Exploring the cost and performance benefits of AWS Step Functions using a data processing pipeline

In traditional cloud computing, dedicated hardware is substituted by dynamically allocated, utility-oriented resources such as virtualized servers. While cloud services are following the pay-as-you-go pricing model, resources are billed based on instance allocation and not on the actual usage, leading the customers to be charged needlessly. In serverless computing, as exemplified by the Function-as-a-Service (FaaS) model where functions are the basic resources, functions are typically not allocated or charged until invoked or triggered. Functions are not applications, however, and to build compelling serverless applications they frequently need to be orchestrated with some kind of application logic. A major issue emerging by the use of orchestration is that it complicates further the already complex billing model used by FaaS providers, which in combination with the lack of granular billing and execution details offered by the providers makes the development and evaluation of serverless applications challenging. Towards shedding some light into this matter, in this work we extensively evaluate the state-of-the-art function orchestrator AWS Step Functions (ASF) with respect to its performance and cost. For this purpose we conduct a series of experiments using a serverless data processing pipeline application developed as both ASF Standard and Express workflows. Our results show that Step Functions using Express workflows are economical when running short-lived tasks with many state transitions. In contrast, Standard workflows are better suited for long-running tasks, offering in addition detailed debugging and logging information. However, even if the behavior of the orchestrated AWS Lambda functions influences both types of workflows, Step Functions realized as Express workflows get impacted the most by the phenomena affecting Lambda functions

Thrombocytopenia, Microangiopathy and End Organ Damage in Snakebites: A Descriptive study

OBJECTIVES: The study was conducted to determine the prevalence of thrombotic microangiopathy in snakebites and to describe the clinical profile of these patients, with relation to the envenomation syndrome and venom induced consumption coagulopathy (VICC). METHODS: This study was an observational cohort, consisting of a prospective cohort (Recruited from June 2017 to July 2018) and a retrospective cohort (April 2012 to March 2017). All patients above the age of 18 years, presenting with a hemotoxic snake bite, with a platelet count <1,50,000/cumm were recruited. Patients were observed both clinically and with appropriate investigations daily till discharge. Additional information for analysis was obtained from the clinical workstation. Descriptive statistics such as mean, standard deviation were analysed using Kruskal Wallis test across TMA spectrum and lab investigations and outcomes. Categorical variables like envenomation syndrome, Fisher’s exact test was used. RESULTS: TMA is a spectrum disorder that ranges from isolated Thrombocytopenia, thrombocytopenia with MAHA, and Thrombocytopenia, MAHA and renal failure (full spectrum TMA disorder). Prevalence of TMA spectrum was 51.35% and full spectrum TMA disorder was 21.6% in the prospective cohort. Majority of hemotoxic snakebites had a Russell’s viper like envenomation syndrome (69.4%). More importantly all the patients (30 subjects) who had full spectrum TMA had a Russell’s viper like envenomation syndrome. Majority of hemotoxic snakebites presented with VICC (81%). Patient group who did not have VICC, but presented with Thrombocytopenia (19%). Treatment outcomes were noted to be worse in the TMA spectrum with renal failure, requiring higher doses of ASV with longer hospital/ICU stay and with 73.3% of these patients requiring dialysis. Hence it is clear that patients who developed a TMA full spectrum disorder have a more severe illness with worse outcomes

Bioactivity Studies on Titania Coatings and the Estimation of Their Usefulness in the Modification of Implant Surfaces

Morphologically different titania coatings (nanofibers (TNFs), nanoneedles (TNNs), and nanowires (TNWs)) were studied as potential biomedical materials. The abovementioned systems were produced in situ on Ti6Al4V substrates via direct oxidation processes using H2O2 and H2O2/CaCl2 agents, and via thermal oxidation in the presence of Ar and Ar/H2O2. X-ray diffraction and Raman spectroscopy have been used to structurally characterize the produced materials. The morphology changes on the titanium alloy surface were investigated using scanning electron microscopy. The bioactivity of the samples has been estimated by the analysis of the produced titania coatings’ biocompatibility, and by the determination of their ability to reduce bacterial biofilm formation. The photoactivity of the produced nanocoatings was also analyzed, in order to determine the possibility of using titania coated implant surfaces in the sterilization process of implants. Photocatalytic activity was estimated using the methylene blue photodegradation kinetics, in the presence of UV light

A Novel Approach to ICD Lead Revision in a Patient with Extensive Vascular Thrombosis

