Efficient Fair Queueing using Deficit Round Robin

Fair queuing is a technique that allows each flow passing through a network device to have fair share of network resources. previous schemes for fair queuing that achieved nearly perfect fairness were expensive to implement: specifically, the work required to process a packet in these schemes was O(log(n)), where n is the number of active flows. This is expensive at high speeds. On the other hand, cheaper approximations of fair queuing that have been reported in the literature exhibit unfair behavior. In this paper, we describe a new approximation of fair queuing, that we call Deficit Round Robin. Our scheme achieves nearly perfect fairness in terms of throughput, requires only O(1) work to process a packet, and is simple enough to implement in hardware. Deficit Round Robin is also applicable to other scheduling problems where servicing cannot be broken up into smaller units

Personal or planetary health? Direct, spillover and carryover effects of non-monetary benefits of vegetarian behaviour

There is a debate about whether framing motivations as personal or planetary benefits - or both - is more effective at encouraging sustainable actions and promoting positive behavioural spillovers. In a pre-registered online longitudinal experiment, we randomly allocate n=1,242 respondents to either a control condition, or to one of three novel, interactive implementation intention interventions framing the benefits of a vegetarian diet in terms of either personal health, or planetary health, or both personal and planetary health. We ask respondents to choose between real vegetarian or non-vegetarian foods. We then ask them to donate part of their money to a charity. We finally measure their food choices three days and two months after the interventions. Compared to the control group, we find that participants assigned to any of the behavioural interventions are twice as likely to choose a vegetarian option. We find no statistically significant differences in the proportions of vegetarian options across the three experimental conditions. We find evidence of a positive behavioural spillover on the donations to charity amongst participants exposed to combined personal and planetary health. Three days after the interventions, participants allocated to this combined frame still reported to eat more vegetarian meals than in the control group. Such carryover effects, however, did not persist two months after the interventions. Overall, our research offers new insights about framing behavioural interventions to motivate sustainable actions and their potential behavioural spillovers

Comparative study of papanicolaou smear and colposcopy in the evaluation of cervical lesions

Background: Cervical cancer is the third most common type of cancer among females. Study aims to critically evaluate the sensitivity and specificity of colposcopy versus papanicolaou (Pap) smear in the early detection of dysplasias. Its secondary objective to correlate the findings in the evaluation of unhealthy cervix by cytology, colposcopy and colposcopy guided biopsy.Methods: This was a tertiary care teaching hospital based, prospective, cross sectional study done in Department of Obstetrics and Gynaecology, at Vydehi Institute of Medical Sciences and Research Centre, Bangalore, conducted on 200 women attending Gynaecology OPD.Results: PAP smear was taken for all 200 patients. 73% of smear was found to be normal, 11% showed inflammatory atypia, 9% showed low grade squamous intraepithelial lesion (LSIL), 3.5% showed atypical squamous cells of undetermined significance (ASCUS) and 3.5% showed High Grade Squamous Intraepithelial Lesion (HSIL). Among the 200 cases studied, 38% (76/200) were diagnosed as colposcopically abnormal. Among the abnormal cases, AW areas were diagnosed in 4%. Punctate pattern of vessels was seen in 5% of women. Normal findings was present in 62%, Erosion cervix in 6%, inflammatory changes were seen in 6% and polyps were diagnosed in 7.5%, leucoplakia was found in 2% and unsatisfactory colposcopy finding was seen in 4% and underwent endocervical curettage. 32 cases out of 200 women were positive on Pap smear. 66 out of 200 women were positive on Biopsy. Pap smear was positive in 22 out of 66 biopsy proven positive cases.Conclusions: The commonest presenting complaint was vaginal discharge (182/200; 91% of the patients. the PAP smear  is found to have sensitivity of 33.33%  and specificity of 92.54%. colposcopy is found to have sensitivity of 81.82%  and specificity of 82.84%

Study on knowledge and experience about emergency contraception at a tertiary care centre family planning clinic

