Modeling the dynamics of leptospirosis in India.

Leptospirosis, a formidable zoonotic threat spawned by Leptospira, plagues tropical and subtropical realms. This study delves deep into tropical Indian states, namely, Kerala, Gujarat, Karnataka, Maharashtra, and Tamil Nadu, unraveling the dynamics of leptospirosis through a comprehensive mathematical model that embraces temperature-driven growth rates of Leptospira. Sensitivity analysis and parameter estimation techniques fortified the model's accuracy, unraveling the factors shaping leptospirosis transmission. Notably, the numerical results highlight the significant impact of rainfall, fishing, climate, mining, agriculture, and cattle farming on leptospirosis prevalence in the endemic states of India. Finally, our study urges resolute preventive action to control and combat leptospirosis in India. Strengthening surveillance, impactful awareness campaigns, targeted interventions, and improved hygiene practices among high-risk individuals are vital. Embracing these proactive strategies will alleviate the burden of leptospirosis and enhance public health in India and beyond.

Production systems and breeding practices of Begaria cattle breed as input for a community-based breeding program.

This study aimed to describe the production systems and breeding practices of Begaria cattle breeds as a resource for community-based conservation and breeding program. A semi-structured questionnaire and focus group discussions were employed to identify and describe the breeding practice of the farmer. Three kebeles: Almahal, Fanguso, and Mankush were considered for the study. The data were analyzed using R software. Cattle were kept for a variety of reasons, including milk, breeding, meat, cash, and saving. It was typical throughout the study area to see herd mixing and keeping together (4.7 ± 0.33 herds on average), herd movement during the dry season, and breeding bull sharing (1.9 ± 1.55 shared bulls). During the summer season, cattle rearing in the areas was hindered by feed and water shortages. The breed's major reproduction constraints were abortion (24 %), repeat breeding (19), and calf mortality (14). The primary reason for keeping Begaria cattle was for milk (29 %), cash (26), meat (22), and breeding (0.22). The average age at first calving (AFC), calving interval (CI) and milk yield per day of the breed were 41.5 ± 1.63, 16.0 ± 0.43 months, and 3.2 ± 0.12 L respectively. The average age of breeding bull selection was 3 ± 0.1 years, and it was based on several criteria, including their phenotype, growth, and white coat colour. Based on the current findings, it is recommended that a multi-trait selection program be designed with full stakeholder participation.

Impact of critical eddy diffusivity on seasonal bloom dynamics of Phytoplankton in a global set of aquatic environments.

The intensity of eddy diffusivity and the spatial average of water velocity at the depths of the water column in oceans and lakes play a fundamental role in phytoplankton production and phytoplankton and zooplankton biomass, and community composition. The critical depth and intensity of turbulent mixing within the water column profoundly affect phytoplankton biomass, which depends on the sinking characteristic of planktonic algal species. We propose an Nutrient-Phytoplankton-Zooplankton (NPZ) model in 3D space with light and nutrient-limited growth in a micro-scale ecological study. To incorporate micro-scale observation of phytoplankton intermittency in bloom mechanism in stationary as well as oceanic turbulent flows, a moment closure method has been applied in this study. Experimental observations imply that an increase in turbulence is sometimes ecologically advantageous for non-motile planktonic algae. How do we ensure whether there will be a bloom cycle or whether there can be any bloom at all when the existing phytoplankton group is buoyant, heavier, motile, or non-motile? To address these questions, we have explored the effects of critical depth, the intensity of eddy diffusivity, spatial average of water velocity, on the concentration as well as horizontal and vertical distribution of phytoplankton and zooplankton biomass using a mathematical model and moment closure technique. We quantify a critical threshold value of eddy diffusivity and the spatial average of water velocity and observe the corresponding changes in the phytoplankton bloom dynamics. Our results highlight the importance of eddy diffusivity and the spatial average of water velocity on seasonal bloom dynamics and also mimic different real-life bloom scenarios in Mikawa Bay (Japan), Tokyo Bay (Japan), Arakawa River (Japan), the Baltic Sea, the North Atlantic Ocean, Gulf Alaska, the North Arabian Sea, the Cantabrian Sea, Lake Nieuwe Meer (Netherlands) and several shallower lakes.

