Impact of obesity with impaired glucose tolerance on retinal degeneration in a rat model of metabolic syndrome.

PurposeMetabolic syndrome (MetS) is associated with several degenerative diseases, including retinal degeneration. Previously, we reported on progressive retinal degeneration in a spontaneous obese rat (WNIN/Ob) model. In this study, we investigated the additional effect of impaired glucose tolerance (IGT), an essential component of MetS, on retinal degeneration using the WNIN/GR-Ob rat model.MethodsThe retinal morphology and ultrastructure of WNIN/GR-Ob and age-matched littermate lean rats were studied by microscopy and immunohistochemistry. The retinal transcriptome of WNIN/GR-Ob was compared with the respective lean controls and with the WNIN/Ob model using microarray analysis. Expression of selected retinal marker genes was studied via real-time PCR.ResultsProgressive loss of photoreceptor cells was observed in WNIN/GR-Ob rats with an onset as early as 3 months. Similarly, thinning of the inner nuclear layer was observed from 6 months in these rats. Immunohistochemical analysis showed decreased levels of rhodopsin and postsynaptic density protein-95 (PSD-95) proteins and increased levels of glial fibrillary acidic protein (GFAP), vascular endothelial growth factor (VEGF), and calretinin in WNIN/GR-Ob rats compared with the age-matched lean controls, further supporting cellular stress/damage and retinal degeneration. The retinal transcriptome analysis indicated altered expression profiles in both the WNIN/GR-Ob and WNIN/Ob rat models compared to their respective lean controls; these pathways are associated with activation of pathways like cellular oxidative stress response, inflammation, apoptosis, and phototransduction, although the changes were more prominent in WNIN/GR-Ob than in WNIN/Ob animals.ConclusionsWNIN/GR-Ob rats with added glucose intolerance developed retinal degeneration similar to the parent line WNIN/Ob. The severity of retinal degeneration was greater in WNIN/GR-Ob rats compared to WNIN/Ob, suggesting a possible role for IGT in this model. Hence, the WNIN/GR-Ob model could be a valuable tool for investigating the impact of MetS on retinal degeneration pathology

The assessment of knowledge, attitude and practice of antibiotic stewardship among healthcare providers in a tertiary care hospital

Background: Antibiotics are the most commonly used drugs often associated with inappropriate use leading to resistance. While knowledge enlightens and provides an insight into the problems faced, behavioral change solely depends on the beliefs and attitude. Aim of this study to evaluate the knowledge and beliefs about antimicrobial prescribing among prescribers in a teaching tertiary care hospitalMethods: The present study was conducted in the Department of Pharmacology, ESIC   Medical College and Hospital, Faridabad. after  Ethical clearance from the Institutional Ethics Committee. Design of this study was a prospective, cross-sectional study carried out in the form of a survey in which a pretested, semi-structured, validated questionnaire of 30 questions was provided to Junior residents, Senior residents and Faculty of different specialties and response was recorded. Questionnaire comprises of 10 questions each in knowledge, attitude and practice section.Results: Out of 132 prescribers 86.5% believed that irrational practice will cause global resistant development. majority (92.3%) were expressing the need that sample culture should be sent before starting antibiotics but only 69.2 % were of the opinion that culture and sensitivity should be done in all infections and 92.3% were expressing the view that hospital antibiotics policy is useful in reducing AMR.Conclusions: The present survey on antibiotic usage gives useful information about the knowledge, attitudes and practices of prescribers and help plan suitable educational interventions that aim at improving the antimicrobial prescribing and minimizing the development of resistance

Progress The Excellence Of Scattered Power Productions

This calculate the current dynamics and harmonics of the parameters to generate the control values to meet the requirements of repeated power while releasing the complete synchronization and used as a new value for ' the driving force of the electric current. This demonstrates the analysis and improvement of the electrical quality (soft wax, swelling and coupling) of the related smart inverter performance used by the distributed generation. The designed controller controls the actual power and motion provided by the DOs in the PCC. The controller is designed to provide current access to the PCC Solidarity agent. The increased demand for power transmission and harmonics in a PCC due to load and resistance changes may have an impact on system costs in a PCC

A randomized, placebo-controlled clinical trial evaluating olipudase alfa enzyme replacement therapy for chronic acid sphingomyelinase deficiency (ASMD) in adults : one-year results