Background: Unintended pregnancies and unsafe abortions are the major reproductive health challenges faced by women of developing countries. According to WHO 42 million induced abortions occur annually and out of which 20 million are performed in unsafe condition and by unskilled providers.Methods: It is a questionnaire-based study planned to be conducted in the family planning clinic of Department Of Obstetrics and Gynaecology, at Vydehi Institute of Medical Sciences and Research Centre, Bangalore. Statistical analysis is done by percentage analysis, paired T test or Wilckoxer signed rank test and Mcnemer test.Results: This is a questionnaire-based study conducted on 300 urban educated women seeking termination of pregnancy. Among 300 women studied majority were in the age group of 21-30 years i.e. 174 women (58%). Among 300 women studied about 126 women who had some knowledge about EC and Medias (like TV, radio and magazine) constitutes the major source of knowledge i.e. 60 women (47.6%) then Doctors and nurse i.e. 36 women (28.5%) and other sources like friends, relative and Teachers i.e. 30 women (23.8%). Knowledge about the side effects of EC was very limited in present study, i.e. 30 women (23.8%) were unaware of side effects, 60 women (47.6%) were aware of minor side effects like nausea, vomiting and pain abdomen, and only 36 women (28.5%) were aware of hormonal side effects like menstrual irregularity.Conclusions: From present study it is shown that even among urban educated women knowledge about emergency contraception is very limited. For the proper use of emergency contraception, women should have basic knowledge about fertility and contraception. According to present study only 23.8% of urban educated women have knowledge about safe and unsafe period only (42.8%) had knowledge about timing of use of Emergency contraception

The study of antiphospholipid antibodies in recurrent pregnancy loss

Background: Around 15% of clinically recognised pregnancies in women less than 35 years old result in spontaneous miscarriage. However recurrent pregnancy loss (RPL) is encountered in 5% of couples with two or more losses and in around 1–2% of couples with three or more losses. In view of the increasing burden of recurrent pregnancy loss in the society and in view of Anti-phospholipid syndrome being one of the undisputed treatable cause for recurrent pregnancy loss, this study aims to evaluate the significance of the antibody profiles of APS in relation to RPL in OBG dept of VIMS and RC.Methods: Patients coming to the Obstetric and Gynaecology department of Vydehi Institute of Medical Sciences and Research Centre, Bangalore, from December 1st 2014 to June 30th 2016. A detailed history of patients was taken based on set questionnaires. Detailed general and gynaecological examination findings were taken. Routine blood investigations were sent along with investigations for aPLAs which included: - Lupus Anticoagulant (LA) - Anti Cardiolipin Antibody (ACA) - Anti β2 glycoprotein 1 (Anti-β2GP1Ab). Final results are statistically evaluated.Results: A total of 56 patients of recurrent miscarriage with two or more prior pregnancy losses were considered. Out of the 56 patients, 23 patients were excluded as per the exclusion criteria and 33 patients were included in the present study. The mean age of the study group was 24.63 years (Range: 20-32 years). Overall, seven patients (21.21%) were seen to have positive antiphospholipid antibody titers amongst the 33 patients, with repeat testing done after 12 weeks to confirm the positivity. Five patients (15.15%) were positive for ACA antibody. Four (12.12%) patients were positive for LA and B2GP1 each. Two patients (6.06%) were positive for both LA and ACA antibodies. Two patients (6.06%) were positive for LA and B2GP1 antibodies and two other (6.06%) patients were positive for ACA and Anti-β2GP1Ab. There was a statistically significant association noticed between ACA positivity and POG at 1st pregnancy loss. However, the overall association of APLA positivity and POG at pregnancy loss was not statistically significant.Conclusions: There was a significant difference of POG at first pregnancy loss in ACA positive patients as compared to the ACA negative patients. However, when all the APLA positive patients were considered the difference was not statistically significant

Un processus d'admission aux programmes de médecine basé sur la localisation géographique n'influence pas les résultats académiques avant l'externat ni ceux à l'examen menant à l’obtention du permis d'exercice

