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Translation process research is almost four decades old. Translator cognition is one of the most complex translation research areas to study. This complexity stems mainly from the difficulties involved in collecting and analyzing translation process data. The Element reviews and discusses the developments in translation process research. Specifically, it highlights the key terms in translation process research, its data sources, the developments this area has witnessed in four decades, and the efforts made in modelling the translation process so far. The work also proposes a translation process model which shows the central role monitoring plays in managing other translation subprocesses and evaluating the information being processed. Based on the issues reviewed and discussed, it is concluded that translation process research is still maturing. Making further developments in this translation research area requires addressing some contextual and methodological gaps, and investigating particular neglected research dimensions.
The concept of digital psychiatry, encompassing technologies such as mental health apps, Virtual Reality (VR), Artificial Intelligence (AI), and telepsychiatry, emerges as a potential solution to bridge the existing gaps in the mental health system of Pakistan. However, one of the major barriers to the implementation of these technologies is hesitancy to adopt digital tools by psychiatrists.
Objectives
This study aims to explore the current understanding of digital psychiatry, the barriers faced by psychiatrists in its’ widespread implementation, and their willingness to adopt these services in clinical practice.
Methods
This cross-sectional study surveyed psychiatrists’ knowledge, attitudes, and practices on digital psychiatry from 39 public hospitals across Pakistan using an online validated questionnaire from January to July 2023. Participants included psychiatry residents, fellows, and consultants practicing in Pakistan. Responses were analyzed with Raosoft software, Quirkos, and SPSS 26 using thematic analysis and correlation.
Results
A total of 200 participants responded to the questionnaire, primarily in the age range of 20-30 years (56%). The gender distribution was 55% male (N = 111) and 45% female (N = 89). Among the professional roles, 23% were consultants, 7% were registrars, 54% were psychiatry residents, and 17% were medical officers. Respondents came from both rural (N = 148, 74%) and urban (N = 52, 26%) practice settings. Regarding telepsychiatry, 46% strongly agreed that they are familiar with telepsychiatry, while 58% agreed that telepsychiatry can save time and money. Additionally, 22% strongly agreed that it’s a viable approach for patient care. Concerning perspectives on Artificial Intelligence (AI) in digital psychiatry readiness, only 40% of participants had received AI training. However, 55% expressed interest in collaborating with international centers on AI-related projects. In terms of mental health apps, 62% of respondents reported limited familiarity with them. Nevertheless, 65% believed that these apps could potentially save time and money for psychiatric health systems. Lastly, concerning Virtual Reality (VR) in psychiatric care, 57% of participants were familiar with VR technology, but only 43% were acquainted with its applications in psychiatry. Notably, 71% did not view VR as a viable replacement for in-person psychiatric management.
Conclusions
This is the first study conducted on understanding digital psychiatry in Pakistan’s healthcare system, which revealed multiple challenges to digital health competency among psychiatrists. This emphasizes on the need for formal training and funding towards resources to overcome obstacles in utilizing mental health technologies.
Antimicrobial resistance (AMR) is a global priority with significant clinical and economic consequences. Multidrug-resistant (MDR) Pseudomonas aeruginosa is one of the major pathogens associated with significant morbidity and mortality. In healthcare settings, the evaluation of prevalence, microbiological characteristics, as well as mechanisms of resistance is of paramount importance to overcome associated challenges.
Methods:
Consecutive clinical specimens of P. aeruginosa were collected prospectively from 5 acute-care and specialized hospitals between October 2014 and September 2017, including microbiological, clinical characteristics and outcomes. Identification and antimicrobial susceptibility test were performed using the BD Phoenix identification and susceptibility testing system, matrix-assisted laser desorption ionization–time-of-flight mass spectrometry (MALDI-TOF MS), and minimum inhibitory concentration (MIC) test strips. Overall, 78 selected MDR P. aeruginosa isolates were processed for whole-genome sequencing (WGS).
