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Older adults are rarely consulted on health care restructuring. To address this gap, our study explored older adults’ views on “repositioning”, a restructuring initiative to support independent living for older adults with complex chronic disease (CCD). We collected and analysed data from 83 older adults living in one small city and nine rural small towns where “repositioning” of primary and community care was occurring. Average participant age was 75 years; 56 (67%) were women, 44 (53%) had CCD, and 20 (24%) identified as Indigenous or South Asian. The four themes were: unfamiliarity with repositioning; optimism versus skepticism; improving primary and community care (through better home care, improved transportation, and more doctors); and, playing an active role to effect change. For repositioning to be successful, diverse service users must be fully included; rural-dwelling older adults’ priorities for primary and community care need to be addressed, rather than using a “cookie-cutter” approach.
Stripe rust caused by Puccinia striiformis f. sp. tritici (Pst), is a devastating fungal disease of wheat (Triticum aestivum L.). The best economical technique for disease control is breeding for genetic resistance to stripe rust. To find resistance genes in landrace PI388222 from Pakistan, a segregating population was developed by a cross between PI388222 and susceptible Australian spring wheat line Avocet ‘S’. The F2:4 seeds were harvested and seeds were planted in the greenhouse of Washington State University Pullman, to grow F4:5 recombinant inbred lines (RIL). A variable set of seedling reactions were noted when a set of 136 F5 and parental lines were screened with four Puccinia striiformis f. sp. tritici races (PSTv-37, PSTv-40, PSTv-4 and PSTv-51). The great proportion of RILs showed resistant reaction displayed by the RILs was against PSTv-40, for which 85% of the RILs showed resistant reaction, while less resistance to the race PSTv-37 was detected against which the resistance was for only 49% of the RILs. The RIL population was further evaluated at two locations; Palouse Conservation Field Station (PCFS) and Mount Vernon (MV). In MV field, 76% of RILs displayed resistant reaction while 15% of RILs exhibited moderate reaction. About 53% of RILs exhibited resistant reaction to four P. tritici races that were used in glasshouse screening and they were also resistant in field environments at PCFS and MV. This study demonstrates that landrace comprises partial resistance in the range of resistant to moderately resistant lines.
Fire is one of the most magical elements in existence. It is everywhere: in the sky and on the ground, in hearts and in minds, inside and out, in water, in the air and in the soil … It is both divine and demonic. It is between light and dark. It is the source of both life and death. It is a clash. A clash that gave rise to our existence and, simultaneously, the creation of an error.
Soiling can lead to severe performance losses of photovoltaic (PV) plants. Within this study, three different anti-soiling coatings (ASC) were applied to three different commercial, solar-grade rolled glasses with different surface structures. Laboratory soiling experiments were performed including wind simulation and a novel rotational force test to assess the influence of different surface structures of the glass substrate on the anti-soiling performance of the coatings. A detailed microscopic evaluation indicates a consistent ranking of the ASC with regard to particle resuspension behavior for both test methods and all substrates. Furthermore, the rotational force test yields a quantitative measure of the median force needed for particle removal from the respective coating, which is independent of the glass substrate surface morphology.
Inadequate public transportation was recognized as a barrier to social participation, especially for older adults in rural communities and with mobility issues. Older adults will not benefit from opportunities to engage with their community and maintain social networks if they are unable to access them. The purpose of this scoping review was to make recommendations for further research and to summarize areas for improvement identified in the literature that will aid in the development of public transportation initiatives that can better address social isolation for older adults (≥ 55 years of age). Nineteen articles met the inclusion criteria, identifying themes of access to rural public transportation, issues with public transportation, and mobility. In practice, older adults need to prepare for driving cessation and mobility transitions; sound policy requires input to tailor transportation initiatives to an aging population, and future research should explore older adults’ transportation needs and potential solutions in urban and rural communities.
We conceptualize that psychosocial safety climate (PSC) has a positive effect on employees' safety behavior by reducing their psychological distress. A high-level PSC environment reduces psychological distress by eliminating the employees' need for devoting psychological resources toward safety concerns. This preserves psychological resources to be invested in important behaviors i.e., safety compliance and participation. Data were collected from 190 production workers in the oil and gas industry across three states of Malaysia. Results showed strong support for our hypotheses. PSC was negatively linked with psychological distress. Psychological distress predicted safety compliance and participation and mediated the relationship between PSC and safety compliance/participation. Results suggest that in order to improve safety compliance and participation, management in safety-sensitive industries should pay attention to psychosocial factors in the work environment. The implications of these results for safety interventions and further research are discussed.
