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This paper presents a reliable and competent evolutionary-based approach for improving the response time of Emergency Medical Service (EMS) by efficiently allocating ambulances at the base stations. As the prime objective of EMS is to save people's lives by providing them with timely assistance, thus increasing the chances of a person's survivability, this paper has undertaken the problem of ambulance allocation. The work has been implemented using the proposed mutation-based Shuffled Frog Leaping Algorithm (mSFLA) to provide an optimal allocation plan. The authors have altered the basic SFLA using the concept of mutation to improve the quality of the solution obtained and avoid being trapped in local optima. Considering a set of assumptions, the new algorithm has been applied for allocating 50 ambulances among 11 base stations in Southern Delhi. The working environment of EMS, which includes stochastic requests, travel time, and dynamic traffic conditions, has been considered to attain accurate results. The work has been implemented in the MATLAB simulation environment to find an optimized allocation plan with a minimum average response time. The authors have reduced the average response time by 12.23% with the proposed algorithm. The paper also compares mSFLA, Genetic Algorithm (GA), and Particle Swarm Optimization (PSO) for the stated problem. The algorithms are compared in terms of objective value (average response time), convergence rate, and constancy repeatability to conclude that mSFLA performs better than the other two algorithms.

OBJECTIVES: The intestinal permeability (IP) of sugars and their derivatives has been widely used to assess mucosal damage in gastrointestinal diseases. Ulcerative colitis (UC) is a recurring and relapsing disease that causes inflammation of the gut. IP of sugars can be evaluated and correlated with the flare of UC. MATERIALS AND METHODS: A prospective study was conducted on 91 patients with active UC at the tertiary care center in North India. Mayo grading system assessed disease activity, and IP was assessed by measuring sucrose, lactulose, mannitol, and sucralose in urine samples from UC patients. A high-performance liquid chromatography (HPLC) method to detect all of these sugars simultaneously using a refractive index detector was developed and further validated in patients with UC. RESULTS: The analytical recovery rate of the tested sugars ranged from 95% to 146% in the urine matrix. The limit of detection and limit of quantification were 78.838 mg/L and 262.79 mg/L for sucrose, 84.994 mg/L and 283.31 mg/L for lactulose, 74.789 mg/L and 249.30 mg/L for mannitol, and 50.908 mg/L and 169.69 mg/L for sucralose. CONCLUSION: The standardized HPLC method is sensitive and suitable for the simultaneous detection and determination of different sugar moieties in the urine sample. Patients with UC can be evaluated indirectly for the flare by estimating the recovery rate of sugars through gut permeability. The procedure is noninvasive and thus improves the quality of life of chronically ill patients.

Emergency medical service (EMS) control centres should focus on strategically deploying ambulances to enable trauma patients to receive better care. The work proposed here aims to find an optimal deployment plan of ambulances for the existing base stations using the genetic algorithm (GA) based optimization component. The GA has been modified by incorporating a new proportion-based population seeding method for initializing the population. Considering a set of assumptions, the authors have applied the new strategy for allocating an optimal count of ambulances to 28 base stations in Delhi. The working environment of EMS that includes stochastic requests, travel time, and dynamic traffic conditions has been taken into account, and the optimization strategy has been implemented in a MATLAB environment. With the proposed work, the authors have been able to reduce the average response time (ART) by 6.7%. The simulation result has also demonstrated a comparison between GA and particle swarm optimization (PSO). In addition, some numerical experiments are performed to conclude the impact of different attributes on the value of ART.

Background and Purpose:Plantar fasciitis is one of the common cause of foot/heel pain and impairment of functional status, leading to disability. The use and interpretation of patient-rated outcome measures that accurately detect change over time in this patient population is of paramount importance. PFPS is a newly developed scale, whereas, MFPDI and FFI are one of the major functional scales which are widely used to assess the pain and functional status of PF. The purpose of this study is to determine the test retest reliability, construct validity and responsiveness of Manchester foot pain and disability index (MFPDI), foot functional index (FFI) and plantar fasciitis foot pain and disability scale (PFPS) in subjects with plantar fasciitis.Methodology:In this single group pre and post design, 30 Subjects (n=30) presenting to physical therapy with plantar fasciitis completed MFPDI, FFI and PFPS at baseline examination and follow up. All patients completed the Global Rating Of Change at follow up, used to dichotomize patients as improved or stable. Baseline and follow-up scores were used to determine the test-retest reliability, construct validity, and responsiveness for MFPDI, FFI and PFPSResults: ICC shows low to moderate Test retest reliability of PFPS (ICC = 0.55 – 0.85), and responsiveness of MFPDI, FFI and PFPS. Whereas poor construct validity for MFPDI (15 items) and PFPS with p > 0.05 in 30 Plantar Fasciitis subjects.Conclusion:PFPS is a reliable tool for assessing pain and functional limitation or disability. Whereas, MFPDI (15 items) and PFPS are not valid tools in order to assess pain and functional limitation. All the variables of 3 scales are able to measure responsiveness except superficial and deep variable of PFPS in PF subjects.

