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PurposeTo evaluate the safety of an intensive cataract surgery training programme.MethodsAn intensive cataract surgery training programme was implemented in August 2010 for year 3 ophthalmology trainees in the East Midlands Deanery North Rotation (United Kingdom). Trainees participated in extra-ocular surgery and 50 h of virtual reality cataract surgery simulator training over a 2-year period. Their third year comprised 6 months of intensive phacoemulsification training in a tertiary centre followed by a 6-month period of consolidation in a district general hospital. The complication rates and case numbers were evaluated after the first 2 years of implementation.ResultsAt 2 years, three trainees had completed a full year of intensive training. In the first 6 months of training, Trainee 1 completed 156 cases, Trainee 2 completed 194 cases, and Trainee 3 completed 151 full cases as primary surgeons with an average rate of posterior capsule rupture (PCR) of 1%. At 12 months, Trainee 1 completed 291, Trainee 2 completed 318, and Trainee 3 completed 294 cases, with an average PCR rate of 0.66%. The trainees required 84 lists on average to complete 150 full cataract procedures.ConclusionThe combination of simulation and the new intensive training programme is safer than the traditional programme for cataract surgery training. [ABSTRACT FROM AUTHOR]

Over the years, individual firms and professional researchers have compiled many "Best Practices" for distributors. These practices have been time tested and the best approach is now known for almost every imaginable distributor activity. Meanwhile, the pressure to perfect distribution operations has never been higher with customers continually demanding higher performance at lower cost. While each best practice has been analyzed in isolation and projections of its impact on the Profit & Loss (P&L) statement and balance sheet have been made, very few have successfully considered the impact of implementing improved practices (across various distributor functions) on the firm's Return On Investment (ROI) and net profit. The objective of this consortium is to determine exactly how profitable a distributor could become by implementing best practices across all functional areas. The analysis will facilitate distributors and manufacturers optimize their operations potential and help financial firms assess the potential profitability of mergers and acquisitions. To address this need, a research consortium (Optimizing Distributor Profitability) was conducted in 2007 by the Supply Chain Systems Laboratory at Texas A&M University. The consortium was sponsored by 11 distributors from 6 different channels. [ABSTRACT FROM AUTHOR]

The paper first takes a look at the current practices that distributors follow in order to optimize the profit and loss statement (P&L) and hence Return on Investment (ROI). The results are based on survey/interviews conducted by the authors with distribution companies across multiple distribution channels. The paper addresses the objectives that distributors typically set as far as the financial goals are concerned. The Supply Chain Systems Laboratory at Texas A&M University conducts distribution research by partnering with distributors across the globe. One of the topics that the lab is currently working on is 'Optimizing Distributor Profitability'. A consortium of companies in North America was formed by the laboratory to address the common distributor practices and determine techniques to optimize profitability. The paper addresses the survey that was conducted to determine the current practices in the distribution community and also determine the research direction of the optimizing distributor profitability consortium based on the participants' business requirements and online surveys. This paper addresses the respondents' results with respect to 7 major categories: Financials, Inventory Management, Pricing Optimization, Lean Distribution, Facilities/Network Optimization, Sales Force and Human Resources. [ABSTRACT FROM AUTHOR]

The paper gives an introduction to lean principles and provides a roadmap for implementation in any distribution environment. A summary of the lean tools widely used and a lean tool selection matrix is also provided. The roadmap is then applied to a distribution facility to make the processes more efficient. In this paper, a 10-step lean problem solving approach is introduced and applied in detail to a distribution warehouse operation. Initial process study revealed several problem areas. Two of the most glaring problems a) High Customer Wait Time and b) Pending Days Sales Outstanding (DSO) were chosen for analysis. The 10 step method is then applied by first Value Stream Mapping (VSM) the current process to understand Customer Value Add (CVA), Business Value Add (BVA) and Non Value Add (NVA) activities. A future state Value Stream Map is proposed with the objective of eliminating Non Value Add activities and minimizing Business Value Add activities for overall lead time reduction. Potential improvement opportunities are identified and weighted based on their impact on the organization's Key Performance Indicators (KPIs). Standard Operating Procedures (SOPs) in the form of future VSMs are created and new employee productivity measures are introduced to ensure process control and employee accountability. The loop is then completed by selecting the next major process and applying the general framework to establish a culture of ongoing improvements. [ABSTRACT FROM AUTHOR]

The article puts into perspective the social structure of Chandpur village located near the Palampur City of Himachal Pradesh, India. The size of land holdings is very small in the village. Female members of the household take care of cultivation of the farm and its sowing, while harvesting is supported by the male members. Rajputs and scheduled castes are the numerical dominant groups, closely followed by Brahmins and other service castes. Apart from highlighting various marriage systems and rituals, the article also illustrates on the political system of the village.

