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Practical Techniques in Molecular Biotechnology intends to familiarise students with the basics of the well-known experiments of molecular biotechnology and related courses like chemical biotechnology and cell biology. The content of the book will be useful in strengthening the basic skills and help students to apply the concepts to real-world problems. This book emphasises important concepts like bioanalytical techniques, biochemical analysis of proteins, recombinant DNA, and protein technology etc. The text will help students to understand the theoretical aspects of the techniques and provide experience with hands-on techniques to demonstrate practical troubleshooting and data analysis. The text is supported with diagrams, data, summaries for the quick recap and appendices with useful protocols and calculation methods.
To complete the audit cycle on compliance of MHA documentation (including MCA1 form at admission and 3 months, T2 form, SOAD request and T3 form authorization) on patients on section 3 staying 90 days and over in adult wards at Roseberry park hospital
In the initial audit, we collected data from all inpatients on section 3 staying 90 days and over, in Adult acute and rehab wards on Roseberry park hospital between the time period 28/10/19–04/11/19. Using a designated audit data collection tool, information was gathered from each patient's electronic record pertaining to the standards. The same method was used in re-audit where data were collected from all inpatients on section 3 staying 90 days and over in Adult acute wards on Roseberry park hospital between the time period 04/11/20–11/11/20. To note, the rehab ward at Roseberry park hospital was closed in Feb 2020. The data were analysed by the project lead.
In the initial audit, 16 patients records were identified as meeting criteria,out of these 7 (44%) patients were on acute wards and 9 (56%) at rehab ward. Where as in re-audit 5 patients records were identified as meeting criteria and all were on acute wards. Days in Hospital - Ranged from 120 days to 664 days, average being 295 days and median of 186 days in the initial audit compared to121 days to 290 days, average being 170 days and median of 150 days in the reaudit. Percentage of patients records with documented capacity assessment at admission and 3 months were same at 80% and 60% respectively in both audits.T2 form was completed in all consenting patients in both audits. SOAD request sent was recorded in only 1 (25%) patient in the reaudit, which was lower than the initial audit, where in SOAD request was sent in 7 (78%) patients but recorded in 5 (56%) of them. For patients lacking capacity, T3 form was documented only in 4 (45%) patients but T3 form authorisation was discussed with patient and evidenced in case notes in only 1(11%) case in the initial audit, where as in reaudit T3 form was not documented or discussed for any patient.
There needs to be improvement in MHA documentation for detained patients.
Myocardial fibrosis is associated with adverse events in idiopathic dilated cardiomyopathy. Cardiac MRI with late gadolinium enhancement can detect myocardial fibrosis. We evaluated the conditional survival of children and adolescents based on native T1 mapping (combined proton signal from myocytes and interstitium prior to contrast administration by the measurement of myocardial and blood relaxation time) as a means to assess myocardial fibrosis. This retrospective case–cohort over a 3-year period included all consecutive patients (aged ≤ 21 years) with advanced heart failure from dilated cardiomyopathy (echocardiographic left ventricular ejection fraction ≤ 45% and NYHA class ≥ 2) who underwent cardiac MRI.
Conditional survival (follow-up ≥ 6 months after cardiac MRI) was assessed to include NYHA functional class and time to event (death or heart transplantation). A total of 57 patients (mean age 11.7 ± 6.1 years; 58% male) had a median NYHA Class III (31/57) and median left ventricular ejection fraction 25% (20–38%). Survival data were available in 82% patients (46/57) and the crude mortality rate was 24% (11/46) and one patient (2%) underwent heart transplantation. The median native T1 was elevated at 1351 ms (95% CI 1332, 1394) and it showed no difference between the groups who survived to those who died. Performing a multilevel regression analysis on prognosis failed to predict 6-month conditional survival.
