Factors influencing the local scale colonisation and change in density of a widespread invasive plant species, Lantana camara, in South India

Identifying factors that underlie invasive species colonisation and change in density could provide valuable insights into the mechanisms of biological invasions and for invasive species management. We examined a suite of factors potentially influencing the landscape-level invasion of Lantana camara L., one of the most ubiquitous invasive species in South Asia. These factors included disturbance factors like forest fires, historical habitat modification, and edge effects, in addition to factors like propagule pressure and habitat suitability. We examined the relative importance of these factors on the colonisation and change in density of L. camara in the Biligiri Rangaswamy Temple Tiger Reserve, Western Ghats, India. We used extensive (1997–2008) datasets tracking the presence and abundance of L. camara and combined these with corresponding data on disturbances, propagule pressure, and habitat suitability. We used an information-theoretic model selection approach to determine the relative importance of each factor on the colonisation and change in density of L. camara. Colonisation was mainly a function of proximity to already established populations (i.e. propagule pressure), whereas increase in L. camara density appeared to be constrained by high fire frequency. Research and management efforts need to recognize the multi dimensional nature of mechanisms underlying L. camara’s success during different invasion phases when strategizing interventions to mitigate its effects

Reappraising the Role of Eplerenone in the Management of Heart Failure

Background: In India, the prevalence of heart failure (HF) is increasing at 1.2/1,000 people according to a study in northern India, and the mortality rate at 1 year (INTERnational Congestive Heart Failure [INTER-CHF]) is 37%. Due to the diverse phenotypes of HF, nonadherence to guideline-directed medical therapy (GDMT), resistance to uptitration of medication and underuse of mineralocorticoid receptor antagonists (MRAs), such as eplerenone, a uniform management approach may not be feasible. This review is aimed at assessing the burden of HF, reasons for underutilization of MRAs in treatment, evaluating the evidence and reappraising the disease-modifying role of eplerenone in HF management. Methods: An electronic database search was performed to identify relevant literature. Results: The review details various studies that demonstrate the role of MRA eplerenone as a disease-modifying agent in patients with mild-to-moderate hypertension and those with acute myocardial infarction (MI) complicated by left ventricular dysfunction and HF. It also outlines different patient profiles for eplerenone use and ways to handle minor side-effects. Conclusions: Eplerenone shows a promising effect in selectively blocking aldosterone receptors to suppress fibrosis and reverse cardiac remodeling

Azilsartan: the novel ARB with unique mechanism of action

Hypertension is attributed to be one of the major risk factors in the pathophysiology of ischemic heart disease, stroke, heart failure and renal dysfunction. Angiotensin receptor blockers (ARBs) are one of the first line drugs recommended for clinical use in hypertension by JNC 8. Azilsartan is the recent addition to this family of ARBs and is perceived as one of the potent antihypertensive drugs today. Azilsartan was developed by replacing the tetrazole ring in candesartan with a 5 member oxo-oxadiazole ring. In India Azisartan was recently approved by DCGI in December 2016 for use in hypertension. In various randomized, double blind clinical studies Azilsartan was found to be to be superior in terms of clinical efficacy over other ARBs like Candesartan, Olmesartan and Valsartan and angiotensin converting enzyme inhibitor like Ramipril. In terms of safety profile Azilsartan appears to be equivalent to the currently available ARBs. Azilsartan due to its superior efficacy and comparative safety profile appear to be a new addition to the armamentarium in the treatment of hypertension.

Effect of aliskiren on post-discharge outcomes among diabetic and non-diabetic patients hospitalized for heart failure: insights from the ASTRONAUT trial

Aims The objective of the Aliskiren Trial on Acute Heart Failure Outcomes (ASTRONAUT) was to determine whether aliskiren, a direct renin inhibitor, would improve post-discharge outcomes in patients with hospitalization for heart failure (HHF) with reduced ejection fraction. Pre-specified subgroup analyses suggested potential heterogeneity in post-discharge outcomes with aliskiren in patients with and without baseline diabetes mellitus (DM). Methods and results ASTRONAUT included 953 patients without DM (aliskiren 489; placebo 464) and 662 patients with DM (aliskiren 319; placebo 343) (as reported by study investigators). Study endpoints included the first occurrence of cardiovascular death or HHF within 6 and 12 months, all-cause death within 6 and 12 months, and change from baseline in N-terminal pro-B-type natriuretic peptide (NT-proBNP) at 1, 6, and 12 months. Data regarding risk of hyperkalaemia, renal impairment, and hypotension, and changes in additional serum biomarkers were collected. The effect of aliskiren on cardiovascular death or HHF within 6 months (primary endpoint) did not significantly differ by baseline DM status (P = 0.08 for interaction), but reached statistical significance at 12 months (non-DM: HR: 0.80, 95% CI: 0.64-0.99; DM: HR: 1.16, 95% CI: 0.91-1.47; P = 0.03 for interaction). Risk of 12-month all-cause death with aliskiren significantly differed by the presence of baseline DM (non-DM: HR: 0.69, 95% CI: 0.50-0.94; DM: HR: 1.64, 95% CI: 1.15-2.33; P < 0.01 for interaction). Among non-diabetics, aliskiren significantly reduced NT-proBNP through 6 months and plasma troponin I and aldosterone through 12 months, as compared to placebo. Among diabetic patients, aliskiren reduced plasma troponin I and aldosterone relative to placebo through 1 month only. There was a trend towards differing risk of post-baseline potassium ≥6 mmol/L with aliskiren by underlying DM status (non-DM: HR: 1.17, 95% CI: 0.71-1.93; DM: HR: 2.39, 95% CI: 1.30-4.42; P = 0.07 for interaction). Conclusion This pre-specified subgroup analysis from the ASTRONAUT trial generates the hypothesis that the addition of aliskiren to standard HHF therapy in non-diabetic patients is generally well-tolerated and improves post-discharge outcomes and biomarker profiles. In contrast, diabetic patients receiving aliskiren appear to have worse post-discharge outcomes. Future prospective investigations are needed to confirm potential benefits of renin inhibition in a large cohort of HHF patients without D

