#Balaguru

[akultalkies]

Gautham Karthik, Revathy, Pugazh, Madhusudhan Rao, Neelima Rani, Jason Shah, Richard Ashton, Suresh Ekambaram, Dheeran, Balaguru, Udhaya Kumar, Sathya, Uma Kasthuri, Ravishankar, Subramanian, Solai, Agran, David, Sabbita Roi, Durai Navaneethan,

[mariacallous]

For over a year, global ocean temperatures have been consistently shattering records, shocking scientists. Now hurricane watchers are getting even more worried, given that ocean heat is what fuels the biggest, most destructive cyclones. Researchers at the University of Arizona just predicted an extremely active North Atlantic season—which runs from June 1 to the end of November—with an estimated 11 hurricanes, five of them being major (meaning Category 3 or higher, with sustained wind speeds of at least 111 miles per hour). That would dwarf the 2023 season—itself the fourth-most-active season on record—which saw seven hurricanes, three of which intensified into major ones.

“Part of the reason is very warm ocean surface temperatures in the tropical Atlantic Ocean,” says Xubin Zeng, director of the Climate Dynamics and Hydrometeorology Center at the University of Arizona. The other reason is that the Pacific Ocean is transitioning from a warm El Niño, which discourages the formation of Atlantic hurricanes, into cold La Niña, which encourages them. “So those two factors together give us a very active hurricane season prediction for this year.”

As a tropical cyclone grows, scientists measure sustained wind speeds to get an idea of how it’s intensifying. (“Tropical cyclone” is the general term for these storms. The ones that hit the coasts of the US are known as hurricanes.) When the speeds increase by 30 knots (35 miles per hour) or more in 24 hours, that’s considered “rapid intensification.” Last year’s Hurricane Lee, for instance, grew from 70 knots to 116 knots over just 12 hours. Previous research has found a huge increase in this sort of rapid intensification near coastlines since 1980.

And it’ll only get worse from here. A study from another group of scientists, published today in Earth’s Future, finds that across the planet, hurricanes have been intensifying faster and faster. It looked at hurricane behavior near coasts, as opposed to when they’re traveling across the open ocean, and measured intensification generally instead of rapid intensification specifically.

The study found that globally in the last four decades, the tropical cyclone intensification rate has grown by 3 knots per 24 hours. Put another way: We can expect a hurricane today to intensify by 3 extra knots over the course of a day, on average. Between 1979 and 2000, the average rate of intensification increased by 0.37 knots every six hours of a hurricane’s lifespan, rising to 1.15 knots every six hours in the period between 2000 and 2020.

The authors warn that climate change is creating the conditions for plenty more coastal intensification going forward. That, in turn, is making hurricanes more dangerous than ever, as the storm can suddenly intensify close to shore into something fiercer than what emergency agencies were preparing for. “This increase in intensification near the coast is supported by changes in the environment,” says Pacific Northwest National Laboratory climate scientist Karthik Balaguru, lead author of the paper in the journal Earth’s Future. “The projected changes also show increasing intensification of tropical cyclones in a future climate.”

Three main factors converge to intensify hurricanes. The first is that as the world in general warms, so too do the oceans. Water evaporating off the surface rises, releasing heat that fuels the developing hurricane. The warmer a patch of ocean water is, the more energy a cyclone has to exploit. If a hurricane like Lee forms off the coast of Africa, it’s got a lot of Atlantic ocean to feed on as it moves toward the East Coast of the United States. As we approach this year’s hurricane season, tropical Atlantic temperatures remain very high.

The second factor is humidity. As the atmosphere warms, it can hold more water vapor, so some parts of the world are getting more humid. Hurricanes love that, as drier air can lead to cooling and downdrafts that counteract the updrafts that drive the storm. “So long as it remains moist, the storm can strengthen, or maintain its intensity,” says Balaguru. “However, once the core enters into a dry environment or becomes less moist, then the storm will start weakening.”

And lastly, hurricanes hate wind shear, or winds of different speeds and directions at different altitudes. (Think of it like layers of a cake, only made of air.) Instead, cyclones like a stable atmosphere, which allows their winds to get swirling and intensifying. Wind shear can also inject drier air from outside the storm into the core of the hurricane, further weakening it. As the world warms, wind shear is decreasing along the US East Coast and East and South Asia, providing the ideal atmospheric conditions for cyclones to form and intensify. “Under climate change, the upper troposphere is expected to warm up at a higher pace than the surface,” says Balaguru. “This can enhance the stability of the atmosphere and also weaken the circulation in the tropics.”

