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Malnutrition among adolescents is often associated with inadequate dietary diversity (DD). We aimed to explore the prevalence of inadequate DD and its socio-economic determinants among adolescent girls and boys in Bangladesh. A cross-sectional survey was conducted during the 2018–19 round of national nutrition surveillance in Bangladesh. Univariate and multivariable logistic regression was performed to identify the determinants of inadequate DD among adolescent girls and boys separately. This population-based survey covered eighty-two rural, non-slum urban and slum clusters from all divisions of Bangladesh. A total of 4865 adolescent girls and 4907 adolescent boys were interviewed. The overall prevalence of inadequate DD was higher among girls (55⋅4 %) than the boys (50⋅6 %). Moreover, compared to boys, the prevalence of inadequate DD was higher among the girls for almost all socio-economic categories. Poor educational attainment, poor maternal education, female-headed household, household food insecurity and poor household wealth were associated with increased chances of having inadequate DD in both sexes. In conclusion, more than half of the Bangladeshi adolescent girls and boys consumed an inadequately diversified diet. The socio-economic determinants of inadequate DD should be addressed through context-specific multisectoral interventions.
Yasui procedure is surgical repair intended to preserve biventricular function for patients with left ventricle outflow tract obstruction associated with aortic arch lesions and ventricular septal defect.
Retrospective chart review analysis of all patients who had Yasui procedure (2008–2020) comparing midterm outcome of one versus two stage repair.
Twenty patients (70% female) underwent Yasui procedure in our center. Eight patients (40%) had left ventricle outflow tract obstruction /interrupted aortic arch, 7 patients (35%) had left ventricle outflow tract obstruction /coarctation of aorta, 3 patients (15%) had double outlet ventricle and ventricular septal defect that were unattainable for tunneling to one of the semilunar valves without creating obstruction, and 2 patients (10%) had aortic atresia with hypoplastic aortic arch. All patients had associated ventricular septal defect. Fifteen patients (75%) had one-stage repair and 5 patients (25%) had two-stage repair. Means age and weight for one and two-stage repair were 1.3 ± 2 months, 13.4 ± 11.5 months and 3.3 ± 0.6 kg, 7.8 ± 3.4 kg, respectively. During follow up, 8 patients (40%) required re- intervention, mainly for right ventricle–pulmonary artery conduit either dilation or replacement. The average duration of follow up was 5 years with nil mortality.
Yasui procedure is effective approach for children who have left ventricle outflow tract obstruction associated with aortic arch anomalies and ventricular septal defect. Survival rate with single or staged repair is comparably good. During the first 5 year of follow up, nearly 40% of operated patients required re-intervention.
Delivery of enteral nutrition in critical infants post-paediatric cardiac surgery is sometimes hampered, necessitating direct feeding into the small intestine. This study is highlighting the role of ultrasound-guided post-pyloric feeding tube insertion performed by the paediatric cardiac ICU intensivist in critically ill infants.
We carried out a prospective pilot observational experimental study in peri-operative cardiac infants with feeding intolerance between 2019 and 2021. Feeding tube insertion depends on a combination of ultrasound and gastric insufflation with air-saline mixture. Insertion was confirmed by bedside abdominal X-ray.
Out of 500 peri-operative cardiac infants, 15 needed post-pyloric feeding tube insertion in median 15 postoperative day. All were under 6 months of age with average weight of 3 ± 0.2 kg. Median Risk Adjustment for Congenital Heart Surgery Categories was 4. Median insertion time was 15 minutes. No complications have been reported. First pass success rate was 87%, while a second successful insertion attempt was needed in 2 cases (13%). Target daily calorie intake was achieved within average of 3.5 ± 0.4 days. Mean post-pyloric feeding tube stay was 20 ± 3 days. Out of 15 infants, 3 patients died, 1 patient needed gastrostomy tube, and 11 patients were discharged home on oral feeds.