Assessment of indigenous Shaka cattle structural indices reared in Shaka zone, south west Ethiopia.

The study encompassed quantitative traits of the Shaka cattle reared in Shaka zone, Anderacha and Masha weredas of south western, Ethiopia. The study covered quantitative parameters which were taken from 240 cows and 120 bulls from randomly slected120 households. The means for the quantitative traits were compared using Duncan's Multiple Range test, the values were considered significant at P < 0.05 and P < 0.01. The results of morphometrical measurements of bulls reared at Masha wereda had wider (P < 0.05) values for their pelvic width and the Chest Depth for the bulls aged ≥7 years was higher (P < 0.01). While the canon bone circumference was also wider when compared to the bulls reared at Anderacha wereda. Contrary the bulls aged ≤5 years and reared at Anderacha wereda had higher (P < 0.05) for Body Weight, Height at Withers and Chest Depth. Morphometrical measurement for cows ≤5 year age group and reared at Masha wereda have longer (P < 0.05) Neck Length and for cows ≥7 years have wider (P < 0.05) Hock Bone Circumference and Pelvic Width. Contrary the cows aged ≤5 years raised at Anderacha wereda has wider (P < 0.05) for Cannon Bone Circumference, and (P < 0.01) for Chest Girth, higher Body Weight, Rump Length, Ear Length, Neck Circumference and Chest Depth. Among the cows aged ≥7 years have longer (P < 0.01) face length and deeper (P < 0.05) Chest. There is a significant difference in the length index (LI2) and body ratio (BR) (P < 0.05) throughout the research locations, with Anderacha wereda having the higher result, and Masha wereda having the higher depth index (DI) and transverse pelvic index (TPI) (P < 0.05).The results of body indices of both sex indicate that, the cattle is suited for grazing in the forest areas and are of dual type.

Effect of productivity and seasonal variation on phytoplankton intermittency in a microscale ecological study using closure approach.

A microscale ecological study using the closure approach to understand the impact of productivity controlled by geographical and seasonal variations on the intermittency of phytoplankton is done in this paper. Using this approach for a nutrient-phytoplankton model with Holling type III functional response, it has been shown how the dynamics of the system can be affected by the environmental fluctuations triggered by the impact of light, temperature, and salinity, which fluctuate with regional and seasonal variations. Reynold's averaging method in space, which results in expressing the original components in terms of its mean (average value) and perturbation (fluctuation) has been used to determine the impact of growth fluctuation in phytoplankton distribution and in the intermittency of phytoplankton spreading (variance). Parameters are estimated from the nature of productivity and spread of phytoplankton density during field observation done at four different locations of Tokyo Bay. The model validation shows that our results are in good agreement with the field observation and succeeded in explaining the intermittent phytoplankton distribution at different locations of Tokyo Bay, Japan, and its neighboring coastal regions.

Delay induced interaction of humoral- and cell-mediated immune responses with cancer.

A mathematical model for the quantitative analysis of the interaction between cancer cells and cell-mediated immune system with two discrete-time delays, considering the role of antibodies, is studied in this paper. The model is analyzed both analytically and numerically to understand the dynamics of interaction delay and proliferation enhancement effect delay in the eradication of cancer. Hopf bifurcation occurs when one-time delay crosses the critical value in the absence of the other. It is also observed that as we increase any of the delays, it will increase the cancer burden. The analysis shows that a cancer-free state cannot be obtained solely by the killing rate of cytotoxic T-lymphocytes, but humoral response in combination with cell-mediated immune responses plays an important role to eradicate cancer.

Modeling the dynamics of COVID-19 pandemic with implementation of intervention strategies.