Mucormycosis is a rare systemic fungal infection seen in immune-compromised patients. Gastrointestinal tract involvement is not usual. A 36 years female presented with fever and progressive bilateral leg swelling for 25 days. She was diagnosed as nephrotic syndrome and started on methylprednisolone and cyclophosphamide. She developed hematochezia during hospital stay. On colonoscopy, ulcero-proliferative lesion was noted in caecum. Histopathology examination has confirmed it as mucormycosis of Caecum. Mucormycosis is an opportunistic angioinvasive disease caused by fungus zygomycosis it is a rare disease and often manifests as a life-threatening condition in immune-compromised patient. Invasion by fungal hyphae leads to arterial thrombosis, tissue infarction, hemorrhage and, necrosis. Diagnosis is confirmed by histopathological examination and culture. It is usually treated by the anti-fungal drug- liposomal amphotericin and surgical debridement. Mucormycosis is a fatal systemic fungal infection, which can present as lower gastrointestinal bleeding in immunocompromised patients. [ABSTRACT FROM AUTHOR]

Finger millet (Elusine coracana) in an important nutria-rich cereal crop. A total of 42 Indian genotypes were used to identify quantitative trait loci (QTL) associated with root traits (root length and root weight) and biochemical parameters (activities of catalase (CAT), ascorbate peroxidase (APX), glutathione reductase (GR), peroxidase (POD), and superoxide dismutase (SOD) enzymes) under drought condition in finger millet. The highest root length (126.40 cm), fresh weight (32.67 gm) and CAT activity (873.13 μM min−1g−1 FW) were observed in TRY-01 genotype under drought condition. Furthermore, the highest APX enzyme activity was observed in GPU-28, INDOF-08, ML-365, THRV-PP, PR-202, and INDOF-07 genotypes. In the present study, five (qtlSSR - 06 , qtlUGEP - 13 , qtlUGEP - 18 , qtlUGEP - 104 and qtlUGEP - 106) and two (qtlUGEP - 07 and qtlUGEP - 16) QTL were associated with root length and root weight respectively. Six QTL were associated with biochemical traits such as APX (qtlSSR-06 and qtlUGEP-16), CAT (qtlUGEP-07 and qtlUGEP-16), GR (qtlUGEP-18, qtlUGEP-95 , and qtlUGEP-101), SOD (qtlSSR-06 and qtlUGEP-16), and POD (qtl SSR-06 and qtl UGEP-16) activities. An In-silico comparative genomic analysis was performed with genomes of various Poaceae family members to find the QTL associated with any candidate gene. The qtlUGEP- 07 was associated with five candidate genes in the different Poaceae family members. Similarly, the qtlUGEP-13 was corresponding to two candidate genes of Panicum hallii. Furthermore, qtlUGEP-16 and qtlUGEP-95 were also associated with candidate genes in foxtail millet and maize. This study will help improve finger millet genotypes under both biotic and abiotic stress conditions. • To determine the response of 42 finger millet genotypes grown under vegetative drought and their responses to root and biochemical traits in greenhouse analysis. • Total of 42 Indian genotypes of finger millet were used to identify quantitative trait loci (QTL) associated with root traits and biochemical parameters. • Totally, five and two QTL were associated with root length and root weight respectively. • In-silico comparative genomic analysis was performed with genomes of various Poaceae family members to find the QTL associated with any candidate gene. • This study will help to improve finger millet genotypes under both biotic and abiotic stress conditions. [ABSTRACT FROM AUTHOR]

