Search

A detailed study on radiolarian biostratigraphy and paleoecology has been carried out from three outcrops on Havelock Island, belonging to the Ritchie's Archipelago of Andaman and Nicobar Group of islands. Though most of the radiolarian taxa aremoderately preserved, it was possible to demarcate an age ranging from late early to early middle Miocene based on index radiolarians of RN4 andRN5 zones. An attempt has been made to correlate the radiolarian events recorded herein with earlier reports on radiolarians from different DSDP, ODP, and IODP sites of the Indian Ocean and the onshore sections of different islands of the Andaman and Nicobar Basin. A total of 119 radiolarian taxa belonging to 70 genera have been recorded in the present study, out of which 4 species are being reported for the first time from the northeastern part of the Indian Ocean. Diversity analyses were performed to deduce the Shannon Diversity Index, Simpson Index, Margalef Richness, and Pielou's Evenness. The Water Depth Ecology index (WADE) has been analyzed for a better understanding of the paleoecological perspectives, and the Nassellaria-Spumellaria ratio of each outcrop has been calculated to ascertain the water depth. Comparison of the data obtained from diversity analysis and WADE index provides a clear picture of the environment during the late early to early middle Miocene. The overwhelming dominance of warm species of radiolarians may be linked to the Miocene Climate Optimum (MCO) event.

The present study has been carried out from the NGHP sediment core (NGHP-01-17A) of northeast Indian Ocean on different siliceous microfossils represented by diatoms and radiolarians along with calcareous nannofossils. Samples from the bottommost subunit Ic of the sediment core (684.09 mbsf to 369.62 mbsf) have been analysed. This contribution is the first comprehensive account on the Tortonian diatom assemblages from the offshore of northeast Indian Ocean that has been integrated with the radiolarian zonations. For determining the relative age of the sequence more precisely the obtained dataset also have been correlated to the calcareous nannofossil zones and eventually an attempt has been made to establish an integrated biostratigraphy. Detailed taxonomic analysis of the diatoms reveals the presence of 118 diatom taxa belonging to 49 genera. Three diatom biozones have been determined using CONISS cluster analysis. Based on the index radiolarian taxa in the studied samples, the entire sequence is assignable to RN6, RN7 and RN8 zones. The samples also contain stratigraphic marker taxa of calcareous nannofossils that allow identifying NN9, NN10 and NN11 zones corresponding to CNM13 - CNM16 zones. The ages of the bottommost and topmost sample of the analysed section of the core have been estimated < 10.49 Ma and > 7.39 Ma respectively. To estimate the sedimentation rate an age-depth model has been proposed using diatom, radiolarian and calcareous nannofossil events. All the microfossil assemblages of the present study have been correlated with the known assemblages of late Miocene, specifically Tortonian from DSDP, ODP, IODP expeditions and onshore sediments of Indian Ocean as well as equatorial Pacific Ocean. Diversity analysis has been carried out to quantitatively estimate the diversity and dominance of the diatom taxa. Planktic/benthic ratio of the diatoms has been calculated to evaluate the water depth.

Burnout is a syndrome of emotional exhaustion, loss of meaning at work, feeling of ineffectiveness, and a tendency to view people as objects rather than as a human being. Physician burnout leads to dissatisfaction at work and suboptimal patient care. Various causes of burnout at the individual, work environment, and health system levels have been identified. In this review, we initially focus on the burden of burnout. Subsequently, we describe the determinants of this problem in India and the West, while drawing on relevant literature. Finally, we provide evidence based practical suggestions to deal with physician burnout. Strategies suggested to deal with burnout need to be implemented based on locally available resources. Repeated assessment of burnout constructs using validated questionnaires can evaluate the effectiveness of an intervention. Hospitals, educational institutions, and physician societies need to collaborate with practicing physicians to address burnout and invest in physician well-being to continue providing high-quality medical care in the future.

The 2019 COVID-19 pandemic has thrown the global health-care system into a chaotic flux. Consolidating and reviewing all available knowledge will be crucial to combating the spread of this novel coronavirus. Prevention is paramount, but health care workers are at increased risk, and protective supplies are being limited and being rationed. Common symptoms include fever, cough, and shortness of breath. Hospitalizations are estimated to occur in about 20% of cases and are mostly due to pneumonia.[1] While multiple promising treatments are being reported in the medical literature; there is limited, reliable clinical data are available. To minimize exposure of medical staff to contagious patients and to provide rapid escalation of care to these patients, a telehealth strategy could be leveraged. Such a strategy would entail the use of both telemedicine visits for communication and digital health platforms for monitoring.

In the present study from the late Pliocene of Neill West Coast Formation, Neil Island, serpulid tubes assignable to Ditrupa gracillima Grube have been identified with the help of tube morphological (light microscopy) and ultrastructural (SEM) studies. This is the first record of the species from the late Pliocene of India. The outer layer of D. gracillima is entirely different from other invertebrates, and the presence of Ridged Prismatic Structure (RRP) exclusively characterises this particular species. The mineralogical analysis (Raman spectroscopy and EDS) reveals a Mg-Ca skeletal for D. gracillima. Isotopic analysis indicates that there is a narrow range of variation in the delta 18 O values of D. gracillima The delta 13 C of D. gracillima shows significant variation and displays the most 13 C depleted values. Based on isotopic analysis it has been inferred that the deposition of sediments took place in a shallow marine environment and D. gracillima thrived in the proximity of hydrocarbon seepages. The present day distributional pattern of D. gracillima indicates that they are mainly confined in the Indo-Pacific region.

Traditional communication of medical literature using evidence-based terminologies are inadequate as the body of COVID-19 literature increases thereby requiring alternate methods of communication like podcasts, webinars, social media. A common theme in all these alternate forms of communication is the art of storytelling that allows physicians to make a connection with a patient by understanding their perspectives. Apart from few situations where story telling can be distracting in many situations where the patient's history is complex and require great listening skills and empathy.. Learning to be a good storyteller can help the physician help patients be a great change agent for them. Communicating with these patients can be done effectively using standard communication tools and using effective storytelling techniques can reinforce the patients trust in the provider and strengthen patient physician relationship. This could have a salutatory result both for the patient by increasing patient satisfaction and compliance with treatment and physician satisfaction by increasing to understand their patient's true concerns.