Ultrasound-guided post-pyloric feeding tube insertion using gastric insufflation with air-saline mixture in peri-operative cardiac infants with feeding intolerance is a useful and practical bedside tool, and it can be performed by a trained paediatric cardiac ICU intensivist. It may have potential positive effects on morbidity and outcome.
Lectins are glycoproteins of a non-immune origin often used as histochemical reagents to study the distribution of glycoconjugates in different types of tissues. In this study, we performed a comparative cellular localization of sugar residues in bull and donkey testes using immunofluorescent lectin histochemistry. We inspected the cellular localization of the glycoconjugates within the testes using 11 biotin-labeled lectins (LCA, ConA, PNA, WGA, DBA, SBA, ECA, BPL, PTL-II, UEA-1, and PHA-E4) classified under six groups. Although the basic testicular structure in both species was similar, the cellular components showed different lectin localization patterns. The statistical analysis revealed no significant association between the intensity of labeling and different variables, including group and type of lectin and type of cell examined, at p < 0.05. However, a stronger response tended to occur in the donkey than in the bull testes (odds ratio: 1.3). These findings may be associated with the different cellular compositions of the glycoproteins and modification changes during spermatogenesis. Moreover, glycoconjugate profiling through lectin histochemistry can characterize some cell-type selective markers that will be helpful in studying bull and donkey spermatogenesis.
Cyprinid fishes have one of the simplest types of gastrointestinal tract among vertebrates. Those fish species do not possess a true stomach that is replaced by a simple dilatation at the anterior part of the intestine called the intestinal bulb. Twenty adult specimens of grass carp were used in the present study to identify the cellular components as well as the immunohistochemical and surface architectural characteristics of the intestinal bulb. The mucosa of the intestinal bulb shows numerous, deep longitudinal folds arranged in zigzagging-like patterns. The epithelium is composed mainly of absorptive columnar cells covered by microvilli and mucous goblet cells. Spindle-shaped enteroendocrine cells and some migratory immune cells such as intraepithelial lymphocytes and rodlet cells could be identified between the absorptive cells. The epithelium also contains many secretory granules and large numbers of vacuoles containing digestive enzymes mostly in the basal part. The immunohistochemistry revealed that CD20-positive B-lymphocytes are immunolocalized mainly in the connective tissue core lamina propria of the mucosal folds. However, CD3-immunopositive T-lymphocytes are highly concentrated in the lamina propria. In addition, intraepithelial T-lymphocytes expressed immunopositivity to CD3. The current study presented many types of immune cells and suggests their essential immunological role for the intestinal blub.
Beachpea (Vigna marina) is a halophytic wild leguminous plant which occurs throughout tropical and subtropical beaches of world. As quantitative trait loci (QTLs) for salt tolerance in V. marina and its crossability with other Vigna species are known, the current study was undertaken to know the presence of these QTLs in the V. marina accessions along with check varieties of pulses. Accordingly, 20 Vigna genotypes (15 accessions of V. marina collected from sea-shore areas of Andaman and Nicobar Islands along with five check varieties of green gram and black gram) were subjected to molecular characterization using seven simple sequence repeat (SSR) markers associated with salt tolerance. Of the markers used, only four SSR markers amplified in the studied germplasm. Number of alleles detected per primer and size of alleles ranged from 1 to 3 and 100 to 325 bp, respectively. Polymorphism information content and heterozygosity values ranged from 0.305 to 0.537 and 0.375 to 0.612, respectively. Three major clusters, cluster I, II and III were obtained at Jaccard's similarity coefficient value of 0.48 through the un-weighted paired group method with arithmetic means method of cluster analysis. It grouped green gram and black gram genotypes in clusters I (04) and II (01), whereas all V. marina genotypes were grouped in cluster III (15). Principal co-ordinate analysis explained 85.9% of genetic variation among genotypes which was further confirmed by cluster analysis. This study indicated the effectiveness of SSR markers in separating cultivated Vigna species from wild V. marina. The findings will be useful for transferring trait of robust salt tolerance of V. marina in cultivated Vigna species using marker-assisted breeding.