Results:
The overall prevalence of MDR P. aeruginosa isolates was 5.9% (525 of 8,892) and showed a decreasing trend; 95% of cases were hospital acquired and 44.8% were from respiratory samples. MDR P. aeruginosa demonstrated >86% resistance to cefepime, ciprofloxacin, meropenem, and piperacillin-tazobactam but 97.5% susceptibility to colistin. WGS revealed 29 different sequence types: 20.5% ST235, 10.3% ST357, 7.7% ST389, and 7.7% ST1284. ST233 was associated with bloodstream infections and increased 30-day mortality. All ST389 isolates were obtained from patients with cystic fibrosis. Encoded exotoxin genes were detected in 96.2% of isolates.
Conclusions:
MDR P. aeruginosa isolated from clinical specimens from Qatar has significant resistance to most agents, with a decreasing trend that should be explored further. Genomic analysis revealed the dominance of 5 main clonal clusters associated with mortality and bloodstream infections. Microbiological and genomic monitoring of MDR P. aeruginosa has enhanced our understanding of AMR in Qatar.
Over the last 25 years, radiowave detection of neutrino-generated signals, using cold polar ice as the neutrino target, has emerged as perhaps the most promising technique for detection of extragalactic ultra-high energy neutrinos (corresponding to neutrino energies in excess of 0.01 Joules, or 1017 electron volts). During the summer of 2021 and in tandem with the initial deployment of the Radio Neutrino Observatory in Greenland (RNO-G), we conducted radioglaciological measurements at Summit Station, Greenland to refine our understanding of the ice target. We report the result of one such measurement, the radio-frequency electric field attenuation length $L_\alpha$. We find an approximately linear dependence of $L_\alpha$ on frequency with the best fit of the average field attenuation for the upper 1500 m of ice: $\langle L_\alpha \rangle = ( ( 1154 \pm 121) - ( 0.81 \pm 0.14) \, ( \nu /{\rm MHz}) ) \,{\rm m}$ for frequencies ν ∈ [145 − 350] MHz.
Online cognitive behaviour therapy (CBT), self-help and guided self-help (GSH) interventions have been found to be efficacious and cost-effective for treatment of anxiety and depression, but there are limited data from low- and middle-income countries on culturally adapted digital interventions for these common mental disorders. The aim of this study was to investigate the feasibility and acceptability of an online culturally adapted CBT-based guided self-help (CaCBT-GSH) for patients with anxiety and depression in Pakistan. This randomized controlled trial recruited 39 participants from primary care in Karachi, Pakistan and randomized them to two groups. The intervention group received seven modules of CaCBT-GSH plus treatment as usual (TAU) over 12 weeks. The control group was a waitlist control plus TAU. The primary outcomes were feasibility and acceptability. Clinical outcomes included results from the Hospital Anxiety and Depression Scale (HADS) and the WHO Disability Assessment Schedule 2 (WHODAS 2). Assessments were carried out at baseline and at 12 weeks. All 39 individuals who met eligibility criteria for the study agreed to participate. Adherence to the intervention was excellent, with 85% (17/20) completing more than five modules. Statistically significant improvements were found in all clinical outcomes in the intervention group. This was the first trial of an online CaCBT-GSH intervention, which was found to be feasible and acceptable to Pakistani patients with anxiety and depression. CaCBT-GSH may help improve symptoms, depression, anxiety and overall functioning in this population. The results provide rationale for a larger, confirmatory randomized controlled trial of digital CaCBT-GSH.
Key learning aims
(1) Leveraging digital and virtual platforms to deliver psychosocial interventions may contribute to addressing the significant treatment gap in low-resource settings.
(2) CBT-informed guided self-help is feasible and acceptable in the treatment of common mental disorders in Pakistan.
(3) The results of this study merit a larger, appropriately powered confirmatory randomized controlled trial to determine clinical and cost effectiveness.
Cognitive behaviour therapy (CBT), self-help and guided self-help interventions have been found to be efficacious and cost effective for victims of trauma, but there are limited data from low- and middle-income countries on culturally adapted interventions for trauma.
Aims:
To investigate the feasibility and acceptability of culturally adapted trauma-focused CBT-based guided self-help (CatCBT GSH) for female victims of domestic violence in Pakistan.
