Dynamics and drivers of mycorrhizal fungi after glacier retreat.

The development of terrestrial ecosystems depends greatly on plant mutualists such as mycorrhizal fungi. The global retreat of glaciers exposes nutrient-poor substrates in extreme environments and provides a unique opportunity to study early successions of mycorrhizal fungi by assessing their dynamics and drivers. We combined environmental DNA metabarcoding and measurements of local conditions to assess the succession of mycorrhizal communities during soil development in 46 glacier forelands around the globe, testing whether dynamics and drivers differ between mycorrhizal types. Mycorrhizal fungi colonized deglaciated areas very quickly (< 10 yr), with arbuscular mycorrhizal fungi tending to become more diverse through time compared to ectomycorrhizal fungi. Both alpha- and beta-diversity of arbuscular mycorrhizal fungi were significantly related to time since glacier retreat and plant communities, while microclimate and primary productivity were more important for ectomycorrhizal fungi. The richness and composition of mycorrhizal communities were also significantly explained by soil chemistry, highlighting the importance of microhabitat for community dynamics. The acceleration of ice melt and the modifications of microclimate forecasted by climate change scenarios are expected to impact the diversity of mycorrhizal partners. These changes could alter the interactions underlying biotic colonization and belowground-aboveground linkages, with multifaceted impacts on soil development and associated ecological processes.

The importance of species addition 'versus' replacement varies over succession in plant communities after glacier retreat.

The mechanisms underlying plant succession remain highly debated. Due to the local scope of most studies, we lack a global quantification of the relative importance of species addition 'versus' replacement. We assessed the role of these processes in the variation (ß-diversity) of plant communities colonizing the forelands of 46 retreating glaciers worldwide, using both environmental DNA and traditional surveys. Our findings indicate that addition and replacement concur in determining community changes in deglaciated sites, but their relative importance varied over time. Taxa addition dominated immediately after glacier retreat, as expected in harsh environments, while replacement became more important for late-successional communities. These changes were aligned with total ß-diversity changes, which were more pronounced between early-successional communities than between late-successional communities (>50 yr since glacier retreat). Despite the complexity of community assembly during plant succession, the observed global pattern suggests a generalized shift from the dominance of facilitation and/or stochastic processes in early-successional communities to a predominance of competition later on.

Local climate modulates the development of soil nematode communities after glacier retreat.

The worldwide retreat of glaciers is causing a faster than ever increase in ice-free areas that are leading to the emergence of new ecosystems. Understanding the dynamics of these environments is critical to predicting the consequences of climate change on mountains and at high latitudes. Climatic differences between regions of the world could modulate the emergence of biodiversity and functionality after glacier retreat, yet global tests of this hypothesis are lacking. Nematodes are the most abundant soil animals, with keystone roles in ecosystem functioning, but the lack of global-scale studies limits our understanding of how the taxonomic and functional diversity of nematodes changes during the colonization of proglacial landscapes. We used environmental DNA metabarcoding to characterize nematode communities of 48 glacier forelands from five continents. We assessed how different facets of biodiversity change with the age of deglaciated terrains and tested the hypothesis that colonization patterns are different across forelands with different climatic conditions. Nematodes colonized ice-free areas almost immediately. Both taxonomic and functional richness quickly increased over time, but the increase in nematode diversity was modulated by climate, so that colonization started earlier in forelands with mild summer temperatures. Colder forelands initially hosted poor communities, but the colonization rate then accelerated, eventually leveling biodiversity differences between climatic regimes in the long term. Immediately after glacier retreat, communities were dominated by colonizer taxa with short generation time and r-ecological strategy but community composition shifted through time, with increased frequency of more persister taxa with K-ecological strategy. These changes mostly occurred through the addition of new traits instead of their replacement during succession. The effects of local climate on nematode colonization led to heterogeneous but predictable patterns around the world that likely affect soil communities and overall ecosystem development.

Frontal changes in medium-sized glaciers in Sikkim, India during 1988-2018: Insights for glacier-climate synthesis over the Himalaya.

The study assesses terminus retreat of medium-sized glaciers (1988-2018) using geospatial dataset and field study in Sikkim which is under the direct influence of the Indian SW monsoon. It also explores the causes of intra-regional and inter-regional diverse patterns of glacier retreat under the purview of topographical and climatic factors to develop a glacier-climate synthesis over the region. Glaciers have retreated in a range from 63.9 to 3.9 m yr-1 and lost a total area of ∼2.53% (0.08% yr-1) in the study area. The intra-regional heterogeneity in glaciers retreat seems to be caused by topographical factors in the study area. A comparison of glacier retreats with other parts of the Himalayas reveals a declining gradient from the northwest to the eastern Himalayas, broadly. This inter-regional disparity in the retreat rate seems to be caused by existing climatic regimes over different parts of the Himalayas. The results help to comprehend the glacier-climate synthesis over the Himalayan region.

