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Storm Daniel struck northeastern Libya on September 10, 2023, causing severe infrastructure damage and significant human loss. Derna was the most affected city, with the University of Derna suffering extensive damage and the tragic loss of 37 medical students. Medical students face unique psychological and academic stressors, and tend to have higher rates of psychiatric disorders compared to their peers of the same age. This is the first study to investigate the storm’s psychological impact on medical students at the University of Derna. The study has a cross-sectional design and lasted from February 1 to March 1, 2024. We used the Generalized Anxiety Disorder-7 (GAD-7) to assess anxiety and the Patient Health Questionnaire-9 (PHQ-9) to assess depression, along with sociodemographic questions in our questionnaire. We included only active students enrolled in the 7-year undergraduate program at the University of Derna. Statistical tests such as the chi-square test and binary logistic regression were used in the analysis. About 225 students completed the survey. The means and standard deviations for GAD-7 and PHQ-9 scores were 9.2 (3.9) and 10.8 (5.0), respectively. The prevalence of anxiety was 42.2% for cases classified as moderate and severe (cut-off ≥10). Depression had a prevalence of 51.1% for cases classified as moderate, moderately severe and severe (cut-off ≥ 10). Suicidal ideation was reported at a rate of 48.9% for “several days” or more and at 16.5% for “more than half of the days” and “nearly every day.” Internal displacement following the storm was significantly associated with both anxiety (p = 0.033) and depression (p = 0.003). However, age, gender, year of study, monthly allowance and residence status (living with family or alone) did not show a statistically significant association with either anxiety or depression (p > 0.05 for all variables). Logistic regression analysis identified gender as the only significant predictor of anxiety (p = 0.041) and internal displacement as the sole significant predictor of depression (p = 0.023). Medical students at the University of Derna reported high rates of anxiety, depression and suicidal ideation following Storm Daniel. Internal displacement was significantly associated with both anxiety and depression. These results highlight the need for targeted interventions to address medical students’ mental health challenges and improve their overall well-being.
High-precision pulsar timing observations are limited in their accuracy by the jitter noise that appears in the arrival time of pulses. Therefore, it is important to systematically characterise the amplitude of the jitter noise and its variation with frequency. In this paper, we provide jitter measurements from low-frequency wideband observations of PSR J0437$-$4715 using data obtained as part of the Indian Pulsar Timing Array experiment. We were able to detect jitter in both the 300–500 MHz and 1 260–1 460 MHz observations of the upgraded Giant Metrewave Radio Telescope (uGMRT). The former is the first jitter measurement for this pulsar below 700 MHz, and the latter is in good agreement with results from previous studies. In addition, at 300–500 MHz, we investigated the frequency dependence of the jitter by calculating the jitter for each sub-banded arrival time of pulses. We found that the jitter amplitude increases with frequency. This trend is opposite as compared to previous studies, indicating that there is a turnover at intermediate frequencies. It will be possible to investigate this in more detail with uGMRT observations at 550–750 MHz and future high-sensitive wideband observations from next generation telescopes, such as the Square Kilometre Array. We also explored the effect of jitter on the high precision dispersion measure (DM) measurements derived from short duration observations. We find that even though the DM precision will be better at lower frequencies due to the smaller amplitude of jitter noise, it will limit the DM precision for high signal-to-noise observations, which are of short durations. This limitation can be overcome by integrating for a long enough duration optimised for a given pulsar.
Twenty-nine exotic common bean germplasms and three elite cultivars were examined for phenotypic diversity in two bean-producing environments (Kanpur and Shimla) across three winter seasons and one rainy season. The estimate of genetic variability parameters revealed that the exotic bean germplasm has enough diversity for all the evaluated features. The highest genotypic and phenotypic coefficients of variation were found in seed yield, followed by 100-seed weight, pods per plant and pod length. Furthermore, seed yield was the most heritable and genetically advanced quantitative feature, followed by 100-seed weight, pod length and pods per plant. According to a trait association study, the days to maturity of phenological traits have a strong positive correlation with the days to initial flowering and the days to 50% flowering. Pods per plant and seeds per pod most strongly influence increased grain yield. The first two principal components accounted for 63.3% of the variation and demonstrated significant diversity among exotic bean lines for the traits studied, according to the principal component analysis. According to the hierarchical clustering analysis, 29 accessions and three cultivars were divided into three groups. Cluster I contains early flowering and maturing accessions, while cluster III contains high pods per plant and an increased grain yield of germplasms. The fundamental source of phenological fluctuations in both environmental circumstances is temperature. This study found four genetically divergent and stable performance accessions, including EC932021, EC932189 (earliness), and EC931452, EC931971 (high grain yield), which may aid in the establishment of a bean breeding programme.
