Relative percentage signal intensity recovery of perfusion metrics—an efficient tool for differentiating grades of glioma

OBJECTIVE

Glioma classification and characterization may be facilitated by a multiparametric approach of perfusion metrics, which could not be achieved by conventional MRI alone. Our aim is to explore the potential of relative percentage signal intensity recovery (rPSR) values, in addition to relative cerebral blood volume (rCBV) and relative cerebral blood flow (rCBF) of first-pass T2* dynamic susceptibility contrast (DSC) perfusion MRI, in differentiating high- and low-grade glioma.

METHODS

This prospective study included 39 patients with low-grade and 25 patients with high-grade glioma. rPSR, rCBV and rCBF were calculated from the first-pass T2* DSC perfusion MRI. rPSR was calculated using standard software and validated with dedicated perfusion metrics analysis software. The statistical analysis was performed using analysis of variance and receiver operating characteristic (ROC) curves.

RESULTS

Variation in rPSR, rCBV and rCBF values between low- and high-grade gliomas were statistically significant (p < 0.005). The ROC curve analysis for each of them yielded 96% sensitivity and 71.8% specificity; 88% sensitivity and 69.2% specificity; and 72% sensitivity and 66.7% specificity. The area under the curve (AUC) from the ROC curve analysis yielded 0.893, 0.852 and 0.702 for rPSR, rCBV and rCBF, respectively. The rPSR calculation with the validation software yielded 92.3% sensitivity and 72% specificity with an AUC of 0.864.

CONCLUSION

rPSR inversely correlates while rCBV and rCBF values directly correlate with the tumour grade. Furthermore, the overall diagnostic performance of rPSR is better than rCBV and rCBF values.

ADVANCES IN KNOWLEDGE

rPSR of T2* DSC perfusion is an indicator of blood-brain barrier status and lesion leakiness, which has not been explored yet compared with the usual haemodynamic parameters, rCBV and rCBF.

Implementation and impact of a post-exposure prophylaxis helpline

BACKGROUND

Despite a 2007 national and regional training programme, there was poor implementation of a post-exposure prophylaxis (PEP) programme to prevent occupational transmission of HIV in health care workers (HCWs) in Delhi. A new initiative was therefore launched by the Delhi State AIDS Control Society in 2010 to improve uptake of PEP in HCWs.

AIMS

To assess the implementation and efficacy of the PEP programme in Delhi.

METHODS

The initiative included a PEP poster and a telephone helpline together with a workshop for senior doctors of 46 public hospitals nominated as PEP supervisors. Data concerning use of the PEP help line and number of HCWs enrolling for PEP between January 2011 and May 2014 were analysed.

RESULTS

Until September 2010, only 61% (28) of Delhi hospitals had PEP drugs and medical supervisors to manage the programme and reports concerning the programme were not sent. After roll-out of the PEP helpline, 4057 HCWs accessed the helpline, all public hospitals started implementing the programme and sent monthly reports. During the same period, 1450 HCWs suffered from occupational exposures, 15% were started on PEP drugs of who 98% completed the full course of prophylaxis.

CONCLUSIONS

The PEP helpline is probably the first in a developing country and has been helpful for the effective implementation of the national PEP programme in Delhi.

Optimizing age of bull at first use in relation to fertility of Murrah breeding bulls

Aim:

The aim of the present investigation was to optimize the age at first use (AAFU) of semen of Murrah breeding bulls, which will help in early selection of bulls under progeny testing program for improving the reproductive performance in the herd.

Materials and Methods:

The data on AAFU, conception rate based on first A.I. (CRFAI), overall conception rate (OCR), and birth weight (B.WT) of 57 Murrah bulls during 1993-2014 at NDRI center pertaining to 14 sets of Network Project on Buffalo Improvement at ICAR-National Dairy Research Institute, Karnal, Haryana, India were adjusted for significant environmental influences and subsequently analyzed. Simple and multiple regression models were used for prediction of CRFAI and OCR of Murrah breeding bulls. Comparative evaluation of three developed models (I-III) showed that Model III, having AAFU and B.WT, fulfill the accuracy of model as revealed by high coefficient of determination, low mean sum of squares due to error, low conceptual predictive value, and low Bayesian information criterion.

Results:

The results revealed that the average predicted CRFAI was highest (39.95%) at <3.5 years and lowest (34.87%) at >4.5 years of age at first A.I/use. Similarly, average predicted OCR was highest (41.05%) at <3.5 years and lowest (39.42%) at >4.5 years of age at first A.I/use of Murrah bulls.

Conclusion:

In organized herd under progeny testing program, Murrah bulls should be used at young age, i.e. prior to 3.5 years, which is expected to result in 5.08% better CRFAI and 1.63% better OCR in comparison to Murrah bulls used after 4.5 years of age.

Effects of high neutron doses and duration of the chemical etching on the optical properties of CR-39

Effects of the duration of chemical etching on the transmittance, absorbance and optical band gap width of the CR-39 (Polyallyl diglycol carbonate) detectors irradiated to high neutron doses (12.7, 22.1, 36.0 and 43.5 Sv) were studied. The neutrons were produced by bombardment of a thick Be target with 12 MeV protons of different fluences. The unirradiated and neutron-irradiated CR-39 detectors were subjected to a stepwise chemical etching at 1h intervals. After each step, the transmission spectra of the detectors were recorded in the range from 200 to 900 nm, and the absorbances and optical band gap widths were determined. The effect of the etching on the light transmittance of unirradiated detectors was insignificant, whereas it was very significant in the case of the irradiated detectors. The dependence of the optical absorbance on the neutron dose is linear at short etching periods, but exponential at longer ones. The optical band gap narrows with increasing etching time. It is more significant for the irradiated dosimeters than for the unirradiated ones. The rate of the narrowing of the optical band gap with increasing neutron dose increases with increasing duration of the etching.

