Catalytic Philanthropy In India

Catalytic Philanthropy is still in its infancy in India. Despite this, there are a surprising number of exemplary cases where Indian philanthropists are creating large-scale social change far beyond the resources invested. This report highlights these practices as well as the key issues that need to be addressed to accelerate its evolution

DASMcC: Data Augmented SMOTE Multi-Class Classifier for Prediction of Cardiovascular Diseases Using Time Series Features

One of the leading causes of mortality worldwide is cardiovascular disease (CVD). Electrocardiography (ECG) is a noninvasive and cost-effective tool to diagnose the heart’s health. This study presents a multi-class classifier for the prediction of four different types of Cardiovascular Diseases, i.e., Myocardial Infarction, Hypertrophy, Conduction Disturbances, and ST-T abnormality using 12-lead ECG. There are four key steps involved in the presented work: data preprocessing, feature extraction, data preparation, and augmentation, and modelling for multi-class CVD classification. The sixteen-time domain augmented features are used to train the classifier. The work is divided into three parts: extracting the features from raw 12-lead ECG signals, data preparation and augmentation, and training, testing, and validating the classifier. A comparative study of the performance of five different classifiers (i.e., Random Forest (RF), K Nearest Neighbors (KNN), Gradient Boost, Adda Boost, and XG Boost has also been presented. Accuracy, precision, recall, and F1 scores are used for performance evaluation. Further, the Receiver Operating Curve (ROC) is traced, and the Area Under the Curve (AUC) is calculated to ensure the unbiased performance of the classifier. The application of the proposed classifier in the Smart Healthcare framework has also been discussed.publishedVersio

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Case Reports1. A Late Presentation of Loeys-Dietz Syndrome: Beware of TGFβ Receptor Mutations in Benign Joint Hypermobility

Background: Thoracic aortic aneurysms (TAA) and dissections are not uncommon causes of sudden death in young adults. Loeys-Dietz syndrome (LDS) is a rare, recently described, autosomal dominant, connective tissue disease characterized by aggressive arterial aneurysms, resulting from mutations in the transforming growth factor beta (TGFβ) receptor genes TGFBR1 and TGFBR2. Mean age at death is 26.1 years, most often due to aortic dissection. We report an unusually late presentation of LDS, diagnosed following elective surgery in a female with a long history of joint hypermobility. Methods: A 51-year-old Caucasian lady complained of chest pain and headache following a dural leak from spinal anaesthesia for an elective ankle arthroscopy. CT scan and echocardiography demonstrated a dilated aortic root and significant aortic regurgitation. MRA demonstrated aortic tortuosity, an infrarenal aortic aneurysm and aneurysms in the left renal and right internal mammary arteries. She underwent aortic root repair and aortic valve replacement. She had a background of long-standing joint pains secondary to hypermobility, easy bruising, unusual fracture susceptibility and mild bronchiectasis. She had one healthy child age 32, after which she suffered a uterine prolapse. Examination revealed mild Marfanoid features. Uvula, skin and ophthalmological examination was normal. Results: Fibrillin-1 testing for Marfan syndrome (MFS) was negative. Detection of a c.1270G > C (p.Gly424Arg) TGFBR2 mutation confirmed the diagnosis of LDS. Losartan was started for vascular protection. Conclusions: LDS is a severe inherited vasculopathy that usually presents in childhood. It is characterized by aortic root dilatation and ascending aneurysms. There is a higher risk of aortic dissection compared with MFS. Clinical features overlap with MFS and Ehlers Danlos syndrome Type IV, but differentiating dysmorphogenic features include ocular hypertelorism, bifid uvula and cleft palate. Echocardiography and MRA or CT scanning from head to pelvis is recommended to establish the extent of vascular involvement. Management involves early surgical intervention, including early valve-sparing aortic root replacement, genetic counselling and close monitoring in pregnancy. Despite being caused by loss of function mutations in either TGFβ receptor, paradoxical activation of TGFβ signalling is seen, suggesting that TGFβ antagonism may confer disease modifying effects similar to those observed in MFS. TGFβ antagonism can be achieved with angiotensin antagonists, such as Losartan, which is able to delay aortic aneurysm development in preclinical models and in patients with MFS. Our case emphasizes the importance of timely recognition of vasculopathy syndromes in patients with hypermobility and the need for early surgical intervention. It also highlights their heterogeneity and the potential for late presentation. Disclosures: The authors have declared no conflicts of interes

Versatility of PEEK as a fixed partial denture framework

Materials used for fixed partial denture (FPD) frameworks have had properties of excellent strength, durability, and biocompatibility. Some of the materials which have been used till date include alloys, ceramics, and high-performance polymers such as zirconia, Ni–Cr, lithium disilicate, and so on. All these, though excellent, have their advantages and disadvantages. Hence, the search has always been on for a better material. One such material, which has made its foray into dentistry in the recent times, is polyetheretherketone (PEEK). It is a semicrystalline thermoplastic material. PEEK has an excellent chemical resistance and mechanical properties that are retained at high temperatures. The versatility of PEEK as a dental material for FPD framework was evaluated in this case report