Background Patients from various countries may have unique patterns of using complementary and alternative medicine (CAM) and unique reasons for using it. Objective Our objective was to assess the use of CAM among patients from the Gulf region attending the Executive and International Health Program of the Department of General Internal Medicine at Mayo Clinic in Rochester, Minnesota. Methods This cross-sectional survey was administered to all patients who were from the Gulf region and were undergoing outpatient evaluation in the Executive and International Health Program. After their initial medical evaluation by a physician, the patients were invited to anonymously complete the modified International Complementary and Alternative Medicine Questionnaire. Results The survey was completed by 69 patients (41 women, 27 men; mean age, 45.4 years). The most frequently seen providers for CAM treatments were physicians (71.0% of patients), spiritual healers (29.0%), and chiropractors (20.3%). CAM treatments most frequently received from a physician were massage therapy (51.0%), hijama (38.8%), spiritual healing (24.5%), and acupuncture or herbs (16.3%). The most frequently used dietary supplements were ginger (42.0%), bee products (30.4%), and garlic (27.5%). The most common self-help therapies were prayers for health (68.1%), meditation (15.9%), and relaxation techniques (11.6%). CAM therapy, including visits to CAM providers, was used by 92.8% of patients. CAM was mainly used to improve well-being and long-term health conditions rather than for acute illnesses. Conclusion The use of CAM was high among our patients from the Gulf region, and the CAM therapies used by this population differed from the ones used by US patients. Physicians providing care to patients from the Gulf region should be aware of how the use of CAM may affect the care needs of these patients.

Annona reticulata Linn, has been shown to possess antipyretic, antihelmintic, hypoglycemic, antiulcer and wound healing properties. However, its immunomodulatory role is yet to be explored.In the present study, we intended to investigate the effects of A. reticulata leaf ethanol extract on various components of the immune system.The effects of A. reticulata leaf extract on human peripheral blood mononuclear cells, monocyte (THP1), and human macrophage (U937) cell lines were investigated. An animal study was conducted to observe the effect of the extract on humoral as well as cell mediated immunity.The extract stimulated proliferation of human PBMC, monocytes (THP1), and macrophages (U937) significantly in a dose dependent manner; expression of transforming growth factor-beta (TGF-β) increased in western blot analysis. Additionally, the extract treated macrophages exhibited features of activation under the microscope with a significant hike in the NO production. Flow cytometry of extract treated human PBMC revealed increased proliferation of lymphocytes (CD4, CD8B-cells) along with enhanced intracellular expression of IL-2, IL-6. Animal study data indicate a significant rise in the antibody titer as well as a strong delayed type hypersensitivity response in the extract (150 mg/kg and 300 mg/kg) treated mice; furthermore, the expression of IL-2 and IL-6 in mice PBMC was augmented.The collective data evince the immunomodulatory potential of A. reticulata L. leaf.

Relatively large specimens (6–12 μm long) of the nannolith Nicklithus amplificus are characteristic of the late Miocene, having evolved in NN11 from the typical Miocene species Orthorhabdus rugosus. The present study was performed in order to identify the earliest occurrence, and to examine the evolutionary lineage, palaeogeography and palaeoclimatic implications, of N. amplificus in the Indian Ocean, incorporating information on its youngest record from the Paratethys. In addition to this, other members of the Ceratolithaceae from the Mediterranean region were used to add to our understanding of the phylogenetic lineage. The first relatively small (

Newborn oil massage is a widespread practice. Vigorous massage with potentially harmful products and forced removal of vernix may disrupt skin barrier integrity. Hospitalized, very-preterm infants treated with sunflower seed oil (SSO) have demonstrated improved growth but community-based data on growth and health outcomes are lacking.We aimed to test whether SSO therapy enhances neonatal growth and reduces morbidity at the population level.We conducted an open-label, controlled trial in rural Uttar Pradesh, India, randomly allocating 276 village clusters equally to comparison (usual care) and intervention comprised of promotion of improved massage practices exclusively with SSO, using intention-to-treat and per-protocol mixed-effects regression analysis.We enrolled 13,478 and 13,109 newborn infants in demographically similar intervention and comparison arms, respectively. Adherence to exclusive SSO increased from 22.6% of intervention infants enrolled in the first study quartile to 37.2% in the last quartile. Intervention infants gained significantly more weight, by 0.94 g · kg-1 · d-1 (95% CI: 0.07, 1.82 g · kg-1 · d-1, P = 0.03), than comparison infants by intention-to-treat analysis. Restricted cubic spline regression revealed the largest benefits in weight gain (2-4 g · kg-1 · d-1) occurred in infants weighing2000 g at birth. Weight gain in intervention infants was higher by 1.31 g · kg-1 · d-1 (95% CI: 0.17, 2.46 g · kg-1 · d-1; P = 0.02) by per-protocol analysis. Morbidities were similar by intention-to-treat analysis but in per-protocol analysis rates of hospitalization and of any illness were reduced by 36% (OR: 0.64; 95% CI: 0.44, 0.94; P = 0.02) and 44% (OR: 0.56; 95% CI: 0.40, 0.77; P0.001), respectively, in treated infants.SSO therapy improved neonatal growth, and reduced morbidities when applied exclusively, across the facility-community continuum of care at the population level. Further research is needed to improve demand for recommended therapy inside hospital as well as in community settings, and to confirm these results in other settings.This trial was registered at www.isrctn.com as ISRCTN38965585 and http://ctri.nic.in as CTRI/2014/12/005282.

