A clinical comparative study of ropivacaine versus ropivacaine with fentanyl by continuous epidural infusion for post-operative analgesia and ambulation in patients undergoing major gynecological surgery

Background: To compare the effect of continuous epidural infusion of ropivacaine versus ropivacaine-fentanyl for post-operative analgesia and ambulation in patients undergoing major gynaecological surgeries.Methods: A total of 60 patients of age 20 to 50 yrs of body mass index (BMI) within normal range (18.5to24.9 kg/m2) posted for major gynecological surgeries were divided into two equal groups (Group R and RF) in a prospective, randomized, double-blind fashion. In Group RF (n=30) 0.1% Ropivacaine with 2µg/ml Fentanyl and in Group R (n =30) 0.1% ropivacaine were used. General anaesthesia was given to all patients. Continuous epidural infusion using elastomeric pump was started at ‘0’ post-operative hours at 6ml/hour. Post -operative pain (Visual Analogue Scale Score), ambulation (James Modified Bromage Scale) and side effects were noted at 0, 2, 4, 6, 12, 18, 24, 36 and 48hrs.Results: The differences in VAS Score of subjects of both the groups were statistically significant(p<0.05) at 18 hrs, 24hrs, 36hrs and 48 hrs and the differences in Modified Bromage Scale of subjects of the groups were statistically similar at most of the time intervals. Also, the side effects were statistically similar between the groups.Conclusions: Author concluded that ropivacaine-fentanyl is better than ropivacaine alone by continuous epidural infusion for post-operative analgesia in major gynecological surgeries with no statistically significant side effects, effect on ambulation being similar in both the groups

Introducing algorithm portfolios to a class of vehicle routing and scheduling problem

The paper presents a comprehensive foundation and implementation of Algorithm Portfolios to solve Theater Distribution Vehicle Routing and Scheduling Problems (TDVRSP). In order to evaluate the performance of proposed approach, it has been applied to varying dimensions of theater distribution problem. In particular, eight random search metaheuristics embedded in four processors, packed to form different portfolios. Four basic algorithms- Genetic Algorithm (GA), Simulated Annealing (SA), Tabu Search (TS) and Artificial Immune System (AIS), as well as their group theoretic counterparts have been utilized. The proposed approach also takes care of platform dependence and helps evolving a robust solution pack. The portfolio concept is shown to be computationally advantageous and qualitatively competitive over the benchmark set of problems. The paper does not only provide modeling to TDVRSP, but also aids in developing a generic solution framework for other problems of its kind

Evidence-based focused approach for fulfillment of aims: Experiences of an asthma clinic

Background: A new health system for the 21st century should be based on the best scientific knowledge, according to the Institute&nbsp;of Medicine, US. Objective: We have evaluated the effectiveness of asthma clinic providing comprehensive care based on the best&nbsp;available scientific evidence. Materials and Methods: This intervention study was conducted in a tertiary care hospital having&nbsp;a devoted asthma clinic for the&nbsp; comprehensive management. All children diagnosed as having asthma were included, and data&nbsp;of cases managed from July 2014 to June 2016 were analyzed. Intervention - comprehensive management of asthma including&nbsp;assessment, monitoring, health education, avoidance of triggers, management of comorbid conditions, appropriate medications,&nbsp;written asthma action plan, and counseling for follow-up. Outcome measures were treatment direction, asthma control, emergency&nbsp;visits, and hospitalizations. Results: 260 children were treated over a 2-year period. The effects of focused approach with progressive&nbsp;expertise lead to statistically significant benefits over the two successive years from July 2014 to June 2015 and July 2015 to June2016. These were in: (i) Treatment direction: Cases requiring stepping up of treatment decreased from 36.49% to 17.24% (relative&nbsp;risk [RR]: 0.473 [95% confidence interval {CI}: 0.249-0.895]); p=0.01229, (ii) asthma control: Cases with not well-controlled&nbsp;asthma decreased from 16.44% to 7.02% (RR 0.427: [95% CI: 0.199-0.914]); p=0.045, (iii) emergency department visits decreased&nbsp;from 35.62% to 21.05% (RR 0.591: [95% CI: 0.39-0.897]), p=0.00766, (iv) hospitalizations decreased from 16.44% to 5.26% (RR&nbsp;0.32: [95% CI: 0.135-0.757]), p=0.00462. Conclusion: Establishing an asthma clinic and progressive expertise leads to significant&nbsp;beneficial results

Genotypes, Antibiotic Resistance, and ST-8 Genetic Clone in Campylobacter

Rectal swabs from 155 sheep and 252 goats from Grenada were evaluated to determine the prevalence of Campylobacter spp., antibiotic resistance, and multilocus sequence types. Fifteen Campylobacter isolates were obtained (14 C. jejuni and 1 C. coli). The prevalence (3.7%) did not differ significantly between sheep (4.5%) and goats (3.2%). Among the seven antimicrobials tested, resistance was only detected for tetracycline (30.8%) and metronidazole (38.5%). Campylobacter isolates showed no significant difference between sheep and goats for type of antimicrobial resistance or percent of resistant isolates. Twelve of the isolates were successfully genotyped consisting of four recognized clonal complexes and three novel sequence types. Importantly, one isolate from one goat was identified as the C. jejuni sequence type-8, a zoonotic and tetracycline-resistant clone reported to be a highly virulent clone associated with ovine abortion in the USA. Although most samples were from comingled sheep and goat production units, there were no shared sequence types between these two host species. None of the sequence types identified in this study have previously been reported in poultry in Grenada, suggesting sheep- and goat-specific Campylobacter clones in Grenada. This is the first report of genotyping of Campylobacter isolates from sheep and goats in the Eastern Caribbean

