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Drought and high temperature each damage rice (Oryza sativa L.) crops. Their effect during seed development and maturation on subsequent seed quality development was investigated in Japonica (cv. Gleva) and Indica (cv. Aeron 1) plants grown in controlled environments subjected to drought (irrigation ended) and/or brief high temperature (HT; 3 days at 40/30°C). Ending irrigation early in cv. Gleva (7 or 14 days after anthesis, DAA) resulted in earlier plant senescence, more rapid decline in seed moisture content, more rapid seed quality development initially, but substantial decline later in planta in the ability of seeds to germinate normally. Subsequent seed storage longevity amongst later harvests was greatest with no drought because with drought it declined from 16 or 22 DAA onwards in planta, 9 or 8 days after irrigation ended, respectively. Later drought (14 or 28 DAA) also reduced seed longevity at harvest maturity (42 DAA). Well-irrigated plants provided poorer longevity the earlier during seed development they were exposed to HT (greatest at anthesis and histodifferentiation; no effect during seed maturation). Combining drought and HT damaged seed quality more than each stress alone, and more so in the Japonica cv. Gleva than the Indica cv. Aeron 1. Overall, the earlier plant drought occurred the greater the damage to subsequent seed quality; seed quality was most vulnerable to damage from plant drought and HT at anthesis and histodifferentiation; and seed quality of the Indica rice was more resilient to damage from these stresses than the Japonica.
Bangladesh, like many emerging economies of South-East Asia, has started to experience a double burden of continuing high rates of undernutrition and increasing rates of overweight and obesity. A lack of assessment of the nutritional shift leaves a gap in current policies: the growing overweight and obesity is yet to be addressed. The present paper investigates the change in nutritional status, particularly the shift in BMI, of Bangladeshi women of reproductive age (15–49 years) and characterizes the vulnerable households for both underweight and overweight status during a period of 10 years (2004–2014).
Generalized linear mixed-effect models were fitted for both urban and rural residents to assess underweight and overweight status.
Bangladesh Demographic and Health Surveys.
Women aged 15–49 years (n 53 077).
The proportion of overweight increased during 2004–2014 from 10·7 to 25·1 % and the proportion of underweight decreased from 32·6 to 18·2 %. Prevalence of underweight status remained high in rural areas and prevalence of overweight increased rapidly in both rural and urban areas, creating a double burden. The significant contributors to this double burden were the change in women’s level of education, increased household wealth, divisional location and rapid urbanization.
The findings indicate that specific cohort- or area-based intervention policy studies in line with the UN Decade of Action on Nutrition are required to address the nutritional double burden in Bangladesh.
This paper presents a vision-based path planning strategy that aims to reduce the computational time required by a robot to find a feasible path from a starting point to the goal point. The proposed algorithm presents a novel strategy that can be implemented on any well-known path planning algorithm such as A*, D* and probabilistic roadmap (PRM), to improve the swiftness of these algorithms. This path planning algorithm is suitable for real-time scenarios since it reduces the computational time compared to the basis and traditional algorithms. To test the proposed path planning strategy, a tracking control strategy is implemented on a mobile platform. This control strategy consists of three major stages. The first stage deals with gathering information about the surrounding environment using vision techniques. In the second stage, a free-obstacle path is generated using the proposed reduced scheme. In the final stage, a Lyapunov kinematic tracking controller and two Artificial Neural Network (ANN) based-controllers are implemented to track the proposed path by adjusting the rotational and linear velocity of the robot. The proposed path planning strategy is tested on a Pioneer P3-DX differential wheeled mobile robot and an Xtion PRO depth camera. Experimental results prove the efficiency of the proposed path planning scheme, which was able to reduce the computational time by a large percentage which reached up to 88% of the time needed by the basis and traditional scheme, without significant adverse effect on the workability of the basis algorithm. Moreover, the proposed path planning algorithm has improved the path efficiency, in terms of the path length and trackability, challenging the traditional trade-off between swiftness and path efficiency.