Recurrent respiratory papillomatosis (RRP) causes significant morbidity in laryngology. The incidence of dysplasia in adult patients with RRP has not been well described. In this study, the risk factors and incidence of RRP-associated dysplasia are investigated. Pathology specimens from patients with RRP over a 6-year period are reviewed, along with the patients' clinical and demographic information. Fifty-two male and 21 female patients (mean, 50 years) with RRP were identified. Some degree of dysplasia was identified in 22 of 170 specimens (13%). Sixteen of the 73 patients (21.9%) were found to have dysplasia at some point during their clinical course. Although the patients with RRP-associated dysplasia were older (56.3 versus 48.3 years of age), this difference did not reach statistical significance (p < 0.09, unpaired t-test). There was a male preponderance in both dysplastic (10 of 16; 62.5%) and non-dysplastic (42 of 57; 73%) cases. The mean number of operations for RRP was 2.4 for patients without dysplasia and 3.2 for those with dysplasia; there was no significant difference between the groups. Seven of the 16 patients with dysplasia (44%) and 22 of the 57 patients without dysplasia (39%) had a history of tobacco use (p < 0.77, Fisher's exact test). Dysplasia was discovered in more than 20% of adult patients with RRP studied over a 6-year period. Age, gender, tobacco history, and operative frequency were not identifiable risk factors for the presence of dysplasia.

Head and neck cancers include cancers of the oral cavity, oropharynx (throat), larynx or voice box, salivary glands, thyroid and parathyroid gland, and skin cancers. Viruses such as Epstein barr virus and HIV are known to cause cancers. More recently, the risk of human papilloma virus, the same virus causing cervical cancer, has also been linked to the development of oropharyngeal or throat cancers, especially in younger patients who have not had significant alcohol and tobacco usage. Other presentations of head and neck cancer include lumps and bumps on the neck, unilateral ear infections, difficulty with swallowing or breathing, nonhealing ulcers, hoarseness, loose teeth, poorly fitting dentures, bleeding and changing skin lesions.

In this work, two Schiff-base-based chemosensors L1 and L2 containing electron-rich quinoline and anthracene rings were designed. L1 is AIEE active in a MeOH-H2O solvent system while formed aggregates as confirmed by the DLS measurements and fluorescence lifetime studies. The chemosensor L1 was used for the sensitive, selective, and reversible ‘turn-on’ detection of Al3+ and Ga3+ ions as well as Aspartic Acid (Asp). Chemosensor L2, an isomer of L1, was able to selectively detect Ga3+ ion even in the presence of Al3+ ions and thus was able to discriminate between the two ions. The binding mode of chemosensors with analytes was substantiated through a combination of 1H NMR spectra, mass spectra, and DFT studies. The ‘turn-on’ nature of fluorescence sensing by the two chemosensors enabled the development of colorimetric detection, filter-paper-based test strips, and polystyrene film-based detection techniques.

In this work, two Schiff-base-based chemosensors L1 and L2 containing electron-rich quinoline and anthracene rings were designed. L1 is AIEE active in a MeOH-H[sub.2]O solvent system while formed aggregates as confirmed by the DLS measurements and fluorescence lifetime studies. The chemosensor L1 was used for the sensitive, selective, and reversible ‘turn-on’ detection of Al[sup.3+] and Ga[sup.3+] ions as well as Aspartic Acid (Asp). Chemosensor L2, an isomer of L1, was able to selectively detect Ga[sup.3+] ion even in the presence of Al[sup.3+] ions and thus was able to discriminate between the two ions. The binding mode of chemosensors with analytes was substantiated through a combination of [sup.1]H NMR spectra, mass spectra, and DFT studies. The ‘turn-on’ nature of fluorescence sensing by the two chemosensors enabled the development of colorimetric detection, filter-paper-based test strips, and polystyrene film-based detection techniques.