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Both India and Nepal are prone to a wide range of natural and man-made disasters. Almost 85% of India’s area is vulnerable to one or more hazards, and more than 80% of the total population of Nepal is at risk of natural hazards. In terms of the number of people affected in reported disastrous events, India is in the top 10 and Nepal is in the top 20 globally. Over the last two decades, India and Nepal have taken steps to establish their respective National Disaster Management organizations, which provide essential disaster responses. However, key gaps still remain in trained clinical capacity for managing impacts from various disasters. Our review of the region has shown that large parts of the population suffer injuries, diseases, disabilities, psychosocial, and other health-related problems from disasters.
Develop disaster medicine clinical capacity to reduce morbidities and mortalities from disasters.
Independent published data and work undertaken by the lead author in various disasters in India and Nepal since 1993 formed the basis of establishing the Faculty of Disaster Medicine for South Asia. The Faculty of Disaster Medicine - India and Nepal (FDMIN) was launched from Pune in March 2015. This initiative is supported by the National Association of Primary Care (UK), Public Health England, Faculty of Pre-hospital Care of Royal College of Surgeons - Edinburgh and CRIMEDIM (Novara) - Italy.
FDMIN has international expert advisors and has outlined 16 modules training curriculum for health care professionals. FDMIN currently has partnerships for teaching disaster medicine program with 3 medical universities and 12 major health care providers. Six pilot training programmes have been conducted in Pune, Delhi, Chennai, and Kochin. Work is underway to submit an application to the Indian regulatory bodies for approval to establish a post-graduate diploma and Master’s for Disaster Medicine.
Both extinct and extant hominin populations display morphological features consistent with Bergmann's and Allen's Rules. However, the functional implications of the morphologies described by these ecological laws are poorly understood. We examined this through the lens of endurance running. Previous research concerning endurance running has focused on locomotor energetic economy. We considered a less-studied dimension of functionality, thermoregulation. The performance of male ultra-marathon runners (n = 88) competing in hot and cold environments was analysed with reference to expected thermoregulatory energy costs and the optimal morphologies predicted by Bergmann's and Allen's Rules. Ecogeographical patterning supporting both principles was observed in thermally challenging environments. Finishers of hot-condition events had significantly longer legs than finishers of cold-condition events. Furthermore, hot-condition finishers had significantly longer legs than those failing to complete hot-condition events. A degree of niche-picking was evident; athletes may have tailored their event entry choices in accordance with their previous race experiences. We propose that the interaction between prolonged physical exertion and hot or cold climates may induce powerful selective pressures driving morphological adaptation. The resulting phenotypes reduce thermoregulatory energetic expenditure, allowing diversion of energy to other functional outcomes such as faster running.
Quantitative analysis of the elemental distributions within AlGaN has been investigated using electron energy loss spectroscopy in a scanning transmission electron microscopy. The nanowires were grown on c-sapphire by radio frequency plasma assisted molecular beam epitaxy. Crystallographic and compositional analyses of the nickel seeds used to promote the nanowire type growth yielded values of lattice spacings within the seeds remaining at the growth tip which were attributed to either (002) NiO, (111) Ni3Ga or (111) Ni-Ga solid solution. The seeds structures exhibited a metallic core encompassed by an oxide shell. The relative gallium and nickel concentrations were quantified by EELS analyses and were found to be consistent with the equilibrium phase α' of Ni3Ga or Ni-Ga solid solution. No nitrogen was observed within the seeds, which is predicted thermodynamically due to the instability of Ni-N compounds at the NW growth temperature used in this study. No aluminium was detected at the tip of nanowires. These measurements are compared with previous studies made concerning pure GaN nanowires. The Al distribution along the nanowire length was measured and is discussed in respect of a possible Al incorporation mechanism.
The tensile strain in AlGaN layers on GaN is well established to lead to cracking if a critical thickness is reached, unless measures such as interlayers are applied to prevent their formation. However in devices, such as HFETs such an approach is impractical. Growth of AlGaN-GaN structures was carried out by MOVPE using a standard two stage process for the growth of the GaN on sapphire. The crack structures were examined by optical and atomic force microscopy. Studies on thin AlGaN layers on GaN close to the crack critical thickness show the stress centres from which the cracks propagate are threading dislocations with cracks often initially forming to link together these stress centres if they are in close proximity. These cracks then extend and “lock” into the generally observed 〈2110〉 direction in more highly strained layers. A macroscopically uniform crack array is observed in these thin AlGaN samples.
This study compared the efficacy and safety of sertraline to placebo in treating panic disorder.
178 out-patients with panic disorder who exhibited at least four panic attacks during the four weeks prior to screening and three during the two weeks of lead-in were randomly assigned to 12 weeks of double-blind treatment with sertraline (50, 100 or 200 mg) or placebo.
Sertraline was superior to placebo in reducing the number of panic attacks, situational attacks, unexpected attacks, limited symptom attacks, and time spent worrying (all P < 0.01) and the Hamilton Anxiety Scale (P < 0.05), although Clinical Global Impression (Improvement) did not significantly differentiate groups at 12 weeks and at end-point. No serious adverse events were associated with sertraline. No dose relationship was found for adverse events; overall drop-out rates were not different for sertraline or placebo, although more sertraline-treated subjects discontinued for adverse events, typically early in the study. Only dry mouth and ejaculation failure (primarily ejaculation delay) were associated significantly with sertraline. Conclusions Sertraline was effective and safe in reducing panic attacks. Higher doses were no more effective than the 50 mg dose.