Background: Healthcare-associated infections (HAIs) are a major global threat to patient safety. Systematic surveillance is crucial for understanding HAI rates and antimicrobial resistance trends and to guide infection prevention and control (IPC) activities based on local epidemiology. In India, no standardized national HAI surveillance system was in place before 2017. Methods: Public and private hospitals from across 21 states in India were recruited to participate in an HAI surveillance network. Baseline assessments followed by trainings ensured that basic microbiology and IPC implementation capacity existed at all sites. Standardized surveillance protocols for central-line–associated bloodstream infections (CLABSIs) and catheter-associated urinary tract infections (CAUTIs) were modified from the NHSN for the Indian context. IPC nurses were trained to implement surveillance protocols. Data were reported through a locally developed web portal. Standardized external data quality checks were performed to assure data quality. Results: Between May 2017 and April 2019, 109 ICUs from 37 hospitals (29 public and 8 private) enrolled in the network, of which 33 were teaching hospitals with >500 beds. The network recorded 679,109 patient days, 212,081 central-line days, and 387,092 urinary catheter days. Overall, 4,301 bloodstream infection (BSI) events and 1,402 urinary tract infection (UTI) events were reported. The network CLABSI rate was 9.4 per 1,000 central-line days and the CAUTI rate was 3.4 per 1,000 catheter days. The central-line utilization ratio was 0.31 and the urinary catheter utilization ratio was 0.57. Moreover, 3,542 (73%) of 4,742 pathogens reported from BSIs and 868 (53%) of 1,644 pathogens reported from UTIs were gram negative. Also, 1,680 (26.3%) of all 6,386 pathogens reported were Enterobacteriaceae. Of 1,486 Enterobacteriaceae with complete antibiotic susceptibility testing data reported, 832 (57%) were carbapenem resistant. Of 951 Enterobacteriaceae subjected to colistin broth microdilution testing, 62 (7%) were colistin resistant. The surveillance platform identified 2 separate hospital-level HAI outbreaks; one caused by colistin-resistant K. pneumoniae and another due to Burkholderia cepacia. Phased expansion of surveillance to additional hospitals continues. Conclusions: HAI surveillance was successfully implemented across a national network of diverse hospitals using modified NHSN protocols. Surveillance data are being used to understand HAI burden and trends at the facility and national levels, to inform public policy, and to direct efforts to implement effective hospital IPC activities. This network approach to HAI surveillance may provide lessons to other countries or contexts with limited surveillance capacity.
Uttarakhand is an Indian state in the Himalayan foothills, a favored adventure destination in the country due to abundant natural beauty. However, the terrain has also conferred an increased risk of earthquakes, flash floods, and major road tragedies, resulting in as many as 8 major natural disasters in the state in the preceding 20 years. AIIMS Rishikesh, an autonomous central institute, has been entrusted to build a Level 1 Trauma Center in Uttarakhand, which would help improve the response, coordination, and hence outcome in mass casualty scenarios (MCSs).
As a step toward the achievement of this larger goal, a workshop on MCS and management was conducted by the Department of Trauma Surgery in collaboration with Rambam Hospital, Haifa. We hereby present our template for conducting MCS drills in low resource settings like ours and the lessons learnt.
Process, logistics, limitations, workforce, scheduling, overview, and report of the MCS drill conducted are discussed hereafter.
This template may be replicated by hospitals that intend to conduct similar MCS drills in low resource settings, realizing the real threat of MCS occurrence in our country at anytime.
Resistance to colistin, a last resort antibiotic, has emerged in India. We investigated colistin-resistant Klebsiella pneumoniae(ColR-KP) in a hospital in India to describe infections, characterize resistance of isolates, compare concordance of detection methods, and identify transmission events.
Retrospective observational study.
Case-patients were defined as individuals from whom ColR-KP was isolated from a clinical specimen between January 2016 and October 2017. Isolates resistant to colistin by Vitek 2 were confirmed by broth microdilution (BMD). Isolates underwent colistin susceptibility testing by disk diffusion and whole-genome sequencing. Medical records were reviewed.
Of 846 K. pneumoniae isolates, 34 (4%) were colistin resistant. In total, 22 case-patients were identified. Most (90%) were male; their median age was 33 years. Half were transferred from another hospital; 45% died. Case-patients were admitted for a median of 14 days before detection of ColR-KP. Also, 7 case-patients (32%) received colistin before detection of ColR-KP. All isolates were resistant to carbapenems and susceptible to tigecycline. Isolates resistant to colistin by Vitek 2 were also resistant by BMD; 2 ColR-KP isolates were resistant by disk diffusion. Moreover, 8 multilocus sequence types were identified. Isolates were negative for mobile colistin resistance (mcr) genes. Based on sequencing analysis, in-hospital transmission may have occurred with 8 case-patients (38%).
Multiple infections caused by highly resistant, mcr-negative ColR-KP with substantial mortality were identified. Disk diffusion correlated poorly with Vitek 2 and BMD for detection of ColR-KP. Sequencing indicated multiple importation and in-hospital transmission events. Enhanced detection for ColR-KP may be warranted in India.
