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In a recent floristic field survey of overall vegetation to some border areas of Maharashtra and Madhya Pradesh, we have collected the numerous grasses. After critical laboratory observation of grass species and literature survey has revealed the addition of two new grass species for the Madhya Pradesh state. Their vegetative and reproductive morphology was studied in detail and differences with their allied species are mentioned here.

The work in this paper deals with reconstructing and optimizing the wing geometry of an Unmanned Combat Aerial Vehicle for improved performance and reviewing the impact of the modification on flight parameters in a steady flight. The behavior of airfoils at planned flight conditions under I.S.A. is checked in XFLR5 software. Following up by 2-D CFD and boundary layer analysis of former and new airfoil, dimensions of the wing are re-developed, keeping the fuselage and tail structure same. The existing wing and the optimized wing design is analyzed by Vortex Lattice Method and Triangular Panel Method, with an objective to make the shape of the wing aerodynamically suitable for an increased Lift to Drag ratio and thereby minimizing drag coefficients.

Leaves are most important part of the plant and can be used for the identification of a taxon. An appropriate understanding of leaf development in terms of shape and responsible abiotic factors is necessary for improvement in plant. Leaf shape variation could be evaluated successfully, and the symmetrical and asymmetrical elements of the overall shape variation could be detected. The aim of the present study was to establish a quantitative analysis method of leaf shape by elliptic Fourier descriptors and principal component analysis (EF-PCA). EF-PCA describes an overall shape mathematically by transforming coordinate information concerning its contours into elliptic Fourier descriptors (EFDs) and summarizing the EFDs by principal component analysis. We can be able to extract six variables by using leaf specimen images from field and herbarium specimens. In the present study, total leaf area with respect to notch area is more variable within species. Within a species the major source of the symmetrical elements may be governed by genotypic features and the asymmetrical elements are strongly affected by the environment. We could discuss the value of morphometrics to detect subtle morphological variation which may be undetectable by human eye.

The aim of the present study is to do the balancing between the science and cultural practices in an increasingly complex developing society and policy on the traditional knowledge landscape. Various quantitative indices are proposed to determine the cultural importance of socio-religious and ethnobotanically valuable plants as a tool for the evaluation of cultural heritage. These indices were applied to an ethnobotanical, sociocultural survey of plants and plant parts traditionally used and consumed in the selected study area. Selected plants were grouped into seven use categories for further analysis. The cultural value index (CV), use value index (UV), the relative frequency of citation (RFC), relative importance (RI), and cultural importance index (CI) were calculated for different plant species cited by 45 informants in different traditional societies from the studied states. The calculated values of the cultural importance of plants through diverse indices generated interesting variations from three regions of India. There were eight common species through all the three states. Among these eight species Butea monosperma shows the highest values from Rajasthan and Ziziphus jujube shows the lowest values from Gujarat region. While Nelumbo nucifera, Vigna mungo, and Nymphaea lotus were also portrayed high calculated values in the CI, RI, and CVs. The combined use of these indices makes it possible to quantify the role which has given to a particular plant within a specific culture in one or many festivals in general or religious rituals.

Background: The present study was carried out to describe the Histopathological features of various neoplasms in the urinary bladder biopsies and to categorize the neoplastic lesions according to W.H.O (2016)/ISUP classification of urinary bladder tumors. Materials and Methods: A total of 37 cases, 28 urinary bladder biopsies (TURBT) and 9 cystectomy specimens of urinary bladder neoplasia [histologically proved] of patients were studied retrospectively over the period from June 2016- Oct 2018 in Pathology department of Smt. N.H.L. medical college. All cases of urothelial carcinomas were graded histologically according to WHO (2016)/ISUP classification. Results: Maximum numbers of patients are in age group 60-69 years. Males (78.37%) are more frequently affected as compared to female. The most frequent Neoplastic findings in Urinary bladder is Invasive Papillary Urothelial carcinoma (81.06%); Low grade (37.8%) being more common than High grade (35.14%). A large percentage (80%) of high grade invasive urothelial cell carcinomas presented with muscle invasion. Conslusion: Invasion to the muscle propria layer correlates with high grade tumor. In 18.5% cases detrusor muscle was absent, hence the importance of including detrusor muscle in the biopsy specimens needs to be emphasized. We must accept the fact that grading is highly subjective and that in future various molecular and immunohistochemical studies will provide better reproducibility. Keywords: Invasive papillary urothelial carcinoma, Muscle invasion, Urinary bladder neoplasms.

