INTRODUCTION:Obesity is highly prevalent in India, creating an urgent need for effective management interventions. The study hypothesizes that synthetic semaglutide has comparable safety and efficacy to the innovator drug when used in obese adults for weight management. METHODS:A phase III multicenter randomized active-controlled non-inferiority trial enrolled adults with obesity across 19 centers in India. Subjects were randomized to the test arm receiving synthetic semaglutide (Alkem Laboratories Limited) or the reference arm administered with innovator semaglutide (Wegovy®, Novo Nordisk) over 24 weeks in a 2:1 ratio. The primary efficacy endpoint was the percentage change in body weight,24 weeks post-intervention. Synthetic semaglutide was established to be non-inferior if the lower bound of the one-sided 97.5% confidence interval for the between-group difference did not exceed 4.5%. RESULTS:Of the 249 randomized participants, 246 (98.8%) completed the study. Mean percentage weight loss after 24 weeks was -14.39 ± 4.17% in the test arm and -14.61 ± 4.36% in the reference arm. The least square-mean difference was 0.15% (-0.93 to 1.24), meeting the predefined non-inferiority criterion. Weight loss >10% was achieved by 86.67% (n=143) in the test arm and 83.95% (n=68) in the reference arm (p = 0.5666), while >15% weight loss occurred in 38.79% (n=64) and 40.74% (n=33), respectively (p = 0.7683). Mean body mass index decreased by -4.93 ± 1.43 kg/m² in the test arm and -5.00 ± 1.50 kg/m² in the reference arm (p = 0.7128). Treatment-emergent adverse events were reported in 55.42% (n=92) of test-arm participants and 54.22% (n=45) of reference-arm participants. CONCLUSIONS:Test semaglutide demonstrated non-inferior efficacy, comparable safety, and similar tolerability to the innovator product.
The emergence of sixth-generation (6G) networks facilitates robust capabilities such as ultra-low latency and massive device connectivity, which simultaneously raise critical challenges in securing cloud-based data transmission. This study proposes a novel anomaly detection framework that integrates Autoencoders (AEs), Convolutional Neural Networks (CNNs), and Federated Learning (FL) to deliver real-time, privacy-preserving intrusion detection for 6G-enabled cloud computing environments. The framework is evaluated using four benchmark datasets, including NSL-KDD, UNSW-NB15, CIC-IDS2017, and CIC-DDoS2019. Across all datasets, the model achieved an average accuracy of 99.85%, precision of 99.76%, recall of 99.82%, and F1-score of 99.79%, while maintaining a False Alarm Rate (FAR) as low as 0.0011. The model also demonstrated high efficiency, operating with inference latency below 350 ms, making it highly suitable for the stringent requirements of 6G infrastructure. Enhanced with explainability tools, the system ensures transparent decision-making, offering an interpretable solution towards next-generation cybersecurity threats.
In-situ compressive strength and rate of degradation over time are key factors in determining the longevity and dependability of reinforced cement concrete (RCC) constructions. The rebound hammer test and destructive core testing are two examples of traditional techniques that are time-consuming, expensive, and sometimes inappropriate for newly built or important buildings. This study describes the design and development of a small, inexpensive, and non-destructive concrete testing tool that may be used on-site to assess the strength and remaining service life of concrete components. In order to measure and visualise data in real time, the system interfaces a number of sensors, including piezoelectric vibration sensors, a temperature sensor, a capacitive moisture sensor, and an accelerometer-gyroscope module, with an microcontroller and an OLED display. In order to determine compressive strength, the device analyses vibration responses and ultrasonic pulse velocity (UPV) from the piezoelectric sensors. Temperature and moisture data are used as adjustment factors to increase accuracy. To evaluate material stiffness and ageing behaviour, the accelerometer-gyroscope module offers further vibration and damping data. Both the instantaneous strength and the predicted ageing factor of the tested RCC element are calculated by processing the recorded values using empirical and regression-based models. According to experimental validation, the suggested device offers improved mobility, shorter testing times, and easier operation while achieving near agreement with conventional non-destructive testing (NDT) techniques. The device's small size and multi-sensor fusion capabilities make it perfect for field engineers and construction workers to perform continuous inspections of concrete constructions in both new and existing buildings.
