Dengue infection carries a potential risk of death despite stringent management of plasma leak and haemorrhage. It appears that the extent of liver dysfunction determines the outcome.
We present a ...postmortem study of five patients, died of dengue shock syndrome who had markedly elevated liver enzymes and irreparable circulatory failure.
All were females with a median age of 46 years (range 20-50 years). All had positive NS1 and IgM. Clinically, one patient developed severe degree of hepatic encephalopathy whilst three patients developed uncontrollable bleeding manifestations. Dengue virus was detected in three liver specimens by reverse transcription PCR. Histology of the liver revealed massive necrosis with haemorrhages in these patients with evidence of micro and macrovesicular steatosis with significant periportal inflammatory infiltrate. No significant ischaemic changes or necrosis was observed in the other organs.
Severe haemorrhagic necrosis of the liver was the cause of death in these patients probably due to direct viral infection. Predilection for severe liver disease remains unknown. Therefore, it is prudent to think beyond plasma leak as the main pathology of dengue infection and attempts should be made to develop other treatment modalities to prevent and manage unforeseen fatal complications of dengue infection.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Seasonal variations affect growth and yield of a crop, primarily by changing its phenological developmental processes. A study was conducted to establish the relationship between growth, yield and ...their seasonal variations using ten mustard accessions (AC 501, 515, 580, 790, 1099, 1814, 2122, 5088, 7788 and 8831). The field study was conducted in a site at Nagollagama in Kurunegala District during two growing seasons, Maha and Yala. There was a significant variation in agronomic and phenological characters in different mustard accessions between two seasons, Maha and Yala, and among the accessions (p ≤ 0.05). Plant growth was affected by variations in climatic conditions. Soil moisture was unlimited and comparatively steady in Maha, but significantly fluctuated during Yala. Difference in soil nutrients, temperature and relative humidity during two seasons also contributed the variation in plant growth. Significantly high yields were obtained from all mustard accessions during the Maha season. There is a substantial variability of yield potential in different mustard genotypes in studied. Three mustard accessions (AC 580, AC 5088 and AC 7788) produced significantly higher yield in Maha and AC 7788 produced highest yield in Yala season as well, showing adaptability to seasonal variations. Key words: Growth; Maha and Yala seasons; mustard accessions; yield; phenological developmentDOI: http://dx.doi.org/10.4038/jas.v6i1.3807 The Journal of Agricultural Sciences, 2011 Vol.6(1) 1-15
Introduction
E‐cigarette, or vaping, product use‐associated lung injury (EVALI) results from inhaling the aerosol of e‐cigarettes and has similar clinical features to coronavirus disease 2019 ...(COVID‐19). EVALI case counts since the declaration of the COVID‐19 pandemic is unknown.
Methods
A retrospective electronic health record chart review of adolescents hospitalized at one institution with EVALI was conducted. Clinical characteristics and hospital course of patients hospitalized during the pandemic were compared to those prepandemic.
Results
The clinical presentation of adolescents hospitalized prior‐to (n = 19) and during the COVID‐19 pandemic (n = 22) were similar with respect to constitutional, respiratory, and gastrointestinal symptoms. All patients hospitalized during the pandemic were tested for COVID‐19 at least once. Only one patient had a positive SARS‐CoV‐2 RT‐PCR test result. Thirty‐one out of 39 patients treated with corticosteroids had clinical improvement within 24 h (79%). Patients hospitalized during the pandemic had a shorter median length of stay (5 vs. 7 days, p < 0.01), and were less often discharged with home oxygen (1 vs. 6 patients, p = 0.04). Pulmonary function tests improved pre‐ to postcorticosteroid treatment and postcorticosteroid to follow‐up.
Conclusions
Eliciting a history of vaping in adolescents presenting with constitutional, respiratory, and gastrointestinal symptoms is important to identify EVALI cases, which have continued throughout the COVID‐19 pandemic. A shorter length of stay with less need for mechanical ventilation and home oxygen in adolescents hospitalized during the pandemic may reflect increased familiarity with EVALI characteristics. Corticosteroids led to clinical and pulmonary function improvement.
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The design of vertical subsurface flow (VSSF) constructed wetlands (CWs) uses kinetic models to calculate the area based on the kinetic reaction rate constant (k) specific to local ...environmental conditions and target pollutants. Currently, kinetic modelling does not fully account for the impact of the hydraulic loading rate (HLR), which influences the wetland performance. This study used four experimental VSSF CWs operated at HLRs of 5, 10, 20 and 40 cm/day to investigate the applicability of three first order kinetic models combining plug-flow and continuous stirred tank reactor (CSTR) flow patterns. The target pollutants were BOD5, NH4+ and NO3-. For each pollutant, estimated k values varied between different HLRs and between plug flow and CSTR models. Assessment of uncertainty in kinetic modelling showed that all three models exhibit a similar trend in predicting the concentrations of BOD5 and NH4+ at 5–20 cm/day HLRs. A substantial removal of BOD5 (>88 %) and NH4+ (>70 %) were found for the investigated HLRs, although NO3- removal was not satisfactory. The HLR had a positive impact on mass removal rates (MRRs) for BOD5 and NH4+. Accordingly, 20 cm/day was deemed as the highest viable HLR for designing effective VSSF wetlands for the removal of BOD5 and NH4+. All three models can be employed to design VSSF wetlands at 20 cm/day HLR to treat BOD5 using k values of 0.352 (k-C), 0.380 (k-C*) and 0.996 (CSTR) m/day and to treat NH4+ using k values of 0.170 (k-C), 0.173 (k-C*) and 0.273 (CSTR) m/day.
