Bharat Forge (India)

Aerosol therapy is widely used in intensive care units (ICUs) for managing respiratory conditions. However, non-adherence to evidence-based guidelines can compromise outcomes and increase healthcare costs. This study evaluated the compliance of aerosol therapy with the "Indian Guidelines on Nebulization Therapy" and the cost incurred in critically ill patients. A prospective observational study was conducted in 307 adult patients across the ICUs of a tertiary care hospital during a six-month study period. Analysis was performed using the chi-square test and the Wilcoxon rank-sum test in RStudio (version 4-4.3, 2024). Multivariate logistic regression identified independent predictors of compliance. Of the 307 ICU patients analyzed, 64.5% were male, with an average age of 57±16 years. Jet nebulizers were used in 91.5% of cases. Bronchodilators (47.13%) and corticosteroids (35%) were widely used classes of drugs. Compliance of drug therapy with evidence-based guidelines varied significantly by duration of ICU stay (P = 0.0062) and by ICU category (P = 0.0005). Drug compliance was higher in critical care and neurology ICUs [odds ratio (OR): 6.500, P = 0.0001; OR: 4.574, P = 0.005]. Administration compliance was significantly associated with the diagnosis category (P = 0.00186) and was higher among patients with non-respiratory diagnoses (OR: 4.96, P =0.0068). Adherence to guidelines for drug therapy significantly lowered costs (P = 0.0103). Targeted interventions, protocol standardization, and staff training are needed to enhance compliance, optimize patient care, and control aerosol-related expenditures. Clinically, these findings highlight that adherence to evidence-based aerosol therapy not only enhances patient outcomes but also reduces ICU expenditure, thereby supporting integration into routine clinical practice.

Health insurance coverage can serve as protection against catastrophic health expenditures. Section 21 (4) of the Mental Healthcare Act, 2017 (MHCA) mandates insurance coverage for mental illness to be on par with that for physical illness. Despite this, anecdotal evidence shows persons with mental health conditions are routinely denied or face difficulties in obtaining medical insurance coverage due to their mental illness. We undertook an analysis of all insurance policy documents published on the Insurance Regulatory and Development Authority of India (IRDAI) webpage for the year 2020-21 to examine their relevance to mental illness and to examine how the policy wording adheres to Section 21 (4) of the MHCA and the core principles of bioethics. We sourced 459 health insurance policies for the year 2020-21 from the IRDAI webpage. Of these, 268 relevant insurance policies were analysed in depth for their adherence to the MHCA guidelines and principles of bioethics. Of the policies analysed (n=268) we found six policies (from two insurance providers) explicitly excluded mental illness across all domains, in direct contradiction of the MHCA and the subsequent guidance issued by the IRDAI. Most insurance policies excluded coverage for injuries due to attempted suicide or self-injury (n=224), or alcohol consumption/substance use (n=267). Out-patient services were included in 23 policies. Health insurance policies continue to contain discriminatory terms for mental illness thus violating the principle of parity put forth by the MHCA and at odds with core principles of bioethics. Sustained advocacy efforts are required to ensure insurance providers abide by the principles of parity in letter and in spirit to remove differential or discriminatory terms for mental illness in their policies in compliance with Section 21 (4) the MHCA.

Abstract The growing demand for privacy-preserving machine learning has driven the advancement of federated learning (FL), facilitating decentralized model training without revealing raw data. Nevertheless, conventional FL methods frequently encounter challenges in achieving an optimal balance between privacy, efficiency, and accuracy. To address these challenges, this study introduces the hybrid adaptive learning framework (HALF)—an innovative, scalable, and privacy-focused FL approach. HALF implements a multi-tiered hierarchical structure that includes local, regional, and global aggregation, combined with adaptive learning rates and integrated differential privacy (ε ≤ 2.3), ensuring robust privacy protection without sacrificing performance. The framework employs a structured five-phase process: Initialization, Device Selection, Training, Aggregation, and Evaluation, and incorporates lightweight algorithms with efficient communication protocols to reduce latency, energy consumption, and overhead. Experimental validation using benchmark datasets demonstrates that HALF consistently surpasses traditional FL by 15%–20% in accuracy while reducing communication overhead by 40%, maintaining ≥89.7% accuracy within 142 min of training. Its resilience under non-identical and independently distributed (non-IID) and heterogeneous data conditions, as well as its deployment with up to 10,000 clients, underscores its scalability. Relevant to critical sectors such as healthcare, Internet of Things (IoT), finance, and smart cities, HALF addresses existing FL limitations and establishes a foundation for secure, efficient, and adaptable AI solutions in sensitive data environments.

