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Many examinees approach medical statistics with a lot of apprehension. This is justified in most circumstances as we do not regularly practise statistics, nor do we study it on a regular basis. Examiners are not different and appreciate this very well. You should remember that when you are asked questions related to medical statistics you are not expected to demonstrate the knowledge of a statistician. The examiners simply wish to satisfy themselves that as an inquisitive orthopaedic surgeon you understand the basic statistical concepts well enough to be able to scrutinize the published orthopaedic evidence. It is very unlikely that you will be asked esoteric questions (unless you do really well). Statistics of direct relevance (for example NJR survival analysis) are very popular with examiners and are frequently asked. Of the six basic science viva questions most of you would probably be asked at least one question related to Medical Statistics.
International airports, ports, and ground crossings are required to have health units for undertaking public health measures during routine times and specific measures during the time of public health emergency of international concern (PHEIC). This study was conducted at a ground crossing of North India to assess the implementation status of International Health Regulations (IHR) (2005) at a ground crossing in the prevention and control of public health emergencies and to assess the risk of imported infections from a ground crossing.
A qualitative study was conducted at the selected point of entry. The World Health Organization (WHO) core capacity assessment tool and in-depth interviews were used for data collection in the form of meetings and visits to isolation sites, and general observations were conducted regarding facilities on routine and other infrastructure and equipment that can be used during emergencies. Respondents were recruited using purposive methods.
The findings reveal that there is lack of awareness among the travelers, which increases the risks of spreading diseases. The overall implementation status at the ground crossing according to the assessment conducted using WHO Tool was 76%. It showed the need for further strengthening of the implementation at the site. Gaps were identified regarding the local capacity for handling chemical, radiological and nuclear hazards, and shortage of regular staff through stakeholders.
The findings from this study, as well as the suggestions and recommendations given by stakeholders, should help revise the current strategies of action. Hence, the gaps identified should be fulfilled to better respond to PHEIC at the ground crossings.
We argue that understanding of autism can be strengthened by increasing involvement of autistic individuals as researchers and by exploring cascading impacts of early sensory, perceptual, attentional, and motor atypicalities on social and communicative developmental trajectories. Participatory action research that includes diverse participants or researchers may help combat stigma while expanding research foci to better address autistic people's needs.
Unintended pregnancy and sexually transmitted infections (STIs) pose a huge public health problem in the United States. Efforts towards reducing unintended pregnancies have previously focused on women, but the role of men in family planning and preventing unwanted pregnancy is becoming clearer. The primary objective of the study was to fully examine the utilization of family planning services by men in the US, and to determine whether factors such as race, health insurance type and number of sexual partners influenced their utilization and receipt of family planning services and STI-related health services. Data were from the 2006–2010 National Survey on Family Growth (NSFG) study conducted in the US. The study sample comprised 7686 men aged 14–44 who ever had sex with women, and who had had at least one sexual partner in the 12 months before the survey. The receipt of family planning and STI-related health services by this group of men was estimated. The results showed that non-Hispanic Black men were more likely to receive family planning and STI-related services than Hispanic and non-Hispanic White males. Given that non-Hispanic Black men are disproportionately affected by STIs and are a high-risk group, the finding that this group received more family planning and STI services is a positive step towards reducing the disproportionately high prevalence of STIs in men in this under-privileged population.
This paper reports on an ultra-wideband low-noise distributed amplifier (LNDA) in a transferred-substrate InP double heterojunction bipolar transistor (DHBT) technology which exhibits a uniform low-noise characteristic over a large frequency range. To obtain very high bandwidth, a distributed architecture has been chosen with cascode unit gain cells. Each unit cell consists of two cascode-connected transistors with 500 nm emitter length and ft/fmax of ~360/492 GHz, respectively. Due to optimum line-impedance matching, low common-base transistor capacitance, and low collector-current operation, the circuit exhibits a low-noise figure (NF) over a broad frequency range. A 3-dB bandwidth from 40 to 185 GHz is measured, with an NF of 8 dB within the frequency range between 75 and 105 GHz. Moreover, this circuit demonstrates the widest 3-dB bandwidth operation among all reported single-stage amplifiers with a cascode configuration. Additionally, this work has proposed that the noise sources of the InP DHBTs are largely uncorrelated. As a result, a reliable prediction can be done for the NF of ultra-wideband circuits beyond the frequency range of the measurement equipment.