A third of patients diagnosed with major depressive disorder (MDD) experience treatment-resistant depression (TRD). Relatively few pharmacological agents have established efficacy for TRD. Therefore, the evaluation of novel treatments for TRD is a pressing priority. Statins are pleiotropic agents and preclinical studies as well as preliminary clinical trials have suggested that these drugs may have antidepressant properties.
To report on a protocol for a 12-week, randomised, double-blind, placebo-controlled trial of add-on treatment with simvastatin for patients meeting DSM-5 criteria for MDD who have failed to respond to at least two adequate trials with approved antidepressants. The trial has been registered with Clinicaltrials.gov in (ClinicalTrials.gov identifier: NCT03435744).
After screening and randomisation to the two parallel arms of the trial, 75 patients will receive simvastatin and 75 patients will receive placebo as adjuncts to treatment as usual. The primary outcome is change in Montgomery–Åsberg Depression Rating Scale scores from baseline to week 12 and secondary outcomes include changes in scores on the 24-item Hamilton Rating Scale for Depression, the Clinical Global Impression scale, the 7-item Generalized Anxiety Disorder scale and change in body mass index from baseline to week 12. Assessments will take place at screening, baseline, and weeks 2, 4, 8 and 12. Checklists for adverse effects will be undertaken at each visit. Simvastatin (20 mg) will be given once daily. Other secondary outcomes include C-reactive protein and plasma lipids measured at baseline and week 12.
This trial will assess simvastatin's efficacy and tolerability as an add-on treatment option for patients with TRD and provide insights into its putative mechanisms of action.
As the first trial investigating the use of simvastatin as an augmentation strategy in patients with TRD, if the results indicate that adjuvant simvastatin is efficacious in reducing depressive symptoms, it will deliver immediate clinical benefit.
Declaration of interest
I.B.C. and N.H. have given lectures and advice to Eli Lilly, Bristol Myers Squibb, Lundbeck, Astra Zeneca and Janssen pharmaceuticals for which they or their employing institution have been reimbursed. R.R. and M.M.H. have received educational grants and support for academic meetings from Pfizer, Roche, Novartis and Nabiqasim. A.H.Y. has been commissioned to provide lectures and advice to all major pharmaceutical companies with drugs used in affective and related disorders. A.H.Y. has undertaken investigator-initiated studies from Astra Zeneca, Eli Lilly, Lundbeck and Wyeth. None of the companies have a financial interest in this research.
This paper investigates the passive and active control strategies to provide a physical assistance and rehabilitation by a 7-DOF exoskeleton robot with nonlinear uncertain dynamics and unknown bounded external disturbances due to the robot user's physiological characteristics. An Integral backstepping controller incorporated with Time Delay Estimation (BITDE) is used, which permits the exoskeleton robot to achieve the desired performance of working under the mentioned uncertainties constraints. Time Delay Estimation (TDE) is employed to estimate the nonlinear uncertain dynamics of the robot and the unknown disturbances. To overcome the limitation of the time delay error inherent of the TDE approach, a recursive algorithm is used to further reduce its effect. The integral action is employed to decrease the impact of the unmodeled dynamics. Besides, the Damped Least Square method is introduced to estimate the desired movement intention of the subject with the objective to provide active rehabilitation. The controller scheme is to ensure that the robot system performs passive and active rehabilitation exercises with a high level of tracking accuracy and robustness, despite the unknown dynamics of the exoskeleton robot and the presence of unknown bounded disturbances. The design, stability, and convergence analysis are formulated and proven based on the Lyapunov–Krasovskii functional theory. Experimental results with healthy subjects, using a virtual environment, show the feasibility, and ease of implementation of the control scheme. Its robustness and flexibility to deal with parameter variations due to the unknown external disturbances are also shown.
