Community acquired pneumonia: risk factors associated with mortality in a tertiary care hospitalized patients

OBJECTIVE: To evaluate risk factors associated with mortality in patients hospitalized with CommunityAcquired Pneumonia (CAP) from a developing country. METHODS: An observational study was conducted on adult patients admitted with a diagnosis of CAP from January 2002 to August 2003 at Aga Khan University hospital, Karachi, Pakistan. Clinical records were reviewed for demographic characteristics, clinical and laboratory features, hospital course, and risk factors associated with mortality. RESULTS: A total of 329 patients (187 males) were admitted with CAP. Two-third of patients had underlying co-morbid medical illnesses. Complications developed in 15.7% cases and the overall mortality rate was 11%. Risk factors were identified on initial clinical assessment, laboratory and radiological features and during hospital course. On admission elevated blood urea, new onset of confusion, abnormal liver function test, low serum albumin, cardiomegaly and presence of underlying malignancy were strongly associated with increased mortality. Failure to respond to therapy was associated with a high risk of mortality as depicted by complication during hospital stay (Odds Ratio = 23.3, 95% Confidence Interval = 10.3-52.8), need for mechanical ventilation (OR = 17.1, 95% CI = 7.4-39.8) and need for intensive care unit (OR = 9, 95% CI = 4.2-19.3). CONCLUSIONS: Abnormal liver function test, low albumin and presence of cardiomegaly were more significant mortality risk factors than age, respiratory rate and blood pressure. Elevated blood urea and confusion remain strong risk factors on admission. Failure of response to therapy and onset of complications heralded a high risk of death

Susceptibility of optimal train schedules to stochastic disturbances of process times

This work focuses on the stochastic evaluation of train schedules computed by a microscopic scheduler of railway operations based on deterministic information. The research question is to assess the degree of sensitivity of various rescheduling algorithms to variations in process times (running and dwell times). In fact, the objective of railway traffic management is to reduce delay propagation and to increase disturbance robustness of train schedules at a network scale. We present a quantitative study of traffic disturbances and their effects on the schedules computed by simple and advanced rescheduling algorithms. Computational results are based on a complex and densely occupied Dutch railway area; train delays are computed based on accepted statistical distributions, and dwell and running times of trains are subject to additional stochastic variations. From the results obtained on a real case study, an advanced branch and bound algorithm, on average, outperforms a First In First Out scheduling rule both in deterministic and stochastic traffic scenarios. However, the characteristic of the stochastic processes and the way a stochastic instance is handled turn out to have a serious impact on the scheduler performance

Genetic diversity of pran (Allium cepa var. prolliferum) in Kashmir

Ten pran genotypes were evaluated using RAPD markers to determine the genetic relationships among genotypes showing morphological variations. Fourty three decamer primers were used in this study. Genetic diversity in the genotypes studied was analyzed using several variability parameters. Genotypes were grouped into two main clusters based on jaccard similarity coefficient. A dendrogram based on UPGMA analysis grouped the ten genotypes into two main clusters. Genotypes representing cluster-I are superior over genotypes in cluster-II with respect to yield attributes. Some genotypes did not show any similarity with either cluster, depicting their diverse nature. The grouping that was obtained with the RAPD analysis was at par with the morphological grouping based on yield attributes. The results of Principal Co-ordinate (PCO) analysis were comparable to the cluster analysis. Finally, the investigation of the genetic variation of pran with RAPD indicated that this marker is a suitable tool for assessing polymorphism and estimating the genetic similarity. &nbsp

Genetic diversity of pran (Allium cepa var. prolliferum) in Kashmir

Ten pran genotypes were evaluated using RAPD markers to determine the genetic relationships among genotypes showing morphological variations. Fourty three decamer primers were used in this study. Genetic diversity in the genotypes studied was analyzed using several variability parameters. Genotypes were grouped into two main clusters based on jaccard similarity coefficient. A dendrogram based on UPGMA analysis grouped the ten genotypes into two main clusters. Genotypes representing cluster-I are superior over genotypes in cluster-II with respect to yield attributes. Some genotypes did not show any similarity with either cluster, depicting their diverse nature. The grouping that was obtained with the RAPD analysis was at par with the morphological grouping based on yield attributes. The results of Principal Co-ordinate (PCO) analysis were comparable to the cluster analysis. Finally, the investigation of the genetic variation of pran with RAPD indicated that this marker is a suitable tool for assessing polymorphism and estimating the genetic similarity. &nbsp

