In this paper, a novel dynamic recurrent functional link neural network (DRFLNN) is proposed for the identification of unknown dynamics of the nonlinear systems. The proposed structure contains a ...self-feedback loop(s) as well as the adjustable weighted feed-through of the input signals to the output neuron(s). A learning algorithm is developed using the combination of Lyapunov stability and dynamic back-propagation method and is applied to derive the stable parameter adjustment equations. The performance evaluation of the proposed DRFLNN model is done by comparing it with the multi-layer perceptron (consisting of a single hidden layer), radial basis function network, Elman recurrent neural network (ERNN), nonlinear auto-regressive moving average, and the conventional functional link neural network. Three benchmark systems have been used on which all these models are applied. From the results, it is found that ERNN provided better prediction accuracy as compared to the remaining models and the second-best accuracy is obtained from the proposed model. Further, the ERNN model is more complex and offers more parameters to be tuned as compared to the DRFLNN model. Thus, the training of the ERNN model is quite difficult as compared to the DRFLNN.
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DOBA, EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, IZUM, KILJ, KISLJ, MFDPS, NLZOH, NUK, ODKLJ, OILJ, PILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UILJ, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
In this paper, we have solved one of the widely popular problems in the domain of control systems – distance optimization using two separate swarm intelligence algorithms – particle swarm and ant ...colony optimization. The problem is successfully solved with both algorithms and subsequently quantitative comparison between their performances is done. Simulated results show the more recently developed ant colony optimization algorithm to be better and more robust of the two. The requisite simulations are carried out and results are obtained in the MATLAB environment.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Global climate change is significantly triggering the dynamic evolution of high-mountain lakes which may pose a serious threat to downstream areas, warranting their systematic and regular monitoring. ...This study presents the first temporal inventory of glacial and high-altitude lakes in the Sikkim, Eastern Himalaya for four points in time i.e., 1975, 1991, 2000 and 2017 using Hexagon, TM, ETM+ and OLI images, respectively. First, a baseline data was generated for the year 2000 and then the multi-temporal lake changes were assessed. The annual mapping of SGLs was also performed for four consecutive years (2014-2017) to analyze their nature and occurrence pattern. The results show an existence of 463 glacial and high-altitude lakes (>0.003 km2) in 2000 which were grouped into four classes: supraglacial (SGL; 50) pro/peri glacial lake in contact with glacier (PGLC; 35), pro/peri glacial lake away from glacier (PGLA; 112) and other lakes (OL; 266). The mean size of lakes is 0.06 km2 and about 87% lakes have area 80%) are persistent in nature, followed by drain-out (15-20%) and recurring type lakes (7-8%). The new-formed lakes (9-17%) were consistently noticed in all the years (2014-2017). The results of this study underline that regional climate is accelerating the cryosphere thawing and if the current trend continues, further glacier melting will likely occur. Therefore, formation of new lakes and expansion of existing lakes is expected in the study area leading to increase in potential of glacial lake outburst floods. Thereby, persistent attention should be paid to the influences of climatic change in the region.