Abstract The adaptive ability of sperm in the female reproductive tract micromilieu signifies the successful fertilization process. The study aimed to analyze the preparedness of sperm to the prevailing osmotic and pH stressors in the female reproductive tract. Fresh bovine sperm were incubated in 290 (isosmotic-control), 355 (hyperosmotic-uterus and oviduct), and 420 (hyperosmotic-control) mOsm/kg and each with pH of 6.8 (uterus) and 7.4 (oviduct). During incubation, the changes in sperm functional attributes were studied. Sperm kinematics and head area decreased significantly (p

Introduction: Executing their daily duties, police officers are expected to perform complex, physically demanding activities, often at maximal levels of exertion. Given these criteria, training must be rigorous enough to ensure that when trainees graduate, they are competent in their response to crisis and flexible enough to sustain this for the span of their career. The present study aimed to determine the impact of scale diet and physical training (SDPT) on body composition and aerobic performance among Nepal police officer trainees. Method: We conducted a cross-sectional analytic study among 570 Nepal Police recruits from Nepal Police Academy of Butwal and Kathmandu. Null hypothesis was created followed by an alternative hypothesis. Alpha (1 - ?) for the above-mentioned study design were set. Parametric statistical analysis was done with criteria set for acceptance or rejection of the null hypothesis. We collected the data from the field as per Nepal police basic exercise and diet protocol to determine the effect of physical training and scale diet on body composition and aerobic performance. We enrolled all the recruits from March to May, 2019 who met the eligibility criteria in the study. We used Microsoft Excel 2013 for data entry and R program (version: 4.0.3) for statistical analysis. Results:There was a significant rise in aerobic performance (4.51 ± 3.39 ml/kg/min) and remarkable reduction in body fat (-4.49 ± 2.33 %) and Body Mass Index (-0.433 ± 1.00 kg/m2) after SDPT among participants with normal BMI at the time of recruitment. Body fat was significantly reduced (-4.36 ± 2.3%) and aerobic performance was significantly increased (6.93±4.70 ml/kg/min) among overweight participants at the time of recruitment. Conclusions: The methodology adopted in the physical training of Nepal Police was effective in reducing body mass index and fat, improving the physical capacity. . Key words: Scale Diet; Physical Training, Body Fat; Aerobic Performance; VO2max, Body Mass Index

The present study investigated the optimum levels of ambient temperature, salinity and light intensity for the growth of marine diatoms and microalgae. The marine diatoms Thalassiosira subtilis, Entomoneis paludosa and microalgae Isochrysis galbana were optimized for the growth. Subcultures were prepared in filtered natural seawater enriched with f/2 media for diatoms and Conway media for I.galbana. Cultures were grown under three different levels of three parameters consists of 27 combinations in 96 well plates. Ten replicates of cultures were maintained for each combination of ambient levels. The algal density was determined by spectrometric absorbance of culture at 680 nm. Likewise, the growth was estimated from the rate of increase in the absorbance values over a period of time. The durations of growth differed between the species. The I.galbana was grown for prolonged culture duration up to 15 days followed by E.paludosa with 12 days and T.subtilis with 8 days. Levels of ambient temperature and light intensity are the driving parameters for optimum growth of the species studied while the optimum salinity of 30 psu was observed for all species.Ambient levels of 28 °C, 30 psu and 2500 lux were found optimum for the growth of T. subtilis and E.paludosa attained its optimum growth at 24 °C, 30 psu and 2500 lux. The higher light intensity (4500 lux) hasenhanced the growth of I.galbanaalong with 24 °C of temperature and 30 psu of salinity.