Background and Objectives: Antibiotic misuse contributes to antibiotic resistance and is a growing public health threat in the United States and globally. Professional medical societies promote antibiotic stewardship education for medical students, ideally before inappropriate practice habits form. To our knowledge, no tools exist to assess medical student competency in antibiotic stewardship and the communication skills necessary to engage patients in this endeavor. The aim of this study was to develop a novel instrument to measure medical students’ communication skills and competency in antibiotic stewardship and patient counseling. Methods: We created and pilot tested a novel instrument to assess student competencies in contextual knowledge and communication skills about antibiotic stewardship with standardized patients (SP). Students from two institutions (N=178; Albert Einstein College of Medicine and Warren Alpert Medical School of Brown University) participated in an observed, structured clinical encounter during which SPs trained in the use of the instrument assessed student performance using the novel instrument. Results: In ranking examinee instrument scores, Cronbach α was 0.64 (95% CI: 0.53 to 0.74) at Einstein and 0.71 (95% CI: 0.60 to 0.79) at Brown, both within a commonly accepted range for estimating reliability. Global ratings and instrument scores were positively correlated (r=0.52, F [3, 174]=30.71, P

Introduction The head-to-toe approach to teaching the physical examination (PE) focuses on technique and performing a comprehensive PE whereas core + clusters and hypothesis-driven PE (HDPE) approaches integrate clinical reasoning into performing a focused PE. These approaches can be implemented in a developmental sequence. We report the implementation and evaluation of an HDPE educational session. Methods We designed a 3-hour HDPE session as part of a transition to clerkship program. For each of five clinical vignettes, rising third-year students worked in pairs and then in small groups to generate a differential diagnosis and determine relevant PE maneuvers. Students next performed these maneuvers on peers with facilitator observation and feedback. Students completed postsession surveys on their retrospective pre- and postsession knowledge and confidence, as well as their satisfaction with the session. We completed quantitative and qualitative analyses on survey data. Results One hundred ninety-two students participated, and 140 (73%) completed the survey. Students were significantly more likely to report feeling confident generating a differential diagnosis and using it to select PE maneuvers for common complaints postsession. Over 80% of respondents felt the session improved critical thinking about patient presentations and would help them in clerkships. Discussion Our session increased student confidence in the progression to performing an HDPE just prior to the start of clerkships. The session is feasible and straightforward to implement. It requires a large number of faculty to facilitate, but the breadth of cases used allows inclusion of faculty from all fields.

A Gesture Vocalizer is a small scale or a large scale system that provides a way for dumb and mute people to communicate easily. The research paper defines a technique, Finger Gesture Vocalizer which includes sensors attached to the gloves above the fingers of the person who wants to communicate. The sensors are arranged in such a way on the gloves, that they can capture the movements of the fingers and based on the change in resistance of the sensors, it can be identified what the person wants to say. The message is displayed on the LCD and is also converted to audio using the APR33A3 audio processing unit. Standard sign languages such as that of American Sign Language which is used by dumb and mute people to communicate can be employed while wearing these gloves.

Background While leadership training is increasingly incorporated into residency education, existing assessment tools to provide feedback on leadership skills are only applicable in limited contexts. Objective We developed an instrument, the Leadership Observation and Feedback Tool (LOFT), for assessing clinical leadership. Methods We used an iterative process to develop the tool, beginning with adapting the Leadership Practices Inventory to create an open-ended survey for identification of clinical leadership behaviors. We presented these to leadership experts who defined essential behaviors through a modified Delphi approach. In May 2014 we tested the resulting 29-item tool among residents in the internal medicine and pediatrics departments at 2 academic medical centers. We analyzed instrument performance using Cronbach's alpha, interrater reliability using intraclass correlation coefficients (ICCs), and item performance using linear-by-linear test comparisons of responses by postgraduate year, site, and specialty. Results A total of 377 (of 526, 72%) team members completed the LOFT for 95 (of 519, 18%) residents. Overall ratings were high—only 14% scored at the novice level. Cronbach's alpha was 0.79, and the ICC ranged from 0.20 to 0.79. Linear-by-linear test comparisons revealed significant differences between postgraduate year groups for some items, but no significant differences by site or specialty. Acceptability and usefulness ratings by respondents were high. Conclusions Despite a rigorous approach to instrument design, we were unable to collect convincing validity evidence for our instrument. The tool may still have some usefulness for providing formative feedback to residents on their clinical leadership skills.

