Assessment of a non-invasive haemoglobin sensor NBM 200 among pregnant women in rural India

Objective: This study aimed to assess a non-invasive haemoglobin sensor NBM 200 in pregnant women in a rural Indian setting. Methods: The study population consisted of women between 3 to 5 months of pregnancy, from 33 villages in Tuljapur and Lohara blocks of Osmanabad district, Maharashtra between April 2014 and June 2015. Haemoglobin (Hb) measurements obtained from the non-invasive sensor NBM 200 were compared with measurements obtained from an automated haematology analyser Sysmex XP-100, using the Bland Altman method and Spearman’s Rank correlation coefficient. Interclass correlation coefficient (ICC), sensitivity and specificity values were used to assess the anaemia diagnostic accuracy of NBM 200 against the gold standard (Sysmex XP-100). Results: Data were obtained from 269 pregnant women (median age: 21 years, Interquartile range: 19 to 23 years). Haemoglobin levels estimated by the Sysmex XP-100 analyser ranged from 5.5 g/dL to 14.1 g/dL (mean: 10.0 g/dL, standard deviation (SD): 1.28), while measurements obtained from NBM 200 ranged from 9.5 g/dL to 14.6 g/dL (mean: 11.9 g/dL, SD: 1.43). The Spearman’s test found a significant, moderately positive correlation between the two methods (rs= 0.4, p<0.001), ICC was 0.22, and the Bland-Altman analysis showed a mean difference of -1.8 g/dL (95% Confidence interval (CI): -2.06 to -1.71) indicating a systematic overestimation of Hb using the NBM 200. The NBM 200 showed low sensitivity (33.7%; 95% CI: 27.3 - 40.5) but high specificity (91.8%; 95% CI: 81.9 - 97.3) for the diagnosis of anaemia. Conclusion: Haemoglobin measurements obtained from the NBM 200 were higher with consequent underestimation of anaemia as compared with the gold standard reference method. This limits the use of the NBM 200 as an anaemia diagnostic test in our study population consisting of women during pregnancy

IEA EBC Annex 57 ‘Evaluation of Embodied Energy and CO_2eq for Building Construction'

The current regulations to reduce energy consumption and greenhouse gas emissions (GHG) from buildings have focused on operational energy consumption. Thus legislation excludes measurement and reduction of the embodied energy and embodied GHG emissions over the building life cycle. Embodied impacts are a significant and growing proportion and it is increasingly recognized that the focus on reducing operational energy consumption needs to be accompanied by a parallel focus on reducing embodied impacts. Over the last six years the Annex 57 has addressed this issue, with researchers from 15 countries working together to develop a detailed understanding of the multiple calculation methods and the interpretation of their results. Based on an analysis of 80 case studies, Annex 57 showed various inconsistencies in current methodological approaches, which inhibit comparisons of results and difficult development of robust reduction strategies. Reinterpreting the studies through an understanding of the methodological differences enabled the cases to be used to demonstrate a number of important strategies for the reduction of embodied impacts. Annex 57 has also produced clear recommendations for uniform definitions and templates which improve the description of system boundaries, completeness of inventory and quality of data, and consequently the transparency of embodied impact assessments

Incidence of Co-infection of Malaria and Typhoid and their Diagnostic Dilemmas

Background: This study was carried out to know the incidence of co-existence of typhoid and malaria in western part of Uttar Pradesh. Both these infections are common febrile illnesses prevalent in tropical countries including India.Materials and Methods: A total of 300 blood samples were collected from the patients presenting with fever for more than one week. Diagnosis of typhoid was carried out using Widal test and blood culture and for diagnosis of malaria blood film examination was done.Results: Out of total 300 patients, 31 (10.3%) were positive for malarial parasite and 82 (27.3%) were positive for typhoid by Widal test while 12 (4%) were positive for typhoid by blood culture. Rate of co-infection was found out to be 21 (6.7%) with Widal test and 3 (1%) with blood culture.Conclusion: As there is paucity of data on co-infection of malaria and typhoid from this part of country, this study was carried out to know their prevalence. As both these illnesses present with same clinical features, the clinicians must look for co-existence of these infections. Hence, to facilitate the diagnosis and treatment more such studies must be carried out from different parts of the country

Involvement of endogenous circadian rhythm in photoperiodic ovarian response of subtropical tree sparrow, Passer montanus

Investigations on the mechanism of photoperiodic time measurement in regulation of ovarian growth and function have been done in the subtropical population of tree sparrow (Passer montanus). Photosensitive female tree sparrows were subjected to various intermittent light dark cycles of different durations such as: 2L/ 2D, 3L/ 3D, 4L/ 4D, 6L/ 6D, 8L/ 8D and 12L/ 12D along with two control groups: one under short days (9L/ 15D) and the other under long days (14L/ 10D) for 30 days. Birds, under short days, did not show follicular enlargement while those experiencing long days exhibited ovarian growth confirming their photosensitive at the beginning of the experiment. Further, the birds under all the intermittent light regimes showed gonadal response except the birds under 8L/ 8D. The mean follicular diameter was significantly greater in the birds under 2L/ 2D as compared to the birds under 12L/12D. On the other hand, no significant variation in follicular diameter was observed among the birds maintained under 2L/ 2D, 3L/ 3D, 4L/ 4D and 6L/ 6D light dark cycles. Further, no significant variation was observed between the groups of birds exposed under 2L/ 2D and14L/10D (gonadostimulatory control group). Histomorphometric analysis of the ovary revealed a significant increase in the thickness of the follicular wall and follicular differentiation in the birds under gonadostimulatory light dark cycles. No significant different in body weight was observed in the birds under any of the light regimes. The above results are in agreement with the avian external coincidence model of photoperiodic time measurement and indicate that an endogenous circadian rhythm is involved during the initiation of the gonadal growth in the female tree sparrow. They further suggest that multiple flashes of light are more effective in inducing follicular growth than a broad pulse of light of same duration

