Search

The aim of this study was to analyze factors associated with pathologic complete response (pCR) following neoadjuvant chemoradiation (NCRT) and esophagectomy for carcinoma of the esophagus (EC) and gastroesophageal junction (GEJ).Patients with EC and GEJ tumors who received NCRT and underwent esophagectomy between January 2010 to March 2021 were included. Univariate and multivariate analyses were performed to evaluate the factors associated with pCR by comparing the patients who achieved pCR (pCR group) with those who did not achieve pCR (non-pCR group).A total of 321 patients were included in the study, with squamous cell carcinoma (SCC) accounting for the majority of cases (76%). One hundred and sixty (49.8%) patients had pCR. SCC histology and pretreatment radiographic node-negative status (cN0) were associated with pCR. Patients in the pCR group had significantly better overall and disease-free survival compared with patients in the non-pCR group.SCC histology and pretreatment radiographic node-negative status were associated with pCR. For patients with tumors of EC and GEJ who received NCRT and underwent esophagectomy, pCR was associated with improved prognosis compared with those not achieving pCR.

The antimicrobial trends over 6 years were studied, and the effect of revised Clinical Laboratory Standards Institute (CLSI) breakpoints (2012) for ciprofloxacin susceptibility reporting in typhoidal Salmonellae was determined. A total of 874 (95.4%) isolates were nalidixic acid-resistant (NAR). Using the CLSI 2011 guidelines (M100-S21), 585 (66.9%) isolates were ciprofloxacin susceptible. The susceptibility reduced to 11 (1.25%) isolates when interpreted using 2012 guidelines (M100-S22). Among the forty nalidixic acid susceptible (NAS) Salmonellae, susceptibility to ciprofloxacin decreased from 37 isolates (M100-S21) to 12 isolates (M100-S22). The 25 cases which appeared resistant with newer guidelines had a minimum inhibitory concentration (MIC) range between 0.125 and 0.5 μg/ml. MIC50 for the third generation cephalosporins varied between 0.125 and 0.5 μg/ml over 6 years whereas MIC90 varied with a broader range of 0.19–1 μg/ml. The gap between NAR and ciprofloxacin-resistant strains identified using 2011 guidelines has been reduced; however, it remains to be seen whether additional NAS, ciprofloxacin-resistant isolates are truly resistant to ciprofloxacin by other mechanisms of resistance.

The health-care workers (HCWs) are at an occupational risk of exposure to blood-borne pathogens, mainly, HIV, hepatitis B virus (HBV) and hepatitis C virus. HBV is currently the only blood-borne virus for which a vaccine is available. All health-care institutions must encourage the HCWs to undergo screening for blood-borne pathogens.

The antimicrobial trends over 6 years were studied, and the effect of revised Clinical Laboratory Standards Institute (CLSI) breakpoints (2012) for ciprofloxacin susceptibility reporting in typhoidal Salmonellae was determined. A total of 874 (95.4%) isolates were nalidixic acid-resistant (NAR). Using the CLSI 2011 guidelines (M100-S21), 585 (66.9%) isolates were ciprofloxacin susceptible. The susceptibility reduced to 11 (1.25%) isolates when interpreted using 2012 guidelines (M100-S22). Among the forty nalidixic acid susceptible (NAS) Salmonellae, susceptibility to ciprofloxacin decreased from 37 isolates (M100-S21) to 12 isolates (M100-S22). The 25 cases which appeared resistant with newer guidelines had a minimum inhibitory concentration (MIC) range between 0.125 and 0.5 μg/ml. MIC50 for the third generation cephalosporins varied between 0.125 and 0.5 μg/ml over 6 years whereas MIC90 varied with a broader range of 0.19-1 μg/ml. The gap between NAR and ciprofloxacin-resistant strains identified using 2011 guidelines has been reduced; however, it remains to be seen whether additional NAS, ciprofloxacin-resistant isolates are truly resistant to ciprofloxacin by other mechanisms of resistance.

This work focuses on the comparison between the results obtained by gamma-ray tomography (experimental) and the FLUENT code (simulation). The physical property targeted here is the void distributio...

Background: To evaluate and compare the role of Ziehl–Neelsen (ZN) staining and mycobacterial culture in diagnosis of tuberculous lymphadenitis. Materials and Methods: A total of 56 fine needle aspirations (FNAs) from patients who were clinically suspected to have tuberculous lymphadenitis were included. Acid-fast Bacilli detection was attempted by ZN staining on smears as well as culture on Middlebrook 7H9 broth. Percentage positivity of both smears and culture was calculated. Results: Of the 56 cases, 46 showed cytomorphological features consistent with tuberculosis (TB). The most common pattern was only necrosis in 37 cases followed by necrotizing granulomas in 13 cases. ZN-stained smears were positive in 40 cases while culture was positive in only 27 cases. The highest smear and culture positivity was noted in cases with only necrosis. In six cases, diagnosis of TB was made on culture alone since smear was negative in these cases. Conclusion: FNA is a reliable technique for early and accurate diagnosis of tuberculous lymphadenitis in many cases. Mycobacterial culture by newer rapid techniques can assist in bacillary detection in smear-negative cases and also allows for drug sensitivity testing. Hence, culture should be resorted to in such cases.

