Is The Burden of Medical Education Affecting Ethics of Medical Treatment?

A substantial number of medical students in India have to bear an enormous financial burden for earning a bachelor's degree in medicine referred to as MBBS (bachelor of medicine and bachelor of surgery). This degree program lasts for four and one-half years followed by one year of internship. A postgraduate degree, such as MD, has to be pursued separately on completion of a MBBS. Every medical college in India is part of a hospital where the medical students get clinical exposure during the course of their study. All or at least a number of medical colleges in a given state are affiliated to a university that mainly plays a role of an overseeing authority. The medical colleges usually have no official interaction with other disciplines of education such as science and engineering, perhaps because of their independent location and absence of emphasis on medical research. However, many of the medical colleges are adept in imparting high-quality and sound training in medical practices including diagnostics and treatment. The medical colleges in India are generally of two types, i.e., government owned and private. Since only a limited number of seats are available across India in the former category of colleges, only a small fraction of aspiring candidates can find admission in these colleges after performing competitively in the relevant entrance tests. A major advantage of studying in these colleges is the nominal tuition fees that have to be paid. On the other hand, a large majority of would-be medical graduates have to seek admission in the privately run medical institutes in which the tuition and other related fees can be mind boggling when compared to their public counterparts. Except for candidates of exceptionally affluent background, the only alternative for fulfilling the dream of becoming a doctor is by financing one's study through hefty bank loans that may take years to pay back. It is often heard from patients that they are asked by doctors to undergo a plethora of diagnostic tests for apparently minor illnesses, which may financially benefit those prescribing the tests. The present paper attempts to throw light on the extent of disparity in cost of a medical education between state-funded and privately managed medical colleges in India; the average salary of a new medical graduate, which is often ridiculously low when compared to what is offered in entry-level engineering and business jobs; and the possible repercussions of this apparently unjust economic situation regarding the exploitation of patients.

Dynamic Space Warping Of Strokes For Recognition Of Online Handwritten Characters

This paper suggests a scheme for classifying online handwritten characters, based on dynamic space warping of strokes within the characters. A method for segmenting components into strokes using velocity profiles is proposed. Each stroke is a simple arbitrary shape and is encoded using three attributes. Correspondence between various strokes is established using Dynamic Space Warping. A distance measure which reliably differentiates between two corresponding simple shapes (strokes) has been formulated thus obtaining a perceptual distance measure between any two characters. Tests indicate an accuracy of over 85% on two different datasets of characters.

Proteomics of Trypanosoma evansi Infection in Rodents

Background: Trypanosoma evansi infections, commonly called 'surra', cause significant economic losses to livestock industry. While this infection is mainly restricted to large animals such as camels, donkeys and equines, recent reports indicate their ability to infect humans. There are no World Animal Health Organization (WAHO) prescribed diagnostic tests or vaccines available against this disease and the available drugs show significant toxicity. There is an urgent need to develop improved methods of diagnosis and control measures for this disease. Unlike its related human parasites T. brucei and T. cruzi whose genomes have been fully sequenced T. evansi genome sequence remains unavailable and very little efforts are being made to develop improved methods of prevention, diagnosis and treatment. With a view to identify potential diagnostic markers and drug targets we have studied the clinical proteome of T. evansi infection using mass spectrometry (MS).Methodology/Principal Findings: Using shot-gun proteomic approach involving nano-lc Quadrupole Time Of Flight (QTOF) mass spectrometry we have identified over 160 proteins expressed by T. evansi in mice infected with camel isolate. Homology driven searches for protein identification from MS/MS data led to most of the matches arising from related Trypanosoma species. Proteins identified belonged to various functional categories including metabolic enzymes; DNA metabolism; transcription; translation as well as cell-cell communication and signal transduction. TCA cycle enzymes were strikingly missing, possibly suggesting their low abundances. The clinical proteome revealed the presence of known and potential drug targets such as oligopeptidases, kinases, cysteine proteases and more.Conclusions/Significance: Previous proteomic studies on Trypanosomal infections, including human parasites T. brucei and T. cruzi, have been carried out from lab grown cultures. For T. evansi infection this is indeed the first ever proteomic study reported thus far. In addition to providing a glimpse into the biology of this neglected disease, our study is the first step towards identification of diagnostic biomarkers, novel drug targets as well as potential vaccine candidates to fight against T. evansi infections.

