Evaluation of Routing Protocols in Ad Hoc Networks

Ad hoc networks are comprised of a group of workstations or other wireless devices which communicate directly with each other to exchange information without centralized control or established infrastructure. In recent years, several routing protocols have been proposed for ad hoc networks and prominent among them are DSR, AODV and TORA. This survey paper provides an overview of these protocols by presenting their characteristics, functionality, benefits and limitations and then makes their comparative analysis. The objective is to make observations about how the performance of these protocols can be improved by using the quality assurance metrics

Tenant Farming in Punjab: Nature, Pattern and Constraints

The paper has demonstrated slow growth rate of agricultural output, escalating input cost, declining profit margin, fragmentation of land, and unemployment are the symptoms of the Punjab’s economy. In such a situation, it become imperative to study how the tenant farmers survive in farming. To keep in mind the above facts, the present study was undertaken to examine the nature of tenancy system and constraints faced by tenant farmers in the state. The study was based on the primary data, collected from 120 farmers, for all the three agro-climatic zones of Punjab pertaining to the crop year 2017-18. Descriptive tools were used to study the nature of tenancy and mean score was used for constraints analysis. The study highlighted that to make them self employed or fulfill the need of family, tenant farmers took land on leased from cultivator who switched to another sector and migrated in large number outside the country. From the study it was perceived that with the increase of size of holding and majority of tenant farmers adopted land holding to improve the scale of farming and to be economically viable

Association of Intraocular Pressure With Human Immunodeficiency Virus

PURPOSE: Prior studies have shown an association between human immunodeficiency virus (HIV) and reduced intraocular pressures (IOP). The purpose of this study was to determine if patients with HIV on highly active antiretroviral therapy (HAART) had any difference in their IOP compared with patients without HIV or with HIV who are not on HAART. DESIGN: Retrospective cross-sectional study. METHODS: We included 400 patients from our academic eye center between 2000 and 2016. Group 1 (G1) consisted of patients with HIV on HAART (n = 176), Group 2 (G2) consisted of patients with HIV who were not on HAART (n = 48), and Group 3 (G3) consisted of controls without HIV (n = 176). An analysis of variance (ANOVA) was performed to compare mean IOP values. Multivariate linear and logistic regression models were performed to assess factors impacting IOP. Difference in IOP was the primary outcome being measured. RESULTS: The mean IOPs in mm Hg were 13.7 +/- 5.1 (G1), 13.1 +/- 3.6 (G2), and 17.3 +/- 3.8 (G3), P \u3c .01. In regression modeling, having a CD4 count CONCLUSIONS: Absolute CD4 counts may play a role in IOP fluctuations. This association was found in patients with HIV regardless of whether patients were on HAART

Observational cross-sectional study to evaluate the effects of self-medication with topical agents used by patients for superficial fungal skin infection at tertiary care hospital in Mumbai

Background: Superficial fungal infections of the hair, skin, and nails are a major cause of morbidity in the world and their incidence continues to increase. While self-medication is also one of the major health concerns for health authorities worldwide. The aim of the study was to evaluate the effects of topical agents used by patients for self-medication, to enlisting the topical agents used by patients for self-medication, to ensure by whose suggestion’s patients engaged in self-medication.Methods: It was an observational cross-sectional study which was conducted at the outpatient department (OPD) of dermatology in tertiary care hospital. A detailed history of the participant was recorded regarding topical agents used for self-medication and their effects were documented in a predesigned case record form.Results: The population consisted of 128 males and 87 females. All these 215 participants had used 61 topical agents of different brand names and the majority of were irritant, corticosteroids and antifungal much high in use. Among 215 participants, 111 had temporary relief from the infection and reoccurred after stopping its use. 98 showed aggravation in their infection among which 90 showed effects like irritation, burning and itching at the application site, while 8 participants showed dryness or flaking of skin.Conclusions: Self-medication is widely practiced among patients with a superficial fungal skin infection in Mumbai. A pharmacist was the major source for obtaining these topical agents. We can conclude, there is a need to counsel and discourage patients from self-medication and regulations for dispensing the prescribed drugs should be made stringent

Which comorbid conditions should we be analyzing as risk factors for healthcare-associated infections?

OBJECTIVETo determine which comorbid conditions are considered causally related to central-line associated bloodstream infection (CLABSI) and surgical-site infection (SSI) based on expert consensus.DESIGNUsing the Delphi method, we administered an iterative, 2-round survey to 9 infectious disease and infection control experts from the United States.METHODSBased on our selection of components from the Charlson and Elixhauser comorbidity indices, 35 different comorbid conditions were rated from 1 (not at all related) to 5 (strongly related) by each expert separately for CLABSI and SSI, based on perceived relatedness to the outcome. To assign expert consensus on causal relatedness for each comorbid condition, all 3 of the following criteria had to be met at the end of the second round: (1) a majority (&gt;50%) of experts rating the condition at 3 (somewhat related) or higher, (2) interquartile range (IQR)≤1, and (3) standard deviation (SD)≤1.RESULTSFrom round 1 to round 2, the IQR and SD, respectively, decreased for ratings of 21 of 35 (60%) and 33 of 35 (94%) comorbid conditions for CLABSI, and for 17 of 35 (49%) and 32 of 35 (91%) comorbid conditions for SSI, suggesting improvement in consensus among this group of experts. At the end of round 2, 13 of 35 (37%) and 17 of 35 (49%) comorbid conditions were perceived as causally related to CLABSI and SSI, respectively.CONCLUSIONSOur results have produced a list of comorbid conditions that should be analyzed as risk factors for and further explored for risk adjustment of CLABSI and SSI.Infect Control Hosp Epidemiol 2017;38:449–454</jats:sec