Nearer term, La Niña conditions in the Pacific could help form and intensify hurricanes this summer. Even though La Niña’s in a different ocean, it tends to suppress winds over the Atlantic, meaning there’s less of the wind shear that hurricanes hate. Hence the University of Arizona’s prediction for an extremely active hurricane season, combined with very high sea surface temperatures in the Atlantic to fuel the storms. By contrast, last year’s El Niño created wind conditions in the Atlantic that discouraged the formation of cyclones.

Even then, Hurricane Lee developed into a monster storm last September. A week before that, Hurricane Idalia rapidly intensified just before slamming into Florida. That sort of intensification close to shore is extraordinarily dangerous. “When the storm is very close to the coast—let's say it's a day or two out—if it then suddenly intensifies rapidly, then it can throw you off guard in terms of preparations,” says Balaguru. A town may have planned its evacuations expecting winds of 100 mph, and suddenly it’s more like 130 mph.

Unfortunately, Balaguru’s new study finds that climatic conditions, particularly near the coast, are becoming more conducive for storm intensification. It’s up to teams like Zeng’s at the University of Arizona to further hone their forecasts to manage that growing risk to coastal populations. “For scientists, seasonal forecasting is a reality check of our understanding,” says Zeng. “We have done pretty well over the past few years, and it's going to give us more confidence.”

[blogynews]

Mysterious Deaths of Ragpickers near Kumbakonam: Did They Fall Victim to a Deadly Combination of Booze and Sanitizer? Uncover the Shocking Truth Here

Two ragpickers were discovered dead under mysterious circumstances in Sakkaraipadithurai, Thanjavur district, Tamil Nadu. Authorities suspect that the duo may have consumed a mixture of liquor and sanitizer. The deceased individuals have been identified as M Balaguru, aged 50, from Perumandi, and T Soundrarajan, aged 40, from Karnakollai. Both men were previously married but separated from their…

[blogynewz]

Mysterious Deaths of Ragpickers near Kumbakonam: Did They Fall Victim to a Deadly Combination of Booze and Sanitizer? Uncover the Shocking Truth Here

Two ragpickers were discovered dead under mysterious circumstances in Sakkaraipadithurai, Thanjavur district, Tamil Nadu. Authorities suspect that the duo may have consumed a mixture of liquor and sanitizer. The deceased individuals have been identified as M Balaguru, aged 50, from Perumandi, and T Soundrarajan, aged 40, from Karnakollai. Both men were previously married but separated from their…

[blogynewsz]

Mysterious Deaths of Ragpickers near Kumbakonam: Did They Fall Victim to a Deadly Combination of Booze and Sanitizer? Uncover the Shocking Truth Here

Two ragpickers were discovered dead under mysterious circumstances in Sakkaraipadithurai, Thanjavur district, Tamil Nadu. Authorities suspect that the duo may have consumed a mixture of liquor and sanitizer. The deceased individuals have been identified as M Balaguru, aged 50, from Perumandi, and T Soundrarajan, aged 40, from Karnakollai. Both men were previously married but separated from their…

[firstbuzz]

Study says warming may push more hurricanes toward US coasts

Changes in air patterns as the world warms will likely push more and nastier hurricanes up against the United States’ east and Gulf coasts, especially in Florida, a new study said.

While other studies have projected how human-caused climate change will probably alter the frequency, strength and moisture of tropical storms, the study in Friday’s journal Science Advances focuses on the crucial aspect of where hurricanes are going.

It’s all about projected changes in steering currents, said study lead author Karthik Balaguru, a Pacific Northwest National Laboratory climate scientist.

“Along every coast they’re kind of pushing the storms closer to the U.S.,” Balaguru said. The steering currents move from south to north along the Gulf of Mexico; on the East Coast, the normal west-to-east steering is lessened considerably and can be more east-to-west, he said.

