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Over the last decades, acupuncture has been seen as an acceptable primary detoxification treatment for opiate dependence, and currently used to relieve the severity of opiate withdrawal symptoms among MMT patient.
To investigate the effectiveness of electroacupuncture treatment in reducing opiate withdrawal symptoms among MMT patient.
This was a pilot study with randomized, single-blinded, and parallel. Recruitment of 22 subjects, 11 in methadone treatment + acupuncture and 11 in methadone treatment without acupuncture. The severity of withdrawal reaction was assessed by Objective Opiate Withdrawal Scale (OOWS) and Subjective Opiate Withdrawal Scale (SOWS) at baseline, third, fifth, seventh, tenth and fourteenth day of treatment.
One way Analysis of Variance (ANOVA) comparing the mean scores of the OOWS between treatment and control group has shown at tenth day of treatment p value is 0.026 and at fourteenth day p value is 0.022. One way ANOVA comparing the mean scores of the SOWS between treatment and control groups has shown at tenth day of treatment, p value is 0.015 and at fourteenth day, p value is 0.009.
The study has shown the promising results, where electroacupuncture treatment had an effectiveness in relieving opiate withdrawal symptoms among MMT patient.
High prevalence of poor sleep quality has been reported among Methadone Maintenance Therapy (MMT) patients. in order to reduce side effects and prevent relapse, new treatment approaches should be considered and recently, electroacupuncture (EA) has believed to have a therapeutic effect in the treatment of drug addiction.
To investigate the effects of EA on sleep quality in patients receiving MMT.
A prospective, open-labelled, parallel, randomized-controlled trial was conducted among MMT patients in Kajang, Selangor, Malaysia. A total of 22 drug misusers who met DSM-IV were randomly assigned into two groups. The treatment group was given methadone plus EA stimulation at 1.1+80Hz while the control group received methadone plus Sham EA without increasing the intensity of the stimulation. Both groups received the EA treatment 30 minutes per session for 14 days. Sleep quality was assessed by validated Pittsburgh Sleep Quality Index.
In terms of pre and post treatment comparison, we found that there were significant difference of mean sleep latency (p= 0.011), use of medication (p= 0.043) and global PSQI (p= 0.009) for the treatment group. However, only sleep efficiency (p= 0.014) showed a significant difference between pre and post treatment for the control group. in terms of group comparison, we found that there was significant difference of mean sleep latency (p= 0.004), sleep efficiency (0.004) and global PSQI (0.008) for post treatment. No significant difference was found for pre treatment.
Electroacupuncture may have adjunct effect on sleep improvement and have potential to reduce Benzodiazepine use among MMT patients.
The “problem of memory” in epistemology is concerned with whether and how we could have knowledge, or at least justification, for trusting our apparent memories. I defend an inductive solution – more precisely, an abductive solution – to the problem. A natural worry is that any such solution would be circular, for it would have to depend on memory. I argue that belief in the reliability of memory can be justified from the armchair, without relying on memory. The justification is, roughly, that my having the sort of experience that my apparent memory should lead me to expect is best explained by the hypothesis that my memories are reliable. My solution is inspired by Harrod's (1942) inductive solution. Coburn (1960) argued that Harrod's solution contains a fatal flaw. I show that my solution is not vulnerable to Coburn's objection, and respond to a number of other, recent and likely objections.
The aim of this study is to determine early changes in cardiac function of children with chronic kidney disease by using 2D-speckle tracking echocardiography.
The study included 38 children – 16 girls and 22 boys – diagnosed as having chronic kidney disease in the nephrology department with a glomerular filtration rate of <90 ml/minute/1.73 m2 for at least 3 months. A total of 37 – 15 girls and 22 boys – age- and sex-matched healthy children were included as the control group. 2D-Speckle tracking echocardiography was performed in all subjects.
The mean age was 13.45±2.8 years in patients and 12.89±3.07 years in controls. Systolic and diastolic blood pressures and left ventricular mass index were significantly higher in patients (p<0.05). The values of mitral e, mitral a, mitral e/a ratio, and mitral deceleration time were not different between the groups. Tricuspid annular plane systolic excursion values were lower in patients (p<0.01). Global strain values in apical long-axis 3-chamber and 2-chamber views were significantly lower in patients (p<0.05). Longitudinal, radial, and circumferential peak systolic strain values were lower in patients, but the difference was statistically significant in all segments of longitudinal view and basal segment of circumferential view (p<0.05). Radial and circumferential systolic strain rates were significantly lower in patients in all three segments (p<0.05). Moreover, early diastolic strain rate was significantly lower in longitudinal and radial apical segments and in all segments of circumferential measurements in patients. Besides, strain rate e/a ratio was significantly lower in all longitudinal segments of patients (p=0.01).
