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The objective of this study was to assess differences in myocardial systolic and diastolic function and vascular function in children 2−5 years of age born to diabetic as compared to non-diabetic mothers.
This study was a retrospective cohort conducted in 2016 at The Aga Khan University Hospital, Karachi, Pakistan. It included children between 2 and 5 years of age born to mothers with and without exposure to diabetes in utero (n = 68 in each group) and who were appropriate for gestational age. Myocardial morphology and function using echocardiogram and carotid intima media thickness (cIMT) and pulse wave velocity was performed to evaluate cardiac function as well as macrovascular remodelling in these children. Multiple linear regression was used to compare the groups.
There was no significant difference in cardiac morphology, myocardial systolic and diastolic function, and macrovascular assessment between the exposed and unexposed groups of AGA children. Subgroup analysis demonstrated a significantly decreased mitral E/A ratio in children whose mothers were on medications as compared to those on dietary control (median [IQR] = 1.7 [1.6–1.9] and 1.56 [1.4–1.7], respectively, p = 0.02), and a higher cIMT in children whose mothers were on medication as compared to controls (0.48 [0.44–0.52] and 0.46 [0.44–0.50], respectively, p = 0.03).
In utero exposure to uncontrolled maternal diabetes has an effect on the cardiovascular structure and function in children aged 2−5 years. However, future work requires long-term follow-up from fetal to adult life to assess these changes over the life course.
Sparsely distributed and self-organized gold-nanocones are fabricated by broad argon ion beam sputtering on the gold surface with grazing incident angle. The rotation of the sample with respect to the vertical axis has found to influence the morphology of the obtained nanostructures. Ion beam irradiation of the sample leads to formation of nanoripples when the sample is held stationary, otherwise nanocones are formed if the sample is rotated during irradiation. A hybrid gold-nanocone/graphene/gold-nanohole based surface-enhanced Raman scattering (SERS) sensor is proposed and shown to exhibit an enhancement factor of 109 via finite-difference time-domain (FDTD) simulations.
Individuals with bipolar disorder (BD) show aberrant brain activation patterns during reward and loss anticipation. We examined for the first time longitudinal changes in brain activation during win and loss anticipation to identify trait markers of aberrant anticipatory processing in BD.
Thirty-four euthymic and depressed individuals with BD-I and 17 healthy controls (HC) were scanned using functional magnetic resonance imaging twice 6 months apart during a reward task.
HC, but not individuals with BD, showed longitudinal reductions in the right lateral occipital cortex (RLOC) activation during processing of cues predicting possible money loss (p-corrected <0.05). This result was not affected by psychotropic medication, mood state or the changes in depression/mania severity between the two scans in BD. Elevated symptoms of subthreshold hypo/mania at baseline predicted more aberrant longitudinal patterns of RLOC activation explaining 12.5% of variance in individuals with BD.
Increased activation in occipital cortex during negative outcome anticipation may be related to elevated negative emotional arousal during anticipatory cue processing. One interpretation is that, unlike HC, individuals with BD were not able to learn at baseline that monetary losses were smaller than monetary gains and were not able to reduce emotional arousal for negative cues 6 months later. Future research in BD should examine how modulating occipital cortical activation affects learning from experience in individuals with BD.
Trauma exposure is associated with development of depression and anxiety; yet, some individuals are resilient to these trauma-associated effects. Differentiating mechanisms underlying development of negative affect and resilience following trauma is critical for developing effective interventions. One pathway through which trauma could exert its effects on negative affect is reward-learning networks. In this study, we examined relationships among lifetime trauma, reward-learning network function, and emotional states in young adults.
One hundred eleven young adults self-reported trauma and emotional states and underwent functional magnetic resonance imaging during a monetary reward task. Trauma-associated neural activation and functional connectivity were analyzed during reward prediction error (RPE). Relationships between trauma-associated neural functioning and affective and anxiety symptoms were examined.
Number of traumatic events was associated with greater ventral anterior cingulate cortex (vACC) activation, and lower vACC connectivity with the right insula, frontopolar, inferior parietal, and temporoparietal regions, during RPE. Lower trauma-associated vACC connectivity with frontoparietal regions implicated in regulatory and decision-making processes was associated with heightened affective and anxiety symptoms; lower vACC connectivity with insular regions implicated in interoception was associated with lower affective and anxiety symptoms.
In a young adult sample, two pathways linked the impact of trauma on reward-learning networks with higher v. lower negative affective and anxiety symptoms. The disconnection between vACC and regions implicated in decision-making and self-referential processes may reflect aberrant regulatory but appropriate self-focused mechanisms, respectively, conferring risk for v. resilience against negative affective and anxiety symptoms.
