Efficacy of 0.5% levobupivacaine with clonidine 30 μg versus 0.5% levobupivacaine with 150 μg buprenorphine for USG guided interscalene brachial plexus block for shoulder, upper and middle humerus surgeries: a prospective randomized double blinded comparative study

Background: Ultrasound imaging is increasingly used for peripheral nerve blocks, offering real-time visualization of nerves, surrounding structures, and needle tips. Levobupivacaine, a local anesthetic, provides excellent intraoperative and postoperative analgesia. Buprenorphine, a partial µ-opioid receptor agonist, and clonidine, an α2 adrenergic agonist, also offer postoperative analgesia. We aimed to compare levobupivacaine with clonidine versus levobupivacaine with buprenorphine for ultrasound-guided interscalene block for shoulder and upper-arm surgeries. This study aimed to determine the onset and duration of sensory and motor block, duration of postoperative analgesia, hemodynamics, complications, and sedation. Methods: Patients scheduled for elective shoulder and upper-middle humerus surgeries received either levobupivacaine with clonidine or levobupivacaine with buprenorphine. Assessments include onset and duration of sensory and motor blockade, analgesia duration, sedation, side effects, and block quality. Onset and duration of sensory and motor blockade, and analgesia duration was analyzed using unpaired T-Test. Results: Levobupivacaine with clonidine group showed longer duration of analgesia (595±148 mins) compared to levobupivacaine with buprenorphine group (445±44.16 mins), with a significant difference (P<0.039). Conclusions: Levobupivacaine with clonidine provided excellent blockade quality, and both clonidine and buprenorphine added to levobupivacaine offered good surgical and postoperative analgesia. However, levobupivacaine with clonidine significantly prolonged postoperative analgesia compared to buprenorphine

Spatial Heterogeneity of Temporal Shifts in Extreme Precipitation across India

When analyzing trends and patterns of extreme precipitation, one can easily generalize the shifts caused by external climate forcings and map a single temporal shift of annual precipitation. However, the complexity of a changing environment evidences spatially distributed shifts particularly those of extreme precipitation which are essential in planning and designing enterprises and, ultimately, in managing infrastructure across scales. The goal of this study is to characterize the spatial heterogeneity of shifts in the increasing pace of extreme events over India. The study has a two-part hypothesis: (1) the number of grid cells with significant trends in annual precipitation (P), extreme precipitation (R95) and very extreme precipitation (R99) will reflect the extent of geophysically vulnerable areas subject to increasing or decreasing annual precipitation and (2) the dispersion of cells with significant shifting points (which has occurred at different historical periods) will evidence the heterogeneity of the changes in P, R95 and R99 regimes. To test this hypothesis, we used the Mann-Kendall and Pettitt’s tests to estimate the significance of the increasing and decreasing trends and shifting points, respectively, in P, R95 and R99 from 1901-2015 for mainland India. Based on a gridded dataset of 0.25° resolution, results showed significant temporal trends for spatially averaged R95 and R99, whereas non-significant inclining temporal trend was found for P. Trend analyses applied to the precipitation gridded product of the Indian Meteorological Department revealed statistically significant trends for almost 38%, 36% and 31% of India’s territory for P, R95 and R99, respectively. Further, the magnitude of these trends proved higher for R95 (i.e., 0.42 mm year-1) compared with R99 (i.e., 0.31 mm year-1), supporting the idea of an increasing liability for flash floods. Results also showed that most of the temporal shifts in the time series of P, R95 and R99 occurred between 1941-1980, at 34%, 31% and 22% of the grids, respectively. In addition, the opposite trends before and after the inflection point were found for locations showing significant temporal shifts in R95 and R9