For bacteria to thrive in an environment with competitors, phages and environmental cues, they use different strategies, including Type VI Secretion Systems (T6SSs) and Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) to compete for space. Bacteria often use quorum sensing (QS), to coordinate their behavior as the cell density increases. Like other aliivibrios, Aliivibrio wodanis 06/09/139 harbors two QS systems, the main LuxS/LuxPQ system and an N-acyl homoserine lactone (AHL)-mediated AinS/AinR system and a master QS regulator, LitR. To explore the QS and survival strategies, we performed genome analysis and gene expression profiling on A. wodanis and two QS mutants (ΔainS and ΔlitR) at two cell densities (OD600 2.0 and 6.0) and temperatures (6 and 12°C). Genome analysis of A. wodanis revealed two CRISPR systems, one without a cas loci (CRISPR system 1) and a type I-F CRISPR system (CRISPR system 2). Our analysis also identified three main T6SS clusters (T6SS1, T6SS2, and T6SS3) and four auxiliary clusters, as well about 80 potential Type VI secretion effectors (T6SEs). When comparing the wildtype transcriptome data at different cell densities and temperatures, 13–18% of the genes were differentially expressed. The CRISPR system 2 was cell density and temperature-independent, whereas the CRISPR system 1 was temperature-dependent and cell density-independent. The primary and auxiliary clusters of T6SSs were both cell density and temperature-dependent. In the ΔlitR and ΔainS mutants, several CRISPR and T6SS related genes were differentially expressed. Deletion of litR resulted in decreased expression of CRISPR system 1 and increased expression of CRISPR system 2. The T6SS1 and T6SS2 gene clusters were less expressed while the T6SS3 cluster was highly expressed in ΔlitR. Moreover, in ΔlitR, the hcp1 gene was strongly activated at 6°C compared to 12°C. AinS positively affected the csy genes in the CRISPR system 2 but did not affect the CRISPR arrays. Although AinS did not significantly affect the expression of T6SSs, the hallmark genes of T6SS (hcp and vgrG) were AinS-dependent. The work demonstrates that T6SSs and CRISPR systems in A. wodanis are QS dependent and may play an essential role in survival in its natural environment.

We report a case of esotropia with high hyperopia in a 3-year-old female child. She was initially treated with hyperopic correction and noted to have residual esotropia, which was diagnosed as partial accommodative esotropia. Later when she presented with headache, she was diagnosed to have an intracranial tumour. To our surprise, after neurosurgical excision of tumour, her non-accommodative component of the esotropia resolved over 1 year implying that the intracranial lesion was an additional causative factor for this acute onset Accommodative esotropia. The child attained Orthophoria with the same hyperopic correction.

Zinc (Zn) is an essential micronutrient for plants and humans. Nearly 50% of the agriculture soils of world are Zn-deficient. The low availability of Zn reduces the yield and quality of the crops. The zinc-regulated, iron-regulated transporter-like proteins (ZIP) family and iron-regulated transporters (IRTs) are involved in cellular uptake of Zn, its intracellular trafficking and detoxification in plants. In addition to Zn, ZIP family transporters also transport other divalent metal cations (such as Cd2+, Fe2+, and Cu2+). ZIP transporters play a crucial role in biofortification of grains with Zn. Only a very limited information is available on structural features and mechanism of Zn transport of plant ZIP family transporters. In this article, we present a detailed account on structure, function, regulations and phylogenetic relationships of plant ZIP transporters. We give an insight to structure of plant ZIPs through homology modeling and multiple sequence alignment with Bordetella bronchiseptica ZIP (BbZIP) protein whose crystal structure has been solved recently. We also provide details on ZIP transporter genes identified and characterized in rice and other plants till date. Functional characterization of plant ZIP transporters will help for the better crop yield and human health in future.

Abstract This paper concerns the problem of enhanced results on robust finite time passivity for uncertain discrete time Markovian jumping BAM delayed neural networks with leakage delay. By implementing a proper Lyapunov–Krasovskii functional candidate, reciprocally convex combination method, and linear matrix inequality technique, we derive several sufficient conditions for varying the passivity of discrete time BAM neural networks. Further, some sufficient conditions for finite time boundedness and passivity for uncertainties are proposed by employing zero inequalities. Finally, the enhancement of the feasible region of the proposed criteria is shown via numerical examples with simulation to illustrate the applicability and usefulness of the proposed method.

Background: The widespread availability of ultrasonography has facilitated the evaluation of thyroid nodules, to differentiate between malignant and benign nodules and between metastatic and reactive lymph nodes. From the radiologists' suite, ultrasound has moved into the surgeon's office. Aim: The aim of the present study was to evaluate the relevance of surgeon-performed ultrasound (SPUS) in the diagnosis of malignancy of the thyroid. Methods: SPUS for 389 consecutive patients attending the outpatient department of endocrine surgery in a tertiary care institute in Chennai. The SPUS data of 350 patients who underwent total thyroidectomy were compared with the report of radiologist-performed ultrasonogram, fine-needle aspiration cytology, and histopathology examination. Results: SPUS ranked the maximum with a Spearman's correlation of 0.886 (P < 0.0001). The sensitivity and specificity of positive-predictive value and negative-predictive value of SPUS were 98.53%, 95.72%, 96.81%, and 98%, respectively. Conclusion: SPUS is a very useful clinical adjunct in diagnosing malignancy of the thyroid and saves the patient time and resource in visiting another consultant. A surgeon who is more familiar with the anatomy and pathophysiology of thyroid disorders triages the nodule better.

