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A wide range of natural and man-made hazards increases the health risks at mass gatherings (MGs). Building on the Sendai Framework for Disaster Risk Reduction 2015-2030, the World Health Organization (WHO) developed the Health Emergency and Disaster Risk Management (H-EDRM) framework to strengthen preparedness, response, and recovery from health emergencies in the communities and emergency-prone settings, such as MGs. The Jeddah tool is derived from the H-EDRM framework as an all-hazard MG risk assessment tool, which provides a benchmark for monitoring progress made in capacity strengthening over a given period for recurrent MGs. Additionally, it introduces a reputational risk assessment domain to complement vulnerability and capacity assessment matrixes. This paper describes the key elements of the Jeddah tool to improve the understanding of health risk assessment at MGs in the overarching contexts of health emergencies and disaster risk reduction, in line with international goals.
This study was conducted to monitor the cellular and molecular changes of buffalo cumulus–oocytes complexes (COCs) cultured under high or low oxygen levels. Morphologically good quality COCs (n = 1627) were screened using brilliant cresyl blue (BCB) staining and placed into three groups (BCB+, BCB− and control). All groups of COCs were cultured under low (5%) or high (20%) oxygen tensions. Intracellular and molecular changes including oocyte ultrastructure, lipid contents, mitochondrial activity and transcript abundance of genes regulating different pathways were analyzed in the matured oocyte groups. The results revealed that oxygen tension did not affect cumulus expansion rates, however the BCB+ group had a higher (P ≤ 0.05) expansion rate compared with the BCB− group. BCB− oocytes recorded the lowest meiotic progression rate (P ≤ 0.05) under high oxygen levels that was linked with an increased level of reactive oxygen species (ROS) compared with the BCB+ oocytes. Ultrastructure examination indicated that BCB+ oocytes had a higher rate of cortical granules migration compared with BCB− under low oxygen tension. In parallel, our results indicated the upregulation of NFE2L2 in groups of oocytes cultured under high oxygen tension that was coupled with reduced mitochondrial activity. In contrast, the expression levels of MAPK14 and CPT2 genes were increased (P ≤ 0.05) in groups of oocytes cultured under low compared with high oxygen tension that was subsequently associated with increased mitochondrial activity. In conclusion, data from the present investigation indicated that low oxygen tension is a favourable condition for maintaining the mitochondrial activity required for nuclear maturation of buffalo oocytes. However, low-quality oocytes (BCB−) responded negatively to high oxygen tension by reducing the expression of gene-regulating metabolic activity (CPT2). This action was an attempt by BCB− oocytes to reduce the increased levels of endogenously produced ROS that was coupled with decreased expression of the gene controlling meiotic progression (MAPK14) in addition to nuclear maturation rate.
In this paper, a compact 4-port band-notched multi-input-multi-output (MIMO) antenna with asymmetric coplanar strip (ACS) feed is presented for ultra-wide band (UWB) applications. The MIMO antenna is comprised of four semi-elliptical radiators with ACS feed for UWB applications and it is printed on inexpensive FR4 substrate of size 48 × 52 mm2 with ɛr = 4.4 and 1.6 mm height. The impedance characteristics of the suggested MIMO antenna ranges from 2.7 to 11 GHz with a band-notched behavior from 3 to 4 GHz to reduce the interception with WiMAX applications, and the isolation level over the achieved band is more than 20 dB between any two adjacent elements. Moreover, the radiation pattern of the proposed UWB antenna is almost omnidirectional with an average realized gain of 3.5 dBi over the entire achieved frequency band. The proposed ACS-fed antenna is confirmed by fabricating and measuring it's impedance and radiation characteristics. Finally, good consistency between simulation and measured outcomes is obtained confirming the validity of the MIMO antenna for real-life UWB wireless systems.
Rhabdomyoma is the most common cardiac tumour in children. It is usually associated with tuberous sclerosis complex caused by mutations in TSC-1 or TSC-2 genes. This tumour typically regresses by unknown mechanisms; however, it may cause inflow or outflow obstruction that necessitates urgent surgery. Here we investigate the clinical features and the genetic analysis of patients with tuberous sclerosis complex presenting with large rhabdomyoma tumours. We also investigate the potential role of autophagy and apoptosis in the pathogenesis of this tumour.
All the patients with cardiac rhabdomyoma referred to Aswan Heart Centre from 2010 to 2018 were included in this study. Sanger sequencing was performed for coding exons and the flanking intronic regions of TSC1 and TSC2 genes. Histopathological evaluation, immunohistochemistry, and western blotting were performed with P62, LC3b, caspase3, and caspase7, to evaluate autophagic and apoptotic signaling.