Tuberous Sclerosis Complex-Varied Presentations in Family Clusters.

Tuberous sclerosis complex (TSC) is a disease of varying presentations characterised by the presence of multiple hamartomas in various organ systems in the body. This is an Autosomal dominant disease with damages in two suppressor genes namely TSC1 and TSC2 located on chromosome 9 (9q34-hamartin) and chromosome 16 (16p13.3-tuberin). It is a lifelong disease with neurological manifestations, for example, epilepsy, mental retardation and autism and major dermatological features like facial fibromas (adenoma sebaceum), periungual fibromas, shagreen patches and hypopigmented macules. Some conditions, for example, autosomal dominant polycystic kidney disease can co-exist with TSC as a result of concurrent deletion of both polycystic kidney disease 1 and TSC2 genes present on chromosome 16p13.3. We present a cluster of three families with TSC having varied presentations.

Analyzing musculoskeletal risk-severity among small scale casting workers using ergonomic assessment tools: A statistical approach.

BACKGROUND: Work-related musculoskeletal disorders (WMSDs) are leading cause of injuries among economically backward workers employed under small scale metal casting units especially in developing countries. In India, most casting unit's falls under small and medium enterprises having inadequacy of advanced technological equipment's due to several economic constraints and rely intensively on manual labour. Foundry work is very much prone to WMSDs involving much physical interaction of workers with their jobs which includes several risk factors. OBJECTIVE: The study objectives were to analyse the musculoskeletal risk prevalence among small scale casting workers using ergonomic assessment tools and statistical approach. METHODS: In present study, WMSDs risk prevalence has been examined using Rapid Entire Body Assessment (REBA) and virtual ergonomics. Further, risk evaluations were analysed using Mann-Whitney U test and Taguchi L25 orthogonal array. RESULTS: Results revealed manual handling task as being most vulnerable followed by the fettling section. Statistically significant differences were observed (p-value < 0.05) among all the work-sections except lift-lower task and molding section (p = 0.361; p > 0.05) for left side region; and lift-lower task and fettling section (p = 0.230; p > 0.05) for the right side region, where differences were not statistically significant. ANOVA results indicated that workstation height followed by population percentile and object weight were dominant factors significantly affecting the response parameter i.e. L4-L5 spine compression (p-value < 0.01); however workstation width (p-value > 0.05) had no significant effect. CONCLUSION: The present study may guide foundry industrialists in analysing the mismatch between the workers' job profile and redesigning existing workstation layouts in small scale foundries based on minimizing the WMSDs risk severity associated with the work tasks.

Assessment of thermal comfort in a hot and humid indoor built environment of a kitchen at a university canteen.

BACKGROUND: The hot and humid environment inside the kitchen is a cumulative sign of health impact that deteriorates the well-being and productivity of cooking workers, which could be a barrier to thermal comfort. As the cooking task progresses throughout the day, uncomfortable thermal conditions inside a kitchen work environment may diminish the work quality of the kitchen workers. OBJECTIVE: The objectives of the study were to evaluate the measured environmental factors of thermal comfort during various cooking periods [morning, day, evening, night] and examine the occupant's perception votes followed by further investigating the worker's thermal comfort conditions using PMV, PPD, SET, WBGT, and TSI indices. METHODS: The study was carried out inside the kitchen of the university canteen at IIT Guwahati, India. The objective and subjective measurements were accomplished during the summer season, while CBE thermal comfort software was employed for calculating the thermal comfort indices like PMV, PPD, and SET. RESULTS: The results of this study revealed that during entire cooking time, the recorded environmental factors of thermal comfort were found outside the recommended limits as per ASHRAE-55 standard, which indicates very hot prevalent conditions. Also, cook's perception vote (TSV, TCV) for the existing environment did not follow the central three categories of votes (+1, 0, -1), even the cooking workers were also not satisfied with the prevailing environmental conditions, as 88% subjects responded dissatisfaction with the thermal environment. While, estimated values of thermal comfort indices (PMV, PPD, and SET) designated morning time cooking period slightly comfortable than the other cooking periods, but still not accordance with the ASHRAE-2017 standard. The WBGT index designated day cooking period as hazardous, with rest of cooking periods under severe risk level. In contrast, the TSI index indicated entire cooking periods under "slightly warm" thermal sensation. CONCLUSION: The assessment of this study showed that the existing kitchen environment of the university canteen is not conducive for workers. Improper ventilation design may cause the overheating inside the kitchen, which may increase the dissatisfaction rate of the employed workers and also affects the energy savings in the kitchen environment, which helps maintain thermal comfort. Further studies are required to improve the thermal comfort of the kitchen occupants by providing proper design interventions based on heating and cooling air ventilation systems.