Background: Students are selected for admission to the Northern Ontario School of Medicine University (NOSM U) MD degree program using criteria aiming to maximize access of persons thought most likely to practice in the region, including use of a geographic context score (GCS) which ranks those with lived experience in northern Ontario and/or rurality most highly. This study investigates the effect of this admissions process upon medical school academic performance.  Methods: We used a retrospective cohort design combined with multiple linear regression analysis to investigate the relationship between admission scores and performance on pre-clerkship courses, and the Medical Council of Canada Qualifying Exam Part 1 (MCCQE1). The GCS did not significantly explain performance variance on any pre-clerkship course, nor on the MCCQE1, while the undergraduate Grade Point Average correlated with most assessment scores.  The number of prior undergraduate biomedical courses predicted science and clinical skills performance, particularly in Year 1, but not with MCCQE1 scores. Performance on Year 2 courses, particularly foundational sciences and clinical skills, significantly predicted MCCQE1 scores. Results: Our data suggest that admission geographic context scoring is unrelated to future academic performance. Further, students with fewer prior undergraduate biomedical courses may benefit from increased support and/or a modified program during the early years. Contexte : La sélection étudiants à l'École de médecine du Nord de l'Ontario est fondée sur des critères visant à faciliter l’admission de candidats qu’on estime susceptibles de pratiquer dans la région. Un de ces critères est le score de contexte géographique (SCG) qui classe au premier rang les personnes ayant déjà vécu dans le Nord de l'Ontario ou en milieu rural. Cette étude examine l'effet de ce processus d'admission sur les résultats académiques des étudiants en médecine. Méthodes : Nous avons utilisé un modèle de cohorte rétrospective et une analyse par régression linéaire multiple pour étudier la relation entre les scores d'admission et les résultats obtenus aux cours avant l’externat et à l'examen d'aptitude du Conseil médical du Canada (EACMC), partie 1. Le SCG n'explique pas de manière significative la variance des résultats dans les cours pré-cliniques, ni à l'EACMC1, tandis que la moyenne pondérée cumulative au premier cycle est en corrélation avec la plupart des scores d'évaluation. Le nombre de cours en sciences biomédicales suivis dans un programme de premier cycle ont permis de prédire les résultats en sciences et en compétences cliniques, en particulier en première année, mais pas les résultats à l'EACMC1. Les résultats aux cours de deuxième année, en particulier de sciences fondamentales et de compétences cliniques, ont permis de prédire de manière significative les résultats à l'EACMC1. Résultats : Nos données portent à croire que le score de contexte géographique au moment de l'admission est sans lien avec les résultats académiques subséquents. En outre, les étudiants ayant suivi moins de cours en sciences biomédicales au premier cycle pourraient bénéficier d’un soutien plus important ou d'un programme adapté au cours des premières années

Cd40–Cd40 Ligand Interactions in Vivo Regulate Migration of Antigen-Bearing Dendritic Cells from the Skin to Draining Lymph Nodes

Whereas CD40–CD40 ligand interactions are important for various dendritic cell (DC) functions in vitro, their in vivo relevance is unknown. We analyzed the DC status of CD40 ligand −/− mice using a contact hypersensitivity (CHS) model system that enables multiple functions of DCs to be assessed in vivo. Immunohistochemistry of skin sections revealed no differences in terms of numbers and morphology of dendritic epidermal Langerhans cells (LCs) in unsensitized CD40 ligand −/− mice as compared with wild-type C57BL/6 mice. However, after contact sensitization of CD40 ligand −/− mice, LCs failed to migrate out of the skin and substantially fewer DCs accumulated in draining lymph nodes (DLNs). Furthermore, very few antigen-bearing DCs could be detected in the paracortical region of lymph nodes draining sensitized skin. This defect in DC migration after hapten sensitization was associated with defective CHS responses and decreased cutaneous tumor necrosis factor (TNF)-α production and was corrected by injecting recombinant TNF-α or an agonistic anti-CD40 monoclonal antibody. Thus, CD40–CD40 ligand interactions in vivo regulate the migration of antigen-bearing DCs from the skin to DLNs via TNF-α production and play a vital role in the initiation of acquired T cell–mediated immunity