The ongoing COVID-19 epidemic spread rapidly throughout India, with 34,587,822 confirmed cases and 468,980 deaths as of November 30, 2021. Major behavioral, clinical, and state interventions have implemented to mitigate the outbreak and prevent the persistence of the COVID-19 in human-to-human transmission in India and worldwide. Hence, the mathematical study of the disease transmission becomes essential to illuminate the real nature of the transmission behavior and control of the diseases. We proposed a compartmental model that stratify into nine stages of infection. The incidence data of the SRAS-CoV-2 outbreak in India was analyzed for the best fit to the epidemic curve and we estimated the parameters from the best fitted curve. Based on the estimated model parameters, we performed a short-term prediction of our model. We performed sensitivity analysis with respect to R 0 and obtained that the disease transmission rate has an impact in reducing the spread of diseases. Furthermore, considering the non-pharmaceutical and pharmaceutical intervention policies as control functions, an optimal control problem is implemented to reduce the disease fatality. To mitigate the infected individuals and to minimize the cost of the controls, an objective functional has been formulated and solved with the aid of Pontryagin's maximum principle. This study suggest that the implementation of optimal control strategy at the start of a pandemic tends to decrease the intensity of epidemic peaks, spreading the maximal impact of an epidemic over an extended time period. Our numerical simulations exhibit that the combination of two controls is more effective when compared with the combination of single control as well as no control.

Quality improvement report: setting up a hospital at night service, limitations of bleep filtering and using an electronic task management system.

The 'hospital at night' concept was developed at a joint conference of the London Deanery and Clinical Staff in 2002, as an issue for education and service provision. At the start of the project, our trust had issues with both the structure of the hospital at night handover and the working practices overnight. The vision was to improve team working out of hours, expedite review of sick patients and reorganise care to seek a reduction in bleeps to medical junior doctors overnight in a way that all patients had access to the right person with the right skills for their needs at the right time. The hospital at night project at our hospital was started in 2019 by a multidisciplinary working group. We tried bleep filtering for 4 months and this was later followed on by the development of an electronic out of hour's task list as part of our hospital at night set-up. The bleep analysis data showed an improved distribution of workload but the process was dependent on individuals. The electronic task management system was built in pre-existing online software. The system helped prioritise and review tasks requested by nurses on medical wards. But it was not without its limitations. We worked with the local information technology (IT) team to improve speed and proposed developing an IT solution that is fast and not desktop based to ensure tasks can be assigned and viewed while on the go. The project was overall a success as it demonstrated positive feedback from junior doctors, improved perception of teamwork and ability to take rest breaks. It also demonstrated a drop in ward-based cardiac arrest rates. The hospital at night project at our trust remains a work in progress, but a lot of positive changes have been delivered.

Determination of critical community size from an HIV/AIDS model.

After an epidemic outbreak, the infection persists in a community long enough to engulf the entire susceptible population. Local extinction of the disease could be possible if the susceptible population gets depleted. In large communities, the tendency of eventual damp down of recurrent epidemics is balanced by random variability. But, in small communities, the infection would die out when the number of susceptible falls below a certain threshold. Critical community size (CCS) is considered to be the mentioned threshold, at which the infection is as likely as not to die out after a major epidemic for small communities unless reintroduced from outside. The determination of CCS could aid in devising systematic control strategies to eradicate the infectious disease from small communities. In this article, we have come up with a simplified computation based approach to deduce the CCS of HIV disease dynamics. We consider a deterministic HIV model proposed by Silva and Torres, and following Nåsell, introduce stochasticity in the model through time-varying population sizes of different compartments. Besides, Metcalf's group observed that the relative risk of extinction of some infections on islands is almost double that in the mainlands i.e. infections cease to exist at a significantly higher rate in islands compared to the mainlands. They attributed this phenomenon to the greater recolonization in the mainlands. Interestingly, the application of our method on demographic facts and figures of countries in the AIDS belt of Africa led us to expect that existing control measures and isolated locations would assist in temporary eradication of HIV infection much faster. For example, our method suggests that through systematic control strategies, after 7.36 years HIV epidemics will temporarily be eradicated from different communes of island nation Madagascar, where the population size falls below its CCS value, unless the disease is reintroduced from outside.