In India, there is a lack of information about the adequate daily dose of vitamin D3 supplementation in school children. Hence, we undertook this study to evaluate the adequacy and efficacy of different doses of vitamin D3 in schoolchildren. A total of 1008 vitamin D-deficient (VDD) children, aged 6–16 years with serum 25-hydroxyvitamin D (25(OH)D) levels <50nmol/l, were cluster randomised into three groups (A-344, B-341 and C-232) for supplementation (600, 1000 and 2000 IU daily) of vitamin D3 under supervision for 6 months. Of the 1008 subjects who completed the study, 938 (93 %) were compliant. Baseline and post-supplementation fasting blood and urine samples were evaluated for Ca, phosphates, alkaline phosphatase, 25(OH)D and parathormone and urine Ca:creatinine ratio. The mean age of the subjects was 11·7 (sd 2·4) years, and the overall mean baseline serum 25(OH)D level was 24·3 (SD 9·5)nmol/l. Post-supplementation rise in serum 25(OH)D in compliant group was maximum with 2000 IU (70·0 (SD 30·0)nmol/l), followed by 1000 IU (46·8 (SD 22·5)nmol/l) and 600 IU (36·5 (SD 18·5)nmol/l), and serum 25(OH)D levels of ≥50nmol/l were achieved in 71·5, 81·8 and 92·9 % by groups A, B and C, respectively. Secondary hyperparathyroidism decreased from 31·7 to 8·4 % post-supplementation. Two participants developed hypercalciuria, but none developed hypercalcaemia. Children with VDD benefit maximum with the daily supplementation of 2000 IU of vitamin D3. Whether recommendations of 400 IU/d by Indian Council of Medical Research or 600 IU by Indian Academy of Pediatrics or Institute of Medicine would suffice to achieve vitamin D sufficiency in children with VDD remains debatable.
The paper describes the design and development of a low profile wide scanned conformal active 1 × 32 phased array antenna for Ku-band SATCOM applications. The realized antenna is diagonally polarized and covers full transmit frequency band (i.e. 13.75–14.5 GHz) of Ku band SATCOM. All the developed sub-systems of the antenna, i.e. conformal radiating array, conformal transmit module, manifold network, and beam steering unit are described. The VSWR of the antenna is better than 1.65 over the complete transmit frequency band. The antenna has the beam steering capability of ±60° in the array plane. Designed antenna is best suited for airborne applications, where antenna profile contributes considerable aero drag and RCS to the host platform.
The possible association between teat morphometric traits and subclinical mastitis (SCM) in dairy buffaloes was studied. Teat morphometric parameters, i.e. teat shape (bottle, conical, cylindrical, and others), teat-end shape (flat, round, and pointed), teat length (TL), teat diameter (TD), and teat-end to floor distance were measured before milking, but after proper milk let-down, in clinically healthy buffaloes (47 Murrah and 34 Nili-Ravi breeds). Subclinical mastitis was defined on the basis of bacteriology and somatic cell count (SCC) of quarter foremilk samples. A high proportion of cylindrical teats (40%) and pointed teat-ends (64·4%) was observed. Hind teats were longer and thicker than fore teats (P < 0·05). A significant breed effect was found with respect to teat shape, length and diameter (P < 0·05). Teats were mostly cylindrical (43·3 vs. 35·4%) and conical (34·2 vs. 30·8%) shaped, smaller (mean 8·2 vs. 9·5 cm) and thinner (mean 3·3 vs. 3·6 cm) in the Murrah breed compared with the Nili-Ravi breed. Teats that had ‘other’ shapes and were longer, wider, and placed closer to the floor were more associated with SCM (P < 0·05). Mean SCC was significantly higher (P < 0·05) in Nili-Ravi buffaloes, teat shapes classified as ‘others’, and quarters with SCM. Teat morphometric traits seem to be associated with indicators of udder health in buffaloes, thus, their inclusion in breeding programmes for selection against undesirable dairy type traits may be of value in reducing susceptibility to intramammary infections in Indian buffaloes.
