A prospective, randomised, controlled clinical trial to evaluate the effect of nitrous oxide on propofol requirement in elective craniotomy in which entropy was used to measure depth of anaesthesia

Background: Propofol is known to have a favourable effect on cerebral haemodynamics. The role of nitrous oxide (N2O) in neurosurgical anaesthesia is still being debated. The primary aim of this study was to assess the dose-sparing effect of N2O on propofol infusion maintenance dosing.Method: Fifty American Society of Anesthesiology (ASA) grade I and II adults scheduled for elective craniotomies for supratentorial tumours were enrolled in the study. The patients received a standard anaesthetic comprising a fentanyl 2 μg/kg bolus prior to propofol induction. Anaesthesia was maintained with an infusion of fentanyl (2 μg/kg/hour), atracurium and propofol. The patients were randomised into two groups. Group A received 67% N2O. Group B did not receive N2O concomitantly with the propofol infusion. Entropy was used to guide the titration of the propofol infusion in both groups.Results: The propofol maintenance dose requirements were 47% lower in Group A (54.30 ± 11.47 μg/kg/minute) vs. Group B (102.30 ± 14.00 μg/kg/minute), (p < 0.001).Conclusion: The use of supplemental N2O significantly decreased propofol infusion rate requirements, compared with the propofol infusion alone, in ASA I and II patients undergoing elective supratentorial tumour excision.Keywords: anaesthesia depth, entropy, intracranial surgery, nitrous oxide, propofo

Measuring Spatial Variability of Land Use Associated with Hydrological Impact in Urbanised Quaternary Catchments using Entropy

Decision making for water resources is needed for land-use change due to urbanisation, which impacts hydrological variables such as mean annual runoff (MAR) of catchments. Urbanisation introduces some degree of uncertainty (expressed as entropy) to this specific variable. This study uses Shannon or theoretic entropy as a tool for measuring land use variability/diversity of urbanised areas in South Africa. Positive correlations between entropy and increase in mean annual runoff (MAR) due to urbanisation are derived. Also, relationships between return period/risk of failure (flooding or water supply) and entropy are established. A case of Pieter Wright Dam of the Vaal drainage region is used to demonstrate these relationships. Consequently, the reliability of this dam is shown to be positively correlated with entropy. Data on surface water resources of South Africa 1990 (WR90) compiled by the Water Resource Commission (WRC) were used in this study

Fighting malaria in Madhya Pradesh (Central India): Are we loosing the battle?

Malaria control in Madhya Pradesh is complex because of vast tracts of forest with tribal settlement. Fifty four million individuals of various ethnic origins, accounting for 8% of the total population of India, contributed 30% of total malaria cases, 60% of total falciparum cases and 50% of malaria deaths in the country. Ambitious goals to control tribal malaria by launching "Enhanced Malaria Control Project" (EMCP) by the National Vector Borne Disease Control Programme (NVBDCP), with the World Bank assistance, became effective in September 1997 in eight north Indian states. Under EMCP, the programme used a broader mix of new interventions, i.e. insecticide-treated bed nets, spraying houses with effective residual insecticides, use of larvivorous fishes, rapid diagnostic tests for prompt diagnosis, treatment of the sick with effective radical treatment and increased public awareness and IEC. However, the challenge is to scale up these services

Space-Time-Frequency Analysis of Rainfall, Runoff and Temperature in the Casamance River basin, Southern Senegal, West Africa

Using long-term data on rainfall and annual runoff, an investigation was made of the spatial and temporal variability of rainfall and runoff in the Casamance River basin located in southern Senegal, West Africa. A 5-year moving average was employed to identify trends in the data. Monthly and annual rainfall tends to have been decreasing, and the annual maximum temperature rising from around the mid-1960s. In addition, there has been a decreasing rainfall gradient from the coast to the interior. The analysis also showed a simultaneous runoff decline as a result of the rainfall decline. Available data on rainfall, temperature, and surface runoff from two upstream stations were used to develop a procedure for estimating runoff from the annual surplus values of precipitation minus reference evaporation. The resulting equations accounted for 74% to 77% of the variation in runoff. Spatial and temporal distribution of rainfall and runoff affects salinity migration inland and data are, therefore, useful for salinity management in the Casamance River basin

Intra-operative measurement of tumour size in breast cancer and its comparison with other methods: a prospective study

Accurate measurement of breast tumour size determines staging and prognosis. Discrepancies amongst clinical examination (CE), ultrasonography (USG), mammography, pathological examination (PE) and magnetic resonance imaging have been reported. However, few studies have evaluated changes in breast tumour size from the operating table to the laboratory

Src Dependent Pancreatic Acinar Injury Can Be Initiated Independent of an Increase in Cytosolic Calcium

