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There are few longitudinal studies about South Asians (SAs) and little information about recruitment and retention approaches for this ethnic group.
We followed 906 SAs enrolled in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) cohort for 5 years. Surviving participants were invited for a second clinical exam from 2015 to 2018. A new wave of participants was recruited during 2017–2018. We assessed the yields from different methods of recruitment and retention.
A total of 759 (83%) completed the second clinical exam, and 258 new participants were enrolled. Providing a nearby community hospital location for the study exam, offering cab/shared ride reimbursement, and conducting home visits were the most effective methods for enhancing retention. New participant recruitment targeted women and individuals with lower socioeconomic status, and we found that participant referrals and active community engagement were most effective. Mailing invitational letters to those identified by electronic health records had very low yield.
Recruitment and retention strategies that address transportation barriers and increase community engagement will help increase the representation of SAs in health research.
We assessed the impact of an embedded electronic medical record decision-support matrix (Cerner software system) for the reduction of hospital-onset Clostridioides difficile. A critical review of 3,124 patients highlighted excessive testing frequency in an academic medical center and demonstrated the impact of decision support following a testing fidelity algorithm.
In this paper, we study the relative perturbation bounds for joint
eigenvalues of commuting tuples of normal
matrices. Some Hoffman–Wielandt-type relative perturbation
bounds are proved using the Clifford algebra technique. We also extend a
result for diagonalisable matrices which improves a relative perturbation
bound for single matrices.
Background: Granulomatosis with polyangitis (GPA) is a rare systemic vasculitis with a prevalence of 0.6 per million in the pediatric population. CNS involvement occurs in 7-18% of cases. Pituitary involvement is only noted in 1% of cases. Methods: A 16-year-old girl with newly-diagnosed GPA presented to our hospital with progressive debilitating headaches, polyuria, and polydipsia. Results: Initial MRI showed changes to the pituitary. Lumbar puncture (LP) revealed opening pressure of 26. She developed central diabetes insipidus (DI) and visual changes. Repeat head imaging showed adenohypophysitis. The GPA was previously treated with steroids and cyclophosphamide, followed by Cellcept. Once the pituitary involvement was discovered, she was given re-induction therapy with Rituximab and steroid dose was increased. DI is being treated with DDAVP. Her headaches are improving. Conclusions: CNS inflammatory diseases are rare in childhood. Pituitary involvement is extremely rare in GPA. Induction therapy for adults with GPA and pituitary involvement includes glucocorticoids and cyclophosphamide, which often leads to improvement of MRI abnormalities but is not effective in resolving pituitary dysfunction. Our patient had already received this treatment when she developed the CNS findings. This case demonstrates that cerebral involvement is often resistant to classic therapy, and one should be vigilant in looking for CNS inflammation in these patients.
Coronal Mass Ejections (CMEs) contribute to the perturbation of solar wind in the heliosphere. Thus, depending on the different phases of the solar cycle and the rate of CME occurrence, contribution of CMEs to solar wind parameters near the Earth changes. In the present study, we examine the long term occurrence rate of CMEs, their speeds, angular widths and masses. We attempt to find correlation between near sun parameters of the CMEs with near the Earth measurements. Importantly, we attempt to find what fraction of the averaged solar wind mass near the Earth is provided by the CMEs during different phases of the solar cycles.
We have studied three Interplanetary Coronal Mass Ejections (ICMEs) having clear signatures of magnetic cloud (MC) arrival at 1 AU and their associated solar sources during 2011 to 2013. Comparing the axial magnetic field strength (B0) of the near-Sun coronal flux-ropes with that of the MC at 1 AU, we have found that the average inferred value of B0 at 1 AU assuming the self-similar expansion of the flux-rope is two times smaller than the value of B0 obtained from the results of MC fitting. Furthermore, by comparing the initial orientation of the flux-rope near the Sun and its final orientation at 1 AU we have found that the three CMEs exhibited more than 80° rotation during its propagation through the interplanetary medium. Our study suggests that although the near-Sun magnetic properties of coronal flux-ropes can be used to infer the field strength of the associated MC at 1 AU, it is difficult to estimate the final orientation of the MC axis in order to predict the geo-effectiveness of the ICMEs.
