Apnea, bradycardia and desaturation spells in premature infants: impact of a protocol for the duration of 'spell-free' observation on interprovider variability and readmission rates.

ObjectiveTo study the impact of implementing a protocol to standardize the duration of observation in preterm infants with apnea/bradycardia/desaturation spells before hospital discharge on length of stay (LOS) and readmission rates.Study designA protocol to standardize the duration of in-hospital observation for preterm infants with apnea, bradycardia and desaturation spells who were otherwise ready for discharge was implemented in December 2013. We evaluated the impact of this protocol on the LOS and readmission rates of very low birth weight infants (VLBW). Data on readmission for apnea and an apparent life-threatening event (ALTE) within 30 days of discharge were collected. The pre-implementation epoch (2011 to 2013) was compared to the post-implementation period (2014 to 2016).ResultsThere were 426 and 368 VLBW discharges before and after initiation of the protocol during 2011 to 2013 and 2014 to 2016, respectively. The LOS did not change with protocol implementation (66±42 vs 64±42 days before and after implementation of the protocol, respectively). Interprovider variability on the duration of observation for apneic spells (F-8.8, P=0.04) and bradycardia spells (F-17.4, P<0.001) decreased after implementation of the protocol. The readmission rate for apnea/ALTE after the protocol decreased from 12.1 to 3.4% (P=0.01).ConclusionImplementing an institutional protocol for VLBW infants to determine the duration of apnea/bradycardia/ desaturation spell-free observation period as recommended by the American Academy of Pediatrics clinical report did not prolong the LOS but effectively reduced interprovider variability and readmission rates

Identification of geospatial variability of fluoride contamination in ground water of Mathura District, Uttar Pradesh, India

Groundwater is one of the major sources of water in arid and semi-arid regions. Groundwater quality data and its spatial distribution are important for the purpose of planning and management. Geo-statistical methods are one of the most advanced techniques for interpolation of groundwater quality. In this study, kriging methods were used for predicting the spatial distribution of fluoride content in groundwater. Data were collected from 13 wells in Mathura district (Uttar Pradesh, India). After normalization of data, semivariogram was drawn, for selecting suitable model for fitness on experimental semivariogram, less residual sum of squares (RSS) value was used. Then fluoride endemic areas of the Mathura District (study area) were identified from developed semivariogram model and Geospatial variability (high and low fluoride containing areas) map was generated with the help of GeographicInformation System. In the analysis, spatial distribution characteristics and variation of fluoride concentration in shallow groundwater found to be 3.4 and 4.6 mg/l at Sahar, Shahpur were higher than the standard limits (1.5 mg/l) of drinking water and shows remarkable spatial variability

Acute intermittent porphyria with syndrome of inappropriate antidiuretic hormone secretion (SIADH) and neurological crisis, successfully treated with haemodialysis

We report a 35 years old male, a case of Acute Intermittent Porphyria (AIP) with Syndrome of Inappropriate Antidiuretic Hormone secretion (SIADH) and neurological crisis for its rarity. Since specific parenteral medication (hemin) was not available, patient was empirically treated with haemodialysis with satisfactory outcome

Evaluation of CSM-CERES-wheat in simulating wheat yield and its attributes with different sowing environments in Tarai region of Uttarakhand

Crop Environment Resource Synthesis (CSM-CERES)-Wheat model was used to simulate responses of two wheat varieties with various sowing environments. In this context, during the year 2007-08 and 2008-09, experiments on three sowing dates viz. November 20, December 15, and January 9 and two varieties (PBW-343 and WH-542) with three replications were conducted at the Norman E. Borlaug Crop Research Centre of G.B. Pant University of Agriculture & Technology, Pantnagar (29°N, 79.29°E with 243.80 m above msl). Soil, plant, management and climatic data were collected from the experimental field. The data of 2007-08 and 2008-09 were used for model calibration and validation, respectively. Results revealed that the for model outputs were in good agreement with their corresponding observed values with 20th November sown crop than other sowings of crop in terms of phenological events, biomass accumulation and grain yields. However, variety PBW-343 showed close proximity between simulated and observed outcomes with all sowing dates. The percent root mean square error (% RMSE) values ranged from 5.9 – 15.6%, 2.2 – 7.6% for days to attain anthesis and physiological maturity, respectively. Moreover, %RMSE and t-value ranged from 5.7–12.2% (t= -4.5 to 1.8), 1.6 – 3.3% (t= -4.1 to 4.5) and 1.9 – 5.8% (t= -3.7 to 1.5) for product weight, vegetative weight and product harvest index, respectively. Inspite of that, model fails to simulate maximum leaf area index having % RMSE from 53.2 – 62.9%. These results indicate that CERES-Wheat model can be used as a tool to support decision-making for wheat production in Tarai region of Uttarakhand

Magnetoresistance behavior of a ferromagnetic shape memory alloy: Ni_1.75Mn_1.25Ga

A negative-positive-negative switching behavior of magnetoresistance (MR) with temperature is observed in a ferromagnetic shape memory alloy Ni_1.75Mn_1.25Ga. In the austenitic phase between 300 and 120 K, MR is negative due to s-d scattering. Curiously, below 120K MR is positive, while at still lower temperatures in the martensitic phase, MR is negative again. The positive MR cannot be explained by Lorentz contribution and is related to a magnetic transition. Evidence for this is obtained from ab initio density functional theory, a decrease in magnetization and resistivity upturn at 120 K. Theory shows that a ferrimagnetic state with anti-ferromagnetic alignment between the local magnetic moments of the Mn atoms is the energetically favoured ground state. In the martensitic phase, there are two competing factors that govern the MR behavior: a dominant negative trend up to the saturation field due to the decrease of electron scattering at twin and domain boundaries; and a weaker positive trend due to the ferrimagnetic nature of the magnetic state. MR exhibits a hysteresis between heating and cooling that is related to the first order nature of the martensitic phase transition.Comment: 17 pages, 5 figures. Accepted in Phys. Rev.