Antiperovskite materials are of high research interest because of their unusual physical properties and technological applications. Here, we report the structural stability and transport properties of Sr3AsN from first-principles study. The calculated equilibrium lattice parameters are in good agreement with the available data. We find that Sr3AsN is mechanically, energetically and dynamically stable at ambient conditions. Our calculated electronic structure indicates that it is a direct band gap semiconductor, with a band gap value ∼1.2 eV. Sr-4d and N-2p orbitals predominantly contribute to the formation of the direct band gap. The calculated Seebeck coefficient of Sr3AsN is high (298 μV/K at 300 K), while the lattice thermal conductivity is comparatively low (1.73 W/m K). The considerable mass difference between Sr, As, and N gives rise to an intense phonon scattering that results in such low lattice thermal conductivity. Our calculated maximum thermoelectric figure of merit (ZT) is 0.75 at 700 K, indicating that it is a potential material for thermoelectric device applications.
A new circularly polarized microstrip array antenna using the orthogonal feed technique is proposed in this paper. The antenna has a multi-layer structure and a new 3-way power divider employing the both-sided microwave integrated circuit technology is designed to configure the feed network of the array. Circular polarization (CP) is realized by creating a quadrature phase difference between orthogonal feed circuits of the patches. The multi-layer structure gives flexibility to adjust the patch spacing that helps to reduce the sidelobe level of the antenna. It is found that the multi-layer structure exhibits a gain of about 2 dB higher than that of a single layer structure by means of sidelobe reduction. The proposed structure also exhibits good CP performances that are verified by a good agreement of measured and simulated results. Simple and compact structure makes the antenna suitable for various wireless applications.
Cuprous oxide (Cu2O) thin films have been grown on both soda lime glass (SLG) microscope slides and Fluorine-doped Tin Oxide (FTO) substrates by a modified SILAR technique. The pH level of the bath solution was systematically varied in the range of 4.50 – 7.95 to elucidate their effect on the physical properties of the deposited product. The prepared films showed compact surface morphology composed of spherical grains evident from their SEM images. The XRD measurement showed that the as-deposited films were single phase Cu2O with (111) preferred orientation and this texturing was found to be increasing with increasing pH and annealing temperature. The annealed Cu2O films were found to be stable up to 200 °C and completely converted to cupric oxide (CuO) phases when the temperature reached to 350 °C. The estimated optical bandgaps of the as-grown samples were found in the range of 2.28 – 2.48 eV using UV-Vis-NIR transmission data and showing a bandgap narrowing trend with the decreasing level of solution pH. The effect of post-annealing temperatures (75-350 0C) on the as-deposited films was also studied and found to be crucial to control the optical bandgap (1.44 – 2.13) eV and electrical properties of the films. The sheet resistance of the as-deposited samples was found to be decreasing from 4120 MΩ/square to 800 MΩ/square while grown with increasing acetic acid content in the precursor solutions and decreasing up to 2.66 MΩ/square while annealing up to 250 °C in the air.