Background and aims Despite an explosion of evidence-based guidelines, many decisions in clinical practice remain shrouded in uncertainty. Physicians could view ambiguous situations as a source of threat. Uncertainty results from personal lack of knowledge, limits of current medical knowledge and the inability to distinguish between the two. The purpose of this review is to study the prevalence, effects and management of medical uncertainty in clinical practice. Methods PubMed search for articles on prevalence and management of medical uncertainty. Results and conclusion Intolerance to uncertainty among physicians may result in increased test-ordering tendencies, failure to comply with evidence-based guidelines, guide career choices, and result in decreased comfort with geriatric, chronic illness and psychological problems. Factors causing variability of disease management includes: patient factors(inappropriate prioritization, risk aversion, expectations), physicians factors(lack of knowledge, intolerance to medical uncertainty, limited resources, time constraints), biological variability of patient, health system factors, patients comorbidities, technological and media influences contributing further to unrealistic expectations. Physicians’ perceptions of uncertainty in their daily work vary considerably. Urologist and orthopedic surgeons reported less uncertainty in their daily routine compared to psychiatrists, family practitioners and general internists. Effective methods of managing uncertainty include, consensus building among physicians from 3 or more specialties regarding patients problem, building trust between patients, their physicians and health care systems, thoughtful evaluation with exclusion of worrisome diagnosis, apply evidence-based information with effective risk communication, negotiating management strategies with patient and establishing regular follow-up with personalized feedback. (– 245 words).

The present paper deals with the occurrence of a Halimeda bioherm facies represented by five different forms of the genus. The halimedaceans have been identified by thin section analysis of limestones from the middleMiocene (Serravallian) of the Butler Bay Section, Little Andaman Island (Hut Bay), India. All these forms are reported herein for the first time from the Miocene of the northern Indian Ocean. The present record is an important addition to the Halimeda database from this part of the world because specifically from the Cenozoic sediments halimedaceans are poorly known throughout the world. Present day halimedaceans are significant contributors of the carbonate mass of tropical reefs in different parts of the world and they might have played amajor role in maintaining the carbon budget in the middle Miocene.

Background and aim The leaves of AnnonareticulataLinn (牛心果niú x ınguǒ; Bullock’s heart), a member of Annonaceae family, have been used extensively in folk medicine; however, its wound healing potential is yet to be explored. Our aim was to investigate the wound healing ability of A. reticulataleaf extract in vitro and in streptozotocin induced diabetic mice model. Material and methods We observed the plant extract induced proliferation and migration of primary human dermal fibroblast (HDF), human skin fibroblast cell line (GM00637) and human keratinocyte cell line (HACAT). The expression of transforming growth factor beta (TGF-β), connective tissue growth factor (CTGF), vascular endothelial growth factor (VEGF), alpha smooth muscle actin (α-SMA), matrix metalloproteinases (MMP-2, MMP-9), collagen-1, collagen-3, focal adhesion kinase (FAK) were evaluated by Western blot and gelatin zymography. Excisional diabetic wound model was used for in vivo wound healing assay. Furthermore, we processed wound tissue for histological and immunohistochemical study. Result A. reticulata L. leaf extract stimulates proliferation and migration of HDF, skin fibroblast and keratinocyte significantly in a dose dependent manner; expression of TGF-β, CTGF, VEGF, α-SMA, MMP-2, MMP-9, collagen-1, collagen-3, FAK increased. Additionally, an enhanced expression of phospho-SMAD2, phospho-SMAD3 in the treated cells indicated the activation of TGF-β signal transduction pathway, similarly increased expression of phospho-AkT suggested activation of PI3/AkT pathway. Expression of CTGF and α-SMA was also increased significantly in wound tissue. Mass spectrometric analysis revealed that mainly two compounds to be present in the extract: quercetin and β-sitosterol. Conclusion Collective data suggest that A.reticulata leaf extract may have a stimulatory effect in diabetic wound healing., Graphical abstract Image 1, Highlights • While the leaf extract from other species of the Annonaceae family have been studied extensively for wound healing activity, Annona reticulata leaf has not been explored for the same. • The present study showed significantly increased proliferation and migration of both fibroblasts and keratinocytes in the treated group with enhanced expression of various growth factors critical to wound healing.Topical application accelerated wound closure in diabetic mice model compared to the positive control group. • Annona reticulata Linn leaf extract have stimulatory effect in diabetic wound healing.

We live in an age of hyper connectivity, people from around the world are looking outside their own national borders to receive medical care. As more people are learning about the quality that the elite Indian hospitals provide at a competitive, and often more affordable, price compared to other institutions around the world, they are becoming increasingly interested in receiving their medical care in Indian hospitals. It is for this exact reason that it is very important to learn the importance of communicating effectively with people from a diverse background. Over the next decade, the number of international patients that Indian hospitals will provide care for is set to dramatically increase. In this new age of medicine in India, it is imperative that doctors are adequately equipped with the communication skills to appropriately connect with patients coming from very different cultural backgrounds. The interaction with an international patient can be tremendously deepened through effective communication that adheres to the cultural beliefs of the patient. In this article, we detail how to effectively communicate with people from different backgrounds. We explore how to speak with patients and connect on a deeper level and respect the cultural differences that exist. We will also discuss how to avoid offending your patients or miscommunicating your plans to them. Overall, improved awareness of cultural differences will ensure higher patient satisfaction as well as an improved doctor patient interaction.