We are a group of researchers and clinicians with collective experience in child survival, nutrition, cognitive and social development, and treatment of common mental conditions. We join together to welcome an expanded definition of child development to guide global approaches to child health and overall social development. We call for resolve to integrate maternal and child mental health with child health, nutrition, and development services and policies, and see this as fundamental to the health and sustainable development of societies. We suggest specific steps toward achieving this objective, with associated global organizational and resource commitments. In particular, we call for a Global Planning Summit to establish a much needed Global Alliance for Child Development and Mental Health in all Policies.
Little is known about Clostridium difficile infection (CDI) in Asia. The aims of our study were to explore (i) the prevalence, risk factors and molecular epidemiology of CDI and colonization in a tertiary academic hospital in North-Eastern Peninsular Malaysia; (ii) the rate of carriage of C. difficile among the elderly in the region; (iii) the awareness level of this infection among the hospital staffs and students. For stool samples collected from hospital inpatients with diarrhea (n = 76) and healthy community members (n = 138), C. difficile antigen and toxins were tested by enzyme immunoassay. Stool samples were subsequently analyzed by culture and molecular detection of toxin genes, and PCR ribotyping of isolates. To examine awareness among hospital staff and students, participants were asked to complete a self-administered questionnaire. For the hospital and community studies, the prevalence of non-toxigenic C. difficile colonization was 16% and 2%, respectively. The prevalence of CDI among hospital inpatients with diarrhea was 13%. Out of 22 C. difficile strains from hospital inpatients, the toxigenic ribotypes 043 and 017 were most common (both 14%). In univariate analysis, C. difficile colonization in hospital inpatients was significantly associated with greater duration of hospitalization and use of penicillin (both P < 0·05). Absence of these factors was a possible reason for low colonization in the community. Only 3% of 154 respondents answered all questions correctly in the awareness survey. C. difficile colonization is prevalent in a Malaysian hospital setting but not in the elderly community with little or no contact with hospitals. Awareness of CDI is alarmingly poor.
The aim of this feasibility trial was to evaluate the feasibility and acceptability of the locally adapted Group Problem Management Plus (PM+) intervention for women in the conflict affected settings in Swat, Pakistan.
This mixed-methods study incorporated a quantitative component consisting of a two arm cluster randomised controlled feasibility trial, and qualitative evaluation of the acceptability of the Group PM+ to a range of stakeholder groups. For the quantitative component, on average from each of the 20 Lady Health Workers (LHWs) catchment area (20 clusters), six women were screened and recruited for the trial with score of >2 on the General Health Questionnaire and score of >16 on the WHO Disability Assessment Schedule. These LHW clusters were randomised on a 1 : 1 allocation ratio using a computer-based software through a simple randomisation method to the Group PM+ intervention or Enhanced Usual Care. The Group PM+ intervention consisted of five weekly sessions of 2 h duration delivered by local non-specialist females under supervision. The primary outcome was individual psychological distress, measured by levels of anxiety and depression on the Hospital Anxiety and Depression Scale at 7th week after baseline. Secondary outcomes include symptoms of depression, post-traumatic stress disorder (PTSD), general psychological profile, levels of functioning and generalised psychological distress. Intervention acceptability was explored through in-depth interviews.
The results show that lay-helpers with no prior mental health experience can be trained to achieve the desired competency to successfully deliver the intervention in community settings under supervision. There was a good intervention uptake, with Group PM+ considered useful by participants, their families and lay-helpers. The outcome evaluation, which was not based on a large enough study to identify statistically significant results, indicated statistically significant improvements in depression, anxiety, general psychological profile and functioning. The PTSD symptoms and depressive disorder scores showed a trend in favour of the intervention.
This trial showed robust acceptance in the local settings with delivery by non-specialists under supervision by local trained females. The trial paves the way for further adaptation and exploration of the outcomes through larger-scale implementation and definitive randomised controlled trials in the local settings.
Development disorders and delays are recognised as a public health priority and included in the WHO mental health gap action programme (mhGAP). Parents Skills Training (PST) is recommended as a key intervention for such conditions under the WHO mhGAP intervention guide. However, sustainable and scalable delivery of such evidence based interventions remains a challenge. This study aims to evaluate the effectiveness and scaled-up implementation of locally adapted WHO PST programme delivered by family volunteers in rural Pakistan.
