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While industry platforms can transform industries and drive the digital economy, little guidance exists to help managers decide which industry platform to join. Derived from industry research, we propose a six-step return-on-participa- tion (ROP) method that enables managers to clearly and logically review how their firms are affected by a platform, what the benefits are, how current and future var- iable and fixed costs vary, as well as the often-hidden joining costs. We suggest this technique could also be used by managers to compare competing platforms and by platform owners to evaluate the attractiveness of their offerings.

We have sequenced the chloroplast genome of red spruce (Picea rubens) for the first time using the single-end, short-reads (44 bp) Illumina sequences, assembled and functionally annotated it, and identified simple sequence repeats (SSRs). The contigs were assembled using SOAPdenovo2 following the retrieval of chloroplast genome sequences using the black spruce (Picea mariana) chloroplast genome as the reference. The assembled genome length was 122,115 bp (gaps included). Comparatively, the P. rubens chloroplast genome reported here may be considered a near-complete draft. Global genome alignment and phylogenetic analysis based on the whole chloroplast genome sequences of Picea rubens and 10 other Picea species revealed high sequence synteny and conservation among 11 Picea species and phylogenetic relationships consistent with their known classical interrelationships and published molecular phylogeny. The P. rubens chloroplast genome sequence showed the highest similarity with that of P. mariana and the lowest with that of P. sitchensis. We have annotated 107 genes including 69 protein-coding genes, 28 tRNAs, 4 rRNAs, few pseudogenes, identified 42 SSRs, and successfully designed primers for 26 SSRs. Mononucleotide A/T repeats were the most common followed by dinucleotide AT repeats. A similar pattern of microsatellite repeats occurrence was found in the chloroplast genomes of 11 Picea species.

The presence of a disease continuum in inflammatory arthritis (IA) is a recognised concept, with distinct stages from at-risk stage (presence of anti citrullinated-peptide autoantibody) to diagnosis of rheumatoid arthritis (RA), including therapy-induced remission. Despite T-cell dysregulation being a key feature of RA, there are few reports of T-cell phenotyping along the IA-continuum. We investigated the disturbances of naïve, regulatory and inflammation related cell (IRC) CD4+ T-cell subsets in 705 individuals across the IA-continuum, developing a simple risk-score (summing presence/absence of a risk-associated with a subset) to predict progression from one stage to the next. In 158 at-risk individuals, the 3 subsets had individual association with progression to IA and the risk-score was highly predictive (p

Objectives: To identify predictors of remission and disease activity patterns in patients with rheumatoid arthritis (RA) using individual participant data (IPD) from clinical trials. Methods: Phase II and III clinical trials completed between 2002 and 2012 were identified by systematic literature review and contact with UK market authorisation holders. Anonymised baseline and follow-up IPD from non-biological arms were amalgamated. Multiple imputation was used to handle missing outcome and covariate information. Random effects logistic regression was used to identify predictors of remission, measured by the Disease Activity Score 28 (DAS28) at 6 months. Novel latent class mixed models characterised DAS28 over time. Results: IPD of 3290 participants from 18 trials were included. Of these participants, 92% received methotrexate (MTX). Remission rates were estimated at 8.4%(95%CI 7.4%to9.5%) overall, 17%(95%CI 14.8%to19.4%) for MTX-naïve patients with early RA and 3.2% (95% CI 2.4% to 4.3%) for those with prior MTX exposure at entry. In prior MTX-exposed patients, lower baseline DAS28 and MTX reinitiation were associated with remission. In MTX-naïve patients, being young, white, male, with better functional and mental health, lower baseline DAS28 and receiving concomitant glucocorticoids were associated with remission. Three DAS28 trajectory subpopulations were identified in MTX-naïve and MTX-exposed patients. A number of variables were associated with subpopulation membership and DAS28 levels within subpopulations. Conclusions: Predictors of remission differed between MTX-naïve and prior MTX-exposed patients at entry. Latent class mixed models supported differential non-biological therapy response, with three distinct trajectories observed in both MTX-naïve and MTX-exposed patients. Findings should be useful when designing future RA trials and interpreting results of biomarker studies.