Several deleterious intra-acinar phenomena are simultaneously triggered on initiating acute pancreatitis. These culminate in acinar injury or inflammatory mediator generation in vitro and parenchymal damage in vivo. Supraphysiologic caerulein is one such initiator which simultaneously activates numerous signaling pathways including non-receptor tyrosine kinases such as of the Src family. It also causes a sustained increase in cytosolic calcium- a player thought to be crucial in regulating deleterious phenomena. We have shown Src to be involved in caerulein induced actin remodeling, and caerulein induced changes in the Golgi and post-Golgi trafficking to be involved in trypsinogen activation, which initiates acinar cell injury. However, it remains unclear whether an increase in cytosolic calcium is necessary to initiate acinar injury or if injury can be initiated at basal cytosolic calcium levels by an alternate pathway. To study the interplay between tyrosine kinase signaling and calcium, we treated mouse pancreatic acinar cells with the tyrosine phosphatase inhibitor pervanadate. We studied the effect of the clinically used Src inhibitor Dasatinib (BMS-354825) on pervanadate or caerulein induced changes in Src activation, trypsinogen activation, cell injury, upstream cytosolic calcium, actin and Golgi morphology. Pervanadate, like supraphysiologic caerulein, induced Src activation, redistribution of the F-actin from its normal location in the sub-apical area to the basolateral areas, and caused antegrade fragmentation of the Golgi. These changes, like those induced by supraphysiologic caerulein, were associated with trypsinogen activation and acinar injury, all of which were prevented by Dasatinib. Interestingly, however, pervanadate did not cause an increase in cytosolic calcium, and the caerulein induced increase in cytosolic calcium was not affected by Dasatinib. These findings suggest that intra-acinar deleterious phenomena may be initiated independent of an increase in cytosolic calcium. Other players resulting in acinar injury along with the Src family of tyrosine kinases remain to be explored. © 2013 Mishra et al

Visceral Leishmaniasis in Muzaffarpur District, Bihar, India from 1990 to 2008

BACKGROUND: Visceral Leishmaniasis (VL) is a vector-borne disease transmitted by Phlebotomus argentipes. To understand the VL seasonality, annual and monthly variations of VL incidence and its relationship to meteorological variables, the numbers of VL cases reported in Muzaffarpur district, Bihar, India from 1990 to 2008 were studied. METHODS: Annual VL incidence per 10,000 and the total number of annual VL cases reported at block Community Health Centres (CHC), Public Hospitals or Non-Governmental Organisations (NGO) and the number of VL cases per month from 2000 to 2008 as well as the monthly average of cases for 2000-08, 2000-04 and 2005-08 periods along with the monthly averages of temperature, rainfall and relative humidity were plotted. VL Standardised Incidence Ratios per block were computed for the periods of 1990-1993, 1994-1998, 1999-2004 and 2005-2008 and month wise from 2002 to 2008. A negative binomial regression model was used to evaluate the association between meteorological variables and the number of VL cases per month from 2000 to 2008. RESULTS: A total of 68,358 VL cases were reported in Muzaffarpur district from 1990 to 2008, ranging from 1,2481 in 1992 to 1,161 in 2001. The blocks with the highest number of cases shifted from East (1990-98) to West (1999-2008). Monthly averages of cases ranged from 149 to 309, highest peak in March-April and another one in July. Monthly VL incidence was associated positively to rainfall and negatively to relative humidity and the numbers of VL cases in the previous month. INTERPRETATION: The number of cases reported to the public health sector allowed the describing of the spatial distribution and temporal variations in the Muzaffarpur from 1990 to 2008. However, to assess the actual VL burden, as well as the efficacy of the control measures applied in the district, reporting from private practices and NGOs should be encouraged

A hybrid computational intelligence approach to groundwater spring potential mapping

© 2019 by the authors. This study proposes a hybrid computational intelligence model that is a combination of alternating decision tree (ADTree) classifier and AdaBoost (AB) ensemble, namely "AB-ADTree", for groundwater spring potential mapping (GSPM) at the Chilgazi watershed in the Kurdistan province, Iran. Although ADTree and its ensembles have been widely used for environmental and ecological modeling, they have rarely been applied to GSPM. To that end, a groundwater spring inventory map and thirteen conditioning factors tested by the chi-square attribute evaluation (CSAE) technique were used to generate training and testing datasets for constructing and validating the proposed model. The performance of the proposed model was evaluated using statistical-index-based measures, such as positive predictive value (PPV), negative predictive value (NPV), sensitivity, specificity accuracy, root mean square error (RMSE), and the area under the receiver operating characteristic (ROC) curve (AUROC). The proposed hybrid model was also compared with five state-of-the-art benchmark soft computing models, including singleADTree, support vector machine (SVM), stochastic gradient descent (SGD), logistic model tree (LMT), logistic regression (LR), and random forest (RF). Results indicate that the proposed hybrid model significantly improved the predictive capability of the ADTree-based classifier (AUROC = 0.789). In addition, it was found that the hybrid model, AB-ADTree, (AUROC = 0.815), had the highest goodness-of-fit and prediction accuracy, followed by the LMT (AUROC = 0.803), RF (AUC = 0.803), SGD, and SVM (AUROC = 0.790) models. Indeed, this model is a powerful and robust technique for mapping of groundwater spring potential in the study area. Therefore, the proposed model is a promising tool to help planners, decision makers, managers, and governments in the management and planning of groundwater resources

