Erosion of Trust in the Medical Profession in India : Time for Doctors to Act

In India, over the last decade, a series of stewardship failures in the health system, particularly in the medical profession, have led to a massive erosion of trust in these institutions. In many low- and middle-income countries (LMICs), the situation is similar and has reached crisis proportions; this crisis requires urgent attention. This paper draws on the insights from the recent developments in India, to argue that a purely control-based regulatory response to this crisis in the medical profession, as is being currently envisaged by the Parliament and the Supreme Court of India, runs the risk of undermining the trusting interpersonal relations between doctors and their patients. A more balanced approach which takes into account the differences between system and interpersonal forms of trust and distrust is warranted. Such an approach should on one hand strongly regulate the institutions mandated with the stewardship and qualities of care functions, and simultaneously on the other hand, initiate measures to nurture the trusting interpersonal relations between doctors and patients. The paper concludes by calling for doctors, and those mandated with the stewardship of the profession, to individually and collectively, critically self-reflect upon the state of their profession, its priorities and its future direction

Management of Root Knot Nematode on Tomato Through Grafting Root Stock of Solanum Sisymbriifolium

The root-knot nematodes (Meloidogyne spp) are difficult to manage once established in the field because of their wide host range, and soil-borne nature. Thus, the aim of the present study was to examine the use of resistant root stock of wild brinjal (Solanum sisymbriifolium) to reduce the loss caused by the nematodes on tomato. For the management of root-knot nematodes, grafted plant with resistant root stock of the wild brinjal was tested under farmers\u27 field conditions at Hemza of Kaski district. Grafted and non-grafted plants were produced in root-knot nematode-free soil. Around three week-old grafted and non-grafted tomato plants were transplanted in four different plastic tunnels where root-knot nematodes had been reported previously. The plants were planted in diagonal position to each other as a pair plot in 80 × 60 cm2 spacing in an average of 20 × 7 m2 plastic tunnels. Galling Index (GI) was recorded three times in five randomly selected plants in each plot at 60 days intervals. The first observation was recorded two months after transplanting. Total fruit yield was recorded from same plants. In the grafted plants, the root system was totally free from gall whereas in an average of 7.5 GI in 0-10 scale was recorded in the non-grafted plants. Fruits were harvested from time to time and cumulated after final harvest to calculate the total fruit yield. It was estimated that on an average tomato fruit yield was significantly (P>0.05) increased by 37 percent in the grafted plants compared with the non-grafted plants. Grafting technology could be used effectively for cultivation of commonly grown varieties, which are susceptible to root-knot nematodes in disease prone areas. This can be used as an alternative technology for reducing the use of hazardous pesticides for enhancing commercial organic tomato production.Journal of Nepal Agricultural Research Council Vol.3 2017: 27-3

Multi-Phase Manganese Mineralization in the Noamundi Synclinorium, East Indian Shield

Manganese mineralization associated with phyllites in and around Joda, Odisha belongs to the Iron Ore Group of Noamundi basin and is a part of Jamda-Koira belt of East Indian Shield. The present study area comprises low to medium grade tectonites containing economic resources of both iron and manganese. Present study is concentrated on Manganese mineralization. Field study and petro-mineralogical observations reveal syngenetic character of manganese ores comprising lowT higher oxides viz. pyrolusite, cryptomelane, manganite as major Mn-minerals along with highT lower oxides viz. jacobsite, bixbyite, braunite and hausmannite as minor Mn-minerals. The Mn-ore bodies and associated phyllites have undergone multiple phases of deformation and metamorphism followed by hydrothermal and supergene processes. Four deformational phases have been deciphered during field study. Geochemical analyses of ores and phyllitic host rocks show high values of Al2O3, TiO2, Ba, Co, Ni, Cr, Cu, Sc, V, As, Zn but depletion of Sr, Yb, Sm, Nb. Geochemical data infer ores to be a recycling product originally derived from a mafic crustal source of tholeiitic character. Age data obtained from Sm-Nd ratio of two rock samples are 3.46 Ga and 2.79 Ga. Present work provides a critical assessment on the multiphase mineralization of manganese ores

