Software Agent Reusability Mechanism at Application Level

The usage of already available software agents plays a vital role in the process of development of application specific software. This reuse also leads to software development cost benefits as well as may ensure the timely delivery. This paper lay down an idea that for reusing reactive multi-agents systems two factors are to be considered i.e. (i) abstract description of agent in application independent way and (ii) reuse of such systems through adoption in specific domain[25]. For such a development main requirement is the effective reusable software abstractions. In present study the role of abstraction level and dependence level is analyzed for intelligent agents

Abiotrophia Endocarditis in Children with No Underlying Heart Disease: A Rare but a Virulent Organism

Infective endocarditis is extremely rare in children with structurally normal hearts. The most common etiological agents are staphylococcal and streptococcal species. Nutritionally variant streptococci also classified as A biotrophia species are a group of fastidious organisms that account for only 5% to 6% of all cases of culture‐negative infective endocarditis. Only seven cases of A biotrophia infective endocarditis have been previously reported in children with no underlying structural heart disease. We report two cases of A biotrophia infective endocarditis in children without any predisposing factors. Both patients presented with nonspecific symptoms leading to delay in diagnosis. While bacteriological clearance was achieved in both cases, both had a complicated course including development of brain mycotic aneurysms, splenic infarction, renal failure, and irreversible damage to the mitral valve. Both patients required surgical removal of the native mitral valve and replacement. We also present review of seven cases with similar diagnosis published previously in literature and highlight important differences. Our cases highlight special challenges in management of A biotrophia endocarditis in pediatric patients. As the organism may not be isolated in routine culture media, may present with atypical clinical symptoms and may have a complicated course even without antibiotic failure, a high index of suspicion should be maintained in children with subacute symptoms even with no underlying structural cardiac disease.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/108296/1/chd12095.pd

Fungal necrotizing fasciitis of face- a reconstructive challenge

Fungal necrotizing fasciitis (NF), particularly in the face, is an unusual infection. It is mostly seen in immunocompromised individuals and can be gravely destructive if diagnosis and treatment are delayed. We report this rare case of a 27-year-old, immunocompetent male who presented with gangrenous patch of skin on the cheek following blunt trauma to the right side of the face. Till now no case has been reported in literature with such an extensive soft tissue loss of face and involvement of facial skeleton due to fungal etiology. Clinical suspicion of necrotizing fasciitis led to early surgical intervention. Histopathological examination of the debrided tissue identified the infective organism as Apophysomyces elegans. Intravenous antifungal therapy with liposomal amphotericin B was initiated. Despite the prompt commencement of the treatment, the infection continued to spread, and the patient had to undergo serial debridement which resulted in orbital exenteration, partial maxillectomy and mandibulectomy on the right side. This resulted in a huge soft tissue defect requiring flap cover. A free anterolateral thigh flap was harvested to cover the soft tissue defect, but the blood flow could not be established. For salvage, scalp and pectoralis major muscle flaps were raised and used to cover the large hemifacial defect. The oral lining was created with a folded deltopectoral flap in a second stage. However, there was persistence of the fungal elements in wound bed even after prolonged systemic liposomal amphotericin B therapy and it invaded the flap margins due to which there was partial necrosis of the flap. In this article, we aim to describe the difficulties faced by us in the management of such devastating infection and the reconstructive challenge that it posed.

Angiogenesis in Non-Hodgkin's Lymphoma: An Intercategory Comparison of Microvessel Density

Background. This study was aimed at comparing angiogenesis, seen as microvessel density (MVD) in subtypes of non-Hodgkin's lymphoma (NHL). Methods. In this study, 64 cases of NHL diagnosed over a three-year period were included along with 15 lymph node biopsies of reactive hyperplasia. NHLs were classified using REAL classification, and immunohistochemistry was performed for CD34 in all cases. CD34-stained sections were evaluated for “hot spots,” where MVD was assessed and expressed as per mm2. Appropriate statistical methods were applied. Results. There were 6 cases of well-differentiated lymphocytic lymphoma (SLL), 21 diffuse large B-cell lymphoma (DLBCL), 15 follicular lymphoma, 10 lymphoblastic lymphoma, 7 MALToma, and 5 peripheral T-cell lymphoma (PTCL). Mean MVD was highest in reactive hyperplasia (191.92 ± 12.16 per mm2) compared to all NHLs. Among NHLs, PTCL demonstrated the highest MVD (183.42 ± 8.24) followed by DLBCL (149.91 ± 13.68). A significant difference was found in MVD between reactive and individual lymphoma groups. SLL had significantly lower MVD than other lymphoma subtypes. Conclusion. Angiogenesis, assessed by MVD, showed significant differences among subtypes of NHL, especially the indolent types like SLL. The higher MVD in aggressive lymphomas like PTCL and DLBCL can potentially be utilized in targeted therapy with antiangiogenic drugs

