Physico-chemical characteristics and quality assessment of soil in parts of the Banganga Basin in northeastern Rajasthan, NW India.

Soil is a vital natural resource that has a bearing on any developmental activity. A database comprising primary physicochemical characteristics and soil suitability would assist the planners in devising an appropriate land use policy and any intervention strategy for soil quality improvement. The physicochemical characteristics of soils in parts of the Banganga Basin, located in the semi-arid terrain of NW India were evaluated mainly through surface samples and sub-surface ones wherever sections were exposed in stream banks. The soil in the studied terrain is a Quaternary age, pale brown to dark brown and occasionally red, alluvial soil. Sandy loam is the dominant soil type, while sandy soil and loamy sand types also occur. The soil maintains a depth-wise consistency in physicochemical characteristics. The average soil pH value is 8.55, indicating a slightly alkaline and healthy soil. The soil has a high available nitrogen content (0.53 to 2.24%), adequate available phosphorus (23.58 and 62.18 mg/kg), and low potassium (22.5 and 200 mg/kg) contents. The organic carbon, Mg, and Ca levels are generally on the lower side. A consistency in overall soil characteristics is evident in the narrow range of the Soil Quality Index, varying between 10 and 14, and soil can be categorized into three categories with overlapping soil qualities.

The effect of overlapping surgical scheduling on operating theatre productivity: a narrative review.

This article reviews the background to overlapping surgery, in which a single senior surgeon operates across two parallel operating theatres; anaesthesia is induced and surgery commenced by junior surgeons in the second operating theatre while the lead surgeon completes the operation in the first. We assess whether there is any theoretical basis to expect increased productivity in terms of number of operations completed. A review of observational studies found that while there is a perception of increased surgical output for one surgeon, there is no evidence of increased productivity compared with two surgeons working in parallel. There is potential for overlapping surgery to have some positive impact in situations where turnover times between cases are long, operations are short (<2 h) and where 'critical portions' of surgery constitute about half of the total operation time. However, any advantages must be balanced against safety, ethical and training concerns.

How can Never Event data be used to reflect or improve hospital safety performance?

The absolute number of Never Events is used by UK regulators to help assess hospital safety performance, without account of hospital workload. We applied funnel plots, as an established means of taking workload into account, to published Never Event data for 151 acute Trusts in NHS England, matched to finished consultant episodes for 3 years, 2017-2020. Trusts with excess event rates should have the most Never Events if absolute number is a valid way to judge performance. The absolute number of Never Events was correlated with workload (r2 = 0.51, p < 0.001), but the five Trusts above the upper 95% confidence limit did not have the highest number of Never Events. However, a limitation to interpretation was that the data were skewed; 12 out of 151 Trusts lay below the lower 95% limit. This skew probably arises because funnel plots pool all Never Events and workload data; whereas, ideally, different Never Events should use as denominator only the relevant workload actions that could cause them. We conclude that the manner in which Never Event data are currently used by regulators, in part to judge or rate hospitals, is mathematically invalid. The focus should shift from identifying 'outlier' hospitals to reducing the overall national mean Never Event rate through shared learning and an integrated system-wide approach.

Novel Information Measures for Fermatean Fuzzy Sets and Their Applications to Pattern Recognition and Medical Diagnosis.

Fermatean fuzzy sets (FFSs) have piqued the interest of researchers in a wide range of domains. The striking framework of the FFS is keen to provide the larger preference domain for the modeling of ambiguous information deploying the degrees of membership and nonmembership. Furthermore, FFSs prevail over the theories of intuitionistic fuzzy sets and Pythagorean fuzzy sets owing to their broader space, adjustable parameter, flexible structure, and influential design. The information measures, being a significant part of the literature, are crucial and beneficial tools that are widely applied in decision-making, data mining, medical diagnosis, and pattern recognition. This paper aims to expand the literature on FFSs by proposing many innovative Fermatean fuzzy sets-based information measures, namely, distance measure, similarity measure, entropy measure, and inclusion measure. We investigate the relationship between distance, similarity, entropy, and inclusion measures for FFSs. Another achievement of this research is to establish a systematic transformation of information measures (distance measure, similarity measure, entropy measure, and inclusion measure) for the FFSs. To accomplish this aim, new formulae for information measures of FFSs have been presented. To demonstrate the validity of the measures, we employ them in pattern recognition, building materials, and medical diagnosis. Additionally, a comparison between traditional and novel similarity measures is described in terms of counter-intuitive cases. The findings demonstrate that the innovative information measures do not include any absurd cases.

Is 'starting on time' useful (or useless) as a surrogate measure for 'surgical theatre efficiency'?