The expression of mRNAs encoding the three GABAA receptor subunits that are associated with the most abundant benzodiazepine-sensitive GABAA receptor in adult cortex, that is, the α1, β2, and γ2 subunits, was studied in rat cortex during pre- and postnatal development by means of in situ. hybridization γ2 and β2 mRNAs become detectable in neocortex at gestational day 16 (GD16), α1, at GD18. γ2 mRNA exhibits the highest level of expression at early ages, while α1, mRNA levels are low. β2 mRNA rises steeply during the last days of gestation. Around birth, it shows the highest expression of the three subunits studied in cortex, and increases further until postnatal day 15 (PD15). The expression of α1, subunit mRNA also increases markedly shortly before birth and accelerates between PD8 and PD15, when it reaches higher levels than the other two subunits. Following the initial high expression, γ2 mRNA increases gradually and slowly until PD25. During prenatal development, highest expression of all three subunit mRNAs is found in the upper layers of cortex, that is, cortical plate and marginal zone. The subplate layer does not start to express GABAA receptor subunit mRNAs until GD18. At birth, all developing layers of the cortex express mRNAs for the three subunits, except the marginal zone. Highest levels are found in the upper part of the cortical plate. At the end of the first postnatal week (PD8), the laminar distribution of mRNA expression in neocortex becomes more differentiated. For all three subunit mRNAs, highest expression is then observed in neuron-like cells in layer IV in the granular areas, and over layers III and upper V in agranular areas. Subsequently, between PD8 and PD25, increasing levels of expression are observed over the pyramidal cell layer V. This regionally differentiated, developmental pattern suggests a close relationship between development of GABAA receptor subunits, ingrowth of thalamocortical projections, and maturation of neocortical circuitry

There are about 156 operations described forhypospadias. The sheer number of proceduresindicates that no single procedure is standardfor hypospadias. We report our series of 20patients operated for hypospadias by Snodgrassprocedure. The technical details of the proce-dure and post-operative management protocolis discussed.

© 2016 IEEE. Cosimulation platforms are necessary to study the interactions of complex systems integrated in future smart grids. The Virtual Grid Integration Laboratory (VirGIL) is a modular cosimulation platform designed to study interactions between demand-response (DR) strategies, building comfort, communication networks, and power system operation. This paper presents the coupling of power systems, buildings, communications, and control under a master algorithm. There are two objectives: first, to use a modular architecture for VirGIL, based on the functional mockup interface (FMI), where several different modules can be added, exchanged, and tested; and second, to use a commercial power system simulation platform, familiar to power system operators, such as DIgSILENT PowerFactory. This will help reduce the barriers to the industry for adopting such platforms, investigate and subsequently deploy DR strategies in their daily operation. VirGIL further introduces the integration of the quantized state system (QSS) methods for simulation in this cosimulation platform. Results on how these systems interact using a real network and consumption data are also presented.

BACKGROUND: Existing bowel preparation scales (BPS) are limited in their ability to predict interval to next colonoscopy. The US Multi-Society Task Force (MSTF) recommends screening or surveillance colonoscopies be repeated within the year if the preparation does not allow for detection of polyps greater than 5 mm in size. AIMS: To assess reliability and validity of an auditable application of the MSTF in comparison with the Boston BPS (BBPS). METHODS: We developed an auditable application of the MSTF guidelines which we termed the Montreal Bowel Preparation Scale (MBPS). We compared this with the BBPS using a total cut-off score of 6 with each segment score ≥2 (BBPS 2–6). In sensitivity analyses, we applied the MBPS using a cut-off of 3mm rather than 5mm, and also assessed the BBPS using an adequacy threshold of total score ≥5 (BBPS 5). Video recordings of 83 colonoscopies (8 for intra-rater agreements) were independently evaluated by nine physicians trained to use the different scales. Weighted kappas quantified intra- and inter-rater agreements. Intra class correlations were used to assess agreement of the BBPS as a continuous scale. Associations between scores and clinical outcomes were assessed. RESULTS: The BBPS 2–6 and 5mm MBPS showed moderate to substantial intra-rater agreements (κ=0.44–0.63 and κ=0.50–0.53, respectively), while inter-rater agreements were only fair to moderate and slight to moderate (κ=0.25–0.48 and κ=0.19–0.50, respectively). Similar results were noted using alternate thresholds of BBPS 5 and 3mm MBPS. No significant associations were found between scores and clinical outcomes. CONCLUSIONS: For all scales, intra-rater kappas were superior to inter-rater values with the latter reflecting at best moderate agreement. This modest performance may reflect the dichotomized interpretation of the scales (adequate vs inadequate) contrary to previous studies which compared scores assessed as continuous variables. Further validation studies of existing ordinal bowel preparation scales should aim to assess reliability in a categorical manner based on proposed adequacy thresholds in order to determine optimal interpretation with regards to interval to next colonoscopy. FUNDING AGENCIES: None

Background & Objective: Metallo-β-lactamases (MBLs) are metalloenzymes of Ambler class B and are resistant to clavulanic acid.. They require zinc as co-factor for enzymatic activity and their activity is inhibited by ethylene diamine tetra acetic acid(EDTA) and other metal ion chelating agents. The first plasmid-mediated MBL was reported in Pseudomonas aeruginosa in Japan in 1991. Since then many countries including few reports from India are available regarding the prevalence of MBLs. The present study was conducted to determine the prevalence of MBLs in Pseudomonas spp. and Acinetobacter spp. Methods: A total number of 2912 clinical isolates of Pseudomonas spp. (n=2162) and Acinetobacter spp. (n=750) obtained over a period of one year, were screened for MBL production by CDST & DDST. Results: A total of 325 out of 2912 isolates were positive for MBL production; of which 247 (11.42%) and 78(10.40%) were for Pseudomonas spp and Acinetobacter spp. respectively. Conclusion: MBL producing Pseudomonas aeruginosa and Acinetobacter baumannii group are present in this institution, although in low prevalence. However, to prevent the increase in the incidence of these multidrug resistant organisms and to prevent their dissemination, it is important to detect them and make judicious use of antibiotics based on their susceptibility patterns.

32nd European Photovoltaic Solar Energy Conference and Exhibition; 2135-2137, Indian climate is broadly divided into 4 climatic zones, Hot & dry, Hot & humid, Composite and cold & Cloudy. Most of the area comes under composite climate [1]. Further the performance of SPV power plants depends on the site, PV Module technology and load wise inverters/power converters efficiency. So with the change of the technology and site, weighted efficiency of the inverter also varies. This paper coins the new efficiency term as Indian© efficiency based on irradiation distribution similar as European and Californian efficiency which is suitable to Indian climatic condition. To showing technology and site dependency the study also compares the Indian© weighted efficiency of a sample inverter with weighted efficiency using the generation energy weighted factors of a-si, multi-si, HIT and CdTe technology module. It is found that same inverter performs best with CdTe Modules in the composite climate zone of India.

32nd European Photovoltaic Solar Energy Conference and Exhibition; 2158-2160, This paper compares the performances of three standalone inverters used in SPV applications, having three output configurations, viz. transformer less (TL), EI core and toroid core (TC) transformers. The performance is analyzed in terms of efficiency, harmonics generation, crest factor (CF), power factor (PF) and weighted factor for efficiency for linear (LN) and non-linear (NL) type of loads. It is observed that for linear loads the weighted factor of efficiency more than 87%, for TL, EI and TC are 0.85, 0.75 & 0.55 correspondingly whereas for Nonlinear load weighted factor for efficiency more than 85% are 0.80, 0.75 and 0.35 respectively. It has been also observed that in TL inverter distortion in voltage (Uthd) and variation in crest factor (CF) is comparatively less than rest of two other configurations. Further the study also gives the approach for selection of suitable topology of inverter based upon loads requirement.

Motivated mainly by certain interesting recent extensions of the Gamma, Beta and hypergeometric functions, we introduce here new extensions of the Beta function, hypergeometric and confluent hypergeometric functions. We systematically investigate several properties of each of these extended functions, namely their various integral representations, Mellin transforms, derivatives, transformations, summation formulas and asymptotics. Relevant connections of certain special cases of the main results presented here are also pointed out., 14 pages, 0 figures

Study of Variations in the Electron Desity Profiles and the Electrojet Irregularities caused by the Solar Eclipse

Triggering of Ionospheric Irregularities by the Solar Eclipse

CONTEXT: Parental anxiety and apprehension is related to inadequate knowledge of fever and febrile convulsion. AIMS: To study the knowledge, attitude, and practices of the parents of children with febrile convulsions. SETTINGS AND DESIGN: Prospective questionnaire based study in a tertiary care centre carried over a period of one year. SUBJECTS AND METHODS: 140 parents of consecutive children presenting with febrile convulsion were enrolled. STATISTICAL ANALYSIS USED: Chi-square test. RESULTS: 83 parents (59.3%) could not recognise the convulsion; 90.7% (127) did not carry out any intervention prior to getting the child to the hospital. The commonest immediate effect of the convulsion on the parents was fear of death (n= 126, 90%) followed by insomnia (n= 48, 34.3%), anorexia (n= 46, 32.9%), crying (n= 28, 20%) and fear of epilepsy (n= 28, 20%). Fear of brain damage, fear of recurrence and dyspepsia were voiced by the fathers alone (n= 20, cumulative incidence 14.3%). 109 (77.9%) parents did not know the fact that the convulsion can occur due to fever. The long-term concerns included fear of epilepsy (n= 64, 45.7%) and future recurrence (n= 27, 19.3%) in the affected child. For 56 (40%) of the parents every subsequent episode of fever was like a nightmare. Only 21 parents (15%) had thermometer at home and 28 (20%) knew the normal range of body temperature. Correct preventive measures were known only to 41 (29.2%). Awareness of febrile convulsion and the preventive measures was higher in socio-economic grade (P< 0.05). CONCLUSIONS: The parental fear of fever and febrile convulsion is a major problem with serious negative consequences affecting daily familial life.

Internal herniation of small bowel accounts for about 1% of all the patients with intestinal obstruction. Fifty percent of the patients with paraduodenal hernia will have bowel obstruction. Left paraduodenal hernia resulting from abnormal rotation of the midgut during embryonic development is the most common form of congenital internal hernia. A case of a young male presenting with chronic abdominal pain due to left paraduodenal hernia is being reported. A correct preoperative diagnosis of left paraduodenal hernia was made on computerised tomography (CT), and the patient was managed by laparoscopic surgery. The role of imaging in preoperative diagnosis is being highlighted with a brief review of literature.

Neuroblastoma is the most common solid extracranial tumor of childhood. Even though >25% of presentations are orthopaedic in nature, ranging from a limp to lower limb paralysis, neuroblastoma is a rare cause of limping in childhood and can therefore be easily missed by the admitting orthopaedic surgeon. Four cases of metastatic neuroblastoma are reported who all presented with hip pain within the last 3 years at Royal Manchester Children's Hospital. They all posed a diagnostic dilemma and an alternative diagnosis was initially made. A simple screening examination of the abdomen after ultrasonographic hip examination for sepsis would have led to an earlier diagnosis in all 4 cases. We suggest that including the abdomen in children undergoing a hip sonographic examination in those who are slightly atypical in nature or have indications of malignancy may lead to an early diagnosis of this rare cause of hip pain. Copyright © 2013 by Lippincott Williams & Wilkins. 33 4 e45 e51

This communication reports prenatal diagnosis of partial trisomy 21 resulting from balanced translocation (21q;22q) in a 36-year-old gravida 7, para 1 woman. The lady had only one living child and there was history of recurrent spontaneous first trimester abortions. Triple test was abnormal in the present conception. In addition, the woman had pericentric inversion of chromosome 9, a finding scarcely reported previously with carrier status in Indian literature. A few cytogeneticists consider this as a normal variant. However, many reports in the recent literature link pericentric inversion of chromosome 9 with infertility, recurrent abortions and a number of other abnormal conditions. A review of the relevant literature pertinent to the case is provided.

Morgagni hernia is a rare diaphragmatic hernia accounting for only 2% of the congenital diaphragmatic defects. A case of Morgagni hernia was diagnosed radiologically in a 12-months-old male with Down syndrome, with recurrent respiratory distress and chest deformity. The 2-dimensional echocardiography was normal. The diagnosis of Morgagni hernia was confirmed by barium studies. The patient underwent a corrective surgery at 18 months of age following which his symptoms subsided. Literature review revealed only 18 cases of Morgagni hernia with Down syndrome reported till date, with age of presentation varying from neonatal age group to 12 years of age. The mode of presentations varied from asymptomatic detection to severe respiratory distress. The possible mechanism of association and its clinical implication has been discussed. The case emphasises a need for diaphragmatic hernia to be looked for as a possible cause of respiratory distress in Down syndrome.

Autosomal translocations are rare in the patients with ovarian dysgenesis. An 18-year-old female who presented with primary amenorrhoea had hypergonadotropic hypogonadism and streak ovaries with hypoplastic uterus. Karyotype analysis revealed a balanced autosomal translocation involving chromosomes 1 and 11. The probable role of autosomal translocations in ovarian dysgenesis has been discussed.

Enteric fever is a common infectious disease of the tropical world, about 80% of these cases occur in Asian countries. Enteric fever presenting with isolated cerebellar ataxia or nephritis is rare. We report three cases of enteric fever that presented with these complications. Isolated cerebellar ataxia usually occurs in the second week, whereas in our cases it presented within first four days of fever. The common complications of enteric fever related to the urinary tract are cystitis, pyelitis, and pyelonephritis. Glomerulonephritis is uncommon. Most patients with enteric glomerulonephritis present with acute renal failure, hypertensive encephalopathy, or nephritic syndrome. In comparison, our case had milder manifestations. All three patients were treated with parenteral ceftriaxone and showed a prompt recovery.

Neurofibromatosis (NF), Noonan syndrome (NS), and LEOPARD syndrome are all autosomal dominant conditions, each being a distinct clinical entity by itself. Rarely, one encounters cases with features of NF and NS and is termed as the ′Neurofibromatosis-Noonan syndrome′ (NF-NS). The authors report a clinical dilemma with major clinical features of the NF-NS syndrome and LEOPARD syndrome co-existing in the same patient. Also, features of Noonan syndrome and LEOPARD syndrome are compared with the case reported.

We report on the emission of water vapor from biofuel combustion. Concurrent measurements of carbon monoxide and carbon dioxide are used to scale the concentrations of water vapor found, and are compared to carbon in the biofuel. Fuel types included hardwood (oak and African musasa), softwood (pine and spruce, partly with green needles), and African savanna grass. The session-averaged ratio of H2O to the sum of CO and CO2 in the emissions from 16 combustion experiments ranged from 1.2 to 3.7 on average, indicating the presence of water that is not chemically bound. This biofuel moisture content ranged from 33% in the dry African hardwood, musasa, to 220% in fresh pine branches with needles. The moisture content from fresh biofuel contributes distinctly to the water vapor in biomass burning emissions, and its influence on meteorology needs to be evaluated.

The project addresses the contribution of vegetation fires to the local trace gas and particle budgets of the troposphere and the lower stratosphere, their direct and indirect radiative impact, their impact on cloud formation and chemical and microphysical processes in clouds

Scleredema adultorum is a rare connective tissue disorder reported usually following streptococcal infection, influenza, measles, and mumps. It has been reported occasionally following trauma and tuberculous lymphadenitis. This is a report of scleredema adultorum developing after chicken pox in an eight-year-old male child. The diagnosis was established by characteristic picture on skin biopsy using special stain. The patient had a benign course and a spontaneous recovery in two weeks. The case has been reported as the first case of scleredema adultorum developing after chicken pox.

Prenatal exposure to benzodiazepines (BDZ) can cause behavioral dysfunctions both in humans and in experimental animals. In addition, prolonged impairment of cellular immune functions is found in rats after low dose BDZ exposure (e.g., diazepam 1.25 mg/kg/day) during part of fetal life [gestational days (GD) 14-20]. Analysis of diazepam and its metabolites in maternal and fetal tissues revealed that in this rat model the drug is no longer present at birth, which excludes direct effects of diazepam during the postnatal period. The main target of BDZ in brain, the GABAA receptor complex, is structurally and functionally heterogeneous. Besides alpha- and beta-subunits, gamma 2- or gamma 3-subunit should be coexpressed for a fully functional BDZ response. Signals of mRNAs encoding for alpha 1, beta 2 and gamma 2 are detected in fetal rat spinal cord and lower brainstem by GD 14 and reach telencephalic regions in later fetal life, reminiscent of BDZ receptor ontogeny. Regional subunit distribution differs from the adult brain, one interesting feature being a preponderance of gamma 2 mRNA throughout fetal life. Since subunit composition influences the sensitivity to BDZ, these data suggest that prenatal effects of BDZ depend upon regional subunit compositions present at different developmental stages. The delayed depression of cellular immune responses in prenatally BDZ-exposed rat offspring during the first 2 postnatal months is accompanied by various changes in immune cell biology. Binding characteristics of the peripheral (omega 3) type BDZ receptor are altered until adulthood (8 weeks). Membranes of spleen cell preparations containing mainly lymphocytes exhibit a decrease of affinity for the peripheral ligand [3H]PK11195, splenic macrophage preparations a decrease of maximal binding capacity. Various defects in cytokine production by macrophages and T lymphocytes were observed: Mitogen-stimulated release of macrophage-derived tumor necrosis factor-alpha (TNF-alpha) and of the T cell-derived interleukin-2 (IL-2) was drastically reduced at 2 and 4 weeks of life and recovered in young adulthood, exhibiting the same time course of depression as lymphocyte proliferation in response to immune stimuli. Interleukin-6 (IL-6) release remained diminished until adulthood. In female offspring, additional alterations were found in splenic noradrenaline turnover after immune stimulation. The mechanisms underlying the breakdown of the cytokine network in prenatally diazepam-exposed offspring, and the long-term consequences are as yet unknown.

A case of parkinsonism is reported in a 5-years-old male child following prolonged use of chloroquine. The patient presented with reduced spontaneous movements and speech with an expressionless face and a parkinsonian gait but no tremors. His investigations including CT scan brain, CSF study and serum ceruloplasmin were normal. Chloroquine was discontinued and the patient was started on oral trihexyphenidyl. The patient showed gradual recovery and the drug was successfully withdrawn. The toxic manifestations were only transient and reversible.

Contains fulltext : 244566.pdf (Publisher’s version ) (Closed access) BACKGROUND AND AIMS: The case-mix of patients with intestinal failure due to short bowel syndrome (SBS-IF) can differ among centres and may also be affected by the timeframe of data collection. Therefore, the ESPEN international multicenter cross-sectional survey was analyzed to compare the characteristics of SBS-IF cohorts collected within the same timeframe in different countries. METHODS: The study included 1880 adult SBS-IF patients collected in 2015 by 65 centres from 22 countries. The demographic, nutritional, SBS type (end jejunostomy, SBS-J; jejuno-colic anastomosis, SBS-JC; jejunoileal anastomosis with an intact colon and ileocecal valve, SBS-JIC), underlying disease and intravenous supplementation (IVS) characteristics were analyzed. IVS was classified as fluid and electrolyte alone (FE) or parenteral nutrition admixture (PN). The mean daily IVS volume, calculated on a weekly basis, was categorized as 3 L/day. RESULTS: In the entire group: 60.7% were females and SBS-J comprised 60% of cases, while mesenteric ischaemia (MI) and Crohn' disease (CD) were the main underlying diseases. IVS dependency was longer than 3 years in around 50% of cases; IVS was infused ≥5 days/week in 75% and FE in 10% of cases. Within the SBS-IF cohort: CD was twice and thrice more frequent in SBS-J than SBS-JC and SBS-JIC, respectively, while MI was more frequent in SBS-JC and SBS-JIC. Within countries: SBS-J represented 75% or more of patients in UK and Denmark and 50-60% in the other countries, except Poland where SBS-JC prevailed. CD was the main underlying disease in UK, USA, Denmark and The Netherlands, while MI prevailed in France, Italy and Poland. CONCLUSIONS: SBS-IF type is primarily determined by the underlying disease, with significant variation between countries. These novel data will be useful for planning and managing both clinical activity and research studies on SBS.