Method:
This randomized controlled trial (RCT) recruited 50 participants from shelter homes in Karachi and randomized them to two equal groups. The intervention group received GSH in nine sessions over 12 weeks. The control group was a waitlist control. The primary outcomes were feasibility and acceptability. Secondary outcomes included Impact of Event Scale-Revised (IES-R), Hospital Anxiety and Depression Scale (HADS) and the WHO Disability Assessment Schedule 2 (WHO DAS 2). Assessments were carried out at baseline and at 12 weeks.
Results:
Out of 60 clients who met DSM-5 criteria for post-traumatic stress disorder (PTSD), 56 (93.3%) agreed to participate in the study. Retention to the intervention group was excellent, with 92% (23/25) attending more than six sessions. Statistically significant differences were noted post-intervention in secondary outcomes in favour of the intervention.
Conclusions:
A trial of CatCBT GSH was feasible and the intervention was acceptable to Pakistani women who had experienced domestic violence. Furthermore, it may be helpful in improving symptoms of PTSD, depression, anxiety and overall functioning in this population. The results provide a rationale for a larger, confirmatory RCT of CatCBT GSH.
Tuberculosis (TB) is one of the top 10 leading causes of morbidity and mortality worldwide [1]. In 2017, approximately 10 million people were infected with TB and 1.3 million patients faced mortality [1]. Patients with active TB can infect up to 10–15 people over a year. There is a greater risk of transmission in overcrowded areas with limited air ventilation including large family units, prisons and slums [1, 2]. Without proper diagnosis and treatment, roughly 45% of non-HIV positive TB patients face mortality [1]. With the help of global organizations and national TB treatment and control programmes, the global incidence of TB is declining by approximately 2% each year [1]. The World Health Organization (WHO) TB-strategy aims to end the TB epidemic and encourages partners to fund national TB programmes to improve diagnosis and treatment of TB. The goal is to ultimately decrease death rates by 90% and decrease incidence rates by 80% [1]. To achieve these goals, the decline in TB incidence needs to reach approximately 4–5% per year [1]. The WHO 2018 TB report identified multidrug resistant TB (MDR-TB) as the leading factor hindering that goal [1]. The incidence and spread of MDR-TB has drastically increased, where approximately 558 000 new cases of MDR-TB were diagnosed in 2017 causing more than 230 000 deaths globally [1]. MDR-TB is identified by resistance to the two most powerful anti-TB treatment drugs including isoniazid and rifampicin [3]. Patients with MDR-TB are required to start second-line anti-TB drugs (SLDs), which are limited, expensive, less effective and more toxic [1,2]. Therapy duration is one of the major limitations of second-line treatments, which may require up to two years of consistent use. Since TB affects mostly developing countries, long treatment durations and associated costs become a major challenge. In 2015, 15% of new TB cases were reported as MDR-TB, which drastically increased to 24% by 2017 [1]. Even with significant improvements in molecular tests and diagnostic methods, MDR-TB is still on the rise where the success rate of treatments is between 50 and 60% [1]. Additional characteristics including socioeconomic and sociocultural factors need to be considered when targeting and treating patients with MDR-TB.
With the increasing recognition of the pedagogical applications of corpus linguistics, there has been a growing interest in developing teachers’ corpus literacy to popularize the use of corpora in language education. This longitudinal study investigated Arab Gulf EFL student teachers’ immediate and long-term responses to corpus literacy instruction. After teaching a corpus literacy component to two classes of student teachers in a graduate computer-assisted language learning course they attended, the author collected focus group data about their views on this instruction and their own expected future uses of corpora in language learning, teaching and research. Two years later, a group of these student teachers (n = 19) responded to a follow-up questionnaire exploring their beliefs about corpus literacy integration and their multiple uses of corpora. The student teachers reported very positive immediate and long-term perceptions of corpus literacy instruction, but it was found that such instruction has not brought about all the desired changes in their long-term uses of online corpora as a linguistic and pedagogical resource, or their attitudes towards doing corpus-based TESOL research. However, it is expected that the popularization benefits gained from corpus literacy integration could lead to better future developments in using corpora for language education and research purposes in the target context.