The study is a two arm single-blind effectiveness implementation-hybrid cluster randomised controlled trial. WHO PST programme will be delivered by ‘family volunteers’ to the caregivers of children with developmental disorders and delays in community-based settings. The intervention consists of the WHO PST along with the WHO mhGAP intervention for developmental disorders adapted for delivery using the android application on a tablet device. A total of 540 parent-child dyads will be recruited from 30 clusters. The primary outcome is child's functioning, measured by WHO Disability Assessment Schedule – child version (WHODAS-Child) at 6 months post intervention. Secondary outcomes include children's social communication and joint engagement with their caregiver, social emotional well-being, parental health related quality of life, family empowerment and stigmatizing experiences. Mixed method will be used to collect data on implementation outcomes. Trial has been retrospectively registered at ClinicalTrials.gov (NCT02792894).
This study addresses implementation challenges in the real world by incorporating evidence-based intervention strategies with social, technological and business innovations. If proven effective, the study will contribute to scaled-up implementation of evidence-based packages for public mental health in low resource settings.
Registered with ClinicalTrials.gov as Family Networks (FaNs) for Children with Developmental Disorders and Delays. Identifier: NCT02792894 Registered on 6 July 2016.
Among invertebrates and both in modern and ancient marine environments, certain echinoderms have been and are some of the most active and widespread bioturbators and bioeroders. Bioturbation and/or bioerosion of regular and irregular echinoids, starfish, brittle stars, sea cucumbers and crinoids are known from modern settings, and some of the resulting traces have their counterparts in the fossil record. By contrast, surficial trails or trackways produced by other modern echinoderms, e.g., sand dollars, exhibit a lower preservation rate and have not yet been identified in the fossil record. In addition, the unique features of the echinoderm skeleton (e.g., composition, rapid growth, multi-element architecture, etc.) may promote the production of related traces produced by the reutilization of echinoderm ossicles (e.g., burrow lining), predation (e.g., borings), or parasitism (e.g., swellings or cysts). Finally, the skeletal robustness of some echinoids may promote their post mortum use as benthic islands for the settlement of hard-substrate dwellers.
Fossilized tests of 1,053 Echinocyamus stellatus (Capeder, 1906) from the Miocene Globigerina Limestone Formation exposed on the northern coast of Gozo (Maltese Islands) were analyzed for predation traces. Specimens mixed by time-averaging processes can be clearly separated into two distinct samples according to their preservation as phosphatized or nonphosphatized individuals. Overall, 11.1% of the tests reveal holes that are referred to the ichnospecies Oichnus simplex (Bromley, 1981). Because of the hole morphology and diameter, the holes are interpreted as predatory drill holes, most likely produced by cassid gastropods. Redeposited phosphatized echinoids derived from an earlier period of reduced sedimentation rates show drilling frequencies of 20.5%. Younger, autochthonous, nonphosphatized echinoids show drilling frequencies of 8.1%. In both samples, predators predominantly targeted the aboral side of the echinoid test, particularly on the petalodium.
Endoscope-associated infections are reported despite following proper reprocessing methods. Microbiological testing can confirm the adequacy of endoscope reprocessing. Multiple controversies related to the method and interpretation of microbiological testing cultures have arisen that make their routine performance a complex target.
We conducted a pilot study using disposable bronchoscopes (DBs) to simulate different reprocessing times and soaking times and to compare high-level disinfection versus ethylene oxide sterilization. We also reviewed the time to reprocessing and duration of the procedures.
Bronchoscopes were chosen because an alternative disposable scope is commercially available and because bronchoscopes are more prone to delays in processing. Disposable bronchoscopes were contaminated using a liquid bacterial suspension and were then incubated for 1–4 hours. Standard processing and high-level disinfection were performed on 36 endoscopes. Ethylene oxide sterilization was performed on 21 endoscopes. Endoscope cultures were performed using the standard “brush, flush, brush” technique.
