Analysis of long transients and detection of early warning signals of extinction in a class of predator-prey models exhibiting bistable behavior.

In this paper, we develop a method of analyzing long transient dynamics in a class of predator-prey models with two species of predators competing explicitly for their common prey, where the prey evolves on a faster timescale than the predators. In a parameter regime near a singular zero-Hopf bifurcation of the coexistence equilibrium state, we assume that the system under study exhibits bistability between a periodic attractor that bifurcates from the singular Hopf point and another attractor, which could be a periodic attractor or a point attractor, such that the invariant manifolds of the coexistence equilibrium point play central roles in organizing the dynamics. To find whether a solution that starts in a vicinity of the coexistence equilibrium approaches the periodic attractor or the other attractor, we reduce the equations to a suitable normal form, and examine the basin boundary near the singular Hopf point. A key component of our study includes an analysis of the long transient dynamics, characterized by their rapid oscillations with a slow variation in amplitude, by applying a moving average technique. We obtain a set of necessary and sufficient conditions on the initial values of a solution near the coexistence equilibrium to determine whether it lies in the basin of attraction of the periodic attractor. As a result of our analysis, we devise a method of identifying early warning signals, significantly in advance, of a future crisis that could lead to extinction of one of the predators. The analysis is applied to the predator-prey model considered in Sadhu (Discrete Contin Dyn Syst B 26:5251-5279, 2021) and we find that our theory is in good agreement with the numerical simulations carried out for this model.

SoyNet: A high-resolution Indian soybean image dataset for leaf disease classification.

In order to address the challenges related to the classification and recognition of soybean disease and healthy leaf identification, it is essential to have access to high-quality images. A meticulously curated dataset named "SoyNet" has been created to provide a clean and comprehensive dataset for research purposes. The dataset comprises over 9000 high-quality soybean images, encompassing healthy and diseased leaves. These images have been captured from various angles and directly sourced from soybean agriculture fields; The soybean leaves images are organized into two sub-folders: SoyNet Raw Data and SoyNet Pre-processing Data. Within the SoyNet Raw Data folder are separate folders for healthy and diseased images captured using a digital camera. The SoyNet Pre-processing Data folder comprises resized images of 256*256 pixels and the grayscale versions of disease and healthy images, following a similar organizational structure. We captured the images using the Nikon digital camera and the Motorola mobile phone camera, utilizing different angles, lighting conditions, and backgrounds. They were taken in different lighting conditions and backgrounds at soybean cultivation fields to represent the real-world scenario accurately. The proposed dataset is valuable for testing, training, and validating soybean leaf disease classification.

Wilson's disease - a tricky diagnosis on the acute take.

Wilson's disease is a rare genetic disorder that affects copper metabolism in the body, leading to excess copper accumulation in various organs, including the liver and brain. It often presents to both primary and secondary care, with a combination of liver disease and neurological or psychiatric symptoms, but the presentation can be highly variable. Early recognition and treatment of Wilson's disease is important to prevent critical hepatic and neurological complications. In this case report, we describe the presentation of an 18-year-old male university student with a combination of dysphagia, tremors, and slurred speech, which progressed over several months. Through a series of investigations, the patient was diagnosed with Wilson's disease and received appropriate treatment. This report highlights the importance of considering Wilson's disease in patients with a wide range of symptoms and the need for a pragmatic approach to diagnosis, including routine and additional testing as necessary.

Thermal finite element analysis of localized hypothermia treatment of the human eye.

Localized hypothermia treatment can reduce the risk of vision loss due to ocular trauma. Hypothermia reduces inflammation and metabolic rate, and improves blood flow to prevent nerve and tissue damage. This paper presents a finite element thermal analysis to determine the efficacy of local hypothermia treatment administered using a scleral eye contact ring that acts as a heat sink. A realistic model of the human eye orbit, including fat and muscle, is created using MRI scans. A simplified CAD-based model is also created based on the first model. A transient analysis is performed by lowering the contact surface between the device and the eye to 4∘C. The study shows that the device lowers the temperature of the optic nerve head to a therapeutic range of 32-34∘C in less than 10 min of treatment, hence supporting the efficacy of such a device.

