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Shunt-related adverse events are frequent in infants after modified Blalock–Taussig despite use of acetylsalicylic acid prophylaxis. A higher incidence of acetylsalicylic acid-resistance and sub-therapeutic acetylsalicylic acid levels has been reported in infants. We evaluated whether using high-dose acetylsalicylic acid can decrease shunt-related adverse events in infants after modified Blalock–Taussig.
In this single-centre retrospective cohort study, we included infants ⩽1-year-old who underwent modified Blalock–Taussig placement and received acetylsalicylic acid in the ICU. We defined acetylsalicylic acid treatment groups as standard dose (⩽7 mg/kg/day) and high dose (⩾8 mg/kg/day) based on the initiating dose.
There were 34 infants in each group. Both groups were similar in age, gender, cardiac defect type, ICU length of stay, and time interval to second stage or definitive repair. Shunt interventions (18 versus 32%, p=0.16), shunt thrombosis (14 versus 17%, p=0.74), and mortality (9 versus 12%, p=0.65) were not significantly different between groups. On multiple logistic regression analysis, single-ventricle morphology (odds ratio 5.2, 95% confidence interval of 1.2–23, p=0.03) and post-operative red blood cells transfusion ⩾24 hours [odds ratio 15, confidence interval of (3–71), p<0.01] were associated with shunt-related adverse events. High-dose acetylsalicylic acid treatment [odds ratio 2.6, confidence interval of (0.7–10), p=0.16] was not associated with decrease in these events.
High-dose acetylsalicylic acid may not be sufficient in reducing shunt-related adverse events in infants after modified Blalock–Taussig. Post-operative red blood cells transfusion may be a modifiable risk factor for these events. A randomised trial is needed to determine appropriate acetylsalicylic acid dosing in infants with modified Blalock–Taussig.
This case series aimed to describe clinicoradiological, electromyographic, and etiological spectra in palatal tremor (essential=1; symptomatic=26). Patients with symptomatic palatal tremor had 2 to 10 Hz arrhythmic electromyographic bursts, a spectrum of changes in inferior olivary nucleus, with/without lesions in Guillain Mollaret triangle, and varied etiologies (genetic=9, vascular=6, trauma=3, infections=3). Exome sequencing showed variations in POLG, WDR81, NDUFS8, TENM4, and EEF2. Clinical phenotypes of patients with POLG, WDR81, and NDUFS8 variations were consistent with that described in literature. We highlight salient magnetic resonance imaging features, electrophysiological observations, and diverse etiologies in a large cohort of palatal tremor.
Heat stress greatly limits the productivity of wheat in many regions. Knowledge on the degree of genetic diversity of wheat varieties along with their selective traits will facilitate the development of high yielding, stress-tolerant wheat cultivar. The objective of this study were to determine genetic variation in morpho-physiological traits associated with heat tolerance in 30 diverse wheat genotypes and to examine genetic diversity and relationship among the genotypes varying heat tolerance using molecular markers. Phenotypic data of 15 traits were evaluated for heat tolerance under non-stress and stress conditions for two consecutive years. A positive and significant correlation among cell membrane stability, canopy temperature depression, biomass, susceptibility index and grain yield was shown. Genetic diversity assessed by 41 polymorphic simple sequence repeat (SSR) markers was compared with diversity evaluated for 15 phenotypic traits averaged over stress and non-stress field conditions. The mean polymorphic information content for SSR value was 0.38 with range of 0.12–0.75. Based on morpho-physiological traits and genotypic data, three groups were obtained based on their tolerance (HHT, MHT and LHT) levels. Analysis of molecular variance explained 91.7% of the total variation could be due to variance within the heat tolerance genotypes. Genetic diversity among HHT was higher than LHT genotypes and HHT genotypes were distributed among all cluster implied that genetic basis of heat tolerance in these genotypes was different thereby enabling the wheat breeders to combine these diverse sources of genetic variation to improve heat tolerance in wheat breeding programme.
