Implementation of Peltier Cooling in Hermetically Sealed Electronic Packaging Unit for Sub-sea Vessel

This paper presents the methodology adopted for implementation of Peltier cooling in hermetically sealed electronic packaging units used in sub-sea vessels. In sub-sea vessels, sonar front-end electronics is packaged in hermetically sealed electronic packaging units. The thermal design of the unit is a highly challenging task considering the heat dissipation of 300W from the electronics, non-availability of chilled air for cooling and IP68 sealing requirements. Cooling fans cannot be integrated, since these units are to be placed in acoustically sensitive pressure capsule area of the subsea vessel. The electronic cooling in this unit is achieved using conduction cooling with external fins. To enhance the cooling, suitable Peltier cooling (Thermo-electric cooling or TEC) module is selected and implemented with the system. Computational fluid dynamic analysis of the unit is carried-out to study the air-flow and thermal performances with Peltier cooler. The unit is realised and the estimated temperatures validated by experimental temperature measurements on the realised unit. The measured temperatures are within the safe operating limits of the electronic components and hence the cooling design of the unit is satisfactory. It is also observed that maximum temperature reduction has occurred at 1.5A current and card edge temperature of Printed circuit board lowered by 9.28 °C by implementing Peltier cooling

ANALYSIS OF TECHNIQUES IN CRIME PREVENTION USING FUZZY

ABSTRAC

Genotype-phenotype correlates of infantile-onset developmental & epileptic encephalopathy syndromes in South India: A single centre experience

INTRODUCTION: A paucity of literature exists on genotype- phenotype correlates of 'unknown-etiology' infantile-onset developmental-epileptic encephalopathies (DEE) from India. The primary objective was to explore the yield of genetic testing in identifying potential disease causing variants in electro-clinical phenotypes of DEE METHODS: An observational hospital-based study was undertaken on children with unexplained refractory seizure-onset ≤12 months age and developmental delay, whose families consented and underwent genetic testing during a three year time period (2016-2018) by next-generation sequencing (NGS) or multiplex ligand protein amplification. Yield was considered based on demonstration of pathogenic/likely pathogenic variants only and variants of unknown significance (VUS) were documented. RESULTS: Pathogenic/likely pathogenic variants were identified in 26 (31.7 %) out of 82 children with DEE. These included those variants responsible for primarily DEE- 21(76.7 %); neuro-metabolic disorders- 3(18.6 %) and chromosomal deletions- 2(4.7 %). Of these patients, early-infantile epilepsy onset ≤ 6 months age was noted in 22(84.6 %). The DEE studied included Ohtahara syndrome associated with STXBP1 and SCN8A variants with yield of 50 % (2/4 tested); early myoclonic encephalopathy (no yield in 2); West syndrome with CDKL5, yield of 13.3 % (2/15 tested); epilepsy of infancy with migrating partial seizures due to CACNA1A and KCNT1 variants, yield of 67 % (2/3 tested); DEE-unclassified with KCNQ2, AP3B2, ZEB2, metabolic variants (SUOX, ALDH7A1, GLDC) and chromosome deletions (chr 1p36, chr2q24.3); yield of 32 % (8/25 tested). Patients with Dravet syndrome/Dravet-like phenotypes (N = 33) had variants in SCN1A (N = 10), SCN1B, CHD2; yield of 36.4 % (12/33 tested; 57.1 % from NGS). Eighteen patients with potential variants (SCN1A, SCN2A, SCN8A, KCNQ2, ALDH7A1 which also included VUS) could be offered targeted therapy. CONCLUSIONS: Our study confirms a good yield of genetic testing in neonatal and infantile-onset DEE provided robust phenotyping of infants is attempted with prognostic and therapeutic implications, particularly relevant to centres with resource constraints

PIGF deficiency causes a phenotype overlapping with DOORS syndrome

DOORS syndrome is characterized by deafness, onychodystrophy, osteodystrophy, intellectual disability, and seizures. In this study, we report two unrelated individuals with DOORS syndrome without deafness. Exome sequencing revealed a homozygous missense variant in PIGF (NM_173074.3:c.515C>G, p.Pro172Arg) in both. We demonstrate impaired glycosylphosphatidylinositol (GPI) biosynthesis through flow cytometry analysis. We thus describe the causal role of a novel disease gene, PIGF, in DOORS syndrome and highlight the overlap between this condition and GPI deficiency disorders. For each gene implicated in DOORS syndrome and/or inherited GPI deficiencies, there is considerable clinical variability so a high index of suspicion is warranted even though not all features are noted

An evaluation of the implementation of interventions to reduce post-operative infections and optimise antibiotic use across the surgical pathway in India: A mixed methods exploratory study protocol