This article presents a unique cylinder seal found at the site of Tell Abu al-Dhahab, in the Iraqi marshes. The cylinder seal, made of alabaster, is dated to the First Sealand Dynasty period and contains a scene with an introduction to a seated deity. It is accompanied by an inscription identifying the father of its owner as the overseer of the incantation priests. The aim of the article is both to discuss the cylinder seal, but also contextualize it within the temple where it was found and the period to which it is dated.
Health care professionals are particularly concerned with burnout
This study aimed to evaluate the the factors predisposing to occupational burnout
This was a cross sectional study including health care professionals in medical oncology working in public hospitals in Tunisia. It was carried out from 15 January 2019 to 15 June 2019. Health profeessionals were asked to answer the Maslach –Burnout Inventory Test.
The mean age was 34 ± 6.7 years [23 - 57]. The sex ratio was 0.22. Our study population included 37 doctors (53%) and 33 nurses (47%). The inappropriate working conditions mentioned by the participants were as follows: The requirementss of patients and their families (91.5%), the lack of resources (87%), overwork found (83%), unsatisfactory effort- salary ratio (83%) and the reduced number of staff (77%). Several Burn-out factors mentioned by the participants were significantly associated with a high emotional exhaustion syndrome: overwork, poor service organization, lack of resources, lack of time, lack of recognition, conflicts with colleagues, lack of communication, unsatisfactory salary - effort ratio, assaults by patients. Several factors were positively and significantly associated with a high depersonalization score: overwork, poor service organization, small number of staff, lack of resources, lack of respect, lack of recognition. The global burnout associating the achievement of the three dimensions was significantly associated with overwork, lack of recognition, conflicts with colleagues and assault by patients.
Burnout has become a major issue in Tunisian medicine. If left untreated, burnout epidemic may continue to worsen, to the detriment of patients and doctors
Burnout syndrome concerns 27.8% of the general working population against 37% among doctors.
This study aimed to report the prevalence of burnout among health care professionals in medical oncology in Tunisia.
This was a cross sectional study including health care professionals in medical oncology working in public hospitals in Tunisia. It was carried out from 15 January 2019 to 15 June 2019. Health profeessionals were asked to answer the Maslach –Burnout Inventory Test. Three scores allowing to locate the burn-out state of the person: the Score of emotional exhaustion (SEE), the Depersonalization score (SD) and the Score of personal achievement at work (SAP).
Le taux de participation était de 58,3%. La combinaison d’un SEE élevé, d’un SD élevé et d’un SAP bas définit le syndrome de Burn-out. Le SEE était élevé chez 44 travailleurs (63%), indiquant un épuisement émotionnel sévère. Un SD élevé a été trouvé chez 37 répondants (53%). La majorité des participants (59%) avaient un PAS faible. Le burnout est défini par l’association chez la même personne d’un épuisement émotionnel élevé, d’une dépersonnalisation élevée et d’un faible rendement personnel. Cela a été trouvé chez 15 des participants (21%). Selon l’étude analytique, le sexe féminin était significativement associé à un SEE élevé, un SAP bas et un épuisement global. Le travail de nuit était significativement associé à un degré élevé de dépersonnalisation et à un degré élevé d’épuisement général.
Burnout is linked to an increasingly ergonomic load. Health care professionnel, particularly in oncology, are frequently faced to this syndrome.
In the United Kingdom, the move from trainee to consultant psychiatrist can be both exciting and daunting. Trainee psychiatrists have access to support and weekly supervision that is not available to consultants. Having an organised meeting for new consultants could help bridge this gap with peer-led support.
Improving support and guidance to new consultants Networking with peers Promoting wellbeing, good clinical practice and career development
We identified a group of 85 consultants in their first five years of practice. Meetings were held online using videoconference. Senior leaders presented at each meeting, with a group discussion at the end. We surveyed attendees using an online platform.