The study concluded that 2D-speckle tracking echocardiography method can determine cardiac involvement earlier than conventional echocardiography in children with chronic kidney disease having preserved ejection fraction.
One of the most important measures following disasters is setting up a communicable disease surveillance system (CDSS). This study aimed to develop indicators to assess the performance of CDSSs in disasters.
In this 3-phase study, firstly a qualitative study was conducted through in-depth, semistructured interviews with experts on health in disasters and emergencies, health services managers, and communicable diseases center specialists. The interviews were analyzed, and CDSS performance assessment (PA) indicators were extracted. The appropriateness of these indicators was examined through a questionnaire administered to experts and heads of communicable diseases departments of medical sciences universities. Finally, the designed indicators were weighted using the analytic hierarchy process approach and Expert Choice software.
In this study, 51 indicators were designed, of which 10 were related to the input (19.61%), 17 to the process (33.33%), 13 to the product (25.49%), and 11 to the outcome (21.57%). In weighting, the maximum score was that of input (49.1), and the scores of the process, product, and outcome were 31.4, 12.7, and 6.8, respectively.
Through 3 different phases, PA indicators for 4 phases of a chain of results were developed. The authors believe that these PA indicators can assess the system’s performance and its achievements in response to disasters. (Disaster Med Public Health Preparedness. 2019;13:158–164)
We present the findings about chromospheric activity nature of KOI-256 obtained from the Kepler Mission data. First, it was found that there are some sinusoidal variations out-of-eclipses due to cool spot activity. The sinusoidal variations modelled by the spotmodel program indicate that the active component has two different active regions. Their longitudinal variation revealed that one of them has a migration period of 3.95 yrs, while the other has a migration period of 8.37 yrs. Second, 225 flares were detected from the short cadence data in total. The parameters, such as increase (Tr) and decay (Td) times, total flare time (Tt), equivalent durations (P), were calculated for each flare. The distribution of equivalent durations versus total flare times in logarithmic scale is modelled to find flare activity level. The Plateau value known as the saturation level of the active component was calculated to be 2.3121 ± 0.0964 s, and the Half-life value, which is required flare total time to reach the saturation, was computed to be 2233.6 s. In addition, the frequency of N1, which is the number of flares per an hour in the system, was found to be 0.05087 h−1, while the flare frequency N2 that the flare-equivalent duration emitting per an hour was found to be 0.00051. Contrary to the spot activity, it has been found that the flares are in tends to appear at specific phases due to the white dwarf component.
Dendritic cells (DC) are central regulators of immune responses and professional antigen-presenting cells (APCs) with the unique ability to induce both innate immune responses and a highly specific acquired immunity. DC communicates through chemical and mechanical signals in the initiation and maintenance of immune responses. DC forms immunological synapses with T-cells thus pulling T-cells strings and leading to activation of T-cells. Owing to their properties, DC are often called ‘nature's adjuvants’ and thus have become an important component of any vaccination strategy. Coccidiosis is a major intestinal disease caused by Eimeria spp., affecting economically valuable livestock animals such as chickens and turkeys. Economic losses are associated with decreased productivity in afflicted poultry. Vaccination strategies involving DC have been developed owing to the special properties of these cells in coordinating innate and adaptive immune responses. Vaccination of chickens with exosomes isolated from DC containing parasite antigens (Ags) represents a promising alternative strategy to control avian coccidiosis. In recent years, emergence of new chicken DC has opened a new horizon for the development of new vaccines and DC derived vaccine could be a possible strategy to control coccidiosis in field. This review summarises the current state of knowledge of DC and their specific functions in immunity against avian coccidiosis.
The results are presented for eclipsing binary KIC 2557430. The mass ratio was computed as 0.868 ± 0.002, while the inclination (i) was found as 69°.75 ± 0°.01 with T2 = 6271±1 K. 50 frequencies were found in the period analysis. 48 frequencies of them are caused due to the primary component, a γ Doradus star, while two of them are caused by the cool spots. 69 flares were detected in the analyses. Two OPEA models were derived for flares, which indicates that the flares were come from two different sources. The Plateau value was found to be 1.4336 ± 0.1104 s for Source 1, which is seen as possible the secondary component and 0.7550 ± 0.0677 s for Source 2, which is seen as possible third body. The half-life value was computed as 2278.1 s for Group 1 and 1811.2 s for Group 2. The flare frequency N1 was found to be 0.02726 h−1 and N2 was computed as 0.00002 for Group 1, while N1 was found to be 0.01977 h−1 and N2 was computed as 0.00001 for Group 2. In a results, KIC 2557430 is a possible triple system consisting of a γ Doradus-type star, a chromospherically active star, and also a flaring third body.
