access control (CIA3 ). We also suggest categorization of threat-countering techniques specific to 6G communication into three types: cryptographic methods, entity attributes and Intrusion Detection System (IDS). Thus, with this premise, we distributed the authentication techniques in eight types, including handover authentication, mutual authentication, physical layer authentication, deniable authentication, token-based authentication, certificate-based authentication, key agreement-based authentication and multi-factor authentication. We specifically suggested a series of future research directions at the conclusive edge of this surve

Accuracy of procalcitonin levels for diagnosis of culture-positive sepsis in critically ill trauma patients: A retrospective analysis

Background: Abdominal trauma and intra-abdominal sepsis are associated with significant morbidity and mortality. Microcirculation in the gut is disrupted in hemorrhagic and septic shock leading to tissue hypoxia, and the damaged gut acts as a reservoir rich in inflammatory mediators and provides a continual source of inflammation to the systemic circulation leading to sepsis. Sepsis is defined as the presence (probable or documented) of infection together with a systemic inflammatory response to infection. Blood culture is commonly considered to be the preferred approach for diagnosing sepsis, although it is time-consuming, that is, reports are normally available only after 12-48 hours. Procalcitonin levels (PCT) have recently emerged as a promising biomarker in the diagnosis of sepsis. The aim of the present study is to determine the diagnostic accuracy of PCT levels in predicting sepsis in critically ill trauma patients.Methodology: This was designed as a validation study conducted in the Indoor Department of General Surgery, Liaquat National Hospital, Karachi. The sample size was calculated by taking the estimated frequency of sepsis in suspected patients at 62.13%, expected sensitivity of PCT at 70.83%, and specificity at 84.21% and the desired precision level of 12% for sensitivity; the calculated sample size was 96. The non-probability consecutive sampling method was used to recruit participants who were diagnosed with sepsis on clinical assessment. Blood culture samples were sent for the enrolled patients and a final diagnosis was made on the blood culture report. PCT levels were measured in these suspected patients on the same day of sending blood culture. Diagnostic accuracy of PCT size was measured using the receiver operating characteristic (ROC) curve. ROC curve was formulated for PCT levels against culture-proven sepsis to determine the ideal cut-off value of PCT levels. Two different cut-offs were determined to obtain the highest sensitivity and highest specificity accordingly.Results: A total of 97 individuals met the inclusion criteria with a mean age of 34.89 ± 10.52 years. Mean PCT levels were 0.96 ± 0.59, with a gender predilection towards females (p \u3c 0.001). No age difference was documented among gender (p = 0.655). The mean duration of intensive care unit stay was 11.73 ± 3.56 days. Culture-proven sepsis was identified in 67.0% of the study participants with a higher PCT level (p \u3c 0.001). Among the 52.6% males included in the study, half were reported to have culture-positive sepsis, but among the 47.4% females culture was positive in 87% (p \u3c 0.001). ROC revealed PCT was predictive for culture-positive sepsis at a cut-off value 0.47 ng/mL (p \u3c 0.001), with a sensitivity of 92.3%, specificity of 68.7%, positive predictive value (PPV) of 85.7%, and negative predictive value (NPV) of 81.5%. By increasing the cut-off value to 0.90 ng/mL at area under the curve of 0.816, the specificity increased to 81.3% and sensitivity became 66.2%, with a PPV of 87.8% and NPV of 54.2%.Conclusion: Our study determined two cut-values for PCT to predict sepsis, one with the highest sensitivity and the other with better specificity. Other than that, higher PCT levels were significant in female trauma patients. We conclude that PCT is a reliable marker for culture-proven diagnosis of sepsis and may aid physicians/surgeons to promptly manage patients accordingly

Occurrence of rare earth elements in water, sediment, and freshwater fish of diverse trophic levels and feeding ecology: Insights from the Po river (northwest Italy)

To date, the occurrence of rare earth elements (REEs) in freshwater ecosystems has garnered limited attention in the scientific literature. Furthermore, a dearth of data exists regarding their potential bioaccumulation in freshwater fish. To fill this knowledge gap, we studied REEs concentrations in water, sediment, and fish specimens collected along the Po River (northwest Italy) and calculated biota-sediment accumulation (BSAF) and bioconcentration (BCF) factors, while taking into account fish feeding behavior and trophic level effects on the overall content of total REEs (ƩREEs). The fish communities were composed of native and non-native species. Remarkably low concentrations of REEs (<0.0003 mg/L) were detected in the water samples, indicating REEs insolubility. In contrast, sediment samples were found to be a good sink for REEs, with a higher mean ƩREEs recorded for the samples from the Moncalieri station (70.93 mg/kg). Notably, no significant differences in ƩREEs concentration were observed in the muscle tissue of fish samples from the three stations. The highest mean ƩREEs was recorded in the samples from the Murazzi station (0.027 mg/kg). The BSAF was very low, consistently below the unit, indicating an absence of bioaccumulation in fish muscle from sediment. In contrast, the BCF was high for several REEs, mainly for Sc and Y. While feeding ecology did not appear to affect REEs accumulation in muscle, there was a significant negative relationship between the trophic level and ΣREEs, indicating a trophic dilution of REEs from predator (Silurus glanis) to planktivorous (Alburnus arborella) fish. This study provides baseline concentrations, trophic transfers, and patterns of REEs in a river system. Further studies are needed to understand the transfer of REEs to other biotic components of lotic ecosystems.The authors would like to thank Paolo Lo Conte (Città Metropolitana di Torino) for the fish sampling and for his technical support. This study was funded by Fondazione CRT “Richieste Ordinarie”, project: “Come stanno i pesci in città? Valutazione della comunità ittica nel tratto metropolitano del Fiume Po” (RF = 2018.2374).Peer reviewe

