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Abstract Information flow among nodes in a complex network describes the overall cause-effect relationships among the nodes and provides a better understanding of the contributions of these nodes individually or collectively towards the underlying network dynamics. Variations in network topologies result in varying information flows among nodes. We integrate theories from information science with control network theory into a framework that enables us to quantify and control the information flows among the nodes in a complex network. The framework explicates the relationships between the network topology and the functional patterns, such as the information transfers in biological networks, information rerouting in sensor nodes, and influence patterns in social networks. We show that by designing or re-configuring the network topology, we can optimize the information transfer function between two chosen nodes. As a proof of concept, we apply our proposed methods in the context of brain networks, where we reconfigure neural circuits to optimize excitation levels among the excitatory neurons.

Objective:Treating neonatal bloodstream infections and meningitis in South Asia remains difficult given high rates of antimicrobial resistance (AMR). To evaluate changing epidemiology of neonatal infections, we assessed pathogen-specific and clinical features of culture-proven infections in neonates admitted to a neonatal intensive care unit (NICU) in Pune, India.Materials and MethodsThis retrospective cohort study was performed in the King Edward Memorial Hospital and Research Center NICU over 2 years between January 1, 2017 and December 31, 2018. We included all neonates admitted to the NICU with positive blood or cerebrospinal fluid cultures. Demographic, clinical, and microbiologic data were collected from the medical record. We reviewed antimicrobial susceptibility testing (AST) of all isolates.ResultsThere were 93 culture-positive infections in 83 neonates, including 11 cases of meningitis. Fifteen (18%) neonates died. Gram-negative pathogens predominated (85%) and AST showed 74% resistance to aminoglycosides, 95% resistance to third/fourth generation cephalosporins, and 56% resistance to carbapenems. Resistance to colistin was present in 30% of Klebsiella pneumoniae isolates. Birth weight

Objective: To implement the Comprehensive Unit-based Safety Program (CUSP) in four neonatal intensive care units (NICUs) in Pune, India, to improve infection prevention and control (IPC) practices.Design: In this quasi-experimental study, we implemented CUSP in four NICUs in Pune, India, to improve IPC practices in three focus areas: hand hygiene, aseptic technique for invasive procedures, and medication and intravenous fluid preparation and administration. Sites received training in CUSP methodology, formed multidisciplinary teams, and selected interventions for each focus area. Process measures included fidelity to CUSP, hand hygiene compliance, and central line insertion checklist completion. Outcome measures included the rate of healthcare-associated bloodstream infection (HA-BSI), all-cause mortality, patient safety culture, and workload.Results: A total of 144 healthcare workers and administrators completed CUSP training. All sites conducted at least 75% of monthly meetings. Hand hygiene compliance odds increased 6% per month [odds ratio (OR) 1.06 (95% CI 1.03–1.10)]. Providers completed insertion checklists for 68% of neonates with a central line; 83% of checklists were fully completed. All-cause mortality and HA-BSI rate did not change significantly after CUSP implementation. Patient safety culture domains with greatest improvement were management support for patient safety (+7.6%), teamwork within units (+5.3%), and organizational learning—continuous improvement (+4.7%). Overall workload increased from a mean score of 46.28 ± 16.97 at baseline to 65.07 ± 19.05 at follow-up (p < 0.0001).Conclusion: CUSP implementation increased hand hygiene compliance, successful implementation of a central line insertion checklist, and improvements in safety culture in four Indian NICUs. This multimodal strategy is a promising framework for low- and middle-income country healthcare facilities to reduce HAI risk in neonates.

We consider a class of nonlinear control synthesis problems where the underlying mathematical models are not explicitly known. We propose a data-driven approach to stabilize the systems when only sample trajectories of the dynamics are accessible. Our method is built on the density-function-based stability certificate that is the dual to the Lyapunov function for dynamic systems. Unlike Lyapunov-based methods, density functions lead to a convex formulation for a joint search of the control strategy and the stability certificate. This type of convex problem can be solved efficiently using the machinery of the sum of squares (SOS). For the data-driven part, we exploit the fact that the duality results in the stability theory can be understood through the lens of Perron–Frobenius and Koopman operators. This allows us to use data-driven methods to approximate these operators and combine them with the SOS techniques to establish a convex formulation of control synthesis. The efficacy of the proposed approach is demonstrated through several examples.

Sensors in the built environment ensure safety and comfort by tracking contaminants in the occupied space. In the event of contaminant release, it is important to use the limited sensor data to rapidly and accurately identify the release location of the contaminant. Identification of the release location will enable subsequent remediation as well as evacuation decision-making. In previous work, we used an operator theoretic approach—based on the Perron–Frobenius (PF) operator—to estimate the contaminant concentration distribution in the domain given a finite amount of streaming sensor data. In the current work, the approach is extended to identify the most probable contaminant release location. The release location identification is framed as a Bayesian inference problem. The Bayesian inference approach requires considering multiple release location scenarios, which is done efficiently using the discrete PF operator. The discrete PF operator provides a fast, effective and accurate model for contaminant transport modeling. The utility of our PF-based Bayesian inference methodology is illustrated using single-point release scenarios in both two and three-dimensional cases. The method provides a fast, accurate, and efficient framework for real-time identification of contaminant source location.

