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Some new infinite-dimensional generalised Lie symmetries of Einstein’s field equations for perfect fluid distribution are found by using the Lie symmetry analysis. The reduced ordinary differential equations are solved to obtain new non-trivial exact solutions. The software MAPLE is used for computation and MAPLE code is given to facilitate the research in this field. [ABSTRACT FROM AUTHOR]

• Disruptions during the COVID-19 lockdown caused children to miss immunizations. • Government catch-up efforts substantially reversed these effects. • Yet, children that were due vaccinations during the lockdown remained 10–15% less likely to be immunized 4–5 months later. • Catch-up was more likely to be incomplete among children of low socioeconomic status. • Ensuring all children are fully immunized requires careful tracking and disaggregated data. Governments around the world suspended immunization outreach to control COVID-19 spread. Many have since resumed services with an emphasis on catch-up vaccinations. This paper evaluated immunization disruptions during India's March-May 2020 lockdown and the extent to which subsequent catch-up efforts reversed them in Rajasthan, India. In this retrospective observational study, we conducted phone surveys to collect immunization details for 2,144 children that turned one year old between January and October 2020. We used logistic regressions to compare differences in immunization timeliness and completed first-year immunization status among children that were due immunizations just before (unexposed), during (heavily exposed), and after (post-exposure) the lockdown. Relative to unexposed children, heavily exposed children were significantly less likely to be immunized at or before 9 months (OR 0.550; 95% CI 0.367–0.824; p = 0.004), but more likely to be immunized at 10–12 months (OR 1.761; 95% CI 1.196–2.591; p = 0.004). They were also less likely to have completed their key first-year immunizations (OR 0.624; 95% CI 0.478–0.816; p = 0.001) by the time of survey. In contrast, post-exposure children showed no difference in timeliness or completed first-year immunizations relative to unexposed children, despite their younger age. First-year immunization coverage among heavily exposed children decreased by 6.9 pp to 10.4 pp (9.7% to 14.0%). Declines in immunization coverage were larger among children in households that were poorer, less educated, lower caste, and residing in COVID red zones, although subgroup comparisons were not statistically significant. Disruptions to immunization services resulted in children missing immunization during the lockdown, but catch-up efforts after it was eased ensured many children were reached at later ages. Nevertheless, catch-up was incomplete and children due their immunizations during the lockdown remained less likely to be fully immunized 4–5 months after it lifted, even as younger cohorts due immunizations in June or later returned to pre-lockdown schedules. [ABSTRACT FROM AUTHOR]

Keywords: Cost-effectiveness; Diabetes; Non-communicable diseases; India EN Cost-effectiveness Diabetes Non-communicable diseases India 1 3 3 12/09/20 20201209 NES 201209 This comment refers to the article available at https://doi.org/10.1186/s12916-020-01704-9. The authors present a cost-effectiveness analysis of 1007 participants in the K-DPP, finding the societal cost per QALY gained was US$155, and the health system cost per QALY gained about one third of that (i.e., $US50). [Extracted from the article]

Total glossectomy defects resulting from postoncologic resection are commonly reconstructed with locoregional or free flaps. However, effectively managing complications that may arise after reconstruction can be a significant challenge. We present a unique case series describing prosthetic management of flap-related complications following glossectomy in patients treated for locally advanced tongue cancer. Three patients underwent total glossectomy, neck dissection, reconstruction using free flap, and tracheostomy. Two patients developed an intraoral fistula located in the anterior region of the floor of the mouth. The third patient developed a flap failure requiring a second procedure using a pectoralis major myocutaneous flap for correction of the orocutaneous fistula that ultimately did not heal. Mandibular obturator prostheses lined with a soft liner were fabricated for all the patients, which helped reduce salivary incontinence and improve swallowing and speech. This case series highlights that a collaborative interdisciplinary team approach is crucial for optimizing postoperative function and outcomes when managing complications from reconstructive procedures. [ABSTRACT FROM AUTHOR]

The aim of the present study was to determine the prevalence of oral mucosal lesions and their co-relation to deleterious habits of smoking, tobacco and alcohol consumption. 2000 patients visiting both rural and urban centres were screened for oral lesions and information regarding habits was obtained through a questionnaire. The results showed the prevalence of oral mucosal lesion to be 16.7% in the study population. The most frequent observation was the presence of Fordyce's spots (6.2%) followed by smoker's palate( 5.6%), leukoedema (3.15%), leukoplakia (2.1%), oral sumucous fibrosis (2%), recurrent aphthous ulcers and lingual varices (1.6%), Lichen planus (1.2%) and oral candidiasis (1%). The habits were found to be associated with increased prevalence of oral mucosal lesions, especially in men. The study concluded the need for formulation of public health programmes discouraging these practises and public awareness of their ill-effects. [ABSTRACT FROM AUTHOR]

