Realizing topological edge states with Rydberg-atom synthetic dimensions.

A discrete degree of freedom can be engineered to match the Hamiltonian of particles moving in a real-space lattice potential. Such synthetic dimensions are powerful tools for quantum simulation because of the control they offer and the ability to create configurations difficult to access in real space. Here, in an ultracold 84Sr atom, we demonstrate a synthetic-dimension based on Rydberg levels coupled with millimeter waves. Tunneling amplitudes between synthetic lattice sites and on-site potentials are set by the millimeter-wave amplitudes and detunings respectively. Alternating weak and strong tunneling in a one-dimensional configuration realizes the single-particle Su-Schrieffer-Heeger (SSH) Hamiltonian, a paradigmatic model of topological matter. Band structure is probed through optical excitation from the ground state to Rydberg levels, revealing symmetry-protected topological edge states at zero energy. Edge-state energies are robust to perturbations of tunneling-rates that preserve chiral symmetry, but can be shifted by the introduction of on-site potentials.

Clinical Presentation, Management and In-Hospital Outcome of COVID-19 among Non-Healthcare Personnel and Healthcare Personnel in a Tertiary Cardiac Care Hospital.

The huge numbers of non-healthcare personnel (non-HCP) who get infected by corona virus disease 2019 (COVID-19) not only paralyze health care systems but also put health care personnel (HCP) at potential risk globally. Objective of the study was to compare the Healthcare personnel (HCP) and non-HCP COVID-19 cases. This prospective observational study was carried out in National Heart Foundation Hospital and Research Institute of Bangladesh from March 08, 2020 to July 20, 2020. During this study period all admitted non-HCP who subsequently was diagnosed as COVID-19 positive by rRT-PCR and HCP of this hospital, who experienced fever or respiratory symptoms or came in close contact with COVID-19 patients at home or their workplace and become COVID-19 positive, were included. Out of 320 infected patients, 181(56.6%) patients were non-HCP and 139(43.4%) were HCP. Non-HCP were older than HCP (Mean age: 52.95±13.82 years vs. 34.08±11.11 years; p=0.001). Non-HCP were predominantly male and HCP were predominantly female (73.5% vs. 41% & 26.5% vs. 59%; p=0.001). Non-HCP had more risk factors and co-morbidities than HCP (p=0.001). Typical symptoms of COVID-19 such as fever and cough were prevalent in HCP. More aggressive treatment was required for non-HCP. Non-HCP had more severe disease and higher case fatality rate (9.4% vs. 0.7%; p=0.001) than HCP. Disease severity (OR 0.03, 95% CI 0.01-0.15) and DM (OR 0.09, 95% CI 0.01-0.94) were the independent predictor of mortality. Non-HCP was older in age, predominantly male and had more co-morbidities than HCP. Typical symptoms of COVID-19 were prevalent in HCP. Non-HCP had more severe disease and higher case fatality rate than HCP.

Patterns and predictors of undiagnosed and uncontrolled hypertension: observations from a poor-resource setting.

Early detection is the cornerstone of hypertension management; still majority remains undetected until complications arise, especially in poor-resource settings. Paucity of information regarding undiagnosed and uncontrolled hypertension in eastern India thus called for a detailed investigation involving a representative sample of adults in Malda, one of the poorest districts in the region. In a cross-sectional study, between October 2013 and July 2014, using multistage random sampling with probability-proportional-to-size, 18 028 consenting adults were interviewed. Diagnosed cases were defined as uncontrolled if they still had hypertensive level of blood pressure (according to JNC-VIII criteria) while those detected during this study were defined as undiagnosed. Descriptive and regression analyses were performed using SAS version 9.3.2. Among 18 028 participants, 4695 (26.04% (95% confidence intervals: 95% CI=25.40-26.68)) had hypertension, of which 3937 (83.86% (82.80-84.91)) were undiagnosed and 548 (72.30 (69.10-75.49)) had uncontrolled hypertension. Relatively older subjects (adjusted Odds ratio (aOR)41-60 years=0.34 (95% CI=0.26-0.43) and aOR>60 years=0.29 (0.21-0.38)), who were divorced/separated/widowed/widower (aOR=0.76 (0.61-0.95)), had higher education (aOR=0.61 (0.43-0.88)), better socio-economic status (SES) (aORMiddle=0.77 (0.60-0.99) and aORUpper=0.64 (0.48-0.85)) and urban residence (aOR=0.44 (0.36-0.55)) were less likely while subjects who belonged to backward castes (aOR=1.37 (1.15-1.64)) were more likely to have undiagnosed hypertension. Odds of having uncontrolled hypertension were higher among participants aged >60 years (aOR=2.25 (1.27-3.99)). Burden of hypertension (diagnosed and undiagnosed) was high in Malda district of West Bengal. Significant predictors of undiagnosed hypertension were young age, backward caste, poor education and lower SES, while older subjects had poor control. Thus, appropriate surveillance targeting these at-risk groups might be effective in controlling hypertension in similar poor-resource settings.