We present spectroscopic and photometric analysis of the eclipsing binary KIC 7385478. We find that the system is formed by F1V + K4III–IV components. Combining results from analysis of spectroscopic data and Kepler photometry, we calculate masses and radii of the primary and the secondary components as M1 = 1.71 ± 0.08 M⊙, M2 = 0.37 ± 0.04 M⊙ and R1 = 1.59 ± 0.03 R⊙, R2 = 1.90 ± 0.03 R⊙, respectively. Position of the primary component in HR diagram is in the region of γ Doradus type pulsators and residuals from light curve modelling exhibit additional light variation with a dominant period of ~ 0.5 d. These are clear evidences of the γ Doradus type pulsations on the primary component. We also observe occasional increase in amplitude of the residuals, where the orbital period becomes the most dominant period. These may be attributed to the cool star activity originating from the secondary component.
The Western-type diet is associated with an elevated risk of Alzheimer’s disease and other milder forms of cognitive impairment. The aim of the present study was to investigate the effects of the environmental enrichment on amyloid and tau pathology in high-fat and high-sucrose-fed rats.
In total, 40 adult male rats were categorised into two main groups according to their housing conditions: enriched environment (EE, n=16) and standard housing condition (n=24). The groups were further divided into five subgroups that received standard diet, high-fat diet, and high-sucrose diet. We performed the analysis of amyloid β-peptide (Aβ) (1–40), Aβ(1–42), amyloid precursor protein (APP), and tau levels in the hippocampus of rats that were maintained under standard housing conditions or exposed to an EE.
The EE decreased the Aβ(1–40), Aβ(1–42), APP, and tau levels in high-fat and high-sucrose-fed rats.
This observation shows that EE may rescue diet-induced amyloid and tau pathology.
Aneurysm of the sinus of Valsalva is a rare congenital cardiac anomaly. It occurs as an outpouching that progresses like a windsock, and it may rupture producing aortic regurgitation, cardiac tamponade, congestive heart failure, conduction abnormalities, and stroke. We describe a case of rupture of the sinus of Valsalva into the interventricular septum producing a large dissecting aneurysm. Despite the location, it did not produce a conduction abnormality.
This study depends on KIC 9641031 eclipsing binary with a chromospherically active component. There are three type variations, such as geometrical variations due to eclipses, sinusoidal variations due to the rotational modulations, and also flares, in the light curves. Taking into account results obtained from observations in the Kepler Mission Database, we discuss the details of chromospheric activity. The sinusoidal light variations due to rotational modulation and the flare events were modelled. 92 different data subsets separated using the analytic models were modelled separately to obtain the cool spot configuration. Acording to the model, there are two active regions separated by about 180° longitudinally between the latitudes of +50° and +100°. 240 flares, whose parameters were computed, were detected. Using these parameters, the OPEA model was derived, in which the Plateau value was found to be 1.232±0.069 s, and half-life parameter was found as 2291.7 s. The flare frequency N1 was found as 0.41632 h−1, while the flare frequency N2 was found as 0.00027. Considering these parameters together with the orbital period variations demonstrates that the period variations depend on chromospheric activity. Comparing the system with its analogue, the activity level of KIC 9641031 is remarkably lower than the others.
Communicable disease management (CDM) is an important component of disaster public health response operations. However, there is a lack of any performance assessment (PA) framework and related indicators for the PA. This study aimed to develop a PA framework and indicators in CDM in disasters.
In this study, a series of methods were used. First, a systematic literature review (SLR) was performed in order to extract the existing PA frameworks and indicators. Then, using a qualitative approach, some interviews with purposively selected experts were conducted and used in developing the PA framework and indicators. Finally, the analytical hierarchy process (AHP) was used for weighting of the developed indicators.
The input, process, products, and outcomes (IPPO) framework was found to be an appropriate framework for CDM PA. Seven main functions were revealed to CDM during disasters. Forty PA indicators were developed for the four categories.
There is a lack of any existing PA framework in CDM in disasters. Thus, in this study, a PA framework (IPPO framework) was developed for the PA of CDM in disasters through a series of methods. It can be an appropriate framework and its indicators could measure the performance of CDM in disasters.
BabaieJ, ArdalanA, VatandoostH, GoyaMM, AkbarisariA. Developing a Performance Assessment Framework and Indicators for Communicable Disease Management in Natural Disasters. Prehosp Disaster Med. 2016;31(1):27–35.
Religious laws do not usually forbid the use of psychotropic medication, but many do forbid the consumption of animal-based derivatives of bovine and/or porcine origin (e.g. gelatin and stearic acid) such as are found in many medications. Demonstrating awareness of this, combined with a genuine concern about how it affects the patient, may strengthen the doctor—patient relationship and avoid non-adherence. In this article, we outline dietary requirements of key religions and belief systems that may have a bearing when prescribing medication containing animal-based ingredients. We identify common psychotropics that contain animal-based derivatives and suggest alternative prescribing options and approaches to dealing with sensitive ethical issues.
