COMPARISON OF TOP HEIGHT AND DOMINANT HEIGHT WITH TREE VARIABLES AT THE EVEN AGED Pinus caribaea (MORELET) PLANTATION AT YAGIRALA

Top height and dominant heights are 'Confusedlyinterpret in many countries. The mainaim of this study was find the similarity of above two terms and to build some models topredict them.The study was carried out in Yagirala 25 year old even aged Pinus caribaea plantation.Top height and dominant heights were compared with other tree variables. Stratifiedrandom sampling without replacement was used to select the sampling unit. Circular plotsof 0,05 hectare with slope correction and boundary adjustment were used to obtain therequired tree measurementsDiameter at breast height, total height, lower and upper crownheight were measured andbasal area and crown depth were calculated. Top height and dominant height were alsoestimated.Results indicated that there is a significant difference between top and dominant heights.Also two separate equations to predict these two heights were developed. According to theresults initially ten equations were selected. Five equations described the relationshipbetween top and total height while the other five described the relationship betweendominant height and total height. Finally the best two equations were selected usingcoefficient of variation values and the distributions of standard residuals.

Institutionalizing quality within national health systems: Key ingredients for success

Quality improvement initiatives can be fragmented and short-term, leading to missed opportunities to improve quality in a systemic and sustainable manner. An overarching national policy or strategy on quality, informed by frontline implementation, can provide direction for quality initiatives across all levels of the health system. This can strengthen service delivery along with strong leadership, resources, and infrastructure as essential building blocks for the health system. This article draws on the proceedings of an ISQua conference exploring factors for institutionalizing quality of care within national systems. Active learning, inclusive of peer-to-peer learning and exchange, mentoring and coaching, emerged as a critical success factor to creating a culture of quality. When coupled by reinforcing elements like strong partnerships and coordination across multiple levels, engagement at all health system levels and strong political commitment, this culture can be cascaded to all levels requiring policy, leadership, and the capabilities for delivering quality healthcare.Fil: Kandasami, Stephanie. No especifíca;Fil: Babar Syed, Shamsuzzoha. No especifíca;Fil: Edward, Anbrasi. No especifíca;Fil: Sodzi Tettey, Sodzi. Institute for Healthcare Improvement; Estados UnidosFil: Garcia Elorrio, Ezequiel. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Mensah Abrampah, Nana. No especifíca;Fil: Hansen, Peter M.. No especifíca

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Nanocomposite ZnO–SnO2 Nanofibers Synthesized by Electrospinning Method

We report the characterization of mixed oxides nanocomposite nanofibers of (1 − x) ZnO-(x)SnO2 (x ≤ 0.45) synthesized by electrospinning technique. The diameter of calcined nanofibers depends on Sn content. Other phases like SnO, ZnSnO3, and Zn2SnO4 were absent. Photoluminescence studies show that there is a change in the blue/violet luminescence confirming the presence of Sn in Zn-rich composition. Present study shows that the crystalline nanocomposite nanofibers with stoichiometry of (1 − x)ZnO-(x)SnO2 (x ≤ 0.45) stabilize after the calcination and possess some morphological and optical properties that strongly depend on Sn content

JPN Guidelines for the management of acute pancreatitis: epidemiology, etiology, natural history, and outcome predictors in acute pancreatitis