Men make their own history, but they do not make it as they please; they do not make it under self-selected circumstances, but under circumstances existing already, given and transmitted from the past.
– Karl Marx, The Eighteenth Brumaire of Louis Bonaparte (New York: Die Revolution, 1852)
Sir Sayyid considered both Hindus and Muslims as one qaum (nation) – arguing that qaum should be used to describe the inhabitants of India even if they have individual characteristics. Explaining further, he wrote, ‘By the word qaum I mean both Hindus and Muslims. That is the way in which I define the word nation (nation).’ This is in contrast to his opinion on the Hindi–Urdu debate and the participation of Muslims in the programmes of the Indian National Congress (INC). To understand the rationale underlying the positions of Sir Sayyid, situating his ideas in the context of the developments of his times is essential.
This chapter aims to understand Sir Sayyid's political thought by examining how Sir Sayyid responded to the political concerns of his times and contributed to a broader conversation about society, democracy, and political participation. The attempt is to investigate his ideas on two important issues: his response to the Hindi–Urdu controversy and his position regarding the INC.
The first part of this chapter discusses the Hindi–Urdu controversy. Through the Hindi movement, we discover an important facet of the growth of Hindu nationalism in north India and see how the Hindi movement was successful in differentiating Hindi from Urdu and making Hindi a symbol of the Hindu culture. It also shows how people like Sir Sayyid had practically no option but to oppose this movement.
The second part addresses the political participation of the Muslims of India. Sir Sayyid regarded the INC as a step towards the creation of a more advanced ‘nation’ of Bengali specifically, not of Hindus in general. Like many others, he considers this a consequence of the asymmetrical impact of colonial policies in different parts of India, which resulted in a significant section of Hindu and Muslim middle classes – including many zamindars and taluqdars – coming together to oppose the INC. Only a short time before this, many of these protesters had been standing against each other on the Hindi–Urdu issue.
In Pakistan, oral cancer ranks as the most common malignancy in males and the second most common malignancy in females. Cyclooxygenase-2 has been explored as an agent of carcinogenesis in oral and other neoplasms. This study aimed to observe the expression of cyclooxygenase-2 in oral squamous cell carcinoma, and to correlate the expression with patients’ clinical features and overall and disease-free survival.
Immunohistochemistry for cyclooxygenase-2 was performed on a total of 100 oral squamous cell carcinoma formalin-fixed, paraffin-embedded blocks. Expression was correlated with patients’ clinicopathological variables and overall and disease-free survival.
Cyclooxygenase-2 was overexpressed in 55 per cent of oral squamous cell carcinoma patients. Overexpression was correlated with overall survival (p = 0.013) and disease-free survival (p = 0.001) on univariate analysis. However, on multivariate analysis, cyclooxygenase-2 was associated with only disease-free survival (p = 0.044) and not overall survival (p = 0.208).
Expression of cyclooxygenase-2 is associated with poorer overall survival and higher rates of recurrence in oral squamous cell carcinoma patients.
Ultra deep desulfurization of liquid fuels such as gasoline/diesel has attracted considerable attention of modern clean fuel research due to strict environmental regulations. Apart from that, SOx produced during combustion, poison the catalytic converter and exhaust emission system. Comparing to conventional catalytic and hydrodesulfurization techniques, adsorptive method for removal of sulfur bearing compounds e.g. thiophene derivatives is a promising approach which does not require hydrogen gas and high temperature. In this study, we used nickel sulfide nanoparticles incorporated poly(methyl methacrylate)-zirconia membranes as potential affinity material for adsorptive extraction of dibenzothiophene from n-hexane. The functionality and surface morphology of synthesized material was examined by Fourier transformation infrared (FTIR) spectroscopy and atomic force microscopy (AFM) images, respectively. The quantitative data regarding adsorptive removal of dibenzothiophene was determined by monitoring the shift in absorbance values of standard solutions before and after treating with synthesized material under ambient conditions. Nickel sulphide nanoparticles exhibited suitable rebinding response for removal of dibenzothiophene down to 1 ppm due to affinity interactions which is useful concerning ultra deep desulfurization. Finally, nickel sulphide nanoparticles were incorporated in poly(methyl methacrylate)-zirconia membrane which showed potential application for adsorptive desulfurization of dibenzothiophene at ambient conditions.