We analysed more than 7000 theatre lists from two similar UK hospitals, to assess whether start times and finish times were correlated. We also analysed gap times (the time between patients when no anaesthesia or surgery occurs), to see whether these affected theatre efficiency. Operating list start and finish times were poorly correlated at both hospitals (r(2) = 0.077 and 0.043), and cancellation rates did not increase with late starts (remaining within 2% and 10% respectively at the two hospitals). Start time did not predict finish time (receiver operating curve areas 0.517 and 0.558, respectively), and did not influence theatre efficiency (~80-84% at either hospital). Median gap times constituted just 7% of scheduled list time and did not influence theatre efficiency below cumulative gap times of less than 15% scheduled list time. Lists with no gaps still exhibited extremely variable finish times and efficiency. We conclude that resources expended in trying to achieve prompt start times in isolation, or in reducing gap times to under ~15% of scheduled list time, will not improve theatre productivity. Instead, the primary focus should be towards quantitative improvements in list scheduling.

Automatic detection of COVID-19 from chest radiographs using deep learning.

INTRODUCTION: The breakdown of a deadly infectious disease caused by a newly discovered coronavirus (named SARS n-CoV2) back in December 2019 has shown no respite to slow or stop in general. This contagious disease has spread across different lengths and breadths of the globe, taking a death toll to nearly 700 k by the start of August 2020. The number is well expected to rise even more significantly. In the absence of a thoroughly tested and approved vaccine, the onus primarily lies on obliging to standard operating procedures and timely detection and isolation of the infected persons. The detection of SARS n-CoV2 has been one of the core concerns during the fight against this pandemic. To keep up with the scale of the outbreak, testing needs to be scaled at par with it. With the conventional PCR testing, most of the countries have struggled to minimize the gap between the scale of outbreak and scale of testing. METHOD: One way of expediting the scale of testing is to shift to a rigorous computational model driven by deep neural networks, as proposed here in this paper. The proposed model is a non-contact process of determining whether a subject is infected or not and is achieved by using chest radiographs; one of the most widely used imaging technique for clinical diagnosis due to fast imaging and low cost. The dataset used in this work contains 1428 chest radiographs with confirmed COVID-19 positive, common bacterial pneumonia, and healthy cases (no infection). We explored the pre-trained VGG-16 model for classification tasks in this. Transfer learning with fine-tuning was used in this study to train the network on relatively small chest radiographs effectively. RESULTS: Initial experiments showed that the model achieved promising results and can be significantly used to expedite COVID-19 detection. The experimentation showed an accuracy of 96% and 92.5% in two and three output class cases, respectively. CONCLUSION: We believe that this study could be used as an initial screening, which can help healthcare professionals to treat the COVID patients by timely detecting better and screening the presence of disease. IMPLICATION FOR PRACTICE: Its simplicity drives the proposed deep neural network model, the capability to work on small image dataset, the non-contact method with acceptable accuracy is a potential alternative for rapid COVID-19 testing that can be adapted by the medical fraternity considering the criticality of the time along with the magnitudes of the outbreak.

Pneumorrhachis following cervical spine surgery.

A 66-year-old man experienced symptomatic pneumorrhachis (air within the spinal canal) following a cervical laminoplasty for the excision of meningioma. Following an uneventful intraoperative course, he suffered a fluctuating hemiparesis of varying severity. Urgent imaging demonstrated extradural and intradural air in the spinal canal. Treatment with supplemental oxygen and dexamethasone was commenced, and the patient's symptoms improved over a period of three days with full resolution at six weeks. Pneumorrhachis can be avoided by allowing air to escape from the spinal canal through positioning, and displacement with irrigation fluid at the time of wound closure. However, if pneumorrhachis does occur, oxygen therapy, positioning of the patient to mitigate the gravitational effect of the air bubbles and supportive treatment are the central elements of management. Other possible causes of neurological deficit should be ruled out. This is particularly important as treatment options for some differential diagnoses can potentially cause harm if started based on clinical impression alone, for example, re-exploration for suspected haematoma. Only a small number of previous reports have described symptomatic pneumorrhachis as a complication of spinal surgery. This patient was successfully managed with conservative measures following the exclusion of other spinal cord pathologies.

Understanding waiting lists as the matching of surgical capacity to demand: are we wasting enough surgical time?