Natural Frequency of Vibrating Foundations on Layered Soil System-An Experimental Investigation

This paper presents model block vibration tests results on two and three layered soil system underlain by rigid layer. Using sand and sawdust in different positions (either at top or at middle or at bottom) and thickness (es) inside a tank, different layered soil bed are prepared and vibration tests are conducted on each prepared bed using Lazan Type oscillator. A large number of response curves (frequency vs. amplitude) are obtained on different layered system. Maximum amplitudes (resonant amplitude) and corresponding frequencies (resonant frequency) are tabulated to study the effect of layering on resonant frequencies. Effects of position and thickness (es) of the layer/layers on natural frequencies are found to be significant, Natural frequency increases significantly due to presence of thin stiff layer at top compared to natural frequency of bottom layer treating it to be half space whereas it decreases significantly due presence of thin soft layer at top. Several other significant observations are made and presented in the paper. Natural frequencies of the soil foundation on different layered soil systems used for the experimental investigations are predicted using static equivalent stiffness of the system and compared with experimental results. Predicted results are found to be in good agreement with the experimental results

Simulations of the 2004 North American Monsoon: NAMAP2

The second phase of the North American Monsoon Experiment (NAME) Model Assessment Project (NAMAP2) was carried out to provide a coordinated set of simulations from global and regional models of the 2004 warm season across the North American monsoon domain. This project follows an earlier assessment, called NAMAP, that preceded the 2004 field season of the North American Monsoon Experiment. Six global and four regional models are all forced with prescribed, time-varying ocean surface temperatures. Metrics for model simulation of warm season precipitation processes developed in NAMAP are examined that pertain to the seasonal progression and diurnal cycle of precipitation, monsoon onset, surface turbulent fluxes, and simulation of the low-level jet circulation over the Gulf of California. Assessment of the metrics is shown to be limited by continuing uncertainties in spatially averaged observations, demonstrating that modeling and observational analysis capabilities need to be developed concurrently. Simulations of the core subregion (CORE) of monsoonal precipitation in global models have improved since NAMAP, despite the lack of a proper low-level jet circulation in these simulations. Some regional models run at higher resolution still exhibit the tendency observed in NAMAP to overestimate precipitation in the CORE subregion; this is shown to involve both convective and resolved components of the total precipitation. The variability of precipitation in the Arizona/New Mexico (AZNM) subregion is simulated much better by the regional models compared with the global models, illustrating the importance of transient circulation anomalies (prescribed as lateral boundary conditions) for simulating precipitation in the northern part of the monsoon domain. This suggests that seasonal predictability derivable from lower boundary conditions may be limited in the AZNM subregion.open131

Sound Radiated by a Supercritical Airfoil Operating in the Incompressible Regime

Measurements of far-field sound radiated by two and three-dimensional supercritical airfoils (ONERA OAT 15A) placed in a low Mach number flow were performed in an anechoic open-jet facility. The chord-based Reynolds numbers were between 156,000 and 468,000, while the Mach numbers ranged between 0.04 and 0.13. For the three-dimensional airfoil, two different aspect ratios (span-to-chord ratio) of 1.0 and 1.5 were considered. For comparison, the sound radiated by a symmetric NACA 0012 and cambered NACA 2412 airfoil was also measured under the same conditions. The noise from the two-dimensional airfoil was found to scale on the fifth power of Mach number. The noise generated by the cross-flow across the tip was the dominant noise source for the three-dimensional airfoils, particularly under high-lift conditions where it exceeds the noise from the mid-span portion across the considered frequency range. The tip noise spectra for the supercritical airfoils exhibit a prominent peak that scales with the free-stream velocity, but its frequency is a weak function of the lift on the airfoil and the aspect ratio. No such peak was observed for the NACA profiles even for higher lift conditions. The beamformed source maps for NACA profiles reveal an intense high-frequency noise source near the tip leading-edge which is much weaker for the supercritical airfoil due to differences in the curvature of the profiles. The tip noise spectra for the supercritical airfoil can be scaled on the fourth power of Mach number and the length-scale associated with the spectral peak. The tip noise peak magnitude and frequencies were found to be nearly independent of the airfoil aspect ratio; however, a reduction in AR was found to shift the tip noise source region further inboard. Stereo particle image velocimetry (PIV) measurements performed in a cross-plane behind the three-dimensional airfoils show that this is because a reduction in AR also shifts vortex core towards the mid-span. The PIV results were also used to quantify the meander of the tip vortex and it is shown that the amplitude of vortex meandering is independent of the angle of attack and the aspect ratio with a value between 0.5 – 0.6% of the chord-length for all cases considered