Lung surfactant (LS), a thin layer of phospholipids and proteins inside the alveolus of the lung is the first biological barrier to inhaled nanoparticles (NPs). LS stabilizes and protects the alveolus during its continuous compression and expansion by fine-tuning the surface tension at the air-water interface. Previous modelling studies have reported the biophysical function of LS monolayer and its role, but many open questions regarding the consequences and interactions of airborne nano-sized particles with LS monolayer remain. In spite of gold nanoparticles (AuNPs) having a paramount role in biomedical applications, the understanding of the interactions between bare AuNPs (as pollutants) and LS monolayer components still unresolved. Continuous inhalation of NPs increases the possibility of lung ageing, reducing the normal lung functioning and promoting lung malfunction, and may induce serious lung diseases such as asthma, lung cancer, acute respiratory distress syndrome, and more. Different medical studies have shown that AuNPs can disrupt the routine lung functions of gold miners and promote respiratory diseases. In this work, coarse-grained molecular dynamics simulations are performed to gain an understanding of the interactions between bare AuNPs and LS monolayer components at the nanoscale. Different surface tensions of the monolayer are used to mimic the biological process of breathing (inhalation and exhalation). It is found that the NP affects the structure and packing of the lipids by disordering lipid tails. Overall, the analysed results suggest that bare AuNPs impede the normal biophysical function of the lung, a finding that has beneficial consequences to the potential development of treatments of various respiratory diseases.
Age-related macular degeneration (AMD), a retinal degenerative disease that results in a continuous degeneration of photoreceptors in the retina, which eventually leads to complete blindness. One approach to combat AMD is through the use of artificially implantable photodetectors that are physically placed on the retina. Interestingly, 2D materials such as photosensitive and semiconducting molybdenum disulfide (MoS2) and electrically conducting graphene have recently received tremendous promise due to their unique photonic and optoelectronic properties and their potential in various types of micro and nano-devices. In this study, a highly biocompatible 2D graphene-MoS2 photodetectors on a flexible polyimide substrate were designed, fabricated using inkjet printing to form photosensitive pixels and tested as a function of photo intensity and strain. The inkjet printed 2D heterostructure devices were photoresponsive and the photocurrent scaled proportionally with the incident light intensity, exhibiting a photoresponsivity R ∼ 0.30 A/W at room temperature. The strain-dependent measurements of photocurrent with bending showed a photocurrent of Iph ∼ 1.16 μA with strain levels for curvature up to ∼ 0.262 cm-1. Inkjet printed graphene and MoS2 inks were also characterized using techniques such as Raman Spectroscopy, Photoluminescence (PL) and Scanning Electron Microscopy (SEM).
The objective of the study was to investigate the seasonal variations in proximate and fatty acid composition of wild sobaity (Sparidentex hasta) for a one-year period during (i) pre-spawning (October–December), (ii) spawning (January–March), (iii) post-spawning (April–June) and summer (July–September). Five male and five female fish were collected from market each month and used for the study. Skinless fillets from both sides of sobaity were taken, chopped, minced, frozen and freeze dried. Freeze-dried ground male and female fish samples were pooled separately and homogenized for proximate composition and fatty acid analysis. The results of the investigation showed that the muscle proximate composition and fatty acid profile of sobaity differed significantly (P < 0.05) among different seasons with the highest muscle lipid during the pre-spawning and spawning season. Palmitic acid (C16:0) was the most dominant muscle fatty acid followed by oleic acid (C18:1n-9). The muscle docosahexaenoic acid (DHA, C22:6n-3) levels in pre-spawning and spawning seasons were significantly (P < 0.05) higher than those in other seasons. A good n-3/n-6 ratio (2.26–3.11) and the higher DHA levels (10.16–11.47%) observed in muscles during the pre-spawning and spawning season indicated a better nutritional value of sobaity at this time of the year.
Acute respiratory infection (ARI) is a major cause of mortality among children under the age of five in developing countries. This paper examines Demographic and Health Survey (DHS) data on maternal recall of episodes of ARI in the contrasting settings of Bangladesh and Nigeria, where about 11.1% and 3.3% of under-5 children, respectively, are reported to have symptoms of ARI. The surveys found that about 25.6% of married Bangladeshi women and 15.4% of married Nigerian women reported experiencing spousal violence in the past year. To test the proposition that women’s experience of intimate partner violence (IPV) is associated with adversity in their children, the study examined the relationship between spousal violence in the past year and childhood ARI in the past 2 weeks among children under the age of five in Bangladesh and Nigeria. Data were taken from a nationally representative sample of mothers aged 15–49 years obtained from the 2007 Bangladesh DHS and 2008 Nigeria DHS. Random-effects multiple logistic regression models were estimated to assess the association of maternal exposure to IPV with the incidence of ARI in the past 2 weeks among under-5 children after controlling for the potentially confounding effects of maternal social and demographic characteristics. Results from Nigeria suggest that the odds of ARI incidence among children of mothers who were IPV victims were almost two times higher than among their counterparts whose mothers had not experienced IPV (OR = 1.78; 95% CI: 1.45–2.19; p <0.001). Similarly, the odds for the children of Bangladeshi IPV victims were elevated one and half times (OR = 1.61; 95% CI: 1.21–2.14; p <0.001). The findings suggest that under-5 children suffer indirect health consequences of gender-based violence.