If surgical 'capacity' always matched or exceeded 'demand' then there should be no waiting lists for surgery. However, understanding what is meant by 'demand', 'capacity' and 'matched' requires some mathematical concepts that we outline in this paper. 'Time' is the relevant measure: 'demand' for a surgical team is best understood as the total min required for the surgery booked from outpatient clinics every week; and 'capacity' is the weekly operating time available. We explain how the variation in demand (not just the mean demand) influences the analysis of optimum capacity. However, any capacity chosen in this way is associated with only a likelihood (that is, a probability rather than certainty) of absorbing the prevailing demand. A capacity that suitably absorbs the demand most of the time (for example, > 80% of weeks) will inevitably also involve considerable waste (that is, many weeks in which there is spare, unused capacity). Conversely, a level of capacity chosen to minimise wasted time will inevitably cause an increase in size of the waiting list. Thus the question of how to balance demand and capacity is intimately related to the question of how to balance utilisation and waste. These mathematical considerations enable us to consider objectively how to manage the waiting list. They also enable us critically to analyse the extent to which philosophies adopted by the National Health Service (such as 'Lean' or 'Six Sigma') will be successful in matching surgical capacity to demand.

Impact of water deficit stress in maize: Phenology and yield components.

Fifteen million farmers in India engaged in Maize cultivation. India would require 45 MMT of Maize by 2022. But, only 15% of cultivated area of maize is under irrigation and water shortage has been a challenge for sustainability of maize production. Water deficit stress (WDS) during pre-flowering and grain filling stages massively affects the plant performance due to imprecise traits function. Thus, the effect of WDS on non-drought tolerant (NDT) and drought tolerant (DT) maize lines were investigated. WDS increased the flowering days, days to maturity, anthesis silk interval, decreased the leaf number, abnormal expression of secondary stress responsive traits, loss of normal root architecture which overall lead to a reduction in GY/ha. WDS at flowering and grain filling stage leads to significant yield penalty especially in NDT lines than DT lines. The yield penalty was ranged from 34.28 to 66.15% in NDT and 38.48 to 55.95% in DT lines due to WDS. Using multiple statistics, traits which improve WDS tolerance in maize were identified viz; number of leaves, number of stomata on lower surface of leaf, leaf angle at ear forming node internodal length between 3rd and 4th leaf from top, flag leaf length, flag leaf width, ear per plants, leaf senescence, pollen stainability, root fresh weight and root length. These traits would help in trait specific breeding in maize for WDS tolerance.

Measuring the quantitative performance of surgical operating lists: theoretical modelling of 'productive potential' and 'efficiency'.

We previously defined surgical list 'efficiency' as: maximising theatre utilisation, minimising over-running, and minimising cancellations. 'Efficiency' maximises output for input; 'productivity' emphasises total output. We define six criteria that any measure of productivity (better termed 'quantitative performance') needs to satisfy. We then present a theoretical analysis that fulfils these by incorporating: 'speed' of surgery (with reference to average speeds), 'patient contact' (synonymous with minimising gaps between cases), and 'efficiency' (as previously defined). 'Speed' and 'patient contact' together constitute a 'productive potential'. Our formula satisfies the pre-set criteria and yields plausible results in both hypothetical and real data sets, To be productive in these quantitative terms, teams in any specialty need to achieve minimum quality standards defined by their sub-specialty; to plan their lists to utilise the time available with no cancellations or over-runs and to work at least as fast as average with minimal gaps between cases. 'Productive potential' combined with 'efficiency' yielding 'actual productivity' in our theoretical analysis more completely describes quantitative surgical list performance than any other single measure.

The complications of external cephalic version: results from 805 consecutive attempts.

Most breech babies at term are now delivered by caesarean section. Although external cephalic version reduces the number of term breech presentations, its uptake has not been as wide as is recommended by professional bodies. This may be because of fears over safety. Pooled safety data do exist, largely from case series. However, the possibility of reporting and publication biases in such studies maybe preventing both women and obstetricians from being adequately reassured. In this series of 805 consecutive version attempts, we report an extremely low complication rate and 0.5% risk of emergency caesarean section after the procedure.

Helix-destabilization of deoxyribonucleic acid and poly[d(A-T).d(A-T)] by bovine seminal ribonuclease.

A ribonuclease isolated earlier from bovine seminal plasma by DNA-affinity chromatography (Ramakrishnamurti, T. and Pandit, M.W. (1983) J. Chromatogr. 260, 216-222) has now been shown by thermal denaturation studies to destabilize the double-helical structure of DNA and poly[d(A-T).d(A-T)]. Thermal denaturation profiles of DNA in the presence of the protein are much more complicated due to the denaturation of protein itself in the temperature range over which DNA predominantly melts. The protein shows relatively stronger affinity towards denatured DNA as compared to native DNA. The action of micrococcal nuclease on DNA and its complexes with ribonuclease A and bovine seminal ribonuclease indicates that both of these proteins destabilize the double-helical structure of native DNA and thereby render the DNA more sensitive to the micrococcal nuclease.

Denaturation studies on bovine pancreatic ribonuclease. Effect of trichloroacetic acid.