Background: There is an assumption that fetus with restricted growth with an inappropriate intrauterine environment lies under stress. Although small-for-gestational-age (SGA) infants have higher mortality, difference in the outcome of SGA and appropriate-for-gestational-age (AGA) infants regarding respiratory morbidity is controversial. It seems that respiratory morbidities in SGA neonates is different from neonates with AGA. In this study, we intend to compare the mortality and respiratory morbidity rates between the preterm small for gestational age (SGA) and appropriate for age (AGA) neonates of less than 34 weeks of gestation. Methods: This analytical cross-sectional study was conducted on 498 preterm neonates with gestational age of < 34 weeks, admitted to the Neonatal Intensive Care Unit. These neonates were categorized into two groups of SGA (n=210) and AGA (n=286). The data analysis was performed, using Student’s t-test and Mann-Whitney U test for parametric variables and Chi-square and Fisher’s exact tests for nonparametric data. Results: According to the results of the study, the two groups were significantly different in terms of their birth weight (P

Cyber threats are serious concerns for power systems. For example, hackers may attack power control systems via interconnected enterprise networks. This paper proposes a risk assessment framework to enhance the resilience of power systems against cyber attacks. The duality element relative fuzzy evaluation method is employed to evaluate identified security vulnerabilities within cyber systems of power systems quantitatively. The attack graph is used to identify possible intrusion scenarios that exploit multiple vulnerabilities. An intrusion response system (IRS) is developed to monitor the impact of intrusion scenarios on power system dynamics in real time. IRS calculates the conditional Lyapunov exponents (CLEs) on line based on the phasor measurement unit data. Power system stability is predicted through the values of CLEs. Control actions based on CLEs will be suggested if power system instability is likely to happen. A generic wind farm control system is used for case study. The effectiveness of IRS is illustrated with the IEEE 39 bus system model.

Preterm birth survivors are at a higher risk of growth and developmental disabilities compared to their term counterparts. Development of strategies to lower the complications of preterm birth forms the rising need of the hour. Appropriate nutrition is essential for the growth and development of preterm infants. Early administration of optimal nutrition to preterm birth survivors lowers the risk of adverse health outcomes and improves cognition in adulthood. A group of neonatologists, pediatricians, and nutrition experts convened to discuss and frame evidence-based recommendations for optimizing nutrition in preterm low birth weight (LBW) infants. The following were the primary recommendations of the panel: (1) enteral feeding is safe and may be preferred to parenteral nutrition due to the complications associated with the latter; however, parenteral nutrition may be a useful adjunct to enteral feeding in some critical cases; (2) early, fast, or continuous enteral feeding yields better outcomes compared to late, slow, or intermittent feeding, respectively; (3) routine use of nasogastric tubes is not advisable; (4) preterm infants can be fed while on ventilator or continuous positive airway pressure; (5) routine evaluation of gastric residuals and abdominal girth should be avoided; (6) expressed breast milk (EBM) is the first choice for feeding preterm infants due to its beneficial effects on cardiovascular, neurological, bone health, and growth outcomes; the second choice is donor pasteurized human milk; (7) EBM or donor milk may be fortified with human milk fortifiers, without increasing the osmolality of the milk, to meet the high protein requirements of preterm infants; (8) standard fortification is effective and safe but does not fulfill the high protein needs; (9) use of targeted and adjustable fortification, where possible, helps provide optimal nutrition; (10) optimizing weight gain in preterm infants prevents long-term cardiovascular complications; (11) checking for optimal weight and sucking/swallowing ability is essential prior to discharge of preterm infants; and (12) appropriate counseling and regular follow-up and monitoring after discharge will help achieve better long-term health outcomes. This consensus summary serves as a useful guide to clinicians in addressing the challenges and providing optimal nutrition to preterm LBW infants.

Gastrocolic Fistula is, in the majority of cases the pathological communication between stomach and transverse colon. It occurs mostly in adults, but they can be present in infants, as well, as a result of congenital abnormalities or iatrogenic procedures (i.e. migration of naso gastric tube that placed before). We report a case of 10 days old full term, male neonate, was on naso gastric tube feeds, had clinical features of necrotizing enterocolitis (NEC), diagnosed to have gastrocolic fistula on barium enema study and confirmed on CT abdomen. Intraoperatively, baby had multiple perforations with gastrocolic fistula. Histopathological examination was suggestive of NEC. We searched literature, we could find seven case reports.