We present the pulse arrival times and high-precision dispersion measure estimates for 14 millisecond pulsars observed simultaneously in the 300$-$500 MHz and 1260$-$1460 MHz frequency bands using the upgraded Giant Metrewave Radio Telescope. The data spans over a baseline of 3.5 years (2018-2021), and is the first official data release made available by the Indian Pulsar Timing Array collaboration. This data release presents a unique opportunity for investigating the interstellar medium effects at low radio frequencies and their impact on the timing precision of pulsar timing array experiments. In addition to the dispersion measure time series and pulse arrival times obtained using both narrowband and wideband timing techniques, we also present the dispersion measure structure function analysis for selected pulsars. Our ongoing investigations regarding the frequency dependence of dispersion measures have been discussed. Based on the preliminary analysis for five millisecond pulsars, we do not find any conclusive evidence of chromaticity in dispersion measures. Data from regular simultaneous two-frequency observations are presented for the first time in this work. This distinctive feature leads us to the highest precision dispersion measure estimates obtained so far for a subset of our sample. Simultaneous multi-band upgraded Giant Metrewave Radio Telescope observations in 300$-$500 MHz and 1260$-$1460 MHz are crucial for high-precision dispersion measure estimation and for the prospect of expanding the overall frequency coverage upon the combination of data from the various Pulsar Timing Array consortia in the near future. Parts of the data presented in this work are expected to be incorporated into the upcoming third data release of the International Pulsar Timing Array.
This study aims to assess the knowledge, attitude and practice of primary care physicians (PCPs) in Lebanon regarding nutrition counseling and to investigate possible related barriers.
Background
Nutrition counseling is an important aspect of patient care, especially with the increase in nutrition-related disorders.
Methods
This is a descriptive study among a convenience sample of PCPs in Lebanon at two annual conferences in 2014 using an anonymous questionnaire.
Findings
Response rate was 54.6%. Overall, physicians considered that they have good to very good nutritional knowledge. Although they rated their formal nutritional education poorly, they had a positive attitude towards nutritional counseling and reported practicing general nutritional counseling with their patients. Barriers to nutritional counseling were: time, perceived poor patient adherence to diet, gap in physician’s nutritional knowledge and lack of insurance coverage for dietitian fees. Changes should be made to medical education curricula to include nutrition courses related to prevalent health problems.
The identities of two novel perennial nutsedge biotypes collected near Bakersfield, CA, were assessed using isozyme and random-amplified polymorphic deoxyribonucleic acid markers in conjunction with morphological analysis. The two biotypes, designated as CK (Cyperus rotundus cv. ‘Kempeni’) and CR (Cyperus esculentus cv. ‘Robusta’), morphologically resemble purple nutsedge and yellow nutsedge, respectively. Plants from both biotypes exhibited more prolific growth than the typical forms and possessed some traits that are not characteristic of the species they resemble. The morphological study was conducted on a total of 15 purple nutsedge, yellow nutsedge, CK, and CR populations collected in the first year and on 20 additional nutsedge populations were collected in the second year. The genetic analysis was performed on populations from the first year only. In general, there was agreement among the results obtained from the morphometric, isozymatic, and deoxyribonucleic acid studies. Populations of CR clustered with yellow nutsedge populations, indicating that CR is within the normal range of variation of this species and may represent a new introduction. Populations of CK, however, were distinct from both purple nutsedge and yellow nutsedge populations. Considering the low level of genetic variation reported in purple nutsedge and its strict vegetative mode of reproduction, CK might represent a sexually reproducing ecotype of purple nutsedge or a hybrid with yellow nutsedge.
Explanatum explanatum flukes, liver amphistomes of ruminants, cause significant economic loss in the livestock industry by inducing severe liver damage. A total of 66 flukes from 26 buffaloes and 7 cattle in four different geographic areas of Bangladesh and 20 flukes from 10 buffaloes in the Chitwan district of Nepal were subjected for analysis. The sequences (442 bp) of the second internal transcribed spacer (ITS2) of ribosomal DNA and the variable fragments (657 bp) of mitochondrial nicotinamide dehydrogenase subunit 1 (nad1) of E. explanatum flukes from Bangladesh and Nepal were analysed. The aim of this study was molecular characterization of the flukes and to elucidate their origin and biogeography. In the ITS2 region, two genotypes were detected among the flukes from Bangladesh, while flukes from Nepal were of only one genotype. Phylogenetic analyses inferred from the nad1 gene revealed that at least four divergent populations (groups I–IV) are distributed in Bangladesh, whereas two divergent populations were found to be distributed in Nepal. Fst values (pairwise fixation index) suggest that Bangladeshi and Nepalese populations of group I to IV are significantly different from each other; but within groups III and IV, the populations from Bangladesh and Nepal were genetically close. This divergence in the nad1 gene indicates that each lineage of E. explanatum from diverse geography was co-adapted during the multiple domestication events of ruminants. This study, for the first time, provides molecular characterization of E. explanatum in Bangladesh and Nepal, and may provide useful information for elucidating its origin and dispersal route in Asia.