The historical evidence analysed in the introductory chapter examines the dynamics behind pan-Shi'a political agendas, and relationships between different Shi'a groups, in the medieval Muslim world. The rise of various Shi'a states, for the most part through their collaboration and tacit support for each other in the tenth century, resulted in the near extinction of Sunni rule from north-western India to North Africa, with the exception of parts of Khurasan (Afghanistan) and Central Asia. This collaboration was based on the spiritual ideals of Shi'ism, and its claim to the wilayat or vice regency of the first Imam, 'Ali, after Muhammad. Tacit support of the otherwise differing medieval Shi'a sects for each other was also based on this claim. Among them the Isma'ilis and groups related to Twelver Shi'ism collaborated the most, and carved up the Middle East amongst themselves, in the form of the Fatimids and the Buwayhids.
The major reason behind the rise of the various Shi'a factions to power was not political but religious in nature. In spite of adherence to shari'a practices for the most part at the upper echelons of society, the general religiosity that was tolerated, patronised and sometimes even practised by the new rulers was mostly heterodox, and very different from what Shi'ism has become today. It was the infusion and consolidation of these heterodox religious ideas, necessarily Shi'a ones, into popular belief and culture, in areas of Shi'a dominance, which defined the spiritual legacy of medieval Shi'ism. One such area was the middle Indus region with Multan as its capital, which had become a jazira or province of Fatimid Egypt. Fatimid rule in Multan gave rise to syncretic Isma'ili beliefs amongst the population, which included elements of local religiosity and piety. This religiosity was at times crushed by the same agency due to which it arose, in the case of Multan by the Fatimid state, but was also tolerated to an extent, and often reasserted itself. Other examples of such phenomena, which had elements of multi-faith beliefs, were the Druze sect related to the Fatimid Caliph al-Hakim (ruled 996-1021), the Ikhwan al-Safa who flourished in Buwayhid Iraq, and the Qarmati messiah of Persian descent who abolished the shari'a completely at the conjunction of Jupiter and Saturn, and ‘instituted practises which shocked Muslims.’
This book represents the first serious consideration of Ismaili-Shia esotericism in material and architectural terms, as well as of pre-modern conceptions of religious plurality in rituals and astrology. Sufism has long been reckoned to have connections to Shi'ism, but without any concrete proof. The book shows this connection in light of current scholarly work on the subject, historical sources, and most importantly, metaphysics and archaeological evidence. The monuments of the Suhrawardi Order, which are derived from the basic lodges set up by Pir Shams in the region, constitute a unique building archetype. The book's greatest strength lies in its archaeological evidence and in showing the metaphysical commonalities between Shi'ism/Isma'ilism and the Suhrawardi Sufi Order, both of which complement each other. In addition, working on premise and supposition, certain reanalysed historical periods and events in Indian Muslim history serve as added proof for the author's argument.
Entrance and axiality in orthodox Islamic burial: The qibla (Mecca) direction
This chapter and the one after it deal specifically with Suhrawardi architecture, which reflects the order's secret belief system. The two cover the major monuments left behind by the order in Multan and Uch, in the backdrop of a brief introduction to the order's notable Isma'ili contemporaries (in chapter 6). The common shrine archetype discovered for Pir Shams, his descendants, and their Suhrawardi contemporaries, exhibits certain architectural traits that contrast starkly with traditional Islamic monuments from the same era. For the greater part, this difference is in terms of the axial arrangement of the building plans and the various entrances, which are highly unorthodox. To explain the difference with reference to the conventional Islamic model, this chapter will briefly delve into established theses on orthodox Islamic burial. The subject of axiality in (traditional) Islamic burial was researched by the late Delbert Highlands, who was this author's professor when he was a student of architecture.
Highlands' research deduces the conscious incorporation of the orthodox Islamic burial axis, which is based on the Mecca direction, into the orthodox Muslim mindset, which subsequently makes its way into monument (mosque) design. Highlands observes this phenomenon in orthodox Islamic buildings as, a) always facing Mecca upon entrance to a burial chamber or a mosque, which represents the centrality of Mecca in Islam, and b) facing the exact opposite direction of Mecca while leaving the monument, which signifies the expansion of Islam as emanating from Mecca and the mosque itself, to eventually take over the whole world. In Saudi Arabia, this emphasis has recently reached new heights of literalism, where Muslims always enter the mosque from an entrance located on the right hand side of the Mecca facing facade, and leave from an exit located on the left hand side of the same facade. Even if there are secondary entrances, as is the case in large modern mosques designed to accommodate multitudes of people, the central emphasis is always on the Mecca direction.
To substantiate his thesis Highlands compared the Mecca axiality of Islamic buildings with the inverse signification of Jewish synagogues and with the Jewish mindset in general.