Characteristic abnormalities in cerebrospinal fluid biochemistry in children with cerebral malaria compared to viral encephalitis

BACKGROUND: In developing countries where Plasmodium falciparum malaria is endemic, viral encephalitis and cerebral malaria are found in the same population, and parasitemia with Plasmodium falciparum is common in asymptomatic children. The objective of this study was to investigate the cerebrospinal fluid (CSF) biochemistry in children with cerebral malaria compared to those with presumed viral encephalitis. METHODS: We studied the following CSF parameters: cell count, glucose, protein, lactic dehydrogenase (LDH) and adenosine deaminase (ADA) levels, in children with cerebral malaria, with presumed viral encephalitis, and in control subjects who had a lumbar puncture after a febrile convulsion with postictal coma. RESULTS: We recruited 12 children with cerebral malaria, 14 children with presumed viral encephalitis and 20 controls prospectively, over 2 years in the Government General Hospital in Kakinada, India. Patients with cerebral malaria had significantly lower CSF glucose, and higher protein, LDH, CSF/blood LDH ratio and CSF ADA levels but a lower CSF/serum ADA ratio compared to controls (p < 0.01). Patients with cerebral malaria had lower CSF white cell count, glucose, protein, LDH levels and CSF/serum ADA ratio compared to patients with presumed viral encephalitis. CSF/serum ADA ratio was lower in patients with cerebral malaria due to the fact that serum ADA levels were significantly higher in patients with cerebral malaria compared to the other two groups. A CSF/serum ADA ratio of <0.38 and a CSF glucose level of <3.4 mmol/l were selected as the cut-off values with the highest sensitivities and specificities for comparing the two conditions. CONCLUSION: CSF/serum ADA ratio and CSF glucose levels were the best discriminators of cerebral malaria from presumed viral encephalitis in our study. Further studies are needed to explore their usefulness in epidemiological studies

Evaluation of Medical Officer Certificate Programme Course Competency Based Learning

Background: Medical Officer Certificate Programme (MOCP) is a 6 months training programme in Pediatrics/Medicine at medical colleges wherein doctors work like postgraduate students, learn various Out Patients and In Patient Department (OPD and IPD) procedures, attain hands on skills, perform day and night duties, attend postgraduate training programmes and specialty clinics. This is a course unique to Maharashtra. It has been designed to overcome shortage of Pediatricians and Physicians in the state. Objective: To evaluate the efficacy of MOCP courses for medical officers by finding out if their clinical skills have improved and if they have achieved expected level of competence. Methods: Public Health Department deputed 28 medical officers of primary health centers. At the end of 6 months training course, they were evaluated during 2012-2013. Results: OPD increased by 24% and IPD by 54%. There was a decrease in the number of cases referred to tertiary centers by 24%, post-MOCP training. Infant immunization increased by 35% after training. Number of children with severe acute malnutrition/moderate acute malnutrition treated increased by 22%, treatment of neonatal emergencies, resuscitation, sepsis, jaundice increased by 36%. Number of adults with diarrhoea and snake bite treated increased by 40% and 63% respectively. Number of ECGs taken and myocardial infarctions managed also has shown rising trend. Conclusion: There was tremendous benefit to the patients after MOCP training. Skill of doctors was found to have enhanced. It is therefore recommended that such novel trainings should be imparted in other states of India too

BiLaWO6: Er3+/Tm3+/Yb3+ phosphor: study of multiple fluorescence intensity ratiometric thermometry at cryogenic temperatures

publishe

Reduced Levels of Membrane-Bound Alkaline Phosphatase Are Common to Lepidopteran Strains Resistant to Cry Toxins from Bacillus thuringiensis

Development of insect resistance is one of the main concerns with the use of transgenic crops expressing Cry toxins from the bacterium Bacillus thuringiensis. Identification of biomarkers would assist in the development of sensitive DNA-based methods to monitor evolution of resistance to Bt toxins in natural populations. We report on the proteomic and genomic detection of reduced levels of midgut membrane-bound alkaline phosphatase (mALP) as a common feature in strains of Cry-resistant Heliothis virescens, Helicoverpa armigera and Spodoptera frugiperda when compared to susceptible larvae. Reduced levels of H. virescens mALP protein (HvmALP) were detected by two dimensional differential in-gel electrophoresis (2D-DIGE) analysis in Cry-resistant compared to susceptible larvae, further supported by alkaline phosphatase activity assays and Western blotting. Through quantitative real-time polymerase chain reaction (qRT-PCR) we demonstrate that the reduction in HvmALP protein levels in resistant larvae are the result of reduced transcript amounts. Similar reductions in ALP activity and mALP transcript levels were also detected for a Cry1Ac-resistant strain of H. armigera and field-derived strains of S. frugiperda resistant to Cry1Fa. Considering the unique resistance and cross-resistance phenotypes of the insect strains used in this work, our data suggest that reduced mALP expression should be targeted for development of effective biomarkers for resistance to Cry toxins in lepidopteran pests