Regions of homozygosity and a novel variant in Steel syndrome: An added dilemma to diagnosis.

Steel syndrome is an autosomal recessive disorder that is caused by mutations in COL27A1 gene. The majority of reported cases have been of Puerto Rican origin, with few reports from India. The present case adds to the repertoire of homozygous recessive disorders from non-consanguineous Indian families. With the present case, a 4-year-old girl, we wish to signify that although mutations in several genes are known to cause skeletal abnormalities, identification of underlying mutations is important as it not only helps with the ascertainment of diagnosis but also aids in determining the role of surgical interventions which is particularly true for Steel syndrome, where the outcome of surgical intervention is usually dismal.

Synthesis of different manganese tungstate nanostructures for enhanced charge-storage applications: theoretical support for experimental findings.

Manganese tungstate (MnWO4) has been widely studied over the past few years due to its outstanding magnetic, catalytic, and sensing features. However, the electrochemical properties of the morphology tuned MnWO4 nanoform is less explored in the literature. Herein, we report the synthesis of MnWO4 nanostructures of different aspect ratios by subtle tuning of the reaction temperature and reaction time. An immediate utility of the size-controlled nanostructures is their use as the electrode material for supercapacitors. The impact of various reaction parameters, namely the growth time and processing temperature, over the MnWO4 nanorods size was studied by different characterization techniques, such as X-ray diffraction, field emission scanning electron microscopy, and Raman spectroscopy. It was shown that all the samples showed considerably good charge-storage properties with the highest values of specific capacitance being 455.07 and 239.07 F g-1 at 2 mV s-1 and 1 A g-1, respectively. The corresponding sample further showed an appreciable capacitance retention of ∼94% even after 10 000 long charge-discharge cycles, indicating a high electrochemical stability of the electrode. Theoretical analysis using density functional theory predicted that the presence of electronic states near Fermi level and the enhanced quantum capacitance were the prime reasons behind the excellent charge-storage performance of the as-synthesized MnWO4.

Geographically diverse lineage of mycobacterium tuberculosis in Sub-Himalayan region of Kangra, Himachal Pradesh.

We present the lineages of Mycobacterium tuberculosis (MTB) found using spoligotyping in the Sub-Himalayan Region of Kangra District in Himachal Pradesh. The DNA from clinical isolates was used for spoligotyping using a PCR based method to simultaneously detect and type Mycobacterium tuberculosis complex, performed by an outsource agency namely Mapmygenome, Hyderabad. Spoligotyping and database comparison was done. We found the following families: Indo Oceanic (51.2%) Central Asian (37.8%), West African (4.8%), East Asian (3.6%), Euro American and M.africanum (1.2%) each. There were genetically diverse strains of MTB causing pulmonary tuberculosis in Kangra region, indicating cosmopolitan nature of its population.

Evidence of sheep and abattoir environment as important reservoirs of multidrug resistant Salmonella and extended-spectrum beta-lactamase Escherichia coli.