Patient Journey Champions: A project to facilitate delivery of effective board rounds for inpatients, aiding flow through the hospital.

Our quality improvement project was designed to enable delivery of high-quality board rounds across the hospital with a view to improving patient flow. We designed a Patient Journey Champion campaign to enable this. As part of our campaign, we ran sessions with junior doctors. These comprised education on the structure of a board round, giving them an insight into the bigger picture on patient flow and eventually aiming to empower them to lead an effective board round on their respective wards, where they would act as 'Patient Journey Champions'. Following the workshops, we audited the quality of board rounds and compared it with baseline. The quality was measured against the hospital standard operating procedure. We noticed an improvement in the quality of board rounds and also a positive effect on length of stay on the acute admissions ward. We anticipate a continuing trend of improvement as this intervention is rolled out across more doctors and other staff groups, although this relies on the need to involve doctors in board rounds and empowering them with the appropriate skills. Simultaneously, work is now being undertaken by matrons of respective wards to upskill ward nurses and other allied healthcare professionals to aid delivery of improved board rounds.

Economic Analysis of Primary Eye Care Services Provided through Vision Centers in Eastern India.

Purpose: Primary eye care services delivered through vision centres (VC) form an essential part of the national blindness control efforts, but systematic data on the outputs and cost of providing such services in India are not readily available for further planning and efficient use of resources.Methods: Detailed cost and output data were collected from written records for 2017-2018 fiscal year using standardized methods at nine VC in Kolkata city in West Bengal, India. The total economic cost for these VC was computed and the relation of unit cost of services per patient screened with VC scale was assessed using regression analysis. Break-even point was estimated from average and marginal cost functions.Results: 25,009 patients were screened at the 9 VC (range 709-5,717; median 2,826). The overall total economic cost was INR 7,304,172 (USD 113,306), ranging from INR. 509,618 (USD. 7,905) to INR. 1,390,855 (USD. 21,576). Personnel salaries made up 37.8% of the total cost. The unit economic cost of screening a patient was INR 292.1 (USD 4.4) and varied threefold between 9 VC. With a multiple regression model (p < .035, R2 = 0.797), apart from the fixed costs, the incremental cost for each patient screened was INR 81.33 (USD 1.26). Break-even analysis suggested that 44.4% of the VCs were functioning below optimal scale.Conclusion: A further reduction in the unit costs is possible if the optimal scale of services is achieved. These findings can inform resource requirement for the primary eye care services in India.

QUALITY IMPROVEMENT: Supporting a hospital in difficulty: -experience of a '-buddying' agreement to implement a new medical pathway.

Increased NHS regulation has identified many healthcare organisations with operational and/or financial difficulties. Although the causes are often complex, most cases are effectively managed internally with limited input from external agencies. How best to support the few organisations needing additional support has not been established. 'Buddying', in which senior clinical and managerial teams from a well performing organisation work with colleagues from an organisation in difficulty has been proposed as a potential solution. Previous reports suggest that these partnerships are generally valued by the organisation in difficulty but there is a paucity of measured operational benefit. In this article we present our experience of a 'buddying agreement' and its impact on the introduction of a new 'whole system' medical pathway (ie rotas, staffing, process) at an organisation in difficulty. We describe the process, problems, effect on operational performance, staff survey feedback six months post-implementation and the lessons learned. Factors critical to success were good communication; clear responsibilities, common values and strong governance; incorporation into an effective local improvement programme; targeting of specific issues; ability to influence people and foster relationships; adequate 'manpower' and gradual transition to local 'ownership'.