Purpose – Motivation is a widely explored topic and numerous studies have been done to determine motivation importance and implementation. However, no studies have been identified that investigate what motivators are most important to physicians and if physician leaders agree with the importance physicians place on specific motivational aspects. The purpose of this paper is to investigate this missed management learning opportunity. Design/methodology/approach – A fully inclusive sampling of all (n=2,547) public-practice physicians and physician leaders (clinic and hospital employed, non-private practice) in Minneapolis and St. Paul Minnesota was conducted in the summer and fall of 2013. The surveys were sent in a link via a web survey software program by the study researchers. The surveys were anonymous and minimally intrusive, asking only for perspectives regarding the most important motivational elements by physicians and physician leaders. Findings – Generally, the responses were surprisingly similar between physicians and physician leaders. The two statistically different motivators – interesting work and job security – were ranked as more important by physicians than the physician leaders. This suggests that leaders should be more attentive to ensuring variety, challenge, and engagement is an active part of the physicians’ work. This also suggests that managers should emphasize and reinforce the fact that – if it is the case – jobs are secure and that staffing stability is a key goal for management. As Kovach (1987) suggests, as employees’ income increases, money becomes less of a motivator and as employees get older, interesting work becomes more of a motivator. Research limitations/implications – Conclusions and generalizations can be made about the population sampled. Practical implications – The two statistically different motivators – interesting work and job security – were ranked as more important by physicians than the physician leaders. This suggests that leaders should be more attentive to ensuring variety, challenge, and engagement is an active part of the physicians’ work. This also suggests that managers should emphasize and reinforce the fact that – if it is the case – jobs are secure and that staffing stability is a key goal for management. Social implications – As this study reveals, physicians have clear preferences when it comes to workplace motivation. It is not unreasonable then to determine that the more satisfied the employee, the better he or she will perform. Accordingly, the environment that managers create for their employees must be one that is constructive to positive energy. If employees feel happy when they are working, then they will be naturally encouraged to work, thus producing improved quality healthcare for patients. Originality/value – What are the most important motivators for physicians and do physician leaders understand what motivators are to enhance physician productivity, well-being, and morale? Answers to this question may be beneficial to designing leadership education that enhances the understanding of the impact effectively identified and effectively applied motivation techniques may have on employee behavior and attitudes. Insights will also benefit the design of motivational structures and methods in the healthcare workplace.

Several medications have been used perioperatively in patients undergoing noncardiac surgery in an attempt to improve outcomes. Antiplatelet therapy for primary prevention of cardiovascular events should generally be discontinued seven to 10 days before surgery to avoid increasing the risk of bleeding, unless the risk of a major adverse cardiac event exceeds the risk of bleeding. Antiplatelet therapy for secondary prevention should be continued perioperatively, except before procedures with very high bleeding risk, such as intracranial procedures. Antiplatelet drugs should be continued and surgery delayed, if possible, for at least 14 days after percutaneous coronary intervention without stent placement, 30 days after percutaneous coronary intervention with bare-metal stent placement, and six to 12 months after percutaneous coronary intervention with drug-eluting stent placement. Perioperative beta blockers are recommended for patients already receiving these agents, and it is reasonable to consider starting therapy in patients with known or strongly suspected coronary artery disease or who are at high risk of perioperative cardiac events and are undergoing procedures with a high risk of cardiovascular complications. Long-term statin therapy should be continued perioperatively or started in patients with clinical indications who are not already receiving statins. Clonidine should not be started perioperatively, but long-term clonidine regimens may be continued. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers generally can be continued perioperatively if patients are hemodynamically stable and have good renal function and normal electrolyte levels.

The genus Dicroidium Gothan, belonging to Corystospermaceae, is characterised by pinnately compound leaves with proximally forked primary rachis. The genus was earlier included under the genus Thinnfeldia Ettingshausen. Dicroidium is the most consistent macrofloral element in the Triassic strata of Southern Hemisphere. The present reassessment deals with the morphotaxonomy and stratigraphic significance of the species of Dicroidium in India. A critical review of the literature reveals that the specimens of Dicroidium described so far from India require reassessment, because same morphotypes have often been placed under different species names and sometimes dissimilar elements have been assigned to the same species. In view of this, a thorough analysis of Indian Dicroidium was undertaken based on fresh collections along with the species described earlier by previous workers. The present reappraisal reveals that the genus in the Triassic of Peninsular India is represented by eight species. These are D. hughesii (Feistmantel) Lele, D. zuberi (Szajnocha) Archangelsky, Dicroidium sp. cf. D. crassinervis (Geintz) Anderson & Anderson, D. townrovii Retallack, D. nidpurensis Bose & Srivastava, D. gopadensis Bose & Srivastava, D. giarensis Pal and Dicroidium sp. In Indian peninsula, appearance of Dicroidium heralds the onset of Triassic sediments belonging to the early Triassic Panchet Formation (Induan). In the younger sequence of Triassic, i.e. during late Triassic Tiki and Parsora formations (Carnian to Norian–Rhaetian), the diversity and species richness of the genus gradually enhanced and Dicroidium foliages became the most predominant component of Triassic macroflora of India. The genus does not occur in strata younger than the Triassic and thereby the total extinction of Dicroidium signifies the end of the Triassic Period.

Maintenance of professional competence remains an exercise of permament learning and an essential requirement for evidence –based medical practice. Physicians attend continuing professional development (CPD) programs to acquire new knowledge. Often CPD programs remain the main source for updates of information. CPD organizers have a considerable responsibility in determining appropriate curriculum for their conferences. Organizing an effective CPD activity often requires understanding of the principles of adult education. Prior to deciding on the curriculum for a CPD, course organizers should conduct needs assessment of physicians. CPD planners should create activities that would consistently improve physician competence. CPD sessions that are interactive, using multiple methods of instructions for small groups of physicians from a single specialty are more likely to change physician knowledge and behavior. The effectiveness of a CPD program should be evaluated at a level beyond measuring physician satisfaction. CPD planners should incorporate methods to determine the course attendees’ improvement of knowledge, skills and attitudes during the CPD activities. Pre and post conference evaluations of physicians using multiple choice questions may form a useful method of assessment.

Macroscopic fossil charcoal has been discovered in the carbonaceous shales associated with Seam-VI of Raniganj Formation, Upper Permian, Damodar Basin, India. A pycnoxylic gymnosperm wood is described and confirms the occurrence of palaeo-wildfire in this area during the Late Permian. The integration of the data presented in the current study with previously published data for the Raniganj Formation, principally related to the occurrence of (pyrogenic) inertinites within coal layers, demonstrates that palaeo-wildfires were common events during the deposition of the preserved material. In addition, the presence of charcoal in Permian sediments associated with coal levels at different Gondwana localities demonstrates that wildfires have been relatively common events across the continent during this period.

