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Introduction: The occurrence of invasive fungal infections has increased significantly worldwide, premature infants in Neonatal Intensive Care Unit (NICU) along with other risk factors are at particular risk of these invasive fungal infections which lead to fungal septicaemia in newborns. Candidaemia is the most common form of invasive candidiasis associated with an unacceptably high mortality rates. Candida colonisation in neonates is considered the first step towards developing neonatal sepsis. Aim: To determine the prevalence of Candida colonisation and its characterisation among neonates admitted in NICU. Materials and Methods: The present study was a prospective cross-sectional study with 150 neonates included in the study. Swabs were taken from four different sites of each neonate and inoculated on Chocolate agar and Sabouraud’s Dextrose Agar (SDA) and incubated at 37°C for seven days. Candida species isolated were confirmed by gram stain, germ tube test, growth on Chromogenic (CHROM) agar and cornmeal agar. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 11.0. Results: A total of 32 (21.3%) neonates had Candida colonisation. Twenty two (68.7%) were low birth weight and 24 (75%) were born premature. Perineum was the most common (56%) site of colonisation. Among Candida isolates, Candida tropicalis (63%) was the commonest followed by Candida parapsilosis (25%) and Candida glabrata and Candida albicans (6%). The risk factors identified were low birth weight, premature birth, use of antibiotics. Conclusion: Colonisation of preterm and low birth weight neonates by Candida species is a major risk factor and needs attention to avoid dissemination and life threatening infection.

Determining the layers of gene regulation within the innate immune response is critical to our understanding of the cellular responses to infection and dysregulation in disease. We identified a conserved mechanism of gene regulation in human and mouse via changes in alternative first exon (AFE) usage following inflammation, resulting in changes to the isoforms produced. Of these AFE events, we identified 95 unannotated transcription start sites in mice using a de novo transcriptome generated by long-read native RNA-sequencing, one of which is in the cytosolic receptor for dsDNA and known inflammatory inducible gene, Aim2. We show that this unannotated AFE isoform of Aim2 is the predominant isoform expressed during inflammation and contains an iron-responsive element in its 5′UTR enabling mRNA translation to be regulated by iron levels. This work highlights the importance of examining alternative isoform changes and translational regulation in the innate immune response and uncovers novel regulatory mechanisms of Aim2.

Background &objectivesThough there are studies to evaluate the effectiveness of blended learning in pharmacy education, most of them originate from USA and have used previous year students' scores as control. Also there is less research in comparing use of self -regulated learning strategies between blended and other learning strategies. Primary aim was to evaluate the effectiveness of blended learning on knowledge score using clinical research modules. Secondary objective was designed to compare the use of self-regulated learning strategies between blended learning, web-based e-learning and didactic teaching.Materials and methodsA prospective cluster randomized trial was conducted with didactic teaching as control and web-based e-learning and blended learning as interventions. The target population was final year Pharm D students. Outcome was assessed using a validated knowledge questionnaire, a motivated strategies for learning questionnaire and a feedback form. All statistical analyses were carried out using Statistical Package for Social Science (SPSS) Version 20.ResultsA total of 241 students from 12 colleges completed the study. Mean knowledge score of students in blended learning group was higher than those in the didactic teaching and web- based e- learning program (64.26±18.19 Vs 56.65±8.73 Vs 52.11±22.06,pConclusionBlended learning approach is an effective way to teach clinical research module. Students of blended learning group employed all motivational and learning strategies more often than students of the didactic and web- based e-learning groups except strategies of intrinsic goal orientation, task value, control of learning belief and help seeking.

Existing structures require repair and strengthening owing to degradation caused by incorrect design and construction, environmental impacts, or structural upgradation to meet new seismic design standards or to correct execution problems that occurred during construction. These strengthening requirements can be satisfied by a variety of strengthening techniques. The creation of a fibre-reinforced polymer (FRP) composite system offers a new design method for the strengthening of existing structures. In this study, posttensioned beams are strengthened by using sustainable materials such as natural jute fibre-reinforced polymer (FRP) composites. The performance of these composite systems in the flexural strengthening of posttensioned beams was used to assess their effectiveness. Consequential result for longitudinal reinforcement throughout the length of the beam for flexural strengthening was evaluated. Flexural performance, crack width, ductility, and load-deflection relationship study of control beams (Scheme A) and retrofitted beams (Schemes B and C) under different wrappings were considered in the investigation. An experimental study depicts that using the full wrapping (FW) technique increases the flexural strength of PSC beams wrapped in JFRP by 23% and, by using the strip wrapping (SW) technique, the flexural strength is increased by 10%. The JFRP composite system of strengthening has shown the highest deformability index and showed that the JFRP material has enormous potential as a structural strengthening material.