Invasive Fungal Infections have posed a difficult challenge in the recovery of people infected with COVID-19. COVID-19-associated pulmonary aspergillosis (CAPA) has been described and found in about ...30 % of ICU patients worldwide. Here we present an unusual microscopic finding in a case of CAPA in an ICU patient which was helpful in initiating early definite therapy. A 56-year-old gentleman presented with complaints of fever and shortness of breath and subsequently tested positive for COVID. Post admission, his respiratory distress worsened and his condition deteriorated. A provisional diagnosis of COVID pneumonia with acute respiratory distress syndrome (ARDS) was established based on chest radiographic finding of left lower lobe consolidation, increased pulmonary infiltrates in bilateral lung fields with evidence of pleural effusion. Pleural Aspirate obtained via ultrasound guided thoracocentesis revealed branched hyaline septate hyphae along with structures which were composed of elongated vesicle with one layer of phialides covering two-thirds of the vesicle and bearing globose conidia on KOH direct mount. Aspergillus flavus grew on culture, which was later confirmed by MALDI TOF VITEK MS. Patient was diagnosed with Proven Invasive Pulmonary Aspergillosis with COVID-19 and voriconazole was started. Patient successfully recovered and was discharged. Identifying the Aspergillus species directly on the basis of KOH Mount, helped in decreasing the turnaround time, in early initiation of definite therapy and possibly contributed to the favorable outcome. CAPA is a potentially life-threatening complication in patients with severe COVID-19, thus a timely diagnosis and treatment becomes crucial in the management. Keywords: CAPA, COVID-19, Aspergillus
Available surface energy balance (SEB) studies on the Himalayan glaciers generally investigate the melt-governing energy fluxes at a point-scale. Further, the annual glacier-wide mass balance (
B
a
) ...reconstructions have often been performed using temperature-index (T-index) models. In the present study, a mass- and energy-balance model is used to simulate the
B
a
on Dokriani Bamak Glacier (DBG, central Himalaya) and Chhota Shigri Glacier (CSG, western Himalaya) using the bias-corrected ERA5 data from 1979 to 2020. The model is calibrated using
in-situ B
a
and validated against available
in-situ
altitudinal and geodetic mass balances. DBG and CSG show mean
B
a
of −0.27 ± 0.32 and −0.31 ± 0.38 m w.e. a
−1
(meter water equivalent per year), respectively, from 1979 to 2020. Glacier-wide net shortwave radiation dominates the SEB followed by longwave net radiation, latent heat flux, and sensible heat flux. The losses through sublimation are around 22% on DBG and 20% on CSG to the total ablation with a strong spatial and temporal variability. Modeled
B
a
is highly sensitive to snow albedo —with sensitivities of 0.29 and 0.37 m w.e. a
−1
for 10% change in the calibrated value—on DBG and CSG, respectively. The sensitivity of the modeled mean
B
a
to 1°C change in air temperature and 10% change in precipitation, respectively is higher on DBG (−0.50 m w.e. a
−1°
C
−1
, 0.23 m w.e. a
−1
) than the CSG (−0.30 m w.e. a
−1°
C
−1
, 0.13 m w.e. a
−1
). This study provides insights into the regional variations in mass-wastage governing SEB fluxes at a glacier-wide scale, which is helpful for understanding the glacier–climate interactions in the Himalaya and stresses an inclusion of sublimation scheme in T-index models.
The availability of syndrome-based panels for various ailments has widened the scope of diagnostics in many clinical settings. These panels can detect a multitude of pathogens responsible for a ...particular condition, which can lead to a timely diagnosis and better treatment outcomes. In contrast to traditional identification methods based on pathogen growth on culture, syndrome-based panels offer a quicker diagnosis, which can be especially beneficial in situations requiring urgent care, such as intensive care units. One such panel is the Biofire Filmarray Pneumonia plus Panel (BFP), which we have compared against microbiological culture and identification. The lower respiratory samples from patients were tested with BFP, culture, and identification with culture considered the gold standard. The phenotypic antibiotic susceptibility results (Vitek 2) were compared with the antimicrobial resistance (AMR) genes detected in BFP. Statistical analysis was carried out using GraphPad 7.0 and MS Excel (Microsoft Inc.). The results showed a positive percent agreement of 100% and a negative percent agreement of 47.8% with an overall agreement of 76.72% compared to culture. BFP was better at identifying fastidious bacteria, and the agreement with culture was higher for high bacterial identification numbers (10
and 10
). There was also a correlation between the number of pathogens detected and growth in culture. Carbapenemase genes were detected in around 80% of phenotypically resistant samples and correlated with in-house PCR 60% of the time. Hence, BFP results need to be interpreted with caution especially when multiple pathogens are detected. Similarly, the presence or absence of AMR genes should be used to guide the therapy while being watchful of unusual resistance or susceptibility. The cost constraints and low throughput call for patient selection criteria and prioritization in emergency or resource-limited conditions.IMPORTANCEApplication of syndrome-based panels in clinical microbiology is of huge support in infectious conditions requiring urgent interventions, such as pneumonia. Interpreting the results requires caution; hence, we have compared the results obtained from Biofire Filmarray Pneumonia plus Panel with standard microbiological methods.