Development of urea-SCR dosing control strategies for a diesel electric hybrid car

With every new revision of government emission regulations, the limit on the tailpipe NOx is getting lower, forcing engine manufacturers to innovate in order to meet new targets. NOx emission reduction can be achieved through engine management strategies, however, there is a limit to the level of NOx reduction and, often, a penalty is associated with completely relying on engine strategies. Urea-SCR system, a type of diesel aftertreatment, provides a means of reduction of NOx downstream of the engine so as to provide the engine more flexibility to operate at higher efficiencies, which can be associated with high engine-out NOx emissions. The aim of this research is to explore various urea-SCR dosing control strategies and evaluate the benefits and tradeoffs associated with change in operating parameters as well as amongst different strategies for a light-duty diesel application. Various components such as supply module, urea injector, sensors, etc., were calibrated and integrated to form the urea-SCR system, centrally controlled by Woodward SECM112 controller. The system integration included communication channel setup and internal diagnostics for fault detection. Two principal dosing control strategies were developed, namely stoichiometric dosing strategy and NH3 feedback control strategy. Stoichiometric dosing strategy doses DEF to produce NH3 which is in stoichiometric equivalence to the engine-out NOx. NH3 feedback control uses the NH3 sensor to track a certain NH3 slip set-point. Protocols were developed for dynamometer testing in order to ensure repeatability of tests and to maintain the system at conditions that would ensure all measurement equipment was in safe operating region. Testing of the current platform was done on a chassis dynamometer and measurements were taken from on-board sensors. Steady-state and transient tests were performed by multiple parameters such as catalyst temperature and ANR (Ammonia to NOx Ratio). Drive cycles such as the UDDS and the HWFET were run to perform transient testing. The lowest measured tailpipe emission levels were 0.47 g/mile for a UDDS cycle with a constant ANR of 2. The performance of the NH3 feedback control was evaluated in terms of ability to track an NH3 slip set-point for steady state and in the presence of disturbances such as fluctuating NOX concentrations upstream and fluctuating space velocities at the catalyst. The performance of the feedback control system was found to be robust. This thesis concludes with recommendations for improvement in the performance of the current urea-SCR system based on the results obtained from testing

Factors influencing the local scale colonisation and change in density of a widespread invasive plant species, Lantana camara, in South India

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Factors influencing the local scale colonisation and change in density of a widespread invasive plant species, Lantana camara, in South India

Identifying factors that underlie invasive species colonisation and change in density could provide valuable insights into the mechanisms of biological invasions and for invasive species management. We examined a suite of factors potentially influencing the landscape-level invasion of Lantana camara L., one of the most ubiquitous invasive species in South Asia. These factors included disturbance factors like forest fires, historical habitat modification, and edge effects, in addition to factors like propagule pressure and habitat suitability. We examined the relative importance of these factors on the colonisation and change in density of L. camara in the Biligiri Rangaswamy Temple Tiger Reserve, Western Ghats, India. We used extensive (1997–2008) datasets tracking the presence and abundance of L. camara and combined these with corresponding data on disturbances, propagule pressure, and habitat suitability. We used an information-theoretic model selection approach to determine the relative importance of each factor on the colonisation and change in density of L. camara. Colonisation was mainly a function of proximity to already established populations (i.e. propagule pressure), whereas increase in L. camara density appeared to be constrained by high fire frequency. Research and management efforts need to recognize the multi-dimensional nature of mechanisms underlying L. camara’s success during different invasion phases when strategizing interventions to mitigate its effects

Clinical Decision Pathway for the Use of Fondaparinux in the Management of Acute Coronary Syndrome (ACS) in Hospitals with and Without Catheter Laboratories: An Expert Opinion from India

Abstract The current recommendations by Indian experts who are focused on the challenges in the management of patients with acute coronary syndrome (ACS) in rural areas, due to limited catheterization (CATH) lab facilities and interventional cardiologist coverage across the country, are described. 120 cardiologist experts drafted recommendations during ten advisory board meetings conducted from April to May 2022. Experts framed statements based on experience, collective clinical judgment from practical experience, and available scientific evidence regarding ACS. The consensus positioned fondaparinux as highly useful in non-CATH-lab-based hospitals for patients diagnosed with non-ST elevation acute coronary syndrome (NSTE-ACS) and ST elevation acute coronary syndrome (STE-ACS) patients who cannot be shifted to percutaneous coronary intervention (PCI)-capable centres, or for patients who are thrombolysed at peripheral centres