Evaluation of safety and immunogenicity of a live attenuated tetravalent (G1-G4) Bovine-Human Reassortant Rotavirus vaccine (BRV-TV) in healthy Indian adults and infants.

BACKGROUND: Rotavirus infections, prevalent in human populations worldwide are mostly caused by Group A viruses. Live attenuated rotavirus vaccines are highly effective in preventing severe rotavirus gastroenteritis. However, the cost of these vaccines and local availability can be a barrier for widespread adoption in public health programs in developing countries where infants suffer a heavy burden of rotavirus related morbidity and mortality. A phase I/II study was carried out with the long term aim to produce a locally licensed vaccine which is equally safe and immunogenic as compared to available licensed vaccines. METHODS: This study was conducted in two cohorts. In the first cohort, 20 healthy adults were administered a single dose of the rotavirus vaccine (highest antigen concentration planned for infants) or placebo and were followed up for 10 days for safety. Following demonstration of safety in adult volunteers, 100 healthy infants were recruited (cohort 2) and randomly divided into five equal study groups. They were administered three doses of either the investigational rotavirus vaccine (BRV-TV) at one of the three antigen concentrations or Rotateq or Placebo at 6-8, 10-12 and 14-16 weeks of age. All infants were followed up for safety till 28 days after the third dose. Immune response to the vaccine, in terms of seroresponse and geometric mean concentrations, was compared across the five study groups. RESULTS: Increase in anti-rotavirus serum IgA antibodies from baseline, demonstrated higher immune response for all the three antigen concentrations of BRV-TV vaccine and RotaTeq in comparison with the placebo. Sero-response rates for placebo, BRV-TV dose-levels 10(5.0) FFU, 10(5.8) FFU, 10(6.4) FFU, and Rotateq at 28 days post third dose were 11.1%, 27.8%, 41.2%, 83.3%, and 63.2% respectively using the four-fold or more criteria. The BRV-TV vaccine arm corresponding to the highest antigen concentration of 10(6.4) FFU had a higher sero-response rate compared to the active comparator arm (RotaTeq), 28 days post each vaccine dose. The safety profile was comparable across the treatment groups. CONCLUSIONS: Overall, the results showed that all three doses of BRV-TV vaccine were safe, well tolerated and displayed good immunogenicity (dose-response) in healthy Indian infants.

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.

Comparison between Single Dose Azithromycin and Six Doses, 3 Day Norfloxacin for Treatment of Cholera in Adult.

AIM: To evaluate the efficacy of single dose Azithromycin (1 gram) in treatment of cholera in adults. A randomized, controlled clinical trial on 120 adults with acute watery diarrhoea and moderate to severe dehydration compared the efficacy of azithromycin (1 gram) single dose and Norfloxacin (400 mg) twice daily for three days in treating cholera. Data were analysed for 64 patients who were stool culture positive for Vibrio cholerae. In conjunction with rehydration therapy, 32 patients received Azithromycin and 32 patients received Norfloxacin. Patients in the two treatment groups had comparable clinical characteristics on admission. CONCLUSIONS: Result shows Azithromycin and Norfloxacin has got almost similar efficacy in reducing stool output, duration of diarrhoea and fluid requirement in cholera positive cases.