Childhood stunting remains a major public health concern in Bangladesh. To accelerate the reduction rate of stunting, special focus is required during the first 23 months of a child’s life when the bulk of growth takes place. Therefore the present study explored individual-, maternal- and household-level factors associated with stunting among children under 2 years of age in Bangladesh.
Data were collected through a nationwide cross-sectional survey conducted between October 2015 and January 2016. A two-stage cluster random sampling procedure was applied to select 11 428 households. In the first stage, 210 enumerations areas (EA) were selected with probability proportional to EA size (180 EA from rural areas, thirty EA from urban slums). In the second stage, an average of fifty-four households were selected from each EA through systematic random sampling.
Rural areas and urban slums of Bangladesh.
A total of 6539 children aged 0–23 months.
Overall, 29·9 % of the children were stunted. After adjusting for all potential confounders in the modified Poisson regression model, child’s gender, birth weight (individual level), maternal education, age at first pregnancy, nutrition (maternal level), administrative division, place of residence, socio-economic status, food security status, access to sanitary latrine and toilet hygiene condition (household level) were significantly associated with stunting.
The study identified a number of potentially addressable multilevel risk factors for stunting among young children in Bangladesh that should be addressed through comprehensive multicomponent interventions.
There is limited evidence on ethnic differences in personality disorder prevalence rates. We compared rates of people with personality disorder admitted to hospital in East London from 2007 to 2013.
Of all people admitted to hospital, 9.7% had a personality disorder diagnosis. The admission rate for personality disorder has increased each year. Compared with White subjects, personality disorder was significantly less prevalent among Black and other minority ethnic (BME) groups. Personality disorder was diagnosed in 20% of forensic, 11% of general adult, 8% of adolescent and 2% of old-age in-patients.
The increasing number of personality disorder diagnoses year on year indicates the increasing impact of personality disorder on in-patient services. It is important to identify and appropriately manage patients with a personality disorder diagnosis due to the significant strain they place on resources. The reasons for fewer admissions of BME patients may reflect alternative service use, a truly lower prevalence rate or under-detection.
In this paper, an electromagnetic (EM) simulation assisted parameter extraction procedure is demonstrated for accurate modeling of down-scaled transferred-substrate InP HBTs. The external parasitic network associated with via transitions and device electrodes is carefully extracted from calibrated three-dimensional EM simulations up to 325 GHz. Following an on-wafer multi-line Through-Reflect-Line calibration procedure, the external parasitic network is de-embedded from the transistor measurements and the active device parameters are extracted in a reliable way. The small-signal model structure augmented with the distributed parasitic network provides accurate small-signal prediction up to 220 GHz.
To understand caregivers’ perceptions of children’s linear growth and to identify the cultural meanings and perceptions of risk associated with poor height attainment.
Three investigators from Bangladesh conducted twelve focus group discussions.
The study was conducted in rural and slum settings in Bangladesh.
Participants included mothers and alternative caregivers (n 81) who were recruited by household screening. No eligible, recruited subjects refused participation.
Caregivers reported limited experience with growth monitoring services from the health system. Caregivers mainly use visual cues and developmental milestones to understand if children are growing properly, and recognize that children normally experience both weight gain and linear growth with age. Mothers expressed concern over children’s malnutrition and short stature, but did not discuss children’s failure to attain a ‘growth potential’ or distinguish inherited short stature from stunting. Caregivers interpret the consequences of poor height attainment as primarily social and economic and cite few health risks.