Causes and Reasons of Insect Decline and the Way Forward

There are lot of reasons and causes of insect decline. The main causes of insect decline is attributed to habitat destruction, land use changes, deforestation, intensive agriculture, urbanization, pollution, climate change, introduction of invasive insect species, application of pesticides, mass trapping of insects using pheromones and light traps, pathological problems on various insects, and introduction of exotic honey bees in new areas that compete with the native bees for resource portioning and other management techniques for pest management, and even not leaving any pest residue for predators and parasitoids for their survival. The use of chemical insecticides against target or non-target organisms is major cause for insect decline. The diseases and decline of the important pollinators is still a mistry for colony collapse disorder. To overcome the cause of insect decline, various conservation techniques to be adopted and augmentation of artificial nesting and feeding structures, use of green pesticides, maintaining the proper pest defender ratio (P:D), policies and reaching to political audience at global level and other factors already discussed in the chapter may be helpful for mitigating the insect decline and especially for the pollinators, a key insect for life

Reframing Technological Innovation Capabilities: Empirical Evidence and a Framework for Study

A firm’s technological innovation capabilities are dependent on the cultivation of strategic expertise and competitive technologies. Current literature does not adequately represent the wide-ranging perspectives on this topic or instill an appropriate amount of apprehension over the competitiveness of current firms’ technological innovation capabilities. This chapter contributes to the micro-foundations of technological innovation research by defining the technological innovation capabilities of both individuals and firms and clarifying their relationship to a firm’s competitiveness. First, this chapter will present a conceptual framework of the dimensions required to build competitiveness through technological innovation capabilities. Second, building on the framework, this paper will offer empirical evidence based on a case study of SMEs, providing valuable insights into their capacity for technological innovation.Post-print / Final draf

The In Vivo Role of the RP-Mdm2-p53 Pathway in Signaling Oncogenic Stress Induced by pRb Inactivation and Ras Overexpression

The Mdm2-p53 tumor suppression pathway plays a vital role in regulating cellular homeostasis by integrating a variety of stressors and eliciting effects on cell growth and proliferation. Recent studies have demonstrated an in vivo signaling pathway mediated by ribosomal protein (RP)-Mdm2 interaction that responds to ribosome biogenesis stress and evokes a protective p53 reaction. It has been shown that mice harboring a Cys-to-Phe mutation in the zinc finger of Mdm2 that specifically disrupts RP L11-Mdm2 binding are prone to accelerated lymphomagenesis in an oncogenic c-Myc driven mouse model of Burkitt's lymphoma. Because most oncogenes when upregulated simultaneously promote both cellular growth and proliferation, it therefore stands to reason that the RP-Mdm2-p53 pathway might also be essential in response to oncogenes other than c-Myc. Using genetically engineered mice, we now show that disruption of the RP-Mdm2-p53 pathway by an Mdm2C305F mutation does not accelerate prostatic tumorigenesis induced by inactivation of the pRb family proteins (pRb/p107/p130). In contrast, loss of p19Arf greatly accelerates the progression of prostate cancer induced by inhibition of pRb family proteins. Moreover, using ectopically expressed oncogenic H-Ras we demonstrate that p53 response remains intact in the Mdm2C305F mutant MEF cells. Thus, unlike the p19Arf-Mdm2-p53 pathway, which is considered a general oncogenic response pathway, the RP-Mdm2-p53 pathway appears to specifically suppress tumorigenesis induced by oncogenic c-Myc

Seduced by the dark side: integrating molecular and ecological perspectives on the influence of light on plant defence against pests and pathogens.

Plants frequently suffer attack from herbivores and microbial pathogens, and have evolved a complex array of defence mechanisms to resist defoliation and disease. These include both preformed defences, ranging from structural features to stores of toxic secondary metabolites, and inducible defences, which are activated only after an attack is detected. It is well known that plant defences against pests and pathogens are commonly affected by environmental conditions, but the mechanisms by which responses to the biotic and abiotic environments interact are only poorly understood. In this review, we consider the impact of light on plant defence, in terms of both plant life histories and rapid scale molecular responses to biotic attack. We bring together evidence that illustrates that light not only modulates defence responses via its influence on biochemistry and plant development but, in some cases, is essential for the development of resistance. We suggest that the interaction between the light environment and plant defence is multifaceted, and extends across different temporal and biological scales