This review article discusses the current and future possibilities for the application of in situ transmission electron microscopy to reveal synthesis pathways and functional mechanisms in complex ...and nanoscale materials. The findings of a group of scientists, representing academia, government labs and private sector entities (predominantly commercial vendors) during a workshop, held at the Center for Nanoscale Science and Technology- National Institute of Science and Technology (CNST-NIST), are discussed. We provide a comprehensive review of the scientific needs and future instrument and technique developments required to meet them.
•Evaluation of currently available technology for performing in situ experiments using transmission electron microscope.•Limitations of currently available instrumentation with respect to base TEM, specialty TEM holders, and data acquisition systems.•Guidelines and wish list for the areas of future development.
Due to their varied outcomes, men with biochemical recurrence (BCR) following radical prostatectomy (RP) present a management dilemma. Here, we evaluate Decipher, a genomic classifier (GC), for its ...ability to predict metastasis following BCR.
The study population included 85 clinically high-risk patients who developed BCR after RP. Time-dependent receiver operating characteristic (ROC) curves, weighted Cox proportional hazard models and decision curves were used to compare GC scores to Gleason score (GS), PSA doubling time (PSAdT), time to BCR (ttBCR), the Stephenson nomogram and CAPRA-S for predicting metastatic disease progression. All tests were two-sided with a type I error probability of 5%.
GC scores stratified men with BCR into those who would or would not develop metastasis (8% of patients with low versus 40% with high scores developed metastasis, P<0.001). The area under the curve for predicting metastasis after BCR was 0.82 (95% CI, 0.76-0.86) for GC, compared to GS 0.64 (0.58-0.70), PSAdT 0.69 (0.61-0.77) and ttBCR 0.52 (0.46-0.59). Decision curve analysis showed that GC scores had a higher overall net benefit compared to models based solely on clinicopathologic features. In multivariable modeling with clinicopathologic variables, GC score was the only significant predictor of metastasis (P=0.003).
When compared to clinicopathologic variables, GC better predicted metastatic progression among this cohort of men with BCR following RP. While confirmatory studies are needed, these results suggest that use of GC may allow for better selection of men requiring earlier initiation of treatment at the time of BCR.
Trauma systems have been successful in saving lives and preventing disability. Making sure that the right patient gets the right treatment in the shortest possible time is integral to this success. ...Most trauma systems have not fully developed trauma triage to optimize outcomes. For trauma triage to be effective, there must be a well-developed pre-hospital system with an efficient dispatch system and adequately resourced ambulance system. Hospitals must have clear designations of the level of service provided and agreed protocols for reception of patients. The response within the hospital must be targeted to ensure the sickest patients get an immediate response. To enable the most appropriate response to trauma patients across the system, a well-developed monitoring programme must be in place to ensure constant refinement of the clinical response. This article gives a brief overview of the current approach to triaging trauma from time of dispatch to definitive treatment.
Major crops subject to field burning of crop residue (FBCR) generated an estimated 284 Tg of residue in India, of which 40% was contributed by wheat in the year 2000. About 7.5% of this total ...generated wheat straw was subjected to on-site burning, that is expected to emit large amounts of trace gases and particulate matter (PM) to the atmosphere, whose country-specific estimates and emission factors (EFs) are presently not available. An in situ experiment for wheat straw burning was undertaken for developing India specific EFs. The EFs of
CO
2
,
CH
4
, CO,
N
2
O
,
NO
x
, NO and
NO
2
were found to be
1787
±
36
,
3.6
±
2.7
,
28.1
±
20.1
,
0.74
±
0.46
,
1.70
±
1.68
,
0.78
±
0.71
and
0.56
±
0.47
g
kg
-
1
, whereas those for organic carbon (OC), black carbon (BC) and total carbon (TC) were
0.3
±
0.1
,
0.2
±
0.1
, and
0.5
±
0.2
g
kg
-
1
, respectively. Although these EFs have been generated from a single field experiment nevertheless they address important information gap on FBCR in the region. Further, the total emissions of
CH
4
,
CO
2
, CO,
N
2
O
,
NO
x
, NO,
NO
2
, OC, BC and TC from wheat straw burning in India for the year 2000 was estimated as
68
±
51
,
34435
±
682
,
541
±
387
,
14
±
9
,
33
±
32
,
15
±
14
,
11
±
9
,
6
±
2
,
3
±
1
and
10
±
4
Gg, respectively.
