Cardiovascular Response to High Altitude Hypoxia

Normal and abnormal cardiovascular response to high altitude (HA) hypoxia were studied in 98 healthy subjects and in 15 patients with HA pulmonary oedema (HAPO) and acute mountain sickness (AMS) at an altitudeof 3,658 m. The healthy sea level (SL) residents showed marked blood volume changes during the first week with pulmonary hypotension and depression of left ventricular (LV) performance and physical work capacity (PWC). The HA natives, however, had better LV performance and PWC indicating a better adaptation to HA hypoxia. HAPO subjects showed evidence of severe pulmonary hypertension with normal left atrial pressures but the exact mechanism of this condition is still not clear. AMS subjects showed no circulatory abnormalities 'but had relative hypercapnia and severe hypoxemia suggesting that AMS may be causcd by relative hyposensitiveness of the respiratory centre to hypoxia or hypercapnia

Service Quality Variability and Termination Behavior

We investigate the roles of the level and variability in quality in driving customer retention for a new service. We present model-free evidence that while high average quality helps in retaining customers, high variability leads to higher termination rates. Apart from these main effects, we use model-free evidence to document the presence of (a) an interaction effect between average service quality and its variability on termination rates, (b) customer learning about service quality over time, and (c) slower rate of learning among households that experience high variability. We postulate a mechanism involving risk aversion and learning, which can induce this interaction effect and test this against several alternative explanations. We show that it is important to consider variability in quality while inferring the impact of improvements to average quality - ignoring the interaction effect between average quality and variability leads 18% to 64% (5% to 31%) overestimation (underestimation) of quality improvement elasticities among high-variability (low-variability) households. Given that responsiveness to quality decreases with variability, it is better for the firm to focus quality improvement efforts on customers experiencing low variability; increasing average quality by 1% lowers termination by 1.1% for low-variability households, but only by 0.41% for high-variability households.http://deepblue.lib.umich.edu/bitstream/2027.42/106392/1/1224_Siriam.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/106392/4/1224_Sriram_Sept14.pdfDescription of 1224_Sriram_Sept14.pdf : Sept 2014 revisio

A Multicoloured View of 2S 0114+650

We report the results of radio and X-ray observations of the high mass X-ray binary 2S 0114+650, made with the Giant Meterwave Radio Telescope and the Rossi X-ray Timing Explorer respectively. No emission was detected at radio wavelengths. The neutral hydrogen column density was found to vary over the orbital period, while no variability over the the super-orbital period was observed. We discuss the causes of the observed relationships and the implications for the underlying mechanisms.Comment: 4 pages, 2 figures; to appear in proceedings for "The multicoloured landscape of compact objects and their explosive progenitors", Cefalu, Sicily, 2006 June 11-24, AIP, submitte

BRCA awareness and testing experience in the UK Jewish population: a qualitative study

Background 1 in 40 UK Jewish individuals carry a pathogenic variant in BRCA1/BRCA2. Traditional testing criteria miss half of carriers, and so population genetic testing is being piloted for Jewish people in England. There has been no qualitative research into the factors influencing BRCA awareness and testing experience in this group. This study aimed to explore these and inform improvements for the implementation of population genetic testing. Methods Qualitative study of UK Jewish adults who have undergone BRCA testing. We conducted one-to-one semistructured interviews via telephone or video call using a predefined topic guide, until sufficient information power was reached. Interviews were audio-recorded, transcribed verbatim and interpreted using applied thematic analysis. Results 32 individuals were interviewed (28 carriers, 4 non-carriers). We interpreted five themes intersecting across six time points of the testing pathway: (1) individual differences regarding personal/family history of cancer, demographics and personal attitudes/approach; (2) healthcare professionals’ support; (3) pathway access and integration; (4) nature of family/partner relationships; and (5) Jewish community factors. Testing was largely triggered by connecting information to a personal/family history of cancer. No participants reported decision regret, although there was huge variation in satisfaction. Suggestions were given around increasing UK Jewish community awareness, making information and support services personally relevant and proactive case management of carriers. Conclusions There is a need to improve UK Jewish community BRCA awareness and to highlight personal relevance of testing for individuals without a personal/family history of cancer. Traditional testing criteria caused multiple issues regarding test access and experience. Carriers want information and support services tailored to their individual circumstances