Phage Displayed Short Peptides against Cells of Candida albicans Demonstrate Presence of Species, Morphology and Region Specific Carbohydrate Epitopes

Candida albicans is a commensal opportunistic pathogen, which can cause superficial infections as well as systemic infections in immuocompromised hosts. Among nosocomial fungal infections, infections by C. albicans are associated with highest mortality rates even though incidence of infections by other related species is on the rise world over. Since C. albicans and other Candida species differ in their susceptibility to antifungal drug treatment, it is crucial to accurately identify the species for effective drug treatment. Most diagnostic tests that differentiate between C. albicans and other Candida species are time consuming, as they necessarily involve laboratory culturing. Others, which employ highly sensitive PCR based technologies often, yield false positives which is equally dangerous since that leads to unnecessary antifungal treatment. This is the first report of phage display technology based identification of short peptide sequences that can distinguish C. albicans from other closely related species. The peptides also show high degree of specificity towards its different morphological forms. Using fluorescence microscopy, we show that the peptides bind on the surface of these cells and obtained clones that could even specifically bind to only specific regions of cells indicating restricted distribution of the epitopes. What was peculiar and interesting was that the epitopes were carbohydrate in nature. This gives insight into the complexity of the carbohydrate composition of fungal cell walls. In an ELISA format these peptides allow specific detection of relatively small numbers of C. albicans cells. Hence, if used in combination, such a test could help accurate diagnosis and allow physicians to initiate appropriate drug therapy on time.

ORTHOPYROXENE plus SILLIMANITE PREDATING SAPPHIRINE plus QUARTZ: A RARE CASE OF ULTRAHIGH-TEMPERATURE METAMORPHISM FROM THE CENTRAL ZONE, LIMPOPO COMPLEX, SOUTH AFRICA

Sapphirine + quartz and orthopyroxene + sillimanite occur in garnet from an Mg-Al granulite from the Central Zone of the Limpopo Complex in South Africa. Textural evidence and a chemical gradient in garnet between the zones preserving the inclusions argue for the formation of sapphirine + quartz after orthopyroxene + sillimanite. Petrological observations, pressure-temperature phase diagrams, and compositional and model proportion results on isopleths indicate the sapphirine + quartz + garnet + orthopyroxene (high-Al) assemblage as the peak metamorphic assemblage (similar to 1050 degrees C at similar to 8.5 kbars), whereas orthopyroxene (low-Al) + sillimanite represents the prograde stage (at ca. 900 degrees C at similar to 8.5 kbars). Our report of these two diagnostic ultrahigh-temperature mineral assemblages in garnet from an Mg-Al granulite is unique, given the rare occurrence of sapphirine + quartz postdating orthopyroxene + sillimanite assemblage in granulites.

Single-Cell Optical Absorbance Characterization With High-Throughput Microfluidic Microscopy

Morphological changes in cells associated with disease states are often assessed using clinical microscopy. However, the changes in chemical composition of cells can also be used to detect disease conditions. Optical absorption measurements carried out on single cells using inexpensive sources, detectors can help assess the chemical composition of cells; thereby enable detection of diseases. In this article, we present a novel technique capable of simultaneously detecting changes in morphology and chemical composition of cells. The presented technique enables characterization of optical absorbance-based methods against microscopy for detection of disease states. Using the technique, we have been able to achieve a throughput of about 1000 cells per second. We demonstrate the proof-of-principle by detecting malaria in a given blood sample. The presented technique is capable of detecting very lower levels of parasitemia within time scales comparable to antigen-based rapid diagnostic tests.

Interference of Two Closely Spaced Strip Footings on Sand Using Model Tests

By using small scale model tests, the interference effect on the ultimate bearing capacity of two closely spaced strip footings, placed on the surface of dry sand, was investigated. At any time, the footings were assumed to (1) carry exactly the same magnitude of load; and (2) settle to the same extent. No tilt of the footing was allowed. The effect of clear spacing (s) between two footings was explicitly studied. An interference of footings leads to a significant increase in their bearing capacity; the interference effect becomes even more substantial with an increase in the relative density of sand. The bearing capacity attains a peak magnitude at a certain (critical) spacing between two footings. The experimental observations presented in this technical note were similar to those given by different available theories. However, in a quantitative sense, the difference between the experiments and theories was seen to be still significant and it emphasizes the need of doing a further rigorous analysis in which the effect of stress level on the shear strength parameters of soil mass can be incorporated properly.