Country-Scale Analysis of Methane Emissions with a High-Resolution Inverse Model Using GOSAT and Surface Observations

We employed a global high-resolution inverse model to optimize the CH4 emission using Greenhouse gas Observing Satellite (GOSAT) and surface observation data for a period from 2011–2017 for the two main source categories of anthropogenic and natural emissions. We used the Emission Database for Global Atmospheric Research (EDGAR v4.3.2) for anthropogenic methane emission and scaled them by country to match the national inventories reported to the United Nations Framework Convention on Climate Change (UNFCCC). Wetland and soil sink prior fluxes were simulated using the Vegetation Integrative Simulator of Trace gases (VISIT) model. Biomass burning prior fluxes were provided by the Global Fire Assimilation System (GFAS). We estimated a global total anthropogenic and natural methane emissions of 340.9 Tg CH4 yr−1 and 232.5 Tg CH4 yr−1, respectively. Country-scale analysis of the estimated anthropogenic emissions showed that all the top-emitting countries showed differences with their respective inventories to be within the uncertainty range of the inventories, confirming that the posterior anthropogenic emissions did not deviate from nationally reported values. Large countries, such as China, Russia, and the United States, had the mean estimated emission of 45.7 ± 8.6, 31.9 ± 7.8, and 29.8 ± 7.8 Tg CH4 yr−1, respectively. For natural wetland emissions, we estimated large emissions for Brazil (39.8 ± 12.4 Tg CH4 yr−1), the United States (25.9 ± 8.3 Tg CH4 yr−1), Russia (13.2 ± 9.3 Tg CH4 yr−1), India (12.3 ± 6.4 Tg CH4 yr−1), and Canada (12.2 ± 5.1 Tg CH4 yr−1). In both emission categories, the major emitting countries all had the model corrections to emissions within the uncertainty range of inventories. The advantages of the approach used in this study were: (1) use of high-resolution transport, useful for simulations near emission hotspots, (2) prior anthropogenic emissions adjusted to the UNFCCC reports, (3) combining surface and satellite observations, which improves the estimation of both natural and anthropogenic methane emissions over spatial scale of countries

A comprehensive analysis of Trehalose-6-phosphate synthase (TPS) gene for salinity tolerance in chickpea (Cicer arietinum L.)

Soil salinity affects various crop cultivation but legumes are the most sensitive to salinity. Osmotic stress is the first stage of salinity stress caused by excess salts in the soil on plants which adversely affects the growth instantly. The Trehalose-6-phosphate synthase (TPS) genes play a key role in the regulation of abiotic stresses resistance from the high expression of different isoform. Selected genotypes were evaluated to estimate for salt tolerance as well as genetic variability at morphological and molecular level. Allelic variations were identified in some of the selected genotypes for the TPS gene. A comprehensive analysis of the TPS gene from selected genotypes was conducted. Presence of significant genetic variability among the genotypes was found for salinity tolerance. This is the first report of allelic variation of TPS gene from chickpea and results indicates that the SNPs present in these conserved regions may contribute largely to functional distinction. The nucleotide sequence analysis suggests that the TPS gene sequences were found to be conserved among the genotypes. Some selected genotypes were evaluated to estimate for salt tolerance as well as for comparative analysis of physiological, molecular and allelic variability for salt responsive gene Trehalose-6-Phosphate Synthase through sequence similarity. Allelic variations were identified in some selected genotypes for the TPS gene. It is found that Pusa362, Pusa1103, and IG5856 are the most salt-tolerant lines and the results indicates that the identified genotypes can be used as a reliable donor for the chickpea improvement programs for salinity tolerance

Climate Change and COP26: Are Digital Technologies and Information Management Part of the Problem or the Solution? An Editorial Reflection and Call to Action

The UN COP26 2021 conference on climate change offers the chance for world leaders to take action and make urgent and meaningful commitments to reducing emissions and limit global temperatures to 1.5 °C above pre-industrial levels by 2050. Whilst the political aspects and subsequent ramifications of these fundamental and critical decisions cannot be underestimated, there exists a technical perspective where digital and IS technology has a role to play in the monitoring of potential solutions, but also an integral element of climate change solutions. We explore these aspects in this editorial article, offering a comprehensive opinion based insight to a multitude of diverse viewpoints that look at the many challenges through a technology lens. It is widely recognized that technology in all its forms, is an important and integral element of the solution, but industry and wider society also view technology as being part of the problem. Increasingly, researchers are referencing the importance of responsible digitalization to eliminate the significant levels of e-waste. The reality is that technology is an integral component of the global efforts to get to net zero, however, its adoption requires pragmatic tradeoffs as we transition from current behaviors to a more climate friendly society