Disposal rate in different age groups of Karan Fries (Crossbred) males in organized herd

AIM

The present study was carried out to analyze the disposal rate in different age groups of Karan Fries (KF) males in National Dairy Research Institute herd.

MATERIALS AND METHODS

Records on 1740 KF crossbred bulls born during the period 1997-2012 were collected with an objective to ascertain the effect of genetic and non-genetic (Period of birth and season of birth) factors on the disposal pattern of KF males. The percent of animals disposed from the herd due to mortality and culling was calculated by proportion using descriptive statistics. The data were subjected to Chi-square test to test the difference due to different factors.

RESULTS

Overall disposal rate for the different age groups of 0-1 m, 1-2 m, 2-3 m, 3-6 m, 6-18 m, 18 m-3 year and 3-5 year were calculated as 17.9, 16.3, 14.2, 25.8, 49.0, 37.6 and 51.65%, respectively. In the age groups, 3-6 m, 6-18 m and 3-5 year, effect of periods of birth were found to be statistically significant (p<0.01) for overall disposal rate. Across different seasons of birth, overall disposal rates differed significantly (p<0.01) in different age group except in 3-5 year age group. Differences in overall disposal rate due to genetic group were statistically significant (p<0.01) in 1-2 m, 2-3 m, 3-6 m, 6-18 m, 18-3 year and 3-5 year age groups.

CONCLUSION

Overview of the results indicated that higher overall disposal rate in age group of 1 month was due to mortality while, in the age groups of >1 month, culling was the primary cause.

Repetitive transcranial magnetic stimulation induced modulations of resting state motor connectivity in writer's cramp

BACKGROUND AND PURPOSE

Writer's cramp (WC) is a focal task-specific dystonia of the hand which is increasingly being accepted as a network disorder. Non-invasive cortical stimulation using repetitive transcranial magnetic stimulation (rTMS) has produced therapeutic benefits in some of these patients. This study aimed to visualize the motor network abnormalities in WC and also its rTMS induced modulations using resting state functional magnetic resonance imaging (rsfMRI).

METHODS

Nineteen patients with right-sided WC and 20 matched healthy controls (HCs) were prospectively evaluated. All patients underwent a single session of rTMS and rsfMRI was acquired before (R1) and after (R2) rTMS. Seed-based functional connectivity analysis of several regions in the motor network was performed for HCs, R1 and R2 using SPM8 software. Thresholded (P < 0.05, false discovery rate corrected) group level mean correlation maps were used to derive significantly connected region of interest pairs.

RESULTS

Writer's cramp showed a significant reduction in resting state functional connectivity in comparison with HCs involving the left cerebellum, thalamus, globus pallidus, putamen, bilateral supplementary motor area, right medial prefrontal lobe and right post central gyrus. After rTMS there was a significant increase in the contralateral resting state functional connectivity through the left thalamus-right globus pallidus-right thalamus-right prefrontal lobe network loop.

CONCLUSIONS

It is concluded that WC is a network disorder with widespread dysfunction much larger than clinically evident and changes induced by rTMS probably act through subcortical and trans-hemispheric unaffected connections. Longitudinal studies with therapeutic rTMS will be required to ascertain whether such information could be used to select patients prior to rTMS therapy.

Molecular phylogenetic profiling of gut-associated bacteria in larvae and adults of flesh flies

Flesh flies of the genus Sarcophaga (Diptera: Sarcophagidae) are carrion-breeding, necrophagous insects important in medical and veterinary entomology as potential transmitters of pathogens to humans and animals. Our aim was to analyse the diversity of gut-associated bacteria in wild-caught larvae and adult flesh flies using culture-dependent and culture-independent methods. Analysis of 16S rRNA gene sequences from cultured isolates and clone libraries revealed bacteria affiliated to Proteobacteria, Actinobacteria, Firmicutes and Bacteroidetes in the guts of larval and adult flesh flies. Bacteria cultured from larval and adult flesh fly guts belonged to the genera Acinetobacter, Bacillus, Budvicia, Citrobacter, Dermacoccus, Enterococcus, Ignatzschineria, Lysinibacillus, Myroides, Pasteurella, Proteus, Providencia and Staphylococcus. Phylogenetic analysis showed clone sequences of the genera Aeromonas, Bacillus, Bradyrhizobium, Citrobacter, Clostridium, Corynebacterium, Ignatzschineria, Klebsiella, Pantoea, Propionibacterium, Proteus, Providencia, Serratia, Sporosarcina, Weissella and Wohlfahrtiimonas. Species of clinically significant genera such as Ignatzschineria and Wohlfahrtiimonas spp. were detected in both larvae and adult flesh flies. Sequence analysis of 16S rRNA gene libraries supported culture-based results and revealed the presence of additional bacterial taxa. This study determined the diversity of gut microbiota in flesh flies, which will bolster the ability to assess microbiological risk associated with the presence of these flies. The present data thereby establish a platform for a much larger study.

The prevalence of culture-confirmed toenail onychomycosis in at-risk patient populations

Onychomycosis is a fungal infection of the nail and is the most common nail affliction in the general population. Certain patient populations are at greater risk of infection and the prevalence of onychomycosis reported in the literature has yet to be summarized across these at-risk groups. We performed a systematic review of the literature and calculated pooled prevalence estimates of onychomycosis in at-risk patient populations. The prevalence of dermatophyte toenail onychomycosis was as follows: general population 3.22% (3.07, 3.38), children 0.14% (0.11, 0.18), the elderly 10.28% (8.63, 12.18), diabetic patients 8.75% (7.48, 10.21), psoriatic patients 10.22% (8.61, 12.09), HIV positive patients 10.40% (8.02, 13.38), dialysis patients 11.93% (7.11, 19.35) and renal transplant patients 5.17% (1.77, 14.14). Dialysis patients had the highest prevalence of onychomycosis caused by dermatophytes, elderly individuals had the highest prevalence of onychomycosis caused by yeasts (6.07%; 95% CI = 3.58, 10.11) and psoriatic patients had the highest prevalence of onychomycosis caused by non-dermatophyte moulds (2.49%; 95% CI = 1.74, 3.55). An increased prevalence of onychomycosis in certain patient populations may be attributed to impaired immunity, reduced peripheral circulation and alterations to the nail plate which render these patients more susceptible to infection.