The increase in antimicrobial-resistant (AMR) foodborne pathogens, including E. coli and Salmonella in animals, humans, and the environment, is a growing public health concern. Among animals, cattle, pigs, and chicken are reservoirs of these pathogens worldwide. There is a knowledge gap on the prevalence and AMR of foodborne pathogens in small ruminants (i.e., sheep and goats). This study investigates the prevalence and antimicrobial resistance of extended-spectrum beta-lactamase (ESBL) E. coli and Salmonella from sheep and their abattoir environment in North Carolina. We conducted a year-round serial cross-sectional study and collected a total of 1128 samples from sheep (n = 780) and their abattoir environment (n = 348). Sheep samples consisted of feces, cecal contents, carcass swabs, and abattoir resting area feces. Environmental samples consisted of soil samples, lairage swab, animal feed, and drinking water for animals. We used CHROMAgar EEC with 4 µg/ml of Cefotaxime for isolating ESBL E. coli, and ESBL production was confirmed by double-disk diffusion test. Salmonella was isolated and confirmed using standard methods. All of the confirmed isolates were tested against a panel of 14 antimicrobials to elucidate susceptibility profiles. The prevalence of ESBL E. coli and Salmonella was significantly higher in environmental samples (47.7% and 65.5%) compared to the sheep samples (19.5% and 17.9%), respectively (P < 0.0001). We recovered 318 ESBL E. coli and 368 Salmonella isolates from sheep and environmental samples. More than 97% (310/318) of ESBL E. coli were multidrug-resistant (MDR; resistant to ≥3 classes of antimicrobials). Most Salmonella isolates (77.2%, 284/368) were pansusceptible, and 10.1% (37/368) were MDR. We identified a total of 24 different Salmonella serotypes by whole genome sequencing (WGS). The most common serotypes were Agona (19.8%), Typhimurium (16.2%), Cannstatt (13.2%), Reading (13.2%), and Anatum (9.6%). Prevalence and percent resistance of ESBL E. coli and Salmonella isolates varied significantly by season and sample type (P < 0.0001). The co-existence of ESBL E. coli in the same sample was associated with increased percent resistance of Salmonella to Ampicillin, Chloramphenicol, Sulfisoxazole, Streptomycin, and Tetracycline. We presumed that the abattoir environment might have played a great role in the persistence and dissemination of resistant bacteria to sheep as they arrive at the abattoir. In conclusion, our study reaffirms that sheep and their abattoir environment act as important reservoirs of AMR ESBL E. coli and MDR Salmonella in the U.S. Further studies are required to determine associated public health risks.

Transoral retroauricular neck dissection (TREND): A novel combination approach.

Early-stage oral squamous cell carcinoma is treated preferably by wide local tumour excision along with elective neck dissection. The conventional neck dissection leaves an unaesthetic scar, which remains a major challenge that adversely impacts patient satisfaction, their social interactions, and quality of life (QoL). In recent times, retroauricular assisted endoscopic and robotic neck dissection techniques that avoid unaesthetic neck scars have gained popularity. The pitfalls in attaining universal acceptance of these techniques are the need for specialized instrumentation, training, and increased costs. The need for an endoscope or robotic camera when using the retroauricular approach arises mainly while addressing the level I lymph nodes, due to poor access. A combination of transoral and retroauricular approaches that overcomes these factors is presented here, named the transoral retroauricular neck dissection (TREND). The technique successfully avoids a visible neck scar while providing adequate exposure of level I lymph nodes without the need for specialized instrumentation. This approach has been applied, with adequate lymph node clearance achieved in all patients. This novel combination approach of neck dissection is oncologically safe, easy to replicate, and improves patient aesthetics, functional outcomes, and QoL. We recommend that clinicians practice this simple technique and enhance the practice of remote access neck dissection.

Factors Associated with Intrauterine Fetal Death at Paropakar Maternity Women's Hospital.