India's COVID-19 lockdown, one of the most severe in the world, is widely believed to have disrupted critical non-COVID health services. However, linking these disruptions to effects on health outcomes has been difficult due to the lack of reliable, up-to-date health outcomes data. We identified all dialysis patients under a statewide health insurance program in Rajasthan, India (N = 2110), and conducted surveys to examine the effects of the lockdown on non-COVID care access and health outcomes. Post-lockdown mortality was our primary outcome and morbidity and hospitalization were secondary outcomes. 63% of patients experienced a disruption to their care. Transport barriers, hospital service disruptions, and difficulty obtaining medicines were the most common causes. We compared monthly mortality in the four months after the lockdown with pre-lockdown mortality trends, as well as with mortality trends for a similar cohort in the previous year. Mortality in May 2020, after a month of exposure to the lockdown, was 1.70 percentage points (95% CI 0.01–0.03) or 64% higher than in March 2020 and total excess mortality between April and July was estimated to be 22%. A 1SD increase in an index of care disruptions was associated with a 0.17SD (95% CI 0.13–0.22) increase in a morbidity index, a 3.1 percentage point (95% CI 0.012–0.051) increase in hospitalization, and a 2.1 percentage point (95% CI 0.00–0.04) increase in probability of death between May and July. Females, socioeconomically disadvantaged groups, and patients living far from the health system faced worse outcomes. The results highlight the unintended consequences of the lockdown on critical, life-saving non-COVID health services that must be taken into account in the implementation of future policy efforts to control the spread of pandemics. • India's nationwide COVID-19 lockdown severely disrupted critical chronic care. • Non-COVID-19 morbidity and mortality increased sharply in the subsequent months. • Socioeconomically disadvantaged patients were worst affected. • Indirect health effects increase the toll of pandemics and worsen health inequality. • Pandemic control policies must ensure critical health services continue. [ABSTRACT FROM AUTHOR]

Despite an increase in the offshore outsourcing of information technology (IT) projects, little research has been carried out to identify issues that client managers (CMs) encounter when managing projects with offshore vendors. Also research on how CMs’ responsibilities change to effectively manage offshore outsourcing relationships has received little attention. We conducted a case study of an offshore outsourcing relationship between a U.S. client and its Indian vendors engaged in software-testing projects. In this paper, we identify six project management activities that underwent substantial change. We then describe the coping strategies that CMs employed effectively to deal with changing project management activities. We conclude by discussing the interplay of multiple global boundary variables and its effect on the project management activities. We integrate insights from literature on global distributed teams, organizational communications, and offshore outsourcing to theoretically ground the relationship between the boundary variables and the coping strategies. [ABSTRACT FROM PUBLISHER]

Summary The saprophytic fungus Aspergillus fumigatus is the most important air-borne fungal pathogen. The cell wall of A. fumigatus has been studied intensively as a potential target for development of effective antifungal agents. A major role in maintaining cell wall integrity is played by the mitogen-activated protein kinase (MAPK) MpkA. To gain a comprehensive insight into this central signal transduction pathway, we performed a transcriptome analysis of the Δ mpkA mutant under standard and cell wall stress conditions. Besides genes involved in cell wall remodelling, protection against ROS and secondary metabolism such as gliotoxin, pyomelanin and pseurotin A, also genes involved in siderophore biosynthesis were regulated by MpkA. Consistently, northern and western blot analyses indicated that iron starvation triggers phosphorylation and thus activation of MpkA. Furthermore, localization studies indicated that MpkA accumulates in the nucleus under iron depletion. Hence, we report the first connection between a MAPK pathway and siderophore biosynthesis. The measurement of amino acid pools and of the pools of polyamines indicated that arginine was continuously converted into ornithine to fuel the siderophore pool in the Δ mpkA mutant strain. Based on our data, we propose that MpkA fine-tunes the balance between stress response and energy consuming cellular processes. [ABSTRACT FROM AUTHOR]

Abstract: Aspergillus fumigatus is the most important air-borne fungal pathogen, causing severe infections in immunocompromised patients. Mitogen-activated protein kinase (MAPK) signaling pathways are involved in the regulation of various cellular responses to environmental changes in eukaryotes. Genome Blast analysis revealed that the central core of the cell wall integrity signaling pathway in A. fumigatus is composed of three protein kinases designated Bck1, Mkk2 and MpkA. This pathway is of particular interest because it represents a possible target for new antifungal drugs. Deletion of these genes resulted in severe sensitivity of the mutants against cell wall-disturbing compounds and drastic alterations of the fungal morphology. Western blot analysis demonstrated that Bck1 and Mkk2 directly activate MpkA during vegetative growth and under cell wall stress conditions further confirming that Bck1, Mkk2 and MpkA form a MAP kinase module. Interestingly, this MAP kinase module affects the formation of pyomelanin derived from tyrosine degradation. [Copyright &y& Elsevier]

Businesses need to continuously focus on change and innovation in order to survive in dynamic environments. The ability of an organization to deploy appropriate business processes requires that the fit between business processes and systems that support the management of these processes is continuously maintained and evolved. Acquisition and use of the knowledge about the context in which business processes are defined, modified, and implemented can help maintain this fit. We identify requirements for a business process management system (BPMS) capable of managing contextual knowledge. Based on these requirements, we have enhanced KOPeR, a knowledge-based system for business process improvement, with an explanation facility that can acquire and maintain knowledge about the context behind process definitions and design choices. A case study that illustrates the functionalities of this system which is designed to improve the fit between business processes and BPMS is presented. [ABSTRACT FROM AUTHOR]

Focuses on several issues related to the development deployment of fourth generation (4G) wireless networks. Features of 4G wireless technologies; Service offering of third generation networks; Problems in the deployment of 4G wireless networks; Quality of service of 4G networks.