Purpose: This trial aimed to assess the efficacy and safety of olipudase alfa enzyme replacement therapy for non–central nervous system manifestations of acid sphingomyelinase deficiency (ASMD) in adults. Methods: A phase 2/3, 52 week, international, double-blind, placebo-controlled trial (ASCEND; NCT02004691/EudraCT 2015-000371-26) enrolled 36 adults with ASMD randomized 1:1 to receive olipudase alfa or placebo intravenously every 2 weeks with intrapatient dose escalation to 3 mg/kg. Primary efficacy endpoints were percent change from baseline to week 52 in percent predicted diffusing capacity of the lung for carbon monoxide and spleen volume (combined with splenomegaly-related score in the United States). Other outcomes included liver volume/function/sphingomyelin content, pulmonary imaging/function, platelet levels, lipid profiles, and pharmacodynamics. Results: Least square mean percent change from baseline to week 52 favored olipudase alfa over placebo for percent predicted diffusing capacity of the lung for carbon monoxide (22% vs 3.0% increases, P = .0004), spleen volume (39% decrease vs 0.5% increase, P < .0001), and liver volume (28% vs 1.5% decreases, P < .0001). Splenomegaly-related score decreased in both groups (P = .64). Other clinical outcomes improved in the olipudase alfa group compared with the placebo group. There were no treatment-related serious adverse events or adverse event–related discontinuations. Most adverse events were mild. Conclusion: Olipudase alfa was well tolerated and associated with significant and comprehensive improvements in disease pathology and clinically relevant endpoints compared with placebo in adults with ASMD

A Game Theoretic Approach to Modelling Jamming Attacks in Delay Tolerant Networks

Cyberspace plays a prominent role in our social, economic and civic welfare and cyber security issues are of paramount importance today. Growing reliance of the intertwined military and civilian applications on wireless computer networks makes these networks highly vulnerable to attacks of which jamming attacks are a vital and exigent problem. In this paper, we study defence against jamming attacks as game in a delay tolerant network, with two adversarial players: the jammer playing against the transmitter. The transmitters seek to choose an optimal time to schedule his transmission securely, so as to maximize the probability of successful delivery before his session expires, while these transmissions are subject to inference from the jammer, who attempts to minimize this probability . We design strategies for the transmitters that offset transmission period based inference of network traffic by the jammer. We model these interactions and decisions as a game and use simulation as a tool to evaluate the games. Probability distribution functions over finite set of strategies are proposed to compute the expected payoff of both the players. Simulation results are used to evaluate the expected payoff along with the resulting equilibrium in cases where players are biased and unbiased. These results are used to strategically decide on the optimal time for both the players, and evaluate the efficiency of the strategies used by the transmitters against jammer attacks.

Study of Knowledge, Perceptions and Practices Related to Blood Donation Among the Healthcare Support Staff of a Tertiary Care Hospital in Gujarat, India

Background: There is a serious mismatch between demand and availability of blood in our country. One of the important factors motivating people for donating blood is their interaction with staff of health facilities including support staff. The knowledge and perceptions of support staff about blood donation have not been studied adequately. Methodology: Data was collected from randomly selected 100healthcare support staff using a pretested questionnaire. The questionnaire was based on prior qualitative analysis of perceptions of few of the potential participants. Results: 91% of the respondents felt that blood donation was not safe. Only 16% had adequate knowledge about eligibility for blood donation and all of them were females. 39% respondents had donated blood themselves and 79% had family history of blood donation. None of the socio-demographic factors except young age were found to be associated with better knowledge or positive perceptions about blood donation. Many among those who had donated blood also did not perceive blood donation as safe. Apprehension about blood being not properly used and not having been approached by anyone were commonest reasons for not donating. Conclusions: The knowledge about safety, eligibility and motivation for blood donation is very poor among the healthcare support staff. Efforts must be made to educate these employees and promote voluntary blood donation among them. Various incentives as suggested by employees themselves and several international bodies may be considered to promote blood donation among healthcare support staff