Chronic extensive thrombosis of the venous system is a commonly encountered problem in end stage renal disease (ESRD) patients undergoing transvenous device implantation, lead extraction or lead revision. We describe a case of an ESRD patient with an implantable cardioverter defibrillator (ICD) that failed to deliver therapy due to lead fracture. Patient needed revision of the ICD lead system, but had extensive axillary-subclavian-superior vena cava occlusion. Patient refused a thoracotomy approach as well as lead extraction as he had a complicated course of lead extraction in the past. We successfully improvised a novel technique to revise the ICD system

Interference of 802.11B WLAN and Bluetooth: Analysis and Performance Evaluation

IEEE 802.11 and Bluetooth, these two operating in the unlicensed 2.4 GHz frequency band are becoming more and more popular in the mobile computing world. The number of devices equipped with IEEE 802.11 and Bluetooth is growing drastically. Result is the number of co-located devices, say within 10 meters, grown to a limit, so that it may causes interference issues in the 2.4 GHz radio frequency spectrum. Bluetooth supports both voice synchronous connection oriented (SCO) data and asynchronous connection less (ACL) packets. In this paper, we investigate the interference issues of 2.4 GHz frequency band. In addition, this paper presents a new Bluetooth voice packet Synchronous Connection Oriented with Repeated Transmission (SCORT) scheme to optimize the performance of 2.4 GHz frequency band by minimizing the interference between Bluetooth and 802.11 wireless networks. For the sake of experimental verifications, we provide a comprehensive simulation results using Matlab Simulink

Molecular Docking Study of Several Antiviral Drugs to Defeat Covid-19

Corona virus is one of the significant pathogens that destructs the human respiratory functioning. Deaths and casualties caused by coronaviruses (CoVs) include the severe acute respiratory syndrome (SARS)-CoV and the Middle East respiratory syndrome (MERS)-CoV. The aim of the work was to compare several antiviral drugs and find out which is the most active drug that might be used in treatment for COVID -19. In this study Molecular Docking approach was used to determine the binding affinities of 62 antiviral molecules. The study was carried out using Molegro Virtual Docker 6.0 with PDB 2GTB procured from RCSB Protein Data Bank. Simeprevir and Telaprevir were discovered to be most potent having high MolDock and Rerank scores of -225.158, -78.4383 and -209.467, -136.155 respectively. Further studies may be conducted to design more potent analogue and defeat COVID-19

A scoping review on laboratory surveillance in the WHO Southeast Asia Region: Past, present and the future

Background The South-East Asia (SEA) region bears a significant proportion of the world’s communicable disease burden. The onset of the COVID-19 pandemic has further affected the situation. A well-established laboratory-based surveillance (LBS) can reduce the burden of infectious diseases. In light of this, the review collated the existing literature on LBS system in the region and the modifications adopted by the surveillance systems during the pandemic. Methodology We followed the guidelines for scoping review as prescribed by Arskey and O’Malley. We comprehensively searched three databases (PubMed, Scopus and CINAHL) and supplemented it with grey literature search. The screening of the articles was conducted at the title and abstract followed by full-text screening. This was followed by data extraction using a pre-tested data extraction tool by two independent reviewers. The results were presented narratively. Results Including 75 relevant articles and documents, we compiled a list of surveillance systems. A shift from paper to dual (paper and electronic) modalities was identified across the countries. This largely low- and middle-income countries (LMIC) area face challenges in reporting, resources, and collaboration-related issues. While some countries have well-established National Reference Laboratories; others have more private than public-owned laboratories. Given the COVID-19 pandemic, modifications to the existing laboratory capacities to enable real-time surveillance was identified. Laboratory capacity complemented with genomic surveillance can indubitably aid in disease detection and control. Limitations due to inaccessible government portals, and language barriers are acknowledged. This review identified a comprehensive list of surveillance systems in the region, challenges faced in using these surveillance systems and inform the decision makers about the benefits of integrating fragmented surveillance systems. Conclusion Regionally and nationally integrated genomic and laboratory surveillance systems justify capital investments, as their payoffs rationalise such costs owing to economies of scale over time. Further, as data flows are harmonized and standardized, algorithm- and computing-based pattern recognition methods allow for targeted and accurate disease prediction when integrated with, potentially, climate and weather systems data. Trained human resources are a sine qua non to optimize such investments, but in the medium to long run, such investments will buttress initiatives in other arenas at the regional level

Functional outcome of elbow joint in AO type 13C fractures treated with open reduction and internal fixation using dual plates