This study associated Human Papillomavirus (HPV) infection and other clinical parameters with five-year survival of oral squamous cell carcinoma patients at a tertiary care hospital in Karachi, Pakistan.
A total of 140 patients diagnosed with oral squamous cell carcinoma were enlisted. HPV status and subtypes were established through polymerase chain reaction performed in a previously published study. Clinical data including five-year survival were obtained through institutional medical records.
Ninety-five patients (67.9 per cent) were positive for HPV. Of these, 85 patients were HPV 16 positive while 2 patients were HPV 18 positive. The mean survival time for HPV positive patients was 44.3 months, whereas survival time for HPV negative patients was 46.9 months. Univariate analysis showed that HPV status in oral squamous cell carcinoma was not a statistically significant factor in determining five-year survival rate (p = 0.386).
There is a high prevalence of HPV positive oral squamous cell carcinoma in Pakistan; however, there is no difference in the five-year survival rate when compared to HPV negative oral squamous cell carcinoma.
Medialisation thyroplasty is considered the ‘gold standard’ treatment for unilateral vocal fold paralysis, enabling improvement of voice and swallowing function, and preventing life-threatening aspiration events. The most commonly used laryngeal implants induce some degree of local tissue inflammatory response, and carry the risk of immediate or delayed implant extrusion.
This paper describes a novel approach for medialisation thyroplasty. Specifically, it utilises a ribbon of autologous tensor fascia lata harvested at the time of surgery. This is layered within the paraglottic space in a manner similar to Gore-Tex thyroplasty.
Thus far, this method has been accomplished in two patients with unilateral vocal fold paralysis, who also received prior radiotherapy to the head and neck.
Given the increased risk of post-operative wound breakdown and infection in irradiated patients, it is suggested that this new approach will lead to improved outcomes, and a decrease in complications such as extrusion or wound infection, particularly in this patient population.
Children with a history of maltreatment suffer from altered emotion processing but the neural basis of this phenomenon is unknown. This pioneering functional magnetic resonance imaging (fMRI) study investigated the effects of severe childhood maltreatment on emotion processing while controlling for psychiatric conditions, medication and substance abuse.
Twenty medication-naive, substance abuse-free adolescents with a history of childhood abuse, 20 psychiatric control adolescents matched on psychiatric diagnoses but with no maltreatment and 27 healthy controls underwent a fMRI emotion discrimination task comprising fearful, angry, sad happy and neutral dynamic facial expressions.
Maltreated participants responded faster to fearful expressions and demonstrated hyper-activation compared to healthy controls of classical fear-processing regions of ventromedial prefrontal cortex (vmPFC) and anterior cingulate cortex, which survived at a more lenient threshold relative to psychiatric controls. Functional connectivity analysis, furthermore, demonstrated reduced connectivity between left vmPFC and insula for fear in maltreated participants compared to both healthy and psychiatric controls.
The findings show that people who have experienced childhood maltreatment have enhanced fear perception, both at the behavioural and neurofunctional levels, associated with enhanced fear-related ventromedial fronto-cingulate activation and altered functional connectivity with associated limbic regions. Furthermore, the connectivity adaptations were specific to the maltreatment rather than to the developing psychiatric conditions, whilst the functional changes were only evident at trend level when compared to psychiatric controls, suggesting a continuum. The neurofunctional hypersensitivity of fear-processing networks may be due to childhood over-exposure to fear in people who have been abused.
In this present study, different volume percentages of titanium dioxide nanoparticles were added as dispersions in commercially pure magnesium using the blend-press-sinter powder metallurgy process followed by hot extrusion. The physically blended titanium dioxide nanoparticles dispersoid induced a significant grain refinement in the extruded magnesium matrix. Characterization of the mechanical properties revealed that the increasing volume percentage of titanium oxide nanoparticles dispersion was effective in enhancing the ductility of magnesium without disturbing the strength under tensile loading and enhancing the strength of magnesium without disturbing the ductility under compressive loading. The dominating deformation mechanism in pure magnesium was the dislocation slip, which was subdued by the tensile twinning deformation mechanism due to the increasing presence of titanium dioxide dispersion. The effect of shift in the dominating deformation mechanism was displayed by the elimination of tensile-compressive asymmetry in magnesium when dispersed with 1 vol% of titanium dioxide nanoparticles.
