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Hundreds of high-elevation medieval strongholds are dispersed throughout the Central Himalayan region of Garhwal Himalaya, India. Believed to have originated in the eleventh century AD, these sites are interwoven into local folklore, yet they have been subject to limited research. This article presents new survey data, along with computational and spatial analyses of 193 Garhwal strongholds, facilitating the assessment of more complex hypotheses—particularly visual-signalling theories—concerning the fortification phenomenon. The results strongly suggest the integration of Garhwal's strongholds as a coherent visual-signalling network. In turn, the method also holds great potential for the evaluation of putative visual-signalling networks in other archaeological contexts.
Patient and public involvement in Health Technology Assessment (HTA) is gaining increased interest among research and policy communities. Patients’ organizations represent an important link between individual patients and the health system. Social theories are increasingly being used to explain doctor–patient–system interactions, expanding understanding beyond the mere clinical perspective. In this sense, patient involvement in HTA can also be considered through the Habermas’s theory of communicative action. From a Habermasian perspective, HTA as part of the instrumental rationality contributes to an increased efficiency of resource use within the system; however, such rationalization threatens to colonize the lifeworld by making it “increasingly state administered with attenuated possibilities for communicative action as a result of the commercialization and rationalization in terms of immediate returns.” Using Habermasian system/lifeworld framework, this paper explores opportunities and obstacles to patient involvement in HTA, whereby trying to understand current and possible roles of patients’ organizations as a mediating force between HTA as a function of the system and the lifeworld represented by patients.
Genetic resources are of paramount importance for developing improved crop varieties, particularly for biotic and abiotic stress tolerance. Spot blotch (SB) is a destructive foliar disease of wheat prevalent in warm and humid regions of the world, especially in the eastern parts of South Asia. For the management of this disease, the most effective measure is the development of resistant cultivars. Thus, the present investigation was carried out to confirm SB resistance in 200 germplasm accessions based on phenotypic observations and molecular characterization. These elite breeding lines obtained from the International Centre for Maize and Wheat Improvement, Mexico, are developed deploying multiple parentages. These lines were screened for SB resistance in the field under artificially created epiphytotic conditions during 2014–15 and 2015–16 along with two susceptible checks (CIANO T79 and Sonalika) and two resistant checks (Chirya 3 and Francolin). Eighty-two out of 200 germplasm accessions were found resistant to SB and resistance in these lines was confirmed with a specific SSR marker Xgwm148. Three accessions, VORONA/CNO79, KAUZ*3//DOVE/BUC and JUP/BJY//URES/3/HD2206/HORK//BUC/BUL were observed possessing better resistance than the well-known SB-resistant genotype Chirya3. These newly identified resistant lines could be used by wheat breeders for developing SB-resistant wheat varieties.
Cordia sinensis, locally known as ‘Goondi’ in India, is an underexploited multipurpose fruit species found in hot arid regions that is well adapted to drought, salt and hot conditions. The present study was undertaken to collect fruit samples from different locations in the Kachchh region of Gujarat, India, and to determine their field establishment for characterization, conservation and utilization. The maximum distribution of the species was observed in Bhuj (45%) and Mandvi (25%). Field boundaries (35%) and scrub forests (30%) had greater frequencies, whereas backyards had rarer frequencies (10%). The species most commonly occurred on levelled topography (60%) with a soil pH in the range of 8–8.5 (63%). Morphological data of three-year-old plants in the field gene bank showed a maximum coefficient of variation in the number of leaves per plant (66.6), followed by the number of branches per plant (45.62) and collar diameter (27.69). Wide variations were recorded in plant height (121.67–212 cm), spread (118–223 cm2) and the number of branches per plant (6–24.33). Specific accessions were identified for fodder (CBCG-12, CBCG-13 and CBCG-16), early flowering and fruiting (CBCG-12, CBCG-13 and CBCG-14), easier propagation by seeds (CBCG-12 and CBCG-13) and salt tolerance (CBCG-15 and CBCG-16). Preliminary findings and information provided about this species' utilization and other aspects might be useful for future research on its domestication, sole plantation and conservation aspects, improving the exploitation of this species by present and future generations.