The present study aims to identify the role of inflammatory markers such as C-reactive protein, interleukin-6, and fractalkine in CHD-associated pulmonary hypertension in children.
Methods
This is a prospective review of 37 children with CHD-related pulmonary hypertension, 21 children with congenital heart defects, and 22 healthy children.
Results
Serum C-reactive protein and interleukin-6 levels were significantly higher in the children with CHD-related pulmonary hypertension (respectively, p=0.049 and 0.026). Serum C-reactive protein concentrations correlated negatively with ejection fraction (r=−0.609, p=0.001) and fractional shortening (r=−0.452, p=0.007) in the pulmonary hypertension group. Serum fractalkine concentrations correlated negatively with ejection fraction (r=−0.522, p=0.002) and fractional shortening (r=−0.395, p=0.021) in the children with pulmonary hypertension. Serum interleukin-6 concentrations also correlated negatively with Qs (r=−0.572, p=0.021), positively with Rs (r=0.774, p=0.001), and positively with pulmonary wedge pressure (r=0.796, p=0.006) in the pulmonary hypertension group. A cut-off value of 2.2 IU/L for C-reactive protein was able to predict pulmonary hypertension with 77.5% sensitivity and 77.5% specificity. When the cut-off point for interleukin-6 concentration was 57.5 pg/ml, pulmonary hypertension could be predicted with 80% sensitivity and 75% specificity.
Conclusion
Inflammation is associated with the pathophysiology of pulmonary hypertension. The inflammatory markers C-reactive protein and interleukin-6 may have a role in the clinical evaluation of paediatric pulmonary hypertension related to CHDs.
Pneumonia is a leading cause of death among children less than five years old during humanitarian emergencies. Haemophilus influenzae type b (Hib) and Streptococcus pneumoniae are the leading causes of bacterial pneumonia. Vaccines for both of these pathogens are available to prevent pneumonia.
Problem
This study describes an economic analysis from a publicly funded health care system perspective performed on a birth cohort in Somalia, a country that has experienced a protracted humanitarian emergency.
Methods
An impact and cost-effectiveness analysis was performed comparing: no vaccine, Hib vaccine only, pneumococcal conjugate vaccine 10 (PCV10) only, and both together administered through supplemental immunization activities (SIAs). The main summary measure was the incremental cost per disability-adjusted life-years (DALYs) averted. One-way sensitivity analysis was conducted for uncertainty in parameter values.
Results
Each SIA would avert a substantial number of cases and deaths. Compared with no vaccine, the DALYs averted by two SIAs for two doses of Hib vaccine was US $202.93 (lower and upper limits: $121.80-$623.52), two doses of PCV10 was US $161.51 ($107.24-$227.21), and two doses of both vaccines was US $152.42 ($101.20-$214.42). Variables that influenced the cost-effectiveness for each strategy most substantially were vaccine effectiveness, case fatality rates (CFRs), and disease burden.
Conclusions
The World Health Organization (WHO) defines a cost-effective intervention as costing one to three times the per capita gross domestic product (GDP; in 2011, for Somalia=US $112). Based on the presented model, Hib vaccine alone, PCV10 alone, or Hib vaccine and PCV10 given together in SIAs are cost-effective interventions in Somalia. The WHO/Strategic Advisory Group of Experts decision-making factors for vaccine deployment appear to have all been met: the disease burden is large, the vaccine-related risk is low, prevention in this setting is more feasible than treatment, the vaccine duration probably is sufficient for the vulnerable period of the child’s life, cost is reasonable, and herd immunity is possible.
GarganoLM, HajjehR, CooksonST. Pneumonia Prevention during a Humanitarian Emergency: Cost-effectiveness of Haemophilus Influenzae Type B Conjugate Vaccine and Pneumococcal Conjugate Vaccine in Somalia. Prehosp Disaster Med. 2015;30(4):110.
The present study describes the activity of a nanomaterial on protoscoleces of Echinococcus granulosus, which exhibited morphological changes and apoptosis. Apoptotic changes were deduced on the basis of effector caspase activation and nucleosomal laddering. Invaginated protoscoleces maintained in vitro became evaginated and had hooks, presumptive suckers and stalks. Degenerative changes of protoscoleces were evidenced after treatment with praziquantel and nano-combination. Protoscoleces treated with praziquantel had distinct attestation of necrosis and nano-combination-treated protoscoleces had signatures of apoptosis.
