Search

Clouds play a significant role in the dynamics and thermodynamics of the atmosphere. To understand the impact of clouds on climate and for better representation of these in the global models, accurate information about the temporal, spatial and vertical distribution of cloud properties such as microphysical, morphological and types are essential. In the present work, vertical structure and microphysics of clouds during southwest (SW) monsoon has been studied from a high altitude site (Mahabaleshwar (17.92°N, 73.66°E, and 1348 m above mean sea level (MSL)) and within ± 0.1 degrees) over Western Ghats, India. Vertical structure of the clouds has been detailed using radiosonde observations. Warm cloud microphysics was investigated using in-situ ground and aircraft cloud measurements. Radiosonde profiles showed the presence of single and multi-layered clouds over the observational site. Higher occurrence frequency for cloud layers below 2 km and above 6 km altitude compared to mid-level clouds (2 to 6 km) during SW monsoon were noticed. Higher occurrences of single layer clouds during June and September (transition period) were noticed whereas frequency of two-layer was higher in July and August (core period). Low (~30%) and high-level (~60%) clouds were dominantly seen compared to mid-level clouds over the observational site during SW monsoon. Warm cloud microphysics was investigated using collocated ground and airborne in situ measurements. Cloud microphysical properties such as cloud droplet number concentration (CDNC), liquid water content (LWC), droplet effective diameter (ED), droplet mean radius (Rm) respectively were analyzed. The cloud liquid water content and the effective droplet diameter showed increase with altitude. Analyzed cloud droplet size distribution (DSD) showed a steep decrease in number concentration of droplets above 25 µm diameters at altitudes above 1800 m, suggesting active collision-coalescence. This is the first such report combining in situ observations from two different platforms to study the vertical structure of monsoon clouds over a complex terrain like the Western Ghats in India.

The temporal variability of the planetary boundary layer height (PBLH) over Mahabaleshwar was studied for a period of 1 year from 1 December 2015 to 30 November 2016 using microwave radiometer (MWR) observations. The PBLH over Mahabaleshwar was found to be the highest during the pre-monsoon (March-May) season and lowest during the winter (December-February) season. The seasonal mean of PBLH was estimated to be 339±88 m during winter, 485±70 m during pre-monsoon, 99±153 m during monsoon, and 438±24 m during post-monsoon season. Frequency distribution analysis of PBLH during pre-monsoon season revealed that the formation of turbulence internal boundary layer (TIBL) is evident. In contrast, cold and moist air mass during the monsoon season enhances the wind shear with lower buoyancy term which results in lowering of PBLH. The comparison of PBLH between MWR and radiosonde observations shows a good correlation (r2 = 0.66, p=0.001). The growth rate was observed to be 388 m/h during pre-monsoon, 206 m/h during winter, 57 m/h during monsoon, and 167 m/h during post-monsoon season. The seasonal mean concentration of PM2.5 was found to be 42.3±4.6 μg/m3during winter, 33.4±8.7 μg/m3 during pre-monsoon, 6.6±2.2 μg/m3 during monsoon, and 26.1±1.7 μg/m3during post-monsoon season. The effect of higher loading of scattering-type aerosol (dust particle) was also investigated as a case study. The analysis reveals the inverse relationship between the PBL height variability and the particulate loading indicating the importance of aerosol direct effect. Analysis of the ventilation coefficient (Vc) revealed that the dissipation potential was higher (1736 m2/s) during pre-monsoon season as compared to (1191 m2/s, 455m2/s, and 1580 m2/s) winter, monsoon, and post-monsoon seasons.

The temporal variability of the planetary boundary layer height (PBLH) over Mahabaleshwar was studied for a period of 1 year from 1 December 2015 to 30 November 2016 using microwave radiometer (MWR) observations. The PBLH over Mahabaleshwar was found to be the highest during the pre-monsoon (March-May) season and lowest during the winter (December-February) season. The seasonal mean of PBLH was estimated to be 339±88 m during winter, 485±70 m during pre-monsoon, 99±153 m during monsoon, and 438±24 m during post-monsoon season. Frequency distribution analysis of PBLH during pre-monsoon season revealed that the formation of turbulence internal boundary layer (TIBL) is evident. In contrast, cold and moist air mass during the monsoon season enhances the wind shear with lower buoyancy term which results in lowering of PBLH. The comparison of PBLH between MWR and radiosonde observations shows a good correlation (r