Five patients were included and had the clinical features of tuberous sclerosis complex. Three patients, who were having obstructive tumours, were found to have pathogenic mutations in TSC-2. The expression of two autophagic markers, P62 and LC3b, and two apoptotic markers, caspase3 and caspase7, were increased in the tumour cells compared to normal surrounding myocardial tissue.
All the patients with rhabdomyoma were diagnosed to have tuberous sclerosis complex. The patients who had pathogenic mutations in the TSC-2 gene had a severe disease form necessitating urgent intervention. We also demonstrate the potential role of autophagy and apoptosis as a possible mechanism for tumourigenesis and regression. Future studies will help in designing personalised treatment for cardiac rhabdomyoma.
Yield gaps in milk production are here defined as the differentials between the actual yield obtained by the dairy farmer and the potential farm yield (production achieved by the top 10% of farmers: Gap 2) as well as the differential between this potential farm yield and the yield registered in the research stations (Gap 1). Assessment of yield gaps provides valuable information on potential production enhancement and drivers behind yield gaps. Milk production can be increased by narrowing the predominant large yield gaps in resource-poor smallholder farming system. Hence, this study assessed the milk yield gap and factors affecting the yield gap in Ri-Bhoi district of Meghalaya, a state located in the north-eastern Himalayan region of India. This research paper provides a scope for exploring the possibilities for improving dairy production in the state as well as contributing to literature through incorporating crucial determinants responsible for milk yield gap. A sample of 81 respondents was drawn purposely from two blocks of the district. The results indicated that the average number of cattle per household was 9.38 in standard animal units. The total yield gap was estimated at 6.20 l (91.06%) per day, composed of 0.80 l (11.76%) per day of yield gap I and 5.40 l (79.30%) per day of yield gap II. This demonstrates that the top performing farms were achieving a production level not dissimilar to that obtained on the research stations, but many were doing far less well. The size of cattle shed, dairy farming experience, concentrate price and human labour were the important determinants of the yield gap. Hence, encouraging the right stocking density of cattle, training on the preparations of home-made concentrates, access to cheap and quality concentrates, incorporating training and experience sharing on proper dairy management practices and use of technology could benefit the dairy farmers of the region.
The present study aims to investigate the efficacy of intravenously injected mesenchymal stem cells (MSCs) in treating neuropathic pain either before or after its induction by a chronic constriction injury (CCI) model. Rats were divided into four groups: control group, neuropathic group, and treated groups (pre and postinduction) with i.v. mononuclear cells (106 cell/mL). For these rats, experimental testing for both thermal and mechanical hyperalgesia was evaluated. The cerebral cortex of the rats was dissected, and immunohistochemical analysis using anti-proliferating cell nuclear antigen (PCNA), CD117, nestin, and glial fibrillary acidic protein was performed. Our results showed that a single injection of MSCs (either preemptive/or post-CCI) produced equipotent effects on allodynia, mechanical hyperalgesia, and thermal response. Immunohistochemical analysis showed that the stem cells have reached the cerebral cortex. The injected group with MSCs before CCI showing few stem cells expressed PCNA, CD117, and nestin in the cerebral cortex. The group injected with MSCs after CCI, showing numerous recently proliferated CD117-, nestin-, PCNA-positive stem cells in the cerebral cortex. In conclusion, our findings demonstrate that the most probable effect of i.v. stem cells is the central anti-inflammatory effect, which opens concerns about how stem cells circulating in systemic administration to reach the site of injury.
This in situ transmission electron microscopy work presents a nanoscale characterization of the microstructural evolution in 3D-printed Inconel 718 (IN718) while exposed to elevated temperature and an associated change in the mechanical property under tensile loading. Here, we utilized a specially designed specimen shape that enables tensile testing of nano-sized thin films without off-plane deformations. Additionally, it allows a seamless transition from the in situ heating to tensile experiment using the same specimen, which enables a direct correlation of the microstructure and the mechanical property of the sample. The method was successfully used to observe the residual stress relaxation and the formation of incoherent γ′ precipitates when temperature was increased to 700°C. The subsequent in situ tensile test revealed that the exposure of the as-printed IN718 to a high temperature without full heat treatment (solutionizing and double aging) leads to loss of ductility.