Background Intrauterine fetal death (IUFD) is a demise occurring at 20 or more weeks of gestation and weight 500 gram or more. Intrauterine fetal death at any point during gestation is a traumatic event not only to the patient but also to the care giver. The purpose of this study is to know the risk factors associated with intrauterine fetal death. Objective To determine the factors associated with intrauterine fetal death. Method Prospective observational study was conducted at Paropkar maternity women's hospital, Thapathali, Kathmandu. All the cases with intrauterine fetal death were admitted and delivered in the hospital with period of gestation 20 weeks to term pregnancy. All the relevant data were recorded in pre-designed proforma. The collected data were entered in SPSS 25 version for analysis. Result There was a total 5153 deliveries in three months, with prevalence of 1.2% and intrauterine rate of 12.03 per 1000 births. Out of 50 enrolled cases, 78% (n=50) of patient had not attended antenatal checkup. Majority (n=50; 74%), belonged to age group 21-35 years, 48% of intrauterine fetal death were term pregnancies of 37 to 42 weeks of gestation. Maximum 20% of IUFD, weighed between (1-1.5 kg) (1.5-2 kg) and (2.5-3 kg). Thirty-nine babies were macerated and eleven non-macerated. Pregnancy induced hypertension was most common (26%), followed by ante-partum hemorrhage (8%), hypothyroidism and anemia (6%), meconium stained liquor and cord prolapse (6%), gestational diabetes mellitus, congenital anomalies, chronic hypertension (4%), intrauterine growth restriction and urinary tract infection (2%). Twelve cases underwent cesarean section. Postpartum complications were found in 10 cases; 4 cases had postpartum hemorrhage, 4 had prolonged hospital stay and 2 cases developed hemolysis, elevated liver enzyme, low platelet count (HELLP) syndrome. Conclusion This study concluded that maximum no. of intrauterine fetal death were seen antenatally, as 78% of cases were found macerated. The commonest identified risk factor was pregnancy induced hypertension, followed by ante-partum hemorrhage, anemia, hypothyroidism, which seem to be preventable risk factors of intrauterine fetal death, but still unidentified risk factors are of great challenges for the obstetricians.

Antibiotic resistance in patients with chronic ear discharge awaiting surgery in Nepal.

SETTING: Biratnagar Eye Hospital, Biratnagar, Nepal, which offers ear surgery for chronic suppurative otitis media (CSOM). OBJECTIVE: In patients with CSOM awaiting surgery, to determine the 1) sociodemographic characteristics 2) bacterial isolates and their antibiotic resistance patterns and 3) characteristics of those refused surgery, including antibiotic resistance. DESIGN: A cohort study using hospital data, January 2018-January 2020. RESULTS: Of 117 patients with CSOM and awaiting surgery, 64% were in the 18-35 years age group, and 79% were cross-border from India. Of 118 bacterial isolates, 80% had Pseudomonas aeruginosa and 16% had Staphylococcus aureus. All isolates showed multidrug resistance to nine of the 12 antibiotics tested. The lowest antibiotic resistance in P. aeruginosa was for vancomycin (29%) and moxifloxacin (36%), and for S. aureus, this was vancomycin (9%) and amikacin (17%). Fourteen (12%) patients underwent surgery: myringoplasty (n = 7, 50%), cortical mastoidectomy with tympanostomy (n = 4, 29%) and modified radical mastoidectomy (n = 3, 21%). Those infected with P. aeruginosa and with resistance to over six antibiotics were significantly more likely to be refused for surgery. CONCLUSION: Patients awaiting ear surgery were predominantly infected with multidrug-resistant P. aeruginosa and were consequently refused surgery. This study can help inform efforts for improving surgical uptake and introducing cross-border antimicrobial resistance surveillance.

LIEU: Hôpital ophtalmologique de Biratnagar, Népal, qui propose des interventions chirurgicales de l'oreille aux patients atteints d'otite moyenne chronique suppurée (CSOM). OBJECTIF: Déterminer 1) les caractéristiques sociodémographiques, 2) les isolats bactériens et leurs profils de résistance aux antibiotiques et 3) les caractéristiques des patients se voyant refuser la chirurgie (dont résistance aux antibiotiques) chez les patients atteints de CSOM en attente de chirurgie. MÉTHODE: Étude de cohorte réalisée à l'aide de données hospitalières, janvier 2018-janvier 2020. RÉSULTATS: Sur les 117 patients atteints de CSOM en attente de chirurgie, 64% appartenaient à la tranche d'âge des 18­35 ans et 79% étaient des patients transfrontaliers en provenance d'Inde. Sur 118 isolats bactériens, 80% étaient des isolats de Pseudomonas aeruginosa et 16% de Staphylococcus aureus. Tous les isolats ont montré une résistance à neuf des 12 antibiotiques testés. Les plus faibles résistances chez P. aeruginosa étaient celles à la vancomycine (29%) et à la moxifloxacine (36%). Pour S. aureus, il s'agissait de celles à la vancomycine (9%) et à l'amikacine (17%). Quatorze (12%) patients ont subi une intervention chirurgicale : myringoplastie (n = 7, 50%), mastoïdectomie corticale avec tympanotomie (n = 4, 29%) et mastoïdectomie radicale modifiée (n = 3, 21%). Les patients infectés par P. aeruginosa avec une résistance à plus de six antibiotiques étaient significativement plus susceptibles de se voir refuser la chirurgie. CONCLUSION: Les patients en attente de chirurgie de l'oreille étaient principalement infectés par un isolat multirésistant de P. aeruginosa, et se sont donc vu refuser la chirurgie. Cette étude peut permettre d'orienter les efforts visant à améliorer le taux de chirurgies réalisées et à mettre en place une surveillance transfrontalière des résistances antimicrobiennes.

