A comparison of smooth basis constructions for isogeometric analysis

In order to perform isogeometric analysis with increased smoothness on complex domains, trimming, variational coupling or unstructured spline methods can be used. The latter two classes of methods require a multi-patch segmentation of the domain, and provide continuous bases along patch interfaces. In the context of shell modeling, variational methods are widely used, whereas the application of unstructured spline methods on shell problems is rather scarce. In this paper, we therefore provide a qualitative and a quantitative comparison of a selection of unstructured spline constructions, in particular the D-Patch, Almost-$C^1$, Analysis-Suitable $G^1$ and the Approximate $C^1$ constructions. Using this comparison, we aim to provide insight into the selection of methods for practical problems, as well as directions for future research. In the qualitative comparison, the properties of each method are evaluated and compared. In the quantitative comparison, a selection of numerical examples is used to highlight different advantages and disadvantages of each method. In the latter, comparison with weak coupling methods such as Nitsche's method or penalty methods is made as well. In brief, it is concluded that the Approximate $C^1$ and Analysis-Suitable $G^1$ converge optimally in the analysis of a bi-harmonic problem, without the need of special refinement procedures. Furthermore, these methods provide accurate stress fields. On the other hand, the Almost-$C^1$ and D-Patch provide relatively easy construction on complex geometries. The Almost-$C^1$ method does not have limitations on the valence of boundary vertices, unlike the D-Patch, but is only applicable to biquadratic local bases. Following from these conclusions, future research directions are proposed, for example towards making the Approximate $C^1$ and Analysis-Suitable $G^1$ applicable to more complex geometries

Costs of TB services in India (No 1).

BACKGROUND: There is a dearth of economic analysis required to support increased investment in TB in India. This study estimates the costs of TB services from a health systems´ perspective to facilitate the efficient allocation of resources by India´s National Tuberculosis Elimination Programme.METHODS: Data were collected from a multi-stage, stratified random sample of 20 facilities delivering TB services in two purposively selected states in India as per Global Health Cost Consortium standards and using Value TB Data Collection Tool. Unit costs were estimated using the top-down (TD) and bottom-up (BU) methodology and are reported in 2018 US dollars.RESULTS: Cost of delivering 50 types of TB services and four interventions varied according to costing method. Key services included sputum smear microscopy, Xpert® MTB/RIF and X-ray with an average BU costs of respectively US$2.45, US$17.36 and US$2.85. Average BU cost for bacille Calmette-Guérin vaccination, passive case-finding, TB prevention in children under 5 years using isoniazid and first-line drug treatment in new pulmonary and extrapulmonary TB cases was respectively US$0.76, US$1.62, US$2.41, US$103 and US$98.CONCLUSION: The unit cost of TB services and outputs are now available to support investment decisions, as diagnosis algorithms are reviewed and prevention or treatment for TB are expanded or updated in India

Anterior ischaemic optic neuropathy secondary to cluster headache.

This report describes a patient with cluster headache who developed anterior ischaemic optic neuropathy during an attack of headache, an association not previously described. A possible pathophysiologic mechanism based upon the understanding of optic disc physiology and ocular vascular pathology in headache syndromes is proposed

Optic perineuritis with secondary syphilis.

Optic perineuritis is characterized by swollen optic discs in the absence of raised intracranial pressure and visual dysfunction. A patient with secondary syphilis who presented with these features is described. The need to recognize the spectrum of ocular and optic nerve involvement in secondary syphilis is emphasized

Demyelinating optic neuropathy with Miller-Fisher syndrome. The case for overlap syndromes with central and peripheral demyelination.

The syndrome of ataxia, areflexia and ophthalmoplegia, or Miller-Fisher syndrome, has been considered to be a variant of Guillain-Barré syndrome with pathology restricted to the peripheral nervous system. A patient with Miller-Fisher syndrome and bilateral demyelinating optic neuropathy suggesting associated central nervous system pathology is presented. Clinical and experimental evidence regarding the association of central and peripheral nervous system demyelination is reviewed

Spinal epidural lipomatosis: report of a case secondary to hypothyroidism and review of literature.

Epidural lipomatosis usually occurs as a complication of steroid therapy. This report includes the first description of a case secondary to hypothyroidism. Adults in all age groups can be affected and present with progressive signs and symptoms of spinal cord or cauda equina compression. The dorsal aspect of the thoracic spine is most commonly involved, usually in its total extent. Spine radiographs are normal and myelography poorly delineates the nature and extent of abnormality. While computed tomography can provide information about the nature of the spinal mass, magnetic resonance imaging is the investigation of choice. Extensive decompressive laminectomy is useful but the results are variable. Correction of underlying endocrine abnormality can reverse the process. The need for early diagnosis of this disorder is therefore emphasized

A community based cross sectional study on the prevalence of low birth weight neonates and maternal factor responsible for the low birth weight

Introduction: Birth Weight is a major determinant of child health and nutrition and LBW [low birth weight] used as benchmark of mellowness. It has remained significant community health problem in India both because of high frequency and related mortalities and morbidities with it. This study was designed to find out the prevalence of LBW and possible maternal factors affecting it. Method: A cross-sectional hospital based community study was conducted at Dhiraj Hospital from Feb 2017 to April 2017; total 100 pregnant women were participated in this study, who delivered babies at obstetrics and gynecology ward. Information was collected from the mothers by pre-tested semi structured questionnaire. Percentage of incidences and statistical tests like Odds ratio [OR], chisquare test were used to evaluate the association between maternal factors and birth weight. Result: The incidence of LBW was found to be 38%. Gender wise evaluation of LBW babies shows about 53% of male child and 47% of female child, which indicates near about equal incidence of LBW in male and female babies. In the present study the risk of LBW associated with maternal factors like age of mother < 20 yrs [OR=2.1], <10.0 % Hemoglobin [OR=1.7] and education of mother [OR=1.4].Conclusion: LBW was found to be 38% and it is considered as major public problem which needs attention. By proper counseling for marriageable age, conception age of mother and improving maternal nutrition will directly benefit the health of mothers and child

Evidence for increased lipid peroxidation in multiple sclerosis.

Pentane and ethane are degradation products of unsaturated fatty acids which are released during lipid peroxidation. In order to assess whether multiple sclerosis is associated with lipid peroxidation, we measured pentane and ethane excretion by 16 patients with multiple sclerosis and compared them to healthy control subjects. Patients with acute exacerbation of multiple sclerosis had significantly higher concentrations of pentane (10.5 +/- 4.2 nmol/l)(p less than 0.01) compared to either patients in remission (4.5 +/- 1.7 nmol/l) or control subjects (4.9 +/- 1.1 nmol/l). The concentrations of ethane were not significantly different among these groups. Of the patients with acute exacerbation who later achieved remission, the pentane excretion also returned to normal (5.6 +/- 0.9 nmol/l). One patient who failed to reachieve clinical remission continued to excrete large amounts of pentane. We conclude that oxygen free radical activity is enhanced during exacerbation of multiple sclerosis