Introduction: Postoperative infections represent a significant burden of disease, demanding antibiotic prescriptions, and are contributing to antimicrobial resistance. The burden of infection as a surgical complication is greater in low- and middle-income countries (LMICs). We report the protocol of a pilot study for the co-design, implementation and evaluation of two infection prevention and control (IPC) and antimicrobial stewardship (AMS) interventions across the surgical pathway in a teaching hospital in India. Methods and analysis: The two interventions developed following in-depth qualitative enquiry are (i) surveillance and feedback of postoperative infections to optimise the use of antibiotics in two surgical departments (gastrointestinal and cardiovascular and thoracic surgery) and (ii) raising awareness amongst patients, carers and members of public about IPC and AMS. We will conduct a prospective study, formatively evaluating the implementation process of delivering the two co-designed interventions using implementation science frameworks. The study will systematically assess the context of intervention delivery, so that implementation support for the interventions may be adapted to the needs of stakeholders throughout the study. Analysis of implementation logs and interviews with stakeholders upon completion of the implementation period, will offer insights into the perceived acceptability, appropriateness, feasibility and sustainability of the interventions and their implementation support. Implementation costs will be captured descriptively. Feasibility of clinical data collection to investigate effectiveness of interventions will also be assessed for a future larger study. Thematic framework analysis and descriptive statistics will be used to report the qualitative and quantitative data, respectively. Strengths and limitations of this study: • The paired interventions have been co-designed from their inception with involvement of stakeholders at different stages in the surgical pathway. • Simultaneous evaluation of implementation and clinical outcomes will inform the development of a future larger study to enable/assess the scalability of interventions • The study offers a novel combination of implementation theory-informed, stakeholder-driven and clinically relevant evaluation, carried out in the context of a middle-income country hospital. • The project may not be applicable to every low-resource setting and surgical context due to differences in healthcare systems and cultures. However, the application of implementation science concepts may facilitate transferability and adaptation to other settings

Diuretic Effects of Cleistanthin A and Cleistanthin B from the Leaves of Cleistanthus Collinus in Wistar Rats

To study the diuretic effects of cleistanthin A and cleistanthin B, phytoconstituents were isolated from the leaves of Cleistanthus collinus in Wistar rats. The in vivo diuretic effects of cleistanthins A and B were determined according to the Lipschitz test. Prior to the experiment, the animals were fasted for 5 h and placed individually in metabolic cages. Cleistanthins A and B (12.5, 25, and 50 mg/kg) and furosemide (5 mg/kg) were suspended in 0.5% w/v carboxymethyl cellulose and administered orally. The urine was collected up to 5 h after administration and subsequently up to 24 h after administration. The acidity and urine volume were measured immediately. The urinary sodium and potassium levels were determined using a flame photometer, and the chloride level was determined by argentometric titration. The diuretic index and diuretic activity were calculated mathematically. While cleistanthins A and B showed a diuretic index of more than one, the diuretic activity of these compounds was less than one, indicating inferior activity compared with furosemide. Both cleistanthin A and B produced a significant increase in the urine volume and alterations in urinary electrolyte levels. However, the effect of the compounds was not dose dependent. Cleistanthin A and cleistanthin B exert diuretic effects in male Wistar rats without affecting the urinary acidity

Are current infection prevention and control expectations fit for purpose? Interim results from an ethnographic study in South India

Copyright © 2020 The Authors). Background: Carer involvement around the world has varied impact on infection prevention and control (IPC) practices in hospitals. We investigated the experiences of patients and carers in the surgical pathway of a tertiary hospital in south India, exploring their involvement in IPC and therapeutic decision-making along the patient pathway. Methods and materials: Ethnographic study through observations from ward rounds, semi-structured interviews, in-depth case studies and documentary analysis. Field notes from observations and interview transcripts were subsequently coded using NVivo and analysed using grounded theory. Data collection and analysis were iterative, recursive and continued until thematic saturation was achieved. Results: We conducted 48 interviews (44 healthcare professionals, 4 patients), over 100 hours of observations, and 2 in-depth case studies aided by documentary analysis of patient records. Institutional expectations of families are formalised in policies which demand that patients are accompanied by a relative at all times. Such intense presence embeds families in the care environment of the patients, as demonstrated by their high engagement not only in direct personal care (i.e. bathing patients) but also clinical tasks (i.e. wound care), hence playing an important yet implicit IPC role. The informal carers actively discussed the patient's progress with healthcare workers, received post-discharge advice and, more often than not, decided on therapeutic options on behalf of patients. Such care leadership was assumed and accepted by patients (aware of such involvement in decision-making), healthcare workers and the institution (where policies about additional relatives staying in the ward were routinely ignored), reflecting a culture of communal and collective care. For patients and relatives, infections were ‘brought in’ by other visitors, resulting in recently discharged patients being kept within the home, where the environment could be controlled and visitors restricted. This approach further highlights the importance of relatives as community carers and gatekeepers of care-related infection. Conclusion: Applying the current worldwide IPC perspectives focused on patients as sole decision-makers in India may overlook the wider social-cultural context and the constellation of persons who play a role in care and by extension decisions about IPC. Culture-sensitive IPC policy which embrace the roles that informal carers play is urgently needed

Indispensable yet invisible: A qualitative study of the roles of carers in infection prevention in a South Indian hospital

Copyright © 2022 The Authors. Objectives: We investigated the roles of patient carers in infection-related care on surgical wards in a South Indian hospital from the perspective of healthcare workers (HCWs), patients, and their carers. Methods: Ethnographic study included ward-round observations (138 hours) and face-to-face interviews (44 HCWs, 6 patients/carers). Data (field notes, interview transcripts) were coded in NVivo 12 and thematically analyzed. Data collection and analysis were iterative, recursive, and continued until thematic saturation. Results: Carers have important, unrecognized roles. At the study site, institutional expectations are formalized in policies, demanding a carer to always accompany in-patients. Such intense presence embeds families in the patient care environment, as demonstrated by their high engagement in direct personal (bathing patients) and clinical care (wound care). Carers actively participate in discussions on patient progress with HCWs, including therapeutic options. There is a misalignment between how carers are positioned by the organization (through policy mandates, institutional practices, and HCWs expectations), and the role that they play in practice, resulting in their role, though indispensable, remaining unrecognized. Conclusion: Current models of patient and carer involvement in infection prevention and control are poorly aligned with sociocultural and contextual aspects of care. Culture-sensitive infection prevention and control policies which embrace the roles that carers play are urgently needed.Economic and Social Research Council Grant number: ES/P008313/1