Protocol for establishing a model for integrated influenza surveillance in Tamil Nadu, India.

The potential for influenza viruses to cause public health emergencies is great. The World Health Organisation (WHO) in 2005 concluded that the world was unprepared to respond to an influenza pandemic. Available surveillance guidelines for pandemic influenza lack the specificity that would enable many countries to establish operational surveillance plans. A well-designed epidemiological and virological surveillance is required to strengthen a country's capacity for seasonal, novel, and pandemic influenza detection and prevention. Here, we describe the protocol to establish a novel mechanism for influenza and SARS-CoV-2 surveillance in the four identified districts of Tamil Nadu, India. This project will be carried out as an implementation research. Each district will identify one medical college and two primary health centres (PHCs) as sentinel sites for collecting severe acute respiratory infections (SARI) and influenza like illness (ILI) related information, respectively. For virological testing, 15 ILI and 10 SARI cases will be sampled and tested for influenza A, influenza B, and SARS-CoV-2 every week. Situation analysis using the WHO situation analysis tool will be done to identify the gaps and needs in the existing surveillance systems. Training for staff involved in disease surveillance will be given periodically. To enhance the reporting of ILI/SARI for sentinel surveillance, trained project staff will collect information from all ILI/SARI patients attending the sentinel sites using pre-tested tools. Using time, place, and person analysis, alerts for abnormal increases in cases will be generated and communicated to health authorities to initiate response activities. Advanced epidemiological analysis will be used to model influenza trends over time. Integrating virological and epidemiological surveillance data with advanced analysis and timely communication can enhance local preparedness for public health emergencies. Good quality surveillance data will facilitate an understanding outbreak severity and disease seasonality. Real-time data will help provide early warning signals for prevention and control of influenza and COVID-19 outbreaks. The implementation strategies found to be effective in this project can be scaled up to other parts of the country for replication and integration.

Biomarkers in the diagnosis and study of psychogenic nonepileptic seizures: A systematic review.

OBJECTIVE: Video electroencephalography (vEEG) is the gold-standard method for diagnosing psychogenic nonepileptic seizures (PNES), but such assessment is expensive, unavailable in many centers, requires prolonged hospitalization, and many times is unable to capture an actual seizure episode. This paper systematically reviews other non-vEEG candidate biomarkers that may facilitate both diagnosis and study of PNES as differentiated from epileptic seizures (ES). METHODS: PubMed database was searched to identify articles between 1980 and 2015 (inclusion: adult PNES population with or without controls, English language; exclusion: review articles, meta-analyses, single case reports). RESULTS: A total of 49 studies were examined, including neuroimaging, autonomic nervous system, prolactin, other (non-prolactin) hormonal, enzyme, and miscellaneous marker studies. Functional MRI studies have shown PNES is hyperlinked with dissociation and emotional dysregulation centers in the brain, although conflicting findings are seen across studies and none used psychiatric comparators. Heart rate variability suggests increased vagal tone in PNES when compared to ES. Prolactin is elevated in ES but not PNES, although shows low diagnostic sensitivity. Postictal cortisol and creatine kinase are nonspecific. Other miscellaneous biomarkers (neuron specific enolase, brain derived neurotropic factor, ghrelin, leptin, leukocytosis) showed no conclusive evidence of utility. Many studies are limited by lack of psychiatric comparators, size, and other methodological issues. CONCLUSION: No single biomarker successfully differentiates PNES from ES; in fact, PNES is only diagnosed via the negation of ES. Clinical assessment and rigorous investigation of psychosocial variables specific to PNES remain critical, and subtyping of PNES is warranted. Future investigational and clinical imperatives are discussed.

Role of inhibition of nitric oxide production in monocrotaline-induced pulmonary hypertension.

Monocrotaline (MCT)-induced pulmonary hypertension (PH) is associated with impaired endothelium-dependent nitric oxide (NO)-mediated relaxation. To examine the role of NO in PH, Sprague-Dawley rats were given a single subcutaneous injection of normal saline [control (C)], 80 mg/kg MCT, or the same dose of MCT and a continuous subcutaneous infusion of 2 mg.kg-1.day-1 of molsidomine, a NO prodrug (MCT+MD). Two weeks later, plasma NO3- levels, pulmonary arterial pressure (Ppa), ratio of right-to-left ventricular weights (RV/LV) to assess right ventricular hypertrophy, and pulmonary histology were evaluated. The plasma NO3- level in the MCT group was reduced to 9.2 +/- 1.5 microM (n = 12) vs. C level of 17.7 +/- 1.8 microM (n = 8; P < 0.02). In the MCT+MD group, plasma NO3- level was 12.3 +/- 2.0 microM (n = 8). Ppa and RV/LV in the MCT group were increased compared with C [Ppa, 34 +/- 3.4 mmHg (n = 6) vs. 19 +/- 0.8 mmHg (n = 8) and 0.41 +/- 0.01 (n = 9) vs. 0.25 +/- 0.008 (n = 8), respectively; P < 0.001]. In the MCT+MD group, Ppa and RV/LV were not different when compared with C [19 +/- 0.5 mmHg (n = 5) and 0.27 +/- 0.01 (n = 9), respectively; P < 0.001 vs. MCT]. Medial wall thickness of lung vessels in the MCT group was increased compared with C [31 +/- 1.5% (n = 9) vs. 13 +/- 0.66% (n = 9); P < 0.001], and MD partially prevented MCT-induced pulmonary vascular remodeling [22 +/- 1.2% (n = 11); P < 0.001 vs. MCT and C]. These results indicate that a defect in the availability of bioactive NO may play an important role in the pathogenesis of MCT-induced PH.