Analysis of EXCOBULLE two-phase expansion tests

analysis of a complex physical problem and the close agreement they achieved with observations. However, the following points need to be clarified. First of all the authors assume that during the initial phases of expansion, the Tayior's instability sets in due to the acceleraacceleration of lighter fluid against the more dense cold water.

Structure-Based Phylogeny as a Diagnostic for Functional Characterization of Proteins with a Cupin Fold

Background: The members of cupin superfamily exhibit large variations in their sequences, functions, organization of domains, quaternary associations and the nature of bound metal ion, despite having a conserved beta-barrel structural scaffold. Here, an attempt has been made to understand structure-function relationships among the members of this diverse superfamily and identify the principles governing functional diversity. The cupin superfamily also contains proteins for which the structures are available through world-wide structural genomics initiatives but characterized as ``hypothetical''. We have explored the feasibility of obtaining clues to functions of such proteins by means of comparative analysis with cupins of known structure and function. Methodology/Principal Findings: A 3-D structure-based phylogenetic approach was undertaken. Interestingly, a dendrogram generated solely on the basis of structural dissimilarity measure at the level of domain folds was found to cluster functionally similar members. This clustering also reflects an independent evolution of the two domains in bicupins. Close examination of structural superposition of members across various functional clusters reveals structural variations in regions that not only form the active site pocket but are also involved in interaction with another domain in the same polypeptide or in the oligomer. Conclusions/Significance: Structure-based phylogeny of cupins can influence identification of functions of proteins of yet unknown function with cupin fold. This approach can be extended to other proteins with a common fold that show high evolutionary divergence. This approach is expected to have an influence on the function annotation in structural genomics initiatives.

Effect of relative density and confining pressure on Poisson ratio from bender and extender elements tests

By using the bender and extender elements tests, together with measurements of the travel times of shear (S) and primary (P) waves, the variation of Poisson ratio (nu) was determined for dry sands with respect to changes in relative densities and effective confining pressures (sigma(3)). The tests were performed for three different ranges of particle sizes. The magnitude of the Poisson ratio decreases invariably with an increase in both the relative density and the effective confining pressure. The effect of the confining pressure on the Poisson ratio was found to become relatively more significant for fine-grained sand as compared with the coarse-grained sand. For a given material, at a particular value of sigma(3), the magnitude of the Poisson ratio decreases, almost in a linear fashion, with an increase in the value of maximum shear modulus (G(max)). The two widely used correlations in literature, providing the relationships among G(max), void ratio (e) and effective confining pressure (sigma(3)), applicable for angular granular materials, were found to compare reasonably well with the present experimental data for the fine- and medium-grained sands. However, for the coarse-grained sand, these correlations tend to overestimate the values of G(max).

An improved representation of vehicle incompatibility in frontal NCAP tests using a modified rigid barrier

With the objective of better understanding the significance of New Car Assessment Program (NCAP) tests conducted by the National Highway Traffic Safety Administration (NHTSA), head-on collisions between two identical cars of different sizes and between cars and a pickup truck are studied in the present paper using LS-DYNA models. Available finite element models of a compact car (Dodge Neon), midsize car (Dodge Intrepid), and pickup truck (Chevrolet C1500) are first improved and validated by comparing theanalysis-based vehicle deceleration pulses against corresponding NCAP crash test histories reported by NHTSA. In confirmation of prevalent perception, simulation-bascd results indicate that an NCAP test against a rigid barrier is a good representation of a collision between two similar cars approaching each other at a speed of 56.3 kmph (35 mph) both in terms of peak deceleration and intrusions. However, analyses carried out for collisions between two incompatible vehicles, such as an Intrepid or Neon against a C1500, point to the inability of the NCAP tests in representing the substantially higher intrusions in the front upper regions experienced by the cars, although peak decelerations in cars arc comparable to those observed in NCAP tests. In an attempt to improve the capability of a front NCAP test to better represent real-world crashes between incompatible vehicles, i.e., ones with contrasting ride height and lower body stiffness, two modified rigid barriers are studied. One of these barriers, which is of stepped geometry with a curved front face, leads to significantly improved correlation of intrusions in the upper regions of cars with respect to those yielded in the simulation of collisions between incompatible vehicles, together with the yielding of similar vehicle peak decelerations obtained in NCAP tests.