The Askaryan Radio Array (ARA) experiment at the South Pole is designed to detect high-energy neutrinos which, via in-ice interactions, produce coherent radiation at frequencies up to 1000 MHz. Characterization of ice birefringence, and its effect upon wave polarization, is proposed to enable range estimation to a neutrino interaction and hence aid in neutrino energy reconstruction. Using radio transmitter calibration sources, the ARA collaboration recently measured polarization-dependent time delay variations and reported significant time delays for trajectories perpendicular to ice flow, but not parallel. To explain these observations, and assess the capability for range estimation, we use fabric data from the SPICE ice core to model ice birefringence and construct a bounding radio propagation model that predicts polarization time delays. We compare the model with new data from December 2018 and demonstrate that the measurements are consistent with the prevailing horizontal crystallographic axis aligned near-perpendicular to ice flow. The study supports the notion that range estimation can be performed for near flow-perpendicular trajectories, although tighter constraints on fabric orientation are desirable for improving the accuracy of estimates.
Electroconvulsive therapy (ECT) has a long history in treating depression and its benefits are well known. Repetitive transcranial magnetic stimulation (rTMS) has been introduced more recently to the treatment spectrum.
Aims:
To test the equivalence of rTMS with ECT, and compare the neurocognitive side effects of both treatment modalities.
Methods:
This is a randomized comparative study, forty patients with major depressive disorder referred for ECT were randomly assigned to either a 20 session course of r TMS to the left dorsolateral prefrontal cortex or a standard course of ECT. The primary outcome measure was the score on the Hamilton Depression Rating Scale HAM-D. Secondary outcome measures were cognitive battery that assessed different aspects of cognitive functions and a subjective mood visual analogue scale. The cognitive battery comprised the Rey-Osterrieth complex figure test, the Trail making test A and B, the Digit span subtest from the Wechsler Adult Intelligence Scale.
Results:
ECT was more effective than rTMS in the short-term treatment of major depressive disorder as evident by HAM-D scores. rTMS was well tolerated with less impact on the cognitive functions compared to ECT. Level of improvement by ECT was correlated with older age, and severe baseline HAM-D symptoms, while the level of improvement by rTMS was correlated with more memory affection at the end of treatment.
Conclusions:
ECT was more effective than rTMS in the short-term treatment of major depressive disorder regarding the overall mood symptoms. rTMS was well tolerated with less impact on the cognitive functions.
Origanum vulgare is a natural, less toxic, residue free feed supplement for poultry when compared to other synthetic ingredients. It contains key bioactive components, including as thymol and carvacrol. O. vulgare as a poultry feed supplement has had an antimicrobial, antioxidant, antiviral, immunomodulatory and antiparasitic effect. The potential advantages of utilising oregano extracts, in poultry diets include improved feed intake and feed conversion, enhanced digestion, expanded productive performance, down-regulated disease incidence and economic losses. From the available literature, average inclusions of oregano essential oil up to 600 mg/kg in broiler diets increased body weight gain. Using 1% oregano oil in broiler diets improved feed conversion ratio and feed utilisation. Moreover, oregano can induce a marked improvement on the intestinal microbiota and ileal villus height of broilers when combine with attapulgite by ratio 15 mg/kg of oregano. Broilers fed 300 ppm oregano oil in their diet display higher IgG titres relative to those reared on control (without supplementation) diet. Including 240 mg oregano supplementation per kg diet appears to give an optimum level for protecting broiler chickens from C. perfringens infections. Bioactive components extracted from O. vulgare parts could be used in poultry diets levels of 10 to 30 g/kg. This review includes information on the use of O. vulgare and its derivatives in poultry nutrition. To maximise the overall productivity of poultry, oregano may be used as a natural alternative to antibiotics and drugs due to the absence of side effects and residues.