Frailty is independently associated with worse health-related quality of life (HRQOL) in chronic kidney disease (CKD). However, the relationship between frailty and symptom experience is not well ...described in people living with CKD. This study's aim was to evaluate the relationship between frailty and symptom-burden in CKD.
This study is a secondary analysis of a cross-sectional observational study, the QCKD study (ISRCTN87066351), in which participants completed physical activity, cardiopulmonary fitness, symptom-burden and HRQOL questionnaires. A modified version of the Frailty Phenotype, comprising 3 self-report components, was created to assess frailty status. Multiple linear regression was performed to assess the association between symptom-burden/HRQOL and frailty. Logistic regression was performed to assess the association between experiencing symptoms frequently and frailty. Principal Component Analysis was used to assess the experienced symptom clusters.
A total of 353 patients with CKD were recruited with 225 (64%) participants categorised as frail. Frail participants reported more symptoms, had higher symptom scores and worse HRQOL scores. Frailty was independently associated with higher total symptom score and lower HRQOL scores. Frailty was also independently associated with higher odds of frequently experiencing 9 out of 12 reported symptoms. Finally, frail participants experienced an additional symptom cluster that included loss of appetite, tiredness, feeling cold and poor concentration.
Frailty is independently associated with high symptom-burden and poor HRQOL in CKD. Moreover, people living with frailty and CKD have a distinctive symptom experience. Proactive interventions are needed that can effectively identify and address problematic symptoms to mitigate their impact on HRQOL.
Indian aerosols: present status Mitra, A.P; Sharma, C
Chemosphere (Oxford),
12/2002, Volume:
49, Issue:
9
Journal Article, Conference Proceeding
Peer reviewed
This article presents the status of aerosols in India based on the research activities undertaken during last few decades in this region. Programs, like International Geophysical Year (IGY), Monsoon ...Experiment (MONEX), Indian Middle Atmospheric Program (IMAP) and recently conducted Indian Ocean Experiment (INDOEX), have thrown new lights on the role of aerosols in global change. INDOEX has proved that the effects of aerosols are no longer confined to the local levels but extend at regional as well as global scales due to occurrence of long range transportation of aerosols from source regions along with wind trajectories. The loading of aerosols in the atmosphere is on rising due to energy intensive activities for developmental processes and other anthropogenic activities. One of the significant observation of INDOEX is the presence of high concentrations of carbonaceous aerosols in the near persistent winter time haze layer over tropical Indian Ocean which have probably been emitted from the burning of fossil-fuels and biofuels in the source region. These have significant bearing on the radiative forcing in the region and, therefore, have potential to alter monsoon and hydrological cycles.
In general, the SPM concentrations have been found to be on higher sides in ambient atmosphere in many Indian cities but the NO
x
concentrations have been found to be on lower side. Even in the haze layer over Indian Ocean and surrounding areas, the NO
x
concentrations have been reported to be low which is not conducive of O
3 formation in the haze/smog layer. The acid rain problem does not seem to exist at the moment in India because of the presence of neutralizing soil dust in the atmosphere. But the high particulate concentrations in most of the cities’ atmosphere in India are of concern as it can cause deteriorated health conditions.
The realisation of human potential for development requires age-specific investment throughout the 8000 days of childhood and adolescence. Focus on the first 1000 days is an essential but ...insufficient investment. Intervention is also required in three later phases: the middle childhood growth and consolidation phase (5–9 years), when infection and malnutrition constrain growth, and mortality is higher than previously recognised; the adolescent growth spurt (10–14 years), when substantial changes place commensurate demands on good diet and health; and the adolescent phase of growth and consolidation (15–19 years), when new responses are needed to support brain maturation, intense social engagement, and emotional control. Two cost-efficient packages, one delivered through schools and one focusing on later adolescence, would provide phase-specific support across the life cycle, securing the gains of investment in the first 1000 days, enabling substantial catch-up from early growth failure, and leveraging improved learning from concomitant education investments.
Renal colic is a common, acute presentation of urolithiasis that requires immediate pain relief. European Association of Urology guidelines recommend nonsteroidal anti-inflammatory drugs (NSAIDs) as ...the preferred analgesia. However, the fear of NSAID adverse effects and the uncertainty about superior analgesic effect have maintained the practice of advocating intravenous opioids as the initial analgesia.
