To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Coagulopathy is the loss of balance between hemostatic and fibrinolytic processes resulting in excessive bleeding, intravascular thrombosis, or abnormalities in coagulation testing. It is frequently encountered in the neurocritical care unit and can contribute to poor outcomes. Coagulopathies present unique challenges to the neurointensivist, where early recognition and appropriate management are key. In this chapter, we will discuss techniques to assess coagulopathies as well as treatment strategies for the brain-injured patient.
Dromedary camel (Camelus dromedarius) is adapted to survive the harsh environments. It has some key adaptation peculiarities in various organs. In this study, we aimed to map the distribution pattern of unique regulatory devices along the course of the pulmonary vessels using histological and histochemical analyses. Arteries with variable wall thickness and spirally oriented course were recorded within the adventitia of the main pulmonary artery. Throttle arteries and glomus bolsters were found within the wall of the lobar pulmonary artery. The bronchial artery was located within the wall of all bronchi reaching the subsegmental branches and it had elastic longitudinal muscular intima bolsters. Arteries with double muscular media were demonstrated in the pulmonary pleura. These bolsters are suggested to play a complicated role that allows for hemodynamic, humeral, and thermoregulatory activities. The lumen of some subsegmental pulmonary veins revealed occasional constrictions arising from the corresponding muscular pad-like protrusions of the tunica media. These veins may possess occlusive or constrictive mechanisms and their obstruction induces engorgement of the associated capillary bed in addition to restricting venous outflow. Collectively, these data strongly recommend a crucial role for the special regulatory devices in preserving the camel pulmonary function in the harsh desert environment.
Paediatric obesity is a worldwide health burden, with growing evidence linking obesity to myocardial function impairments. The study aims to evaluate left ventricular functions among prepubertal obese children to obesity-related clinical and metabolic parameters.
Between June 2019 and March 2020, 40 prepubertal children with obesity were recruited and compared to 40 healthy controls. Patients were assessed for body mass index z scores, waist circumference, body adiposity by bioimpedance analysis, and obesity-related laboratory tests, for example, serum chemerin. Left ventricular functions were assessed using variable echocardiographic modalities, such as M-mode, tissue Doppler, and two-dimensional speckle tracking.
Mean patients’ age was 9.25 ± 1.05 years. Left ventricular mass index, E/E’, and myocardial performance index were significantly increased in obese children than controls. Although M-mode-derived ejection fraction was comparable in both groups, two-dimensional speckle tracking-derived ejection fraction, global longitudinal strain, and global circumferential strain were significantly lower in cases than controls. Left ventricular mass index displayed a positive correlation with body mass index z score (p = 0.003), fat mass index (p = 0.037), and trunk fat mass (p = 0.021). Global longitudinal strain was negatively correlated with body mass index z score (p = 0.015) and fat mass index (p = 0.016). Serum chemerin was positively correlated with myocardial performance index (p = 0.01).
Alterations of left ventricular myocardial functions in prepubertal obese children could be detected using different echocardiographic modalities. Chemerin, body mass index z score, fat mass index, and trunk fat mass were correlated with subclinical left ventricular myocardial dysfunction parameters before puberty. Our results reinforce early and strict management of childhood obesity upon detection of changes in anthropometric and body adiposity indices.
Several ADHD teenagers had difficult behavioral problems during countries closing down due to Covid-19 pandemic. One of these negative outcomes that parents cannot control children’s behavior toward desired unhealthy food and the impulsive consequences. It was a great opportunity to convention a teletherapy program as a tool of intervention seeking for help to reduce uncontrolled self- management and nutrition, which may affect all sorts of childhood growth, development, health and behavior. Furthermore, it can affects daily life and academic success.
We tried through our study to enhance the teletherapy as a therapeutic tool, during the first and second phase of Covid-19 pandemic, trying to help parents and patient to overcome the impulsive behavior by using a specific therapy technique based on nutrition and behavioral therapy
Our case study is a young girl aged 12:4 Yrs. In middle bilingual Arabic/ American School. The therapeutic program designed via teletherapy program using multi-media and thru multi phases sessions, to increase focus attention, emotional control and reduce impulsivity.
The outcomes of the enhancing nutrition and behavior teletherapy program, showed significant improvement for the specific goal. Sensible change in the girl’s impulsive behavior, more focusing, emotional control and more accepting about health nutrition habits.
