Recreational, Cultural and Aesthetic Services from Estuarine and Coastal Ecosystems

The role of economic analysis in guiding the sustainable development of estuarine and coastal ecosystems is investigated based on a comprehensive review of the literature on the valuation of the recreation, cultural and aesthetic services. The implications of the findings for the sustainable management of coral reefs, Marine Protected Areas, and Small Island Developing States are discussed. Finally, the potential of meta-analytical benefit transfer and scaling up of values at various aggregation levels is demonstrated in the context of coastal tourism and recreation in Europe. The results of the study support the conclusion that the non-material values provided by coastal and estuarine ecosystems in terms of recreational, cultural and aesthetic services represent a substantial component of human well-being.Aesthetic Values, Coastal Recreation, Coral Reefs, Cultural Values, Ecosystem Services Valuation, Ecosystem Services, Estuarine Ecosystems, Marine Protected Areas, Non-market Valuation, Non-use Values, Passive Values, Recreational Fishing, Small Island Developing States, Spiritual and Religious Values.

Multiple Choriangiomas of Placenta

Placental chorangiomas, not an uncommon condition is often small and hence usually goes unnoticed . However the incidence of complications is high when the chorangioma is large. We hereby present an unusual case of large and multiple choriangiomas with secondary changes and associated congenital anomalies with hydrops fetalis

Simple and Fast Biased Locks

Locks are used to ensure exclusive access to shared memory locations. Unfortunately, lock operations are expensive, so much work has been done on optimizing their performance for common access patterns. One such pattern is found in networking applications, where there is a single thread dominating lock accesses. An important special case arises when a single-threaded program calls a thread-safe library that uses locks. An effective way to optimize the dominant-thread pattern is to "bias" the lock implementation so that accesses by the dominant thread have negligible overhead. We take this approach in this work: we simplify and generalize existing techniques for biased locks, producing a large design space with many trade-offs. For example, if we assume the dominant process acquires the lock infinitely often (a reasonable assumption for packet processing), it is possible to make the dominant process perform a lock operation without expensive fence or compare-and-swap instructions. This gives a very low overhead solution; we confirm its efficacy by experiments. We show how these constructions can be extended for lock reservation, re-reservation, and to reader-writer situations

Simple Direct Drug Susceptibility Tests on Sputum Samples for Early Detection of Resistance in Tubercle Bacilli

Background: Direct sensitivity test either by sputum concentrate (DS) or swab method (DSM) set up along with the primary culture would avoid the delay of four or more weeks required for the indirect test. A comparison of these two methods against the standard indirect sensitivity method under routine laboratory conditions is necessary to prove their merit. Method: Smear positive sputum samples were aliquoted and sensitivity tests were set up by both the direct methods as also an indirect test set up from the primary culture of the same sample. Results: The agreement with the indirect test results for isoniazid (INH) ranged from 97-98% for the DS method and 93- 97% for the DSM method. The corresponding figures were 96-98% by the DS and 94-99% by the DSM method for rifampicin (R). The agreement was less satisfactory for ethambutol (Emb). Conclusion: This study showed that direct sensitivity tests such as DS and DSM methods can detect most of the cultures resistant to INH and R (MDR) from the time growth appears on the primary culture , even as early as the second week of setting up the tests

Comparison of different methods of assessing in vitro resistance of Mycobacterium tuberculosis to rifampicin

Background & objectives: Definitions of in vitro resistance to rifampicin in. strains of Mycobacterium tuberculosis by different methods have not been consistent, leading to variations in the interpretation and validity of results. This study compared three methods of defining in vitro resistance to rifampicin. Methods: (i) A total of 598 clinical isolates of M. tuberculosis were concurrently compared by the minimal inhibitory concentration (MIC) and the proportion method on Lowenstein-Jensen medium; (ii) 54 strains tested by the MIC method were retested by the proportion method and the BACTEC radiometric method; and (iii) 72 strains which yielded an MIC of 64 mg/l by the MIC method were retested by the same method. Results: Out of 598 cultures tested by the MIC and the proportion methods, identical classification as susceptible or resistant was observed in 99.7 per cent. A 100 per cent agreement was observed when 54 strains were tested by the MIC, proportion and BACTEC radiometric methods. When 72 strains with an MIC of 64 mg/l were retested by the same method, 61 (85%) yielded a lower MIC, 9 (12%) gave the same MIC while 2 (3%) yielded a higher MIC of 128 mg/l, reflecting perhaps the inherent limitations of the variations in the inoculum size. Interpretation & conclusion: All 3 definitions of resistance, viz., an MIC of 128 mg/l, a proportion of I per cent or more on 40 mg/l by the proportion method, both on L-J medium and a growth of 1 per cent or more on 2 mg/l by the radiometric method were found to be equally satisfactory