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

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Nucleophile-Catalyzed Additions to Activated Triple Bonds. Protection of Lactams, Imides, and Nucleosides with MocVinyl and Related Groups

Additions of lactams, imides, (S)-4-benzyl-1,3-oxazolidin-2-one, 2-pyridone, pyrimidine-2,4-diones (AZT derivatives), or inosines to the electron-deficient triple bonds of methyl propynoate, tert-butyl propynoate, 3-butyn-2-one, N-propynoylmorpholine, or N-methoxy-N-methylpropynamide in the presence of many potential catalysts were examined. DABCO and, second, DMAP appeared to be the best (highest reaction rates and E/Z ratios), while RuCl3, RuClCp*(PPh3)2, AuCl, AuCl(PPh3), CuI, and Cu2(OTf)2 were incapable of catalyzing such additions. The groups incorporated (for example, the 2-(methoxycarbonyl)ethenyl group that we name MocVinyl) serve as protecting groups for the above-mentioned heterocyclic CONH or CONHCO moieties. Deprotections were accomplished via exchange with good nucleophiles: the 1-dodecanethiolate anion turned out to be the most general and efficient reagent, but in some particular cases other nucleophiles also worked (e.g., MocVinyl-inosines can be cleaved with succinimide anion). Some structural and mechanistic details have been accounted for with the help of DFT and MP2 calculations

Genetically encoded intrabody sensors report the interaction and trafficking of β-arrestin 1 upon activation of G protein-coupled receptors

Agonist stimulation of G protein-coupled receptors (GPCRs) typically leads to phosphorylation of GPCRs and binding to multifunctional proteins called β-arrestins (βarrs). The GPCR-βarr interaction critically contributes to GPCR desensitization, endocytosis, and downstream signaling, and GPCR-βarr complex formation can be used as a generic readout of GPCR and βarr activation. Although several methods are currently available to monitor GPCR-βarr interactions, additional sensors to visualize them may expand the toolbox and complement existing methods. We have previously described antibody fragments (FABs) that recognize activated βarr1 upon its interaction with the vasopressin V2 receptor C-terminal phosphopeptide (V2Rpp). Here, we demonstrate that these FABs efficiently report the formation of a GPCR-βarr1 complex for a broad set of chimeric GPCRs harboring the V2R C terminus. We adapted these FABs to an intrabody format by converting them to single-chain variable fragments (ScFvs) and used them to monitor the localization and trafficking of βarr1 in live cells. We observed that upon agonist simulation of cells expressing chimeric GPCRs, these intrabodies first translocate to the cell surface, followed by trafficking into intracellular vesicles. The translocation pattern of intrabodies mirrored that of βarr1, and the intrabodies co-localized with βarr1 at the cell surface and in intracellular vesicles. Interestingly, we discovered that intrabody sensors can also report βarr1 recruitment and trafficking for several unmodified GPCRs. Our characterization of intrabody sensors for βarr1 recruitment and trafficking expands currently available approaches to visualize GPCR-βarr1 binding, which may help decipher additional aspects of GPCR signaling and regulation