An Analytic Model for left invertible Weighted Translation Semigroups

M. Embry and A. Lambert initiated the study of a semigroup of operators $\{S_t\}$ indexed by a non-negative real number $t$ and termed it as weighted translation semigroup. The operators $S_t$ are defined on $L^2(\mathbb R_+)$ by using a weight function. The operator $S_t$ can be thought of as a continuous analogue of a weighted shift operator. In this paper, we show that every left invertible operator $S_t$ can be modeled as a multiplication by $z$ on a reproducing kernel Hilbert space $\cal H$ of vector-valued analytic functions on a certain disc centered at the origin and the reproducing kernel associated with $\cal H$ is a diagonal operator. As it turns out that every hyperexpansive weighted translation semigroup is left invertile, the model applies to these semigroups. We also describe the spectral picture for the left invertible weighted translation semigroup. In the process, we point out the similarities and differences between a weighted shift operator and an operator $S_t.$Comment: 14 page

Assessment of socio-clinical profile of neonates admitted in sick neonatal care unit of tertiary care hospital: Odisha

Background: Neonatal mortality rate of 29 and early neonatal mortality rate is 20 which contributes 53% of IMR. India targets to achieve single digit under 5 and neonatal death by 2030. Early identification and management of common morbidities among neonates is desirable for improving the survival. Therefore, this study was conducted with the aim of assessing socio-clinical profile of neonates admitted to SNCU and its impact on morbidities of newborn from different strata.Methods: A cross sectional study was conducted in SNCU of MKCG medical college from January 2016 to December 2016. Convenient sampling was done. Data was collected using pre-designed semi structured questionnaire.Results: Total 752 study subjects were taken. Most common cause of admission was sepsis (47.4%) followed by prematurity (27.8%), birth asphyxia (13.9%) and IUGR (7.5%). Majority of out born neonates were admitted for sepsis (87.9%) while in born neonates for birth asphyxia (81.9%). All the morbidities were significantly higher among early neonates, babies born to illiterate mother and those with inadequate antenatal check-up.Conclusions: Majority of babies were out born, may be due to delay and lack of quality new born care in the referring facilities. Sepsis was most common preventable morbidity by simple intervention of clean delivery practices which should be promoted. Birth asphyxia can be reduced by adequate skill development training of the staffs and minimising the 3 delays maternal care

Evaluation of buprenorphine as an adjuvant to 2% lidocaine during intravenous regional anaesthesia

Background: Intravenous regional anaesthesia (IVRA) is a simple, effective method of anaesthesia for surgical procedures on the extremities. Major limitations are tourniquet pain, short duration of block and absence of post-operative analgesia. Buprenorphine is known to improve the quality of anaesthesia. Aim of this study is to evaluate the efficacy of buprenorphine as an adjuvant to lignocaine in IVRA. Methods: Sixty patients between 18-60 years age, belonging to the ASA grade 1, 2 undergoing upper limb surgeries were enrolled into the study. Patients belonging to group BL patients received 10 ml of preservative free lidocaine 2% diluted to 40 ml. Group BB-patients received 10 ml of preservative free lidocaine 2% mixed with 60 mcg of buprenorphine diluted to 40 ml. Onset of sensory and motor block; recovery time and postoperative analgesia were noted. Data were analyzed using chi-square test, independent ‘t’ test. Results: The onset time of both sensory and motor block were significantly shortened, the recovery of sensory and motor block was prolonged, the incidence of tourniquet pain was comparatively lesser and there was significantly increased duration of post-operative analgesia in the buprenorphine group. Haemo-dynamic parameters were similar in both groups Conclusions: Sixty mcg buprenorphine as an adjuvant to lidocaine in IVRA effectively enhances the anaesthesia and post-operative analgesia.

Induced hypotension for functional endoscopic sinus surgery: comparison between dexmedetomidine and nitro-glycerine

Background: Functional endoscopic sinus surgery (FESS) is a minimally invasive technique used to restore sinus ventilation and normal function by opening sinus air cells and ostia. FESS requires bloodless field, several techniques and drugs have been used in the past for achieving controlled hypotension such as nitroglycerine, esmolol, remifentanil, dexmedetomidine, isoflurane, propofol. Therefore, this study was conducted to compare between dexmedetomidine and nitroglycerine for controlled hypotension for FESS. Primary aim to compare quality of surgical field using average category scale and surgeon satisfaction and secondary aim to compare arterial pressure and heart rate changes between dexmedetomidine and nitroglycerine when used to induce hypotension.Methods: This study was conducted in 40 consenting adult patients posted for FESS and were randomly divided into two groups, group D received dexmedetomidine 1 mcg/kg and group N received nitroglycerine 0.5 mcg/kg/min, both infusions started 10 min after induction. Parameters such as quality of surgical field by average category scale, heart rate and mean arterial pressure (MAP) recorded every 10 minutes.Results: Dexmedetomidine and nitroglycerine both had comparable quality of surgical field. ACS grading of 1 or 2 were found among both the groups. Dexmedetomidine group had better mean arterial pressure at 10th, 20th, 30th, 40th, 50th, 60th and 70th min and heart rate at 10th, 20th, 30th, 40th, 50th, 60th and 70th min when compared to nitroglycerine group.Conclusions: Dexmedetomidine and nitroglycerine both were found to be safe to use for controlled hypotension in functional endoscopic sinus surgeries