The Kargil Molasse Group of northwest Ladakh Himalaya is divided into Kargil, Tharumsa and Pashkyum formations, composed mainly of sandstone, mudstone, siliceous clay and grey to dark brown carbonaceous shale. Plant fossils recorded in these sequences are represented by angiosperm leaf impressions, pteridophytic spores, gymnosperm and angiosperm pollen grains, algal and fungal remains and gyrogonites of charophytes. The present study deals with reworked palynoflora of Gondwanic affinity of late Permian (Tatarian) and early Triassic (Scythian) age embodied in the l ate Cenozoic sediments of Tharumsa Formation of northwest Himalaya. The occurrence of reworked palynomorphs in the younger sediments is very significant. It can be interpreted that Palaeozoic and Mesozoic Tethyan sediments, deposited along the northern margin of Indian Plate, were transported and eroded and eventually got accumulated in the Tharumsa Formation during the process of orogenesis in this region.

In this work the effect of multi-pass friction stir processing (FSP) followed by warm pressing on an as-extruded ZK60 Mg plate was investigated. The microstructure, texture and resulting mechanical properties are reported here. Multi-pass FSP to partial depths on the top and bottom plate surfaces produced a novel, layered structure with three distinct microstructural zones associated with stirred, transition and core regions. In the stirred zone, FSP, followed by pressing at 200 °C, created a 0.8 μm ultrafine grain size which accounts for ∼55 vol.% of the material. The transition region (∼10 vol.%), showed extensively sheared coarse grains distributed in a matrix of finer grains. However, the core region (∼35 vol.%) showed extensive twinning inside coarse grains in an overall bimodal microstructure reminiscent of extrusion. The processed Mg with a strong basal texture exhibited high yield strength (>300 MPa) and retention of adequate tensile ductility (>10%). The enhancement in mechanical properties of processed Mg is found to be highly influenced by the layered microstructure: UFG grained stirred zone, finer precipitates and strong basal texture.

The carbonate rocks of the Shella Formation (Middle Eocene) belonging to the Jaintia Group in the Jaintia Hills of Meghalaya are represented by two sandstone units in alternation with three limestone units, viz. Lakadong Limestone, Umlatdoh Limestone and Prang Limestone respectively in chronological order. Umlatdoh Limestone, the middle limestone unit of Shella Formation is conformably underlain by the Lakadong Sandstone and overlain by Narpuh Sandstone. Samples from the Umlatdoh Limestone were collected from the outcrop on the Jowai-Badarpur Road, about 1 km southwest of Lumshnong. Calcareous algae have been recovered from four samples and two distinct facies have been recognized. One of the facies is dominated by non-geniculate coralline red algae and benthic foraminifera. The non-geniculate corallines are represented by Lithothamnion and Mesophyllum (Family Hapalidiaceae), Lithoporella (Family Corallinaceae) and Sporolithon (Family Sporolithaceae). The other facies is rich in calcareous green algae along with benthic foraminifera. The green algal genera belong to families Dasycladaceae, Udoteaceae and Halimedaceae. Previously, a green algal assemblage was recorded from the Umlatdoh Limestone Member of Shella Formation exposed in the low lying hills between Sutnga and Litang valleys of Jaintia Hills. However, this is the first report on the occurrence of non-geniculate coralline red algae from the Umlatdoh Limestone Member of the Shella Formation. Based on the algal-foraminiferal assemblages, interpretation has been made on the palaeoenvironment and palaeobathymetry.

Friction stir processing (FSP) was carried out on a multi-layered copper–nickel 70/30, deposited on a copper–nickel 70/30 substrate via laser-assisted direct metal deposition (DMD). Microstructural changes associated with single and overlapping FSP passes were analyzed using electron microscopy. Mechanical property and corrosion behavior were also evaluated before and after FSP. It was observed that FSP reduces porosity, refines grains, increases hardness, reduces ductility and increases corrosion rate in comparison to DMD copper–nickel 70/30.

The present paper deals with the plant megafossil assemblage from the Maitur Formation, the lower part of Panchet Group of rocks, unconformably overlain by coal bearing Raniganj Formation in Raniganj Coalfield, West Bengal. The plant fossils are collected from two localities exposed in Nonia Nala Section near Asansol, Burdwan District, West Bengal. The assemblages are represented by the typical elements of Glossopteris flora, viz. Trizygia speciosa, Neomariopteris hughesii. N. lobifolia, Dichotomopteris lindleyii, D. ovata, Glossopteris indica, G. tenuifolia, G. emarginata, G. angustifolia. G conspicua, G. intermedia, G. retifera, G. gopadensis, G. taeniensis, Glossopteris sp. cf. G. dhenkanalensis, one new species G. burdwanensis sp. nov., glossopterid scale-leaves and seed-like body. The age of Maitur Formation has been assigned to Early Triassic but the plant fossil assemblages are comparable with the Late Permian plant fossils of Kamthi, Pachhwara and Bijori formations in having narrow leaf forms of Glossopteris. The investigation supports the view that there is no floral break at the Raniganj-Panchet Boundary and flora of Maitur Formation in all probability represents the ultimate stage of Glossopteris flora in Raniganj Coalfield before the onset of Early Triassic Dicroidium flora in Deoli/Hirapur Formation belonging to upper part of Panchet Sequence in Raniganj Coalfield, West Bengal.

Studies done by various phycologists have brought about remarkable changes in the present-day coralline algal taxonomy. The taxonomy of fossil coralline red algae also has been under the process of continuous revision and modification since 1993. Prior to 1993 it was believed that several diagnostic characters used in recent coralline red algae were unpreservable in fossil forms. Palaeoalgologists have now understood the value of unification of taxonomy, for extant and fossil corallines to accurately interpret the phylogeny, palaeoecology and palaeobiogeography. Phylogenetically, the corallines are very important as they represent a major evolutionary line within the red algae as evidenced by anatomical studies on recent forms as well as various studies on gene sequence analysis. The present contribution deals with the remarkable changes that have taken place since 1993 in the taxonomic aspects of fossil coralline algae and the modern trends of research in this context. Presently, an attempt has been made to establish the possible origin and evolution of coralline red algae.