Exposure of ribonuclease (EC 3.1.27.5) to 5% trichloroacetic acid solution is found to partially inactivate the enzyme. This inactivation is a function of time of exposure to trichloroacetic acid and reaches a plateau of about 45% residual activity. Higher concentrations of trichloroacetic acid lead to greater inactivation. Physicochemical properties such as sedimentation coefficient, gel-filtration behaviour and polyacrylamide gel electrophoresis of the trichloroacetic acid-treated enzyme remain unaffected as compared to the untreated enzyme. However, spectrophotometric titration of the trichloroacetic acid-treated enzyme revealed that one of the three 'buried' groups of tyrosine is exposed to the outside surface of the molecule. Near ultraviolet CD spectra supported these observations. Far ultraviolet CD spectra suggested some refolding of the enzyme after trichloroacetic acid treatment. Immunological determinants on the molecule remain unaltered upon trichloroacetic acid treatment. It is concluded that the exposed tyrosine group may be causing a conformational change in the protein and this change may be indirectly responsible for the observed reduction in the activity after trichloroacetic acid treatment.

Self-association of diisopropylphosphoryl-alpha-chymotrypsin: the involvement of active site of the enzyme in its self-association behaviour.

The self-association of diisopropylphosphoryl(DIP)-alpha-chymotrypsin is studied in order to find out whether the active site of the enzyme is involved in its self-association behaviour or not. Sedimentation coefficient as well as the weight-average (Archibald) molecular weight data are obtained as a function of concentration using an analytical ultracentrifugation technique. The analysis indicated that the experimental data fits the model of indefinite self-association. The comparison of the data with earlier data on alpha-chymotrypsin revealed that after the modification at the active site, the association constant for the self-association is reduced by about 47%, and the system deviated from ideality. Results showed further that Ser-195, at the active site, appears to be involved in the self-association behaviour of alpha-chymotrypsin; however, the participation of other groups at the active site is also implicated.

Studies on the enzymatic and physicochemical behaviour of the trichloroacetic acid-treated and untreated bovine pancreatic ribonuclease.

Exposure of ribonuclease A to 5% trichloroacetic acid inactivates the enzyme partially. One of the possible reasons for such inactivation might be the exposure of one of the buried tyrosyl groups to the outside surface of the molecule (Sagar and Pandit (1983) Biochim. Biophys. Acta 743, 303-309). The trichloroacetic acid-treated enzyme hydrolysed 2':3'-cCMP with an efficiency of about 60%; while with rRNA as substrate, it is about 45%. Results indicate that apart from the reduction in the activity on trichloroacetic acid treatment, the enzyme possesses a reduced ability to break down the secondary structures of substrates such as rRNA in the first phase of the reaction. Thermal unfolding of ribonuclease A was followed by various physicochemical techniques such as UV absorbance, CD-spectroscopy and differential scanning microcalorimetry. The results indicate that the enzyme, after trichloroacetic acid-treatment, has a less ordered structure when compared to that of untreated enzyme. Thermal unfolding profiles reveal that trichloroacetic acid-treated ribonuclease A, like the untreated enzyme, follows a one-step transition with relatively lower transition temperature (Tm). NMR-spectral data suggests perturbations in the histidyl environment at the active site.

Lactoferrin contains structural motifs of ribonuclease.

A high molecular weight ribonuclease isolated from human milk (hmRNAase) shares identical immunological, physical, structural features and considerable sequence homology with human lactoferrin; and it has been demonstrated to be an isoform of lactoferrin. We have analyzed the sequence data of lactoferrin looking for the existence of specific features corresponding to the consensus sequence of pyrimidine-specific ribonucleases. The analysis was done by comparing sequence features with respect to elements which are, in principle, responsible for RNAase activity. This revealed the existence of a ribonuclease-signature pattern in lactoferrin. Further analysis of X-ray data together with molecular modeling studies have revealed close similarities between the spatial geometry of the constituent groups of the active site of pyrimidine-specific ribonucleases and the corresponding groups comprising the potential active site of lactoferrin. Our results provide the strong structural basis for the existence of ribonuclease activity in lactoferrin.

Identity of the ribonuclease from bovine seminal plasma with ribonuclease BS-1, and its sensitivity to polyvinyl sulphate.

A ribonuclease (RNAase BSD) isolated by us earlier from bovine seminal plasma by DNA-affinity chromatography is shown to be homogeneous on polyacrylamide gel electrophoresis, analytical ultracentrifuge and high performance liquid chromatography. From amino acid analysis, high performance liquid chromatography and enzymatic and physicochemical studies, this enzyme is shown to be identical to RNAase BS-1 reported by D'Alessio et al. ((1972) Eur. J. Biochem. 26, 153-161). Immunological studies support this observation. It has also been shown that, as compared to RNAase A, this enzyme is more sensitive to polyvinyl sulphate inhibition.