Terpenoids are a wide class of secondary metabolites with geroprotective properties that can alter the mechanism of aging and aging-related diseases. Camphorquinone (CQ) is a bicyclic monoterpenoid compound that can be efficiently synthesized through the continuous bromination and oxidation reaction of camphor. The purpose of this study is to investigate the effects of CQ on oxidative-stress-induced senescence and its underlying mechanisms. To generate oxidative stress in human bone marrow mesenchymal stem cells (hBM-MSCs) and mice, we used hydrogen peroxide (200 μM twice) and D-galactose (D-Gal) (150 mg/kg for 10 weeks), respectively. Our findings suggest that CQ potentially reduces senescence in hBM-MSCs and mouse heart tissue. In addition, we found that CQ boosted AMPK/SIRT1 activation and autophagy in both models. These results were subsequently verified in hBM-MSCs using compound C (an AMPK inhibitor) but AMPK inhibition by CC did not significantly reduce the SIRT1 and the autophagy markers. CQ treatment also reduced the gene expression of inflammation markers in D-Gal-induced aging mouse heart tissue. Furthermore, we determined that CQ fits all of the pharmacological parameters using the freely available SwissADME Web tool. Collectively, our findings demonstrate that CQ possesses antisenescence and cardioprotective properties, and that oxidative-stress-induced senescence could be suppressed by AMPK/SIRT1 and autophagy mechanisms.

Purpose of the study: The purpose of this study was to report clinical features, neuroimaging, and visual outcome in pediatric optic neuritis (ON) in Indian population. Materials and Methods: This is a retrospective study of children up to the age of 16 years, diagnosed with ON, that presented at pediatric and neuroophthalmology clinic of a tertiary eye care center, in South India, within the period of 2010–2015. Results: We identified 62 eyes of 40 children diagnosed as ON within the study period. The mean age was 11.15 ± 3.24 years (1–15 years) with mean follow-up of 13 months. In this series, there was female preponderance (67%). Mean logarithm of the minimum angle of resolution visual acuity at presentation was 1.14 ± 0.93, which after treatment recovered to 0.10 ± 0.26 at final visit (P < 0.001). Involvement was bilateral in 22 children (55%) and recurrent in 3 eyes of 3 children. Preceding febrile illness was reported in seven cases (18%). Four (10%) cases were diagnosed as multiple sclerosis (MS), one with neuromyelitis optica , and one with acute disseminated encephalomyelitis. One case was associated with tuberculous meningitis, 1 with septicemia, and 1 with bilateral maxillary sinusitis. Neuroimaging studies of optic nerve in 14 children demonstrated isolated optic nerve enhancement. Magnetic resonance imaging brain revealed white matter T2 hyperintense lesions separate from optic nerve in ten cases, of which four cases were diagnosed as MS. Conclusions: Bilateral presentation was common, association with MS was low. Papillitis was more frequent than retrobulbar neuritis and prognosis was good in pediatric ON in Indian population.

Background: Studying the outcomes in patients presenting with cardiogenic shock with ST-segment elevation myocardial infarction (CS-STEMI) and undergoing primary or rescue percutaneous coronary intervention (PCI) may give an insight to the unmet needs in STEMI-care in our region and may help in future recommendations in improving survival. Materials and methodolgy: During the period from January 2001- June 2017, there were 114 patients included in the study. The demographic, clinical and angiographic characteristics were compared between the survivors and non-survivors. All these variables were also compared between two-time frames (Phase 1- January 2001 to June 2007; Phase 2- July 2007 to June 2017). Results: Among patients undergoing PCI for STEMI, 7.5% were in cardiogenic shock. In-hospital mortality for the patients included in the study was 53.5%. Total ischemic time (OR = 0.99, 0.99–1; p = 0.02), left ventricular ejection fraction (LVEF) (OR = 0.90, 0.82–0.98; p = 0.02), need for cardio-pulmonary resuscitation (OR = 0.12, 0.24–0.66; p = 0.01), and post PCI TIMI flows (OR = 0.08, 0.02–0.29; p