Haemoparasites of domestic poultry and wild birds in Selangor, Malaysia

Avian haemoparasites are known to exert negative pressures on their hosts causing considerable pathology and mortalities. The present study reports on the prevalence of haemoprotozoa and microfilaria in various species of wild birds and domestic poultry in Selangor, Malaysia, and contributes to the database on the occurrence of these pathogens among avifauna in the country. Giemsa-stained thin blood smears were screened from 728 birds representing five avian orders, namely Galliformes, Anseriformes, Phoenicopteriformes, Pelecaniformes and Gruiformes. The most common haemoparasite was Plasmodium, with a prevalence of 8.0%. The aquatic/ wetland species of birds (Anseriformes and Gruiformes) were the most common hosts for this pathogen with high infection rates (31.8% – 50.0%). The prevalence of Plasmodium in domestic poultry was moderate (2.7%). Leucocytozoon sabrazesi and L. caulleryi were confined to the Galliformes with relatively low average infection rates of 0.7% and 0.5%, respectively. Haemoproteus was detected for the first time in domestic poultry and Red Jungle fowls in the country, with an average prevalence of 0.8%. Trypanosomes and microfilaria were only present in the village chickens and Red Jungle fowls, with high microfilaraemia rates (19.0%) in the latter. The current compilation will contribute to our understanding on avian haemoparasite transmission in the country

Uncertainty Quantification in Water Resource Systems Modeling: Case Studies from India

Regional water resource modelling is important for evaluating system performance by analyzing the reliability, resilience and vulnerability criteria of the system. In water resource systems modelling, several uncertainties abound, including data inadequacy and errors, modeling inaccuracy, lack of knowledge, imprecision, inexactness, randomness of natural phenomena, and operational variability, in addition to challenges such as growing population, increasing water demands, diminishing water sources and climate change. Recent advances in modelling techniques along with high computational capabilities have facilitated rapid progress in this area. In India, several studies have been carried out to understand and quantify uncertainties in various basins, enumerate large temporal and regional mismatches between water availability and demands, and project likely changes due to warming. A comprehensive review of uncertainties in water resource modelling from an Indian perspective is yet to be done. In this work, we aim to appraise the quantification of uncertainties in systems modelling in India and discuss various water resource management and operation models. Basic formulation of models for probabilistic, fuzzy and grey/inexact simulation, optimization, and multi-objective analyses to water resource design, planning and operations are presented. We further discuss challenges in modelling uncertainties, missing links in integrated systems approach, along with directions for future

Spatial Heterogeneity of Temporal Shifts in Extreme Precipitation across India

When analyzing trends and patterns of extreme precipitation, one can easily generalize the shifts caused by external climate forcings and map a single temporal shift of annual precipitation. However, the complexity of a changing environment evidences spatially distributed shifts particularly those of extreme precipitation which are essential in planning and designing enterprises and, ultimately, in managing infrastructure across scales. The goal of this study is to characterize the spatial heterogeneity of shifts in the increasing pace of extreme events over India. The study has a two-part hypothesis: (1) the number of grid cells with significant trends in annual precipitation (P), extreme precipitation (R95) and very extreme precipitation (R99) will reflect the extent of geophysically vulnerable areas subject to increasing or decreasing annual precipitation and (2) the dispersion of cells with significant shifting points (which has occurred at different historical periods) will evidence the heterogeneity of the changes in P, R95 and R99 regimes. To test this hypothesis, we used the Mann-Kendall and Pettitt’s tests to estimate the significance of the increasing and decreasing trends and shifting points, respectively, in P, R95 and R99 from 1901-2015 for mainland India. Based on a gridded dataset of 0.25° resolution, results showed significant temporal trends for spatially averaged R95 and R99, whereas non-significant inclining temporal trend was found for P. Trend analyses applied to the precipitation gridded product of the Indian Meteorological Department revealed statistically significant trends for almost 38%, 36% and 31% of India’s territory for P, R95 and R99, respectively. Further, the magnitude of these trends proved higher for R95 (i.e., 0.42 mm year-1) compared with R99 (i.e., 0.31 mm year-1), supporting the idea of an increasing liability for flash floods. Results also showed that most of the temporal shifts in the time series of P, R95 and R99 occurred between 1941-1980, at 34%, 31% and 22% of the grids, respectively. In addition, the opposite trends before and after the inflection point were found for locations showing significant temporal shifts in R95 and R9

Physical, chemical and geotechnical characterization of fly ash, bottom ash and municipal solid waste from Telangana State in India