Primary care is geared to manage patients with mild to moderate presentations of common mental disorders and to refer patients with more severe mental disorders to specialist mental health services. With growing demand for specialty care, the quality of the referral is increasingly important to ensure efficient patient flow across the primary/secondary care interface and appropriate use of secondary services. We report on an initiative in a Qatari mental health clinic to improve the quality of referrals from primary care to specialist mental health services through an educational intervention for family physicians. We highlight the problem, the intervention and the outcome of our initiative, which was the first of its kind in the region. The number of inappropriate referrals fell by 93%, and the number of referrals with inadequate clinical information declined from 15 (January 2019) to 1 (September 2019). Feedback was very positive; respondents reported feeling supported, with better understanding of care pathways, the scope of primary care and mental health services.
A user interface (UI) design that meets the preferences, differences, and needs of the group of users can potentially increase the usability of a system. Users, in general, feel more familiar with the context that reflects their cultural values and practices. The Arabic culture plays a significant role in how Arab users interact and communicate with technologies. The customs, artifacts, and traditions of the Arab world are different in nature from the Western cultures. Thus, it is essential to consider these differences when designing the UI prototype. This study investigated the role of certain cultural preferences in the design of UI for Arab users. A think-aloud approach and Hofstede's cultural dimensions were used on 23 Arab users to generate the necessary design guidelines for the UI of mobile health application. Then, 78 participants were recruited to evaluate the proposed UI design. The usability results showed high satisfaction among Arab users about the role of culture in the design of the UI. Findings from this study can be used by designers and developers to aid their design of UI for group-specific cultural preferences and values.
Digital technologies have made it possible for people to work from literally anywhere in the world, as long as they have the right devices and Wi-Fi (Torten et al., 2016). At the same time, the number of self-employed workers is growing rapidly. This group usually does not have an office in a firm they can go to every day, to work. Digital technologies open up an array of possibilities. Working is possible anywhere and anytime. Self-employed workers can choose to work from home, a rented hot desk in a co working space, in coffee-shops, hotel lobbies, and even on the beach in a sunny resort on a beautiful island. In this chapter, the focus lies on self-employed workers who work in hotel lobbies that were not primarily designed as co-working spaces.
Since December 2019, the clinical symptoms of coronavirus disease 2019 (COVID-19) and its complications are evolving. As the number of COVID patients requiring positive pressure ventilation is increasing, so is the incidence of subcutaneous emphysema (SE). We report 10 patients of COVID-19, with SE and pneumomediastinum. The mean age of the patients was 59 ± 8 years (range, 23–75). Majority of them were men (80%), and common symptoms were dyspnoea (100%), fever (80%) and cough (80%). None of them had any underlying lung disorder. All patients had acute respiratory distress syndrome on admission, with a median PaO2/FiO2 ratio of 122.5. Eight out of ten patients had spontaneous pneumomediastinum on their initial chest x-ray in the emergency department. The median duration of assisted ventilation before the development of SE was 5.5 days (interquartile range, 5–10 days). The highest positive end-expiratory pressure (PEEP) was 10 cmH2O for patients recieving invasive mechanical ventilation, while 8 cmH2O was the average PEEP in patients who had developed subcutaneous emphysema on non-invasive ventilation. All patients received corticosteroids while six also received tocilizumab, and seven received convalescent plasma therapy, respectively. Seven patients died during their hospital stay. All patients either survivor or non-survivor had prolonged hospital stay with an average of 14 days (range 8−25 days). Our findings suggest that it is lung damage secondary to inflammatory response due to COVID-19 triggered by the use of positive pressure ventilation which resulted in this complication. We conclude that the development of spontaneous pneumomediastinum and SE whenever present, is associated with poor outcome in critically ill COVID-19 ARDS patients.
The present work aimed at studying the efficacy of mebendazole (MBZ) compared to artemisinin (ART) for the treatment of trichinellosis at various phases of infection. Seventy Swiss albino mice were orally infected by 300 Trichinella spiralis (T. spiralis) larvae. Mice were divided into infected untreated control group and infected groups treated with 50 mg kg−1 MBZ and 300 mg kg−1 ART for three and five consecutive days, respectively, at the enteral phase [2–4 days post infection (PI)], invasive phase (10–12 days PI) and encapsulated phase (28–30 days PI). All mice were sacrificed 35–42 days PI. MBZ and ART revealed a significant decrease in mean larval counts and increase of larval per cent reduction (LR %) when treatment was initiated during the enteral phase compared to the other phases. MBZ showed significantly higher LR % (99.7, 83.95 and 89.65%) than ART (80.58, 67.0 and 79.2%) when administered at the three infection phases. Histopathological study showed a decrease in the number of encysted larvae, their surrounding cellular infiltrates and increased regenerative muscles in all treated mice. In conclusion, ART possesses a substantial anthelmintic activity against T. spiralis infection in mice both at the enteral and encapsulated phases, yet, significantly lower than MBZ.