Optimal management of hereditary hemorrhagic telangiectasia

Hereditary hemorrhagic telangiectasia (HHT), also known by the eponym Osler–Weber–Rendu syndrome, is a group of related disorders inherited in an autosomal dominant fashion and characterized by the development of arteriovenous malformations (AVM) in the skin, mucous membranes, and/or internal organs such as brain, lungs, and liver. Its prevalence is currently estimated at one in 5,000 to 8,000. Most cases are due to mutations in the endoglin (HHT1) or ACVRLK1 (HHT2) genes. Telangiectasias in nasal and gastrointestinal mucosa generally present with recurrent/chronic bleeding and iron deficiency anemia. Larger AVMs occur in lungs (~40%–60% of affected individuals), liver (~40%–70%), brain (~10%), and spine (~1%). Due to the devastating and potentially fatal complications of some of these lesions (for example, strokes and brain abscesses with pulmonary AVMs), presymptomatic screening and treatment are of utmost importance. However, due to the rarity of this condition, many providers lack an appreciation for the whole gamut of its manifestations and complications, age-dependent penetrance, and marked intrafamilial variation. As a result, HHT remains frequently underdiagnosed and many families do not receive the appropriate screening and treatments. This article provides an overview of the clinical features of HHT, discusses the clinical and genetic diagnostic strategies, and presents an up-to-date review of literature and detailed considerations regarding screening for visceral AVMs, preventive modalities, and treatment options

On the curious case of the recent decade, mid-spring precipitation deficit in central Europe

Central Europe has experienced a severe drought almost every April for the last 14 years consecutively, driven by record high temperatures, low flows, high evapotranspiration, and high soil moisture deficit. The dynamic of this recent and recurrent mid-spring dryness is not yet understood. Here we show that the period 2007â€``2020 was characterized by a reduction of ~50% of the usual April rainfall amount over large areas in central Europe. The precipitation deficit and the record high temperatures were triggered by a multiyear recurrent high-pressure system centered over the North Sea and northern Germany and a decline in the temperature gradient between the Arctic region and the mid-latitudes, which diverted the Atlantic storm tracks northward. From a long-term perspective, the precipitation, temperature, and soil moisture anomalies observed over the last 14 years have reached the highest amplitudes over the observational record. Our study provides an in-depth analysis of the hydroclimate extremes in central Europe over the last 140 years and their atmospheric drivers, enabling us to increase our dynamical understating of long-term dry periods, which is vital to enhance forecasting and mitigation of such events

Clomiphene citrate versus letrozole for ovulation induction in anovulatory infertility: a prospective study

Background: The objective of this study was to compare clomiphene citrate with letrozole for ovulation induction in anovulatory infertile women.Methods: This study was conducted in the infertility clinic and department of obstetrics and gynecology, S.P. Medical College and Associated P. B. M. Hospital, Bikaner, Rajasthan, from 1st August 2018 to 31st July 2019. The study group comprised of infertile females attending infertility clinic or gynae outdoor in department of obstetrics and gynecology, S. P. Medical College Bikaner for infertility. 100 women with anovulatory infertility were enrolled in the study after fulfilling the inclusion and exclusion criteria. Proper counseling was done and written informed consent taken.Results: Ovulation rate was statistically significantly greater in letrozole group. Monofollicular development was statistically significant greater in let group (CC 18%, Let 66%). The endometrial thickness on the day of ßhCG administration in CC group was 7.40±1.08 mm and in let group was 8.20±0.82 mm. Letrozole treated cases had better trilaminar pattern of endometrium as compared to clomiphene. The pregnancy rate was higher in letrozole group.Conclusions: As compare to clomiphene, letrozole is associated with higher pregnancy rate and ovulation rates among infertile women with anovulation

A Game Theoretic Software Test-bed for Cyber Security Analysis of Critical Infrastructure

National critical infrastructures are vital to the functioning of modern societies and economies. The dependence on these infrastructures is so succinct that their incapacitation or destruction has a debilitating and cascading effect on national security. Critical infrastructure sectors ranging from financial services to power and transportation to communications and health care, all depend on massive information communication technology networks. Cyberspace is composed of numerous interconnected computers, servers and databases that hold critical data and allow critical infrastructures to function. Securing critical data in a cyberspace that holds against growing and evolving cyber threats is an important focus area for most countries across the world. A novel approach is proposed to assess the vulnerabilities of own networks against adversarial attackers, where the adversary’s perception of strengths and vulnerabilities are modelled using game theoretic techniques. The proposed game theoretic framework models the uncertainties of information with the players (attackers and defenders) in terms of their information sets and their behaviour is modelled and assessed using a probability and belief function framework. The attack-defence scenarios are exercised on a virtual cyber warfare test-bed to assess and evaluate vulnerability of cyber systems. Optimal strategies for attack and defence are computed for the players which are validated using simulation experiments on the cyber war-games testbed, the results of which are used for security analyses