An assessment of the usefulness of a rapid immuno-chromatographic test, "Determine™ malaria pf" in evaluation of intervention measures in forest villages of central India

BACKGROUND: Plasmodium falciparum malaria, is a major health problem in forested tribal belt of central India. Rapid and accurate methods are needed for the diagnosis of P. falciparum. We performed a blinded evaluation of the recently introduced Determine™ malaria pf test (Abbott, Laboratories, Japan) compared with microscopy and splenomegaly in children in epidemic prone areas of district Mandla to assess the impact of intervention measures. METHODS: Children aged 2–10 yrs with and without fever were examined for spleen enlargement by medical specialist by establishing a mobile field clinic. From these children thick blood smears were prepared from finger prick and read by a technician. Simultaneously, rapid tests were performed by a field lab attendant. The figures for specificity, sensitivity and predictive values were calculated using microscopy as gold standard. RESULTS: In all 349 children were examined. The sensitivity and specificity for Determine rapid diagnostic test were 91 and 80% respectively. The positive predictive values (PPV), negative predictive values (NPV) and accuracy of the test were respectively 79, 91 and 85%. On the contrary, the sensitivity and specificity of spleen in detecting malaria infection were 57 and 74 % respectively with PPV of 73%, NPV 59 % and an accuracy of 65%. CONCLUSIONS: Determine™ malaria rapid diagnostic test is easier and quicker to perform and has other advantages over microscopy in not requiring prior training of personnel or quality control. Thus, highlighting the usefulness of a rapid antigen test in assessing prevailing malaria situation in remote areas

Characterization and predictive value of near infrared 2-deoxyglucose optical imaging in severe acute pancreatitis

Background: Studying the uptake of 2-deoxy glucose (2-DG) analogs such as 2-Deoxy-2-[18F] fluoroglucose (FDG) is a common approach to identify and monitor malignancies and more recently chronic inflammation. While pancreatitis is a common cause for false positive results in human studies on pancreatic cancer using FDG, the relevance of these findings to acute pancreatitis (AP) is unknown. FDG has a short half-life. Thus, with an aim to accurately characterize the metabolic demand of the pancreas during AP in real-time, we studied the uptake of the non-radioactive, near infrared fluorescence labelled 2-deoxyglucose analog, IRDye1® 800CW 2-DG probe (NIR 2-DG; Li-Cor) during mild and severe biliary AP. Methods: Wistar rats (300 g; 8-12/group) were administered NIR 2-DG (10 nM; I.V.). Mild and severe biliary AP were respectively induced by biliopancreatic duct ligation (DL) alone or along with infusing glyceryl trilinoleate (GTL; 50 μL/100 g) within 10 minutes of giving NIR 2-DG. Controls (CON) only received NIR 2-DG. Imaging was done every 5-10 minutes over 3 hrs. Average Radiant Efficiency [p/s/cm2/sr]/[μW/cm2] was measured over the pancreas using the IVIS 200 in-vivo imaging system (PerkinElmer) using the Living Image® software and verified in ex vivo pancreata. Blood amylase, lipase and pancreatic edema, necrosis were measured over the course of AP. Results: NIR 2-DG uptake over the first hour was not influenced by AP induction. However, while the signal declined in controls and rats with mild AP, there was significantly higher retention of NIR 2-DG in the pancreas after 1 hour in those with GTL pancreatitis. The increase was > 3 fold over controls in the GTL group and was verified to be in the pancreas ex vivo. In vitro, pancreatic acini exposed to GTL had a similar increase in NIR 2-DG uptake which was followed by progressively worse acinar necrosis. Greater retention of NIR 2-DG in vivo was associated with worse pancreatic necrosis, reduced ATP concentrations and mortality, which were not predicted by the blood parameters. Conclusion: In-vivo fluorescent imaging of a non-radioactive near infrared 2-DG optical probe can predict the AP severity early during the disease