The objective of this systematic review and meta-analysis was to compare the safety and efficacy of NSAIDs with opioids and paracetamol (acetaminophen) for the management of acute renal colic.
Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, World Health Organization International Clinical Trials Registry Platform, Google Scholar, and the reference list of retrieved articles were searched up to December 2016 without language restrictions. Two reviewers independently assessed eligible studies using the Cochrane Collaboration tool for assessing and reporting the risk of bias and abstracted data using predefined data fields.
From 468 potentially relevant studies, 36 randomized controlled trials (RCTs) including 4887 patients, published between 1982 and 2016, were included in this systematic review. The treatment effect observed indicated marginal benefit of NSAIDs over opioids in initial pain reduction at 30min (11 RCTs, n=1985, mean difference MD –5.58, 95% confidence interval CI –10.22 to –0.95; heterogeneity I2=81%). In the subgroup analyses by the route of administration, NSAIDs required fewer rescue treatments (seven RCTs, n=541, number needed to treat NNT 11, 95% CI 6–75) and had lower vomiting rates compared with opioids (five RCTs, n=531, NNT 5, 95% CI 4–8). Comparisons of NSAIDs with paracetamol showed no difference for both drugs at 30min (four RCTs, n=1325, MD –5.67, 95% CI –17.52 to 6.18, p=0.35; I2=89%). Patients treated with NSAIDs required fewer rescue treatments (two trials, n=1145, risk ratio 0.56, 95% CI 0.42–0.74, p<0.001; I2=0%).
NSAIDs were equivalent to opioids or paracetamol in the relief of acute renal colic pain at 30min. There was less vomiting and fewer requirements for rescue analgesia with NSAIDs compared with opioids. Patients treated with NSAIDs required less rescue analgesia compared with paracetamol. Despite observed heterogeneity among the included studies and the overall quality of evidence, the findings of a lower need for rescue analgesia and fewer adverse events, in conjunction with the practical advantages of ease of delivery, suggest that NSAIDs should be the preferred analgesic option for patients presenting to the emergency department with renal colic.
In kidney stone–related acute pain episodes in patients with adequate renal function, treatment with nonsteroidal anti-inflammatory drugs offers effective and most sustained pain relief, with fewer side effects, when compared with opioids or paracetamol.
Nonsteroidal anti-inflammatory drugs (NSAIDS) provided effective and most sustained pain relief with fewer side effects. The combined pragmatic benefits of ease of administration and lack of analgesia abuse or addiction properties establish NSAIDS as the first-line analgesia to treat acute renal colic pain.
Budget estimate for carbonaceous aerosols including black carbon (BC) and organic carbon, emitted from the combustion of various fuels, is very important for regional climate studies. Emission ...factors for carbonaceous aerosols from bio-fuels and soft coke were determined in a controlled combustion study. The emission factors thus obtained along with those available for other fossil fuels consumed in different sectors have been applied to assess the budget for carbonaceous aerosols from India. Preliminary calculations give a range of 1.6–1.8
Tg of carbonaceous aerosols that include 0.4–1.4
Tg of BC. A major (∼80%) portion of carbonaceous aerosols emitted from India is found to originate from the use of biomass for energy as 70–80% of energy requirement in rural India is met by combustion of traditional bio-fuels.
Chemical simulations in most of the atmospheric chemistry models require surface emissions in a specific form (gridded), which are often not available. Simple interpolation of broader level emissions ...to obtain gridded data may lead to erroneous results. An attempt has been made in this paper to develop a geographical information system (GIS) based methodology for distributing the emissions from a broader level inventory to finely gridded emission values, considering local micro-level details and activity data. Given the importance of Carbon Monoxide emissions in ozone pollution chemistry over India, an emission inventory for CO from various sources for India has been used to demonstrate the GIS-based gridding methodology. The total CO emissions over India for 2001, which are estimated to be around 69.0
Tg
year
−1, have been downscaled source-wise (distinguishing between rural and urban bio-fuel, vehicular traffic, coal and biomass burning) from state-level (28 points) to district level (∼500 points) before mapping through a GIS utility and finally gridded to a 1°×1° resolution with a data loss of only about 13%. The final results provide detailed information with emission “hot spots” and the relative contribution of various sources. This article focuses on usage of the GIS based statistical methodology for gridding the inventory and the results obtained thereof are discussed.
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