Ciprofloxacin-Resistant Neisseria meningitidis, Delhi, India

Decreased susceptibility of Neisseria meningitidis isolates to ciprofloxacin emerged from an outbreak in Delhi, India. Results of antimicrobial susceptibility testing of the meningococcal isolates to ciprofloxacin and further sequencing of DNA gyrase A quinolone-resistance–determining region confirmed the emergence of ciprofloxacin resistance in the outbreak

SARS-CoV-2 neutralizing antibodies : longevity, breadth, and evasion by emerging viral variants

The Severe Acute Respiratory Syndrome Coronavirus 2 (SAU ARS-CoV-2) antibody neutralization response and its evasion by emerging viral variants and variant of concern (VOC) are unknown, but critical to understand reinfection risk and breakthrough infection following vaccination. Antibody immunoreactivity against SARS-CoV-2 antigens and Spike variants, inhibition of Spike-driven virus–cell fusion, and infectious SARS-CoV-2 neutralization were characterized in 807 serial samples from 233 reverse transcription polymerase chain reaction (RT-PCR)–confirmed Coronavirus Disease 2019 (COVID-19) individuals with detailed demographics and followed up to 7 months. A broad and sustained polyantigenic immunoreactivity against SARS-CoV-2 Spike, Membrane, and Nucleocapsid proteins, along with high viral neutralization, was associated with COVID-19 severity. A subgroup of “high responders” maintained high neutralizing responses over time, representing ideal convalescent plasma donors. Antibodies generated against SARS-CoV-2 during the first COVID-19 wave had reduced immunoreactivity and neutralization potency to emerging Spike variants and VOC. Accurate monitoring of SARS-CoV-2 antibody responses would be essential for selection of optimal responders and vaccine monitoring and design

Supporting bodily communication in video consultations of physiotherapy

© 2018 Dr Deepti AggarwalPhysiotherapists are increasingly organising video consultations to support their patients over-a-distance. Physiotherapy is all about movements, and physiotherapists work on improving the subtle differences in the movements to restore the functioning of the affected body part. However, there exists a limited understanding on how physiotherapists assess and treat patient’s movements over video particularly when the limitations of video technology in mediating bodily information are already known. This thesis attempts to fill the gap by investigating how interactive technologies can support physiotherapists in understanding the patient’s bodily information during video consultations. To address this question, I conducted three studies each employing a different methodology. Study 1 examined the challenges that physiotherapists face in interpreting patients’ bodily information during video consultations through a field study. This study highlighted that video technology limits physiotherapists in understanding subtle differences in patient’s movements particularly related to lower limbs. Findings of this study guided the development of a research prototype, SoPhy - a wearable technology that monitors lower limb movements of patients over-a-distance. SoPhy consists of two parts: (1) a pair of socks with embedded sensors that captures patient’s movements; and (2) a web-interface that displays information about weight distribution, range of movement, and foot orientation to physiotherapists in real-time. Study 2 and 3 were focused on the evaluation of the developed prototype first in the laboratory through experimental research, and then in the hospital setting through field deployments. Study 2 showed that SoPhy increased the diagnostic confidence of physiotherapists in assessing lower limb movements over video. And Study 3 showed that SoPhy enhanced the clinician-patient communication, and guided more accurate assessment and treatment of the patients during video consultations. This thesis makes four contributions: First, it provides a detailed understanding of how bodily communication is employed by physiotherapists during video consultations. Secondly, it develops an understanding of the limitations of video technology in supporting the tasks of physiotherapists. The third contribution is a novel technology, SoPhy, that communicates information of patient’s weight distribution patterns over-a-distance to support physiotherapists in their clinical tasks. Finally, the thesis demonstrates that the efficacy of physiotherapists to assess and treat patients over video can be enhanced by using sensing technologies like SoPhy. The thesis aims to stimulate interest in designing novel technologies that can support effective assessment and treatment of body movements over-a-distance