Power Transformers with more than one secondary winding are not uncommon in industrial applications. But new classes of applications where very large number of independent secondaries are used are becoming popular in controlled converters for medium and high voltage applications. Cascade H-bridge medium voltage drives and Pulse Step Modulation (PSM) based high voltage power supplies are such applications. Regulated high voltage power supplies (Fig.1) with 35-100 kV, 5-10 MW output range with very fast dynamics (μS order) uses such transformers. Such power supplies are widely used in fusion research. Here, series connection of isolated voltage sources with conventional switching semiconductor devices is achieved by large number of separate transformers or by single unit of multi-secondary transformer. Naturally, a transformer having numbers of secondary windings (~40) on single core is the preferred solution due to space and cost considerations. For design and simulation analysis of such a power supply, the model of a multi-secondary transformer poses special problem to any circuit analysis software as many simulation softwares provide transformer models with limited number (3-6) of secondary windings. This article discusses a more detailed representation of flux coupled magnetic model with saturable core properties to simulate actual transformers very close to its observed parameters in test and actual usage.

Delay tolerant networks (DTN) are wireless networks where disconnections arise often due to the mobility of nodes, failures of energy, the low density of nodes, or when the network extends over long distances. In these situations, traditional routing protocols that have been developed for mobile ad hoc networks prove to be unsuccessful to the scope of transmitting messages between nodes. The Spray and Wait routing may achieve low routing and energy efficiency due to the blindness in the spray phase. To deal with this situation, we propose an opportunistic routing with enclosed message copies, called the Vibrant Energy aware Spray and Wait (VESW), which utilizes the information about vibrancy of node and remaining energy to allocate the number of copies between the corresponding pair nodes in the spray phase.

5-Chloromethyl-8-quinolinol was condensed stoichiometrically with benzotriazole in presence of potassium carbonate. The resulting 5-[1(H)-benzo triazole methylene]-8-quinolinol (BTMQ) was characterized by elemental analysis and spectral studies. The transition metal chelatesviz. Cu2+, Ni2+, Co3+, Mn2+and Zn2+of BTMQ were prepared and characterized by metal-ligand (M:L) ratio, IR and reflectance spectral studies and magnetic properties. The antifungal activity of BTMQ and its metal chelates was screened against various fungi. The results show that all these samples are good antifungal agents.

Nuclear hormone receptor-responsive element binding specificity has been reported to reside predominantly in the proximal box (P-box), three amino acids located in a DNA-recognition alpha-helix situated on the C-terminal side of the first zinc finger. To further define the residues in the vitamin D receptor (VDR) DNA binding domain (DBD) that mediate its interaction as a retinoid X receptor (RXR) heterodimer with the rat osteocalcin vitamin D-responsive element (VDRE), chimeric receptors were created in which the core DBD of VDR was replaced with that of the homodimerizing glucocorticoid receptor (GR). Systematic alteration of GR DBD amino acids in these chimeras to VDR DBD residues identified arg-49 and lys-53, just C-terminal of the P-box within the base recognition alpha-helix of human VDR (hVDR), as the only two amino acids among 36 differences required to convert the GR core zinc finger domain to that of the VDR. Gel mobility shift and 1,25-dihydroxyvitamin D3-stimulated transcription assays verified that an hVDR-GR DBD chimera is functional on the rat osteocalcin VDRE with only the conservative change of lys-49 to arg, and of the negatively charged glu-53 to a basic amino acid (lys or arg). Thus, for RXR heterodimerizing receptors like VDR, the P-box requires redefinition and expansion to include a DNA specificity element corresponding to arg-49 and lys-53 of hVDR. Examination of DNA specificity element amino acids in other nuclear receptors in terms of conservation and base contact in cocrystal structures supports the conclusion that these residues are crucial for selective DNA recognition.