Pressure and temperature control of spin-switchable metal-organic coordination polymers from ab initio calculations.

We explore a combination of density-functional theory with supplemented Coulomb U (DFT+U) and ab initio molecular dynamics simulations to investigate the spin-crossover (SCO) phenomenon in coordination polymers. We demonstrate the applicability of the method for the case of bimetallic metal-organic framework Fe(2)[Nb(CN)(8)]·(4-pyridinealdoxime)(8)·2H(2)O [see S. Ohkoshi et al. Nat. Chem. 3, 564 (2011)]. Our study shows that this approach is capable of capturing the SCO transitions driven by pressure as well as temperature. In addition to discovering novel spin-state transitions, magnetic states involving changes in the long-range magnetic ordering pattern are achieved, thereby offering the tunability of spin states as well as the long-range order of the spins. We compare the SCO transition in the Fe-based framework with a computer designed Mn-based variant.

Evaluation of a rapid dipstick test for identifying cholera cases during the outbreak.

BACKGROUND & OBJECTIVES: Intermittent cholera outbreaks are major problem in many of the states of India. It is essential to identify cholera at the earliest for timely mobilization of public health responses and to abort the outbreaks. The present study was a part of a diarrhoeal outbreak investigation in Secunderabad, India, during May 2009 where the usefulness of Crystal VC rapid dipstick kit was assessed for detecting the aetiologic agent of the outbreak. METHODS: Stool specimens were collected from 15 hospitalized patients with acute watery diarrhoea and analyzed for detection of cholera vibrios using Crystal VC rapid dipstick kit and the usefulness of the kit was determined by comparative analysis of the same set of specimens using both microbiological and real-time PCR (RT-PCR) based assays. RESULTS: Detection of Vibrio cholerae O1 from 10 of 15 specimens was recorded using dipstick assay. Microbiological methods detected V. cholerae O1 positivity among 11 specimens. However, RT-PCR based assay showed all 15 specimens positive for the presence of V. cholerae O1. In addition, the same assay showed that the pathogen load in the dipstick as well as RT-PCR positive specimens ranged from 10 6 colony forming units (cfu)/ml or more. INTERPRETATION & CONCLUSIONS: Crystal VC kit had the potential to identify cholera cases in 10 min in field conditions without having good laboratory support. Therefore, dipstick kit may be considered as cholera detecting tool in diarrhoeal outbreak investigations. Specimens from clinically typical cholera cases, if negative by dipstick, should be reanalyzed by culture based methods.

Cholera in India: an analysis of reports, 1997-2006.

OBJECTIVE: To more accurately define the annual incidence of cholera in India, believed to be higher than reported to the World Health Organization (WHO). METHODS: We searched the biomedical literature to extract data on the cases of cholera reported in India from 1997 to 2006 and compared the numbers found to those reported annually to WHO over the same period. The latter were obtained from WHO's annual summaries of reported cholera cases and National health profile 2006, published by India's Central Bureau of Health Intelligence. FINDINGS: Of India's 35 states or union territories, 21 reported cholera cases during at least one year between 1997 and 2006. The state of West Bengal reported cases during all 10 years, while the state of Maharashtra and the union territory of Delhi reported cases during nine, and Orissa during seven. There were 68 outbreaks in 18 states, and 222 038 cases were detected overall. This figure is about six times higher than the number reported to WHO (37 783) over the same period. The states of Orissa, West Bengal, Andaman and Nicobar Islands, Assam and Chhattisgarh accounted for 91% of all outbreak-related cases. CONCLUSION: The reporting of cholera cases in India is incomplete and the methods used to keep statistics on cholera incidence are inadequate. Although the data are sparse and heterogeneous, cholera notification in India is highly deficient.

Surgical outcomes for vitrectomy in Eales' disease.