We had excellent attendance rates from the group, with 30 to 45 consultants attending each webinar. Over 60% of attendees had been a consultant for less than a year. For 90%, this was their first experience of a new consultant forum. Attendees gave excellent feedback (Table). Being able to meet consultants from different specialties, hearing career stories from senior leaders and how they have managed the COVID-19 pandemic were cited as benefits.
Table: Feedback scores (0 = not useful to 100 = very useful)
The forum helped me feel supported
Topics covered are relevant to me
I feel more connected with colleagues
The forum was popular and the feedback was excellent. Using an online format worked well and made it easier to organise and plan sessions. There is potential to implement similar fora for other senior psychiatrists across Europe.
Involuntary electroconvulsive therapy (ECT) can be a life-saving intervention for patients suffering from potentially lethal conditions who are unable to give informed consent. However, its use is not widespread, probably partly due to the scarce data on hard outcomes following involuntary ECT. In Denmark, involuntary ECT is only used when patients are at imminent/potential risk of dying if not receiving ECT.
We aimed to assess the effectiveness of involuntary ECT by estimating the 1-year survival following its administration.
We conducted a register-based cohort study involving i) all patients receiving involuntary ECT in Denmark between 2008 and 2019, ii) age and sex-matched patients receiving voluntary ECT, and iii) age and sex-matched individuals from the general population. 1-year survival rates were compared via mortality rate ratios.
We identified 618 patients receiving involuntary ECT, 547 patients receiving voluntary ECT, and 3,080 population-based controls. The survival rate in the year after involuntary ECT was 90%. For patients receiving involuntary ECT, the 1-year mortality rate ratios were 3.1 (95% confidence interval (CI)= 1.9-5.2) and 5.8 (95%CI = 4.0-8.2) compared to those receiving voluntarily ECT and to the population-based controls, respectively. Risk factors for early death among patients receiving involuntary ECT were male sex, being ≥70 years old and having organic mental disorder as the treatment indication.
Treatment with involuntary ECT is associated with a high survival rate, suggesting that the intervention is effective. However, patients receiving involuntary ECT constitute a high-risk population that should be monitored closely after this treatment.
Freudenberger was the first to define burnout as a feeling of helplessness and guilt, as well as boredom and disinterest.
Our study aimed to analyze functional complaints and the behavior of healthcare professionals in this area associated with this syndrome.
This was a cross sectional study including health care professionals in medical oncology working in public hospitals in Tunisia. It was carried out from 15 January 2019 to 15 June 2019. Health professionals were asked to answer the Maslach –Burnout Inventory Test.
The average age was 34 years ± 6.7. Burn-out was found in 15 of the participants, (21%). In our population, a high emotional exhaustion score was significantly associated with its repercussions: Sadness, Blockage, sleep disturbances, unexplained pain, Epigastralgia / fatigue, Addictive behavior ; avoidance behavior, repercussions on the relationship with those around them, desire for a transfer, regret for choosing a profession, suicidal thoughts, absenteeism and smoking. A high depersonalization score was significantly associated with several functional and behavior complaints, in particular: irritability, anger, feeling of indifference, guilt, unexplained pain, decreased performance, suicidal thoughts. A low personal achievement score was significantly associated with psychotropic drug use. Global burn-out was significantly associated with feeling of blockage, guilt, unexplained pain, epigastralgia and fatigue, addictive behaviors and avoidance behaviors as well as suicidal thoughts, absenteeism and consumption of psychotropic drugs.
Through its impact on professionals, burnout in medical oncology represents a major threat to the quality of care and the survival of institutions.