A soft and ductile aluminum foil is embedded within a workpiece undergoing friction stir processing (FSP) to observe the deformation zone. A whirlpool of material is detected in the stir zone which consumes the foil over time. Among different approaches to estimate material strain, a logarithmic thickness strain is defined and experimentally measured by observing the gradual change in thickness of ductile aluminum foil. Additionally a strain-rate is numerically evaluated from the FSP process parameters and the deformed foil geometry using finite-element analysis. It is believed that this method provides reliable strain-rates in the friction stir process.

The low-temperature superplastic (SP) flow behavior of two lots of Ti-6Al-4V sheet, each with an ultrafine microstructure, was established by performing tension tests at temperatures of 775 °C and 815 °C and true strain rates of 10−4 and 10−3 s−1. The as-received microstructures of the two materials comprised either equiaxed or slightly elongated alpha particles in a beta matrix. The material with equiaxed alpha particles exhibited flow hardening, which was correlated with concurrent (dynamic) coarsening. The rate of dynamic coarsening was rationalized in terms of static coarsening measurements and the enhancement of kinetics due to pipe diffusion. By contrast, the material with initially elongated alpha particles exhibited comparable flow hardening at the lower strain rate but a complex, near-steady-state behavior at the higher strain rate. These latter observations were explained on the basis of the evolution of the alpha particle shape and size during straining; dynamic coarsening or dynamic spheroidization was concluded to be most important at the lower and higher strain rates, respectively. The plastic flow behavior was interpreted in the context of a long-wavelength flow localization analysis.

Four coordination polymeric complexes, [{Cu2(aepn)2Pt(CN)4·H2O}(H2O){Pt(CN)4}]n, (1), [{Cu(dpt)2Pt(CN)4}]n (2), [{Cu(dien)Pt(CN)4}]n (3) and [{Cu(iprdien)Pt(CN)4}]n (4) (where aepn = N-(2-aminoethyl)-1,3-propanediamine, dpt = 3,3′-imino bispropylamine, dien = diethylenetriamine, iprdien = N′-isopropyldiethylenetriamine), have been synthesized and characterized by X-ray single crystal structure determination and variable temperature magnetic measurements. The formation of the supramolecular assemblies has been rationalized and it has been shown that competition between coordinative forces and hydrogen bonding interactions is crucial in the determination of final solid-state packing. A zig-zag/helical 1D chain (2 and 3) appears when the chelating amine at the Cu(II) center is capable of forming the maximum number of hydrogen bonds, on the other hand when one or more of the amine sites are blocked, due to the prevention of the maximization of hydrogen bonding, (4,2) ribbons (1 and 4) appear. Variable temperature magnetic measurement shows the presence of weak antiferromagnetic interactions in all the complexes.

Introduction The National Kidney Foundation published Kidney Disease Outcomes Quality Initiative guidelines that recommend early detection and management of chronic kidney disease (CKD) and timely referral to a nephrologist. Many patients with CKD are seen by primary care doctors who maybe less experienced than a nephrologist to offer optimal early CKD care. It is not known whether postgraduate training adequately prepares a future internist in CKD management. Methods We developed a 15-item questionnaire instrument to assess knowledge of CKD guidelines among internal medicine residents in USA using an online survey programme. We studied the validity and reliability measures of our instrument. Results The survey was completed by 166 PGY1 (postgraduate year one), 187 PGY2 and 126 PGY3. The questionnaire tested various aspects of CKD including definition, classification, identification of risk factors, laboratory evaluation, development of clinical action plan, identification of complications, anaemia and bone and mineral disorder, referral to a nephrologist and medication use. Validity was supported by the use of official guidelines and an expert panel of nephrologists to develop content and improvement in mean test performance with increasing level of training (PGY1 59.2 +/- 13.5%, PGY2 62.6 +/- 12.3% and PGY3 64.3 +/- 12.2%; P = 0.002). The reliability coefficient for the questionnaire instrument (Cronbach's alpha) was 0.69. Conclusion Our brief questionnaire is a valid and reliable instrument to assess knowledge of CKD guidelines among internal medicine residents and identify specific gaps for improvement.

The purpose of this research is to investigate possible changes in warm formability of thixomolded Mg alloys by applying severe deformation processing. The microstructure of as-thixomolded magnesium alloys can be complex, as it can contain a variety of constituents such as Mg 17 Al 12 intermetallic particles, shrinkage and gas porosity, as well as internal oxide films and entrapped residues. These inherent heterogeneities affect their fracture properties when these alloys are hot rolled to sheet or formed. It has been found in this research that dissolved gases and heterogeneities can adversely influence warm formability of the molded sheet, and contribute to variability in strength and ductility. Using thixomolded AM60 Mg (Mg–6%Al) plate from a commercial supplier, various heat treatments, hot rolling treatment and friction stir processing treatment were performed to introduce severe plastic deformation processing to alter microstructure. Macrostructure and microstructure resulting after these treatments demonstrated that for a given lot of thixomolded Mg plate, considerable changes in the microstructure, porosity and warm formability can be caused by stirring and severe deformation processing approach. The knowledge gained from this study could benefit thixomolding community, as well as Mg wrought materials applications in regard factors that affect formability of these materials.