Summary: Background: Improving the quality of hospital antibiotic use is a major goal of WHO's global action plan to combat antimicrobial resistance. The WHO Essential Medicines List Access, Watch, and Reserve (AWaRe) classification could facilitate simple stewardship interventions that are widely applicable globally. We aimed to present data on patterns of paediatric AWaRe antibiotic use that could be used for local and national stewardship interventions. Methods: 1-day point prevalence survey antibiotic prescription data were combined from two independent global networks: the Global Antimicrobial Resistance, Prescribing, and Efficacy in Neonates and Children and the Global Point Prevalence Survey on Antimicrobial Consumption and Resistance networks. We included hospital inpatients aged younger than 19 years receiving at least one antibiotic on the day of the survey. The WHO AWaRe classification was used to describe overall antibiotic use as assessed by the variation between use of Access, Watch, and Reserve antibiotics, for neonates and children and for the commonest clinical indications. Findings: Of the 23 572 patients included from 56 countries, 18 305 were children (77·7%) and 5267 were neonates (22·3%). Access antibiotic use in children ranged from 7·8% (China) to 61·2% (Slovenia) of all antibiotic prescriptions. The use of Watch antibiotics in children was highest in Iran (77·3%) and lowest in Finland (23·0%). In neonates, Access antibiotic use was highest in Singapore (100·0%) and lowest in China (24·2%). Reserve antibiotic use was low in all countries. Major differences in clinical syndrome-specific patterns of AWaRe antibiotic use in lower respiratory tract infection and neonatal sepsis were observed between WHO regions and countries. Interpretation: There is substantial global variation in the proportion of AWaRe antibiotics used in hospitalised neonates and children. The AWaRe classification could potentially be used as a simple traffic light metric of appropriate antibiotic use. Future efforts should focus on developing and evaluating paediatric antibiotic stewardship programmes on the basis of the AWaRe index. Funding: GARPEC was funded by the PENTA Foundation. GARPEC-China data collection was funded by the Sanming Project of Medicine in Shenzhen (SZSM2015120330). bioMérieux provided unrestricted funding support for the Global-PPS.

There is a lack of characterization of the aerosol population in Western India, how it is affected by meteorological parameters, and new particle formation and the influence on cloud condensation nuclei (CCN). For this reason, measurements of particle number size distribution, aerosol chemical composition, meteorology and cloud condensation nuclei number concentration were monitored at High Altitude Cloud Physics Laboratory (HACPL) in Mahabaleshwar mountain town in Western India between November 2016 and February 2017. Most air masses in this period originated from the Indian continent to the north-east of HACPL. New particle formation (NPF) events were observed on 47 days and mainly associated with these north-easterly air masses and high SO2 emissions and biomass burning activities, while weaker or non-NPF days were associated with westerly air masses and relatively higher influence of local air pollution. The growth of newly formed particles enhanced the mass concentration of secondary organic and inorganic species of aerosol particles. The mean growth rate, formation rate, condensation sink and coagulation loss for the 13 strongest events was found to be 2.58 ± 0.38 nm h−1, 2.82 ± 1.37 cm−3 s−1, 22.3 ± 2.87 * 10-3 s−1 and 1.62 ± 1.04 cm−3 s−1 respectively. A closer examination of 5 events showed that low relative humidity and solar radiation favoured new particle formation. These NPF events lead to a significant increase in CCN concentration (mean ~ 53 ± 36 %). The NanoMap method revealed that NPF took place up to several hundred kilometers upwind and to the north-east of HACPL.

Though pericardial disease is common in patients with renal disease, purulent pericarditis is very rare. We report a fatal case of purulent pericarditis and sepsis due to methicillin-resistant Staphylococcus aureus in a 78-year-old male with systemic hypertension and renal disease along with the molecular characterization of its resistant mechanism.

Higher prevalence of extended-spectrum β-lactamase (ESBL)-producing Escherichia coli fecal carriage has been reported in the nosocomial setting than in the community. We tried to determine the fecal carriage of ESBL-producing E. coli among healthy volunteers in a relatively isolated community.This study was conducted on 115 healthy adult volunteers from whom one fecal sample was collected and was plated on selective media. Each morphotypes were identified, characterized, and ESBL phenotype was confirmed by double-disk potentiation method. Molecular characterization of ESBL gene was done using multiplex polymerase chain reaction and pulse-field gel electrophoresis (PFGE) was done to identify their clonal relation.ESBL-producing E. coli had a prevalence of 19% (22/115) among the healthy volunteers in the community. CTX-M was the predominant type, showed a presence 95.5% (21/22), TEM 63%, SHV 9%, and both TEM and CTX-M were present in 63.6% (14/22), all three present in 4.5% (1/22). The lineage using PFGE showed a single clone in 17 isolates. Seven isolates were type A (all TEMCTX-M), six were type A1 (all TEMCTX-M except 2), four were type A2 (all CTX-M), and three belonged to types B, C, and D respectively Conclusion: High prevalence rate of 19% in the community indicated by this study implies the possibility of sustained ESBL carriage even among isolated population, which could serve as a reservoir for enriching the ESBL pool in the hospital. Clonal relations also indicate a possible epidemiological source that needs to be evaluated.