Background: Distal end of the humerus, with its unique orientation of articular surfaces supported by a meagre amount of cancellous bone, makes its fracture a constant challenge to orthopaedic surgeons. Aim of the study is to evaluate the functional outcome of surgical management of intercondylar AO type C fractures of distal end of humerus using dual plating.Methods: A prospective study was conducted at our hospital between January 2015 to December 2016. Thirty five consecutive patients with intercondylar (AO Type C) fracture of distal humerus, included in study as per inclusion criteria. All patients were treated surgically using triceps reflecting approach and posterior trans-olecranon approach with ulnar nerve exploration and fixation using dual plating and tension band wiring for olecranon osteotomy wherever done.Results: In 35 patients, final results using MEPS scoring system excellent outcome is noticed in 15 patients (42.86%), good results is noticed in 13 patients (37.14%), fair result is noticed in 5 patients (14.29%) and poor result is noticed in 2 patients (5.71%). There was statistical significant difference in flexion range of movement arc at 2 and 6 months in our study.Conclusions: Open reduction and internal fixation of AO type 13C fractures is challenge to surgeon, preoperative planning and mastering the technique over a period of time gives good to excellent functional outcomes.

Profile of Pediatric Kidney Transplantation at a Tertiary Care Centre in Southern India

Introduction: Renal transplantation offers the best chance of survival to children with End Stage Renal Disease (ESRD). Patient survival and growth are superior in children with a renal allograft compared to dialysis. The aim of the study was to evaluate the outcomes of pediatric transplants done at a tertiary care hospital in Kochi, India over the study period.Materials and Methods: In this retrospective study, the data of children who underwent renal transplantation at Amrita Institute of Medical Sciences from 2002 to 2016 Kochi were analyzed.Results: Thirty-four children underwent renal transplantation over a 14-year period. Thirty-three underwent live related transplant whereas one underwent deceased donor transplantation. The mean age and weight of the recipients at transplantation was 14.3 years and 35.7 kg, respectively. Fourteen children were boys and twenty were girls. Thirty-one patients underwent hemodialysis prior to transplant, 2 were taken up preemptively, and 1 patient was on continuous ambulatory peritoneal dialysis. There were 5 documented urinary tract infections. No surgical complications were noted in the immediate post-transplant period. There were 5 episodes of acute rejection (14.7%). Two cases experienced Delayed Graft Function and the patient survival rate was 100%.Conclusions: Renal transplantation is a viable option to manage children with ESRD with satisfactory long term results and can be done in a developing nation’s set-up. Keywords: Kidney transplantation; India; Child

Role of adrenergic receptors in shock

Shock is a severe, life-threatening medical condition with a high mortality rate worldwide. All four major categories of shock (along with their various subtypes)—hypovolemic, distributive, cardiogenic, and obstructive, involve a dramatic mismatch between oxygen supply and demand, and share standard features of decreased cardiac output, reduced blood pressure, and overall hypoperfusion. Immediate and appropriate intervention is required regardless of shock type, as a delay can result in cellular dysfunction, irreversible multiple organ failure, and death. Studies have shown that dysfunction and downregulation of adrenergic receptors (ARs) are often implicated in these shock conditions; for example, their density is shown to be decreased in hypovolemic and cardiogenic shock, while their reduced signaling in the brain and vasculature decrease blood perfusion and oxygen supply. There are two main categories of ARs, α, and β, each with its subtypes and distributions. Our group has demonstrated that a dose of .02 mg/kg body wt of centhaquine (CQ) specifically activates α2B ARs on venous circulation along with the central α2A ARs after hypovolemic/hemorrhagic shock. Activating these receptors by CQ increases cardiac output (CO) and reduces systemic vascular resistance (SVR), with a net increase in blood pressure and tissue perfusion. The clinical trials of CQ conducted by Pharmazz Inc. in India have demonstrated significantly improved survival in shock patients. CQ improved blood pressure and shock index, indicating better blood circulation, and reduced lactate levels in the blood compared to in-use standard resuscitative agents. After successful clinical trials, CQ is being marketed as a drug (Lyfaquin®) for hypovolemic/hemorrhagic shock in India, and United States FDA has approved the phase III IND application. It is anticipated that the phase III trial in the United States will begin in 2023. Thus, we have demonstrated that α2 ARs could be suitable targets for treating or managing hypovolemic/hemorrhagic shock. Further understanding of ARs in shock would help find new potential pharmacological targets