White matter correlates of cognitive impairment in essential tremor

BACKGROUND AND PURPOSE

Impairment of cognitive functions occurs in essential tremor, though the mechanism is largely unknown. The aim of this study was to find microstructural correlates of cognitive dysfunction seen in essential tremor by using DTI and neuropsychological assessment.

MATERIALS AND METHODS

Fifty-five patients with essential tremor and 55 matched healthy controls were evaluated. Essential tremor was diagnosed by using the National Institutes of Health criteria. Subjects were assessed by using a structured neuropsychological battery. DTI data were acquired by using 3T MR imaging and were analyzed by using tract-based spatial statistics. Fractional anisotropy, mean diffusivity, radial diffusivity, and axial diffusivity were analyzed.

RESULTS

Patients were considered cognitively impaired when the test score was 1.5 SDs below or above the mean of healthy controls (depending on the type of test) in ≥3 neuropsychological tests. Patients with cognitive impairment had significantly higher mean diffusivity, radial diffusivity, and axial diffusivity values in the bilateral frontoparietal regions. In patients with cognitive impairment, mean diffusivity, radial diffusivity, and axial diffusivity showed correlations with various neuropsychological test scores. Executive function correlated with DTI measures of the frontal white matter, cingulum, inferior superior longitudinal and uncinate fasciculi, anterior thalamic radiations, and posterior lobe of the cerebellum. Visuospatial function correlated with the right parieto-occipital lobe, whereas visual-verbal memories correlated with the anterior thalamic radiations, inferior longitudinal and uncinate fasciculi, and the posterior lobe of the cerebellum. No significant correlations were found between fractional anisotropy and any of the neuropsychological test scores.

CONCLUSIONS

The present study demonstrates a correlation between neuropsychological test scores and DTI measures, suggesting a neuroanatomic basis for cognitive impairment seen in patients with essential tremor.

Strategic planning and designing of a hospital disaster manual in a tertiary care, teaching, research and referral institute in India

BACKGROUND

As per the "Disaster Management Act, 2005" of India, it is mandatory for government hospitals in India to prepare a disaster plan. This study aimed to prepare a disaster manual of a 1 900 bed tertiary care hospital, in consultation and involvement of all concerned stakeholders.

METHODS

A committee of members from hospital administration, clinical, diagnostic and supportive departments worked on an initial document prepared according to the Act and gave their inputs to frame a final disaster manual.

RESULTS

The prepared departmental standard operating procedures involved 116 people (doctors and paramedical staff), and were then synchronized, in 12 committee meetings, to produce the final hospital disaster manual.

CONCLUSIONS

The present disaster manual is one of the few comprehensive plans prepared by the stakeholders of a government hospital in India, who themselves form a part of the disaster response team. It also helped in co-ordinated conduction of mock drills.

Outcomes of surgical site infections in orthopedic trauma surgeries in a tertiary care centre in India

BACKGROUND

Surgical site infections (SSIs) still cause significant morbidity and mortality despite advances in trauma care. We have studied in this paper the rate of SSIs, their outcomes in patients undergoing interventions for trauma and SSI trends in developing countries.

MATERIALS AND METHODS

A 16-month study (May, 2011- August, 2012) was carried out. Patients undergoing interventions for orthopedic trauma were followed and assessed for SSIs and their outcomes and antimicrobial sensitivity patterns of the micro-organisms isolated were noted and correlated.

RESULTS

A total of 40 (4.4%) confirmed cases of SSIs were identified among 852 patients of orthopedic trauma. Based on the new CDC criteria, after ruling out cellulitis, only 24 (2.6%) were found to have SSIs. A total of 12.5% of the SSIs were detected during follow-up. Acinetobacter baumannii was the predominant organism as also Staphylococcus aureus. Outcomes observed included changes in antibiotic regime, revision surgery, readmission to hospital and deaths.

CONCLUSION

SSI is prevalent in orthopaedic trauma patients and an active surveillance program will help in early management and prevention.

Effect of coupling strength on a two-lane partially asymmetric coupled totally asymmetric simple exclusion process with Langmuir kinetics

We analyze an open system comprised of two parallel totally asymmetric simple exclusion processes with particle attachment and detachment in the bulk under partially asymmetric coupling conditions. The phase diagrams are obtained using boundary layer analysis of continuum mean-field equations and characterized for different values of lane-changing rates. The structure of the phase diagram remains qualitatively the same as the one in fully asymmetric coupling conditions up to a certain critical order of lane-changing rates, after which significant changes are found in the phase diagram. The effect of system size on the steady-state dynamics has also been examined. To validate theoretical findings, extensive Monte Carlo simulations are carried out.