The important finding that intensive, focused nutation and self-management techniques provided via teletherapy as solitary program brought benefits to individual’s, family and reduced impulsivity outcomes. In addition, family education to become an expert at learning simple techniques in daily life can brining a sense of pleasure for long life wellbeing.
To determine the case-fatality rate (CFR) of coronavirus disease 2019 (Covid-19) and its associated determinants in order to understand the true magnitude of the problem during the ongoing conflict in Yemen.
The CFR among the confirmed Covid-19 cases in Yemen was calculated. The data was retrieved from national Covid-19 surveillance between April 10, when the first COVID-19 case reported, and May 31, 2020.
A total of 419 confirmed Covid-19 cases were reported. There were 14.1% and 5.7% of cases who required intensive care and mechanical ventilators, respectively. Out of the total cases, 95 deaths were reported, giving a CFR of 22.6% which is much higher compared to other countries. CFR was significantly higher among elderly people compared to young adults and varied between governorates. Mortality was associated with pre-existing hypertension (OR: 2.30; 95% CI: 1.58, 3.54) and diabetes (OR: 1.68; 95% CI: 1.08, 2.61).
The elderly and those with comorbidities, in particular hypertension and diabetes, have higher risk for poor outcomes and therefore should receive more attention in the clinical setting. Preventive measures should also be prioritized to protect those groups in order to reduce the severe cases and deaths-associated COVID-19 in armed-conflict.
In the Kingdom of Saudi Arabia (KSA), Old World cutaneous leishmaniasis (CL) is mainly caused by Leishmania major and Leishmania tropica parasites. Diagnosis of CL is predominately made by clinicians, who at times fail to detect the disease and are unable to identify parasite species. Here, we report the development of a chemiluminescent enzyme-linked immunosorbent assay (CL-ELISA) to measure the levels of anti-α-galactosyl antibodies in human sera. Using this assay, we have found that individuals infected with either Leishmania spp. had significantly elevated levels (up to 9-fold higher) of anti-α-Gal IgG compared to healthy control individuals. The assay sensitivity was 96% for L. major (95% CI; 94–98%) and 91% for L. tropica (95% CI; 86–98%) infections and therefore equivalent to restriction fragment length polymorphism-polymerase chain reaction analysis of parasite ITS1 gene. In addition, the assay had higher sensitivity than microscopy analysis, which only detected 68 and 45% of the L. major and L. tropica infections, respectively. Interestingly, up to 2 years following confirmed CL cure individuals had 28-fold higher levels of anti-α-Gal IgG compared to healthy volunteers. Monitoring levels of anti-α-Gal antibodies can be exploited as both a diagnostic tool and as a biomarker of cure of Old World CL in disease elimination settings.
This paper reports the results of fieldwork conducted in the 2010 and 2011 DMP field seasons and of analysis of samples collected during these and previous years. Research has involved 1) studying palaeolake sediment outcrops, 2) using ground penetrating radar (GPR) to determine their extent under the Dahān Ubārī, and 3) coring palaeolakes in order to determine their palaeoenvironmental records. Research on these samples is continuing but some initial findings are discussed in this paper. The most extensive palaeolake sediments are found within the al-Mahruqah Formation and were deposited by a giant lake system that developed in the Fazzān Basin during past humid periods. Stratigraphic analysis of Lake Megafazzān sediments suggests two different sedimentary successions, a lake margin succession distinctive for its lacustrine and palaeosol carbonates, and a clastic-dominated, intensely rootleted, basin-centre succession which has terrestrial intervals (aeolian and palaeosols) as well as in the upper parts lacustrine limestones. Both basin margin and basin centre successions are underlain by fluvial deposits. Magnetostratigraphy suggests that the formation may be as old as the mid-Pliocene. After the Lake Megafazzān phase, smaller palaeolakes developed within the basin during subsequent humid periods. One of the largest is found in the Wādī al-Hayāt in the area between Jarma and Ubārī. Similar deposits further west along the Wādī at progressively higher altitudes are interpreted as small lakes and marshes fed by springs issuing from aquifers at the base of the escarpment, last replenished during the Holocene humid phase. Dating of sediments suggests that this was between c. 11 and c. 8 ka. The Wādī ash-Shāţī palaeolake core also provides a Holocene palaeoclimate record that paints a slightly different picture, indicating lake conditions until around 7 ka, whereupon it started oscillating until around 5.5 ka when sedimentation terminates. The reasons for the differences in these records are discussed.