Childhood abuse is associated with abnormalities in brain structure and function. Few studies have investigated abuse-related brain abnormalities in medication-naïve, drug-free youth that also controlled for psychiatric comorbidities by inclusion of a psychiatric control group, which is crucial to disentangle the effects of abuse from those associated with the psychiatric conditions.
Cortical volume (CV), cortical thickness (CT) and surface area (SA) were measured in 22 age- and gender-matched medication-naïve youth (aged 13–20) exposed to childhood abuse, 19 psychiatric controls matched for psychiatric diagnoses and 27 healthy controls. Both region-of-interest (ROI) and whole-brain analyses were conducted.
For the ROI analysis, the childhood abuse group compared with healthy controls only, had significantly reduced CV in bilateral cerebellum and reduced CT in left insula and right lateral orbitofrontal cortex (OFC). At the whole-brain level, relative to healthy controls, the childhood abuse group showed significantly reduced CV in left lingual, pericalcarine, precuneus and superior parietal gyri, and reduced CT in left pre-/postcentral and paracentral regions, which furthermore correlated with greater abuse severity. They also had increased CV in left inferior and middle temporal gyri relative to healthy controls. Abnormalities in the precuneus, temporal and precentral regions were abuse-specific relative to psychiatric controls, albeit at a more lenient level. Groups did not differ in SA.
Childhood abuse is associated with widespread structural abnormalities in OFC–insular, cerebellar, occipital, parietal and temporal regions, which likely underlie the abnormal affective, motivational and cognitive functions typically observed in this population.
Chinese older adults may be at increased risk of social isolation and loneliness, and a fragmented understanding exists about the challenges they face for social participation in their neighbourhoods and communities. A scoping review was undertaken to describe the current knowledge on social isolation and loneliness in urban-dwelling Chinese older adults living in Western societies to inform future research, practice, and policy in Canada. Nineteen articles met the inclusion criteria. The World Health Organization’s age-friendly community framework contextualized the study findings. Studies identified issues related to (1) social participation; (2) community support and health services; (3) housing; (4) community and information; (5) respect and social inclusion; (6) outdoor spaces and public buildings; (7) civic participation and employment; and (8) transportation. Social isolation and loneliness is a growing concern in this population in Canada, and additional research is needed to identify its scope and effective interventions.
The aetiology and outcomes for patients with acquired subglottic stenosis are highly variable. This study aimed to identify risk factors for subglottic stenosis and patient characteristics that predict long-term clinical outcomes.
A retrospective review was performed on 63 patients with subglottic stenosis and 63 age-matched controls. Patient demographics and clinical characteristics were compared. Subglottic stenosis patients were further grouped according to tracheostomy status (i.e. tracheostomy never required, tracheostomy initially required but patient eventually decannulated, and tracheostomy-dependent). Patient factors from these three groups were then compared to evaluate risk factors for long-term tracheostomy dependence.
Compared to controls, patients with subglottic stenosis had a significantly higher body mass index (30.8 vs 26.0 kg/m2; p < 0.001) and were more likely to have diabetes (23.8 per cent vs 7.94 per cent; p = 0.01). Comparing tracheostomy outcomes within the subglottic stenosis group, body mass index trended towards significance (p = 0.08). Age, gender, socio-economic status, subglottic stenosis aetiology and other co-morbidities did not correlate with outcome.
Obesity and diabetes are significant risk factors for acquiring subglottic stenosis. Further investigations are required to determine if obesity is also a predictor for failed tracheostomy decannulation in subglottic stenosis.
Globus pharyngeus has been linked to salivary hypofunction. We hypothesise that a considerable portion of the globus experienced by patients is due to a drying effect secondary to anticholinergic medication use; this study aimed to determine their association.
A cross-sectional study was conducted of 270 patients who presented to a laryngology practice over 6 months. Participants rated globus sensation on a 5-point severity scale, with those scoring 0 considered as controls (non-globus). Participants were excluded if they had a likely cause of globus. Scores were compared with participants’ medication lists, co-morbidities, age and gender, and evaluated using multivariate analysis, with significance set at p < 0.05.
Any participant taking at least 2 anticholinergic medications had a 3.52 increased odds (p = 0.02) of experiencing globus. A previous diagnosis of gastroesophageal reflux disease was also significantly associated with globus (p = 0.004), with an odds ratio of 3.75.
A substantial portion of idiopathic globus may be due to anticholinergic use or reflux. The findings implicate medication use as a risk factor for globus. An awareness of these associations is invaluable for identifying cause and treating globus.