BackgroundBreast cancer is one of the common causes of cancer related mortality in women. Early detection and treatment can combat the morbidity and mortality of breast cancer. Most first-world countries have a screening program to facilitate early detection of breast malignancy. A lack of similar programs in developing countries, compounded with ignorance and financial crunch, often leaves women vulnerable due to late detection and complications. Identification of early physical changes in breasts through regular breast self-examination (BSE) can potentially aid in the early detection of breast lumps. Ideally, all women should have access to screening programs, although, practically, it is difficult to achieve mass screening in resource-poor areas. BSE cannot completely bridge this gap in health care; however, it can undoubtedly aid in increased awareness, identification of danger signs, and timely approach to the health care center for intervention.Materials and methodA cross-sectional study was conducted at Bharati Vidyapeeth Medical College, Pune, India. The participants were administered a pretested questionnaire to collect information about their understanding of BSE. The data were analyzed using the Statistical Package for Social Sciences (SPSS) statistical software, Version 25. Mean and frequencies were used to compare participants from various backgrounds.ResultsThe total sample consisted of 1,649 women from various educational backgrounds. Every doctor had heard about BSE compared to 81% of women from the general population; 84% of doctors and less than 40% of women representing the general population were taught to perform BSE; however, only around 34% of all women perform BSE. Women from the general population were largely unaware of the correct age to begin BSE, the frequency of performance, its correlation with the menstrual cycle, and the steps necessary to perform it. Women employed in the health care industry were better informed than the general population but still needed to be aware of BSE's details.ConclusionThe study highlighted the lack of information regarding breast malignancy and self-examination among women from all educational and professional backgrounds. Women in the health care sector are better informed about the topic than the general population but still lack adequate information. There is a dire need to train women about the procedure, frequency, and correct time of conducting BSE and the telltale signs of breast carcinoma. Women in the health care industry can be educated and trained as educators on the topic, who can further disseminate the information to the general population to promote early detection of breast malignancy.

Abstract The growing competitiveness in the emerging global market is a challenge that transforms into a vast need for the industry to begin to expand. Each manufacturing industry cares about the quality of its products so as to stay ahead of its rivals and so become their consumers’ first choice. It is essential that the finished product meets standard requirements. Since customer satisfaction is derived from quality products and services, it is very important to control quality. In all types of engines, the crankshaft is the significant powerful component. Most crankshafts are made of micro-alloy steel, to acquire the mechanical characteristics necessary. Many designs of the crankshaft are inherently complicated by various defects, e.g. underfilling, overlapping, misalignment, scaling pits, etc. Various types of forging processes die materials for forging and crankshaft production processes are briefly discussed in this paper. The overview of the latest research on forging analysis for single-cylinder crankshafts is presented here by the practice of high-quality tools used to eliminate defects in crankshaft production. This research study explored the use of quality tools, including Pareto graph and chart of cause and effect, to evaluate various forging defects in the crankshaft manufacturing industries to reduce the rejection rate and increase profitability of production yield. Finally, corrective measures are recommended to resolve significant defects in the crankshaft production process. The execution of the remedial plan would diminish the rate of rejection from 4.54 to 0.72%.KeywordsCrankshaftsQuality toolsForging defects

The present study was conducted to compare the performance of patient self-collected oral swab (OS) with healthcare worker (HCW)-collected nasopharyngeal swab (NPS) for SARS-CoV-2 detection by reverse transcription polymerase chain reaction (RT-PCR) in real-world setting. Paired OS and NPS were collected from 485 consecutive individuals presenting with symptoms of coronavirus disease-19 (COVID-19) or asymptomatic contacts of COVID-19 cases. Both specimens were processed for RT-PCR and cycle threshold (Ct) value for each test was obtained. Positive percent agreement (PPA), negative percent agreement (NPA), overall percent agreement (OPA) and kappa were calculated for OS RT-PCR compared with NPS RT-PCR as reference. A total of 116/485 (23.9%) participants were positive by NPS RT-PCR. OS had PPA of 71.6%, NPA of 98.8%, OPA of 92.4% and kappa of 0.771. Almost all participants (483/485, 99.6%) reported OS as a convenient and comfortable sample for SARS-CoV-2 testing over NPS. All participants with Ct values <25 and majority (90.8%) with Ct values <30 were detected by OS. To conclude, OS self-sampling was preferred in comparison with NPS due the ease and comfort during collection. The performance of OS RT-PCR for SARS-CoV-2 detection, however, was sub-optimal in comparison with NPS RT-PCR.

The hot salt stress corrosion cracking (HSSCC) behavior of the selectively laser melted (SLM) Ti-6Al-4V alloy in the as-built and heat-treated conditions was studied at 300 and 400 °C. The HSSCC resistance of very susceptible as-built alloy can be significantly increased through annealing at 750 °C, losing only a small amount of ultimate tensile strength (UTS). The improvement in the HSSCC resistance is brought out by a transformation of martensite into lamellar α + β. The absence of equiaxed α found in the wrought alloy seems to help in increasing the HSSCC resistance of SLM Ti-6Al-4V alloy at high strength level.