An adaptive LQR controller based on PSO and maximum predominant frequency approach for semi-active control scheme using MR damper

In the linear quadratic regulator (LQR) problem, the generation of control force depends on the components of the control weighting matrix R. The value of R is determined while designing the controller and remains the same later. Amid a seismic event, the responses of the structure may change depending the quasi-resonance occurring between the structure and the earthquake signal. In this situation, it is essential to update the value of R for conventional LQR controller to get optimum control force to mitigate the vibrations due to the earthquake. Further, the constant value of the weighting matrix R leads to the wastage of the resources using larger force unnecessarily where the structural responses are smaller. Therefore, in the quest of utilizing the resources wisely and to determine the optimized value of the control weighting matrix R for LQR controller in real time, a maximum predominant period τpmax τpmax and particle swarm optimization-based method is presented here. This method comprises of four different algorithms: particle swarm optimization (PSO), maximum predominant period approach τpmax τpmax to find the dominant frequency for each window, clipped control algorithm (CO) and LQR controller. The modified Bouc-Wen phenomenological model is taken to recognize the nonlinearities in the MR damper. The assessment of the advised method is done on a three-story structure having a MR damper at ground floor subjected to three different near fault historical earthquake time histories. The outcomes are equated with those of simple conventional LQR. The results establish that the advised methodology is more effective than conventional LQR controllers in reducing inter-story drift, relative displacement, and acceleration response

Guidelines for Minimization of Uncertainties and Estimation of a Reliable Shear Wave Velocity Profile Using MASW Testing: A State-of-the-Art Review

Resilience against earthquakes has become important in the current scenario, when numerous events of seismic shaking keep on occurring, especially in regions of high population. For that, reliable seismic site characterization is extremely important. The seismic surface wave methods are the commonly adopted methods for seismic site characterization and subsequent applications. After many evolvements, the multichannel analysis of surface waves (MASW) has grown to be the widely chosen surface wave method across the globe. However, the method has numerous peculiar specifications regarding its procedures of data acquisition, analysis, and interpretations. Each step in the MASW can induce notable uncertainties in the results. Even a single mistake in any of the procedures can lead to erroneous results, which are difficult to be identified even by any third party. Many such cases have been reported earlier by researchers. Such practices may foster substantial losses because ultimately the MASW results are useful for the generation of the design response spectra. Due to all these reasons, there is an alarming need for the dissemination of knowledge about the guidelines for the reliable practice of MASW testing. This paper provides a comprehensive account of the fundamentals of the MASW method, the ways to implement its three steps of data acquisition, processing, and inversion, and the ways to improve confidence in the results. It presents a detailed and comprehensive literature review on the topic, including the historical developments and theoretical basis, subsequent evolvements, current practices, and recommendations for reliable testing. The amount of references has been kept very high to facilitate a thorough understanding of the topic and draw sufficient inferences. An elaborate description of the uncertainties in the test and how to deal with them has been presented. The parameters to be set while carrying out those three steps have been discussed, and suggestions are presented. The suggestions are based on the field experiences and literature review of the research works by many prominent researchers

Postliquefaction Undrained Shear Behavior of Sand-Silt Mixtures at Constant Void Ratio

A detailed study on the postliquefaction undrained shear behavior of sand-silt mixtures at constant void ratios is presented in this article. The influence of different parameters such as density, amplitude of cyclic shear stress, and drainage conditions on the postliquefaction undrained response of sand-silt mixtures has been investigated, in addition to the effect of fines content. The results showed that the limiting silt content plays a vital role in the strength of the soil under both cyclic and monotonic shear loading. Both the liquefaction resistance and postliquefaction shear strength of the soils are found to decrease with an increase in the fines content until the limiting silt content is reached. However, further increase in the silt content beyond the limiting silt content increases the liquefaction resistance as well as the postliquefaction shear strength of the soils. It is also observed that these variations on the liquefaction and postliquefaction resistance of soils are closely related to the variations in relative density. (C) 2013 American Society of Civil Engineers