Sequence Analysis and Vegetative Growth in Transgenic Eucalyptus with CRISPR-Cas9-induced Mutations in the Eucalyptus Homologs of the Floral Genes EMBRYO DEVELOPMENT ARREST 33 (EDA33) and TAPETAL DEVELOPMENT AND FUNCTION1 (TDF1)

An impediment to use of exotic and bioengineered trees in many places is their propensity for spread by pollen and/or seeds. Our laboratory has been using gene editing to induce mutations in floral genes as means to impart stable and reliable genetic containment when this is desirable from social (markets, regulation, public opinion) or ecological perspectives. Our studies focus on one of the most widely planted, productive, and sometimes invasive forest tree species, Eucalyptus grandis x Eucalyptus urophylla. We used CRISPR-Cas9 to target two genes expected to be important to reproductive development in Eucalyptus. Based on studies in the model plant Arabidopsis, proteins encoded by the eucalypt homolog of EDA33 (EMBRYO DEVELOPMENT ARREST 33) are expected to be essential for seed dispersal, and proteins encoded by the homolog of TDF1 (TAPETAL DEVELOPMENT AND FUNCTION1) are expected to be essential for pollen development. Bioinformatic studies have shown that each has a single putatively orthologous, functional locus in the Eucalyptus genome. This study focused on determination of the nature of mutations induced, with an emphasis on identifying biallelic loss-of-function mutations, and effects of loss-of-function mutation on vegetative growth and morphology in the greenhouse. Ongoing work in our laboratory is studying the effects of mutation of these genes on floral development and fertility. We generated two CRISPR-Cas9 constructs, each with two guide RNAs that target each gene, and one Cas9-only (no guide RNAs) control construct. We then Agrobacterium-transformed hybrid eucalypt SP7 (E. grandis x urophylla), for which an efficient transformation system was available. We generated 17 and 18 gene insertion events for the EDA33 and TDF1 construct, respectively, and ten events for the Cas9 control. Taking advantage of the natural polymorphisms in the hybrid that we discovered after resequencing near to the target region, we generated and sequenced allele-specific PCR products for each locus. We identified ten insertion events in EDA33 and six in TDF1 events for which there were clear loss-of function mutations in both alleles. Overall, CRISPR-Cas9 was highly efficient in generating knockout mutations, with a rate (per transgenic regenerated shoot) of 83% in EDA33 and 46% in TDF1. The knock-out events and five Cas9 control events were then micropropagated, acclimated, and transplanted into 942 cc3 pots for a greenhouse trial to study variation in plant growth rate and leaf morphology. The three month greenhouse trial used a randomized block design with an average of six ramets per genotype and 14 non-transgenic controls. We measured height and diameter at the start and end of the trial, and relative chlorophyll density, leaf area and weight, and leaf oil gland density at the end of the trial. In a linear mixed effect model, we conducted an overall F-test where blocks and construct were fixed effects and events were considered random effects. We found that blocks were highly statistically significant sources of variation (P<<0.05), which was not surprising as trees were sorted into blocks based on size at the start of the experiment. Presumably due to variation in propagation history, the wild type controls were larger at the outset of the study and continued to grow significantly differently from the transgenic trees, so comparisons between the knock-out and non-mutated events were predominantly based on the transgenic controls. At harvest, none of the traits were different at the 5% significance level among the transgenic genotype groups, though leaf area and old gland density were different at the 10% significance level. Equivalence testing of the differences in means of plant characteristics measured at harvest between the knock-out groups and transgenic controls showed that there was unlikely to be a 10% or greater reduction of any of the trait values in the knock-outs. Our results suggest that the functions of these genes are largely restricted to reproductive development in eucalypts, and imparting sterility through their loss-of-function is unlikely to affect productivity. Longer term studies, preferably in the field under normal forestry conditions, are needed to confirm these results

The effect of adding comorbidities to current centers for disease control and prevention central-line–associated bloodstream infection risk-adjustment methodology

BACKGROUNDRisk adjustment is needed to fairly compare central-line–associated bloodstream infection (CLABSI) rates between hospitals. Until 2017, the Centers for Disease Control and Prevention (CDC) methodology adjusted CLABSI rates only by type of intensive care unit (ICU). The 2017 CDC models also adjust for hospital size and medical school affiliation. We hypothesized that risk adjustment would be improved by including patient demographics and comorbidities from electronically available hospital discharge codes.METHODSUsing a cohort design across 22 hospitals, we analyzed data from ICU patients admitted between January 2012 and December 2013. Demographics and International Classification of Diseases, Ninth Edition, Clinical Modification (ICD-9-CM) discharge codes were obtained for each patient, and CLABSIs were identified by trained infection preventionists. Models adjusting only for ICU type and for ICU type plus patient case mix were built and compared using discrimination and standardized infection ratio (SIR). Hospitals were ranked by SIR for each model to examine and compare the changes in rank.RESULTSOverall, 85,849 ICU patients were analyzed and 162 (0.2%) developed CLABSI. The significant variables added to the ICU model were coagulopathy, paralysis, renal failure, malnutrition, and age. The C statistics were 0.55 (95% CI, 0.51–0.59) for the ICU-type model and 0.64 (95% CI, 0.60–0.69) for the ICU-type plus patient case-mix model. When the hospitals were ranked by adjusted SIRs, 10 hospitals (45%) changed rank when comorbidity was added to the ICU-type model.CONCLUSIONSOur risk-adjustment model for CLABSI using electronically available comorbidities demonstrated better discrimination than did the CDC model. The CDC should strongly consider comorbidity-based risk adjustment to more accurately compare CLABSI rates across hospitals.Infect Control Hosp Epidemiol 2017;38:1019–1024</jats:sec