Generally Coronal Mass Ejections (CMEs) are large eruptions of plasma and magnetic field from the Sun into interplanetary space. CMEs are most frequently associated with a variety of phenomena occurring in the lower corona before, during and after onset of eruption and generally are visible in coronagraph observation. Stealth CMEs do not obviously exhibit any of the low-coronal signatures (LCS) like solar flares, flows, jets, coronal dimmings or brightenings, filament eruptions or the formation of flare loop arcades. In this study, five stealth CMEs are selected using LASCO/SOHO CME catalogue and associated ICMEs (Interplanetaty CMEs) are identified using data from STEREO, ACE and WIND.
We have used the Coronagraphic and Heliospheric Imaging data from Solar TErrestrial RElations Observatory (STEREO) to observe a prominence which is erupted on June 7th 2011. This prominence is subjected to the morphological evolution of MRT instability from the lower solar corona upto the inter-planetary space. The unstable structures are converted into the bunch of localized plasma spikes due to the turbulent mixing, and propagate in the inter-planetary space upto 1 A.U.
Using HINODE/XRT, GOES, SDO/AIA observations, we study a compact C-1.4 class flare outside a major sunspot of AR 12178 on 4 October 2014. This flare is associated with a peculiar coronal jet, which is erupted in two stages in the overlying corona above the compact flaring region. At the time of flare maximum, the first stage of the jet eruption occurs above the flare energy release site, and thereafter in the second stage its magneto-plasma system interacts with the overlying distinct magnetic field domain in its vicinity to build further the typical jet plasma column.
It has been established that Coronal Mass Ejections (CMEs) may have significant impact on terrestrial magnetic field and lead to space weather events. In the present study, we selected several CMEs which are associated with filament eruptions on the Sun. We attempt to identify the presence of filament material within ICME at 1AU. We discuss how different ICMEs associated with filaments lead to moderate or major geomagnetic activity on their arrival at the Earth. Our study also highlights the difficulties in identifying the filament material at 1AU within isolated and in interacting CMEs.
An internationally approved and globally used classification scheme for the diagnosis of CHD has long been sought. The International Paediatric and Congenital Cardiac Code (IPCCC), which was produced and has been maintained by the International Society for Nomenclature of Paediatric and Congenital Heart Disease (the International Nomenclature Society), is used widely, but has spawned many “short list” versions that differ in content depending on the user. Thus, efforts to have a uniform identification of patients with CHD using a single up-to-date and coordinated nomenclature system continue to be thwarted, even if a common nomenclature has been used as a basis for composing various “short lists”. In an attempt to solve this problem, the International Nomenclature Society has linked its efforts with those of the World Health Organization to obtain a globally accepted nomenclature tree for CHD within the 11th iteration of the International Classification of Diseases (ICD-11). The International Nomenclature Society has submitted a hierarchical nomenclature tree for CHD to the World Health Organization that is expected to serve increasingly as the “short list” for all communities interested in coding for congenital cardiology. This article reviews the history of the International Classification of Diseases and of the IPCCC, and outlines the process used in developing the ICD-11 congenital cardiac disease diagnostic list and the definitions for each term on the list. An overview of the content of the congenital heart anomaly section of the Foundation Component of ICD-11, published herein in its entirety, is also included. Future plans for the International Nomenclature Society include linking again with the World Health Organization to tackle procedural nomenclature as it relates to cardiac malformations. By doing so, the Society will continue its role in standardising nomenclature for CHD across the globe, thereby promoting research and better outcomes for fetuses, children, and adults with congenital heart anomalies.
Agreement between echocardiography and right heart catheterisation-derived right ventricular systolic pressure is modest in the adult heart failure population, but is unknown in the paediatric cardiomyopathy population.