Terrorism is often construed as a well-thought-out, extreme form of violence to perceived injustices. The after effects of terrorism are usually reported without understanding the underlying psychological and social determinants of the terrorist act. Since ‘9/11’ Pakistan has been at the epicentre of both terrorism and the war against it. This special paper helps to explain the psychosocial perspective of terrorism in Pakistan that leads to violent radicalisation. It identifies the terrorist acts in the background of Pakistan's history, current geopolitical and social scenario. The findings may also act as a guide on addressing this core issue.
Avian pathogenic Escherichia coli (APEC) is one of the most
economically damaging diseases affecting the poultry industry. This group of
extra-intestinal E. coli causes a variety of clinical
conditions including air-sacculitis and cellulitis. The economic impact of APEC
is mainly due to mortality, slower growth rates and carcass downgrading. In
commercial broiler operations, APEC infections are controlled indirectly by
vaccination against other respiratory diseases and minimising stress conditions,
and directly by administration of antimicrobial agents to suppress symptoms in
infected flocks. Several studies have demonstrated that the most common
virulence factors studied in APEC are rarely present in the same isolate,
showing that APEC strains constitute a heterogeneous group. Different isolates
may harbour different associations of virulence factors, each able to induce
colibacillosis. Despite its economical relevance, the pathogenesis of
colibacillosis is poorly understood. The O antigen, a component of the surface
lipopolysaccharide, has been identified as a promising vaccine target. With the
availability of a novel bioconjugation technology it is expected that
multivalent O antigen conjugate vaccines can be produced on an industrial scale.
Despite the potential for developing an efficacious vaccine to combat this
economically important poultry disease, several obstacles hinder such efforts.
These include cost, vaccine delivery method and timing of vaccination. The
present discusses current knowledge on APEC virulence, host response to
infection and various attempts to develop an effective vaccine
Infectious diseases are major constraint that hinders the poultry industry. Among them parasitic diseases are very common and Ascaridia galli is one of the most common parasitic roundworms found in poultry. Haemorrhages, diarrhoea and listlessness are signs of infection. Parasitic infections such as A. galli are treated with chemical anthelmintics (piperazine, albendazole, levamisole, Ivermectin, benzimidazoles and fenbendazole). These synthetic chemicals can promote resistance, so there is need for alternative ways to treat the disease. Medicinal plants have the potential to combat such parasitism and the development of anthelmintic resistance appears to be very slow against such treatment. This review covers the studies related to the screening of plant materials having in vitro and in vivo anthelmintic activities against A. galli throughout the world. Medicinal plants showing in vitro anthelmintic activity include Anacardium occidentale, Allium sativum, Tribulus terrestris, Bassia latifolia, Piper betle, Morinda citrifolia L.I, Cassia occidentalis L. and Aloe secundiflora while in vivo studies include the use of Psorelia corylifolia, Piper betle, Pilostigma thonningi, Caesalpinia crista, Ocimum gratissimum and Anacardium occidentale. In conclusion, medicinal plants appear to have good anthelmintic activities in poultry and may substitute conventionally used synthetic drugs, and their use may moderate drug resistance in endemic pathogen populations and drug residues in poultry meat.
The poultry sector is an important and vibrant segment of agriculture in Pakistan with a significant contribution to the national GDP (1.3%). Commercial poultry production in Pakistan started in the 1960's and has been providing a significant portion of daily proteins to the Pakistani population ever since. During its evolution the industry enjoyed promotional policies of the Government, but has faced several challenges such as disease outbreaks and retail price fluctuations. Despite its important role in the country's economy, not a single scientific study is available on its evolutionary history. The data available in this regard are scattered and lack reliability. This review is an effort to encompass the history of the overall growth of the poultry industry in Pakistan, its present status (2012 statistics) and future directions and challenges. This article may serve as the basic source of information on Pakistan's poultry industry achievements. It will also guide poultry experts and policy makers for developing strategic planning for further growth of the industry.
The poultry industry is affected by economically important problems such as Newcastle disease (ND). Newcastle disease virus (NDV) belongs to the Paramyxoviridae family and manifests as different strains; lentogenic, mesogenic and velogenic. ND affects the quality of eggs and impairs growth performance of birds. Various efforts have been made to control economic losses due to this disease, including using live and killed vaccines, which do not confer 100% immunity in all cases. Due to mutations within viral strains, NDV can become resistant and difficult to control, and there is a need to search for alternative measures. Medicinal plants are considered as a complementary means to control this virus, especially in developing countries, because they have been implicated in treatments for a variety of infectious and non-infectious diseases. Alkaloids, flavonoids, saponins and tannins found in plants have been regarded as novel antiviral agents. The following paper encompasses the studies related to plants having in vitro antiviral activity against ND such as Momordica balamina, Adansonia digitata, Artemisia annua, Azadirachta indica, Psidium guajava, Moringa oleifera and plants having good in vivo antiviral activity such as Aloe secundiﬂora, Cucumis metuliferus and Anthocleista nobilis as well. It discusses plants with the potential to improve the immunity of infected birds, such as Mangrove halophytes, Nigella sativa, Polysavone, Melissa officinalis, Momordica cochinchinensis, Echinacea purpurea, Withania somnifera and Aspargus Racemosus.