Abstract: Mitogen-activated protein kinase (MAPK) signaling pathways are involved in the regulation of various cellular responses in eukaryotes. In fungal pathogens they are of special interest because of their possible contribution to pathogenicity. Bioinformatic analysis of the genome of the most prevalent airborne human pathogenic fungus Aspergillus fumigatus, revealed the presence of four distinct MAPK-encoding genes. Here, we present the detailed functional analysis of one of these MAPKs, MpkA. Comparative analysis revealed similarities of MpkA with MAPKs involved in cell wall integrity signaling of other fungi. Accordingly, the analysis of mpkA deletion mutants revealed severe sensitivity of the mutants against cell wall active compounds, drastical alterations of the fungal morphology and increased resistance against oxidative stress. The expression of mpkA was induced by cell wall damaging conditions. Despite its involvement in cell wall signaling no influence on virulence of the deletion of mpkA was observed in a murine infection model. [Copyright &y& Elsevier]

Purpose of Study: Preoperative Chemoradiation (CRT) is increasingly being used in patients with locally advanced resectable non-cervical Carcinoma Oesophagus patients. It results in 25-30% pathological complete response (pCR) rate and improved survival. We report the response rates & acute toxicity of this protocol, and dosimetrically compare hybrid radiation plans [3-dimensional conformal radiotherapy (3D-CRT) plus Intensity Modulated Radiotherapy (IMRT)] with all- IMRT or VMAT plans in terms of volume of lung treated to low doses while delivering conformal doses. Materials and Methods: Thirty Six patients were included in the study. Treatment protocol included external beam radiotherapy (Hybrid Plan: Phase-1 3D-CRT: 36Gy in 20fractions followed by Phase-2 IMRT: 14.4Gy in 8fractions, 5 days/ week) for 5weeks with concurrent weekly Inj. Carboplatin (AUC2) and Inj. Paclitaxel (50mg/m2), followed by surgery. The phase-2 plans were optimized to reduce lung, heart & spinal cord doses. The hybrid plans were dosimetrically compared with all-IMRT & all-VMAT plans to same doses. Dose-volume histograms were evaluated for the planning target volume, total lung and heart doses. Lung volumes V5(Volume of lung receiving 5Gy), V10, V13, V20, V30 and mean lung dose(MLD) were compared for each plan. Results: Out of 36 patients, 21 underwent surgery. 15 patients either refused surgery or were found inoperable. Ten patients achieved pCR(47.6%). The most common acute hematological toxicity was neutropenia in 16 patients and non-hematological toxicity was anorexia in 14 patients. None of our patients experienced postoperative complications or 30- day mortality. Hybrid plans treated significantly smaller lung volumes to low doses than IMRT & VMAT plans and significant reduction was for V5, V10 and V13 values & smaller reductions were also found for MLD. IMRT & VMAT Plans showed better PTV coverage and lower heart doses at the cost of higher low dose Lung volumes. Hybrid plans treated much larger extra planning target volumes to prescribed dose levels. Conclusion: Hybrid plans showed reduction in low dose lung volumes while maintaining conformality. High response rates were observed with this treatment protocol, but long term follow up is required to adequately assess clinical outcomes in terms of late toxicity & survival. [ABSTRACT FROM AUTHOR]

Melanins play a crucial role in defending organisms against external stressors. In several pathogenic fungi, including the human pathogen Aspergillus fumigatus, melanin production was shown to contribute to virulence. A. fumigatus produces two different types of melanins, i.e., pyomelanin and dihydroxynaphthalene (DHN)-melanin. DHN-melanin forms the gray-green pigment characteristic for conidia, playing an important role in immune evasion of conidia and thus for fungal virulence. The DHN-melanin biosynthesis pathway is encoded by six genes organized in a cluster with the polyketide synthase gene pksP as a core element. Here, cross-species promoter analysis identified specific DNA binding sites in the DHN-melanin biosynthesis genes pksP- arp1 intergenic region that can be recognized by bHLH and MADS-box transcriptional regulators. Independent deletion of two genes coding for the transcription factors DevR (bHLH) and RlmA (MADS-box) interfered with sporulation and reduced the expression of the DHN-melanin gene cluster. In vitro and in vivo experiments proved that these transcription factors cooperatively regulate pksP expression acting both as repressors and activators in a mutually exclusive manner. The dual role executed by each regulator depends on specific DNA motifs recognized in the pksP promoter region. [ABSTRACT FROM AUTHOR]