ObjectiveTo explore experiences during childhood and adolescence that influenced reproductive and sexual health among women who had entered the sex industry in adolescence.MethodsA qualitative study was conducted using information provided by 25 female sex workers (FSWs) from Tijuana, Mexico, who reported entering the sex industry when younger than 18 years. In-depth, semi-structured interviews were conducted with all participants between January 31, 2011, and July 8, 2011.ResultsFour interrelated themes that shaped health experiences-early sexual abuse, early illicit drug use, ongoing violence, and limited access to reproductive and sexual health care-were identified. Participants reporting these experiences were at risk of unintended teenaged pregnancy, spontaneous abortion or stillbirth, and untreated sexually transmitted infections.ConclusionPrograms and policies that address social, structural, and individual vulnerabilities during adolescence and adulthood are required to promote reproductive and sexual health among FSWs in Tijuana, Mexico.

Background: Muir-Torre syndrome is a rare autosomal dominant genodermatosis, first described in 1967, characterized by the presence of sebaceous tumors and an internal malignancy in the absence of other predisposing factors. Objective: Our purpose was to review and update published literature on Muir-Torre syndrome. Methods: We describe a 66-year-old white man with a history of sebaceous tumors and newly diagnosed transitional cell cancer of the right ureter and adenocarcinoma of the jejunum. The literature on Muir-Torre syndrome is reviewed by means of MEDLINE search and available published reports and updated. Results: Only 205 cases of Muir-Torre syndrome with 399 internal malignancies have been reported. The common presentation is the presence of sebaceous tumors along with a low-grade visceral malignancy. Sebaceous tumors appeared before the internal malignancy in 45 cases (22%), concurrently in 12 (6%), and after the internal malignancy in 114 (56%). In 33 (16%) of 205 patients, a temporal relationship was not reported. The total number of sebaceous gland carcinomas reported is 44; 17 of 44 were neoplasms of the meibomian gland. Keratoacanthomas have been noted in 48 (23%) of 205 patients. Gastrointestinal cancers are the most common internal malignancies (61%), followed by genitourinary (22%). Conclusion: The presence of sebaceous tumors warrants a search for an internal malignancy. In patients with Muir-Torre syndrome, regular follow-up and search for new malignancy is mandatory. Evaluation and monitoring of the family members of patients are also necessary. Patients and their families should be counseled for genetic testing. Genetic analysis of the primary tumor and skin lesions should be arranged as an added research tool if possible to better understand the disease. (J Am Acad Dermatol 1999;41:681-6.)

As a first step in the cloning of the DNA repair gene uvsF of Aspergillus nidulans, uvsF pyrG double mutant strains were transformed with a genomic library which carried the complementing Neurospora pyr-4 gene in the vector. Rare pyr+ uvs+ cotransformants were obtained on media lacking pyrimidines, overlayed with MMS (methyl-methane sulfonate) to which uvsF is hypersensitive. Among MMS-resistant transformants, Southerns revealed two types which showed single bands of different sizes when BglII-digested genomic DNA was probed with the vector. Both types produced uvsF- recombinants without vector sequences in homozygous crosses, but only those with the larger band also produced haploid uvs+ progeny. Using BglII-digested genomic DNA to transform Escherichia coli, plasmids of the corresponding two sizes could be rescued. Their inserts had a short internal region in common, giving evidence of rearrangement(s). In secondary transformation of uvsF mutants, only the plasmids with the larger insert showed complementation and these were used to screen Aspergillus libraries. Three types of genomic and two overlapping cDNA clones were identified. The cDNAs hybridized not only to each other, but also to the common region of the rescued plasmids. Therefore, cDNA subclones were used to map the putative uvsF sequences to a short segment in one genomic clone. In Northerns, the complementing large plasmid hybridized to three mRNAs, while the cDNA subclone identified one of these as the probable uvsF message.