Overall, in a worst-case warming scenario, the number of times a storm hits parts of the U.S. coast in general will probably increase by one-third by the end of the century, the study said, based on sophisticated climate and hurricane simulations, including a system researchers developed.The central and southern Florida Peninsula, which juts out in the Atlantic, is projected to get even more of an increase in hurricanes hitting the coast, the study said.Climate scientists disagree on how useful it is to focus on the worst-case scenario as the new study does because many calculations show the world has slowed its increase in carbon pollution. Balaguru said because his study looks more at steering changes than strength, the levels of warming aren’t as big a factor.The study projects changes in air currents traced to warming in the equatorial eastern Pacific Ocean, just off the coast of South America. Climate change is warming different parts of the world at different rates, and models show the eastern Pacific area warming more quickly, Balaguru said.That extra warming sets things in motion through Rossby waves, according to the study — atmospheric waves that move west to east and are connected to changes in temperature or pressure, like the jet stream or polar vortex events.“I like to explain it to my students like a rock being dropped in a smooth pond,” said University of Albany atmospheric scientist Kristen Corbosiero, who wasn’t part of the study. “The heating is the rock and Rossby waves are the waves radiating away from the heating which disturbs the atmosphere’s balance.”

[mariosportsdoc]

Rethinking Concussion Treatment | Dr. Balaguru Ravi | TEDxBuffalo https://youtu.be/DeFrHAR6_C0 via @YouTube "You shake it, you break it". This describes the fragility of the brain. We need to embrace a new paradigm for concussion protocol in all sports. https://www.instagram.com/p/CqEH9w2Phul/?igshid=NGJjMDIxMWI=

[yahoonewsphotos]

2018 National Geographic Travel Photographer of the Year Contest

The competition is already fierce in the 2018 National Geographic Travel Photographer of the Year Contest, now underway. National Geographic editors have pulled together some of their favorite entries so far from all three categories — Nature, People and Cities.

The event launched on April 10, and photographers of all levels are invited to submit their best shots to the annual competition. The grand prize winner will receive $10,000, have his or her photo posted on the @NatGeoTravel Instagram account, and earn the prestigious title of National Geographic Travel Photographer of the Year. Entries must be submitted by May 31, 2018.

Eligible contestants can visit natgeo.com/travelphotocontest to submit their entries. National Geographic Travel will periodically highlight editors’ favorite photos in online galleries at natgeotravel.com/travelphotocontest.

Photographs @ Hiroki Inoue, Firdaus Hadzri, Tetsuya Nomura, Mattia Passarini, Kelly Beckta/National Geographic Travel Photographer of the Year Contest

See more photos of the 2018 National Geographic Travel Photographer of the Year Contest and our other slideshows on Yahoo News.

[thebigkelu]

Nalesh Balaguru - rainbow canyon

[vietnewspro]

Những bức ảnh du lịch đẹp nhất trong năm 2018

http://vietnewspro.com/cuoc-song/nhung-buc-anh-du-lich-dep-nhat-trong-nam-2018.html

Những bức ảnh du lịch đẹp nhất trong năm 2018

Đây là những bức ảnh xuất sắc nhất trong số các tác phẩm đăng kí tham dự cuộc thi Nhiếp ảnh Du lịch – National Geographic Travel 2018, giải thưởng được ra mắt tháng 4 hàng năm. Nhiếp ảnh gia người Mỹ Naresh Balaguru đã bắt được khoảnh khắc cầu vồng tuyệt đẹp tại hẻm núi Grand Canyon nổi tiếng...

[qualityloveparadise]

[PDF] FRP Composites for Reinforced and Prestressed Concrete Structures By Perumalsamy Balaguru and Antonio Nanni Free Download

FRP Composites for Reinforced and Prestressed Concrete Structures written by Perumalsamy Balaguru and Antonio Nanni is very useful for Civil Engineering (Civil) students and also who are all having an interest to develop their knowledge in the field of Building construction, Design, Materials Used and so on. This Book provides an clear examples on each and every topics covered in the contents of…

[scitechman]

Researchers Weigh the Factors That Power Hurricanes

Researchers Weigh the Factors That Power Hurricanes

The factors that influence the intensity of hurricanes like Irma and Harvey are under scrutiny at the Department of Energy‘s Pacific Northwest National Laboratory, where researchers are sorting the environmental conditions that can spawn such powerful storms.