Influence of multiple delays in brain tumor and immune system interaction with T11 target structure as a potent stimulator.

We present a mathematical model which describes the growth of malignant gliomas in presence of immune responses by considering the role of immunotherapeutic agent T11 target structure (T11TS). The model consider five populations, namely, glioma cells, macrophages, cytotoxic T-lymphocytes, TGF - ß and IFN - γ. The model system has highly nonlinear terms with four discrete time lags, but remains tractable. The goal of this work is to better understand the effect of multiple delays on the interaction between gliomas and immune components in conjunction with an administration of T11 target structure. Analytically, we investigate the conditions for the asymptotic stability of equilibrium points, the existence of Hopf bifurcations and the maximum value of the delay to preserve the stability of limit cycle. For the set of parameter values estimated from experimental data, time delays have hardly any influence on the system behavior. Numerical simulations are carried out to investigate the dynamics of the model with different values for delays with and without administration of T11 target structure.

Effects of feeding different proportions of silver leaf desmodium (Desmodium uncinatum) with banana (Musa paradisiaca) leaf on nutrient utilization in Horro sheep fed a basal diet of natural grass hay.

OBJECTIVE: The objective was to evaluate feed intake, digestibility, body weight change and carcass characteristics of sheep fed a basal diet of hay supplemented with banana leaves and silver leaf desmodium. METHODS: Thirty yearling lambs with an average initial body weight of 15.85±1.6 kg were grouped into six blocks of five rams in each block. The treatments were: hay alone (T1), hay+ 100% banana leaf (T2), hay+67% banana leaf+33% desmodium leaf (T3), hay+33% banana leaf+67% desmodium leaf (T4), andhay+100% desmodium leaf (T5). Three hundred grams of treatment diets were offered daily on as fed basis. The feeding and digestibility trials lasted for 84 and 7 days, respectively, followed by carcass evaluation. RESULTS: The total dry matter (DM) intake for T3, T4, and T5 were greater (p<0.05) than those fed T1 and T2 diets. The lowest (p<0.05) organic matter (OM) intake was recorded in rams reared on T1 diet. The total crude protein (CP) intake was in the following order: T5> T4>T3>T2>T1. Ram lambs receiving supplementary diets had higher (p<0.05) DM, OM, CP, neutral detergent fiber and acid detergent fiber digestibility compared with the control diet. The empty body weight and slaughter weight was highest (p<0.05) in rams receiving T3, T4, and T5 diets. The average daily gain and feed conversion efficiency was highest (p< 0.05) in rams receiving the supplementary diets. The dressing percentage on the basis of hot carcass weight linearly increased with increasing levels of desmodium. Rams reared on supplementary diet had higher (p<0.05) rib eye area compared with the control diet. CONCLUSION: In conclusion, when banana leaf is used as a supplement to poor quality grass, better body weight gain was obtained when fed in combination with desmodium.

Mathematical modeling of cancer-immune system, considering the role of antibodies.

A mathematical model for the quantitative analysis of cancer-immune interaction, considering the role of antibodies has been proposed in this paper. The model is based on the clinical evidence, which states that antibodies can directly kill cancerous cells (Ivano et al. in J Clin Investig 119(8):2143-2159, 2009). The existence of transcritical bifurcation, which has been proved using Sotomayor theorem, provides strong biological implications. Through numerical simulations, it has been illustrated that under certain therapy (like monoclonal antibody therapy), which is capable of altering the parameters of the system, cancer-free state can be obtained.

Quantifying the role of immunotherapeutic drug T11 target structure in progression of malignant gliomas: Mathematical modeling and dynamical perspective.

