Epi-illumination diffraction phase microscopy with white light.

We demonstrate the first reflection-based epi-illumination diffraction phase microscope with white light (epi-wDPM). The epi-wDPM system combines the off-axis, common-path, and white light approaches, in a reflection geometry enabling sub-nanometer spatial and temporal noise levels, while providing single-shot acquisition for opaque samples. We verified the epi-wDPM results by measuring control samples with known dimensions and comparing them to measurements from other well-established techniques. We imaged gold-coated HeLa cells to illustrate the tradeoffs between epi-wDPM with low and high spatial coherence.

Diarrhoea-related knowledge and practice of physicians in urban slums of Kolkata, India.

Diarrhoeal management practices are unsatisfactory in India especially in the slum areas. Dearth of information regarding physicians' diarrhoea-related knowledge and practice in India necessitated this cross-sectional study of allopathic practitioners in the slums of Kolkata, to assess the distribution and interrelationship between physicians' characteristics, knowledge and practice regarding diarrhoea. A total of 264 randomly selected consenting practitioners were interviewed using a field-tested questionnaire. Nineteen percent had good overall knowledge, 49% and 80% prescribed antibiotics to diarrhoea and cholera patients, respectively, and 55% advised stool examination for every case. Qualified and Government physicians had better knowledge regarding diarrhoea [MBBS: odds ratio (OR) 5·96, P < 0·001; postgraduates: OR 9·33, P < 0·001; Government physicians: OR 11·49, P < 0·0001] and were less likely to prescribe antibiotics for all diarrhoea cases (MBBS: OR 0·30, P = 0·002; postgraduates: OR 0·20, P < 0·001; Government physicians OR 0·24, P < 0·029). Better knowledge was associated with a lower likelihood of prescribing antibiotics for diarrhoea (OR 0·72, P < 0·001), cholera (OR 0·78, P = 0·027) and investigative procedure (OR 0·85, P = 0·028). In the slums of Kolkata, diarrhoea-related knowledge and practice were poor with the exception of qualified physicians, hence an improvement in the knowledge of pharmacists and unqualified practitioners is necessary for the overall improvement of diarrhoeal management in these slums.

Assessing Watershed-Scale, Long-Term Hydrologic Impacts of Land-Use Change Using a GIS-NPS Model.

Land-use change, dominated by an increase in urban/impervious areas, has a significant impact on water resources. This includes impacts on nonpoint source (NPS) pollution, which is the leading cause of degraded water quality in the United States. Traditional hydrologic models focus on estimating peak discharges and NPS pollution from high-magnitude, episodic storms and successfully address short-term, local-scale surface water management issues. However, runoff from small, low-frequency storms dominates long-term hydrologic impacts, and existing hydrologic models are usually of limited use in assessing the long-term impacts of land-use change. A long-term hydrologic impact assessment (L-THIA) model has been developed using the curve number (CN) method. Long-term climatic records are used in combination with soils and land-use information to calculate average annual runoff and NPS pollution at a watershed scale. The model is linked to a geographic information system (GIS) for convenient generation and management of model input and output data, and advanced visualization of model results.The L-THIA/NPS GIS model was applied to the Little Eagle Creek (LEC) watershed near Indianapolis, Indiana, USA. Historical land-use scenarios for 1973, 1984, and 1991 were analyzed to track land-use change in the watershed and to assess impacts on annual average runoff and NPS pollution from the watershed and its five subbasins. For the entire watershed between 1973 and 1991, an 18% increase in urban or impervious areas resulted in an estimated 80% increase in annual average runoff volume and estimated increases of more than 50% in annual average loads for lead, copper, and zinc. Estimated nutrient (nitrogen and phosphorus) loads decreased by 15% mainly because of loss of agricultural areas. The L-THIA/NPS GIS model is a powerful tool for identifying environmentally sensitive areas in terms of NPS pollution potential and for evaluating alternative land use scenarios for NPS pollution management.

Fulminant hepatic failure: pediatric aspects.

In children, fulminant hepatic failure is a rare multisystem disorder in which severe impairment of liver function, with or without encephalopathy, occurs in association with hepatocellular necrosis in a patient with no recognized underlying chronic liver disease. Recognized etiologies include infections, toxins, metabolic disorders, infiltrative diseases, autoimmune hepatitis, ischemic or irradiation damage; a proportion of cases are cryptogenic. The diagnosis of the cause is essential to institute lifesaving medical treatment, decide if transplantation is indicated, and offer genetic counseling. The maximum International Normalized Ratio *(INR) reached during the course of the illness is the most sensitive predictor of outcome, mortality being 86% with an INR > or = 4, and 27% with an INR < 4 in our own series. Prognosis is worse in children younger than 2 years. Thus, urgent transplantation should be considered when the INR reaches 4, particularly in very young children. Survival after transplantation is 60% to 68%. Children with fulminant hepatic failure must be treated in specialized centers with facilities for liver transplantation.