It is not uncommon to have prolapse of the atrial septal occluder device despite accurate measurement of atrial septal defect and an appropriately chosen device. This is particularly a problem in cases with large atrial septal defect with absent aortic rim. Various techniques have been described for successful implantation of atrial septal occluder in such a scenario. The essence of all these techniques is to prevent prolapse of the left atrial disc through the defect while the right atrial disc is being deployed. In this brief report, we illustrate the use of cobra head deformity of the device to successfully deploy the device across the atrial septum.
There has been a general increase in poverty over the last decade in Italy, which has mainly affected the younger generations, with children and youth experiencing the worst economic conditions. This is primarily not due to a lack of available economic resources but to the way in which these resources are allocated: mainly in the form of cash transfers rather than services. The provision of adequate services based on professional work needs to be implemented by overcoming two main obstacles which are highlighted by the results of two studies presented here. The first study concerns the quality of professional care and the systematic use of outcome evaluation, the second concerns the vision of professionals and their ability to integrate the provision of services with economic support aimed at improving children’s growth and parenting skills. The two studies were carried out as part of an international debate on how to effectively fight poverty and social exclusion of children which was promoted by the International Association for Outcome-based Evaluation and Research on Family and Children’s Services (iaOBERfcs).
Background: Healthcare-associated infections (HAIs) are a major global threat to patient safety. Systematic surveillance is crucial for understanding HAI rates and antimicrobial resistance trends and to guide infection prevention and control (IPC) activities based on local epidemiology. In India, no standardized national HAI surveillance system was in place before 2017. Methods: Public and private hospitals from across 21 states in India were recruited to participate in an HAI surveillance network. Baseline assessments followed by trainings ensured that basic microbiology and IPC implementation capacity existed at all sites. Standardized surveillance protocols for central-line–associated bloodstream infections (CLABSIs) and catheter-associated urinary tract infections (CAUTIs) were modified from the NHSN for the Indian context. IPC nurses were trained to implement surveillance protocols. Data were reported through a locally developed web portal. Standardized external data quality checks were performed to assure data quality. Results: Between May 2017 and April 2019, 109 ICUs from 37 hospitals (29 public and 8 private) enrolled in the network, of which 33 were teaching hospitals with >500 beds. The network recorded 679,109 patient days, 212,081 central-line days, and 387,092 urinary catheter days. Overall, 4,301 bloodstream infection (BSI) events and 1,402 urinary tract infection (UTI) events were reported. The network CLABSI rate was 9.4 per 1,000 central-line days and the CAUTI rate was 3.4 per 1,000 catheter days. The central-line utilization ratio was 0.31 and the urinary catheter utilization ratio was 0.57. Moreover, 3,542 (73%) of 4,742 pathogens reported from BSIs and 868 (53%) of 1,644 pathogens reported from UTIs were gram negative. Also, 1,680 (26.3%) of all 6,386 pathogens reported were Enterobacteriaceae. Of 1,486 Enterobacteriaceae with complete antibiotic susceptibility testing data reported, 832 (57%) were carbapenem resistant. Of 951 Enterobacteriaceae subjected to colistin broth microdilution testing, 62 (7%) were colistin resistant. The surveillance platform identified 2 separate hospital-level HAI outbreaks; one caused by colistin-resistant K. pneumoniae and another due to Burkholderia cepacia. Phased expansion of surveillance to additional hospitals continues. Conclusions: HAI surveillance was successfully implemented across a national network of diverse hospitals using modified NHSN protocols. Surveillance data are being used to understand HAI burden and trends at the facility and national levels, to inform public policy, and to direct efforts to implement effective hospital IPC activities. This network approach to HAI surveillance may provide lessons to other countries or contexts with limited surveillance capacity.
