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

Kinetics of Oxidation of Hydrazine & Hydroxylamine by N-Chlorobenzamide

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A study of anaemia and its correlates among adolescent girls in schools of Haldwani, India

Background: Anaemia, a manifestation of under nutrition and poor dietary intake of iron is a public health problem, not only among pregnant women, infants and young children but also among adolescents. Anaemia among adolescent girls can result in impaired physical growth, poor cognition, reduced physical fitness and work performance and lower concentration on daily tasks.Methods: A cross-sectional descriptive study was carried out in schools of Haldwani, Uttarakhand, India with the objective studying various socio-demographic characteristics in relation to anaemia among adolescent girls. Multistage random sampling was used to select adolescent girls of 10 to 19 years of age who were interviewed and examined. Statistical analysis was done using Chi-square test and Odds ratios calculated with SPSS v21.Results: Around 371 girls in present study had varying severity of anaemia and majority had mild to moderate anaemia. Place of residence, type of school, birth order, type of family and mother occupation were significantly associated with presence of anaemia. Girls taking mixed diet were 1.23 times more likely to be non-anaemic as compared to girls taking vegetarian diet. Study showed adolescent girls consuming IFA tablets were less likely anaemic compared to those not consuming (OR=0.09, p<0.001).Conclusions: Among school going adolescent girls nearly half are still suffering from anaemia in India, despite the efforts of government and it is still a challenging public health problem

Mechanism of Oxidation of Ascorbic Acid by N-Chlorobenzamide

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A qualitative study to explore various meanings of mental distress and help-seeking in the Yamuna valley, North India

Context: In rural India, mental healthcare remains limited due to scant state services and incongruency between provider- and patient-framing distress. Help-seeking by people with mental health problems is related to how meanings of distress are understood differently by individuals, based on their interaction with various actors in the community and the available cultural explanation within their local ecologies. Methodology: This study examines the mutually constituted relationship between meanings of mental distress and help-seeking among people residing in the Upper Yamuna Valley, Uttarakhand, North India. This qualitative study builds on six in-depth interviews with people with severe mental health issues and one person with epilepsy, referred as people with psychosocial disability (PPSD) in the study. The data analysis was iterative and followed thematic approach. Results: The study found that personal belief based on one's experience, such as negative self-judgment and wider cultural explanations, such as supernatural beliefs, as well as gender roles, impacted the way people address their mental health problems, in turn shaping their help-seeking behavior. Participants lost hope for a cure after years of trying to find an effective solution. Moreover, lack of access to care and remoteness of the mountainous area made help-seeking and recovery feel impossible. Conclusions: This study underscores the need for researchers and policy professionals to explore the local context and culture to improve care and treatment quality. The study also explains that personal explanation of psychosocial problems and help seeking are not unidirectional. It is a complex phenomenon layered with the local contexts which should be addressed in clinical practice, as well as future research. Finally, clinicians' training should address the local cultural language of distress to identify the problem and suggest an effective solution

Medicinal Plants Diversity and their Conservation Status in Wildlife Institute of India (WII) Campus, Dehradun

The present paper deals with the status and distribution pattern of medicinal plants in Wildlife Institute of India campus, Dehradun, Uttarakhand, India. Based on extensive literature survey, of the total (#605 plants) 63% are medicinal plants. These medicinal plants comprise of 63 trees, 55 shrubs, 208 herbs, 34 climbers, 3 ferns and 10 grasses belong to 94 families. Poaceae, Asteraceae, Cyperaceae and Euphorbiaceae are the largest families and have more than 20 species of medicinal plants. Fabaceae, Asteraceae, Poaceae, Euphorbiaceae, Lamiaceae, Malvaceae, Acanthaceae, Apocynaceae, Caesalpiniaceae, Verbenaceae, Cucurbitaceae and Solanaceae are the dominant families with high species diversity. The nativity of plants shows that 21 species are from Himalayan region and 101 from Indian oriental region, while remaining are from various parts of the world. Pyrus pashia and Rubia cordifolia have the distribution up to cool temperate region among trees and climbers, respectively. Among plant parts, bark, leaves and roots are mainly used for trees, shrubs and climbers, respectively. However, the entire plant of herbs, grasses and sedges and leaves and roots of ferns are used. Most of the species of trees, herbs and climbers are used for diarrhoea/dysentery, shrubs for cough/cold, grasses and sedges for fever and ferns for skin diseases. The conservation efforts have been discussed in the paper

Evidence for long-term variability in the ultra high energy photon flux from Cygnus X-3

A time-correlation analysis of atmospheric Cerenkov pulses by a wide-angle photomultiplier system was previously shown to have present in it a nonrandom component which seemed associated with the Right Ascension (RA) range approx. 20+or-04h. A recent examination of multi-muon events recorded by a photon-decay detector shows a similar time-dependent effect, closely matching the previous results, supporting the suggestion that the effect is of cosmic origin. However, even though Cyg. X-3 lies well inside the region of peak intensity, it does not seem possible to ascribe to it the whole effect, for the implied photon flux appears too large to be reconciled to various gamma-ray measurements of Cyg. X-3. The original data were subjected to a phase-histogram analysis and it as found that only 2.5% of overall recorded data are compatible with a phase-dependent emission from Cyg. X-3. Assuming these events to be gamma rays yields a detected flux of (2.6 + or - 0.3) x 10 to the minus 12th power gamma cm -2s-1 above 5 x 10 to the 14th power eV. Comparing this value with more recent ultra high energy (UHE) photon data from the same source, it is suggested that the available data generally favor a long-term reduction in the Cyg. X-3 inferred luminosity ( 10 to the 13th power eV) by a factor of (1.8 + or - 0.3) per year

Explicit MBR All-Symbol Locality Codes

Node failures are inevitable in distributed storage systems (DSS). To enable efficient repair when faced with such failures, two main techniques are known: Regenerating codes, i.e., codes that minimize the total repair bandwidth; and codes with locality, which minimize the number of nodes participating in the repair process. This paper focuses on regenerating codes with locality, using pre-coding based on Gabidulin codes, and presents constructions that utilize minimum bandwidth regenerating (MBR) local codes. The constructions achieve maximum resilience (i.e., optimal minimum distance) and have maximum capacity (i.e., maximum rate). Finally, the same pre-coding mechanism can be combined with a subclass of fractional-repetition codes to enable maximum resilience and repair-by-transfer simultaneously

Investigations on RF Behavior of a V-Band Second Harmonic Gyrotron for 100/200 kW Operation

This article presents the investigations on RF-behavioral aspects for the possible operation of a V -band, continuous wave (CW) second harmonic gyrotron for plasma diagnostic application. Keeping in view the design goals and constraints, initial design studies for the mode selection and the computation of starting currents are carried out. From these studies, two possible modes, namely, TE 7,3 and TE 8,3 are considered for the second harmonic operation. Later, the cold cavity design and self-consistent calculations are carried out for the selected operating modes. All the computations are performed using the latest version of our in-house code Gyrotron Design Studio Second Harmonic Version 2020 (GDS2H-2020) with Glidcop as the cavity material. The RF behavior studies confirm the feasible operation of such a second harmonic gyrotron with power levels in excess of 115.52/217.64 kW with the chosen modes of operation