This paper follows the progress made in India for research and farmer adoption of conservation agriculture (CA) since the publication of Erenstein (2012), who contested the idea that zero-till (ZT) establishment of wheat in rice–wheat systems could be further developed into full CA systems. Data presented in this paper show that research has successfully found solutions for both the wheat and rice phases of the rice–wheat systems of the Indo-Gangetic Plains (IGP) in the past 8 years. It shows that by finding solutions in both the rice and wheat phases, yields, water use efficiency and profits increased, while labour needs reduced. Indian scientists have also confirmed these benefits in participatory on-farm research in various locations, both east and west regions of the IGP. Farmers see for themselves through experimentation that they get higher yields with less cost and with more efficient use of inputs and water. A key factor has been the development of improved seed drills with the help of Indian private sector manufacturers of agricultural equipment. Indian scientists have also successfully conducted CA research on several other crops and in other regions besides the IGP. The paper shows that it is better to introduce parts of the CA management practices in a step-wise fashion first, rather than introducing the entire package at once since farmers first have to test and evaluate a new technology to understand how it benefits them personally before they will adopt it. The paper concludes that in the rice–wheat systems of South Asia, adoption of CA is indeed possible to achieve although it is still a work in progress. CA is a complex technology package and it takes time to overcome all of the contested issues mentioned in Erenstein (2012).
Information on density and abundance of globally threatened species such as tigers Panthera tigris is essential for effective conservation as well as to evaluate the success of conservation programmes. We monitored tigers in Parsa Widlife Reserve, Nepal, using camera traps, in 2013, 2014 and 2016. Once believed to be a sink for tigers from adjacent Chitwan National Park, Parsa now provides a new hope for tigers. Spatially explicit capture–recapture analysis over 3 survey years revealed an increase in tiger density from 0.78 to 1.38 individuals per 100 km2 from 2013 to 2016. The tiger abundance was estimated to be seven (6–13), 11 (10–16) and 17 (17–20) in 2013, 2014 and 2016, respectively. Resettlement of communities from the core area, reduced anthropogenic pressure, and improved security have made Parsa Wildlife Reserve a suitable habitat for tigers. Tiger abundance increased considerably within a 5 km radius of the evacuated village sites, from two in 2013 to eight in 2014 and 10 in 2016. Population turnover has remained moderate (< 30% per year), with persistence of individuals in multiple years. Dispersing tigers from Chitwan's source population accounted for a large portion (c. 40%) of the tigers detected in Parsa. Conservation efforts along with annual monitoring should be continued in Parsa to sustain the increase and monitor the persistence of tigers. The Chitwan–Parsa complex should be managed as a single ecological unit for conserving the Endangered tiger and other wide-ranging species.
Earthquakes are a major natural calamity with pervasive effects on human life and nature. Similar effects are mimicked by man-made disasters such as fuel crises and power outages in developing countries. Natural and man-made disasters can cause intangible human suffering and often leave scars of lifelong psychosocial damage. Lessons from these disasters are frequently not implemented. The main objective of this study was to review the effects of the 2015 earthquakes, fuel crisis, and power outages on the health services of Nepal and formulate recommendations for the future. The impacts of earthquakes on health can be divided into immediate, intermediate, and long-term effects. Power outages and fuel crises have health hazards at all stages. It is imperative to understand the temporal effects of earthquakes, because the major needs soon after the earthquake (emergency care) are vastly different from long-term needs such as rehabilitation and psychosocial support. In Nepal, the inadequate and nearly nonexistent specialized health care at the peripheral level claimed many lives during the earthquakes and left many people disproportionately injured. Preemptive strategies such as mobile critical care units at primary health centers, intensive care training for health workers, and alternative plans for emergency care must be prioritized. Similarly, infrastructural damage led to poor sanitation, and alternative plans for temporary settlements (water supply, food, settlements logistics, space for temporary settlements) must be in place where the danger of disease outbreak is imminent. While much of these strategies are implementable and are often set as priorities, long-term effects of earthquakes such as physical and psychosocial supports are often overlooked. The burden of psychosocial stresses, including depression and physical disabilities, needs to be prioritized by facilitating human resources for mental health care and rehabilitation. In addition, inclusion of mental health and rehabilitation facilities in government health care services of Nepal needs to be prioritized. Similarly, power outages and fuel crises affect health care disproportionately. In the current context where permanent solutions may not be possible, mitigating health hazards, especially cold chain maintenance for essential medicines and continuation of life-saving procedures, are mandatory and policies to regulate all health care services must be undertaken. (Disaster Med Public Health Preparedness. 2017;11:625–632)
This paper presents a high gain, wideband circularly polarized (CP) antenna. High gain of the antenna is achieved by employing a frequency selective surface (FSS) as a reflector. The antenna is a coplanar waveguide-fed structure with a modified L-shaped radiating patch. The unit element of the FSS is formed by connecting two modified dipoles at an angle of 90°. The antenna with reflector has a measured impedance bandwidth of 74.3% (2.2–4.8 GHz) and a 3-dB axial ratio bandwidth (ARBW) of 62% (2.2–4.18 GHz). The maximum boresight gain of the proposed antenna with reflector is 7.1 dB at 3.4 GHz. The radiation patterns of the antenna with the FSS are also measured and compared with simulated patterns. The various aspects of effect of FSS on CP antenna performance are also discussed.