Rigid ryegrass is the most-troublesome, herbicide-resistant weed in cropping systems of southern Australia. Field experiments were undertaken at Roseworthy, South Australia, in 2013 and 2014, to identify effective herbicide options for the control of clethodim-resistant rigid ryegrass in Clearfield canola. PPI trifluralin + triallate followed by (fb) POST imazamox + imazapyr + clethodim + butroxydim had the lowest plant density of rigid ryegrass in 2014 and provided superior control compared with the standard grower practice of PPI trifluralin + triallate fb POST imazamox + imazapyr + clethodim in 1 of 2 yr. Propyzamide either alone or as a split application (PPI fb POST) or in combination with clethodim provided similar rigid ryegrass control to that of the standard grower practice (38 to 553 plants m−2). Rigid ryegrass treated with PPI dimethenamid-P, pethoxamid, pethoxamid + triallate, and PPI trifluralin fb carbetamide POST produced significantly more seeds than the standard grower practice, which would lead to reinfestation of subsequent crops. Canola yield responded positively to effective herbicide treatments, especially in 2014, when rigid ryegrass density was greater. PPI dimethenamid-P and pethoxamid alone or in combination with triallate and propyzamide were ineffective in reducing rigid ryegrass density and seed production to levels acceptable for continuous cropping systems.
Rigid ryegrass, an important annual weed species in cropping regions of
southern Australia, has evolved resistance to 11 major groups of herbicides.
Dose–response studies were conducted to determine response of three
clethodim-resistant populations and one clethodim-susceptible population of
rigid ryegrass to three different frost treatments (−2 C).
Clethodim-resistant and -susceptible plants were exposed to frost in a frost
chamber from 4:00 P.M. to 8:00 A.M. for three nights before or after
clethodim application and were compared with plants not exposed to frost. A
reduction in the level of clethodim efficacy was observed in resistant
populations when plants were exposed to frost for three nights before or
after clethodim application. In the highly resistant populations, the
survival percentage and LD50 were higher when plants were exposed
to frost before clethodim application compared with frost after clethodim
application. However, frost treatment did not influence clethodim efficacy
of the susceptible population. Sequencing of the acetyl coenzyme A
carboxylase (ACCase) gene of the three resistant populations identified
three known mutations at positions 1781, 2041, and 2078. However, most
individuals in the highly resistant populations did not contain any known
mutation in ACCase, suggesting the resistance mechanism was a nontarget
site. The effect of frost on clethodim efficacy in resistant plants may be
an outcome of the interaction between frost and the clethodim resistance
We investigate the possibility of detecting damped Lyman-α systems at high redshifts using GMRT if these clouds are magnified by intervening cluster lenses. We show that if the HI mass of the damped clouds ≥ 2 × 1010 M⊙ then they can be detected with a probability ≥ 0.2 using GMRT.
Addition of antibiotics to artificial diets of insects is a key component in the rearing of insects in the laboratory. In the present study an antimicrobial agent, streptomycin sulphate was tested for its influence on survival and fitness of Spodoptera litura (Fabricus) (Lepidoptera: Noctuidae) as well as its gut microbial diversity. The antibiotic did not adversely affect the survival of S. litura. Faster growth of larvae was recorded on diet amended with different concentrations of streptomycin sulphate (0.03, 0.07 and 0.15%) as compared to diet without streptomycin sulphate. The overall activity of various digestives enzymes increased on S+ diet while the activity of detoxifying enzymes significantly decreased. In addition, alteration in microbial diversity was found in the gut of S. litura larvae fed on diet supplemented with antibiotic (S+) and without antibiotic (S−).
To report the International Nosocomial Infection Control Consortium surveillance data from 40 hospitals (20 cities) in India 2004–2013.
Surveillance using US National Healthcare Safety Network’s criteria and definitions, and International Nosocomial Infection Control Consortium methodology.
We collected data from 236,700 ICU patients for 970,713 bed-days
Pooled device-associated healthcare-associated infection rates for adult and pediatric ICUs were 5.1 central line–associated bloodstream infections (CLABSIs)/1,000 central line–days, 9.4 cases of ventilator-associated pneumonia (VAPs)/1,000 mechanical ventilator–days, and 2.1 catheter-associated urinary tract infections/1,000 urinary catheter–days
In neonatal ICUs (NICUs) pooled rates were 36.2 CLABSIs/1,000 central line–days and 1.9 VAPs/1,000 mechanical ventilator–days
Extra length of stay in adult and pediatric ICUs was 9.5 for CLABSI, 9.1 for VAP, and 10.0 for catheter-associated urinary tract infections. Extra length of stay in NICUs was 14.7 for CLABSI and 38.7 for VAP
Crude extra mortality was 16.3% for CLABSI, 22.7% for VAP, and 6.6% for catheter-associated urinary tract infections in adult and pediatric ICUs, and 1.2% for CLABSI and 8.3% for VAP in NICUs
Pooled device use ratios were 0.21 for mechanical ventilator, 0.39 for central line, and 0.53 for urinary catheter in adult and pediatric ICUs; and 0.07 for mechanical ventilator and 0.06 for central line in NICUs.