Pigeon pea (PP), Cajanus cajan, is a plant that is cultivated for human food and animal feed. It exists as a wide range of cultivars, and their flexibility for use in animal rearing systems have made PP popular, especially for small-scale farmers. PP is grown widely in India and in parts of Africa and Central America. The main producers of PP in the world are India, Uganda, Tanzania, Kenya, Malawi, Ethiopia, Mozambique, the Dominican Republic, Puerto Rico, the West Indies in the Caribbean and Latin America region, Indonesia and the Philippines and Australia. Analysis has shown that PP contains 17.9-24.3% crude protein (CP) in whole grain, and 21.1-28.1% in split seeds, and high protein genotypes contain 32.5%. Optimal levels of utilisation have been shown to improve broiler performance and may reduce daily feed cost. However, PP contains anti-nutritional factors that negatively affect feed efficiency. The use of processing methods such as fermentation, boiling, milling, soaking, and roasting can minimise any harmful effects and improve its nutritive quality, positively enhancing performance parameters. Studies on the use of PP suggested that it can be included at 7.5% of the diet or as 50% substitution for soybean meal in broiler diets.
The potential therapeutic value of Moringa oleifera extract (MOE), due to its anti-inflammatory and anti-oxidant effects, has been reported previously. In this study, Hymenolepis nana antigen (HNA) in combination with MOE was used in immunization against H. nana infection. Adult worm and egg counts were taken, while histological changes in the intestine were observed. Mucosal mast (MMCs) and goblet cells (GCs) were stained with specific stains, while serum and intestinal IgA were assayed using enzyme-linked immunosorbent assay (ELISA). Reduced glutathione (GSH) and lipid peroxidation (thiobarbituric acid reactive substances, TBARS) were assayed. Real-time polymerase chain reaction (PCR) was used for detection of mRNA expression in ileum tissue. The results demonstrated an improvement in the architecture of intestinal villi, decreased inducible nitric oxide synthase (iNOs) and TBARS, and increased GSH in HNA, MOE and MOE + HNA groups. In the same groups, an increase in GCs, mucin 2 (MUC2), interleukins (IL)-4, -5 and -9, and stem cell factor (SCF) versus a decrease in both interferon-gamma (IFN-γ) and transforming growth factor (TGF-β) expression appeared. HNA and MOE + HNA increased serum and intestinal IgA, respectively. MOE decreased MMCs and achieved the highest reductions in both adult worms and eggs. In conclusion, MOE could achieve protection against H. nana infections through decreased TGF-β, IFN-γ and MMC counts versus increased GC counts, T-helper cell type 2 (Th2) cytokines and IgA level.
Linked administrative population data were used to estimate the burden of childhood respiratory syncytial virus (RSV) hospitalization in an Australian cohort aged <5 years. RSV-coded hospitalizations data were extracted for all children aged <5 years born in New South Wales (NSW), Australia between 2001 and 2010. Incidence was calculated as the total number of new episodes of RSV hospitalization divided by the child-years at risk. Mean cost per episode of RSV hospitalization was estimated using public hospital cost weights. The cohort comprised of 870 314 children. The population-based incidence/1000 child-years of RSV hospitalization for children aged <5 years was 4·9 with a rate of 25·6 in children aged <3 months. The incidence of RSV hospitalization (per 1000 child-years) was 11·0 for Indigenous children, 81·5 for children with bronchopulmonary dysplasia (BPD), 10·2 for preterm children with gestational age (GA) 32–36 weeks, 27·0 for children with GA 28–31 weeks, 39·0 for children with GA <28 weeks and 6·7 for term children with low birthweight. RSV hospitalization was associated with an average annual cost of more than AUD 9 million in NSW. RSV was associated with a substantial burden of childhood hospitalization specifically in children aged <3 months and in Indigenous children and children born preterm or with BPD.
To determine whether implementation of a multifaceted intervention would significantly reduce the incidence of central line–associated bloodstream infections.
DESIGN
Prospective cohort collaborative.
SETTING AND PARTICIPANTS
Intensive care units of the Abu Dhabi Health Services Company hospitals in the Emirate of Abu Dhabi.