Glacier-wide mass balances (MBs) of the Gangotri, Chaturangi, Raktavaran, Meru, and Gangotri Glacier System are reconstructed with a temperature-index (T-index) model using bias-corrected ERA5 data ...at a daily temporal resolution over 1979–2020. The model output is calibrated against available geodetic MB for Gangotri Glacier System and validated with satellite-derived snow line altitudes (SLAs) for Gangotri Glacier. Gangotri and Meru glaciers show mean mass wastage of –0.88 ± 0.31 m w. e. a
‒ˡ
(meter water equivalent per year) and ‒0.17 ± 0.29 m w. e. a
‒ˡ
, respectively whereas the mass budgets of fragmented tributary Chaturangi and Raktavaran glaciers are positive with the mean values of 0.49 ± 0.17 m w. e. a
‒ˡ
and 0.62 ± 0.15 m w. e. a
‒ˡ
, respectively over 1979–2020. Gangotri Glacier’s tongue is covered by thick debris having several supra-glacial lakes and ice cliffs (considered as melting hotspots); therefore, despite the presence of thick debris, we assume the melting over this area as of a clean glacier. The whole Gangotri Glacier System shows a moderate wastage of ‒0.27 ± 0.25 m w. e. a
‒ˡ
. The positive MBs of the Raktavaran and Chaturangi glaciers are due to their high area-elevation distribution and heavily debris-covered tongues. The positive MBs on these fragmented tributary glaciers are due to non-climatic topographic reasons and should not be misunderstood as climate change deniers or compared with Karakoram Anomaly. Modelled MBs are most sensitive to the threshold temperature for melt. The altitudinal MB sensitivities to all model parameters become negligible above 6,200 m a.s.l.
Abstract
Introduction
Stenotrophomonas maltophilia
is an emerging environmental, gram-negative, multidrug-resistant organism, associated with risk factors such as prolonged hospitalization, ...invasive procedures, admission to the intensive care unit, mechanical ventilation, use of indwelling catheters, administration of immunosuppressants or corticosteroids, human immunodeficiency virus infection, underlying malignancy, and organ transplantation. The organism, despite being of low invasiveness in immune-competent individuals, is difficult to treat because of intrinsic resistance to several antimicrobial agents.
Materials and Methods
This study focuses on commonly encountered resistance from among the isolates over a duration of 7 years from 2012 to 2018, analyzed retrospectively. Identification and susceptibility testing were performed using Vitek 2 (BioMérieux, Marcy-l'Etoile, France).
Results
Bloodstream infections were found to be most common (52.02%), followed by respiratory infections (35.83%). The median age of the patients was 36 years, and male to female ratio was 143:27. The median duration of hospital stay was 18 days, and mortality was seen in 18.82% of patients. Susceptibility to cotrimoxazole and levofloxacin was seen in 97.1% of isolates (168 out of 173) and 90.1% of isolates (156 out of 173), respectively.
Conclusion
Despite being effective in a majority of
S
.
maltophilia
isolates, both cotrimoxazole and levofloxacin have their shortcomings. Cotrimoxazole is bacteriostatic and can cause bone marrow suppression and resistance to levofloxacin sometimes develops during therapy. Thus, the therapy should be decided considering the characteristics of both of these drugs.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Background: Assessment of correlation between peri-implant parameters and C-reactive protein levels among patients with different obesity levels. Materials and Methods: Evaluation of 60 subjects was ...performed who were scheduled to undergo dental implant therapy for missing mandibular first molars. Three study cohorts were formed, namely, Group A: obese group (BMI between 30 Kg/m2 and 34.9 Kg/m2), Group B: high obese group (BMI over 34.9 Kg/m2), and Group C: non-obese group (BMI under 25 Kg/m2). Each cohort comprised 20 subjects. Dental implant therapy was carried out in all the patients. Peri-implant variables were evaluated in all the patients. Blood samples were obtained, and C-reactive protein levels in subjects having different obesity levels. Statistical analysis was performed using SPSS software. Results: Mean serum C-reactive protein levels among patients of groups A, B, and C occurred to be 3.28 mg/L, 3.65 g/L, and 3.61 g/L, respectively. On comparing numerically, noticeable outcomes were achieved. Mean probing depth among subjects of groups A, B, and C occurred to be 2.9 mm, 3.2 mm, and 1.3 mm, respectively. Mean marginal bone loss among subjects of groups A, B, and C occurred to be 2.1 mm, 2.7 mm, and 0.8 mm, respectively. On comparing numerically, noteworthy outcomes were gathered. Conclusion: There were significantly higher deranged peri-implant inflammatory variables among patients with higher levels of obesity.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
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