The January 2009 fieldwork season conducted geomorphological and palaeoenviromental surveys in as yet unexplored parts of the Lake Megafazzan Basin, as well as continuing research in the Wadi al-Hayat and Ubari Sand Sea. Lake Megafazzan sediments were investigated at two sites on the eastern margin of the basin. At the first site, east of Tamessah, 24 m of stratigraphy was investigated and found to consist of a lacustrine carbonate unit at the base progressing into a fluvial unit and then an upper carbonate unit. The sediments were sampled for magnetostratigraphy and cosmogenic nucleide dating in order to determine their age. Similar studies were undertaken in the vicinity of the Arial Agricultural Project, where 31 m of section were logged and sampled. Here the sediments were quite different, being composed of a deltaic sequence consisting of stacked channels and palaeosols, thought to represent the outflow delta of the palaeolake. Many new Holocene lake sediment deposits were discovered and sampled in the Wadi al-Hayat and the Ubari Sand Sea, including a 5 m section through Jarma Playa that appears to record the last arid-humid cycle. Lake Gabr 'Awn and the moat round Old Jarma were cored in order to gather a detailed picture of recent palaeoenvironmental change. Finally, we implemented a pilot geophysical survey to test the ability of state-of-the-art Ground Penetrating Radar (UltraGPR) technology for detecting and mapping buried palaeolake sediments under the dunes of the Ubari Sand Sea. The UltraGPR was found to be very effective, detecting palaeolake sediments as much as 60 m beneath the surface. Preliminary results suggest such sediments underlie much of the region.
This study was carried out in four adjacent villages in Lower Egypt with a combined population of 24,000. A team of social workers and physicians worked together to introduce the injectable contraceptive depomedroxyprogesterone acetate as a post-partum long-acting contraceptive to the community leaders and the villagers at several meetings. Postpartum women who agreed to use the drug were defined as acceptors (591) and those who did not were defined as rejectors (715). The incidence of polygamy was higher among the rejectors, and rejectors' husbands had more children from their other wives. Acceptors had more previous pregnancies and children of both sexes than rejectors. The interval between the last two pregnancies was shorter among the rejectors. A greater percentage of acceptors had previously used another contraceptive. The commonest reasons for rejection were desire for further pregnancy (69%), health problems (11%) and desire for another method of contraception (8%). Religious factors figured in only 3% of cases.
The effectiveness of association mapping (AM) based on linkage disequilibrium (LD) is currently being tested in a number of crops. An important prerequisite for the application of AM is the availability of collections of accessions with a suitable level of genetic variation for target traits and with limited spurious LD due to the presence of population structure. Herein, the results of a genome-wide molecular characterization of a collection of elite durum wheat accessions well-adapted to Mediterranean environments are presented. Ninety-seven highly polymorphic simple sequence repeats and 166 amplified fragment length polymorphism markers were used to characterize 189 durum accessions, mainly cultivars and advanced breeding lines. Genome-wide significant and sizeable LD indices at a centimorgan scale were observed, while LD mainly decayed within 10 cM. On the other hand, effects due to spurious LD were notably lower than those previously observed in a durum wheat collection sampling durum gene pools of more diverse origin. These results, coupled with the high level of genetic variability detected for a number of important morpho-physiological traits and their high heritability, indicate the suitability of this collection for AM studies targeting agronomically important traits.
The Desert Migrations Project is a new interdisciplinary and multi-dimensional collaborative project between the Society for Libyan Studies and the Department of Antiquities. The geographical focus of the study is the Fazzan region of southwest Libya and in thematic terms we aim to address the theme of migration in the broadest sense, encompassing the movement of people, ideas/knowledge and material culture into and out of Fazzan, along with evidence of shifting climatic and ecological boundaries over time. The report describes the principal sub-strands of the project's first season in January 2007, with some account of research questions, methods employed and some preliminary results. Three main sub-projects are reported on. The first concerns the improved understanding of long-term climatic and environmental changes derived from a detailed palaeoenvironmental study of palaeolake sediments. This geo-science work runs alongside and feeds directly into both archaeological sub-projects, the first relating to prehistoric activity and mobility around and between a series of palaeolakes during wetter climatic cycles; the second to the excavation of burials in the Wadi al-Ajal, exploring the changing relationship between material culture, identity and ethnicity across time, from prehistory to the early Islamic period (the span of the main cemetery zones). In addition, some rock art research and a survey of historic period sites was undertaken in the Wadi ash-Shati and Ubari sand sea.