Communication may be an influential determinant of inequality of access to, engagement with and benefit from psychiatric services.
To review the evidence on interventions designed to improve therapeutic communications between Black and minority ethnic patients and clinicians who provide care in psychiatric services.
Systematic review and evidence synthesis (PROSPERO registration: CRD42011001661). Data sources included the published and the ‘grey’ literature. A survey of experts and a consultation with patients and carers all contributed to the evidence synthesis, interpretation and recommendations.
Twenty-one studies were included in our analysis. The trials showed benefits mainly for depressive symptoms, experiences of care, knowledge, stigma, adherence to prescribed medication, insight and alliance. The effect sizes were smaller for better-quality trials (range of d 0.18–0.75) than for moderate- or lower-quality studies (range of d 0.18–4.3). The review found only two studies offering weak economic evidence.
Culturally adapted psychotherapies, and ethnographic and motivational assessment leading to psychotherapies were effective and favoured by patients and carers. Further trials are needed from outside of the UK and USA, as are economic evaluations and studies of routine psychiatric care practices.
Genetically modified (GM) plants expressing Bt toxin provide protection against lepidopteran pests. The only GM crop in Pakistan is Bt cotton, which was illegally imported and adopted rapidly by cotton producers. Farmers gained access to the seed of many unapproved Bt genotypes before the matter was picked up and formal approval granted by the relevant governmental agencies. The present study was conducted to evaluate the samples of Bt cotton, collected from farmers and seed dealer, for transgene integration and expression. Seeds of 52 cotton genotypes, labelled as Bt, were collected from various farmers and seed dealers. An immunoblot strip test was carried out, which showed that only 0·86 of the samples collected were synthesizing Cry1Ac toxin. According to multiplexed polymerase chain reaction (PCR) results, 0·86 of the genotypes tested were positive for the Mon531 event (an ‘event’ is a specific genetic modification in a specific species) and 0·14 were negative for any transgene. Transcript analysis of transgenes in positive genotypes by real-time Rt-PCR confirmed the synthesis of mRNA in all genotypes but with significant variation. The concentration of Bt toxin revealed by enzyme linked immunosorbent assay (ELISA) showed that only 0·02 genotypes had the reported optimum level. The real-time PCR and ELISA results further confirmed the attenuation of transgene expression at transcriptional and translational level by various internal and external factors. The same type of event was found in all genotypes, with significant variation in toxin level, revealing the impact of genetic background on transgene expression. The findings support the recommendation to improve the existing quality criteria for transgenic cotton variety approval and certification in Pakistan, with the inclusion of toxin concentration in the list of parameters to be considered.
The dynamics of one-dimensional, piston-driven hydrogen–air detonations are predicted in the presence of physical mass, momentum and energy diffusion. The calculations are automatically verified by the use of an adaptive wavelet-based computational method which correlates a user-specified error tolerance to the error in the calculations. The predicted frequency of 0.97 MHz for an overdriven pulsating detonation agrees well with the 1.04 MHz frequency observed by Lehr in a shock-induced combustion experiment around a spherical projectile, thus giving a limited validation for the model. A study is performed in which the supporting piston velocity is varied, and the long time behaviour is examined for an initially stoichiometric mixture at 293.15 K and 1 atm. Several distinct propagation behaviours are predicted: a stable detonation, a high-frequency pulsating detonation, a pulsating detonation with two competing modes, a low-frequency pulsating detonation and a propagating detonation with many active frequencies. In the low-frequency pulsating mode, the long time behaviour undergoes a phenomenon similar to period-doubling. Harmonic analysis is used to examine how the frequency of the pulsations evolves as the supporting piston velocity is varied. It is found that the addition of viscosity shifts the neutral stability boundary by about 2 % with respect to the supporting piston velocity. As the supporting piston velocity is lowered, the intrinsic instability grows in strength, and the effect of viscosity is weakened such that the results are indistinguishable from the inviscid predictions.
