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The aim of this study is to understand the path for establishing digital health technologies-health technology assessment (DHT-HTA) in India.
Methods
A rapid review of HTA and DHT frameworks on PubMed (MEDLINE) and Google Scholar was conducted to identify DHT-HTA guidelines, and HTA processes in India. MS-Excel template was created with key domains for assessing DHT in resource-constrained settings based on studies and reports identified. Responses received from seventeen experts with varying expertise in DHT, HTA, clinical, and research were contacted using an online form. Following the principles of qualitative research rooted on grounded theory approach, themes and domains were derived for a framework which was again circulated through participants. Weightage for each theme was assigned based on the frequency of responses and qualifiers were used to interpret results. Inductively derived themes from these responses were clubbed together to identify macro-level systems requirements, and finally pre-requisites for setting up DHT-HTA framework was synthesized.
Results
HT are commonly perceived by experts (64.7 percent participants) as a technology strictly connected to health information. Real-world data (i.e., electronic health data) are recognized as a relevant tool in support of decision-making for clinical and managerial levels. Experts identified some pre-requisites for the establishment of DHT-HTA in the country in terms of infrastructure, contextual factors, training, finance, data security, and scale-up.
Conclusion
Our research not only identified the pre-requisites for the adoption of a DHT-HTA framework for India, but confirmed the need to address DHT-HTA’s acceptability among. Hospitals and health insurance providers.
We aimed to evaluate the effect of yoga on motor and non-motor symptoms and cortical excitability in patients with Parkinson’s disease (PD).
Methods:
We prospectively evaluated 17 patients with PD at baseline, after one month of conventional care, and after one month of supervised yoga sessions. The motor and non-motor symptoms were evaluated using the Unified Parkinson’s disease Rating Scale (motor part III), Hoehn and Yahr stage, Montreal Cognitive Assessment, Hamilton depression rating scale, Hamilton anxiety rating scale, non-motor symptoms questionnaire and World Health Organization quality of life questionnaire. Transcranial magnetic stimulation was used to record resting motor threshold, central motor conduction time, ipsilateral silent period (iSP), contralateral silent period (cSP), short interval intracortical inhibition (SICI), and intracortical facilitation.
Results:
The mean age of the patients was 55.5 ± 10.8 years, with a mean duration of illness of 4.0 ± 2.5 years. The postural stability of the patients significantly improved following yoga (0.59 ± 0.5 to 0.18 ± 0.4, p = 0.039). There was a significant reduction in the cSP from baseline (138.07 ± 27.5 ms) to 4 weeks of yoga therapy (116.94 ± 18.2 ms, p = 0.004). In addition, a significant reduction in SICI was observed after four weeks of yoga therapy (0.22 ± 0.10) to (0.46 ± 0.23), p = 0.004).
Conclusion:
Yoga intervention can significantly improve postural stability in patients with PD. A significant reduction of cSP and SICI suggests a reduction in GABAergic neurotransmission following yoga therapy that may underlie the improvement observed in postural stability.
Digital psychiatry has become increasingly important and understanding of certain aspects is essential for practising clinicians. This article discusses electronic patient records (EPRs), from their origins to current and future use, the growth and embedding of outcome measurements, the use of social media, and learning and research in virtual arenas.
‘Digital’ is an omnipresent yet often vague, misunderstood or feared topic in health services. There are many current and potential gains for individual patients and local populations, clinicians and organisations through optimisation of digital technologies. We argue that understanding the various aspects of digital psychiatry is an essential contemporary need. This is the first of two articles on the subject, exploring the gains and challenges of virtual/online assessments, including ethical considerations and the use of virtual reality and electronic prescribing.
In this article a compact circular monopole antenna is represented with dimensions of 38.87 × 24.00 × 1.60 mm3 applicable for WLAN/Wi-MAX and satellite band rejection characteristics. The impedance bandwidth is 9.42 GHz (3.12–12.54 GHz) for the final antenna with an equivalent fractional bandwidth of about 120.31%, producing triple notched bands centered at 3.95, 5.20 and 8.90 GHz with assistance of Archimedean spiral slot and incorporation of defected ground structure allowing WLAN (5.2 GHz), WiMAX (3.5 GHz) and higher satellite X-band (8.5 GHz) filtering abilities. Simulations of the antenna are performed to attain preferable return loss properties as well as gain and omni-directional radiation patterns. The suggested antenna yields a peak gain of about 7.46 dBi at 11.30 GHz and experimental values are in good obedience with simulated ones.