Analyzing musculoskeletal risk prevalence among workers in developing countries: an analysis of small-scale cast-iron foundries in India.

Musculoskeletal disorders (MSDs) are the most common health issues around the globe and a major cause of disability among workers. In developing countries, most casting industries fall under Small and Medium Scale Enterprises (SMEs); SMEs lack modern equipment and often intensively rely on manual labor. As processes are mainly labor intensive, workers employed in the metal casting sector are often at risk of MSDs. The main objective of this study is to investigate the exposure of work-related musculoskeletal symptoms prevalent among male workers employed in small scale gray cast-iron foundries of northern India. The techniques used included the Nordic Musculoskeletal Questionnaire (NMQ), anthropometric measures, work postures analysis based on digital human modeling (DHM), Rapid Upper Limb Assessment/RULA and Biomechanics Single Action Analysis/BSAA ergonomic assessment tools. Based on the measured anthropometric variables and work postures attained during various routine tasks, virtual work manikins were created and analyzed using human activity analysis in CATIA V5R20. Subjective assessment revealed that distal upper extremity regions i.e. wrists/hands followed by lower back, neck and shoulders have higher frequency of reported MSDs symptoms. Higher musculoskeletal risk was observed with most of the analyzed work postures, with fettling and Manual Material Handling (MMH) tasks being the most affected. A regression model was developed to predict the L4-L5 spine compression load on the workers' lumbar regions; a coefficient of determination (R2) value of 0.761 indicates an acceptable model fit (R-value = 0.873). Based on the values of the standardized beta coefficients, findings suggested that trunk angle (ß = 0.616), followed by upper arm angle (ß = 0.408), were stronger predictors on the dependent variable (i.e. L4-L5 spine compression) than population percentile (ß = 0.372), object weight (ß = 0.208) and lower arm angle (ß = 0.183). The findings suggest that factors like manual work demands, poor work station structure, repetitive actions and awkward postures held for a longer duration may likely be associated with MSDs risk severity. The present study may guide the foundry industrialists in analyzing the mismatch between the workers' job profiles and redesigning the work station layouts in small scale foundries based on minimizing the risk severity associated with the tasks carried out by staff.

Climatic variability at Gangtok and Tadong weather observatories in Sikkim, India, during 1961-2017.

The present study documents the long-term trends in the temperature and precipitation of a poorly represented region, the Sikkim, eastern Himalaya using the Mann-Kendall non-parametric test and the Sen's slope estimator. Additionally, the normal distribution curves and Cusum charts have been used to identify the shifts in extreme events and to detect the points of change in the climatic data series for robust analysis. The minimum temperatures recorded a positive trend in Gangtok (0.036 ˚C year-1 from 1961 to 2017) as well as in Tadong (0.065 ˚C year-1 from 1981 to 2010) stations, while the maximum temperatures showed no trend in Tadong station from 1981 to 2010 which is consistent with the trend in Gangtok station for the overlapped period. However, it was negative for the overall assessed period (- 0.027 ˚C year-1 from 1961 to 2017) in Gangtok. The average temperatures in Gangtok recorded no trend whereas a positive trend (0.035 ˚C year-1 from 1981 to 2010) was observed at Tadong station. A similar positive trend in the average temperatures has been detected at Gangtok also for the overlapped period. Accelerated warming was noticed during the last two decades with an increase in the probability of extreme events of temperatures (minimum, maximum, average) at the higher end. Precipitation was found to be more variable across the observed period and suggested no trend in the study area.

Evaluation of Risk Factors for Exchange Range Hyperbilirubinemia and Neurotoxicity in Neonates from Hilly Terrain of India.