Linear growth interpretation is determined more by community norms than by guidance from nutrition programming or the health system. Interventions to prevent or reduce linear growth failure may be perceived to have limited value where appropriate linear growth in children is determined by comparison to peers and siblings. Such perceptions may be significant barriers to programmes addressing stunting prevention in settings where many children are stunted. Efforts to raise awareness about the risks of linear growth faltering may need to consider delivering messages to caregivers that emphasize the social and economic consequences of stunting.
Overarching digitalisation is producing significant socio-cultural, economic and policy changes in the European High North. These changes create new opportunities, but also challenges and concerns for people and communities living in the region. Digital development is guided by supranational, national and regional digital policies and is secured through national cybersecurity agendas. These frameworks concentrate on advancing overall economic growth and safeguarding critical information infrastructure and information security, but pay inadequate attention to the interests, needs and fears of people and communities experiencing digitalisation in everyday life. In order to generate a more comprehensive cybersecurity agenda, which focuses on human security and empowering people to influence the digital development, a research framework highlighting the actual ways people use, wish to use, or are unable to use information and communication technologies is needed. The focus of this article is therefore on regionally contextualised digital opportunities and threats as they may be experienced by local people and communities. It utilises insights of securitisation theory to grant people a say in the direction of digital development in their region. The aim is to introduce issues of human security to cybersecurity agendas, for a more comprehensive understanding of the societal changes that digitalisation generates.
Despite progress, levels of malnutrition among children in Bangladesh are among the highest in the world and this is one of the major causes of death in children. The pace of reduction in the prevalence of undernutrition among children is still relatively low. The present study aimed to examine the association between parental education and childhood undernutrition among Bangladeshi children under 5 years of age when adjusting for potential risk factors.
The data set was extracted from a nationally representative survey based on a cross-sectional study, the Bangladesh Demographic and Health Survey (BDHS) 2014.
The base survey was conducted using a two-stage stratified sample of households. In the first stage, 600 enumeration areas (EA) were selected with probability proportional to EA size (207 EA from urban areas, 393 EA from rural areas).
A total of 7173 children under 5 years from 17 863 households were considered for the analysis. A modified Poisson regression model was implemented to the data for assessing the relationship between parental education and childhood undernutrition when demographic and socio-economic covariates for the child, parents, households and clustering were adjusted.
Higher parental education level was associated with lower levels of stunting and underweight, but not with wasting. Maternal and paternal education were both significantly associated with the reduction in prevalence of childhood undernutrition in Bangladesh.
Paternal education appears equally as important as maternal education in reducing undernutrition prevalence among children under 5 years in Bangladesh.
Progressive salinization of water and soil will be increasingly severe in low-lying coastal areas as climate change proceeds. Thus, understanding the economic impacts of salinity intrusion will be essential for effective adaptation planning. This paper uses econometric analysis to predict the impact of climate-induced increases in soil salinity on high-yielding-variety rice production in coastal Bangladesh. Findings indicate an output decline of 15.6 percent in nine subdistricts where soil salinity will exceed 4 deciSiemens per meter before 2050. Without new adaptation strategies, the predicted changes will result in 7.7 and 5.6 percent losses in the Barisal and Chittagong regions, respectively.
Heat stress is a major concern of the broiler industry due to the resulting decreased growth, feed intake and increased FCR ratio and mortality (Cooper and Washburn, 1998). Heat exposed birds decrees feed intake in order to reduce metabolic heat production and maintain hometheremy, resulting in slower growth. Genetic variation in responses to heat stress has been shown to exist between breeds (Yalcin, et al., 1997). The dual feeding program may have transitory effects on heat production during the heat stress (De Basilio et al., 2001). The aim of this research was to evaluate the response of broiler performance when a two different type of diet were offered during the heat stress.