Oceanographer Karthik Balaguru, an expert on hurricane intensification, says it’s well known that warm ocean temperatures feed hurricanes,…

[wigmund]

From National Geographic Photo of the Day; February 26, 2017:

Rainbow Canyon Naresh Balaguru, National Geographic Your Shot

Rainbows can be beautiful anywhere, but above the Grand Canyon makes for an extra illustrious scene. Your Shot photographer Narest Balaguru almost left his perch at Powell Point as a storm approached. But he waited, and was awarded with this view.

This photo was submitted to Your Shot, our storytelling community where photographers can take part in photo assignments, get expert feedback, be published, and more. Join now to submit your photos.

[khamgiodau]

TỨ CHỨNG FALLOT

TỨ CHỨNG FALLOT

1. ĐỊNH NGHĨA

- Là bệnh tim bẩm sinh tím được Etienne Louis Arthur Fallot mô tả đầy đủ các biểu hiện lâm sàng, hình thái học bệnh lý năm 1888, bao gồm: thông liên thất, hẹp đường ra thất phải, động mạch chủ cưỡi ngựa, phì đại thất phải.

- Tỉ lệ 75% các bệnh tim bẩm sinh tím.

- Thường có những bất thường kèm theo: bất thường động mạch vành, kênh nhĩ thất,...

2. CHẨN ĐOÁN

2.1. Lâm sàng:

2.1.1. Hỏi bệnh:

- Tím.

- Khó thở khi gắng sức, ngồi xổm làm giảm triệu chứng khó thở.

- Cơn tím thường xảy ra dưới 2 tuổi.

- Chậm biết đi, chậm lớn, suy dinh dưỡng.

2.1.2. Khám lâm sàng:

- Trẻ chậm phát triển.

- Ngón tay dùi trống, móng khum.

- Tím da niêm.

- Khám tim:

o Tim to.

o Thất phải phì đại: harzer (+).

o Tăng động dọc bờ trái ức.

o Rung miu tâm thu.

o ATTT khoảng liên sườn II - III trái, cường độ 2/6 - 3/6 do hẹp động mạch phổi.

o T2 đơn.

o Có thể nghe âm thổi liên tục ở sau lưng hay trước ngực do tuần hoàn bàng hệ.

- Khám tìm các biến chứng: thuyên tắc não, áp xe não, viêm nội tâm mạc nhiễm trùng.

2.2. Cận Lâm Sàng:

- CTM: Hồng cầu, Hb, Hct tăng cao, tiểu cầu có thể giảm.

- X-quang tim phổi:

o Bóng tim hình chiếc ủng.

o Cung động mạch phổi mất (dấu nhát rìu).

o Tuần hoàn phổi giảm.

o Quai động mạch chủ có thể lệch phải.

- ECG: Trục phải, lớn thất phải.

o V1: QRS có dạng Rs, R, qR, qRs.

o V2: RS hoặc rS.

- Siêu âm tim Doppler: xác định tứ chứng Fallot và tổn thương kèm theo.

- Chụp CTscan ngực có cản quang và dựng hình: khảo sát:

o Kích thước nhánh đmp sát nơi chia vào đm phân thùy. o Kích thước động mạch chủ xuống.

o Tính chỉ số Mc.Goon = (đk đmp P + đk đmp T)/đk đmc xuống (mm).

• Mc.Goon ratio < 01: phẫu thuật tạm thời (B-T shunt).

• Mc.Goon > 1: phẫu thuật triệt để.

o Khảo sát động mạch vành, chú ý nhánh ĐMV quan trọng chạy ngang vùng phễu.

o Kháo sát tuần hoàn bàng hệ chủ - phổi.

o Lỗ TLT, kích thước thất trái.

2.3. Chẩn đoán xác định: lâm sàng và siêu âm tim

2.4. Chẩn đoán phân biệt:

- Tam chứng Fallot: thông liên nhĩ, hẹp đường ra thất (P), dày thất (P).

- Chuyển vị đại ĐM có sửa chữa (phối hợp với thông liên thất hoặc hẹp ĐM phổi): trên siêu âm, ĐM chủ xu���t phát từ thất (P), ĐM phổi xuất phát từ thất (T).

- Thất phải hai đường ra với hẹp ĐM phổi và thông liên thất: trên siêu âm thấy hình ảnh đặc trưng là mất liên tục giữa van 2 lá và thành sau ĐM chủ.

- Thất duy nhất và hẹp ĐM phổi: siêu âm không thấy vách liên thất, chỉ thấy thất chung.