Acute pancreatitis is a common disease with an annual incidence of between 5 and 80 people per 100 000 of the population. The two major etiological factors responsible for acute pancreatitis are alcohol and cholelithiasis (gallstones). The proportion of patients with pancreatitis caused by alcohol or gallstones varies markedly in different countries and regions. The incidence of acute alcoholic pancreatitis is considered to be associated with high alcohol consumption. Although the incidence of alcoholic pancreatitis is much higher in men than in women, there is no difference in sexes in the risk involved after adjusting for alcohol intake. Other risk factors include endoscopic retrograde cholangiopancreatography, surgery, therapeutic drugs, HIV infection, hyperlipidemia, and biliary tract anomalies. Idiopathic acute pancreatitis is defined as acute pancreatitis in which the etiological factor cannot be specified. However, several studies have suggested that this entity includes cases caused by other specific disorders such as microlithiasis. Acute pancreatitis is a potentially fatal disease with an overall mortality of 2.1%–7.8%. The outcome of acute pancreatitis is determined by two factors that reflect the severity of the illness: organ failure and pancreatic necrosis. About half of the deaths in patients with acute pancreatitis occur within the first 1–2 weeks and are mainly attributable to multiple organ dysfunction syndrome (MODS). Depending on patient selection, necrotizing pancreatitis develops in approximately 10%–20% of patients and the mortality is high, ranging from 14% to 25% of these patients. Infected pancreatic necrosis develops in 30%–40% of patients with necrotizing pancreatitis and the incidence of MODS in such patients is high. The recurrence rate of acute pancreatitis is relatively high: almost half the patients with acute alcoholic pancreatitis experience a recurrence. When the gallstones are not treated, the risk of recurrence in gallstone pancreatitis ranges from 32% to 61%. After recovering from acute pancreatitis, about one-third to one-half of acute pancreatitis patients develop functional disorders, such as diabetes mellitus and fatty stool; the incidence of chronic pancreatitis after acute pancreatitis ranges from 3% to 13%. Nevertheless, many reports have shown that most patients who recover from acute pancreatitis regain good general health and return to their usual daily routine. Some authors have emphasized that endocrine function disorders are a common complication after severe acute pancreatitis has been treated by pancreatic resection

Moisture gradients, form a vapor cycle within the viscous boundary layer as an organizing principle to worker termites

Studies of termite mound building have considered the mud they prepare, its properties and its composition. Here we consider the behaviors of the mound building termites Macrotermes michaelseni, (Sjostedt), in the presence of the viscous boundary layer (VBL), which spontaneously forms over any surface that air passes over. We looked how soil moisture and air vapor are coupled to form a feedback loop and a spatiotemporal precursor to worker termites in the presence of mound material. We explored residency and activities of workers when presented with a VBL and either varying substrate temperature gradients or a soil moisture transition within the soil substrate. We report the emergence of a ‘vapor conveyor’, which forms around a neutral evaporative equilibrium point (NEEP) at the soil/air interface, where the soil-borne moisture temperature (along the gradient) and the 100% saturated air-borne vapor temperature coincide within the VBL, forming a bubble of neutral mass transfer which, we propose, worker termites are sensitive to as viscosity changes within. We found, on average, that 67% (std. dev 27%) of behavioral events (clustering, excavation, and deposition) occurred within 10C either side of the NEEP. We found negative correlation (-0.78) between the substrate temperature gradient (0.1-0.9 0C mm-1) and the extents of behavioral activity, suggesting coupling between soil-borne moisture and air-borne vapor advection within the VBL. We recorded unique behaviors relating to interaction with the viscosity of vapor saturated air at this scale. We speculate that workers may exploit the VBL to overcome a classic trade-off, i.e. how to push activities forward into potentially desiccating environments, while conserving moisture in both the termites and the soil they build with

Synchronous twin track percutaneous nephrolithotomy: A preliminary experience

Percutaneous nephrolithotripsy is the treatment of choice for large renal calculi. Total stone clearance as the treatment goal remains elusive, despite staged procedures and multiple tracks. There is also the morbidity of multiple sittings and tracks. We investigated the feasibility of a synchronized approach to clearing these difficult stones with two teams operating through two or more tracks in tandem and also the ergonomic and logistic issues involved

An unusual double fungal infection of the bladder due to Candida and Cladosporium

AbstractFungal cystitis is usually associated with candida species. Most of the cases are asymptomatic and often due to contamination. Following, we describe the case of a young diabetic lady who presented with severe bladder storage symptoms and persistent sterile pyuria. As candida was isolated from the urine, a diagnosis of fungal cystitis was made. Imaging showed a duplex kidney with complete duplication of the ureters on both sides as well as a contracted bladder with small capacity and bilateral grade-3 reflux into the lower-pole moieties. In view of an increasing severity of the symptoms despite an appropriate treatment, it was decided to augment the bladder. The inflamed bladder wall was excised during augmentation. Tissue culture revealed cladosporium