Ultrafast Optically Induced Ferromagnetic State in an Elemental Antiferromagnet.

We present evidence for an ultrafast optically induced ferromagnetic alignment of antiferromagnetic Mn in Co/Mn multilayers. We observe the transient ferromagnetic signal at the arrival of the pump pulse at the Mn L_{3} resonance using x-ray magnetic circular dichroism in reflectivity. The timescale of the effect is comparable to the duration of the excitation and occurs before the magnetization in Co is quenched. Theoretical calculations point to the imbalanced population of Mn unoccupied states caused by the Co interface for the emergence of this transient ferromagnetic state.

Compact, portable, laser induced fluorescence diagnostic for laboratory plasma sources.

As diagnostic groups are increasingly called upon to participate in experimental campaigns at remote facilities, there is a need to develop portable versions of plasma diagnostic systems. One such diagnostic is laser induced fluorescence (LIF). Here, we describe a portable LIF apparatus that eliminates the need for an optical table, beam splitters, and an optical chopper. All of the light exiting the laser system is coupled through optical fibers to the experiment and housekeeping diagnostics. The collected light is coupled through an optical fiber as well. A key feature is modulation of the tapered amplifier current instead of physical modulation of the laser output. Using this portable LIF system, measurements of ion temperature, ion flow, and relative metastable ion density are reported for two different remote experiments.

Resistome of a carbapenemase-producing novel ST232 Klebsiella michiganensis isolate from urban hospital effluent in South Africa.

OBJECTIVES: Klebsiella michiganensis is an emerging pathogen implicated in nosocomial infections. Here we report on the resistome, virulome and mobilome of a carbapenemase-producing K. michiganensis isolate from urban hospital effluent in Pietermaritzburg, KwaZulu-Natal, South Africa. Klebsiella sp. isolate KP124 was originally isolated from the final effluent of an urban tertiary hospital in Pietermaritzburg, KwaZulu-Natal. METHODS: Following phenotypic characterisation and antibiotic susceptibility testing, the genome of carbapenemase-producing isolate KP124 was sequenced using an Illumina MiSeq platform, de novo assembled and analysed using established bioinformatics tools. RESULTS: The draft genome of strain KP124 was 6 544 586 bp in length, comprising 203 contigs >200 bp. Following confirmation of isolate KP124 as K. michiganensis using reference genomes, the blaOXA-181 carbapenemase gene as well as 11 additional genes encoding resistance against ß-lactams, aminoglycosides, fluoroquinolones and sulfonamides were detected. Virulence factors enabling iron acquisition and cell adherence, capsule locus type and plasmid replicon types were identified. CONCLUSION: This study represents the first report of an OXA-181 carbapenemase-producing K. michiganensis isolate from hospital effluent in South Africa. The presence of such a strain in the environment owing to the absence of hospital effluent treatment presents a potential risk to informal communities that may use contaminated surface water domestically.

The lingual sulcus release technique for excision of tongue cancer with trismus.

