Second wave of COVID 19 pandemic in India came with unexpected quick speed and intensity, creating an acute shortage of beds, ventilators, and oxygen at the peak of occurrence. This may have been partly caused by emergence of new variant delta. Clinical experience with the cases admitted to hospitals suggested that it is not merely a steep rise in cases but also possibly the case profile is different. This study was taken up to investigate the differentials in the characteristics of the cases admitted in the second wave versus those admitted in the first wave. Records of a total of 14398 cases admitted in the first wave (2020) to our network of hospitals in north India and 5454 cases admitted in the second wave (2021) were retrieved, making it the largest study of this kind in India. Their demographic profile, clinical features, management, and outcome was studied. Age sex distribution of the cases in the second wave was not much different from those admitted in the first wave but the patients with comorbidities and those with greater severity had larger share. Level of inflammatory markers was more adverse. More patients needed oxygen and invasive ventilation. ICU admission rate remained nearly the same. On the positive side, readmissions were lower, and the duration of hospitalization was slightly less. Usage of drugs like remdesivir and IVIG was higher while that of favipiravir and tocilizumab was lower. Steroid and anticoagulant use remained high and almost same during the two waves. More patients had secondary bacterial and fungal infections in Wave 2. Mortality increased by almost 40% in Wave 2, particularly in the younger patients of age less than 45 years. Higher mortality was observed in those admitted in wards, ICU, with or without ventilator support and those who received convalescent plasma. No significant demographic differences in the cases in these two waves, indicates the role of other factors such as delta variant and late admissions in higher severity and more deaths. Comorbidity and higher secondary bacterial and fungal infections may have contributed to increased mortality.

This paper presents a mechanism for active resource management (ARM) in a differentiated services environment. While the differentiated services architecture and the bandwidth broker agent provide a mechanism for QoS management through resource reservation, this mechanism is based on a static provisioning of resources. As bandwidth requirement are typically dynamic, such a static reservation approach can either lead to wasted bandwidth or leave applications resource-starved. The active resource management approach presented in this paper addresses this problem by dynamically reallocating resources based on current network state and applications requirements. An implementation and evaluation of ARM using the NS-2 simulation toolkit is also presented. Introduction In the current Internet architecture, a large percentage of the traffic is either multimedia related or a form of real-time data that is critical to an application. Typical applications are Voice over IP (VoIP) and video conferencing. Such time-critical data require some level of Quality of Service (QoS) guarantee. QoS is the classification of packets for the purpose of treating certain classes or flows of packets in a particular way as compared to the other packets. The Internet Protocol (IP), however, is based on best effort and lacks the capability to provide such QoS guarantees. 1 Various solutions have been proposed to address this problem by guaranteeing applications their required resources. These include integrated services (e.g., RSVP), differentiated services and multi-protocol label switching (MPLS).The differentiated services (DiffServ) network architecture attempts to provide these QoS guarantees in the most scalable and least complex manner.2 A DiffServ domain defines two levels of service provisioning: the standard best effort INTERNATIONAL JOURNAL OF NETWORK MANAGEMENT Int. J. Network Mgmt 2004; 14: 149-165 (DOI: 10.1002/nem.514) service, which is similar to IP; and the premium services where the client's requests for service guarantees are met. In the DiffServ architecture, the bandwidth broker (BB) manages a domain's resources using service policies which are defined based on the client's requirements. The BB reserves the bandwidth requested by a client for a price. This reservation, however, is made without any understanding of the nature of the information that will be transmitted. Although such a reservation provides a better sense of resource allocation than that provided by the DiffServ domain on its own, the result is still a static provisioning of resources, and can lead to wasted bandwidth. T he ARM approach actively manages the resources is a DiffServ domain by dynamically reallocating resources based on the current requirements and the state of the network.This paper presents the active resource management (ARM) approach that actively manages the resources in a DiffServ domain by dynamically reallocating resources based on the current requirements of applications and the state of the network. The ARM approach is motivated ...

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The success or failure of the entire software development process relies on the software testing component which is responsible for ensuring that the software that is released is free from bugs. One of the major labor intensive activities of software testing is the generation of the test data for the purpose of applying the testing methodologies. Many approaches have been tried and tested for automating the process of generating the test data. Meta-heuristics have been applied extensively for improving the efficiency of the process. This paper analyses the effectiveness of applying genetic algorithms for generating test data automatically using data flow testing approach. An incremental coverage measurement method is used to improve the convergence.

The Oxford-Astra Zeneca COVID 19 vaccine (AZD1222 or ChAdOx1) is an important part of the global vaccine roll-out against SARS-CoV-2, and a locally manufactured version (Covishield by Serum Institute, Pune, India) is the most commonly used vaccine in India. The vaccination program started in January 2021 and here we report effectiveness of the first dose of Covishield in generating antibody response and its kinetics. We further report differences in the quantitative antibody response amongst individuals who had pre-existing antibodies to SARS CoV2 and those who did not. In a group of 135 healthcare workers administered Covishield, we measured antibodies to SARS-CoV-2 directed against the spike protein (S-antigen) using Elecsys Anti-SARS-CoV-2 S quantitative antibody detection kit (Roche Diagnostics) at days 0, 7, 14, and 28. In 44 subjects (32.5%) who had already developed antibodies to SARS-CoV-2 at day 0 (before immunization), it was observed that antibody response was significantly higher at each time point, with the maximum increase seen between days 0 and 7. In contrast the sero-negative group (n=91) started developing antibody response only after 14 days or later. Three sero-negative individuals did not develop any antibody response even at day 28 of vaccination. It is noted that median antibody response at 28 days in seronegative subjects was similar to that of seropositive subjects at baseline (day 0) and was on a rising trajectory. Our data suggests that ChAdOx1 is highly immunogenic, particularly so where previous SARS CoV2 antibody-response is established. Given the high background seropositivity in India, this may be useful in determining optimal timing of the second dose during mass immunization within the constraints of vaccine supply and administration.

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Immunization is expected to confer protection against infection and severe disease for vaccines while reducing risks to unimmunized populations by inhibiting transmission. Here, based on serial serological studies of an observational cohort of healthcare workers, we show that during a Severe Acute Respiratory Syndrome -Coronavirus 2 Delta-variant outbreak in Delhi, 25.3% (95% Confidence Interval 16.9-35.2) of previously uninfected, ChAdOx1-nCoV19 double vaccinated, healthcare workers were infected within less than two months, based on serology. Induction of anti-spike response was similar between groups with breakthrough infection (541 U/ml, Inter Quartile Range 374) and without (342 U/ml, Inter Quartile Range 497), as was the induction of neutralization activity to wildtype. This was not vaccine failure since vaccine effectiveness estimate based on infection rates in an unvaccinated cohort were about 70% and most infections were asymptomatic. We find that while ChAdOx1-nCoV19 vaccination remains effective in preventing severe infections, it is unlikely to be completely able to block transmission and provide herd immunity.

The present study aimed at evaluating the water potability of the different regions of the Ludhiana, the Industrial hub of Pu njab and the Manchester of India. The physicochemical and the bacteriological potability analysis was conducted by affable means to test the water samples collected from six areas of Ludhiana city: Civil lines, Chandigarh Road, Ferozepur Road, Haibowal, Pakhowal Road, Model Town. All the areas of study showed only 20-40 percentage potability although the hardness and pH values were found to be within the permissible limits. The present findings provide an insight into the quality of drinking water in the areas of study and can be used by local water authority to ensure the supply of safe drinking water among population.