Hydropericardium syndrome (HPS) is a fatal disease of broiler chickens causing high mortality and heavy economic losses in various countries. More than 100 million birds have been affected by this destructive disease in less than two years worldwide. As it is a viral disease, the only solution is to vaccinate chickens. Different types of vaccines are being used against this disease in different areas of the world. Liver organ inactivated vaccines are more extensively used to control the disease initially. These vaccines have many drawbacks regarding their dose, un-predictable immune response and secondary bacterial infections. Following this, oil adjuvant vaccine was used to control the disease, however the handling stress and the formation of granuloma at the site of injection remains a problem. Consequently there is a need for cell culture adapted and attenuated vaccines, which can be administered through oral routes. A chicken embryo-adapted inactivated vaccine has shown good results but requires a continuous supply of specific, pathogen-free chicken embryos and a continuous life killing process. The continuous cell lines are a more promising solution for the production of cell culture-adapted and attenuated vaccines, which are safer, more economical and easy to administer. The following review discusses the development of modern HPS vaccines.
Renal failure is a common complication observed in patients with multiple myeloma (MM) and other plasma cell cancers that is generally associated with an adverse clinical outcome. The optimal management of MM patients with renal disease presents a challenge. As numerous drugs are cleared via the kidneys, renal impairment imposes limitation on anti-myeloma therapeutics through decreased drug clearance and enhanced toxicity. Thus optimal renal function assessment is essential, often involving measurements of glomerular filtration rate (GFR), serum creatinine (sCr) levels, and creatinine clearance (CrCl) rates. However, the exact definition and incidence of “renal failure” varies among investigators and depends on the measurement parameter being used. The Kidney Disease Outcomes Quality Initiative (K/DOQI) of the National Kidney Foundation defines kidney disease as either kidney damage or a decreased GFR of <60 ml/min/1.73 m2 for ≥3 months. Using the KDOQI criteria, we observed that 54% of patients seen at Roswell Park Cancer Institute presented with stage ≥3 (<60 ml/min/1.73 m2) kidney disease at the time of diagnosis. When sCr is used to assess kidney function, a value of ≥2 mg/dl specifies impairment and is present in approximately 20% of MM patients[4–7]. Although measurement of sCr is simple and relatively the least cumbersome approach, it varies with age, sex and muscle mass, and is not an absolute reflection of renal function. Patients with MM tend to be elderly with normal or low muscle mass and thus sCr may be lower for a given GFR or CrCl rate. As such, the extent of renal insufficiency is often underestimated in these patients when sCr alone is utilized to assess kidney function[8–13].
We describe the first reported case of a malignant glomus tumour of the larynx.
Case report and review of the world literature concerning malignant glomus tumours.
A 37-year-old man presented with progressive hoarseness and dyspnoea. A smooth, right-sided laryngeal mass was found on flexible nasolaryngoscopy. Initial biopsy of this lesion was reported as a true ‘glomus tumour’, which is a benign lesion. Wide local excision was performed. The final histology of this specimen showed it to be a ‘malignant glomus tumour’. Immunohistochemistry was positive for smooth muscle actin, collagen type IV, vimentin and cluster of differentiation 34 glycoprotein. Total laryngectomy was then performed as a definitive curative procedure.
Glomus tumour is rarely found in visceral locations. This tumour and its malignant counterpart are rare differential diagnoses of laryngeal masses.
Cadmium Sulphide (CdS) thin films have been prepared on ultrasonicated glass substrates using a specially designed chemical bath deposition technique via isochronal synthesis. The structural properties have been determined through XRD. The nanostructures have been identified in FE-SEM images. The chemical analysis has been carried out through EDAX. Optical analysis and PL studies were carried out on these films. The growth conditions and the characterization results exhibit strong dependence on the pH of the precursor solution as well as the temperature of the bath. Cu doping has been employed on the tailored films to make them low resistive and efficient for window layer applications.
The dynamics of a one-dimensional detonation predicted by a one-step irreversible Arrhenius kinetic model are investigated in the presence of mass, momentum and energy diffusion. A study is performed in which the activation energy is varied and the length scales of diffusion and reaction are held constant. As the activation energy is increased, the system goes through a series of period-doubling events and eventually undergoes a transition to chaos. The rate at which these bifurcation points converge is calculated and shown to be in agreement with the Feigenbaum constant. Within the chaotic regime, there exist regions in which there are limit cycles consisting of a small number of oscillatory modes. When an appropriately fine grid is used to capture mass, momentum and energy diffusion, predictions are independent of the differencing scheme. Diffusion affects the behaviour of the system by delaying the onset of instability and strongly influencing the dynamics in the unstable regime. The use of the reactive Euler equations to predict detonation dynamics in the unstable and marginally stable regimes is called into question as the selected reactive and diffusive length scales are representative of real physical systems; reactive Navier–Stokes is a more appropriate model in such regimes.