The dust envelope of the pre-planetary nebula IRAS19475+3119

We present the spectral energy distribution (SED) of the pre-planetary nebula, IRAS 19475+3119 (I19475), from the optical to the far-infrared. We identify emission features due to crystalline silicates in the ISO SWS spectra of the star. We have fitted the SED of I19475 using a 1-D radiative transfer code, and find that a shell with inner and outer radii of 8.8X10^{16} and 4.4X10^{17}cm, and dust temperatures ranging from about 94K to 46K provide the best fit. The mass of this shell is greater than/equal to 1[34cm^{2}g^{-1}/kappa(100micron)][delta/200]M_Sun, where kappa(100micron) is the 100micron dust mass absorption coefficient (per unit dust mass), and delta is the gas-to-dust ratio. In agreement with results from optical imaging and millimeter-wave observations of CO emission of I19475, our model fits support an r^{-3} density law for its dust shell, with important implications for the interaction process between the fast collimated post-AGB winds and the dense AGB envelopes which results in the observed shapes of PPNs and PNs. We find that the observed JCMT flux at sub-millimeter wavelengths (850micron) is a factor ~ 2 larger than our model flux, suggesting the presence of large dust grains in the dust shell of I19475 which are not accounted for by our adopted standard MRN grain size distribution.Comment: 38 pages, 8 figures. Accepted for publication in Ap

A qualitative study examining the benefits and challenges of incorporating patient-reported outcome substance use and mental health questionnaires into clinical practice to improve outcomes on the HIV care continuum.

BACKGROUND: Inadequate identification and treatment of substance use (SU) and mental health (MH) disorders hinders retention in HIV care. The objective of this study was to elicit stakeholder input on integration of SU/MH screening using computer-assisted patient-reported outcomes (PROs) into clinical practice. METHODS: We conducted semi-structured interviews with HIV-positive patients who self-reported SU/MH symptoms on a computer-assisted PROs (n = 19) and HIV primary care providers (n = 11) recruited from an urban academic HIV clinic. Interviews were audio-recorded and transcribed. We iteratively developed codes and organized key themes using editing style analysis. RESULTS: Two themes emerged: (1) Honest Disclosure: Some providers felt PROs might improve SU/MH disclosure; more were concerned that patients would not respond honestly if their provider saw the results. Patients were also divided, stating PROs could help overcome stigma but that it could be harder to disclose SU/MH to a computer versus a live person. (2) Added Value in the Clinical Encounter: Most providers felt PROs would fill a practice gap. Patients had concerns regarding confidentiality but indicated PROs would help providers take better care of them. CONCLUSIONS: Both patients and providers indicated that PROs are potentially useful clinical tools to improve detection of SU/MH. However, patients and providers expressed conflicting viewpoints about disclosure of SU/MH using computerized PROs. Future studies implementing PROs screening interventions must assess concerns over confidentiality and honest disclosure of SU/MH to understand the effectiveness of PROs as a clinical tool. More research is also needed on patient-centered integration of the results of PROs in HIV care

Structure-Activity Relationships in Toll-like Receptor 2-Agonists Leading to Simplified Monoacyl Lipopeptides

Toll-like receptor 2-agonistic lipopeptides typified by S-[2,3-bis(palmitoyloxy)-(2RS)-propyl]-R-cysteinyl-S-serine (PAM2CS) compounds are potential vaccine adjuvants. In continuation of previously reported structure-activity relationships on this chemotype, we have determined that at least one acyl group of optimal length (C16) and an appropriately orientated ester carbonyl group is essential for TLR2-agonistic activity. The spacing between one of the palmitoyl ester carbonyl and the thioether is crucial to allow for an important H-bond, which observed in the crystal structure of the lipopeptide:TLR2 complex; consequently, activity is lost in homologated compounds. Penicillamine-derived analogues are also inactive, likely due to unfavorable steric interactions with the carbonyl of Ser 12 in TLR2. The thioether in this chemotype can be replaced with a selenoether. Importantly, the thioglycerol motif can be dispensed with altogether, and can be replaced with a thioethanol bridge. These results have led to a structurally simpler, synthetically more accessible, and water-soluble analogue possessing strong TLR2-agonistic activities in human blood