BACKGROUND AND AIM: Neonatal hyperbilirubinemia continues to be the most common cause of hospital admissions and readmissions in the neonatal population worldwide and this pattern continues despite attempts to identify neonates at risk of pathological hyperbilirubinemia. Therefore, this study aimed to study the risk factors for severe hyperbilirubinemia in neonates. MATERIALS AND METHODS: An observational prospective study was undertaken for 1 year in neonates with hyperbilirubinemia requiring double volume exchange transfusion in neonatology unit of a tertiary rural health care hospital. RESULTS: Risk factors included ABO incompatibility in 14 (28.5%), Rh incompatibility in 14 (28%). Other risk factors for hyperbilirubinemia were, jaundice in elder sibling, oxytocin use, birth asphyxia, hypothyroidism, ABO along with Rh incompatibility, Glucose-6 phosphate Dehydrogenase deficiency, cephalhematoma, and sepsis in neonates. Ten (20%) neonates were neurologically abnormal with signs of encephalopathy. Significant association of risk factors with neurotoxicity were also found. All neurologically abnormal neonates were small for date and none was appropriate for date (P = 0.05). There were no neurologically abnormal neonates with A+ and O- mothers (P = 0.04). CONCLUSION: The high rate of exchange transfusion warrants aggressive management of neonatal hyperbilirubinemia by health-care providers by adequate dissemination of information, strict following of hour-based normograms, performing total serum bilirubin assessment in all icteric neonates, and stratification into risk groups thereafter.

An eleven year old boy with pain abdomen and early morning neuroparalytic syndrome.

An 11 year old boy presented with pain abdomen and tenderness all over body when he got up from sleep early in the morning and subsequently had one vomiting after 30 min. He had no other significant past medical history. The child was shifted to nearby health facility where he was managed as a case of acute abdomen on the basis of suggestive history and clinical findings. Within 2 h after the onset of clinical features suggestive of acute abdomen the patient went on to develop marked ptosis and flaccid quadriplegia. The young boy underwent a sequence of clinical tests which were noncontributory. Based on the clinical picture, a differential diagnosis of hypokalemic paralysis, botulism, Miller Fischer syndrome and EMNS were considered. Through exclusion, the most probable diagnosis for the symptoms was elapid envenomation hence he was started on anti-snake venom (ASV) with working diagnosis of EMNS. Within 2 h, he began to show improvement. This recovery with ASV suggests the possibility of elapid envenomation.

Formative assessment in postgraduate medical education - Perceptions of students and teachers.

CONTEXT: One of the most important factors of medical education that can revolutionize the learning process in postgraduate students (PGs) is assessment for learning by means of formative assessment (FA). FA is directed at steering and fostering learning of the students by providing feedback to the learner. However, though theoretically well suited to postgraduate training, evidence are emerging that engaging stakeholders in FA in daily clinical practice is quite complex. AIMS: To explore perceptions of PGs and teachers (Ts) about factors that determines active engagement in FA. SUBJECTS AND METHODS: It was a descriptive qualitative study involving focus group discussions (FGDs) with PGs and Ts from Departments of Pediatrics and Orthopedics. FGDs data were processed through points/remarks, data reduction, data display, coding followed by theme generation for content analysis. RESULTS: Four higher order themes emerged: Harsh reality of present summative assessment structure, individual perspectives on feedback, supportiveness of the learning environment, and the credibility of feedback and/or feedback giver. CONCLUSIONS: Engaging in FA with a genuine impact on learning is complex and quite a challenge to both students and Ts. Increased acceptability along with the effective implementation of FA structure, individual perspectives on feedback, a supportive learning environment and credibility of feedback are all important in this process. Every one of these should be taken into account when the utility of FA in postgraduate medical training is evaluated.

The changing profile of infantile tremor syndrome in hilly terrain of India.

BACKGROUND: Infantile tremor syndrome (ITS) is characterized by anemia, skin pigmentation, tremors, physical, and mental regression without a defined etiopathogenesis and low incidence. MATERIALS AND METHODS: We have studied 9 patients over 1 year for the changing clinical and laboratory variables of patients with ITS. Neuroregression and anemia were presented in all followed by tremors in 5 and hypotonia in 2. RESULT: Sepsis screen was positive in 6 and urine cultures in 2. Antibiotics were required in 6. ITS with changing parameters still significantly contributes to healthcare burden. CONCLUSION: It is important to screen for urinary infection and septicemia to avoid antibiotic abuse.

Clinical and demographic profile of snake envenomation in Himachal Pradesh, India.

We describe profile of 60 children [mean (SD) age, 9.5 (3.8) y] presenting to the department of Pediatrics with snake envenomation. Neurotoxic bites were predominant (53%) and required mean (SD) 21.5 (9.29) antisnake venom vials, while children with neurohemotoxic features required mean (SD) 31.2 (10.8) vials to improve. Duration of hospital stay was median (SD) 4.0 (2.71) days. The commonest complication was respiratory dysfunction; mortality rate was 13.3%.