Measurement of neutron spectra generated from bombardment of 4 to 24 MeV protons on a thick ⁹Be target and estimation of neutron yields

A systematic study on the measurement of neutron spectra emitted from the interaction of protons of various energies with a thick beryllium target has been carried out. The measurements were carried out in the forward direction (at 0° with respect to the direction of protons) using CR-39 detectors. The doses were estimated using the in-house image analyzing program autoTRAK_n, which works on the principle of luminosity variation in and around the track boundaries. A total of six different proton energies starting from 4 MeV to 24 MeV with an energy gap of 4 MeV were chosen for the study of the neutron yields and the estimation of doses. Nearly, 92% of the recoil tracks developed after chemical etching were circular in nature, but the size distributions of the recoil tracks were not found to be linearly dependent on the projectile energy. The neutron yield and dose values were found to be increasing linearly with increasing projectile energies. The response of CR-39 detector was also investigated at different beam currents at two different proton energies. A linear increase of neutron yield with beam current was observed.

Clinical profile of patients using normal, high and very high insulin doses in type 2 diabetes

AIMS

Insulin requirement varies between patients with diabetes due to insulin resistance. The clinical profile of patients based on their insulin requirement has not been studied earlier. We stratified the patients based on total daily insulin requirement (TDIR) and studied their clinical profile and carbohydrate consumption.

MATERIALS & METHODS

Sixty patients with type 2 diabetes (aged 30-75 years, using stable insulin dose for last 6 months, HbA1c between 6-7.5%, negative screening tests for Acromegaly and Cushing's disease) participated in this clinical observational study. All patients with major illness, surgery or diabetic ketoacidosis were excluded. The patients were divided into 3 groups: Group 1 (TDIR<1 U/kg, n=30), Group 2 (TDIR 1-2 U/kg, n=20) and Group 3 (TDIR>2U/kg, n=10). Data are presented as mean±S.D and comparison between three groups was done using one way ANOVA test.

RESULTS

The patients (27M: 33F) had mean age 54.3 ± 12.3 years, diabetes duration 10.1±4.7 years and an A1c of 7±0.38%. Patients in group 3 had lower body weight, BMI and highest carbohydrate consumption when compared with the other two groups (P<0.05). Hypoglycemic episodes and complications did not differ between the groups.

CONCLUSION

Our data showed that the low body weight and high carbohydrate intake are associated with increased insulin requirement. The clinical implications of our study are to check the carbohydrate intake in patients with high insulin requirement.

Network meta-analysis of the outcome 'participant complete clearance' in nonimmunosuppressed participants of eight interventions for actinic keratosis: a follow-up on a Cochrane review

The conclusions of pairwise meta-analyses of interventions for actinic keratosis (AK) are limited due to the lack of direct comparison between some interventions. Consequently, we performed a network meta-analysis for eight treatments [5-aminolaevulinic acid (ALA)-photodynamic therapy (PDT), cryotherapy, diclofenac 3% in 2·5% hyaluronic acid (DCF/HA), 5-fluorouracil (5-FU) 0·5% or 5·0%, imiquimod (IMI) 5%, ingenol mebutate (IMB) 0·015-0·05%, methyl aminolaevulinate (MAL)-PDT and placebo/vehicle (including placebo-PDT)] to determine their relative efficacies. As part of a prior Cochrane systematic review, different databases and grey literature were searched for randomized controlled trials up to April 2012. The inclusion criteria were parallel-group studies with nonimmunosuppressed participants: (i) reporting 'participant complete clearance' and (ii) comparing at least two of the interventions. Thirty-two publications met the criteria and they included the following number of individual or pooled studies (n) and total number of participants (N) for the different interventions: 5-FU 0·5% (n = 4, N = 169), 5-FU 5·0% (n = 2, N = 44), ALA-PDT (n = 6, N = 739), cryotherapy (n = 2, N = 174), DCF/HA (n = 5, N = 299), IMI (n = 14, N = 1411), IMB (n = 3, N = 560), MAL-PDT (n = 7, N = 557) and placebo (n = 32, N = 2520). Network analyses using a random-effects Bayesian model were carried out with the software ADDIS v1.16.1. The interventions were ranked as follows based on calculated probabilities and odd ratios: 5-FU > ALA-PDT ≈ IMI ≈ IMB ≈ MAL-PDT > cryotherapy > DCF/HA > placebo. This efficacy ranking was obtained based on the current available data on 'participant complete clearance' from randomized controlled trials and the analysis model used. However, several other factors should also be considered when prescribing a treatment for AK.

Association between cortical volume loss and cognitive impairments in essential tremor

BACKGROUND AND PURPOSE

Impairment of cognitive functions occurs in essential tremor (ET) although the mechanism is largely unknown. A possible association between cognitive performance and brain atrophy in ET patients was examined using neuropsychological tests and voxel-based morphometry (VBM).

METHODS

Twenty-five patients with ET and 25 matched healthy controls were evaluated. ET was diagnosed using the National Institutes of Health collaborative genetic criteria. Severity of tremor was assessed using the Fahn-Tolosa-Marin (FTM) tremor rating scale. Subjects were assessed using a structured neuropsychological battery. Brain images were acquired using a 3T magnetic resonance imaging scanner. VBM analysis was performed using Statistical Parametric Mapping 8.

RESULTS

The age of the patients was 45.0 ± 10.7 years and of controls 45.4 ± 10.7 years. Tremor duration was 9.84 ± 6.63 years and total FTM score was 37.34 ± 17.67. Patients were divided into two groups: ETCI with cognitive impairment (three or more abnormal neuropsychological tests, 1.5 standard deviation criterion) and ETNCI without cognitive impairment. Compared with controls, the ETCI group had significantly impaired performance in neuropsychological tests. One-way analysis of variance was performed between the three groups (ETCI, ETNCI, controls) followed by the two-sample t test. Compared with controls, grey matter volume (GMV) loss was observed in ETCI in the cerebellum (anterior and posterior lobes) and medial frontal gyrus. GMV loss was observed in ETCI compared with ETNCI in the medial frontal gyrus, post central gyrus, anterior cingulate and insula. Impairment in neuropsychological tests significantly correlated with GMV of the medial frontal gyrus, superior parietal lobe, middle temporal gyrus, occipital lobe, lentiform nucleus, insular and cingulate cortices and cerebellum posterior lobe in ETCI.

