Voyages of maintenance: Exploration, infrastructure, and modernity on the Krusenstern–Lisianskii circumnavigation between Russia and Japan from 1803 to 1806

Against the common association of voyages of exploration with discovery and the arrival of modernity, this essay argues that maintenance and repair were essential to the success of such voyages and that maintenance and innovation are best seen as fundamentally integrated. Using the Russian circumnavigatory voyage of Adam von Krusenstern and Urey Lisianskii in 1803–7 as a case study, the essay explores the diverse forms and roles of infrastructure and repair work in enabling a voyage of exploration, and reveals the tensions and debates that considerations of maintenance evoked among ships’ officers, crews, and the peoples they encountered.

Governance and Democracy in Jammu and Kashmir: Measuring Public Trust in Formal Institutions

The common association of political trust, legitimacy and participation within democratic states has engaged scholars to answer questions like: what are the bases of trusting the state and its institutions? And how enculturing trust can strengthen democratic governance? In this direction, institutional trust, which is invariably linked to political legitimacy, is critical to measure the health of governance. This article reflects upon the state-centric approach to governance, by exploring the interplay of institutional trust and public legitimacy in Jammu and Kashmir. The study of the state of institutional trust, as reflected in the post-2002 empirical data, enriches the theoretical discourse on governance in a conflict region.

A Model of Metabolic Supply-Demand Mismatch Leading to Secondary Brain Injury

Secondary brain injury (SBI) is defined as new or worsening injury to the brain after an initial neurologic insult, such as hemorrhage, trauma, ischemic stroke, or infection. It is a common and potentially preventable complication following many types of primary brain injury (PBI). However, mechanistic details about how PBI leads to additional brain injury and evolves into SBI are poorly characterized. In this work, we propose a mechanistic model for the metabolic supply demand mismatch hypothesis (MSDMH) of SBI. Our model, based on the Hodgkin-Huxley model, supplemented with additional dynamics for extracellular potassium, oxygen concentration and excitotoxity, provides a high-level unified explanation for why patients with acute brain injury frequently develop SBI. We investigate how decreased oxygen, increased extracellular potassium, excitotoxicity, and seizures can induce SBI, and suggest three underlying paths for how events following PBI may lead to SBI. The proposed model also helps explain several important empirical observations, including the common association of acute brain injury with seizures, the association of seizures with tissue hypoxia and so on. In contrast to current practices which assume that ischemia plays the predominant role in SBI, our model suggests that metabolic crisis involved in SBI can also be non-ischemic. Our findings offer a more comprehensive understanding of the complex interrelationship among potassium, oxygen, excitotoxicity, seizures and SBI.

Generating a Condensed Representation for Positive and Negative Association Rules

Given a large collection of transactions containing items, a basic common association rules problem is the huge size of the extracted rule set. Pruning uninteresting and redundant association rules is a promising approach to solve this problem. In this paper, we propose a Condensed Representation for Positive and Negative Association Rules representing non-redundant rules for both exact and approximate association rules based on the sets of frequent generator itemsets, frequent closed itemsets, maximal frequent itemsets, and minimal infrequent itemsets in database B. Experiments on dense (highly-correlated) databases show a significant reduction of the size of extracted association rule set in database B.

COVID-19: Is It Rare in Neonate?

Background: The Global pandemic COVID-19 affects mainly adult population with serious devastating effects in some of them, particularly those with chronic comorbidities. It is less common in children and rare in neonates. Objectives: The aim of study was to identify the COVID-19 in neonates so that we can give proper emphasis on neonatal COVID-19. Methods: This cross sectional study was conducted from April 2020 to August 2020 at Dhaka Shishu (Children) Hospital in Bangladesh. Neonates with suspected COVID- 19 were tested for SARS-CoV-2 virus by RT- PCR and positive cases were included in the study. Data were collected and statistical analysis was done by SPSS version 26. Results: Out of 1714 admitted neonates, 32 (2%) cases were COVID-19 positive. Male were 21(67%) and female were 11 (33%). Majority of the cases (28,88%) were at term. Twelve (38%) cases were from Dhaka and 20 (62%) cases came from outside Dhaka. Only 4(13%) cases were found positive for SARS-CoV-2 virus by RT- PCR within 3 days, among them 2 (6%) cases were within 24 hours of age. Nine cases (28%) were RT-PCR test positive within 4-7 days and 19 cases (59%) were RT-PCR positive within 8-28 days. Most of the cases belonged to neonatal medicine (24,75%) and 8(25%) cases were associated with surgical diseases. Sepsis was present in 17(53%) cases, perinatal asphyxia in 8(25%) and pneumonia in 6(19%) cases. Fourteen cases were discharged after improvement, 12 were referred to COVID-19 designated hospital, 2 cases were transferred to corona unit and 4 cases died. Conclusion: In this study a good number of neonates were affected with COVID-19. Perinatal asphyxia, sepsis and pneumonia were common association with COVID-19. So for proper management and prevention of transmission of this disease, it should be properly addressed in neonates. DS (Child) H J 2020; 36(2): 101-106

