Spatiotemporal pattern induced by self and cross-diffusion in a spatial Holling-Tanner model

In this paper, we have made an attempt to provide a unified framework to understand the complex spatiotemporal patterns induced by self and cross diffusion in a spatial Holling-Tanner model forphytoplankton-zooplankton-fish interaction. The effect of critical wave length which can drive the system to instability is investigated. We have examined the criterion between two cross-diffusivity (constant and timevarying)on the stability of the model system and for diffusive instability to occur. Based on these conditions and by performing a series of extensive simulations, we observed the irregular patterns, stationary strips, spots, and strips-spots mixture patterns. Numerical simulation results reveal that the regular strip-spot mixture patterns prevail over the whole domain on increasing the values of self- diffusion coefficients of phytoplankton and zooplankton and the dynamics of the system do not undergo any further changes

Colistin and Tigecycline susceptibility among carbapenemase producing Enterobacteriaceae at a tertiary care hospital of South India

Background: Carbapenem resistance among Enterobacteriaceae is a serious clinical problem and the global spread of such resistant strains has hampered the treatment effort leaving with few choices of antibiotics like tigecycline and colistin. Methods: Therefore, we looked for the susceptibility pattern of tigecycline and colistin among carbapenem-resistant Enterobacteriaceae (CRE) by Epsilometer (E) test at Sri Ramachandra University Hospital, Porur, Chennai, India. This study used the combined disc test with phenylboronic acid and EDTA; and modified Hodge test (MHT) to differentiate the carbapenemases. The minimum inhibitory concentration of tigecycline and colistin susceptibility was determined for CRE isolates by using the E-test strips ranging from 0.016-256 μg /ml. Results: A total of 238 extended spectrum beta lactamase producers from Family Enterobacteriaceae were included in the study. Among those, 37 isolates were MHT positive. On combined disc test, 14 were metallo beta lactamase positive, 4 were Klebseillae pneumoniae carbapenemase positive and only one isolate was found to be positive for both. Out of 51 CRE isolates, the number of tigecycline and colistin resistant were found to be in 30 and 3 respectively according to EUCAST criteria. Conclusion: Tigecycline may be effective but it needs to be monitored routinely. Colistin remains a reliable option for CRE infections. The increasing resistance of CRE to the available antibiotics like tigecycline and colistin is a threat to the therapeutic management of such patients

Paradidymis – Fact/Fiction and its Significance

AbstractA 30-year old infertile male was admitted for microsurgical sub inguinal varicocelectomy. Intraoperatively, two tubular structures of the caliber of neighboring veins were noted. They were distinct from the vas, which was carefully preserved. Histopathology revealed varicose veins along with two convoluted tubular structures lined by ciliated pseudo-stratified epithelium. There was an incomplete thin muscle coat. The lumina were irregular and contained no spermatozoa (Fig. 1). These structures were identified as paradidymis based on the location in the cord and microscopic morphology. We have tried to analyze the medico-legal significance of these benign lesions in our every day practice

Diagnostic errors in paediatric cardiac intensive care

AbstractIntroductionDiagnostic errors cause significant patient harm and increase costs. Data characterising such errors in the paediatric cardiac intensive care population are limited. We sought to understand the perceived frequency and types of diagnostic errors in the paediatric cardiac ICU.MethodsPaediatric cardiac ICU practitioners including attending and trainee physicians, nurse practitioners, physician assistants, and registered nurses at three North American tertiary cardiac centres were surveyed between October 2014 and January 2015.ResultsThe response rate was 46% (N=200). Most respondents (81%) perceived that diagnostic errors harm patients more than five times per year. More than half (65%) reported that errors permanently harm patients, and up to 18% perceived that diagnostic errors contributed to death or severe permanent harm more than five times per year. Medication side effects and psychiatric conditions were thought to be most commonly misdiagnosed. Physician groups also ranked pulmonary overcirculation and viral illness to be commonly misdiagnosed as bacterial illness. Inadequate care coordination, data assessment, and high clinician workload were cited as contributory factors. Delayed diagnostic studies and interventions related to the severity of the patient’s condition were thought to be the most commonly reported process breakdowns. All surveyed groups ranked improving teamwork and feedback pathways as strategies to explore for preventing future diagnostic errors.ConclusionsPaediatric cardiac intensive care practitioners perceive that diagnostic errors causing permanent harm are common and associated more with systematic and process breakdowns than with cognitive limitations.</jats:sec