An ultra-wideband (UWB) slot antenna for diversity applications is introduced. The overall structure of the antenna consists of two similar coplanar waveguide (CPW)-fed stepped rectangular slots placed in an orthogonal position. The slots are asymmetric with respect to their placement in the ground plane. The CPW feeds are double stepped and terminated on hexagonal patches for better impedance matching. A wide impedance bandwidth (measured) from 3 to 12 GHz with an isolation better than 15 dB is obtained with this antenna. To improve the isolation, the design is modified and an I-shaped slot strip is introduced between the two slot antennas. With this, the isolation is brought about 25 dB of most of the band, while the impedance bandwidth remains the same (2.8–12 GHz for port 1, measured and 2.9–12 GHz for port 2, measured). The far-field radiation patterns are also measured and a peak gain of about 5 dBi is obtained. Finally, the diversity parameters such as envelope correlation coefficient and capacity loss are calculated and found to have low values. The antenna is expected to be useful for UWB diversity applications with good isolation.
In this paper, a microstrip fed, L-shape slot antenna for dual polarization is proposed. The two arms of the slot generate electric fields of orthogonal polarizations. By properly sectioning the slot and the feed line, ultra wideband (UWB) behavior is obtained. The measured impedance bandwidth (S11< −10 dB) is more than 8.6 GHz (112%) and 8.2 GHz (104%) for Port 1 and Port 2, respectively. The measured isolation is better than 25 dB over most of the band. The aperture field distribution justifies the dual polarized nature. A modified version which implements a band-notch over 5.1–5.85 GHz wireless local area network (WLAN) band is also presented. With a compact, single substrate design, the antenna can be useful in MIMO transmission systems, polarimetric UWB radar, high performance microwave imaging, and other future wireless communications devices.
A compact slot antenna for high-gain ultra wideband applications is presented. The slot is asymmetrically cut in the ground plane and is a combination of two rectangles. A hexagonal patch with two stepped coplanar waveguide-feed is used to excite the slot. The capacitive reactance of the hexagonal patch is neutralized by the inductive reactance created by the asymmetric slot and results into wider impedance matching. The measured impedance bandwidth of the proposed antenna is 11.85 GHz (2.9–14.75 GHz). The radiation patterns of the proposed antenna are found to be omni-directional in the H-plane and bi-directional in the E-plane. To enhance the gain of the antenna, a compact three-layer frequency selective surface (FSS) is used as a reflector. The overall thickness of the FSS is 3.5 mm. There is 4–5 dBi improvement in antenna gain after application of the FSS. The measured and simulated results are in good agreement.
To maximize heterosis, it is important to understand the genetic diversity of germplasm and associate useful phenotypic traits such as fertility restoration for hybrid rice breeding. The objectives of the present study were to characterize genetic diversity within a set of rice germplasm groups using coefficient of parentage (COP) values and 58 simple sequence repeat (SSR) markers for 124 genotypes having different attributes such as resistance/tolerance to various biotic and abiotic stresses. These lines were also used for identifying prospective restorers and maintainers for wild abortive-cytoplasmic male sterile (CMS) line. The mean COP value for all the lines was 0.11, indicating that the genotypes do not share common ancestry. The SSR analysis generated a total of 268 alleles with an average of 4.62 alleles per locus. The mean polymorphism information content value was 0.53, indicating that the markers selected were highly polymorphic. Grouping based on COP analysis revealed three major clusters pertaining to the indica, tropical japonica and japonica lines. A similar grouping pattern with some variation was also observed for the SSR markers. Fertility restoration phenotype based on the test cross of the 124 genotypes with a CMS line helped identify 23 maintainers, 58 restorers and 43 genotypes as either partial maintainers or partial restorers. This study demonstrates that COP analysis along with molecular marker analysis might encourage better organization of germplasm diversity and its use in hybrid rice breeding. Potential restorers identified in the study can be used for breeding high-yielding stress-tolerant medium-duration rice hybrids, while maintainers would prove useful for developing new rice CMS lines.