Temperature-dependent effects of neonicotinoids on the embryonic development of zebrafish (Danio rerio)

The agricultural use of neonicotinoids is increasing worldwide and poses a threat to non-target organisms. The existing toxicity data of neonicotinoids that is mainly focused on widely used neonicotinoids ignores the influence of environmental factors, like temperature, related to climate changes, etc. To fill this data gap, the present study assessed the temperature-dependent toxicity of six neonicotinoids at four temperatures. Briefly, a fish embryo toxicity test was performed at the following temperatures—20, 23, 28, and 33°C—on zebrafish embryos to evaluate the lethal and sublethal effects of these toxicants. At 28°C, the lethal toxicity (LC50) values for these toxicants were cycloxaprid—3.36 mg/L, nitenpyram—7.08 mg/L, paichongding—17.2 mg/L, imidaclothiz—738.6 mg/L, dinotefuran—2,096 mg/L, and thiamethoxam—4,293 mg/L, respectively. Among the sublethal effects, the enzymatic activities changed significantly in neonicotinoid treatments, which revealed oxidative stress, metabolic disorders, and neurotoxicity. Particularly, acetylcholinesterase inhibition and glutathione S-transferase activation showed a significant dose–response relationship. However, cycloxaprid, nitenpyram, and paichongding were found to be more potent compared with imidaclothiz and thiamethoxam. The influence of temperature on these neonicotinoids demonstrated an inverted V-shaped relationship, in which toxicity decreased with the increase of temperature and then increased with the increase of temperature after exceeding the optimum temperature. This study provides a reference for the multiscale effects and potential mechanisms of neonicotinoids. Temperature-dependent toxicity is of great significance for future toxicity testing and risk assessment of chemicals in the face of global climate changes

Impact Of Multidisciplinary Team Approach To The Management Of Otalgia Patients

Background: Otalgia, one of the most common complain reported in OPD of otorhinolaryngologist, is agonizing and affects all age groups. The objective of the study was to highlight the use of Multidisciplinary team approach to the management of otalgia patients for speedy recovery. Methods: A cross sectional study was conducted on patients having ear pain. These patients presented to the out-patient department (OPD) of otolaryngology of a tertiary care hospital. Data was collected through questionnaire prepared in advance. Informed oral consent was taken from participants before administration of the questionnaire. Results: A total of 216 patients were included in the study. Out of these only 33(15.2%) were less than 18 years of age. Majority [139(64.35%)] of subjects belonged to a low socioeconomic class. Out of these patients 119(55.1%) had ear infections who has to be seen by otolaryngologists. 63(29.2%) of patients had temporomandibular joint pain, referred to the Maxillofacial Surgeons and 34(15.7%) of patients suffering from neck pain, referred to Orthopaedic Surgeon. Conclusion: Multidisciplinary team approach was found effective in treating otalgia patients visiting the otorhinolaryngology clinics for the symptom, should be closely examined and referred to concerned departments if required for complete recovery

Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial

Background: Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding. Methods: We did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries. Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to 100 mL infusion bag of 0·9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h for 24 h, or placebo (sodium chloride 0·9%). Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable. This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124. Findings: Between July 4, 2013, and June 21, 2019, we randomly allocated 12 009 patients to receive tranexamic acid (5994, 49·9%) or matching placebo (6015, 50·1%), of whom 11 952 (99·5%) received the first dose of the allocated treatment. Death due to bleeding within 5 days of randomisation occurred in 222 (4%) of 5956 patients in the tranexamic acid group and in 226 (4%) of 5981 patients in the placebo group (risk ratio [RR] 0·99, 95% CI 0·82–1·18). Arterial thromboembolic events (myocardial infarction or stroke) were similar in the tranexamic acid group and placebo group (42 [0·7%] of 5952 vs 46 [0·8%] of 5977; 0·92; 0·60 to 1·39). Venous thromboembolic events (deep vein thrombosis or pulmonary embolism) were higher in tranexamic acid group than in the placebo group (48 [0·8%] of 5952 vs 26 [0·4%] of 5977; RR 1·85; 95% CI 1·15 to 2·98). Interpretation: We found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding outside the context of a randomised trial

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation