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Antibiotics play a critical role in neonatal sepsis but excessive use is associated with adverse outcomes and the current prescribing rates of antibiotics are unacceptably high.To reduce antibiotic over-use in preterm neonates by implementing an antibiotic stewardship programme using a quality improvement (QI) initiative.This study was conducted at a neonatal intensive care unit in a resource-limited setting. The reasons for antibiotic over-use were analysed and an antibiotic stewardship programme was implemented by using a QI initiative. The duration of the QI was a 1-month baseline phase followed by 3 months of implementation which was undertaken in the form of Plan-Do-Study-Act (P-D-S-A) cycles. The sustainment phase was observed for 2 months. All neonates admitted to the preterm unit were included. The outcome measure was the antibiotic usage expressed as days of therapy (DOT)/1000 patient days.In the baseline phase, DOT/1000 patient days was 1464 which fell to 706, 511, and 442 DOT/1000 patient days, respectively, over 3 months, resulting in a 65% reduction in antibiotic usage. This was achieved by a combination of efforts directed towards defining the conditions for no antibiotics, revising existing antibiotic policy, stopping orders at 48 hours, de-escalation to the narrowest spectrum antibiotic, stopping prophylactic antifungal agents and limited use of broad-spectrum antibiotics. The results were achieved without an increase in culture-positive sepsis or mortality.Implementation of a tailored antibiotic stewardship programme through a QI initiative was effective and safe in reducing antibiotic use in preterm neonates in a resource-limited setting.AIIMS, All India Institute of Medical Sciences; DOT, days of therapy; HIC, high-income countries; ICMR, Indian Council of Medical Research; LMIC, low- to middle-income countries; LOS, late-onset sepsis; NICU, neonatal intensive care unit; NNF, National Neonatology Forum; P-D-S-A, plan-do-study-act; QI, quality improvement; SNCU, Special newborn care unit.

Wastewater treatment plant (WWTP) reduces environmental load by improving the quality of effluent sewage water. A wastewater treatment plant during its operation, consumes energy for circulation an...

A comparative study of aging and a combined treatment of short annealing and aging on mechanical properties and microstructure of cryorolled (CR) Al 6061 alloy is investigated in the present work by using tensile tests, hardness tests, electron backscattered diffraction and transmission electron microscope. The pre-CR solid solution treatment combined with post-CR short annealing (200°C, 5 min) followed by aging treatment (100°C, 57 h) of the Al 6061 alloy showed an improved ductility and well defined ultrafine grain structure as compared to the samples subjected to pre-CR solid solution treatment followed by post-CR aging treatment (100°C, 60 h).

In this paper, we provide the first demonstration that a humanoid robot can learn to walk directly by imitating a human gait obtained from motion capture (mocap) data without any prior information of its dynamics model. Programming a humanoid robot to perform an action (such as walking) that takes into account the robot's complex dynamics is a challenging problem. Traditional approaches typically require highly accurate prior knowledge of the robot's dynamics and environment in order to devise complex (and often brittle) control algorithms for generating a stable dynamic motion. Training using human mocap is an intuitive and flexible approach to programming a robot, but direct usage of mocap data usually results in dynamically unstable motion. Furthermore, optimization using high-dimensional mocap data in the humanoid full-body joint space is typically intractable. We propose a new approach to tractable imitation-based learning in humanoids without a robot's dynamic model. We represent kinematic informati...

Complex cells in primary visual cortex exhibit highly nonlinear receptive field properties such as phase-invariant direction selectivity and antagonistic interactions between individually excitatory stimuli. Traditional models assume that these properties are governed by the outputs of antecedent simple cells, but these models are at odds with studies showing that complex cells may receive direct inputs from the lateral geniculate nucleus (LGN) or can be driven by stimuli that fail to activate simple cells. Using a biophysically detailed model of recurrently connected cortical neurons, we show that complex cell-like direction selectivity may emerge without antecedent simple cell inputs, as a consequence of spike-timing dependent synaptic plasticity during visual development. The directionally-selective receptive fields of model neurons, as determined by reverse correlation and 2-bar interaction maps, were similar to those obtained from complex cells in awake monkey primary visual cortex. These results suggest a new interpretation of complex cells as integral components of an adaptive cortical circuit for motion detection and prediction.

In recent years, there has been a rapid development of computer-aided design (CAD) and computer-aided manufacturing (CAM) techniques for product development. Their application to the design and production of injection molds has the potential to reduce overall production costs substantially, with improved molding quality. It is also possible to obtain a “first time right” mold without any tool tryouts. Thermal analysis is one of the first steps toward developing a CAD system for injection molds. Once the temperatures at different points inside the cavity are known, the cooling channel design can be optimized. Also, stresses and shrinkages inside the cavity can be studied knowing the temperature profiles. In this article, the problem of determining the thermal residual stresses in the injection-molded polystyrene ring has also been studied. Thermal residual stresses are developed due to the nonuniform cooling of the molten plastic inside the mold cavity.

Neurons in the mammalian primary visual cortex are known to possess spatially localized, oriented receptive fields. It has previously been suggested that these distinctive properties may reflect an efficient image encoding strategy based on maximizing the sparseness of the distribution of output neuronal activities or alternately, extracting the independent components of natural image ensembles. Here, we show that a strategy for transformation-invariant coding of images based on a first-order Taylor series expansion of an image also causes localized, oriented receptive fields to be learned from natural image inputs. These receptive fields, which approximate localized first-order differential operators at various orientations, allow a pair of cooperating neural networks, one estimating object identity (‘what’) and the other estimating object transformations (‘where’), to simultaneously recognize an object and estimate its pose by jointly maximizing the a posteriori probability of generating the observed vi...

The importance of optimization of process parameters is increasingly felt in the wake of the adoption of expensive NC technologies into the shop-floor. In this context, the present paper reports the development of an optimization module for determining process parameters for turning operations as part of a PC-based generative C flexibility in the model formulation is highlighted. Following this, improved mathematical models are formulated by modifying the tolerance and workpiece rigidity constraints for multipass turning operations. The formulated models are solved by the combination of geometric and linear programming techniques. APP system. The need for an optimization approach that permits

A simulation package has been developed for the design and implementation of the Flexible Manufacturing Systems. The system was made to suit the actual implementation of it in practical FMSs.The system is designed to take up any type of jobs irrespective of their process plans and of the number of operations. In the system developed, the following have been taken into consideration: the precedences and the alternate process plans, the availability of tools, jigs fixtures and NC programs and the manual involvement in the system.The simulation package has been developed to (i) get the system configuration, (ii) get the part definitions, (iii) do the static scheduling, (iv) create the dynamic schedule, (v) graphically execute it, and (vi) evaluate the system utilization. Of these the static scheduling is the heart of the simulation package and this has been dealth with at length in this paper.The programs, developed in Quick Basic version 4.0., have been made in a modular structure to facilitate further enha...

During the crop season of 1954, a downy mildew inciting spotting of leaves and grains of Sorghum vulgare was collected at the Agricul? ture Farm, Oosmania University, Hyderabad. The disease was unlike that of the downy mildew Sclerospora sorghi Weston & Uppal, which causes shredding of leaves, developing numerous oospores, and is wide? spread in the sorghum-growing areas of the states of Mysore, Bombay and Hyderabad. A detailed morphological study of the disease-inciting organism revealed that the fungus was an undescribed member of the Peronosporales, related in a general way to Peronospora and Sclerospora, but distinct from all the members so far described.