Despite a lower device use ratio in our ICUs, our device-associated healthcare-associated infection rates are higher than National Healthcare Safety Network, but lower than International Nosocomial Infection Control Consortium Report.
Infect. Control Hosp. Epidemiol. 2016;37(2):172–181
This study examined the effects of trichostatin A (TSA) treatment of reconstructed buffalo embryos, produced by hand-made cloning using somatic cells isolated from over a decade old frozen–thawed semen, on their in vitro and in vivo developmental competence, quality and epigenetic status. Following treatment of reconstructed embryos with TSA (0, 50 or 75 nM) for 10 h prior to culture, the cleavage (100.0 ± 0, 94.5 ± 2.3 and 96.1 ± 1.2%, respectively) and blastocyst rate (50.6 ± 2.3, 48.4 ± 2.7 and 48.1 ± 2.6%, respectively), total cell number (275 ± 17.4, 289 ± 30.1 and 317 ± 24.2, respectively) and apoptotic index (5.6 ± 0.7, 3.4 ± 0.9 and 4.5 ± 1.4, respectively) were not significantly different among the three groups. However, TSA treatment increased (P < 0.05) the global level of H4K5ac and decreased (P < 0.05) that of H3K27me3 in blastocysts whereas the global level of H3K18ac was not affected significantly. Transfer of embryos treated with 75 nM TSA (n = 10) to recipients resulted in two pregnancies (20%), one out of which was aborted in the second and the other in the third trimester whereas transfer of control embryos (n = 20) or those treated with 50 nM TSA (n = 12) did not result in any pregnancy. In conclusion, these results suggest that TSA treatment of cloned buffalo embryos produced using somatic cells isolated from frozen–thawed semen improved their epigenetic status but not the in vitro developmental potential and offspring rate.
Two field experiments were conducted during 2012 and 2013 at Roseworthy, South Australia to identify effective herbicide options for the management of clethodim-resistant rigid ryegrass in faba bean. Dose–response experiments confirmed resistance in both field populations (B3, 2012 and E2, 2013) to clethodim and butroxydim. Sequencing of the target site of acetyl coenzyme A carboxylase gene in both populations identified an aspartate-2078-glycine mutation. Although resistance of B3 and E2 populations to clethodim was similar (16.5- and 21.4-fold more resistant than the susceptible control SLR4), the B3 population was much more resistant to butroxydim (7.13-fold) than E2 (2.24-fold). Addition of butroxydim to clethodim reduced rigid ryegrass plant density 60 to 80% and seed production 71 to 88% compared with the standard grower practice of simazine PPI plus clethodim POST. Clethodim + butroxydim combination had the highest grain yield of faba bean (980 to 2,400 kg ha−1). Although propyzamide and pyroxasulfone plus triallate PPI provided the next highest levels of rigid ryegrass control (< 60%), these treatments were more variable and unable to reduce seed production (6,354 to 13,570 seeds m−2) to levels acceptable for continuous cropping systems.