The reaction of [Au(CH3impy)2]PF6 (2), with substituted silver benzoate salts bearing different halide substituents produced a series of new mixed-metal species having two different structural motifs. One structural motif contains discrete tetrametallic Ag2Au2 diamond cores, whereas the other motif contains the same tetrametallic diamond core interconnected by benzoate-bridged silver dimers to form polymers. All the complexes are substitution-inert and stable both in the solid state as well as in solution. We also report the synthesis of oxidative addition products of [Au(CH3impy)2]PF6, which were also obtained during our attempts to oxidize the above-mentioned multimetallic assembly with bromine and iodine. Compounds 3–7 are intensely luminescent in frozen acetonitrile solution, but surprisingly no luminescence is observed at room temperature. All the complexes were completely characterized by 1H, 13C NMR, electronic absorption, emission spectroscopy, elemental analysis and X-ray crystallography. (© Wiley-VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2009)

Trace elements of Sc or Zn were added to Al-Mg sheet alloys. Microstructural examination showed that the Sc addition greatly refined the grain size, especially in the Zn-containing alloy where large amounts of subgrains and fine grains were formed. Meanwhile, a number of large primary intermetallic particles formed in the Sc-adding alloys. In order to evaluate the high-temperature formability, warm tensile tests were carried out at temperatures ranging from 275 °C to 350 °C and at strain rates of 0.015 to 1.5 s−1. The test results showed that, in the alloys with the single addition of Zn or Sc, Zn slightly increased the flow stress but decreased the ductility and Sc worsened both the flow stress and the ductility. However, in the alloy with the combined addition of Zn and Sc, the flow stress was significantly increased at almost all testing conditions and the ductility was also increased at a higher temperature of 350 °C and lower strain rate of 0.015 s−1. The results of superplastic tensile tests and biaxial stretch tests demonstrated that the alloy with both Zn and Sc additions exhibited good high-temperature formability. The effect of Zn and Sc additions on the microstructure and the hot formability is discussed.

Several alloying elements involving Zr, Cu, Zn and Sc were added to Al-Mg sheet alloys in order to obtain an excellent combination of high strength and good high-temperature formability. Microstructural examination showed that coarse intermetallic particles were formed in the microstructure and their amounts changed with variations of the alloying elements. During warm rolling of thermomechanical treatments prior to warm deformation, the coarse particles initiated cracks, decreasing the warm formability. For healing the crack damage and further improving the warm formability, a process of hot isothermal press was developed and optimized to the sheet alloys. With this process, the biaxial stretch formability at 350°C was improved by 22% for an aluminum alloy containing a large amount of coarse particles.

The National Kidney Foundation published Kidney Disease Outcomes Quality Initiative guidelines that recommend early detection and management of chronic kidney disease (CKD) and timely referral to a nephrologist. Many patients with CKD are seen by primary care physicians who are less experienced than nephrologists to offer optimal pre-end-stage renal disease care. It is not known whether current postgraduate training adequately prepares a future internist in CKD management.Cross-sectional study using an online questionnaire survey.Internal medicine residents in the United States (n = 479) with postgraduate year (PGY) distribution of 166 PGY1, 187 PGY2, and 126 PGY3.Awareness and knowledge of CKD clinical practice guidelines measured by using the questionnaire instrument.Total performance score (maximum = 30).Half the residents did not know that the presence of kidney damage (proteinuria) for 3 or more months defines CKD. One-third of the residents did not know the staging of CKD. All residents (99%) knew the traditional risk factors for CKD of diabetes and hypertension, but were less aware of other risk factors of obesity (38%), elderly age (71%), and African American race (68%). Most residents (87%) were aware of estimated glomerular filtration rate in the evaluation of patients with CKD. Most residents (90%) knew goal blood pressure (130/80 mm Hg) for patients with CKD. Most residents identified anemia (91%) and bone disorder (82%) as complications of CKD, but only half recognized CKD as a risk factor for cardiovascular disease. Most residents (90%) chose to refer a patient with a glomerular filtration rate less than 30 mL/min/1.73 m(2) to a nephrologist. A small improvement in mean performance score was observed with increasing PGY (PGY1, 68.8% +/- 15.4%; PGY2, 72.9% +/- 14.7%; and PGY3, 74.0% +/- 12.0%; P = 0.004).Self-selection, lack of nonrespondent data.Our survey identified specific gaps in knowledge of CKD guidelines in internal medicine residents. Educational efforts in increasing awareness of these guidelines may improve CKD management and clinical outcomes.

The influence of microstructure evolution on the low-temperature superplasticity of ultrafine alpha/beta titanium alloys was established. For this purpose, the static and dynamic coarsening response and plastic flow behavior of Ti-6Al-4V with a submicrocrystalline microstructure were determined via a series of heat treatments and uniaxaial compression tests at temperatures of 650 °C, 775 °C, and 815 °C. At all test temperatures, static coarsening exhibited diffusion-controlled (r 3 vs time) kinetics and followed a dependence on phase composition and volume fraction qualitatively similar to previous observations at 850 °C to 950 °C. Dynamic coarsening at 775 °C and 815 °C and strain rates of 10−4 and 10−3 s−1 were similar to prior higher-temperature observations as well in that the kinetics were approximately one order of magnitude faster than the corresponding static behaviors. The increase in coarsening rate with superimposed deformation was attributed to the enhancement of diffusion by dislocations generated in the softer beta phase. With respect to deformation response, plastic flow was superplastic with m values of ∼0.6 at 650 °C, 775 °C, and 815 °C and strain rates of 10−4 and 10−3 s−1. Dynamic coarsening resulted in flow hardening at both temperatures and strain rates for a short preheat time (15 minutes) but was noticeably reduced when a longer preheat time (1 hour) was used prior to testing at 10−3 s−1. The latter behavior was largely attributed to noticeable static coarsening during preheating. A generalized constitutive relation based on a single stress exponent and the instantaneous alpha particle size was shown to describe the superplastic flow of ultrafine Ti-6Al-4V at low and high temperatures.

Warm formability of ultrafine-grain (UFG) AZ31B Mg alloy in the range of 150 °C to 311 °C is investigated. Refinement of grain size significantly improves the formability primarily through increasing strain rate sensitivity of flow stress and increasing diffuse quasi-stable flow, as compared with the coarse-grain AZ31B alloy. Strain rate sensitivity increases with increasing temperatures, and seems to be connected with dynamic recovery and grain boundary processes. For fine-grain sizes, twinning is inhibited. At 200 °C and strain rates below 2 × 10−4 s−1, the UFG AZ31B alloy demonstrates a high rate of strain hardening up to a true strain of 0.6, in addition to its high strain rate sensitivity, which is responsible for its enhanced formability. Examination of the microstructure shows that there is competition between dynamic grain growth and grain refinement during deformation at modest warm forming temperatures, the former causing hardening and the latter causing softening. Increasing the test strain rate and starting with larger grain size initiates deformation twinning during forming, and assists in the refinement of the coarser grains followed by recrystallization.