CONCLUSIONS

A correlation between neurocognitive deficits in ETCI and GMV was observed suggesting that grey matter atrophy appears to be a correlate of cognitive impairment in ET.

Diffusion-weighted imaging in urinary tract lesions

Diffusion-weighted imaging (DWI) utilizes the signal contrast provided by the regional differences in the Brownian motion of water molecules, which is a direct reflection of the cellular micro-environment. DWI emerged as a revolutionary magnetic resonance imaging (MRI) technique in the field of stroke imaging. As far as body imaging is concerned, DWI has come a long way from being an experimental technique to an essential element of almost all abdominal MRI examinations. This progress has been made possible by technical advancements in MRI systems, as well as a better understanding of MRI physics. DWI is quick to perform and has the potential to provide crucial information about the disease process without adding much to the total imaging time. This article provides a brief review of the basic principles of DWI with insights to the information that DWI provides in the evaluation of various diseases of the urinary tract at both 1.5 and 3 T. DWI is helpful for differentiation of various histopathological subtypes of renal cell carcinoma (RCC). Prediction of histopathological grade of RCC is also becoming possible solely based on DWI. Assessment of response to chemotherapeutic agents is possible based on the change in the ADC (apparent diffusion coefficient) value. DWI performed with high b-values increases the confidence in diagnosing prostatic carcinoma. This article highlights the emerging role of DWI in the evaluation of urinary tract lesions.

Point prevalence surveys of healthcare-associated infections and use of indwelling devices and antimicrobials over three years in a tertiary care hospital in India

Few hospitals in India perform regular surveillance for healthcare-associated infections (HAIs) and use of indwelling devices and antimicrobials. The aim of this study was to conduct two one-day point prevalence surveys of HAIs and use of indwelling devices and antimicrobials in a large 1800-bed tertiary care hospital in India. The overall prevalence of HAIs was 7%, and surgical site infections were the most common (33%). Indwelling devices were present in 497 (27%) patients, and 915 (50%) patients were receiving antimicrobials. This study helped to generate robust baseline data on the prevalence of HAIs and use of indwelling devices and antimicrobials in the study hospital.

Asymmetric coupling in two-lane simple exclusion processes with Langmuir kinetics: phase diagrams and boundary layers

We use boundary layer analysis for an open system consisting of two parallel totally asymmetric simple exclusion processes with Langmuir kinetics under a biased lane-changing rule. The two kinds of phase transitions--bulk transitions and surface transitions--have been examined. The dynamics of shock and their dependence on the system parameters have been investigated. We find a reduction in the number of steady-state phases with increase in lane-changing rate.

System efficiency analysis for high power solid state radio frequency transmitter

This paper examines some important relationships, related with the system efficiency, for very high power, radio frequency solid-state transmitter; incorporating multiple solid-state power amplifier modules, power combiners, dividers, couplers, and control/interlock hardware. In particular, the characterization of such transmitters, at the component as well as the system level, is discussed. The analysis for studying the influence of the amplitude and phase imbalance, on useful performance parameters like system efficiency and power distribution is performed. This analysis is based on a scattering parameter model. This model serves as a template for fine-tuning the results, with the help of a system level simulator. For experimental study, this approach is applied to a recently designed modular and scalable solid-state transmitter, operating at the centre frequency of 505.8 MHz and capable of delivering a continuous power of 75 kW. Such first time presented, system level study and experimental characterization for the real time operation will be useful for the high power solid-state amplifier designs, deployed in particle accelerators.

Genetic diversity and bottleneck studies in endangered Bhutia and Manipuri pony breeds

For studying the genetic diversity and bottleneck problem in Bhutia and Manipuri pony breeds of India, we analysed DNA samples of 34 Bhutia and 50 Manipuri, true to breed, ponies using 47 polymorphic microsatellite markers. All the microsatellites were observed to be highly polymorphic in nature in both Bhutia and Manipuri breeds with mean no. of alleles as 8.702 ± 0.0493 and 8.416 ± 0.0548 respectively. Genetic diversity values in terms of heterozygosity values within individual breeds were also high with very low inbreeding (Fis 0.102 and 0.055 in Bhutia and Manipuri ponies, respectively). Number of alleles in both the populations together ranged from 3 to 18 with an average of 10.851 ± 1.583 per locus. The mean effective number of alleles was observed to 5.34 ± 0.253. All loci except ASB017 and HTG004 showed high values of allele richness (>5.0). The mean observed and expected heterozygosities were 0.7159 ± 0.022, 0.7986 ± 0.011 (Levene's) and 0.7936 ± 0.011 (Nei's), respectively. The high mean values of heterozygosity indicated the presence of high genetic diversity in both the pony populations. The overall mean value of within-population inbreeding estimates (Fis) was low (0.101 ± 0.023) indicating low to moderate level of inbreeding. Bottleneck studies revealed that no recent bottleneck problem has taken place in both the populations. Both pony populations were found to be in mutation drift equilibrium. The study reveals that both the pony breeds have high diversity and timely action needs to be taken to conserve them.

Clinical decision-making augmented by simulation training: neural correlates demonstrated by functional imaging: a pilot study

BACKGROUND

Investigation of the neuroanatomical basis of clinical decision-making, and whether this differs when students are trained via online training or simulation training, could provide valuable insight into the means by which simulation training might be beneficial.