Operable oral tongue cancers are managed best with surgery followed by adjuvant therapy as and when indicated. The only factor that affects the prognosis, and is under the control of a surgeon, is the tumour margin. Often in cases with trismus, which is prevalent in tobacco and areca nut users, obtaining a clear margin intraorally can be challenging. Approaches described until now to obtain clear margins in these cases have a great impact on the postoperative recovery and morbidity. In our experience, lingual sulcus release is a safe and reproducible technique for these cases. The transcervically elevated lingual sulcus provides an additional layer of safe margin for the management of squamous cell tongue carcinoma with trismus.

Future perspectives in addressing the global issue of vitamin D deficiency.

Vitamin D is a fundamentally critical nutrient that the human body requires to function properly. It plays an important role in musculoskeletal health due to its involvement in the regulation of calcium and phosphorus. Having a low level of vitamin D in the body may be detrimental for a wide range of health outcomes, including risk of osteoporotic and stress fractures, risk of CVD and some cancers, and lowering of the capability of the immune system. Vitamin D is an unusual nutrient; it is not a vitamin, in the true sense of the word but a pro-hormone. The main source of vitamin D is UV exposure, not dietary intake. Interestingly, there are two forms of vitamin D, vitamin D2 and vitamin D3, both of which are metabolised into 25-hydroxyvitamin D (25(OH)D) in the liver, the biomarker of vitamin D status. Vitamin D deficiency is a global public health problem, especially amongst older people and ethnic minority groups. The newest publication from the UK Government's Public Health England Department recommends that vitamin D intake should be 10 µg daily and this recommendation compares well (albeit lower) with other guidelines such as the Institute of Medicine recommendation of 15 µg for those aged 1-70 years and 20 µg for those 70 years or over. Few countries, however, have a specific vitamin D policy to prevent deficiency in populations. Finland leads the way, demonstrating impressive results in reducing population-level vitamin D deficiency through mandatory food fortification programmes. Collaboration between academia, government and industry, including countries from varying latitudes, is essential to identify long-term solutions to the global issue of vitamin D deficiency. This paper provides a narrative review of the evidence related to the role of vitamin D deficiency in health outcomes, outlines controversies regarding setting levels of adequacy, identifies the prevalence of vitamin D deficiency across the globe, and identifies population-level strategies adopted by countries to prevent vitamin D deficiency.

Deep learning for screening of interstitial lung disease patterns in high-resolution CT images.

AIM: To develop a screening tool for the detection of interstitial lung disease (ILD) patterns using a deep-learning method. MATERIALS AND METHODS: A fully convolutional network was used for semantic segmentation of several ILD patterns. Improved segmentation of ILD patterns was achieved using multi-scale feature extraction. Dilated convolution was used to maintain the resolution of feature maps and to enlarge the receptive field. The proposed method was evaluated on a publicly available ILD database (MedGIFT) and a private clinical research database. Several metrics, such as success rate, sensitivity, and false positives per section were used for quantitative evaluation of the proposed method. RESULTS: Sections with fibrosis and emphysema were detected with a similar success rate and sensitivity for both databases but the performance of detection was lower for consolidation compared to fibrosis and emphysema. CONCLUSION: Automatic identification of ILD patterns in a high-resolution computed tomography (CT) image was implemented using a deep-learning framework. Creation of a pre-trained model with natural images and subsequent transfer learning using a particular database gives acceptable results.

Pregnancy Complicated by Acute Pancreatitis with Ascariasis.

Ascariasis lumbricoides infections are common in tropical and sub-tropical countries. As it is one of the common causes for common bile duct obstruction. But in pregnancy is a rare entity. It may present with complications like acute pancreatitis. Here we present a case of 24 year female gravida 2 para 1 at 34 weeks of pregnancy presented with chief complain of pain over epigastric region radiating to back and associated with two episodes of vomiting, non bilious, not mixed with blood. Ultrasonography showed long tubular hyperechoic structure in gallbladder lumen most likely ascariasis and then she was diagnosed as a case of acute pancreatitis with alive ascariasis.