Ohia rain forest study: ecological investigations of the ohia dieback problem in Hawaii

Reports were scanned in black and white at a resolution of 600 dots per inch and were converted to text using Adobe Paper Capture Plug-in.This final report summarizes the more important results of a two year study of the ohia (Metrosideros collina subsp. polymorpha) rain forest, extending from within Hawaii Volcanoes National Park north across the east flank of Mauna Kea, Island Hawaii. The study focus was on the ohia dieback which occurs in many areas of this terrain. A 1:48,000 vegetation map was produced, which is included in selected copies of this report. In addition, an independent habitat classification was developed from physical soil and moisture regime differences occurring in the area. Over 35 ohia forest stands were sampled in detail for their ohia population structures and 39 releves were analyzed for their floristic content. Five different forms of dieback were recognized. Two of these, called the Dryland and Wetland Diebacks appear to be the more rapid and dramatic forms. Their causes are not from disease or insect attack, but are presumed to be from climatic triggers, acting through the soil. These diebacks are clearly associated with ohia-stand rejuvenation. A third form of dieback, here called Bog-formation Dieback, appears to be a slower form of stand dieback related to permanent site changes. An Ohia-displacement Dieback occurs in the Olaa Tract area, where tree ferns seem to gradually take over the habitats. Here the dieback cause appears to be overmaturity. Individual tree dieback, the fifth form of dieback, is found as an isolated, but common phenomenon in many non-dieback stands examined. All diebacks appear to have natural causes, which are suggested in detail. A new theory is presented, which proposes that there are a number of dynamic phases, including the dieback, which provide for the perpetuation of the shade-intolerant, dominant tree species (ohia) in this rainforest ecosystem.National Park Service Contract No. CX 8000 6 000

Feasibility of Investing in Carbon Efficient Equity Portfolios

The paper investigates the returns and risk given by the carbon efficient equity indices in India, USA, Japan, and Brazil, and compares them with that of their corresponding benchmark market indices. Data with respect to the considered indices were collected from the official websites of the respective stock exchanges. It was found that there was no difference in the return and risk given by the carbon efficient equity indices with that of their benchmark market indices.There was also no substantial difference with respect to the return generated by the carbon efficient equity indices among the four countries. This study is first of its kind and hence original in nature

Congenital anomalies in a tertiary care hospital in North East region, India

Background: Congenital anomalies are important cause of morbidity and mortality in newborns and are defined as structural and functional abnormalities including metabolic disorders present at birth. These defects are of prenatal origin resulting from defective embryogenesis or intrinsic abnormalities in the process of development and are associated with various risk factors.Methods: Our study is a cross sectional study done at Regional Institute of Medical Sciences, Imphal over period of 3 years from January 2015 to December 2017. Aim of study was to find out incidence of congenital anomalies and proportions of different types of congenital anomalies. Outcome was studied in relation to maternal age, religion, parity, and gestational age, sex of the baby, outcome and sex of the baby.Results: Total numbers of congenital anomalies were 257 babies out of 29879 births giving the incidence of 0.86%. Most common congenital anomalies in this study are musculoskeletal followed by craniospinal, genitourinary, cardiovascular and gastrointestinal. It was more common in preterm babies and parity 1-3, more common in 21-30 years of maternal age. Consanguinity was seen in 7 out of 257 patients.Conclusions: Congenital malformations are a major cause of still births and infant mortality. Targeted scan should be done at 18-20 week to find out anomalies and reduce the prevalence. There should be widespread education in the community regarding the common congenital malformations, their outcomes and possible available mode of treatmen