Studies on Separation of 90Y and 90Sr Separation from Hydrochloric Acid Solutions Using TODGA as the Extractant by SLM Method

AbstractYttrium-90 is an important radionuclide known for its therapeutic application in nuclear medicine. Solvent extraction studies with N,N,N’,N’-tetra-octyldiglycolamide (TODGA) has shown that Y(III) is well extracted in 6M HCl while at the same time, extraction of Sr(II) is very low leading to a separation factor (DY/DSr = 60,000). This property of TODGA can be exploited for the separation of Y from Sr. The aim of this present work is to produce carrier free 90Y by using Supported Liquid Membrane (SLM) based separation of Y and Sr with TODGA as the carrier. Solvent extraction studies with various diluents viz. 1-decanol, xylene, MIBK, chloroform etc. indicated that xylene and n-dodecane are most suitable as S.F. >50,000 are obtained. Based on the results, a SLM based separation scheme was developed using 0.1M TODGA in xylene loaded on a microporous PTFE membrane as a polymeric support and 6M HCl as feed and 0.01M HCl as strip phase. The results appear promising for the development of SLM based Y-90 generator. The purity of the product was ascertained by the half life method

Can imaging suggest the aetiology in skull base osteomyelitis? : a systematic literature review

Purpose: To assess differentiating features between bacterial, Aspergillus, and Mucor skull base osteomyelitis (SBO) with regard to clinical presentation and imaging appearances. Material and methods: A literature search was performed in April 2020 for studies on SBO with a minimum sample size of 10 patients. Studies that reported presenting symptoms, cross-sectional imaging findings, complications, and mortality were included in the analysis. The quality of included articles was tested using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. A data extraction form was used to retrieve relevant parameters from each of the articles. Results: Thirteen articles were included in the final analysis. Diabetes mellitus was the most common predisposing factor (12.5-91.0%). Presenting complaints in all bacterial SBO studies were otogenic, while fungal SBO patients had nasal/ocular complaints. Rates of mortality and surgical intervention in the fungal group were 50-100% and 50%, respectively, as compared to the bacterial group - 7-87% and 10%, respectively. On imaging, the site of initial infection in bacterial SBO was the external auditory canal, while in fungal SBO it was the paranasal sinus. The incidenceof orbital extension was < 5% in bacterial and 44-70% in fungal SBO, among which Mucor had rates of 65-70%. Bone erosion was less extensive in bacterial SBO, and the patterns differed. The highest incidence of vascular involvement and non-enhancing lesions (23-36%) was seen in Mucor. Aspergillus showed highest sino-cranial extension (52-55%) and homogenous bright enhancement. Conclusions: Systematic analysis of the clinico-radiological parameters in each of the studies revealed differences in presentation, clinical course, extension, bone erosion, and enhancement

Abortion and contraception practices in COVID-19 era

Background: To protect the gains made in sexual and reproductive health in over the past several decades, care for childbearing women and newborn infant’s needs to continue during the pandemic. The provision of safe abortion and contraceptive services remains critical. When staff and services are under extreme stress there is a real risk of increasing avoidable harm. Aim and objectives were to determine the effect of COVID-19 on accessibility and acceptance of contraception and safe abortion care services.Methods: Questionnaire survey was Done among 500 women in 6 months from April to September 2020, on availability and utilization of safe abortion and contraception services during lock down in covid time from patients getting treatment by Department of Obstetrics and Gynecology, Muzaffarnagar Medical College and health care workers (paramedics and others staff) of reproductive age group working in the institute.Results: Majority (56%) of women were in the age group of 20-30 years. 70% of women have access to contraception at present while it was reduced to 60% during lockdown. Most commonly used method was barrier method (70%) followed by OCP’s which they could avail maximum from pharmacy (40%). 65% of women had access to post delivery and post abortion contraception with most common method adopted being injectables, in 3% cases IUCD was inserted, 1% ligation with LSCS. Among them 42 cases were covid positive who underwent caesarean section and adopted contraception thereafter with tubal ligation in 2 cases.  In this study 32% of women had unwanted pregnancy, among them 35% underwent surgical abortion 61% medical abortion and 4% continued pregnancy.Conclusions: The COVID-19 pandemic has impacted safe abortion and contraception services. Unwanted pregnancy increased to 32%. 62% subjects claimed for accessibility at government centre and door to door by health worker