In the present study, oocytes retrieved from cross bred Karan Fries cows by ovum pick-up technique were graded into Group 1 and Group 2, based on the morphological appearance of the individual cumulus–oocyte complexes (COCs). To analyze whether the developmental potential of the COCs bears a relation to morphological appearance, relative expression of a panel of genes associated with; (a) cumulus–oocyte interaction (Cx43, Cx37, GDF9 and BMP15), (b) fertilization (ZP2 and ZP3), (c) embryonic development (HSF1, ZAR1 and bFGF) and (d) apoptosis and survival (BAX, BID and BCL-XL, MCL-1, respectively) was studied at two stages: germinal vesicle (GV) stage and after in vitro maturation. The competence was further corroborated by evaluating the embryonic progression of the presumed zygotes obtained from fertilization of the graded COCs. The gene expression profile and development rate in pooled A and B grade (Group 1) COCs and pooled C and D grade (Group 2) COCs were determined and compared according to the original grades. The results of the study demonstrated that the morphologically characterized Group 2 COCs showed significantly (P<0.05) lower expression for most of the genes related to cumulus–oocyte interplay, fertilization and embryonic development, both at GV stage as well as after maturation. Group 1 COCs also showed greater expression of anti-apoptotic genes (BCL-XL and MCL1) both at GV stage and after maturation, while pro-apoptotic genes (BAX and BID) showed significantly (P<0.05) elevated expression in poor quality COCs at both the stages. The cleavage rate in Group 1 COCs was significantly higher than that of Group 2 (74.46±7.06 v. 31.57±5.32%). The development of the presumed zygotes in Group 2 oocytes proceeded up to 8- to 16-cell stages only, while in Group 1 it progressed up to morulae (35.38±7.11%) and blastocyst stages (9.70±3.15%), indicating their better developmental potential.
The properties of dust ion acoustic rogue waves (DIARWs) in an unmagnetized collisionless plasma system composed of charged dust grains, superthermal electrons and warm ions as a fluid are studied. The multiple scale perturbation method is used to derive a nonlinear Schrödinger equation (NLSE) for DIARWs. From the coefficients of nonlinearity and dispersion, we have determined the critical wave number threshold kcr at which modulational instability sets in. This critical wave number depends on the various plasma parameters, viz. superthermality of electrons, ion temperature and dust concentration. Within the modulational instability region, a random perturbation of amplitude grows and thus, creates DIARWs. It is found that DIARWs are significantly affected by electron superthermality (via κ), ion temperature (via σ) and dust concentration (via f). In view of the crucial importance of DIARWs in space environments, our results may be useful in understanding the basic features of DIARWs that may occur in space plasmas.
We have prepared 2% Al doped ZnO (AZO) thin films on SrTiO3 and Al2O3 substrates by Pulsed Laser Deposition (PLD) technique at various deposition temperatures (Tdep = 300 °C – 600 °C). Transport and thermoelectric properties of AZO thin films were studied in low temperature range (300 K - 600 K). AZO/STO films present superior performance respect to AZO/Al2O3 films deposited at the same temperature, except for films deposited at 400 °C. Best film is the fully c-axis oriented AZO/STO deposited at 300 °C, with electrical conductivity 310 S/cm, Seebeck coefficient -65 μV/K and power factor 0.13 × 10-3 Wm-1K-2 at 300 K. Its performance increases with temperature. For instance, power factor is enhanced up to × 10-3 Wm-1K-2 at 600 K, surpassing the best AZO film previously reported in literature.
Continuous rice–wheat (RW) cropping with intensive tillage has resulted in land degradation and inefficient use of water in Indo-Gangetic Plains (IGP) of South Asia. Replacement of rice with less water requiring crops such as soybean in RW system and identification of effective strategies for tillage management could result in sustainable cropping system in IGP. A field experiment was conducted for five years on an annual soybean–wheat (SW) rotation in the northwest IGP of India to evaluate effect of tillage, raised bed planting and straw mulch on yield, soil properties, water use efficiency (WUE) and profitability. In soybean, straw mulch reduced soil temperature at seeding depth by about 2.5 °C compared with no mulch. Straw mulch also resulted in slightly reduced water use and slightly higher WUE relative to their respective unmulched treatments. During wheat emergence, raised beds resulted in higher soil temperature by 1.6 °C compared with flat treatments. Bulk density and cumulative infiltration were greater in no-tillage compared with conventional tillage. Soil organic carbon in surface layer increased significantly after five years of experimentation. Soybean and wheat yields were similar under different treatments during all the years of experimentation. Soybean and wheat planted on raised beds recorded about 17% and 23% higher WUE, respectively, than in flat layout. The net returns from SW system were greater in no-tillage and permanent raised beds than with conventional tillage. Both no-tillage and permanent raised bed technologies can be adopted for sustainable crop production in SW rotation in northwest IGP. However, more studies are required representing different soil types and climate conditions for making recommendations for other regions of IGP.