METHODS

The aim of this pilot prospective parallel group cohort study was to investigate the neural correlates of clinical decision-making, and to determine if simulation as opposed to online training influences these neural correlates. Twelve third-year medical students were randomized into two groups and received simulation-based or online-based training on anaphylaxis. This was followed by functional magnetic resonance imaging scanning to detect brain activation patterns while answering multiple choice questions (MCQs) related to anaphylaxis, and unrelated non-clinical (control) questions. Performance in the MCQs, salivary cortisol levels, heart rate, and arterial pressure were also measured.

RESULTS

Comparing neural responses to clinical and non-clinical questions (in all participants), significant areas of activation were seen in the ventral anterior cingulate cortex and medial prefrontal cortex. These areas were activated in the online group when answering action-based questions related to their training, but not in the simulation group. The simulation group tended to react more quickly and accurately to clinical MCQs than the online group, but statistical significance was not reached.

CONCLUSIONS

The activation areas seen could indicate increased stress when answering clinical questions compared with general non-clinical questions, and in the online group when answering action-based clinical questions. These findings suggest simulation training attenuates neural responses related to stress when making clinical decisions.

Microencapsulation for controlled drug delivery: a comprehensive review

Microencapsulation is described as a process of enclosing micron sized particles of solids or droplets of liquids or gasses in an inert shell, which in turn isolates and protects them from the external environment as well as control the drug release profile. Microencapsulated particle is having diameter between 3 [-] 800µm which differ them from other technologies such as nanotechnology and macroparticle in their morphology and internal structure. This review paper will address the background of microencapsulation technology, commonly used microencapsulation methods with its advantages and disadvantages and its applications in pharmaceutical field. This article also gives an overview on the general aspects and recent advances in drug-loaded microparticles to improve the efficiency of various medical treatments. The review paper will also address about the other factors affecting microencapsulation and its limitation. The article will also discuss about various findings described in the published scientific journals and patent literatures. Based on the existing results and authors’ reflection, this review gives rise to reasoning and suggested choices of process parameters and microencapsulation procedure.  DOI: http://dx.doi.org/10.3126/stcj.v1i1.8660  Sunsari Technical College Journal Vol.1(1) 2012 48-54

Combination therapy with naltrexone and bupropion for obesity reduces total and visceral adiposity

The effects of combination naltrexone/bupropion therapy on body composition and visceral adipose tissue (VAT) mass were examined in a subset (n = 107) of obese subjects from a Phase 2 trial that compared the efficacy and safety of placebo, naltrexone monotherapy, bupropion monotherapy or one of three naltrexone/bupropion dose combinations for 24 weeks. Body composition data were obtained using dual-energy X-ray absorptiometry and computed tomography. Eighty subjects completed the substudy. Naltrexone/bupropion resulted in weight loss and a greater reduction in body fat (-14.0 ± 1.3%) than placebo (-4.0 ± 2.0%), naltrexone monotherapy (-3.2 ± 2.5%) and bupropion monotherapy (-4.1 ± 2.9%; all p < 0.01). Reduction in VAT mass was also greater with naltrexone/bupropion (-15.0 ± 1.8%) than placebo (-4.6 ± 2.7%), naltrexone monotherapy (-0.1 ± 3.5%) and bupropion monotherapy (-2.3 ± 4.2%; all p < 0.01). Reductions in body fat and VAT mass with naltrexone/bupropion were proportional with weight loss. Weight loss with naltrexone/bupropion was not associated with a greater relative reduction in lean mass than placebo or the monotherapies.

Ethnic and sex differences in visceral, subcutaneous, and total body fat in children and adolescents

OBJECTIVE

This study investigated ethnic and sex differences in the distribution of fat during childhood and adolescence.

DESIGN AND METHODS

A cross-sectional sample (n = 382), aged 5-18 years, included African American males (n = 84), White males (n = 96), African American females (n = 118), and White females (n = 84). Measures for total body fat (TBF) mass and abdominal adipose tissue (total volume and L4-L5 cross-sectional area) for both subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) depots were assessed by dual-energy X-ray absorptiometry and magnetic resonance image, respectively. Analyses of covariance (ANCOVAs) were used to determine ethnic and sex differences in TBF (adjusted for age) and ethnic and sex differences in SAT and VAT (adjusted for both age and TBF).

RESULTS

Age-adjusted TBF was greater in African Americans (P = 0.017) and females (P < 0.0001) compared with Whites and males, respectively. In age- and TBF-adjusted ANCOVAs, no differences were found in the SAT. The VAT volume was, however, greater in Whites (P < 0.0001) and males (P < 0.0001) compared with African Americans and females, respectively. Similar patterns were observed in SAT and VAT area at L4-L5.

CONCLUSIONS

The demonstrated ethnic and sex differences are important confounders in the prevalence of obesity and in the assignment of disease risk in children and adolescents.

Synthesis and in vitro antioxidant activity of new 3-substituted-2-oxindole derivatives

A series of new 1,3-dihydro-3-hydroxy-3-(2-phenyl-2-oxoethyl)-2H-indol-2-ones (1a-g) and 1,3-dihydro-3-(2-phenyl-2-oxoethylidene)-2H-indol-2-ones (2a-g) were synthesised by Knoevenagel condensation of substituted indole-2,3-diones (isatins) with various acetophenones. The synthesised compounds were characterised by their physical data, elemental, IR, ¹H NMR, ¹³C NMR and mass spectral analyses and their in vitro antioxidant activity was determined by 2,2-diphenyl-1-picrylhydrazyl free radical scavenging assay. These compounds showed moderate to good antioxidant activities as compared with the standard, ascorbic acid. The antioxidant potential of 3-hydroxy-3-substituted oxindoles (1a-g) increased in a concentration-dependent manner from 10 to 500 μg/ml with 5-fluoro and 5-methyl analogues showing maximum activity. Of 3-aroyl methylene indol-2-ones (2a-g), majority of compounds with halogen substitution at position 5 of isatin ring exhibited good antioxidant activity within a concentration range of 5-100 μg/ml and the maximum activity was observed at 20 and 25 μg/ml concentrations. Thus, our study provides evidence that some newly synthesised isatin derivatives exhibit substantial antioxidant activity at low concentrations.

