Association of vitamin D and knee osteoarthritis in younger individuals

BACKGROUND The incidence of primary osteoarthritis knee is gradually increasing among young individuals.The increasing prevalence of obesity,sedentary lifestyle,sporting activity,and vitamin D deficiency(VDD)has been hypothesized for this shifting disease trend.This study was designed to look for the association of serum vitamin D among these young arthritic patients.AIM To look for the association of serum vitamin D in younger knee osteoarthritis(KOA)patients.METHODS In a 2-year observational study,146 non-obese KOA patients of 35-60 years were evaluated clinically(Knee injury and Osteoarthritis Outcome Score,KOOS)and radiologically(Kellegren-Lawrence stage,KL).The serum 25(OH)D level of these patients and 146 normal healthy individuals of same age group were estimated.RESULTS Both the groups were comparable in terms of age and sex.The average serum 25(OH)D level in healthy individuals and KOA patients was 45.83 ng/mL and 34.58 ng/mL,respectively(P<0.001).Inadequate serum 25(OH)D level(<30 ng/mL)was found in 46.57%of KOA patients and 24%of normal healthy participants indicating a significant positive association(odds ratio 2.77,95%CI:1.67-4.54,P<0.001).The 25(OH)D level in KL grade I,II,III and IV was 43.40,30.59,31.56 and 33.93 ng/mL respectively(no difference,P=0.47).Similarly,the KOOS score in sufficient,insufficient and deficient groups were 65.31,60.36 and 65.31,respectively(no difference,P=0.051).CONCLUSION The serum 25(OH)D level is significantly low in younger KOA patients.However,the clinical and radiological severities have no association with serum vitamin D level.

Multimedia Streaming for Ad Hoc Wireless Mesh Networks Using Network Coding

Over the past years, we have witnessed an explosive growth in the use of multimedia applications such as audio and video streaming with mobile and static devices. Multimedia streaming applications need new approaches to multimedia transmissions to meet the growing volume demand and quality expectations of multimedia traffic. This paper studies network coding which is a promising paradigm that has the potential to improve the performance of networks for multimedia streaming applications in terms of packet delivery ratio (PDR), latency and jitter. This paper examines several network coding protocols for ad hoc wireless mesh networks and compares their performance on multimedia streaming applications with optimized broadcast protocols, e.g., BCast, Simplified Multicast Forwarding (SMF), and Partial Dominant Pruning (PDP). The results show that the performance increases significantly with the Random Linear Network Coding (RLNC) scheme.

Network Coding and Quality of Service for Mobile <i>Ad Hoc</i>Networks

Network Coding is a relatively new forwarding paradigm where intermediate nodes perform a store, code, and forward operation on incoming packets. Traditional forwarding approaches, which employed a store and forward operation, have not been able to approach the limit of the max-flow min-cut throughput wherein sources transmitting information over bottleneck links have to compete for access to these links. With Network Coding, multiple sources are now able to transmit packets over bottleneck links simultaneously, achieving the max-flow min-cut through-put and increasing network capacity. While the majority of the contemporary literature has focused on the performance of Network Coding from a capacity perspective, the aim of this research has taken a new direction focusing on two Quality of Service metrics, e.g., Packet Delivery Ratio (PDR) and Latency, in conjunction with Network Coding protocols in Mobile Ad Hoc Networks (MANETs). Simulations are performed on static and mobile environments to determine a Quality of Service baseline comparison between Network Coding protocols and traditional ad hoc routing protocols. The results show that the Random Linear Network Coding protocol has the lowest Latency and Dynamic Source Routing protocol has the highest PDR in the static scenarios, and show that the Random Linear Network Coding protocol has the best cumulative performance for both PDR and Latency in the mobile scenarios.

Perioperative mortality and morbidity of hip fractures among COVID-19 infected and non-infected patients: A systematic review and meta-analysis

Purpose:Hip fractures among elderly patients are surgical emergencies.During COVID-19 pandemic time,many such patients could not be operated at early time because of the limitation of the medical resources,the risk of infection and redirection of medical attention to a severe infective health problem.Methods:A search of electronic databases(PubMed,Medline,CINAHL,EMBASE and the Cochrane Central Register of Controlled Trials)with the keywords"COVID","COVID-19","SARS-COV-2","Corona","pandemic","hip fracture","trochanteric fracture"and"neck femur fracture"revealed 64 studies evaluating treatment of hip fracture in elderly patients during COVID-19 pandemic time.The 30-day mortality rate,inpatient mortality rate,critical care/special care need,readmission rate and complications rate in both groups were evaluated.Data were analyzed using Review Manager(RevMan)V.5.3.Results:After screening,7 studies were identified that described the mortality and morbidity in hip fractures in both COVID-19 infected(COVID-19+)and non-infected(COVID-19-)patients.There were significantly increased risks of 30-day mortality(32.23%COVID-19+deathvs.8.85%COVID-19-death)and inpatient mortality(29.33%vs.2.62%)among COVID-19+patients with odds ratio(OR)of 4.84(95%CI:3.13-7.47,p<0.001)and 15.12(95%CI:6.12-37.37,p<0.001),respectively.The COVID-19+patients needed more critical care admission(OR=5.08,95%CI:1.49-17.30,p<0.009)and they remain admitted for a longer time in hospital(mean difference=3.6,95% CI:1.74-5.45,p<0.001);but there was no difference in readmission rate between these 2 groups.The risks of overall complications(OR=17.22),development of pneumonia(OR=22.25),and acute respiratory distress syndrome/acute respiratory failure(OR=32.96)were significantly high among COVID-19+patients compared to COVID-19-patients.Conclusions:There are increased risks of the 30-day mortality,inpatient mortality and critical care admission among hip fracture patients who are COVID-19+.The chances of developing pneumonia and acute respiratory failure are more in COVID-19+patients than in COVID-19-patients.

A subtree-based approach to failure detection and protection for multicast in SDN

Software-defined networking(SDN) has received tremendous attention from both industry and academia.The centralized control plane in SDN has a global view of the network and can be used to provide more effective solutions for complex problems,such as traffic engineering.This study is motivated by recent advancement in SDN and increasing popularity of multicasting applications.We propose a technique to increase the resiliency of multicasting in SDN based on the subtree protection mechanism.Multicasting is a group communication technology,which uses the network infrastructure efficiently by sending the data only once from one or multiple sources to a group of receivers that share a common path.Multicasting applications,e.g.,live video streaming and video conferencing,become popular,but they are delay-sensitive applications.Failures in an ongoing multicast session can cause packet losses and delay,which can significantly affect quality of service(Qo S).In this study,we adapt a subtree-based technique to protect a multicast tree constructed for Open Flow switches in SDN.The proposed algorithm can detect link or node failures from a multicast tree and then determines which part of the multicast tree requires changes in the flow table to recover from the failure.With a centralized controller in SDN,the backup paths can be created much more effectively in comparison to the signaling approach used in traditional multiprotocol label switching(MPLS) networks for backup paths,which makes the subtree-based protection mechanism feasible.We also implement a prototype of the algorithm in the POX controller and measure its performance by emulating failures in different tree topologies in Mininet.