A novel Smart Routing Protocol for remote health monitoring in Medical Wireless Networks.

In a Medical Wireless Network (MWN), sensors constantly monitor patient's physiological condition and movement. Inter-MWN communications are set up between the Patient Server and one or more Centralized Coordinators. However, MWNs require protocols with little energy consumption and the self-organizing attribute perceived in ad-hoc networks. The proposed Smart Routing Protocol (SRP) selects only the nodes with a higher residual energy and lower traffic density for routing. This approach enhances cooperation among the nodes of a Mobile Ad Hoc Network. Consequently, SRP produces better results than the existing protocols, namely Conditional Min-Max Battery Cost Routing, Min-Max Battery Cost Routing and AdHoc On-demand Distance Vector in terms of network parameters. The performance of the erstwhile schemes for routing protocols is evaluated using the network simulator Qualnet v 4.5.

Predicting the effective thermal conductivity of carbon nanotube based nanofluids.

Adding a small volume fraction of carbon nanotubes (CNTs) to a liquid enhances the thermal conductivity significantly. Recent experimental findings report an anomalously wide range of enhancement values that continue to perplex the research community and remain unexplained. In this paper we present a theoretical model based on three-dimensional CNT chain formation (percolation) in the base liquid and the corresponding thermal resistance network. The model considers random CNT orientation and CNT-CNT interaction forming the percolating chain. Predictions are in good agreement with almost all available experimental data. Results show that the enhancement critically depends on the CNT geometry (length), volume fraction, thermal conductivity of the base liquid and the nanofluid (CNT-liquid suspension) preparation technique. Based on the physical mechanism of heat conduction in the nanofluid, we introduce a new dimensionless parameter that alone characterizes the nanofluid thermal conductivity with reasonable accuracy (∼ ± 5%).

Efficiency of chemically modified low cost adsorbents for the removal of heavy metals from waste water: a comparative study.

In this paper, a comparative study of removal efficiency of heavy metals [copper Cu(II), Manganese--Mn(II), Iron--Fe(II), Nickel--Ni(II), Lead--Pb(II) and Zinc--[Zn(II)] from aqueous solution by adsorption on non-conventional materials and on chemically activated non-conventional materials, is presented. It is found that the adsorption potential varies as a function of contact time, concentration, particle size, pH and flow rate. Of all the low cost adsorbents used in the study, saw dust is found to possess greater adsorption efficiency for all metals, than rice husk under identical experimental conditions. Chemically activated saw dust could remove 98.28% of Cu(II); 100% of Mn(II); 96.72% of Fe(II); 96.72% of Cd(II); 75% of Cr(VI); 80% of Ni(II); 95% of Pb(II) and 93% of Zn(II), from the corresponding metal solution taken one at a time.

Cutaneous zygomycosis due to Rhizopus oryzae in a patient with acute lymphoblastic leukemia.

We report herein a case of primary cutaneous zygomycosis caused by Rhizopus oryzae in a 7-year-old girl with acute lymphoblastic leukemia (ALL) receiving intensive chemotherapy. The diagnosis was based on observation of hyphal elements in cutaneous biopsy and isolation of the fungus in culture. The patient responded to surgical intervention and treatment with amphotericin B.

Model for heat conduction in nanofluids.

A comprehensive model has been proposed to account for the large enhancement of thermal conductivity in nanofluids and its strong temperature dependence, which the classical Maxwellian theory has been unable to explain. The dependence of thermal conductivity on particle size, concentration, and temperature has been taken care of simultaneously in our treatment. While the geometrical effect of an increase in surface area with a decrease in particle size, rationalized using a stationary particle model, accounts for the conductivity enhancement, a moving particle model developed from the Stokes-Einstein formula explains the temperature effect. Predictions from the combined model agree with the experimentally observed values of conductivity enhancement of nanofluids.

Esterase activity of Candida species isolated from immunocompromised hosts

Se ha evaluado la actividad esterasa de 149 aislamientos clínicos de Candida procedentes de pacientes inmunodeficientes, mediante el test de opacidad del Tween 80, prueba bioquímica utilizada principalmente para diferencias entre Candia albicans y Candida dubliniensis. Nuestros resultados muestran que C. albicans (92.3%), Candida tropicales (92,3%), Candida parapsilosis (25%), C. dubliniensis (16,6%), Candida inconspicua (100%) y Candia lipolytica (100%) produjeron halos de opacidad durante un periodo de 10 días post-inoculación. Por el contrario, elresto de las especies de Candida no produjeron una respuesta positiva. Estos hallazgos indican que el test de opacidad del Tween 80 no puede ser utilizado como el único rasgo fenotípico para diferenciar C. albicans y C. dubliniensis(AU)

A total of 149 clinical isolates of Candida species isolated from immunocompromised patients were examined to ascertain their esterase activity by the Tween 80 opacity test, which is a biochemical test used mainly to differentiate between Candida albicans and Candida dubliniensis. Our results showed that C. albicans (92.3%), Candida tropicalis (92.3%), Candida parapsilosis (25%), C. dubliniensis (16.6%), Candida inconspicua (100%), and Candida lipolytica (100%) produced opacity halos through the 10-day post-inoculation period. The remaining Candida species did not produce a positive test response. These findings indicate that Tween 80 opacity test cannot be used as the sole phenotypic trait in the differentiation of C. albicans and C. Dubliniensis(AU)