Massive ossifying fibroma of the mandible in a child

An interesting case of large ossifying fibroma of the mandible in a child with a sickle-cell trait is reported.

Network meta-analysis of the outcome 'participant complete clearance' in nonimmunosuppressed participants of eight interventions for actinic keratosis: a follow-up on a Cochrane review

The conclusions of pairwise meta-analyses of interventions for actinic keratosis (AK) are limited due to the lack of direct comparison between some interventions. Consequently, we performed a network meta-analysis for eight treatments [5-aminolaevulinic acid (ALA)-photodynamic therapy (PDT), cryotherapy, diclofenac 3% in 2·5% hyaluronic acid (DCF/HA), 5-fluorouracil (5-FU) 0·5% or 5·0%, imiquimod (IMI) 5%, ingenol mebutate (IMB) 0·015-0·05%, methyl aminolaevulinate (MAL)-PDT and placebo/vehicle (including placebo-PDT)] to determine their relative efficacies. As part of a prior Cochrane systematic review, different databases and grey literature were searched for randomized controlled trials up to April 2012. The inclusion criteria were parallel-group studies with nonimmunosuppressed participants: (i) reporting 'participant complete clearance' and (ii) comparing at least two of the interventions. Thirty-two publications met the criteria and they included the following number of individual or pooled studies (n) and total number of participants (N) for the different interventions: 5-FU 0·5% (n = 4, N = 169), 5-FU 5·0% (n = 2, N = 44), ALA-PDT (n = 6, N = 739), cryotherapy (n = 2, N = 174), DCF/HA (n = 5, N = 299), IMI (n = 14, N = 1411), IMB (n = 3, N = 560), MAL-PDT (n = 7, N = 557) and placebo (n = 32, N = 2520). Network analyses using a random-effects Bayesian model were carried out with the software ADDIS v1.16.1. The interventions were ranked as follows based on calculated probabilities and odd ratios: 5-FU > ALA-PDT ≈ IMI ≈ IMB ≈ MAL-PDT > cryotherapy > DCF/HA > placebo. This efficacy ranking was obtained based on the current available data on 'participant complete clearance' from randomized controlled trials and the analysis model used. However, several other factors should also be considered when prescribing a treatment for AK.

Semiquinone derivative isolated from Bacillus sp. INM-1 protects cellular antioxidant enzymes from γ-radiation-induced renal toxicity

This study was focused to evaluate protection of indigenous antioxidant system of mice against gamma radiation-induced oxidative stress using a semiquinone (SQGD)-rich fraction isolated from Bacillus sp. INM-1. Male C57bl/6 mice were administered SQGD (50 mg/kgb.w.i.p.) 2 h before irradiation (10 Gy) and modulation in antioxidant enzymes activities was estimated at different time intervals and compared with irradiated mice which were not pretreated by SQGD. Compared to untreated controls, SQGD pretreatment significantly (p < 0.05) accelerates superoxide dismutase, catalase, GSH, and glutathione-S-transferase activities. Similarly, significant (p < 0.05) increase in the expression of superoxide dismutase, catalase, GSH, and glutathione-S-transferase was observed in irradiated mice pretreated by SQGD, compared to only irradiated groups. Total antioxidant status equivalent to trolox was estimated in renal tissue of the mice after SQGD administration. Significant ABTS(+) radical formation was observed in H2O2-treated kidney homogenate, due to oxidative stress in the tissue. However, significant decrease in the levels of ABTS(+) radical was observed in kidney homogenate of the mice pretreated with SQGD. Therefore, it can be concluded that SQGD neutralizes oxidative stress by induction of antioxidant enzymes activities and thus improved total antioxidant status in cellular system and hence contributes to radioprotection.

Occurrence of complications in newly diagnosed type 2 diabetes patients: a hospital based study

Type 2 diabetes is characterised by a long asymptomatic period of hyperglycaemia and many individuals with type 2 diabetes have complications even at the time of diagnosis. The purpose of present study was to study and compare the prevalence of complications at the time of diagnosis of type 2 diabetes in newly diagnosed asymptomatic and symptomatic patients. One hundred and five consecutive newly diagnosed cases of type 2 diabetes were selected for study based on fasting blood glucose level > or = 126 mg/dl. Individuals who were known diabetic, individuals presenting with acute complications were excluded from study. The prevalence rates of various complications in newly diagnosed diabetic patients were studied in both asymptomatic and symptomatic subjects and results were analysed statistically using test of proportion and Chi-square test. There were 40.95% of newly diagnosed diabetes patients who were asymptomatic. There was no significant difference between those having symptoms of diabetes and those without symptoms of diabetes with regard to age, sex, weight and hypertension. Occurrence of both microvascular and macrovascular complications were not different in the two groups studied. We also observed a very high prevalence of microvascular (32.55%) complications in asymptomatic newly diagnosed type 2 diabetes patients. Since 35.20% of cases in this study were below 50 years and various complications develop 10-20 years after onset of disease, this study suggests that screening for diabetes should commence at the age of 40 years in general population.

Viral hepatitis with special reference to hepatitis B virus infection in India: an overview

Hepatitis is a feature of many viral diseases usually resulting as a part of generalised infection which involves the liver. In contrast, there are at least five different hepatitis viruses (HAV to HEV) that primarily target the liver in humans--called hepatitis viruses, whereas the role of sixth virus (HGV) is doubtful. Although symptoms produced are similar, these viruses differ greatly in their structure, mode of replication and transmission. The aim of this article is to bring out salient features of these viruses and approach towards their control/prevention, laying emphasis on HBV which has attained/ become one of major public health problems in India.