Bordetella trematum spp. nov. has been isolated from wounds, ear infections and diabetic ulcers. We report a case of a 7-month-old infant with fever, vomiting and abnormal body movements with bacteremia caused by this novel species. The infant responded to fluoroquinolone and macrolide combination therapy.

Background: Since 1982, Thailand had been reported 372,874 ases of HIV/AIDS, and 98,153 deaths. The north of Thailand has een report as the highest prevalence areas. There were almost 00,000 hill tribe populations live there as a marginalized and vulerable people under lacked of access to health care and limited ducation. Most of them emigrated from China last 200 years ago. hiang Rai Province is the most favorite living area of hill tribe eople. Methods: The retrospective cohort study design aimed to invesigates the TB and HIV situation among hill tribe marginalized nd vulnerable population. The systematic data collection with the ompletedquestionnairewas conducted in the12hospitals, Chiang ai Province. All questionnaires had been tested for reliability and alidity before use. Survival and Cox’s regression were analysis. Results: Of 629 cases of TB reported during 2009-2011 form 12 ospitalswere recruited into the study. 60.7%weremale23.8%aged 1-60 years old, and followed by 41-50 years old (20.2%) (min=1, ax =93). Of 84.6%were pulmonary TB and extra pulmonary 15.4%, 4.6%recieving AFB testing, 77.4%new cases. The results of treatent found that 22.7% were cure, 28.6%complte, 4.3%defults, .1%death, and1.9% failure. Prevalence ofHIV/AIDS amonghill tribe B caseswas 17.2%. Of 88.1% had treatment on CAT1, and 4.6%CAT2, nd 2.3%CAT4. Male had greater pulmonary TB (p-vale =0.044), nd HIV+ than female (p-value =0.023). Survival analysis found hat beingmale (p-value =0.01), non-HIV(p-value

Department of Chemistry, C.M.P. Degree College (University of Allahabad), Allahabad-211 002, Uttar Pradesh, India E-mail : guptarti@yahoo.co.in Manuscript received 4 February 2008, revised 18 August 2008, accepted 19 December 2008 Molecular connectivity calculations have been carried out for highly anisotropic bidentate ligands (C2v symmetry), organometallic substrates of the formulae, R2MX2 (where R is an alkyl group and X is a halogen atom) and organometallic chelates of the formulae, R2MLx (where L is a bidentate ligand). Multiple Chi, m\({\chi_t^v}\) with reference to valence delta, δv have been calculated for the hydrogen suppressed graphs (skeletal structures) for each molecule and have been correlated with molar refractions. These correlations will play a vital role in the SAR studies of biologically active molecules.

It has been suggested that salivary characteristics are important in the progression of erosion. The aim of this investigation was to measure salivary parameters in 22 patients with erosion, 10 with normal (non-pathological) levels of reflux (Group I) and 12 with previously diagnosed pathological levels of gastro-oesophageal reflux (Group II). A further 10 subjects without evidence of erosion and no history of reflux disease acted as controls (Group III). No statistically significant differences in salivary flow rate, buffering power or the concentrations of calcium, phosphorus and fluoride were detected. The results suggest that variation in the characteristics of unstimulated and stimulated saliva collected during waking hours do not have a major role in erosion.

1. This study was undertaken to assess whether the analgesia conferred by Diclofenac sodium in the post operative period following general surgery is enhanced by preoperative administration of the drug. 2. Two groups of patients were studied. Group I patients received narcotic premedication and Group II patients received Diclofenac sodium as premedication. Post operatively both groups were administered intramuscular Diclofenac sodium 8 hourly for 48 hours. 3. Pain scoring using visual analogue scale indicated a better pain relief in Group II patients. In Group I, 75% patients had a pain score less than 3 whereas 85% in Group II had a pain score less than 3 (Figure 1). 4. Pulmonary function tests were done 24 hours after surgery and revealed improved values of all parameters in Group II patients. This indicates a greater degree of analgesia in Group II patients. 5. Preoperative administration of the drug reduces the initiation of pain in the periphery and decreases the inflammatory response after surgery. 6. NSAIDS do not have any central effect or any respiratory depression. Patients in our study were found to be awake, cooperative and pain free. The additional analgesia conferred by preoperative administration in conjunction with adequate postoperative therapy allows us to recommend Diclofenac sodium as a sole analgesic for perioperative pain relief except in those patients with a bleeding diathesis.