Abstract Utilization of fly ash, bottom ash and municipal solid waste in the field of geotechnical engineering necessitates determination of its physical, chemical, morphological and engineering properties. This paper presents detailed physical, chemical and geotechnical characterization of fly ash, bottom ash and municipal solid waste from Telangana State in India. Fly ash and bottom ash samples were collected from Kakatiya thermal power station in India. Municipal solid waste (MSW) sample was collected from Borabanda municipal dump site in the city of Hyderabad, India. From the experimental results, it is noticed that specific gravity of fly ash, bottom ash and municipal solid waste were found to be 1.86, 1.77 and 2.2 respectively. Presence of quartz and mullite; quartz, mullite and calcium carbonate; and quartz and corundum are found to be predominant in fly ash, bottom ash and MSW respectively. The peak friction angle of fly ash, bottom ash and municipal solid waste were found to be 37.02°, 33.77° and 35.23° respectively. Permeability characteristics of fly ash, bottom ash and municipal solid waste were observed to be 1.01E−04 cm/s, 2.01E−04 cm/s and 1.16E−04 cm/s respectively. From the observation of experimental results, it can be concluded that fly ash, bottom ash and municipal solid waste from Telangana state are effective material to be used as backfill material, filter material and embankment construction

Observed Climatology and Trend in Relative Humidity, CAPE, and CIN over India

Water vapor is the most dominant greenhouse gas in the atmosphere and plays a critical role in Earth’s energy budget and hydrological cycle. This study aims to characterize the long-term seasonal variation of relative humidity (RH), convective available potential energy (CAPE), and convective inhibition (CIN) from surface and radiosonde observations from 1980–2020. The results show that during the monsoon season, very high RH values are depicted while low values are depicted during the pre-monsoon season. West Coast stations represent large RH values compared to other stations throughout the year. Irrespective of the season, the coastal regions show higher RH values during monsoon season. Regardless of season, the coastal regions have higher RH values during the monsoon season. During the pre-monsoon season, the coastal region has high RH values, whereas other regions have high RH values during the monsoon season. The rate of increase in RH in North-West India is 5.4%, followed by the West Coast, Central, and Southern parts of India. An increase in water vapor leads to raised temperature, which alters the instability conditions. In terms of seasonal variation, our findings show that CAPE follows a similar RH pattern. CAPE increases sharply in Central India and the West Coast region, while it declines in South India. Opposite features are observed in CIN with respect to CAPE variability over India. The results of the study provide additional evidence with respect to the role of RH as an influencing factor for an increase in CAPE over India

Observed Climatology and Trend in Relative Humidity, CAPE, and CIN over India

Water vapor is the most dominant greenhouse gas in the atmosphere and plays a critical role in Earth’s energy budget and hydrological cycle. This study aims to characterize the long-term seasonal variation of relative humidity (RH), convective available potential energy (CAPE), and convective inhibition (CIN) from surface and radiosonde observations from 1980–2020. The results show that during the monsoon season, very high RH values are depicted while low values are depicted during the pre-monsoon season. West Coast stations represent large RH values compared to other stations throughout the year. Irrespective of the season, the coastal regions show higher RH values during monsoon season. Regardless of season, the coastal regions have higher RH values during the monsoon season. During the pre-monsoon season, the coastal region has high RH values, whereas other regions have high RH values during the monsoon season. The rate of increase in RH in North-West India is 5.4%, followed by the West Coast, Central, and Southern parts of India. An increase in water vapor leads to raised temperature, which alters the instability conditions. In terms of seasonal variation, our findings show that CAPE follows a similar RH pattern. CAPE increases sharply in Central India and the West Coast region, while it declines in South India. Opposite features are observed in CIN with respect to CAPE variability over India. The results of the study provide additional evidence with respect to the role of RH as an influencing factor for an increase in CAPE over India

Analysis of Outcomes in Ischemic vs Nonischemic Cardiomyopathy in Patients With Atrial Fibrillation A Report From the GARFIELD-AF Registry

IMPORTANCE Congestive heart failure (CHF) is commonly associated with nonvalvular atrial fibrillation (AF), and their combination may affect treatment strategies and outcomes