BACKGROUND:The benefits of dialysis in older people with ESKD are not clear. We prospectively evaluated whether dialysis has survival advantage compared to conservative care (CC) in older people who were medically suitable for dialysis therapy. METHODS:This was a prospective observational study of CKD patients aged ≥75 years when eGFR first reached ≤15ml/min/1.73m2. Hazard ratios (HR) for death were compared between patients who chose dialysis versus conservative care (CC) from when first seen in pre-dialysis clinic (eGFR ≤15ml/min/1.73m2), and when initiation of dialysis was first considered (eGFR ≤10ml/min/1.73m2). Patients with co-morbidities likely to significantly reduce life expectancy such as advanced heart failure, advanced dementia, and malignancy, were excluded. RESULTS:There were 204 patients (123 dialysis, 81 CC). 115 went on to record eGFR of ≤10ml/min/1.73m2 (73 dialysis, 42 CC). The median survival from eGFR first ≤15ml/min/1.73m2 for the dialysis and CC groups were 42 (33-50) months and 31 (21-41) months. The adjusted hazard ratio (HR) for death in the dialysis group compared to CC was 0.61 (0.41-0.61, p = 0.01). The median survival from eGFR first ≤10ml/min/1.73m2 for dialysis and CC group were 36 (25-47) months and 12 (0-5) months. The adjusted HR for death in the dialysis group compared to CC was 0.36 (0.21-0.62, p

Chlorpyrifos (CPF) and Cypermethrin (CPM) are toxic and subject to long-term in vivo accumulation in different aquatic species throughout the world. The purpose of the present study was to examine the combined CPF/CPM (Nurocombi) exposure on histology in various tissues of Paratelphusa jacquemontii. The crabs were exposed to combined CPF/CPM concentrations of 0.0187 ppm and 0.0374 ppm (sub lethal) for 28 days with parallel untreated control. The experimental gill tissue exhibited epithelial lifting, edema, necrosis, fusion of secondary lamellae and hemorrhage. The deceased hepatopancreas revealed infiltration, formation of large lumen and disappearance of haemocytes. The pathologic symptoms like atrophy, necrosis, wavy appearance, accumulation of granular material in between muscle fibers, fragmentation, loss of muscle structure, appearance of basophilic deposits were displayed in the muscle tissue. The vas deferens showed remarkable epithelial vacuolar degeneration, irregular appearance of spermatophore matrix associated with reduction in the number of spermatophores and dehiscence of most of the spermatophores. It is concluded that histological biomarkers provide reliable and discriminatory data to augment pesticide pollution and therefore, long-term monitoring is necessary to assess the eco-health of the mangrove system.

To evaluate the attitudes and readiness of students of healthcare professions towards interprofessional learning.A cross-sectional study design was used. Two different scales were used to measure the readiness for and perception of interprofessional learning; these were the 'Readiness for Interprofessional Learning Scale' and the 'Interdisciplinary Education Perception Scale'. A convenience sampling method was employed. The sample was drawn from undergraduate students enrolled in years 1 to 5 of medical, dental, pharmacy and health sciences programme. Descriptive and inferential statistics were used to analyse the data.The overall response rate was 83%. The students mentioned that shared learning with other healthcare professional students will increase their ability to understand clinical problems. The students also mentioned that such shared learning will help them to communicate better with patients and other professionals. The students preferred to work with individuals from their own profession. Participants from medical, dental, pharmacy, and health sciences had a difference in opinion about 'negative professional identity', a domain of the Readiness for Interprofessional Learning Scale. Based on the different year of study of the students, 'team work and collaboration', 'negative professional identity' and 'roles and responsibility' were the Interdisciplinary Education Perception Scale domains where students had a difference in opinion.Attitudes and readiness towards interprofessional learning showed significant differences among students of various healthcare professions; these differences also depended on the students' year of study. Interprofessional learning should be incorporated in the curriculum of all healthcare professional programs, which may foster students to become competent healthcare providers and understand each profession's role.