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Non-Gaussian random-matrix ensembles are important in many applications. We propose Monte Carlo and Langevin methods for generating non-Gaussian ensembles and their eigenvalue spectra. We also provide a general framework for analytic studies of the level density in these ensembles. We show that, in general, the level densities exhibit banded spectra, with important implications for mesoscopic systems and complex nuclei. The universality of energy-level fluctuations is confirmed.

Ventilator associated pneumonia in a tertiary care hospital in India: Incidence, etiology, risk factors, role of multidrug resistant pathogensOriginal Article INTRODUCTIONVentilator associated pneumonia (VAP) is pneumonia that occurs 48 h or more after endotracheal intubation and mechanical ventilation (MV) that was not intubating at the time of admission, also including pneumonia developing after extubation.[1] Pneumonia is the second most common intensive care unit (ICU) acquired infection and 86% of nosocomial pneumonias are VAP.[1] Around 10-20% of patients on MV for longer than 48 h, develops VAP. [2,3] Early onset VAP, which occurs during the fi rst 4 days of MV is usually less severe, associated with a better prognosis and more likely caused by antibiotic sensitive bacteria. Late onset VAP, which develops 5 or more days after initiation of MV, is caused by multidrug resistant (MDR) pathogens and associated with increased mortality and morbidity.[4] The common pathogens causing VAP include aerobic gram negative rods such as Pseudomonas aeruginosa, Acinetobacter species, Klebsiella pneumoniae, and Escherichia coli. [1,5,6] VAP due to methicillin resistant Staphylococcus aureus (MRSA) has been rapidly emerging. [5,6] Treatment of VAP is usually supportive, along with administration of proper antibiotic. The selection of proper antimicrobial agents, active against the VAP pathogens is an important determinant for reducing morbidity and Background: Ventilator associated pneumonia (VAP), a hospital acquired infection (HAI) is seen among critically ill patients on mechanical ventilation (MV) due to various causes, in intensive care units (ICUs). VAP increases morbidity, mortality, as well as the cost of healthcare. Materials and Methods: A prospective study was done over a period of 10 months in a tertiary care hospital in India to determine the incidence, etiological agents, their sensitivity profi les, and risk factors associated with VAP. Combination disc method, ethylenediaminetetraacetic acid (EDTA) disc synergy (EDS) tests, and AmpC disc tests were performed for detection of extendedspectrum beta-lactamases (ESBL), metallo-beta-lactamases (MBL), and AmpC beta-lactamases, respectively. Results: One hundred and forty adult patients, on MV for 48 h and more, were included and 28 (20%) developed VAP. The incidence density rate of VAP was 21.875 per 1,000 ventilator days. Most of the patients had late onset VAP (60.7%) with average number of days for onset around 8 days. Pseudomonas spp. and Acinetobacter spp. were signifi cantly associated with late onset VAP, whereas Enterobacteriaceae, Staphylococcus aureus, Haemophilus infl uenzae, Streptococcus pneumoniae, Burkholderia cepacia, and Candida species were commonly isolated from early onset VAP. Polymicrobial infections occurred in 14 cases, so overall 43 VAP pathogens were isolated. Thirty (69.7%) of them were multidrug resistant (MDR), among which ESBL contributed 23.25%, MBL 30.23%, AmpC beta-lactamases 9.30%, and to methicillin resistant S. aureus (MRSA) c...

A general approach to mapping a discrete quantum mechanical problem by a continuous Hamiltonian is presented. The method is based on the representation of the quantum number by a continuous action variable that extends from -infinity to infinity. The projection of this Hilbert space onto the set of integer quantum numbers reduces the Hamiltonian to a discrete matrix of interest. The theory allows the application of the semiclassical methods to discrete quantum mechanical problems and, in particular, to problems where quantum Hamiltonians are coupled to continuous degrees of freedom. The Herman Kluk semiclassical propagation is used to calculate the nonadiabatic dynamics for a model avoided crossing system. The results demonstrate several advantages of the new theory compared to the existing mapping approaches.