Background Mannitol and hypertonic saline (HTS) are used as boluses during episodes of raised intracranial pressure (ICP) in severe traumatic brain injury (TBI). We recently demonstrated that ICP reduction and neurological outcomes are similar with mannitol and HTS in TBI. In the current post hoc analysis, we hypothesized that this lack of difference between mannitol and HTS is due to increased urinary sodium losses after HTS. Methods In this post hoc analysis of our earlier randomized controlled trial, we analyzed serum and urine osmolarity and sodium levels in 38 patients with severe TBI over 6 days. Equiosmolar boluses of mannitol and HTS were administered whenever ICP increased above 20 mm Hg. Seven hundred sixty samples each of serum sodium, urine sodium, serum osmolarity, and urine osmolarity were analyzed during this period. Results Three hundred and one and 187 boluses of mannitol and HTS, respectively, were required to maintain ICP below 20 mm Hg. The urinary osmolarity was similar between mannitol and HTS groups (p = 0.63). The urinary sodium excretion was significantly higher in HTS group compared with mannitol group (p = 0.002). Serum sodium and osmolarity values were similar between mannitol and HTS groups (p = 0.16 and 0.31, respectively). There was no difference in the mean ICP between the groups (p = 0.31). Conclusion Increased urinary sodium loss after HTS contributes to its lack of superiority over mannitol in controlling raised ICP.

The modern era has been ruled by federated cloud extensively owing to the upward popularity of real-time applications. However, balancing the load among the different service providers in the federation is a challenging task. This is because of the enlarged load of each service provider and the demand for Service Level Agreement (SLA) requirements. Live VM migration is an effective mechanism to balance the load among the different Cloud Service Providers (CSP). Yet, none of the works has focused on both inter- and intra- CSP-based live VM migration in the federated cloud. Besides, they utilized traditional techniques (Pre and Post-copy) to perform live VM migration. This increases migration and downtime in a federated cloud environment. Motivated by this, we propose matching-based data center allocation and Duple live VM migration in clustered federated cloud environment (DALMIG). The proposed DALMIG approach tackles the downsides faced in the federated cloud as yet. In this regard, three processes are contributed that are Matching-based Data Center Allocation, Two-Fold Clustering, and Duple live VM migration. Initially, brokers allocate apt data center to each incoming task using Auction-based Bipartite One to N (A-BON) matching algorithm. And then, we execute two-fold clustering process: Here, the data center is clustered using the Kernel Neutrosophic C-Means (kernel NCM) algorithm. And, we cluster VMs in each data center using the Credal C-Means (CCM) algorithm. To maintain the load of each CSP, we maintain two entities, such as a load monitor and a migrator. Here, the load monitor estimates a load of each data center and the migrator performs a live VM migration process. Here, the live VM migration process is performed using the Hybrid Copy technique. We execute both intra- and inter-CSP live VM migration. Here, intra-live VM migration is performed using the State Action Reward State Action (SARSA) algorithm. Inter-CSP live VM migration is accomplished using the Black Widow Optimization (BWO) algorithm. We show our DALMIG performance in the federation using the Cloudsim tool. The simulation results acquired from Cloudsim are auspicious in the context of metrics including latency, response time, number of VM migrations, Migration time, load fairness, and communication overhead. [ABSTRACT FROM AUTHOR]

Invasive Pulmonary Aspergillosis (IPA) is an important opportunistic infection in critically ill patients with various underlying risk factors and is associated with a high degree of morbidity and mortality. In recent years, it has been reported that the incidence of IPA has also increased in patients with chronic obstructive pulmonary disease (COPD). Aims & Objectives: The purpose of the study was to determine the Serum Galactomannan Assay positivity rate for Invasive Pulmonary Aspergillosis in Chronic Obstructive Pulmonary Disease patients and to study co-morbid conditions and risk factors for invasive aspergillosis. Materials & Methods: The study population included 56 patients admitted to PKTB hospital, Mysore with COPD/AECOPD. Serum Galactomannan antigen detection by ELISA was done in all subjects. Results: Serum Galactomannan assay positivity was seen in 10(17.85%) of the study population. The clinical features seen in the study population were dyspnea (98.2%), chest pain (98.2%), cough with expectoration (83.9%), Haemoptysis (12.5%), fever (10.7%), at the time of presentation. Nonspecific Consolidation(46%) comprised the major XRay finding followed by Diffuse Patchy Infiltration (29%). Comorbidities like Diabetes Mellitus (71.4%), Smoking (83.9%), prior administration of steroid (73.2%), past history of COPD (66.1%), Pulmonary Tuberculosis (10.71%) was seen in the study population. Conclusion: Serum GM assay could increase the diagnostic sensitivity for IPA in COPD patients. Further studies with attention to the assessment of antifungal therapy, false-positive results and utility of the test are needed. [ABSTRACT FROM AUTHOR]