Inter-annual relationship between Atlantic sea surface temperature anomalies and Indian summer monsoon

In this study, the simultaneous inter-annual relationships between SST anomalies over the Northwest Atlantic Ocean and southwest monsoon rainfall over the monsoon core region have been examined using monthly SST and atmospheric data for the period 1951-2005. Statistical analyses reveal significant inter-annual simultaneous relationship between the SST anomalies over North Atlantic and rainfall over the monsoon core region, but with significant epochal variations. The relationship has become stronger after mid-1970s when the El Nino-Indian monsoon relationship has weakened. Positive SST anomalies over the North Atlantic Ocean shift the North Atlantic Jet northwards and the associated circulation changes in the upper troposphere influence Indian monsoon through the circumglobal teleconnection across central Asia. The present study, thus highlights the important role of North Atlantic Ocean as an important source of inter-annual variability of the Indian summer monsoon

Inter-annual relationship between Atlantic sea surface temperature anomalies and Indian summer monsoon

In this study, the simultaneous inter-annual relationships between SST anomalies over the Northwest Atlantic Ocean and southwest monsoon rainfall over the monsoon core region have been examined using monthly SST and atmospheric data for the period 1951-2005. Statistical analyses reveal significant inter-annual simultaneous relationship between the SST anomalies over North Atlantic and rainfall over the monsoon core region, but with significant epochal variations. The relationship has become stronger after mid-1970s when the El Nino-Indian monsoon relationship has weakened. Positive SST anomalies over the North Atlantic Ocean shift the North Atlantic Jet northwards and the associated circulation changes in the upper troposphere influence Indian monsoon through the circumglobal teleconnection across central Asia. The present study, thus highlights the important role of North Atlantic Ocean as an important source of inter-annual variability of the Indian summer monsoon

Case Report: Whole exome sequencing identifies variation c.2308G>A p.E770K in RAG1 associated with B- T- NK+ severe combined immunodeficiency [version 2; referees: 2 approved, 1 not approved]

Severe combined immunodeficiency is a large clinically heterogeneous group of disorders caused by a defect in the development of humoral or cellular immune responses. At least 13 genes are known to be involved in the pathophysiology of the disease and the mutation spectrum in SCID has been well documented. Mutations of the recombination-activating genes RAG 1 and RAG 2 are associated with a range of clinical presentations including, severe combined immunodeficiency and autoimmunity. Recently, our understanding of the molecular basis of immune dysfunction in RAG deficiency has improved tremendously with newer insights into the ultrastructure of the RAG complex. In this report, we describe the application of whole exome sequencing for arriving at a molecular diagnosis in a child suffering from B- T- NK+ severe combined immunodeficiency. Apart from making the accurate molecular diagnosis, we also add a genetic variation c.2308G>A p.E770K to the compendium of variations associated with the disease

Adaptation of the Wound Healing Questionnaire universal-reporter outcome measure for use in global surgery trials (TALON-1 study): mixed-methods study and Rasch analysis

BackgroundThe Bluebelle Wound Healing Questionnaire (WHQ) is a universal-reporter outcome measure developed in the UK for remote detection of surgical-site infection after abdominal surgery. This study aimed to explore cross-cultural equivalence, acceptability, and content validity of the WHQ for use across low- and middle-income countries, and to make recommendations for its adaptation.MethodsThis was a mixed-methods study within a trial (SWAT) embedded in an international randomized trial, conducted according to best practice guidelines, and co-produced with community and patient partners (TALON-1). Structured interviews and focus groups were used to gather data regarding cross-cultural, cross-contextual equivalence of the individual items and scale, and conduct a translatability assessment. Translation was completed into five languages in accordance with Mapi recommendations. Next, data from a prospective cohort (SWAT) were interpreted using Rasch analysis to explore scaling and measurement properties of the WHQ. Finally, qualitative and quantitative data were triangulated using a modified, exploratory, instrumental design model.ResultsIn the qualitative phase, 10 structured interviews and six focus groups took place with a total of 47 investigators across six countries. Themes related to comprehension, response mapping, retrieval, and judgement were identified with rich cross-cultural insights. In the quantitative phase, an exploratory Rasch model was fitted to data from 537 patients (369 excluding extremes). Owing to the number of extreme (floor) values, the overall level of power was low. The single WHQ scale satisfied tests of unidimensionality, indicating validity of the ordinal total WHQ score. There was significant overall model misfit of five items (5, 9, 14, 15, 16) and local dependency in 11 item pairs. The person separation index was estimated as 0.48 suggesting weak discrimination between classes, whereas Cronbach's α was high at 0.86. Triangulation of qualitative data with the Rasch analysis supported recommendations for cross-cultural adaptation of the WHQ items 1 (redness), 3 (clear fluid), 7 (deep wound opening), 10 (pain), 11 (fever), 15 (antibiotics), 16 (debridement), 18 (drainage), and 19 (reoperation). Changes to three item response categories (1, not at all; 2, a little; 3, a lot) were adopted for symptom items 1 to 10, and two categories (0, no; 1, yes) for item 11 (fever).ConclusionThis study made recommendations for cross-cultural adaptation of the WHQ for use in global surgical research and practice, using co-produced mixed-methods data from three continents. Translations are now available for implementation into remote wound assessment pathways