Most of the modern-day improved watermelon varieties succumb to various biotic and abiotic stresses mainly because of their narrow genetic base. Insights into the genetic diversity and population structure are crucial for broadening the genetic base and improving the adaptive value. The present experiment was conducted to study the genetic diversity and population structure of a germplasm panel comprising 336 Citrullus sp. accessions. Another objective was to formulate a core collection of Indian Citrullus sp. accessions. Data from 23 highly polymorphic microsatellite markers were used for genetic diversity and population structure analysis while both molecular and phenotypic data from 17 traits were used to formulate the core set. The markers yielded a total of 69 alleles with an average of three alleles per locus. Initially, the accessions clustered into two populations and an admixture group. Intra-population analysis revealed three and two statistically distinct subpopulations in Pop I and Pop II, respectively. The exotic collections were predominant in Pop I-A, Pop II-A and Pop II-B while the Indian accessions were preponderant in Pop I-B and Pop I-C. Pop I-B recorded the maximum magnitude of gene diversity and the highest number of alleles. The well-adapted Indian landraces could be deployed in future watermelon improvement programmes. The formulated core collection (n = 46; 23.71% of the entire collection studied) would ease in maintenance of the diversity present among indigenous Citrullus sp. accessions; would ease trait search while exploring Indian diversity and can be pooled with other collection(s) to form a global core of watermelon.
Phoebe cooperiana U.N Kanjilal ex A. Das is an indigenous forest tree species yielding fruits consumed widely across the state of Arunachal Pradesh, India. As part of an initiative to domesticate the species, phenotypic variation in fruit and seed morphology as well as the biochemical properties of the pulp were assessed for 14 populations within the state. Nine fruit and seed characters were measured and 12 biochemical parameters of the fruits were analysed. Five trees were selected from each population and a minimum of 30 fruits were collected from each tree. Analysis of variance indicated significant variation in all fruit and seed morphological parameters. The coefficient of variation for fruit weight was reported to be 5.02%, seed weight 5.60%, pulp weight 5.36% and pulp fruit ratio 4.14%. Among biochemical parameters which are of nutritive value, crude protein, vitamin E and A were higher than that found in most common fruits and vegetables. These traits also showed significant variation among the 14 selected populations with crude protein values ranging between 5.99 and 10.76%, vitamin E between 4.80 and 7.33 mg/100 g and vitamin A between 1.88 and 3.13 mg/100 g. The fruits are also high in phenol with a mean value of 22.19 mg/g and displayed promising 2,2-diphenyl-1-picrylhydrazyl radical scavenging properties averaging 56.94% antioxidant activity. However, cyanogen content in the fruits was higher than the permissible amount for human consumption, for which processing is recommended before use. The opportunities for domestication are discussed and some promising traits and populations that can be utilized in the domestication programme are identified.
Some interesting properties such as superelasticity, shape memory effect, kink resistance, good biocompatibility, biomechanical properties, and corrosion resistance made nitinol a popular biomaterial as stent and orthopedic implants. But surface modification is needed to control nickel leaching from its surface, making safe for human body. The aim of this study was to modify the nitinol surface by the silanization technique and electrophoretically deposited hydroxyapatite coating, and to conduct a detailed in vitro and in vivo investigation. Detailed in vitro investigation involved MTT assay with the human osteoblastic cells (MG63 cell) over a period of 5 days and confocal image study. In case of in vivo study, histological study, fluorochrome labeling study, and Micro-Ct study were conducted. The overall in vitro and in vivo results indicate that silanized nitinol samples are showing slightly better level of performance, but both the surface-modified samples are suitable as the potential bio-implant for orthopedic purpose.
The aim of this study was to evaluate the readiness of a tertiary medical cityʼs response to a disaster by assessing the hospital resources and knowledge, attitudes, practices, and familiarity of health care providers toward disaster and emergency preparedness.
All KFMC (King Fahad Medical City) staff with > 1 year of clinical experience were eligible to participate in a cross-sectional study. Participants responded to the Emergency Preparedness Information Questionnaire (EPIQ), knowledge and practice questionnaires, and a disaster planning attitude checklist. Data about resources were collected using the hospital disaster preparedness self-assessment tool.