After brushing was performed, a final water-flush culture procedure was the most effective method of detecting bacterial persistence on the disposable scopes. Klebsiella pneumoniae was the most commonly recovered organism after reprocessing. Ethylene oxide sterilization did not result in total elimination of viable bacteria.
Routine endoscopy cultures may be required to assess the adequacy of endoscopic processing.
We investigated the range of people involved in killing tigers Panthera tigris in the Bangladesh Sundarbans, their motives and methods, and their links to the commercial trade. Using snowball sampling we conducted 141 qualitative interviews with local people. We identified five categories (village residents, poachers, shikaris, trappers and pirates), each with different motives, methods and networks. Village residents kill tigers predominantly for safety, whereas others kill in the forest professionally or opportunistically. Poachers kill tigers for money, but for others the motives are more complex. The motives of local hunters are multifaceted, encompassing excitement, profit, and esteem and status arising from providing tiger parts for local medicine. Pirates kill tigers for profit and safety but also as a protection service to the community. The emerging international trade in tiger bones, introduced to the area by non-local Bangladeshi traders, provides opportunities to sell tiger parts in the commercial trade and is a motive for tiger killing across all groups.
Drinking raw date palm sap is the primary route of Nipah virus (NiV) transmission from bats to people in Bangladesh; subsequent person-to-person transmission is common. During December 2010 to March 2011, we investigated NiV epidemiology by interviewing cases using structured questionnaires, in-depth interviews, and group discussions to collect clinical and exposure histories. We conducted a case-control study to identify risk factors for transmission. We identified 43 cases; 23 were laboratory-confirmed and 20 probable. Thirty-eight (88%) cases died. Drinking raw date palm sap and contact with an infected person were major risk factors; one healthcare worker was infected and for another case transmission apparently occurred through contact with a corpse. In absence of these risk factors, apparent routes of transmission included drinking fermented date palm sap. For the first time, a case was detected in eastern Bangladesh. Identification of new epidemiological characteristics emphasizes the importance of continued NiV surveillance and case investigation.
There is limited information on percent expenditure of household income due to childhood diarrhoea especially in rural Bangladesh. A total of 4205 children aged <5 years with acute diarrhoea were studied. Percent expenditure was calculated as total expenditure for the diarrhoeal episode divided by monthly family income, multiplied by 100. Overall median percent expenditure was 3·04 (range 0·01–94·35). For Vibrio cholerae it was 6·42 (range 0·52–82·85), for enterotoxigenic Escherichia coli 3·10 (range 0·22–91·87), for Shigella 3·17 (range 0·06–77·80), and for rotavirus 3·08 (range 0·06–48·00). In a multinomial logistic regression model, for the upper tertile of percent expenditure, significant higher odds were found for male sex, travelling a longer distance to reach hospital (⩾median of 4 miles), seeking care elsewhere before attending hospital, vomiting, higher frequency of purging (⩾10 times/day), some or severe dehydration and stunting. V. cholerae was the highest and rotavirus was the least responsible pathogen for percent expenditure of household income due to childhood diarrhoea.
This paper explores the utility of cluster- and case-based surveillance established in government hospitals in Bangladesh to detect Nipah virus, a stage III zoonotic pathogen. Physicians listed meningo-encephalitis cases in the 10 surveillance hospitals and identified a cluster when ⩾2 cases who lived within 30 min walking distance of one another developed symptoms within 3 weeks of each other. Physicians collected blood samples from the clustered cases. As part of case-based surveillance, blood was collected from all listed meningo-encephalitis cases in three hospitals during the Nipah season (January–March). An investigation team visited clustered cases’ communities to collect epidemiological information and blood from the living cases. We tested serum using Nipah-specific IgM ELISA. Up to September 2011, in 5887 listed cases, we identified 62 clusters comprising 176 encephalitis cases. We collected blood from 127 of these cases. In 10 clusters, we identified a total of 62 Nipah cases: 18 laboratory-confirmed and 34 probable. We identified person-to-person transmission of Nipah virus in four clusters. From case-based surveillance, we identified 23 (4%) Nipah cases. Faced with thousands of encephalitis cases, integrated cluster surveillance allows targeted deployment of investigative resources to detect outbreaks by stage III zoonotic pathogens in resource-limited settings.