“You’re Nobody’s Mommy”

Chapter 3 focuses on televisual appropriations of broader thematic conventions. It begins with genre and its troubled relationship with intertextuality. Due to its common association with the formulaic, genre might appear to contradict the multifaceted energies of intertextuality. Far from being merely a classificatory framework, however, genre too can be seen as a theory of intersection and entanglement. This chapter carefully teases out an alternative understanding of genre as overlap. It analyzes Damages (FX, 2007–10; Audience Network, 2011–12) as a legal drama that overlaps with the puzzle film and the maternal melodrama. These overlaps, Chapter 3 concludes, also enable reflection on the looseness of genres and their unexpected kinship with intertextuality.

Unusual association of isolation of right pulmonary artery in absent pulmonary valve syndrome

Absence of arterial duct, a sixth aortic arch derivative, plays an important etiologic role in Tetralogy of Fallot with absent pulmonary valve syndrome. When fetal ductus is absent, the large right ventricular stroke volume dilates the pulmonary trunk leading to pulmonary regurgitation. A proximal extension of the embryonic insult to the entire left sixth arch causes absence of the left pulmonary artery, a common association of absent pulmonary valve syndrome. On the contrary, absence of right pulmonary artery is not reported in absent pulmonary valve syndrome. A rare combination of tetralogy, absent pulmonary valve syndrome and isolation of a hypoplastic right pulmonary artery offered challenges to diagnosis and management.

SPECTRUM OF OPTIC NEUROPATHIES PRESENTING IN NEUROOPHTHALMOLOGY CLINIC AT AFIO

Objective: To study the spectrum of optic neuropathies in patient’s presenting at AFIO Rawalpindi. Study Design: Descriptive study/retrospective study. Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi, from Jan 2017 to Dec 2017. Methodology: Retrospective analysis of hospital record of patients coming to neuro-ophthalmic clinic of ArmedForces Institute of Ophthalmology (AFIO), Rawalpindi, from Jan to Dec 2017 was done. Only patients with clearfinal diagnosis of neurophthalmic disease were included. Those with vague diagnosis were excluded. Data wasentered in SPSS version 22 and grouped into variables before analysis. Chi-square test was used for statisticalanalysis. The p<0.05 was considered significant. Results: Forty-five patients were included in study including 33 (73.3%) males and 12 (26.6%) females. Mean age of patients was 41.64 ± 17.74 years. Patients were grouped into ischemic optic neuropathy 20%, toxic optic neuropathies 20%, compressive optic neuropathies 17.7%, inflammatory optic neuropathies 11%, neuroretinitis 6.7%, hereditary optic neuropathies 6.7%, multiple sclerosis (MS) related 4.4%, neuromylitis optics spectrum (NMO-SD) related 4.4%, traumatic optic neuropathies 4.4% and nutritional optic neuropathies 4.4%. Deficiency of vitamin B12 and vitamin D was strongly associated with nutritional optic neuropathies while raised TLC was most common association with inflammatory optic neuropathies (57.14%) and of neuroretinitis (66%). Anti-tuberculosis drugs were most common cause of toxic optic neuropathies (88.88%). Chi square test was used for statistical analysis and p<0.05 was considered significant. Conclusion: Ischemic optic neuropathy is the most common presentation in our population according to ourstudy. However...........

A STUDY OF PREVALENCE OF NON ALCOHOLIC FATTY LIVER IN TYPE 2 DIABETES MELLITUS PATIENTS

Background: NAFLD is commonly associated with Type 2 diabetes mellitus in clinical practice it is overlooked despite the signicant clinical implications of NAFLD in Type 2 diabetes mellitus. This study was done to estimate the prevalence of NAFLD in diabetes mellitus. Material and methods: This study was conducted in 150 patients with Type 2 diabetes mellitus in Department of Medicine, Madhubani Medical College and Hospital, Madhubani, Bihar over a period of 1 year. This study was a cross sectional non interventional study. Results: The prevalence of NAFLD was 51. 3% and the prevalence was higher among females (42.6%) and higher in patients with central obesity and dyslipidemia. Conclusion: Since NAFLD is a common association with diabetes mellitus and the risk of complications is higher in patients with NAFLD, early detection is needed to adopt preventive strategies