The overall mean knowledge score for disaster and emergency preparedness was 4.4 ± 1.1, and the mean overall familiarity score was 3.43 ± 0.97. Most participants knew that disaster drills (90.2%) and training (74.6%) are ongoing. Sixty-six (21.0%) agreed that KFMC is unlikely to experience a disaster. The highest and lowest EPIQ familiarity scores were for decontamination (83.0%) and accessing critical resources and reporting (64.3%), respectively. Most participants (99.4%) have access to work computers; however, only 53.0% used the Internet to access information on bioterrorism and/or emergency preparedness. The hospital is ready to respond in case of a disaster according to the used tool.
The participants’ levels of knowledge, practices, and overall familiarity toward emergency and disaster preparedness were satisfactory; however, participant attitudes and familiarity with where and how to access critical resources in the event of an emergency or disaster situations require reinforcement.
Adverse developmental outcomes for some children following institutional care are well established. Removal from institutional care and placement into families can promote recovery. However, little is known about how positive outcomes are sustained across adolescence among children with histories of severe deprivation. The present study examined the caregiving conditions that are associated with attaining and maintaining competent functioning (i.e., outcomes within typical levels) from middle childhood to adolescence following exposure to early institutional care. The participants included children with and without a history of institutional care who had competence assessed at ages 8, 12, and 16 years across seven domains: family relationships, peer relationships, academic performance, physical health, mental health, substance use (ages 12 and 16 years only), and risk-taking behavior. The participants were grouped based on whether they were always versus not always competent and never versus ever competent at ages 8 through 16 years. Adolescents with a history of institutional care were less likely to be consistently competent than those who were family reared. Among those who were exposed to early institutional rearing, maintaining competent functioning from 8 to 16 years was associated with spending less time in institutions and receiving higher-quality caregiving early in life. Ensuring high quality early caregiving may promote competent functioning following early deprivation.
Dementia represents one of the impending global health challenges, and low and middle-income countries (LMICs) are projected to greatly contribute to the rising dementia global burden. Currently, there is a lack of pharmacological treatment for dementia and therefore research efforts have focused on prevention, with the identification of early lifestyle, demographic and nutritional risk factors. In particular, diet may be an important modifiable risk factor for maintenance of cognitive health in later life. There are plausible suggestions to support the synergistic effects of certain nutrients, such as polyphenols, unsaturated fats and antioxidant vitamins, in having a beneficial role in the modulation of oxidative stress and neuro-inflammation – processes associated with cognitive decline. Therefore, the aim of this systematic review was to evaluate the current evidence on nutritional interventions for the prevention of dementia in developing economies in East Asia.
Materials and Methods
Four comprehensive medical databases were searched from inception until February 2019: MEDLINE, EMBASE, PsycINFO and Scopus. The literature search was restricted to randomised clinical trials [RCTs], conducted in adult humans [ ≥ 18 years], assessing the effect of nutritional interventions on cognitive performance, and / or incidence of mild cognitive impairment [MCI] or dementia. The outcome of interest for the meta-analysis was:  global cognitive performance and  domain specific cognitive performance. Data was pooled by random model analysis and estimates of effect size were given for each domain and sub-categorised according to the type of nutritional intervention.
Twenty-two RCTs were included, of which, sixteen studies showed significant beneficial effects in favor of the nutritional intervention based on single neuropsychological test scores and / or scores of global cognitive assessment tools. Sixteen studies had sufficient data reported for meta-analysis, and marginally significant beneficial effects were found on global cognitive performance in elderly for micro-nutrient supplementation [n = 4 studies, n = 451 participants, std mean difference: 0.41 [-0.03; 0.84], p = 0.07], and EPA / DHA supplementation [n = 4 studies, n = 373 participants, std mean difference 0.57 [-0.01; 1.14], p = 0.06].
Several promising strategies, such as B-vitamin supplementation, EPA / DHA supplementation and nutrition and lifestyle counselling interventions, seem to be able to decrease age-related cognitive decline in East Asia. Large, good quality, long term trials are needed to confirm these findings, to further evaluate the role of nutritional interventions on cognitive function and to identify if these interventions are feasible and effective to decrease dementia incidence in developing economies, like East Asia.