Abstract: BACKGROUND: Allergic rhinitis (AR) is on the rise in India. The disease has a negative impact on the patient’s quality of life and their daily activity. The addition of an antihistamine to montelukast as a combination therapy offers an enhancing and complementary effect, thereby reducing the symptoms of AR effectively. METHODS: A retrospective open-label, single-arm, multicenter, real-world observational study was designed to understand the effectiveness and tolerability of the fixed-dose combination of montelukast/fexofenadine (FDC-M/F [10 mg + 120 mg]) in patients with AR. Patients fulfilling the inclusion criteria aged more than 15 years, having either symptoms suggesting AR (mild-intermittent, mild-persistent, or moderate intermittent) or Total Nasal Symptom Score (TNSS) of 5 or more as per the Allergic Rhinitis and its Impact on Asthma (ARIA) classification (if recorded), with no antihistamine in the previous week and have not received either montelukast plus fexofenadine for at least 4 weeks during the previous 6 months were included in this study. Patients with AR having a history of severe attacks of acute asthma within the span of the past 3 months, comorbidities such as severe hepatic/renal impairment, autoimmune, cardiovascular, or neurological diseases, and pregnant/lactating women were excluded from the study. Medical records were collected from the database of 12 sites across India from June 2022 to June 2023. The primary variables assessed were changes in the TNSS and Total Ocular Symptom Score (TOSS), changes in the Physicians Global Assessment (PGA) scale, Patients Global Assessment Scale (PGAS) from baseline to 4–6 weeks. RESULTS: A total of 329 medical records fulfilled the criteria for the enrolment. A statistically significant improvement was observed in both the TNSS and TOSS with FDC M/F at the end of the study period of 4–6 weeks; mean TNSS at baseline 6.66 (standard deviation [SD] 2.32; 95% confidence interval [CI], P < 0.001) reduced to 0.95 (SD 1.33 95% CI, P < 0.001), a mean difference of 5.71; Mean TOSS at baseline 1.54 (SD 2.32; 95% CI, P < 0.001), reduced to 0.23 (SD 0.73 95% CI, P < 0.001), a mean difference of 1.31 after 4–6 weeks. The combination was well-tolerated, and most of the patients were satisfied with the treatment. CONCLUSION: The FDC M/F led to a significant decrease in TNSS and TOSS compared to baseline. Thus, it may be an attractive treatment option for mild-intermittent, mild-persistent AR for reducing nasal and ocular symptoms.
Background: The rising prevalence of type 2 diabetes mellitus (T2DM) in India, driven by obesity and lifestyle factors, necessitates innovative treatments like oral Semaglutide, a GLP-1 receptor agonist (GLP-1RA). Its oral formulation enhances patient adherence by overcoming barriers associated with injectables, offering glycaemic control, weight loss, and cardiorenal benefits. Methods: A comprehensive literature review was conducted using PubMed, EMBASE, and Cochrane Library, focusing on oral Semaglutide and GLP-1 RAs. An expert panel convened on November 24, 2023, in Bengaluru, India, to develop guidelines for its use in T2DM management. Live opinion polls and panel discussions provided clinical insights across diverse patient populations. Results: Oral semaglutide demonstrated significant HbA1c reductions of −1.3% to −1.5% at 7 mg and 14 mg doses, and weight loss of up to 5 kg across diverse T2DM profiles, including drug-naïve individuals with normal BMI, obesity, ASCVD, and CKD. In CKD patients, it reduced nephropathy risk by HR 0.64 (95% CI: 0.46–0.88). Cardiovascular safety was supported by a 21% reduction in MACE in PIONEER 6. Additional benefits included improved blood pressure, lipid profiles, and a low risk of hypoglycemia, with consistent efficacy across special populations. Conclusion: Oral semaglutide offers a comprehensive, patient-centric approach to managing type 2 diabetes, with benefits extending beyond glycemic control to address cardiovascular, renal, and metabolic health. Its oral formulation enhances adherence, making it suitable for diverse patient populations. This expert consensus provides practical guidance for its effective use in routine clinical care.