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Carbon dioxide (CO 2 ) partial reduction to carbon monoxide (CO) and oxygen has been conducted in a dielectric barrier discharge reactor (DBD) operating a packed bed configuration and the results are compared with that of no packing condition. The effect of diluent gas is studied to understand the influence on dielectric strength of the plasma gas on CO 2 splitting, with the objective of obtaining the best CO selectivity and high energy efficiency. Typical results indicated that among N 2 , He and Ar gases, Ar showed the best decomposition efficiency. Glass beads packing has a strong influence on the performance, probably due to the enhanced field strength due to dielectric nature of the packed material. In a similar manner, Ar mole ratio in the gas mixture also played a significant role, where the maximum CO 2 conversion of 19.5% was obtained with packed DBD at CO 2 :Ar ratio 1:2. The best CO yield (16.8%) was also obtained under the same conditions. The highest energy efficiency was found to be 0.945 mmol/kJ. The activated species formed inside the CO 2 plasma were identified by optical emission spectroscopy.

Background:Though the tumor grade is a key factor influencing the choice of therapies, particularly determining the use of adjuvant radiation and specific chemotherapy protocols, role of abnormality in phosphatase and tensin homolog (PTEN) expression and variation in epidermal growth factor receptor (EGFR) labeling index (LI) and Ki-67 LI in survival and clinical outcome have been studied by many researchers in the recent past.Aims:The aim was to evaluate the expression of PTEN, EGFR and Ki-67 in different grades of astrocytic tumors by means of immunohistochemistry and to judge their role in overall survival (OS).Materials and Methods:This study was conducted on 57 cases of different grades of astrocytomas. Expression of PTEN, EGFR and Ki-67 was assessed by immunohistochemistry on formalin fixed and paraffin-embedded sections and the OS was evaluated by Kaplan–Meier survival curves and log-rank test for 2.5 years from the date of primary resection.Results:Most of the tumors (59.6%; 34 cases out of 57) displayed WHO Grade IV features. Distribution of age, EGFR LI and Ki-67 LI expressed strong positive (≥0.5) correlation with the grade of tumors. However, the PTEN positivity was inversely related with the grade of the tumors. Lower WHO grades, lower values of Ki-67 LI, EGFR LI and PTEN positivity were associated with better survival.Conclusion:Expression of PTEN, EGFR LI and Ki-67 LI should be combined with the basic histopathological features including WHO grade to predict the prognosis and therapeutic outcome.

BACKGROUND Scrub typhus is a mite borne zoonotic bacterial disease caused by Orientia tsutsugamushi. It is transmitted by bite of chiggers of trombiculid mite. Clinical features generally include fever, headache, and myalgia, with or without eschar/rash. People with severe illness may develop organ failure and bleeding which can be fatal if left untreated. This study was done to detect outbreak of cases of scrub typhus in Eastern India. These mites generally live in paddy fields of forested area and people visiting those areas are generally affected. Now a days these mites migrate to urban area resulting in increased incidence of scrub typhus infection in urban area. This study was conducted in collaboration with another institute. The purpose of this study was to find out the incidence of scrub typhus in our area and the relationship between occurrence of scrub typhus and seasonal, age and sex variation. METHODS This study was carried out in our tertiary care hospital with 441 samples for a period of one year (01.01.2019 to 31.12.19). All the blood samples collected from febrile patients were subjected to Weil Felix test. If the titre is > 1 : 160; this was further confirmed by specific IgM testing. Both Weil-Felix tests and IgM scrub typhus positive tests were noted. RESULTS Out of 441 samples, 98 (22.2 %, n = 441) samples were positive for both WeilFelix and scrub typhus IgM by enzyme linked immunosorbent assay (ELISA) testing. Most of the cases were seen in males. Seasonal distribution showed higher cases in the months of September and October. CONCLUSIONS In our study, the highest numbers of scrub typhus cases were found in rural areas, during the harvesting period of July–September specially in monsoon or post monsoon period when there is abundance of mite larva. This infection is also reported high in cases among children in the age group of 1 - 14 years. Patients who tested positive for scrub typhus improved radically with doxycycline. KEYWORDS Orientia Tsutsugamushi, Scrub Typhus, IgM ELISA