Scrambled and Unscrambled Turbulence

The linked fluid dynamics videos depict Rayleigh-Taylor turbulence when driven by a complex acceleration profile involving two stages of acceleration interspersed with a stage of stabilizing deceleration. Rayleigh-Taylor (RT) instability occurs at the interface separating two fluids of different densities, when the lighter fluid is accelerated in to the heavier fluid. The turbulent mixing arising from the development of the miscible RT instability is of key importance in the design of Inertial Confinement Fusion capsules, and to the understanding of astrophysical events, such as Type Ia supernovae. By driving this flow with an accel-decel-accel profile, we have investigated how structures in RT turbulence are affected by a sudden change in the direction of the acceleration first from destabilizing acceleration to deceleration, and followed by a restoration of the unstable acceleration. By studying turbulence under such highly non-equilibrium conditions, we hope to develop an understanding of the response and recovery of self-similar turbulence to sudden changes in the driving acceleration.Comment: 3 pages article, Two videos are include

Learning curve of laparoscopic hysterectomy in a zonal hospital setting: a retrospective analysis of 102 cases operated by a single surgeon

Background: The aim of this study was to analyse the learning curve and clinical efficacy of the art of laparoscopic hysterectomy in a zonal hospital setting.Methods: We conducted a retrospective analysis of 102 women who underwent laparoscopic hysterectomy (LAVH/ TLH) by a single surgeon after post-graduation for benign uterine pathology in a zonal hospital setting. They were divided into two groups of first 50 cases (Group I) and next 52 cases (Group II). The primary outcome was the learning curve of the operating gynaecologist in terms of reduction in duration of surgery, reduced perioperative complications, increasing percentage of TLHs with time.Results: 102 women underwent laparoscopic hysterectomy for the benign uterine pathology successfully. Surgical outcomes of laparoscopic hysterectomy in terms of mean operative time was 135 mins (Group I) vs 93 mins (Group II), estimated blood loss 255 ml (Group I) vs 140 ml (Group II), hospital stay 05 days (Group I) vs 03 days (Group II), duration of postoperative analgesia 07 days (Group I) vs 05 days (Group II). As the surgical experience increased, patients with bigger uterine size (>10-week size) were taken up for hysterectomy, percentage of TLH increased in Group II as compared to Group I (42.31% vs 18%), with decreasing complications and shorter recovery time.Conclusions: Laparoscopic hysterectomy (LAVH/ TLH) has a short learning curve and it's a feasible and beneficial surgical modality for treating benign uterine pathology even in a zonal hospital setting (low resource setting)

Rapid intrapartum test for maternal group B streptococcal colonisation and its effect on antibiotic use in labouring women with risk factors for early-onset neonatal infection (GBS2): cluster randomised trial with nested test accuracy study

Background: Mother-to-baby transmission of group B Streptococcus (GBS) is the main cause of early-onset infection. We evaluated whether, in women with clinical risk factors for early neonatal infection, the use of point-of-care rapid intrapartum test to detect maternal GBS colonisation reduces maternal antibiotic exposure compared with usual care, where antibiotics are administered due to those risk factors. We assessed the accuracy of the rapid test in diagnosing maternal GBS colonisation, against the reference standard of selective enrichment culture. Methods: We undertook a parallel-group cluster randomised trial, with nested test accuracy study and microbiological sub-study. UK maternity units were randomised to a strategy of rapid test (GeneXpert GBS system, Cepheid) or usual care. Within units assigned to rapid testing, vaginal-rectal swabs were taken from women with risk factors for vertical GBS transmission in established term labour. The trial primary outcome was the proportion of women receiving intrapartum antibiotics to prevent neonatal early-onset GBS infection. The accuracy of the rapid test was compared against the standard of selective enrichment culture in diagnosing maternal GBS colonisation. Antibiotic resistance profiles were determined in paired maternal and infant samples. Results: Twenty-two maternity units were randomised and 20 were recruited. A total of 722 mothers (749 babies) participated in rapid test units; 906 mothers (951 babies) were in usual care units. There was no evidence of a difference in the rates of intrapartum antibiotic prophylaxis (relative risk 1.16, 95% CI 0.83 to 1.64) between the rapid test (41%, 297/716) and usual care (36%, 328/906) units. No serious adverse events were reported. The sensitivity and specificity measures of the rapid test were 86% (95% CI 81 to 91%) and 89% (95% CI 85 to 92%), respectively. Babies born to mothers who carried antibiotic-resistant Escherichia coli were more likely to be colonised with antibiotic-resistant strains than those born to mothers with antibiotic-susceptible E. coli. Conclusion: The use of intrapartum rapid test to diagnose maternal GBS colonisation did not reduce the rates of antibiotics administered for preventing neonatal early-onset GBS infection than usual care, although with considerable uncertainty. The accuracy of the rapid test is within acceptable limits. Trial registration: ISRCTN74746075. Prospectively registered on 16 April 2015

Systems Biology Approach Predicts Antibody Signature Associated with Brucella melitensis Infection in Humans

A complete understanding of the factors that determine selection of antigens recognized by the humoral immune response following infectious agent challenge is lacking. Here we illustrate a systems biology approach to identify the antibody signature associated with Brucella melitensis (Bm) infection in humans and predict proteomic features of serodiagnostic antigens. By taking advantage of a full proteome microarray expressing previously cloned 1406 and newly cloned 1640 Bm genes, we were able to identify 122 immunodominant antigens and 33 serodiagnostic antigens. The reactive antigens were then classified according to annotated functional features (COGs), computationally predicted features (e.g., subcellular localization, physical properties), and protein expression estimated by mass spectrometry (MS). Enrichment analyses indicated that membrane association and secretion were significant enriching features of the reactive antigens, as were proteins predicted to have a signal peptide, a single transmembrane domain, and outer membrane or periplasmic location. These features accounted for 67% of the serodiagnostic antigens. An overlay of the seroreactive antigen set with proteomic data sets generated by MS identified an additional 24%, suggesting that protein expression in bacteria is an additional determinant in the induction of Brucella-specific antibodies. This analysis indicates that one-third of the proteome contains enriching features that account for 91% of the antigens recognized, and after B. melitensis infection the immune system develops significant antibody titers against 10% of the proteins with these enriching features. This systems biology approach provides an empirical basis for understanding the breadth and specificity of the immune response to B. melitensis and a new framework for comparing the humoral responses against other microorganisms