Series compensation of transmission lines increase the risk of Sub-Synchronous Resonance (SSR) problems. Use of Thyristor Controlled Series Compensators (TCSC) in place of Fixed Series Capacitors ...(FSC) has benefited in terms of damping SSR. SSR Damping with TCSC can be achieved with supplementary controls or through its inherent damping capability. Use of discrete time models for small signal stability analysis of TCSC is well established. This paper uses a simplified Dynamic Phasor (DP) model of the TCSC for an in-depth evaluation of the inherent SSR damping capability through small signal stability analysis. Source of inherent damping in open loop operation and the representation of it in the DP model is elaborated and the small signal model is validated against Electro Magnetic Transient (EMT) simulations. Effect of inductive-resistive nature of the TCSC on Induction Generator Effect (IGE) and Torsional Interactions (TI) is shown through small signal stability assessment. It is shown that the network resonant frequency exists only in a narrow range of firing angles of the TCSC and thus IGE and TI are avoided in most part of its operating range. IEEE first benchmark system for SSR studies is used to demonstrate the inherent damping capability of a TCSC.
An RT model (RT1) was constructed using 35 agro-morphological characters for 45 mustard (Brassica juncea) accessions. Based on the 'variable importance' of the model RT1, another model (RT2) was ...developed. These models were developed using classification and regression tree algorithms. The classificatory performance of the RT1 model was compared with RT2 model. RT1 and RT2 models classified the mustard accessions with misclassification rates of 2.3% (98% accuracy) and 4.3% (96% accuracy), respectively. The variable importance of RT1 and RT2 explained that leaf length (LLCM), hypocotyl length (HLCM), hypocotyl-anthocynin coloration (ACH) and leaf width (LWCM) at seedling stage and main inflorescence length (LMICM), silique length (SLMM) and seed yield/plant (SYDIVPG) at maturity stage play an important role in classifying mustard accessions. Comparison of RT1 with RT2 revealed that accuracy of classification made by RT1 is higher in predicting class memberships among mustard accessions. A large degree of variability within and between Sri Lankan mustard accessions has been observed for agro-morphological characters with respect to LLCM, HLCM, ACH, LWCM, LMICM, SLMM and SYDIVPG. The genetic diversity of certain mustard accessions such as Accession Numbers 346, 8658 and 9726 is too high and RT models failed to classify them correctly with acceptable accuracy. Key words: Agro-morphological characters; Brassica juncea; Classification Tree Analysis; germplasm DOI: 10.4038/jas.v5i2.2788The Journal of Agricultural Sciences, 2010, vol. 5, no 2 pp.89-97
Suicide rates among Black and Hispanic youth have been increasing over the past decade in the United States. The objective of this study was to identify risk factors for suicide ideation and attempt ...among Black and Hispanic youth in the United States using intersectionality theory and minority stress theory as a framework.
Data from the CDC Youth Risk Behavior Surveillance System (YRBSS; 2015-2019) were analyzed and delimited to include only Black and Hispanic youth.
About 37% of the subsample identified as Black and 63% of the subsample identified as Hispanic; mean age was 16 years (SE = 0.02). Weighted multivariate logistic regressions were used to explore associations between suicide ideation and attempt, depressive symptoms, bullying, dating violence, and being threatened with a weapon. Black and Hispanic youth who had depressive symptoms, experienced bullying, dating violence, or threatened with a weapon all had increased odds of having suicide ideation and suicide attempt. Hispanic youth had the higher odds of suicide ideation and attempt than Black youth. Girls in the study also had elevated odds of suicide ideation.
This study adds to the literature on risk factors of suicide in Black and Hispanic youth and bringing to awareness the gender disparities in suicide ideation and attempt among youth.
Summary Background Spotted fever group (SFG) rickettsial infections are increasingly detected in Sri Lanka. We describe 17 patients with SFG who developed neurological manifestations. Methods The ...cases were studied prospectively from 2008 at the Teaching Hospital, Peradeniya. An immunofluorescent antibody assay (IFA) was used to confirm the diagnosis. Results All had an IFA IgG titer ranging from 1/64 to 1/4096 and a positive IFA IgM titer against Rickettsia conorii antigen; in 10 (59%) cases the IgG titers were ≥1/256 (definitive cases). The median age of the patients was 62 years (range 26–82 years); 10 were male and seven female. The median duration of fever was 12 days (range 4–35 days). Neurological manifestations on admission were drowsiness or confusion in 14 (82%) and a semi-comatose state in three (18%). Rigidity of the limbs occurred in 14 (82%), bradykinesia and resting tremors in 12 (71%), which persisted after defervescence, neck stiffness in seven (42%), weakness of the limbs in five (29%), deafness in two (12%), and stupor in three (18%). Electroencephalograms in three (18%) showed generalized slow waves. Cerebrospinal fluid examination showed a cellular reaction, predominantly lymphocytes, in three cases. Two patients died (fatality rate 12%). Conclusion We have documented for the first time the neurological features of SFG rickettsioses in the Central Province, Sri Lanka. These were predominantly extrapyramidal features in patients of older age.
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