Background Intractable hemorrhage is a dreaded complication after cardiovascular surgery often requiring re-exploration and the administration of large quantities of blood products. In view of problems with aprotinin, a new safer effective agent is needed. Recombinant activated FVII is approved for use in patients with hemophilia A and B who have inhibitors to factors VIII and IX, and has shown promise in off-label use for the management of life-threatening hemorrhage in several clinical scenarios including cardiac surgery. It may help control bleeding, reduce blood product usage, and avoid potential morbidity. Its exact place in the management of bleeding during and after cardiac surgery is not yet fully known. Methods. We performed a retrospective review of patients who were given recombinant factor VIIa (rFVIIa; Novoseven, NovoNordisk, Copenhagen, Denmark) to control bleeding after major cardiovascular surgery requiring cardiopulmonary bypass (CPB) at our institution. The decision to administer rFVIIa was made empirically based on the observation by the surgeons of refractory bleeding that appeared unresponsive to conventional hemostasis agents including the requirement of large volumes of blood components, and was at least severe enough to prevent chest closure. We compared blood loss and blood component usage in patients before and after rFVIIa. We also performed a detailed review of the English literature to determine the role of rFVIIa in the treatment of bleeding after cardiac surgery. Results. Between August 2002 to February 2006, 1295 patients underwent open heart surgery at our institution; of these, 28 were given Novoseven either to control intractable bleeding, or to prevent major bleeding. Table 1 shows the patient characteristics. Satisfactory hemostasis was achieved in all but 3 patients after a single 90 μg/kg intravenous dose of rFVIIa. In all patients, there was a dramatic reduction in the amount of blood components (PRBCs, Platelets and FFP) used after rFVIIa infusion (Table 2). Cryoprecipitate was administered routinely with rFVIIa and its usage did not change significantly (Table 2). No thromboembolic or other complications directly related to rVIIa occurred. Conclusions. We have demonstrated that intravenous rFVIIa is effective, safe, and valuable in the management of intractable bleeding after complicated cardiac surgeries. There are several reports and reviews in the literature which corroborate our experience and indicate that recombinant factor VIIa is a potent pro-hemostatic agent which has a role in the treatment of life-threatening refractory hemorrhage associated with cardiac surgery. Earlier preemptive administration of rFVIIa during or before surgery may be of value in patients at high risk of intractable bleeding in order to limit blood loss, and to avoid potential morbidity from large volume blood component transfusions. Randomized, controlled trials are warranted to assess the efficacy, safety, and cost-benefit of this intervention in cardiac surgical patients. TABLE 1. Characteristics and operative course of the 28 patients Mean age 60 yrs (range 22–85) Male, M 24(85%); F 4(15%) Total number of surgical procedures performed: 34 Aortic valve: 7; Bentall or modified Bentall: 9 (3 emergent) Mitral Valve Replacement: 4; CABG: 10; Redo 2 Left pneumonectomy/resection of L Atrial cuff & pericardium: 1 Removal of Inferior vena cava tumor (Renal cell ca): Re-exploration: 6; Delayed closure: 5; Both re-exploration and delayed closure: Median bypass time: 214 min (65–358) Timing of Novoseven: intra op: 21 including elective use in 2 pts; post op: 7 Dose of Novoseven: 90mcg/kg in 22; 45 mcg/kg 2 patients Responders 25(89%) Outcome: Deaths 11(38%) Autopsies: 2; no evidence of systemic thrombosis Table 2. Details of the blood products administered both before and after rFVIIa infusion. Componen Mean units Before rVIIa Mean units After rVIIa Difference; p value PRBC usage 15.9 5.033333 0.045 Platelet usage 4.448276 1.37931 0.005 FFP Usage 9.931034 5.793103 0.042 Cryoppt 21.71429 12.54167 0.091

Chemical Laboratories, University of Rajasthan, Jalpur-302 004 Paper chromatographic studies and conductance measurements have been used to characterize a few long chain poly(aminium phosphate)s of general composition (BHPO2)n (where BH=organic cations). Number average molecular weights of these polymers have been determined by titrating \(p\)H-metrically the poly(phosphoric acids)s obtained by passing the aqueous solution of (BHP02)n derivatives through a column of cation exchange resin. Molecular weight determinations by vis cometric data also confirm their long chain polymeric character. The viscosity average molecular weights have been calculated from improved values of intrinsic viscosity, which are determined according to the modified procedure suggested by Nagy, using the linear transformation G=AF+B of usual extrapolation of \(\eta\)/spC vs C. Here G=Y/\(\propto\)-x, F=x/\(\propto\)-x and \(\propto\)=Xm+xMwhere Y=\(\eta\)sp/C and xm and xMdenote minimum and maximum concentration.

Chemical Laboratories, Universityof Rajasthan, Jaipur-302 004 Complex Polymetaphosphates of Strongly Electropositive Elements &nbsp

Cesium polymetaphosphate and a number of its complex derivatives with the composition (Cs2/M1/6PO3)n (where M=Ca, Zn, Mg and Ni) have been synthesised by fusion technique. The conductancemeasurements at different formal concentrations show a greater resemblance to Graham's salt, lithiumpolymetaphosphatte and their complex derivatives. Measurements of molecular weights by end-group titrationmethod indicate their polymeric character.