AIM: To present and analyse the anatomical and functional outcomes for vitrectomy in Eales' disease. METHODS: This retrospective case series enrolled 63 patients (71 eyes) who underwent pars plana vitrectomy (PPV) for the complications of Eales' disease. Indications included nonclearing vitreous haemorrhage (VH) with/without epiretinal membranes in 49 (69%) eyes, and retinal detachments (RD) involving/threatening macula in 22 (31%). Additional procedures (scleral buckling; gas/oil tamponade) were performed at surgeon's discretion. Minimum follow-up was 6 months. The primary outcome measures were change in best-corrected visual acuity (BCVA) and posterior segment status. RESULTS: The mean age of the patients was 29.6 years (range: 15-70 years); 60 were male (95%). Preoperatively, posterior vitreous detachment (PVD) existed in 28 (39.4%) eyes. Forty (56.3%) eyes underwent only PPV; the rest required additional surgical procedures (q.v.). The mean baseline BCVA (1/60) improved to 6/24 postoperatively (P<0.0001). Fifty-four eyes of 50 patients (76%) showed an improvement of > or =2 equivalent Snellen lines; six eyes (four patients) remained stable (+/-1 line); visual acuity worsened in 11 eyes (nine patients). The mean final BCVA was similar in eyes operated for VH and RD (P=0.08); but the magnitude of change from baseline was greater in the VH group (P=0.009). PVD had a borderline association with final BCVA (P=0.056); but did not influence the functional/anatomical improvement. Thirteen eyes required repeat interventions; 11 (15.49%) eyes experienced surgical failure. CONCLUSIONS: Although surgical outcomes in Eales' disease depend on preoperative PVD/RD to some extent; good results are possible in the presence of incomplete PVD and tractional sequelae.

Epidemiological, microbiological & electron microscopic study of a cholera outbreak in a Kolkata slum community.

BACKGROUND & OBJECTIVE: Epidemics of cholera caused by Vibrio cholerae O1 or O139 have been reported from different parts of India. Factors such as unsafe water supply, poor environmental sanitation, indiscriminate defaecation and lack of personal hygiene are mainly responsible for continued transmission of this disease. We report here epidemiological and microbiological findings of a localized outbreak of cholera, which occurred during March and April 2004 in the eastern part of Kolkata city. METHODS: The affected slum area has a population of 4409, predominantly muslims. Patients suffering from acute watery diarrhoea attended the health outposts organized by National Institute of Cholera and Enteric Diseases, Kolkata and International Vaccine Institute, South Korea as part of a routine surveillance programme at the locality as well as the emergency medical camp organized by the Kolkata Municipal Corporation. Stool and water samples were collected and tested for diarrhoeagenic pathogens in the laboratory. Bacteriophages specific for V. cholerae were isolates and studied electron microscopically for morphology. RESULTS: A total of 89 diarrhoea cases were reported giving an attack rate of 2 per cent. V. cholerae O1 biotype ElTor, serotype Ogawa was isolated as a sole pathogen from 15 (15.8%) of 89 stool samples screened. Water samples (2 from tube wells, 3 from municipal taps and 1 from well) showed presence of coliform bacilli with high MPN (Most Probable Number) count. Bacteriophages specific to V. cholerae were isolated from 2 of 6 water samples examined. A leakage was detected in the main pipeline supplying drinking water to that area. INTERPRETATION & CONCLUSION: The outbreak was caused by V. cholerae O1 (Ogawa) biotype ElTor. The presence of phages in the water samples was an additional indicator for V. cholerae contamination in this community. Occurrences of such outbreaks support vaccination against cholera as an alternative strategy.

The burden of cholera in the slums of Kolkata, India: data from a prospective, community based study.