This collection of essays is an important contribution to the new literature on frontier studies and the historiography of Northeast India. Moving away from an exclusive dependence on colonial ethnographies, the authors build their arguments on a varied range of sources: from buranjis to revenue records, survey maps to explorers' diaries, and missionary papers to police files. They question the givennes of the categories through which the region is usually described, and contest the stereotypes by which the people of the region are primitivized. They explore the historical processes whereby the region was surveyed, mapped, understood, represented, politically governed, economically refigured, and historically constituted during the colonial period. Though focused on the experience of Northeast India, the volume also raises substantive questions about the idea of the frontier and the border, the primitive and the modern, and the tribal and the settled, the local and the trans-local.
La3+-doped BaSnO3 microtubes (La3+–BaSnO3) have been synthesized by electrospinning method, and the influence of La3+ content on the sensing properties of BaSnO3 for detection of formaldehyde vapor has been investigated. The as-prepared materials have been characterized using XRD, SEM, DSC, XPS, and UV-Vis. The La3+–BaSnO3 sample doped with 4 wt% La exhibited a response as high as 220 to formaldehyde vapor (1000 ppm concentration) along with a very low detection limit of 0.1 ppm at 270 °C, whereas at 140 °C, it exhibited a response of 80 and detection limit of 1 ppm. In addition, the sensor showed excellent selectivity of 57 to formaldehyde at 140 °C when compared with other vapors. Further, the sensor also showed good repeatability and stability over a long period of time suggesting its strong potential as a commercial formaldehyde sensor.
The Infectious Diseases and Beliaghata General Hospital, Kolkata, India witnessed a sudden increase in admissions of diarrhoea cases during the first 2 weeks of August 2015 following heavy rainfall. This prompted us to investigate the event. Cases were recruited through hospital-based surveillance along with the collection of socio-demographic characteristics and clinical profile using a structured questionnaire. Stool specimens were tested at bacteriological laboratory of the National Institute of Cholera and Enteric Diseases (NICED), Kolkata. Admission of 3003 diarrhoea cases, clearly indicated occurrence of outbreak in Kolkata municipal area as it was more than two standard deviation of the mean number (911; s.d. = 111) of diarrhoea admissions during the same period in previous 7 years. Out of 164 recruited cases, 25% were under-5 children. Organisms were isolated from 80 (49%) stool specimens. Vibrio cholerae O1 was isolated from 50 patients. Twenty-eight patients had this organism as the sole pathogen. Among 14 infants, five had cholera. All V. cholerae O1 isolates were resistant to nalidixic acid, followed by co-trimoxazole (96%), streptomycin (92%), but sensitive to fluroquinolones. We confirmed the occurrence of a cholera outbreak in Kolkata during August 2015 due to V. cholerae O1 infection, where infants were affected.
In this article, an extremely wideband, isolation-enhanced, low-profile “Multiple-Input-Multiple-Output” (MIMO) antenna along with dual-band-notched features has been investigated. The antenna proposed herein, possesses two mutually orthogonal staircase-etched radiators for achieving a wide bandwidth. The radiating elements are placed mutually perpendicular in order to achieve polarization diversity and high isolation, i.e. for minimization of mutual coupling effect between adjacent radiating elements. The antenna exhibits an extremely wide frequency bandwidth covering 1.2–19.4 GHz except two frequency band notches centered at 3.5 and 5.5 GHz, respectively, originated due to the incorporation of a “Rectangular Complementary Split Ring Resonator (RCSRR)” structure and by etching dual “L-shaped” slits in the ground plane. The center frequency of the notched bands is adjusted by fine tuning of the dimensions of the incorporated band-notching structures. Isolation level (S21) better than −20 dB has been obtained due to the insertion of a “T-shaped” parasitic element as a decoupling structure. A prototype of the proposed antenna having dimension of 20 mm × 20 mm (0.08 λo × 0.08 λo) is fabricated and the antenna responses have been measured. Obtained results show that the miniaturized MIMO diversity antenna is undoubtedly a capable contender for communications supporting an extremely wide impedance bandwidth along with band-notched features for WLAN and WiMAX.