All patients at a single centre from 2001 to 2012 with a diagnosis of cardiomyopathy who underwent echocardiography and catheterisation within 30 days were included in this study. The correlation between tricuspid regurgitation gradient and catheterisation-derived right ventricular systolic pressure and mean pulmonary artery pressure was determined. Agreement between echocardiography and catheterisation-derived right ventricular systolic pressure was assessed using Bland–Altman plots. Analysis was repeated for patients who underwent both procedures within 7 days. Haemodynamic data from those with poor agreement and good agreement between echocardiography and catheterisation were compared.
A total of 37 patients who underwent 48 catheterisation procedures were included in our study. The median age was 11.8 (0.1–20.6 years) with 22 males (58% total). There was a modest correlation (r=0.65) between echocardiography and catheterisation-derived right ventricular systolic pressure, but agreement was poor. Agreement between tricuspid regurgitation gradient and right ventricular systolic pressure showed wide 95% limits of agreement. There was a modest correlation between the tricuspid regurgitation gradient and mean pulmonary artery pressure (r=0.6). Shorter time interval between the two studies did not improve agreement. Those with poor agreement between echocardiography and catheterisation had higher right heart pressures, but this difference became insignificant after accounting for right atrial pressure.
Transthoracic echocardiography estimation of right ventricular systolic pressure shows modest correlation with right heart pressures, but has limited agreement and may underestimate the degree of pulmonary hypertension in paediatric cardiomyopathy patients.
During the Cretaceous and Paleogene, the Indian subcontinent was isolated as it migrated north from the east coast of Africa to collide with Asia. As it passed over the Reunion hotspot in the late Maastrichtian–early Danian, a series of lava flows extruded, known as the Deccan Traps. Also during this interval, there was a major mass-extinction event at the Cretaceous–Paleogene boundary, punctuated by a meteorite impact at Chicxulub, Mexico. What were the biological implications of these changes in paleogeography and the extensive volcanism in terms of biodiversity, evolution, and biogeography? By combining chronostratigraphic, paleosol, and paleobotanical data, an understanding of how the ecosystems and climates changed and the relative contributions of the Chicxulub impact, Deccan Traps volcanism, and paleogeographic isolation can be gained. Understanding relative ages of paleobotanical localities is crucial to determining floristic changes, and is challenging because different methods (e.g., magnetostratigraphy, radiometric dating, vertebrate and microfossil biostratigraphy) sometimes give conflicting answers, or have not been done for paleobotanical localities. Climatic data can be obtained quantitatively by studying paleosol geochemistry, as well as qualitatively by examining functional traits and nearest living relatives of fossil plants. An additional challenge is revising macrofossil data, which includes some confidently identified taxa and others with uncertain affinities. This is important for understanding ecosystem composition both spatially and temporally, as well as the biogeographic implications of an isolated India.
Starting as a crisis of sub-prime mortgages in the United States, the US financial crisis became intertwined with a global economic crisis during 2007–09. All major economies were adversely affected. While some countries went into deep recession, others escaped with limited erosion in their growth rates. But the crisis also accelerated the pace at which a new world economic order is emerging, the centerpiece of which is a group now referred to as the G20 group. Together the G20 economies comprise about 90 per cent of global gross national product, 80 per cent of world trade (including EU intratrade) and two-thirds of the world population. The epicentre of the world economic power, which had until recently been concentrated in the hands of the G-7 economies, is now more wide spread with considerable economic power slowly shifting to emerging economies like China and India.
In this paper, the author looks at the effects of the global crisis as it affected the G20 members with special reference to India. The global crisis also witnessed a weakening of the efforts regarding international burden sharing for a long-felt need for support for achieving both the MDG goals and international climate change related efforts. He also examines both conventional and innovative methods of financing the international effort for achieving the MDG objectives and the approach that India may develop in this context as part of the G20 group.
This chapter is divided into several sections. The following section looks at the position of the G20 economies as they emerge out of the global crisis. The next section examines the Indian economy as it faced and emerged out of the crisis. Next the author looks at the position of the G20 economies in the context of international burden sharing in the post-crisis world.