AIMS: To conduct a prospective, community based study in an impoverished urban site in Kolkata (formerly Calcutta) in order to measure the burden of cholera, describe its epidemiology, and search for potential risk factors that could be addressed by public health strategies. METHODS: The study population was enumerated at the beginning and end of the study period. Surveillance through five field outposts and two referral hospitals for acute, watery, non-bloody diarrhoea was conducted from 1 May 2003 to 30 April 2004. Data and a stool sample for culture of Vibrio cholerae were collected from each patient. Treatment was provided in accordance with national guidelines. RESULTS: From 62 329 individuals under surveillance, 3284 diarrhoea episodes were detected, of which 3276 (99%) had a stool sample collected and 126 (4%) were culture confirmed cholera. Nineteen (15%) were children less than 2 years of age, 29 (23%) had severe dehydration, and 48 (38%) were hospitalised. Risk factors for cholera included a household member with cholera during the period of surveillance, young age, and lower educational level. CONCLUSIONS: There was a substantial burden of cholera in Kolkata with risk factors not easily amenable to intervention. Young children bear the brunt not only of diarrhoeal diseases in general, but of cholera as well. Mass vaccination could be a potentially useful tool to prevent and control seasonal cholera in this community.

Prevalence of Streptococcus pneumoniae and Staphylococcus aureus nasopharyngeal colonization in healthy children in the United States.

This study documents the colonization of Staphylococcus aureus (SA), Streptococcus pneumoniae (SP) and specific resistant forms of these organisms among healthy children and identifies risk factors associated with these pathogens. Prospective point prevalence survey of nasopharyngeal specimens were obtained from 291 healthy children seeking routine well-child care at a university-based ambulatory paediatric clinic in a large urban city in the United States. A total of 291 children less than 5 years were enrolled during a 1-year period. Fifty-four (18.6%) were colonized with SA and 47 (16.2%) were colonized with SP. Among the 54 SA isolates, five (9.2%) were methicillin resistant (MRSA) and among the SP isolates, three (6.4%) were intermediate to penicillin (DRSP). Eighty per cent of all children enrolled reported no underlying medical condition. Care outside their home was more common among colonized (40.8%, 40/98) than non-colonized children (25.4%, 49/193), P=0.007. Healthy children from households of four or more people were also more likely to be colonized. The colonization rate of SA and SP among healthy children is consistent with what has been reported in the literature. The prevalence of MRSA and DRSP among healthy children colonized with SA or SP is low in this population of children attending a university-based ambulatory care centre in the United States.

Adsorption of sodium dodecyl benzenesulfonate onto coal.

The adsorption behavior of sodium dodecyl benzenesulfonate (NaDDBS) on a raw (as received) coal sample and its demineralized variety with 11.3% and 1.2% ash contents respectively has been studied. The samples have been characterized by their proximate analysis, particle size distribution, surface area, porosity, density, points of zero charge, etc. Adsorption of NaDDBS on these two samples has been studied as a function of concentration of NaDDBS, temperature, pH, and presence of indifferent electrolyte in the medium. It has been observed that the isotherm exhibits two adsorption plateaus below and above the critical micelle concentration (CMC) of NaDDBS. Low heats of adsorption suggest weak hydrophobic bonding between adsorbent and adsorbate. The present work aims to correlate the adsorption of surfactant onto coal particles with the rheological behavior of coal-water slurry (CWS). The results reveal that addition of a very small amount of NaDDBS (0.3 wt% of coal) to 60% (w/w) CWS results in a marked reduction of the apparent viscosity of the CWS at a shear rate of 100 s(-1). The effect of pH on the apparent viscosity of CWS with and without the presence of the surfactant is also investigated.

A comparative study on the effect of felodipine and propranolol on serum lipid profile of rabbits.

Effect of felodipine on serum lipids of rabbits was studied and was compared with that of propranolol. Lipid parameters were estimated at basal (0 wk), end of 4th and 16th week of diet/drug administration by using standard kits for analysis. There was a significant increase in mean serum cholesterol, TG, VLDLc, LDLC and decrease in HDLc, (P<0.05) in the group of rabbits receiving Atherogenic diet (AD)/Propranolol. This effect was maximally observed in rabbits receiving both AD and propranolol. This change was satisfactorily prevented when felodipine was administered from very beginning (P<0.001). In addition, there was a significant increase in HDLc (28.89%) of rabbits receiving felodipine from beginning. Thus both AD and propranolol have dyslipidemic effect and early administration of felodipine favorably changes all lipid parameters.