INTERVENTIONS
A bundled intervention consisting of 3 components was implemented as part of the program. It consisted of a multifaceted approach that targeted clinician use of evidence-based infection prevention recommendations, tools that supported the identification of local barriers to these practices, and implementation ideas to help ensure patients received the practices. Comprehensive unit-based safety teams were created to improve safety culture and teamwork. Finally, the measurement and feedback of monthly infection rate data to safety teams, senior leaders, and staff in participating intensive care units was encouraged. The main outcome measure was the quarterly rate of central line–associated bloodstream infections.
RESULTS
Eighteen intensive care units from 7 hospitals in Abu Dhabi implemented the program and achieved an overall 38% reduction in their central line–associated bloodstream infection rate, adjusted at the hospital and unit level. The number of units with a quarterly central line–associated bloodstream infection rate of less than 1 infection per 1,000 catheter-days increased by almost 40% between the baseline and postintervention periods.
CONCLUSION
A significant reduction in the global morbidity and mortality associated with central line–associated bloodstream infections is possible across intensive care units in disparate settings using a multifaceted intervention.
Infect. Control Hosp. Epidemiol. 2015;36(7):816–822
Let $G$ be a finite group and $H$, $K$ two subgroups of $G$. A group $G$ is said to be a mutually $m$-permutable product of $H$ and $K$ if $G\,=\,HK$ and every maximal subgroup of $H$ permutes with $K$ and every maximal subgroup of $K$ permutes with $H$. In this paper, we investigate the structure of a finite group that is a mutually $m$-permutable product of two subgroups under the assumption that its maximal subgroups are totally smooth.
Strict control measures apply to movement of buffalo in South Africa including testing for Theileria parva, the causative agent of Corridor disease in cattle. The official test is a real-time hybridization PCR assay that amplifies the 18S rRNA V4 hyper-variable region of T. parva, T. sp. (buffalo) and T. sp. (bougasvlei). Mixed infections with the latter organisms affect diagnostic sensitivity due to PCR suppression. While the incidence of mixed infections in the Corridor disease endemic region of South Africa is significant, little information is available on the specific distribution and prevalence of T. sp. (buffalo) and T. sp. (bougasvlei). Specific real-time PCR assays were developed and a total of 1211 samples known to harbour these parasites were screened. Both parasites are widely distributed in southern Africa and the incidence of mixed infections with T. parva within the endemic region is similar (∼25–50%). However, a significant discrepancy exists in regard to mixed infections of T. sp. (buffalo) and T. sp. (bougasvlei) (∼10%). Evidence for speciation between T. sp. (buffalo) and T. sp. (bougasvlei) is supported by phylogenetic analysis of the COI gene, and their designation as different species. This suggests mutual exclusion of parasites and the possibility of hybrid sterility in cases of mixed infections.
A growing trend for nutraceutical and gluten-free cereal-based products highlights the need for development of new products. Buckwheat is one of the potential candidates for such products and the present paper reviews the functional and nutraceutical compounds present in common buckwheat (Fagopyrum esculentum) and tartary buckwheat (Fagopyrum tataricum). The vital functional substances in buckwheat are flavonoids, phytosterols, fagopyrins, fagopyritols, phenolic compounds, resistant starch, dietary fibre, lignans, vitamins, minerals and antioxidants, which make it a highly active biological pseudocereal. Cholesterol-lowering effects that lessen the problems of constipation and obesity are important health benefits that can be achieved through the functional substances of buckwheat.
To highlight a rare cause of Horner's syndrome, and to review the management of blunt carotid artery injury.
Method:
Literature search via PubMed for related articles.
Results:
Horner's syndrome and blunt carotid artery injury are rare phenomena; sexual asphyxia as a cause has not previously been reported. This case is also the first of its kind to have radiological evidence of injury to the external carotid artery but not the internal carotid artery. In Horner's syndrome, additional symptoms of ipsilateral headache or neck pain, tinnitus, or any cerebral ischaemic symptoms should raise suspicion of blunt carotid injury.
Conclusion:
Blunt carotid artery injury is a potentially fatal condition and can present without radiological evidence. Early recognition and management with anticoagulants or antiplatelet drugs is crucial to prevent mortality and morbidity.