We report on the effect of the International Nosocomial Infection Control Consortium's (INICC) multidimensional approach for the reduction of ventilator-associated pneumonia (VAP) in adult patients hospitalized in 21 intensive-care units (ICUs), from 14 hospitals in 10 Indian cities. A quasi-experimental study was conducted, which was divided into baseline and intervention periods. During baseline, prospective surveillance of VAP was performed applying the Centers for Disease Control and Prevention/National Healthcare Safety Network definitions and INICC methods. During intervention, our approach in each ICU included a bundle of interventions, education, outcome and process surveillance, and feedback of VAP rates and performance. Crude stratified rates were calculated, and by using random-effects Poisson regression to allow for clustering by ICU, the incidence rate ratio for each time period compared with the 3-month baseline was determined. The VAP rate was 17·43/1000 mechanical ventilator days during baseline, and 10·81 for intervention, showing a 38% VAP rate reduction (relative risk 0·62, 95% confidence interval 0·5–0·78, P = 0·0001).
No-tillage and raised beds are widely used for different crops in developed countries. A field experiment was conducted on an irrigated maize-wheat system to study the effect of field layout, tillage and straw mulch on crop performance, water use efficiency and economics for five years (2003–2008) in northwest India. Straw mulch reduced the maximum soil temperature at seed depth by about 3 °C compared to the no mulch. During the wheat emergence, raised beds recorded 1.3 °C higher soil temperature compared to the flat treatments. Both maize and wheat yields were similar under different treatments during all the years. Maize and wheat planted on raised beds recorded about 7.8% and 22.7% higher water use efficiency than under flat layout, respectively. Straw mulch showed no effect on water use and water use efficiency in maize. The net returns from the maize-wheat system were more in no tillage and permanent raised beds than with conventional tillage. Bulk density and cumulative infiltration were more in no tillage compared with conventional tillage.
We propose a phototransistor geometry that incorporates silicon nanowires (SiNW) in the device channel. A set of two gates controls the charge flow inside the NW. This improves the device photo-response more than 10x when compared with a single gate phototransistor, leading to a photo-responsivity of greater than 104(A/W), while the dark properties of both devices are similar.
Neat Fibers of HiPco single wall carbon nanotubes extruded from strong acid suspensions exhibit preferred orientation along fiber axes. We characterize the extrusion-induced alignment using x-ray fiber diagrams and polarized Raman scattering, using a model which allows for some fraction of the sample to remain completely unaligned. We show that both x-ray and Raman data are required for a complete texture analysis of SWNT fibers.
Graphitic shells coated ferromagnetic cobalt nanoparticles (C-Co-NPs) with diameters of around 7-9 nm cubic crystalline structures were synthesized by catalytic chemical vapor deposition (CCVD). X-ray diffraction (XRD) and X-ray photoelectron spectroscopy (XPS) analysis indicated that the Co-NPs inside the carbon shells were preserved in the metallic state. Confocal microscope images revealed effective penetrations of C-Co-NPs through plasmatic membranes into the nucleus of the cultured HeLa cancerous cells. Low RF radiation of 350 kHz triggered the cell death, process that was found to be dependent on the NPs concentration and application time. Compared to carbon nanostructures such as single wall carbon nanotubes, super paramagnetic cobalt nanoparticles demonstrated higher specificity for RF absorption and heating. This work indicates a great potential of a new technology for tumor thermal ablation.
Single-wall carbon nanotubes (SWNTs) are potentially an attractive material for PV applications due to their many unique structural and electrical properties. SWNTs can be directly configured as energy conversion materials to fabricate thin-film solar cells, with nanotubes serving as both photogeneration sites and charge carriers collecting/transport layers. SWNTs can be modified into either p-type conductor through chemical doping (like thionyl chloride, or just exposure to air) or n-type conductor through polymer (like polyethylene imine) functionalization. The solar cells consist of either a semitransparent thin film of p-type nanotubes deposited on an n-type silicon wafer or a semitransparent thin film of n-type SWNT on p-type substrate to create high-density p-n heterojunctions between nanotubes and silicon substrate to favor charge separation and extract electrons and holes. The high aspect ratios and large surface area of nanotubes can be beneficial to exciton dissociation and charge carrier transport thus improving the power conversion efficiency.