The paper describes a mathematical model with synergistic interaction between the malignant glioma cells and the immune system, namely, macrophages, activated Cytotoxic T-Lymphocytes (CTLs), the immunosuppressive cytokine Transforming Growth Factor - ß (TGF-ß) and the immuno-stimulatory cytokine Interferon - γ (IFN-γ), using a system of coupled non-linear ordinary differential equations (ODEs). We have introduced a new immunotherapeutic drug T11 Target structure (T11TS) into the model, which boosts the macrophages and CTLs to kill the glioma cells. In our analysis, we have established a criteria for the threshold level of immunotherapeutic drug T11TS for which the system will be gliomas free or tumor free. The analytical findings are supported by numerical simulations using parameters estimated from experimental data.

Oxidative stress in hypothyroid patients and the role of antioxidant supplementation.

CONTEXT: The available data concerning oxidant stress and antioxidant capacity in hypothyroidism are scanty and inconclusive. While some authors suggest that tissues may be protected from oxidant damage because of a hypometabolic state in hypothyroidism, others report increased oxidative stress in hypothyroidism. Selenium acts as a cofactor for the thyroid hormone (TH) deiodinases that activate and then deactivate various THs and their metabolites. Selenium may inhibit thyroid autoimmunity. AIMS: The study was designed, first, to study the impact of oxidative stress in patients of primary hypothyroidism due to autoimmune thyroiditis, by estimation of serum malondialdehyde (MDA) as a biomarker of oxidative stress. Second, to study the change in MDA level pre- and post-L-thyroxine treatment. Finally, to look into the possible role of selenium supplementation on oxidative stress in autoimmune hypothyroidism. SUBJECTS AND METHODS: Patients attending endocrine outpatient department (OPD) services of IPGMER and SSKM hospital were considered for the study. Sixty treatment-naive adult patients (age > 18 years) with hypothyroidism were included in the study. The patients were divided into two groups, each comprised thirty patients. One group was treated with L-thyroxine and placebo (Group A). The other group received L-thyroxine replacement along with selenium (100 mcg twice a day) as antioxidant supplementation (Group B). The patients were blinded about selenium and placebo. The study duration for both groups was 6 months. The starting dose of L-thyroxine was 1.6 mcg/kg body weight free thyroxine (FT4), and thyroid-stimulating hormone (TSH) was repeated after 12 weeks. L-thyroxine dose adjustments were done if needed. MDA was assessed at the beginning and at the end of the study, i.e., after 6 months of treatment. The control cohort was composed of thirty healthy adults. Only overt hypothyroidism (OH) cases were included in the study. STATISTICAL ANALYSIS USED: Normality of data was determined using Anderson-Darling test, Shapiro-Wilk test, and QQ plot. P values were calculated using ANOVA and post hoc Bonferroni tests for normally distributed data. Correlation analysis was carried out using Pearson correlation test. P < 0.05 considered to be statistically significant. RESULTS: After treatment in Group A patients, FT4 showed a significant increment while TSH value decreased. MDA level reduced after treatment, (P < 0.001). After treatment in Group B patients, FT4 showed increment while TSH value decreased (P < 0.05). After treatment, there was a drop in estimated MDA level (P < 0.001). MDA level shows a significant drop in both groups after treatment. In Group B, there is more decline in the MDA percentage but did not reach statistical significance. By performing repeated measure MANOVA, no significant difference was found in the MDA levels between the two groups. MDA reduction when expressed as percentage showed reduction of 39.5% in patients of Group A. Similarly, Group B patients showed a percentage reduction of 45.4%. CONCLUSIONS: Oxidative stress compounds hypothyroidism. Hypothyroidism is a state of increased oxidative stress. In this study, biomarker, MDA level is high in treatment-naive primary hypothyroid patients. After treatment with L-thyroxine, the stress marker is reduced to a significant extent. MDA can be used as a useful biomarker to measure and monitor oxidative stress. The role of the addition of antioxidant in the form of selenium remained inconclusive.

WITHDRAWN:The effect of partial substitution of roasted soybean seed with graded levels of sweet potato (Ipomoea batatas) leaf meal on growth performances and carcass characteristics of broiler chickens.

Ahead of Print article withdrawn by publisher.