Conformations of dehydrophenylalanyl containing peptides. Nuclear Overhauser effect study of two acyclic

Two isomeric, acyclic tetrapeptides containing a Z-dehydrophenylalanine residue (Δz-Phe) at position 2 or 3, Boc-Leu-Ala-Δz-Phe-Leu-OMe (1) and Boc-Leu-Δz-Phe-Ala-Leu-OMe (2), have been synthesized and their solution conformations investigated by 270MHz 1H n.m.r. spectroscopy. In peptide 1 the Leu(4) NH group appears to be partially shielded from solvent, while in peptide 2 both Ala(3) and Leu(4) NH groups show limited solvent accessibility. Extensive difference nuclear Overhauser effect (n.O.e.) studies establish the occurrence of several diagnostic inter-residue n.O.e.s (CαjH ⇆ Ni+1H and NiH ⇆ Ni+1H) between backbone protons. The simultaneous observation of “mutually exclusive” n.O.e.s suggests the presence of multiple solution conformations for both peptides. In peptide 1 the n.O.e. data are consistent with a dynamic equilibrium between an -Ala-Δz-Phe- Type II β-turn structure and a second species with Δz-Phe adopting a partially extended conformation with Ψ values of ± 100° to ± 150°. In peptide 2 the results are compatible with an equilibrium between a highly folded consecutive β-turn structure for the -Leu-Δz-Phe-Ala- segment and an almost completely extended conformation.

Leachability of trace elements from two stabilized low lime Indian fly ashes

Fly ash is a waste by-product obtained from the burning of coal by thermal power plants for generating electricity. When bulk quantities are involved, in order to arrest the fugitive dust, it is stored wet rather than dry. Fly ash contains trace concentrations of heavy metals and other substances in sufficient quantities to be able to leach out over a period of time. In this study an attempt was made to study the leachabilities of a few selected trace metals: Cd, Cu, Cr, Mn, Pb and Zn from two different types of class F fly ashes. Emphasis is also laid on developing an alternative in order to arrest the relative leachabilities of heavy metals after amending them with suitable additives. A standard laboratory leaching test for combustion residues has been employed to study the leachabilities of these trace elements as a function of liquid to solid ratio and pH. The leachability tests were conducted on powdered fly ash samples before and after amending them suitably with the matrices lime and gypsum; they were compacted to their respective proctor densities and cured for periods of 28 and 180 days. A marked reduction in the relative leachabilities of the trace elements was observed to be present at the end of 28 days. These relative leachability values further reduced marginally when tests were performed at the end of 180 days.

Effect of frequency on seismic response of reinforced soil slopes in shaking table tests

This paper studies the effect of frequency of base shaking on the dynamic response of unreinforced and reinforced soil slopes through a series of shaking table tests. Slopes were constructed using clayey sand and geogrids were used for reinforcing the slopes. Two different slope angles 45 degrees and 60 degrees were used in tests and the quantity and location of reinforcement is varied in different tests. Acceleration of shaking is kept constant as 0.3 g in all the tests to maximize the response and the frequency of shaking was 2 Hz, 5 Hz and 7 Hz in different tests. The slope is instrumented with ultrasonic displacement sensors and accelerometers at different elevations. The response of different slopes is compared in terms of the deformation of the slope and acceleration amplifications measured at different elevations. It is observed that the displacements at all elevations increased with increase in frequency for all slopes, whereas the effect of frequency on acceleration amplifications is not significant for reinforced slopes. Results showed that the acceleration and displacement response is not increasing proportionately with the increase in the frequency, suggesting that the role of frequency in the seismic response is very important. Reinforced slopes showed lesser displacements compared to unreinforced slopes at all frequency levels. (C) 2012 Elsevier Ltd. All rights reserved.