The World Health Organization set a target of a 15% relative reduction in the prevalence of insufficient physical activity (IPA) by 2025 among adolescents and adults globally. In Bangladesh, there are no national estimates of the prevalence of IPA among adolescents. The aim of this study was to estimate the prevalence of and risk factors associated with IPA among adolescent girls and boys. Data for 4865 adolescent girls and 4907 adolescent boys, collected as a part of a National Nutrition Surveillance in 2018–19, were analysed for this study. A modified version of the Global Physical Activity Questionnaire (GPAQ) was used to collect physical activity data. The World Health Organization recommended cut-off points were used to estimate the prevalence of IPA. Bivariate and multivariable logistic regression was performed to identify factors associated with IPA. Prevalences of IPA among adolescent girls and boys were 50.3% and 29.0%, respectively, and the prevalence was significantly higher among early adolescents (10–14 years) than late adolescents (15–19 years) among both boys and girls. The IPA prevalence was highest among adolescents living in non-slum urban areas (girls: 77.7%; boys: 64.1%). For both boys and girls, younger age, non-slum urban residence, higher paternal education and increased television viewing time were significantly associated with IPA. Additionally, residing in slums was significantly associated with IPA only among the boys. Higher maternal education was associated with IPA only among the girls. This study identified several modifiable risk factors associated with IPA among adolescent boys and girls in Bangladesh. These factors should be addressed through comprehensive public health interventions to promote physical activity among adolescent girls and boys.
The testis of bamboo shark is characterized by diametric development leading to zonation architecture. Here, we investigated the staining pattern of 12 lectins in 6 groups of differential binding specificities within the germ, somatic, and interstitial cells of each zone. The neutral mucopolysaccharides appeared in the interstitial tissue in all the zones and became more significant in the spermatozoal–Sertoli cell junction. The cellular localization of the lectins varies in testicular zones and cell types. There was a gradual increase in glycosylation toward the degenerative zone. The increased intensity of most lectins in the interstitial cells indicates the association of glycoconjugates in their androgen-secreting activity. Statistical analyses showed a significant correlation between the groups of lectins and each lectin used, stronger response to lectins in the interstitial cells (ICs) than other cell types. Moreover, the response to glucosamine (GlcNAc), galactosamine (GalNAc), and fucose tended to be higher than glucose and galactose. Furthermore, the intensity of response was increased toward the degenerative zone. In addition, we can use peanut agglutinin (PNA) as an acrosomal marker in combination with other marker proteins for studying shark spermatogenesis. These findings refer to the crucial role of glycoconjugates in spermatogenesis in the bamboo shark testis.
There is a paucity of evidence about the prevalence and risk factors for symptomatic infection among children. This study aimed to describe the prevalence of symptomatic coronavirus disease 2019 (COVID-19) and its risk factors in children and adolescents aged 0–18 years in Qatar. We conducted a cross-sectional study of all children aged 0–18 years diagnosed with COVID-19 using polymerase chain reaction in Qatar during the period 1st March to 31st July 2020. A generalised linear model with a binomial family and identity link was used to assess the association between selected factors and the prevalence of symptomatic infection. A total of 11 445 children with a median age of 8 years (interquartile range (IQR) 3–13 years) were included in this study. The prevalence of symptomatic COVID-19 was 36.6% (95% confidence interval (CI) 35.7–37.5), and it was similar between children aged <5 years (37.8%), 5–9 years (34.3%) and 10 + years (37.3%). The most frequently reported symptoms among the symptomatic group were fever (73.5%), cough (34.8%), headache (23.2%) and sore throat (23.2%). Fever (82.8%) was more common in symptomatic children aged <5 years, while cough (38.7%) was more prevalent in those aged 10 years or older, compared to other age groups. Variables associated with an increased risk of symptomatic infection were; contact with confirmed cases (RD 0.21; 95% CI 0.20–0.23; P = 0.001), having visited a health care facility (RD 0.54; 95% CI 0.45–0.62; P = 0.001), and children aged under 5 years (RD 0.05; 95% CI 0.02–0.07; P = 0.001) or aged 10 years or older (RD 0.04; 95% CI 0.02–0.06; P = 0.001). A third of the children with COVID-19 were symptomatic with a higher proportion of fever in very young children and a higher proportion of cough in those between 10 and 18 years of age.