3. ĐIỀU TRỊ

3.1. Nguyên tắc điều trị:

- Điều trị phẫu thuật sửa chữa dị tật.

- Phòng ngừa và điều trị các biến chứng.

3.2. Điều trị đặc hiệu:

- Phẫu thuật sữa chữa hoàn toàn hay tạm thời tùy vào: tuổi, triệu chứng cơ căng, Hct, vòng van động mạch phổi, động mạch phổi, động mạch phổi trái, trái...

- Điều trị tạm thời: phẫu thuật Blalock_Taussig:

o ĐM phổi nhỏ (< 50% giá trị lâm sàng theo diện tích da cơ thể - BSA).

o Chỉ số Mc.Goon < 01.

o Cân nặng < 5kg và Hct > 75% - 80%

- Điều trị triệt để: Vá thông liên thất, mở rộng đường ra thất phải với tuần hoàn ngoài cơ thể.

3.3. Điều trị hỗ trợ:

- Nâng đỡ tổng trạng.

- Điều trị suy tim, chống loạn nhịp.

- Phòng ngừa viêm nội tâm mạc, biến chứng thuyên tắc.

3.4. Điều trị cơn tím:

- Cho trẻ nằm, đầu gối gập vào ngực.

- Thở oxy 100%.

- Morphin: 0,1 - 0,2 mg/kg tiêm dưới da hoặc tiêm bắp để ức chế trung tâm hô hấp làm chậm nhịp thở.

- Gắn đường truyền dịch Nacl 0,9% hoặc Lactated Ringer 5-10 ml/kg.

- Điều trị nhiễm toan bằng NaHCO3 lmEq/kg IV.

- Nếu không hiệu quả có thể phải đặt NKQ, hỗ trợ hô hấp, tuần hoàn.

4. THEO DÕI VÀ TÁI KHÁM

- Điều trị tạm thời: tái khám định kỳ mỗi 1 tháng, 3 tháng, 6 tháng, để xét chỉ định sửa chữa triệt để.

- Điều trị triệt để: tái khám định kỳ 1 tháng, 3 tháng, theo dõi tình trạng suy tim phải, loạn nhịp sau mổ,.

TÀI LIỆU THAM KHẢO

1. Hoàng Trọng Kim (1995), “Tứ chứng Fallot”, Nhi Khoa, Đà Nẵng, ĐH Y Dược TP. HCM, tập 1, tr. 88-98.

2. Hoàng Trọng Kim (2004), “Bện tim bẩm sinh”, bài giảng nhi khoa, ĐH Y Dược TP. HCM, NXB Y học TP. HCM, tập 2, tr. 475-490.

3. Phác đồ điều trị Bệnh Viện Chợ Rẫy , 2013, tr 173-175.

4. Duraisamy Balaguru, M.D.; Muhammad Dilawar, M.D., Pulmonary atresia with ventricular septal defect: systematic review. Heart Reviews, volume 8, no.2 june-august 2005:52-61

5. Kirklin, Barratt Boyes, Ventricular Septal Defect and Pulmonary Stenosis or Atresia, Cardiac Surgery, Churchill Livingstone, 4th Edition, 2013, vol2, p 860-1011.

.Bài viếtTỨ CHỨNG FALLOT xuất hiện lần đầu tại website http://khamgiodau.com

[dontgiveupworld]

Real Story of Balaguru Is More Insiprational than the regular ‘rags to riches’ tales

Real Story of Balaguru Is More Insiprational than the regular ‘rags to riches’ tales

Never underestimate the power of a dream that is propelled by someone’s fire in the belly. It can work wonders, like it did in the life of Balaguru, whose surreal life story is the stuff that scriptwriters churn out in tinsel town.

As a 15-year-old, K Balaguru, son of a daily wage labourer, dreamt of becoming an IAS officer and he never allowed the dream to die, though he lived in a village, in…

[scitechman]

How Does the Ocean’s Saltiness Affect Tropical Storms?

How Does the Ocean’s Saltiness Affect Tropical Storms?

Pounding winds, rising water, flooded homes. While many of us have seen the images of hurricanes and other tropical storms on TV, both Karthik Balaguru and Greg Foltz experienced them in person. Although he now lives in Washington State, Balaguru faced them as a child in India as well as during his graduate work in Texas. Foltz lives in Miami, Florida, a place that’s no stranger to storms.

Both…