Changes in world-wide population trends have provided new demands for new technologies in areas such as care and rehabilitation. Recent developments in the the field of robotics for neurorehabilitation have shown a range of evidence regarding usefulness of these technologies as a tool to augment traditional physiotherapy. Part of the appeal for these technologies is the possibility to place a rehabilitative tool in one's home, providing a chance for more frequent and accessible technologies for empowering individuals to be in charge of their therapy.
Objective: this manuscript introduces the Supervised Care and Rehabilitation Involving Personal Tele-robotics (SCRIPT) project. The main goal is to demonstrate design and development steps involved in a complex intervention, while examining feasibility of using an instrumented orthotic device for home-based rehabilitation after stroke.
Methods: the project uses a user-centred design methodology to develop a hand/wrist rehabilitation device for home-based therapy after stroke. The patient benefits from a dedicated user interface that allows them to receive feedback on exercise as well as communicating with the health-care professional. The health-care professional is able to use a dedicated interface to send/receive communications and remote-manage patient's exercise routine using provided performance benchmarks. Patients were involved in a feasibility study (n=23) and were instructed to use the device and its interactive games for 180 min per week, around 30 min per day, for a period of 6 weeks, with a 2-months follow up. At the time of this study, only 12 of these patients have finished their 6 weeks trial plus 2 months follow up evaluation.
Results: with the “use feasibility” as objective, our results indicate 2 patients dropping out due to technical difficulty or lack of personal interests to continue. Our frequency of use results indicate that on average, patients used the SCRIPT1 device around 14 min of self-administered therapy a day. The group average for the system usability scale was around 69% supporting system usability.
Conclusions: based on the preliminary results, it is evident that stroke patients were able to use the system in their homes. An average of 14 min a day engagement mediated via three interactive games is promising, given the chronic stage of stroke. During the 2nd year of the project, 6 additional games with more functional relevance in their interaction have been designed to allow for a more variant context for interaction with the system, thus hoping to positively influence the exercise duration. The system usability was tested and provided supporting evidence for this parameter. Additional improvements to the system are planned based on formative feedback throughout the project and during the evaluations. These include a new orthosis that allows a more active control of the amount of assistance and resistance provided, thus aiming to provide a more challenging interaction.
Selenium (Se) is an essential micronutrient for human and animal health. Globally, more than one billion people are Se deficient due to low dietary Se. Low dietary intake of Se can be improved by Se supplementation, food fortification and biofortification of crops. Lentil (Lens culinaris Medikus subsp. culinaris) is a popular cool-season food legume in many parts of the world; it is naturally rich in Se and therefore has potential for Se biofortification. An Se foliar application experiment at two locations and a multi-location trial of 12 genotypes at seven locations were conducted from April to December 2011 in South Australia and Victoria, Australia. Foliar application of a total of 40 g/ha of Se as potassium selenate (K2SeO4) – 10 g/ha during full bloom and 30 g/ha during the flat pod stage – increased seed Se concentration from 201 to 2772 μg/kg, but had no effect on seed size or seed yield. Consumption of 20 g of biofortified lentil can supply all of the recommended daily allowance of Se. After Se foliar application, cultivars PBA Herald XT (3327 μg/kg), PBA bolt (3212) and PBA Ace (2957 μg/kg) had high seed Se concentrations. These cultivars may be used in lentil biofortification. In the genotypic evaluation trial, significant genotype and location variation was observed for seed Se concentration, but the interaction was not significant. In conclusion, foliar application of Se as K2SeO4 is an efficient agronomic approach to improve seed Se concentration for lentil consumers and there is also scope for genetic biofortification in lentil.