A cephalometric analysis of Class II dentate subjects to establish a formula to determine the occlusal plane in Class II edentate subjects: A neo adjunct

Purpose: Occlusal plane (OP) differs considerably in participants with skeletal Class I and Class II participants. In this study, cephalometrics has been used to help in the determination of orientation of the OP utilizing the nonresorbable bony anatomic landmarks in skeletal Class II participants and an attempt has been made to predict and examine the OP in individuals with skeletal class II jaw relationship. Materials and Methods: One hundred dentulous participants with skeletal Class II malocclusion who came to the hospital for correcting their jaw relationship participated in the study. Their right lateral cephalogram was taken using standardized procedures, and all the tracings were manually done by a single trained examiner. The cephalograms which were taken for the diagnostic purpose were utilized for the study, and the patient was not exposed to any unnecessary radiation. The numerical values obtained from the cephalograms were subjected to statistical analysis. Pearson's correlation of <0.001 was considered significant, and a linear regression analysis was performed to determine a formula which would help in the determination of orientation of the OP in Class II edentulous participants. Results: Pearson's correlation coefficient and linear regression analysis were performed, and a high correlation was found between A2 and (A2 + B2)/(B2 + C2) with “r” value of 0.5. A medium correlation was found between D2 and (D2 + E2)/(E2 + F2) with “r” value of 0.42. The formula obtained for posterior reference frame through linear regression equation was y = 0.018* × +0.459 and the formula obtained for anterior reference frame was y1 = 0.011* × 1 + 0.497. It was hypothesized that by substituting these formulae in the cephalogram obtained from the Class II edentate individual, the OP can be obtained and verified. Conclusion: It was concluded that cephalometrics can be useful in examining the orientation of OP in skeletal Class II participants

Effect of interfacial interdiffusion on magnetism in epitaxial Fe4_4N films on LaAlO3_3 substrates

Epitaxial Fe$_4$N thin films grown on LaAlO$_3$ (LAO) substrate using sputtering and molecular beam epitaxy techniques have been studied in this work. Within the sputtering process, films were grown with conventional direct current magnetron sputtering (dcMS) and using a high power impulse magnetron sputtering (HiPIMS) process. Surface morphology and depth profile studies on these samples reveal that HiPIMS deposited film has the lowest roughness, the highest packing density, and the sharpest interface. We found that the substrate-film interface and the microstructure play a vital role in affecting the electronic hybridization and magnetic properties of Fe$_4$N films. La from the LAO substrate and Fe from the film interdiffuse and form an undesired interface. The magnetic moment (M$_s$) was compared using bulk, element-specific and magnetic depth profiling techniques. We found that M$_s$ was the highest when the thickness of the interdiffused layer was lowest and such conditions can only be achieved in the HiPIMS grown samples. The presence of a small moment at the N site was also evidenced by element-specific x-ray circular dichroism measurement in the HiPIMS grown sample. A large variation in the M$_s$ values of Fe$_4$N films found in the experimental works carried out so far could be due to such an interdiffused layer which is generally not expected to form in otherwise stable oxide substrate at a low substrate temperature ≈675 K. In addition, a consequence of substrate-film interdiffusion and microstructure resulted in the different kinds of magnetic anisotropies in Fe$_4$N films grown using different techniques. A detailed investigation of the substrate-film interface and microstructure on the magnetization of Fe$_4$N film is presented and discussed in this work

In-situ growth of iron mononitride thin films studied using x-ray absorption spectroscopy and nuclear resonant scattering

We studied the structural and magnetic properties of in-situ grown iron mononitride (FeN) thin films. Initial stages of film growth were trapped utilizing synchrotron based soft x-ray absorption near edge spectroscopy (XANES) at the N K-edge and nuclear resonant scattering (NRS). Films were grown using dc-magnetron sputtering, separately at the experimental stations of SXAS beamline (BL01, Indus 2) and NRS beamline (P01, Petra III). It was found that the initial stages of film growth differs from the bulk of it. Ultrathin FeN films, exhibited larger energy separation between the $t_{2g}$ and $e_g$ features and an intense eg feature in the N K-edge pattern. This indicates that a structural transition is taking place from the rock-salt (RS)-type FeN to zinc-blende (ZB)-type FeN when the thickness of films increases beyond 5nm. The behavior of such N K-edge features correlates very well with the emergence of a magnetic component appearing in the NRS pattern at 100K in ultrathin FeN films. Combining the in-situ XANES and NRS measurements, it appears that initial FeN layers grow in a RS-type structure having a magnetic ground state. Subsequently, the structure changes to ZB-type which is known to be non-magnetic. Observed results help in resolving the long standing debate about the structure and the magnetic ground state of FeN