Photoperiod as a proximate factor in control of seasonality in the subtropical male Tree Sparrow, Passer montanus

Abstract Background Most species of birds exhibit well-defined seasonality in their various physiological and behavioral functions like reproduction, molt, bill color etc. such that they occur at the most appropriate time of the year. Day length has been shown to be a major source of temporal information regulating seasonal reproduction and associated events in a number of avian species. The present study aims to investigate the role of photoperiod in control of seasonal cycles in the subtropical male tree sparrow (Passer montanus) and to compare its responses at Shillong (Latitude 25°34'N, Longitude 91°53'E) with those exhibited by its conspecifics and related species at other latitudes. Results Initial experiment involving study of seasonal cycles revealed that the wild tree sparrows posses definite seasonal cycles of testicular volume, molt and bill color. These cycles were found remarkably linked to annual solar cycle suggesting the possibility of their photoperiodic control. To confirm this possibility in the next experiment, the photosensitive birds were exposed to three different light-dark regimes that were close to what they experience at this latitude: 9L/15D (close to shortest day length), 12L/12D (equinox day length) and 14L/10D (close to longest day length) for 18 months. Tree sparrows showed testicular growth followed by regression and development of photorefractoriness, molting and bill color changes only under long daily photoperiods (12 L and 14 L) but not under short daily photoperiod (9 L). Birds, under stimulatory photoperiods, did not show reinitiation of the above responses after the completion of initiation regression cycle even after their exposure to these photoperiods for 18 months. This precludes the possibility of circannual rhythm generation and suggests the involvement of photoperiodic mechanism in control of their seasonal cycles. Further, replacement of body and primary feathers progressed with gonadal regression only under long days suggesting that the two high energy demanding events of reproduction and molt are phased at two different times in the annual cycle of the bird and are photoperiodically regulated. Results of the final experiment involving exposure of photosensitive birds to a variety of photoperiodic treatments (9L/15D, 10L/14D, 11L/13D, 12L/12D, 14L/10D and 16L/8D) for 30 days suggested that the light falling for 11 h or more is important in inducing testicular growth and function in this species. Conclusion These results clearly indicate that despite of small photofluctuation, subtropical tree sparrows are capable of fine discrimination of photoperiodic information and use day length as a proximate environmental factor to time their seasonal responses similar to their conspecifics and related species at other latitudes suggesting the conservation of photoperiodic control mechanism in them.</p

Developments in MCMC diagnostics and sparse Bayesian learning models

This dissertation consists of three research articles on the topic of Markov chain Monte Carlo (MCMC) diagnostics and sparse Bayesian learning models. The first article consists of MCMC diagnostic tools based on Kullback Leibler (KL) divergence and smoothing methods. These tools can assess the joint convergence of multiple variables and detect non convergence when MCMC chains get stuck at a particular mode of a multi modal stationary distribution. Further, in case of non convergence of multiple MCMC chains, the visualization tool can be used to investigate reasons for non convergence. The second article deals with assessing posterior propriety of some sparse Bayesian learning models. Relevance Vector Machine (RVM) is a popular sparse Bayesian learning model that assumes improper prior over its hyperparameters. We prove that this improper prior leads to an improper posterior. Further, we also provide necessary and sufficient conditions for posterior propriety of RVM. Additionally, we also prove the posterior impropriety of some Bayesian learning models that have a prior structure similar to that of RVM. In the third article, we propose to replace multiple penalties of RVM with a single penalty. The new model is named as single penalty relevance vector machine (SPRVM) and is analyzed using a semi Bayesian approach. The SPRVM allows for computation of Monte Carlo standard errors since we prove the geometric ergodicity of its associated Gibbs sampler. Such a Monte Carlo standard error cannot be computed in the case of RVM since the rate of convergence of its associated Gibbs sampler is not known. Thus, through these three articles we hope to make valuable additions to the literature of MCMC diagnostics and sparse Bayesian learning models

Rhinocerebral mucormycosis: report of a rare case

Background: Mucormycosis is one of the rapidly progressing and lethal form of fungal infection which involves the nose and paranasal sinuses of the head and the neck regions. Mucormycosis also remains a threat to patients with uncontrolled diabetes or other predisposing systemic conditions. It manifests as rhinocerebral, pulmonary, gastrointestinal, cutaneous or disseminated form. The underlying conditions can influence clinical presentation and often delay diagnosis, with resultant poor outcomes.Case Details: We report a case of rhinocerebral mucormycosis in a 75 year-old diabetic patient with emphasise on diagnosis, treatment and survival options of patient from this potentially fatal fungal infection. Extra oral examination revealed mild non-tender swelling on the face, unable to see from left eye, impaired sense of smell, difficulty in speech and nasal stuffiness. Intra-oral examination showed necrosis of mucosa and underlying bone in relation to canine to the tuberosity area of the left vestibular region of the maxilla.Conclusion: Timely diagnosis is critical to survival and minimization of morbidity. Institution of surgical and medical therapy is critical in maximizing the likelihood of good outcome.Keywords: Mucormycosis, fungal, systemic, maxillary sinu