Planting geometry to optimize growth and productivity in faba bean (Vicia faba L.) and soil fertility

Faba bean (Vicia faba L.) responses to alteration of its ambient environment leads to certain modification in the crop phenology, yield attributes and economic yield. To know the extent and pattern of response by faba bean to alterations, a two year field experimentation was carried out with two crop establishment methods (i) flatbed planting (ii) raised bed planting, four planting geometry (i) 30 x 20 cm(ii) 30 x 30 cm (iii) 30 x 45 cm and (iv) 45X45cm and three seeding depth. All the treatment (two crop establishment methods, four planting geometry and three seeding depth) were combined together consisting twenty four treatments, were organized in factorial experiment in complete randomized block design (CRBD) with three replications. Data were recorded on growth and development; yield attributes and yield. Soil analysis was done and finally statistical tool were applied to come in to valid conclusion. Raised bed planting proves superior over flatbed in case of seed yield. Square planting architect with 30 cm apart prove better (3690.9 kg ha(-1)) than other tested planting geometry. Seeding at 10 cm depth showed, significant improvement in seed yield per plant and per ha over other two tested seeding depth. Phosphorus availability was significantly higher in raised bed planting (36.9 kg ha(-1)). However, available K (kg ha(-1)) was significantly influenced by planting geometry and seeding depth. It was maximum (155.2 kg ha(-1)) with 30 x 45 cm plant geometry, proved significantly higher than 30 x 20 cm and 30 x 30 cm and at par with 45 x 45 cm planting.

Reclassification of Bacillus beijingensis Qiu et al. 2009 and Bacillus ginsengi Qiu et al. 2009 as Bhargavaea beijingensis comb. nov. and Bhargavaea ginsengi comb. nov. and emended description of the genus Bhargavaea

We have carried out a polyphasic taxonomic characterization of Bacillus beijingensis DSM 19037T and Bacillus ginsengi DSM 19038T, which are closely related phylogenetically to Bhargavaea cecembensis LMG 24411T. All three strains are Gram-stain-positive, non-motile, moderately halotolerant and non-spore-forming. 16S rRNA gene sequence analyses showed that the strains constituted a coherent cluster, with sequence similarities between 99.7 and 98.7 %. The percentage similarity on the basis of amino acid sequences deduced from partial gyrB gene nucleotide sequences of these three type strains was 96.1–92.7 %. Phylogenetic trees based on the 16S rRNA gene and GyrB amino acid sequences, obtained by using three different algorithms, were consistent and showed that these three species constituted a deeply rooted cluster separated from the clades represented by the genera Bacillus , Planococcus , Planomicrobium , Sporosarcina , Lysinibacillus , Viridibacillus , Kurthia and Geobacillus , supporting their placement in the genus Bhargavaea . All three type strains have menaquinone MK-8 as the major respiratory quinone and showed similar fatty acid profiles. The main polar lipids present in the three type strains were diphosphatidylglycerol and phosphatidylglycerol, and the three strains showed peptidoglycan type A4α with l-lysine as the diagnostic diamino acid. The DNA G+C contents of Bacillus beijingensis DSM 19037T, Bacillus ginsengi DSM 19038T and Bhargavaea cecembensis LMG 24411T were 53.1, 50.2 and 53.7 mol%, respectively. The level of DNA–DNA hybridization among the three strains was 57–39 %, indicating that they are members of different species of the genus Bhargavaea . The phenotypic data are consistent with the placement of these three species in a single genus and support their differentiation at the species level. On the basis of these data, we have emended the description of the genus Bhargavaea and propose the reclassification of Bacillus beijingensis and Bacillus ginsengi to the genus Bhargavaea , as Bhargavaea beijingensis comb. nov. (type strain ge10T  = DSM 19037T  = CGMCC 1.6762T) and Bhargavaea ginsengi comb. nov. (type strain ge14T  = DSM 19038T  = CGMCC 1.6763T).

Low vitamin D levels, prediabetes and prehypertension in healthy African American adults

AIMS

To determine if customary lower serum vitamin D concentrations in healthy African American (AA) adults are associated with modest elevations in fasting plasma glucose (FPG) and/or resting blood pressure (BP). Numerous health disparities between African American (AA) and Caucasian American (CA) adults, especially those which increase cardiovascular morbidity and mortality, have been attributed to lower serum vitamin D concentrations in the AA. Prediabetes (PreDM) and prehypertension (PreHTN) are significantly more prevalent in healthy disease free CA adults with serum vitamin D concentrations below the 75th percentile for the Caucasian cohort. We hypothesized that despite overall lower serum vitamin D concentrations in AA, an increase in the prevalence for PreDM and PreHTN would be seen in those with low vitamin D levels.

METHODS AND RESULTS

Disease free AA adults in the National Health and Nutrition Examination Survey 2001-2006 were assessed. PreDM and PreHTN were diagnosed using the ADA and JNC 7 criteria: (FPG) 100-125 mg/dL and resting systolic (SBP) 120-139 and/or diastolic (DBP) 80-89 mm Hg, respectively. Logistic regression was employed to assess effects of low vitamin D concentrations on the odds for PreDM and PreHTN (n = 621). Age, gender and BMI adjusted odds ratio for co-morbid PreDM and PreHTN in AA men (n = 343) and women (n = 278) with vitamin D levels ≤45.4 versus >45.4 nmol/L was 2.02 (1.11, 3.68), (p < 0.021).

CONCLUSIONS

Evaluating serum vitamin D levels, with consideration for supplementation in seemingly healthy AA adults with prediabetes, prehypertension, or co-existing prediabetes and prehypertension, has merit.