The effects of silicon incorporation on the in vitro and in vivo properties of magnesium phosphate (MgP) bioceramics were studied. Samples were prepared by conventional solid state synthesis method. Scanning electron microscopy and micro-computed tomography (µ-CT) analysis showed that Si doping reduces degradability of MgP. In vitro studies have shown that MG63 cells can attach and proliferate on MgP samples. Live/dead imaging showed that MgP–0.5Si sample had highest cell proliferation, which was also quantitatively confirmed by alamar blue assay. In vivo biocompatibility of MgP ceramics was assessed after implantation in rabbit model. Detailed µ-CT analysis showed new bone tissue formation around the implant after 30 and 90 days. MgP–0.5Si ceramics had 84% bone regeneration compared with 56% for pure MgP ceramics, as confirmed by oxytetracycline labeling. Our finding suggests that Si doping can alter physicochemical properties of MgP ceramics and promotes osseointegration, which can be a useful choice for bone tissue engineering.
Despite various international initiatives and soft/hard law reforms over the last two decades, concerns abound as the extent to which the sustainability agenda has become embedded in emerging economies. This chapter focuses on Mauritius, specifically the emergence of a sustainability discourse as part of corporate governance reforms, the enactment of a national sustainable development agenda, and the implementation of the first corporate social responsibility legislation in the world, requiring companies to finance related projects. Our empirical analysis, primarily focused on corporate settings, and informed by the country’s socio-economic and political contexts, reveals wide variation in corporate engagement and the advent of a form of state control over the execution of projects. Overall, our implications seek to identify lessons for other emerging economies, particularly in terms of state-level attempts to mandate corporate social responsibility.
Feed cost is a major impediment to commercial poultry production in the South Pacific region because traditional feed ingredients (grains and oilseeds) are not grown in the region and imported at high price. As a result, meat has to be imported, which in Fiji increased by 69% between 2010 and 2011 (Diarra, 2017). Samoa was valued at about US$ 17 million or 87% of total cost of meat import in the country in 2012 and 2013. Several ingredients, which are available locally, could be included to reduce feed cost in the region. By-products of root/tuber harvest (peels and leaves), low value crops, fruits and by-products (peels and pulps), oil cakes (copra and palm kernel), by-products from the brewery, livestock/poultry slaughter, hatchery and fish processing and insect meal are readily available in most countries of the region. With adequate processing and correct diet formulation, these materials could replace reasonable proportions of the conventional energy and protein ingredients and reduce feed cost. Several factors including the type and source of material, processing method, diet composition, species, age and class of poultry affect the dietary recommendations of alternative ingredients. Currently however, the use of these resources in feed production in the region is limited due to lack of processing and analytical facilities, likely presence of antinutritional substances and poor knowledge on their nutritive value. Continued research into processing technology, regular training for farmers and extension staff and establishment of community owned feed processing units for optimum utilisation of locally available resources will benefits the poultry industry in the region.
OBJECTIVES/SPECIFIC AIMS: The Duke Multidisciplinary Education and Research in Translational Science (MERITS) program was introduced with the goal of providing education and resources to faculty and trainees who are involved in translational research. However, the definition of what translational science is and entails can be widely variable, even within a single institution or department, which creates difficulties in appropriate dissemination of information regarding translational resources and assistance. This objective of this study was thus to obtain baseline information and views of translational science from a pilot population of Duke faculty. Based on data collected in a previous focus group, we expected to observe a lack of consensus regarding the definition and inclusion principles of translational science. METHODS/STUDY POPULATION: A digital survey was distributed to Duke Department of Surgery faculty regarding translational science, including opinions on definition, impacts, experienced barriers, known resources, and future training preferences. RESULTS/ANTICIPATED RESULTS: Ninety-five total responses were obtained, with 79.3% of respondents identifying their work as translational. There was no consensus on the precise definition of translational science, although the majority of respondents reported similar essential elements including multidisciplinary science and transitioning between investigative stages. Respondents noted that translational science increased their job satisfaction and recognition in their field, but also stated that they had experienced barriers to translational science. These barriers were primarily funding (56.4%) or lack of training (38.2%) related. DISCUSSION/SIGNIFICANCE OF IMPACT: The results of our pilot survey suggest that the MERITS program should focus on training investigators on the resources available for translational investigations and expound upon how it fits into and enhances their current and future research endeavors.