The paper contains procedures for obtaining Nash strategies from simplified models for singularly perturbed systems which are non-linear in the slow variables, and linear in the fast variables and controls. Two classes of problems are considered. The first is a Nash problem on single parameter systems where both the decision makers interact at the slow and fast subsystem levels. The second is a Nash problem on multi-parameter systems where the fast subsystems are individually controlled by each decision maker, and the interaction between the decision makers is only through the slow ‘ core ’. This problem is studied within the framework of multimodelling. The solution procedures for these two problems are compared to reveal the interaction between the slow and fast subsystem designs in the two cases. The simplified Nash solutions of both the problems are shown to be robust, in the sense that there is little incentive for either decision-maker to deviate from the proposed strategy.

This paper develops decentralized team strategies for decision makers using different models of the same large-scale system. Multiparameter singular perturbations are employed to capture the multimodel nature of the fast dynamic subsystems interconnected through slow dynamic variables. The small parameters are appropriately scaled so that the variables in both time scales are well defined. The system considered is linear and the cost criterion is quadratic. First, a multimodel solution is obtained when the decision makers make different noisy linear observations of the random initial state only. Then the solution to this static team problem is utilized to obtain a multimodel solution to the dynamic team problem with sampled observations under the one-step-delay observation sharing pattern. In both cases, the well-posedness of the multimodel solution is demonstrated.

This paper is concerned with modeling and control strategy interaction in a multimodel context. The role of the observability structure in multiple decisionmaker (DM) problems is examined. A procedure is developed for generating multimodel solutions based on certain deterministic information patterns. This is achieved by first explicitly identifying the state space structure induced by the observation sets of the DM's, and then overlapping appropriately the input space structure of each DM. Such a representation is used to identify the class of admissible strategies which generate multimodel solutions. Conditions, which depend on the information pattern, are obtained under which these multimodel solutions admit partial noninteraction among the DM's.

Recent progress in the use of singular perturbation and two-time-scale methods of modeling and design for control systems is reviewed. Over 350 references are organized into major problem areas. Representative issues and results are discussed with a view to outlining research directions and indicating potential areas of application. The survey is aimed at engineers and applied mathematicians interested in model-order reduction, separation of time scales and allied simplified methods of control system analysis and design. The exposition does not assume prior knowledge of singular perturbation methods.

A decentralized filtering and control scheme is presented for obtaining low-order Nash equilibrium strategies for decision makers using different models of the same large-scale system. Multiparameter singular perturbations are employed to capture the multimodel nature of the fast dynamic subsystems interconnected through slow dynamic variables. The small parameters are appropriately scaled so that the variables in both time scales are well defined. The decision makers have decentralized information structures and are constrained to use only finite dimensional compensators of a specified dimension. It is shown that the proposed scheme is in fact the asymptotic limit of the exact solution as the small parameters go to zero.

This paper presents a unified approach to reduced-order modelling and control of large-scale systems with multiple decision makers. The ‘core’ of a large game problem is identified through the information structure and the class of structure preserving strategies. The induced decomposition results in a low-order game problem and two decentralized optimal control problems. An example of a two-area power system demonstrates the computational attractiveness of the proposed design methodology.

This paper is concerned with modeling and control strategy interaction in a multimodel context. The role of the observability structure in multiple deeisionmaker (DM) problems is examined. A procedure is developed for generating multimodel solutions based on certain deterministic information patterns. This is achieved by first explicitly identifying the state space structure induced by the observation sets of the DM's, and then overlapping appropriately the input space structure of each DM. Such a representation is used to identify the class of admissible strategies which generate multimodel solutions. Conditions, which depend on the information pattern, are obtained under which these multimodel solutions admit partial noninteraction among the DM's.

This document analyzes the interaction between model simplification and strategy design in a multimodel context and for multiple agent stochastic decision problems with decentralized information. Under quasi-classical information patterns, and using singular perturbations approach, the authors establish asymptotic optimality of different multimodels which involve continuous and two types of sampled measurements. Our general analysis and discussion serve to enhance our understanding of the interrelationships between structural features of stochastic large scale systems, like time-scales and weak coupling, and strategy design.

With a view to assess the efficacy of intrathecal pentazocine for post-operative pain relief, 60 patients randomly divided into 6 equal groups were administered graded doses (0, 1, 2, 3, 4 and 5 mg respectively) of pentazocine lactate, intrathecally along with 1 per cent bupivacaine. The duration of analgesia was found to be dose related till 3 mg. Higher doses did not increase the duration of analgesia nor were any untoward effects observed. It is concluded that intrathecal pentazocine is safe and effective for post-operative pain relief and 3 mg is the minimum effective dose without side effect.