In recent literature related to mechanical testing of small-volume metal specimens, plastic strain bursts during apparent elastic loading have been reported for materials commonly known to exhibit smooth yielding. Interpretation of the observed plastic yielding effects in these tests have ignored a significant part of the actual experimental findings, and produced conclusions regarding dislocation structure that these tests do not unequivocally support. It is pointed out that the heterogeneity of dislocation debris left in the microstructure does not clearly represent deformation resistance, nor give a clear indication of strain within the specimen. The measured high rate of strain hardening and stability of plastic flow in the small-volume specimens are dependent on stress-state, and are shown to be not correlated with dislocation debris or dislocation-starvation concepts; rather the reason for the observed strengthening is related to the resistance to slip propagation through the specimen surface to form surface steps, viewed as an atomic-scale shear fracture process, elaborated in a companion paper. In a compression test the surface is closed under high compressive stress, thus repeatedly blocking the process, but in a tension test the surface separates more easily, causing loss of plastic stability.

Over the last decade, higher education institutions in the U.S. have faced increased competition and expenditures coupled with declines in financial support. Furthermore, they often have been forced to cater to the needs of an increasingly diverse group of students and must design service strategies based on the unique needs of each group. This paper advocates the use of target marketing principles to effectively and efficiently allocate resources among the various groups. Student registration data from a large, urban, public university, which is routinely available at little cost, is used to identify five student segments. These segments include traditional students, non-traditional students, a sizable international student segment, a graduating segment, and a group of transferees. The unique needs of each segment are identified and appropriate service strategies are formulated for each segment. The diversity of the segments establish the utility of using target marketing principles for designin...

The results of an analysis of creep deformation in hexagonal and circular honeycomb structures using an elastic–plastic finite element method are reported here. Representative unit cells of transverse sections of the honeycomb structures were subjected to compression loading, with the wall material assumed to undergo creep following a power law of the form e ˙ = K σ n . It is shown that, in spite of using a steady-state law, the honeycomb shows primary and tertiary creep stages, arising from inhomogeneous deformation and geometrical effects, respectively. When the creep law is modified to include work-hardening of the wall material, the onset of the tertiary-like stage is delayed. It is also found that a circular honeycomb is stronger than a hexagonal honeycomb of similar relative density due to constraints within the structure. External constraints, such as those which may arise from friction with external surfaces, are also shown to lead to strengthening by producing triaxial compressive stresses within the cell walls.

Thin section analysis of Umlatdoh Limestone belonging to Shella Formation exposed in the southern part of Jaintia Hills yielded well preserved calcareous algae. Detailed taxonomical analyses of the algal forms reveal the existence of udoteacean and halimedacean green algae that includes three species of the genus Ovulites Lamarck belonging to family Udoteaceae. One species of Halimeda Lamouroux belonging to family Halimedaceae also has been described in the present paper. Based on the algal assemblage along with sedimentological and micropalaentological observations interpretations on palaeoenvironment and palaeobathymetry have been made.

This paper reports a novel technique to fabricate hexagonal honeycomb structures. Here, a low-melting coating on stacked circular tubes is used to form liquid bridges at the tube junctions upon heating. The surface tension in these bridges then pulls the curved tube elements continuously to create planar walls, thereby replacing the circular core structures with ones of hexagonal geometry. An analysis of this process explains the rate of evolution of the tube radius based on the flow law of the tube material, the latter being influenced by the penetration of liquid phase along the boundaries of the nickel grains in the tubes.

Strain-rate sensitivity (SRS) of flow stress is an important parameter for deformation mechanism of materials. Definition of SRS is based on incremental changes in strain rate during tests performed at a fixed temperature and fixed microstructure, to determine corresponding changes in flow stress. In the creep literature, a steady state is assumed to be characterized by “constant” structure, but that “steady structure” varies with strain rate and temperature. Strain hardening causes structure to develop during primary creep, and also during low temperature deformation. Incremental tests for SRS minimize effects of changes in structure, temperature and strain hardening during testing, and are used to determine relation between dislocation velocity and stress at constant structure. High strain rate tests used for simulating ballistic applications incorporates multiple deformation mechanisms in a single test. The purpose of those tests has been overextended in recent times to conclude on deformation mechanism in various metals including ultra-fine grain metals. A reexamination of such work and fundamentals of deformation process show that higher SRS values than those for incremental tests are expected at high strain rate due to concurrent strain hardening.

Eight new metal-organic hybrid materials of Cu(ll) have been synthesized by using flexible glutarate/adipate as a bridging ligand, 2,2'-bipyridine/1,10-phenanthroline as a chelating ligand, and BF 4 -/Cl0 4 -/Cl- as a counteranion. These materials are characterized by single-crystal X-ray diffraction analyses and variable temperature magnetic measurements. Out of them, complexes 1, 3, 5, and 8 crystallize in the triclinic system with space group P1. Complexes 2, 4, 6, and 7 crystallize in the monoclinic system with space group P2 1 /n (2, 4), F2 1 /c (6), and C2 (7). The structural analysis reveals that bridging glutarate gives rise to dinuclear and tetranuclear species, whereas the adipate dianion leads to octanuclear, one-dimensional and two-dimensional polymeric complexes, although they have been prepared under similar conditions. Supramolecular architectures of higher dimensionality have been achieved through H-bonding and π-π interaction. In all the complexes, the bridging and/or counteranions as well as chelating ligand have a vital role in directing the solid-state structure. A variable temperature (2-300 K) magnetic susceptibility study discloses the antiferromagnetic coupling for all of the complexes.