This study evaluated the existence of different genotypes of Haemonchus contortus prevailing among goats in West Bengal, India. These parasites were isolated from the abomasum of goat intestine and the molecular characterization was performed by comparing variation of nucleotide sequences of the internal transcribed spacer 1 (ITS-1) gene region. Single-strand conformation polymorphism (SSCP) analysis of ITS-1 amplified product showed the presence of three distinct conformations both in male and female parasites. The sequence analysis of conformations showed two single nucleotide polymorphisms (SNP) in male parasites at nucleotide positions 106 and 107 and one SNP was detected in female parasites at nucleotide position 157. These nucleotide variations in different isolates did not alter the interior loop structure of the predicted secondary RNA, therefore we believe these variations may not be responsible for any evolutionary changes among conformations.
Cystic echinococcosis (CE) caused by the larval stage of Echinococcus granulosus is a disease that affects both humans and animals. In humans the disease is treated by surgery with a supplementary option of chemotherapy with a benzimidazole compound. During the present study heat-shock protein 60 (HSP 60) was identified as one of the most frequently expressed biomolecules by E. granulosus after albendazole treatment. Data were correlated with 14-3-3 protein signature, and overexpression of this molecule after albendazole induction was an indicator of cell survival and signal transduction during in vitro maintenance of E. granulosus for up to 72 h. This observation was further correlated with a uniform expression pattern of a housekeeping gene (actin II). Out of three β-tubulin gene isoforms of E. granulosus, β-tubulin gene isoform 2 showed a conserved point mutation indicative of benzimidazole resistance.
Natural disasters are complex events that challenge the coping abilities of individuals and communities (Alexander, 2005). They are characterised by substantial loss, physical injury and economic hardship, as well as by extensive internal displacement and damage to the infrastructure, as exemplified by the Pakistan Kashmir earthquake of 8 October 2005. Measuring 7.6 on the Richter scale, it affected an area of 30000 square miles and a population of 3.6 million. Approximately 90000 were killed, 200000 were injured and 3.5 million were left homeless (Khan, 2006). Based on a literature review and estimates from the World Health Organization (WHO), the National Plan of Action for Mental Health and Psychosocial Relief of Earthquake Survivors anticipated high levels of trauma-related psychopathology (Rana et al, 2006).
To assess rates of initiation of breast-feeding and exclusive breast-feeding within 2 months after delivery and to determine the factors influencing exclusive breast-feeding.
Design
A health worker-administered questionnaire survey was carried out during the time period 1 August–30 September 2005.
Setting
Immunisation clinics of Pokhara, a submetropolitan city in western Nepal.
Subjects
Three hundred and eighty-five mothers who had delivered a child within the previous 2 months.
Results
The rates of initiation within 1 h and within 24 h of delivery were 72.7 and 84.4%, respectively. Within 2 months after delivery, exclusive breast-feeding was practised by 82.3% of the mothers. Breast milk/colostrum was given as the first feed to 332 (86.2%) babies but 17.2% of them were either given expressed breast milk or were put to the breast of another lactating mother. Pre-lacteal feeds were given to 14% of the babies. The common pre-lacteal feeds given were formula feeds (6.2%), sugar water (5.9%) and cow's milk (2.8%). Complementary feeds were introduced by 12.7% of the mothers. By logistic regression analysis, friends' feeding practices, type of delivery and baby's first feed were the factors influencing exclusive breast-feeding practice of the mothers.
Conclusions
Despite the higher rates of initiation and exclusive breast-feeding, practices such as pre-lacteal feeds and premature introduction of complementary feeds are of great concern in this urban population. There is a need for promotion of good breast-feeding practices among expectant mothers and also the community, especially the families, taking into account the local traditions and customs.
Temperature dependant I-V characteristics were measured on single-crystalline Si (c-Si) TFTs fabricated inside a location-controlled grain by [.proportional]-Czochralski process using an excimer-laser. At ON-state, temperature the activation energy (Ea) of the drain current drops to a negative value. The field effect mobility ([.proportional]FE) also decreases with temperature with a power of -1.86, which indicates that, the carriers transport are governed by acoustic phonon scattering. At OFF state with a small gate bias, leakage current is dominated by thermal generation, however the Ea was 0.9eV, i.e., near the band gap value of Si. This suggests that the carrier generation centers are not located at the mid-gap states. These distinctive results from a typical poly-Si TFTs are systematically investigated for c-Si TFTs having ECR- PECVD and LPCVD SiO2 gate insulator.