Surveillance of drug-resistant tuberculosis in the state of Gujarat, India

BACKGROUND: Limited information about the prevalence of drug-resistant tuberculosis (TB) has been reported from India, the country with the world’s highest burden of TB. We conducted a representative state-wide survey in the state of Gujarat (2005 population: 56 million). METHODS: Mycobacterium tuberculosis isolates from a representative sample of new and previously treated smear-positive pulmonary TB (PTB) cases were subjected to drug susceptibility testing (DST) against fi rst-line drugs at a World Health Organization supranational reference laboratory. Isolates found to have at least both isoniazid (INH) and rifampicin (RMP) resistance (i.e., multidrugresistant TB [MDR-TB]) were subjected to second-line DST. RESULTS: Of 1571 isolates from new patients, 1236 (78.7%) were susceptible to all fi rst-line drugs, 173 (11%) had any INH resistance and MDR-TB was found in 37 (2.4%, 95%CI 1.6–3.1). Of 1047 isolates from previously treated patients, 564 (54%) were susceptible to all fi rst-line drugs, 387 (37%) had any INH resistance and MDR-TB was found in 182 (17.4%, 95%CI 15.0–19.7%). Among 216 MDR-TB isolates, 52 (24%) were ofl oxacin (OFX) resistant; seven cases of extensively drug-resistant TB (XDR-TB) were found, all of whom were previously treated cases. CONCLUSION: MDR-TB prevalence remains low among new TB patients in Gujarat, but is more common among previously treated patients. Among MDR-TB isolates, the alarmingly high prevalence of OFX resistance may threaten the success of the expanding efforts to treat and control MDR-TB

Squeezing of a coupled state of two spinors

The notion of spin squeezing involves reduction in the uncertainty of a component of the spin vector below a certain limit. This aspect has been studied earlier for pure and mixed states of definite spin. In this paper, this study has been extended to coupled spin states which do not possess sharp spin value. A general squeezing criterion has been obtained by requiring that a direct product state for two spinors is not squeezed. The squeezing aspect of entangled states is studied in relation to their spin- spin correlations.Comment: Typeset in LaTeX 2e using the style iopart, packages iopams,times,amssymb,graphicx; 17 pages, 5 eps figure file

Rare Manifestation of a Rare Disease, Acute Liver Failure in Adult Onset Still’s Disease: Dramatic Response to Methylprednisolone Pulse Therapy—A Case Report and Review

Adult onset Still’s disease (AOSD) is a rare systemic inflammatory disorder of unknown etiology. It is characterized by daily fevers, arthralgias or arthritis, typical skin rash, and leukocytosis. Hepatic involvement is frequently observed in the course of AOSD with mildly elevated transaminases and/or hepatomegaly. Fulminant hepatic failure, occasionally requiring urgent liver transplantation, is a rare manifestation of AOSD. Here, we present a case of 22-year-old woman with no significant medical history who initially came with fever, arthralgias, myalgias, generalized weakness, and sore throat. Laboratory data showed mildly elevated transaminases and markedly elevated ferritin levels. She was diagnosed with AOSD based on Yamaguchi diagnostic criteria and was started on prednisone. Three months later, while she was on tapering dose of steroid, she presented with fever, abdominal pain, jaundice, and markedly elevated transaminases. Extensive workup excluded all potential causes of liver failure. She was diagnosed with AOSD associated acute liver failure (ALF). Intravenous (IV) methylprednisolone pulse therapy was started, with dramatic improvement in liver function. Our case demonstrated that ALF can present as a complication of AOSD and IV mega dose pulse methylprednisolone therapy can be employed as a first-line treatment in AOSD associated ALF with favorable outcome