There is increased interest towards the application of carbon based nanomaterials to biosensors since these can be used to quickly detect presence of the toxins in food, agricultural and environmental systems. The accurate, faster and early detection of food toxins is presently very important for ensuring safety and shelf life of agricultural commodities resulting from food contamination. The carbon materials (CNTs) and recently discovered graphene have been predicted to be promising candidates in the development of electrochemical biosensor owing to their exceptionally large surface area and interesting electrochemical properties. We focus on some of the recent results obtained in our laboratories pertaining to the development of biosensors based on multi-walled carbon nanotubes and graphene for mycotoxin(aflatoxin ) detection.
The objective of this study was to develop emission factors (EF) for methane (CH4) emissions from enteric fermentation in cattle native to Benin. Information on livestock characteristics and diet practices specific to the Benin cattle population were gathered from a variety of sources and used to estimate EF according to Tier 2 methodology of the 2006 Intergovernmental Panel on Climate Change (IPCC) Guidelines for National Greenhouse Gas Inventories. Most cattle from Benin are Bos taurus represented by Borgou, Somba and Lagune breeds. They are mainly multi-purpose, being used for production of meat, milk, hides and draft power and grazed in open pastures and crop lands comprising tropical forages and crops. Estimated enteric CH4 EFs varied among cattle breeds and subcategory owing to differences in proportions of gross energy intake expended to meet maintenance, production and activity. EFs ranged from 15.0 to 43.6, 16.9 to 46.3 and 24.7 to 64.9 kg CH4/head per year for subcategories of Lagune, Somba and Borgou cattle, respectively. Average EFs for cattle breeds were 24.8, 29.5 and 40.2 kg CH4/head per year for Lagune, Somba and Borgou cattle, respectively. The national EF for cattle from Benin was 39.5 kg CH4/head per year. This estimated EF was 27.4% higher than the default EF suggested by IPCC for African cattle with the exception of dairy cattle. The outcome of the study underscores the importance of obtaining country-specific EF to estimate global enteric CH4 emissions.
Effect of Gd substitution at Y-site on the structural and magnetic properties of Y1-xGdxMnO3 (x=0, 0.05) nanoparticles prepared by conventional solid state reaction method has been studied. The structural study using X-ray diffraction pattern indicates the hexagonal structure with P63cm space group for all the samples. The average particle size for all the samples lies in the range of 30-40 nm as confirmed by X-ray diffraction and transmission electron microscopy analysis. The change in a and c lattice parameters confirm the substitution of Gd at Y-site. Magnetization versus temperature measurements show enhanced magnetic moment and an increase in Neel temperature with Gd-doping. Spin glass behavior is observed at low temperature in all the samples. Exchange bias effect has been observed at 5 K after field cooling the samples which is ascribed to the formation of antiferromagnetic-ferromagnetic (AFM-FM) core-shell structure of the nanoparticles. A significant improvement in the dielectric properties of Gd-doped samples has also been observed.
We report observations of a long filament that underwent recurrent partial eruptions on August 4, 6, and 8, 2012. The filament reappeared in the subsequent rotation of the Sun, and disappeared completely on August 31, 2012. We implemented an automated filament detection algorithm developed by us for estimating different attributes of these filaments few hours prior to its disappearance in Hα and studied their evolution. Based on these attributes, we determine the onset time of the disappearance of Hα filaments. We then compared these onset times with that of the associated CMEs observed by LASCO/SOHO coronagraphs. This is also useful to understand temporal relationship of EUV and X-ray flux variation associated with filament disappearances in Hα. Our results show the importance of such studies in understanding the mechanism of CME initiation, particularly the role of eruptive filaments, in this process.
We studied three interplanetary coronal mass ejections associated with solar eruptive filaments. Filament plasma remnants embedded in these structures were identified using plasma, magnetic and compositional signatures. These features when impacted the Earth's terrestrial magnetosphere - ionosphere system, resulted in geomagnetic storms. During the main phase of associated storms, along with high density plasma structures, polarity reversals in the Y-component (dawn-to-dusk) of the interplanetary electric field seem to trigger major auroral substorms with concomitant changes in the polar ionospheric electric field. Here, we examine the cases where plasma dynamics and magnetic structuring in the presence of the prompt penetration of the electric field into the equatorial ionosphere affected the space weather while highlighting the complex geomagnetic storm-substorm relationship.