Predictors of mortality in patients with severe COVID-19 pneumonia — a retrospective study

Introduction: The novel coronavirus pandemic has caused significant mortality throughout the world. This study was done as there is scarce data on mortality predictors in severe COVID-19 pneumonia patients admitted to ICU in the Indian population. Material and methods: A retrospective study was conducted on COVID-19 pneumonia patients admitted to tertiary care center during June–October 2020. The records of patients admitted to ICU were collected and data included demography, symptoms, comorbidites and vital parameters. Laboratory parameters included complete hemogram, random blood sugar, S.Ferritin, S.LDH, renal function test, liver function test. Treatment-associated information such as the use of remdesivir, timing of initiating rem-desivir after the symptom onset, the use of steroids, use of anticoagulants, use of HFNC, NIV, ventilator were collected. 30 days mortality data post-discharge was collected via telephonic interview.Results: 4,012 confirmed cases of COVID-19 were admitted to hospital, of which 560 (13.95%)   with severe pneumonia were included in the study. Mean age was 57.75 ± 13.96 years. The mortality rates were 54.64% among severe COVID-19 cases and 5% among mild to moderate COVID-19 cases. The Cox multinominal regression analysis identified SpO2/FiO2 < 400, age > 50 years, duration of symptom > 4 days, serum ferritin > 450 µg/L, respiratory rate > 23/min, the presence of comorbidities and non-usage of remdesivir were independently associated with increased mortality. Mortality rate at 30 days was 56.60%. Conclusion:  Severe COVID-19 pneumonia is associated with very high mortality, especially in a resource-constrained setting. The use of remdesivir may have to be considered early in the course of disease to prevent excess mortality related to COVID-19

Oxygen Moment Formation and Canting in Li2CuO2

The possibilities of oxygen moment formation and canting in the quasi-1D cuprate Li2CuO2 are investigated using single crystal neutron diffraction at 2 K. The observed magnetic intensities could not be explained without the inclusion of a large ordered oxygen moment of 0.11(1) Bohr magnetons. Least-squares refinement of the magnetic structure of Li2CuO2 in combination with a spin-density Patterson analysis shows that the magnetization densities of the Cu and O atoms are highly aspherical, forming quasi-1D ribbons of localised Cu and O moments. Magnetic structure refinements and low-field magnetization measurements both suggest that the magnetic structure of Li2CuO2 at 2 K may be canted. A possible model for the canted configuration is proposed.Comment: 10 pages, 8 figures (screen resolution

Premorbid Cognitive Deficits in Young Relatives of Schizophrenia Patients

Neurocognitive deficits in schizophrenia (SZ) are thought to be stable trait markers that predate the illness and manifest in relatives of patients. Adolescence is the age of maximum vulnerability to the onset of SZ and may be an opportune “window” to observe neurocognitive impairments close to but prior to the onset of psychosis. We reviewed the extant studies assessing neurocognitive deficits in young relatives at high risk (HR) for SZ and their relation to brain structural alterations. We also provide some additional data pertaining to the relation of these deficits to psychopathology and brain structural alterations from the Pittsburgh Risk Evaluation Program (PREP). Cognitive deficits are noted in the HR population, which are more severe in first-degree relatives compared to second-degree relatives and primarily involve psychomotor speed, memory, attention, reasoning, and social-cognition. Reduced general intelligence is also noted, although its relationship to these specific domains is underexplored. Premorbid cognitive deficits may be related to brain structural and functional abnormalities, underlining the neurobiological basis of this illness. Cognitive impairments might predict later emergence of psychopathology in at-risk subjects and may be targets of early remediation and preventive strategies. Although evidence for neurocognitive deficits in young relatives abounds, further studies on their structural underpinnings and on their candidate status as endophenotypes are needed