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Can foreign capital empower dictatorship? This groundbreaking book develops a unified theory that links three prominent forms of international capital to the endurance of dictatorships. International capital empowers governments to finance two key instruments of non-democratic politics: repression and patronage. The Perils of International Capital uses theory, case studies, and cross-national statistical evidence to demonstrate causal effects between foreign capital and authoritarian politics. These finding are crucial to scholars and policymakers alike, as they call for a recalibration of the welfare effects associated with greater financial globalization. Ahmed reveals that, while foreign capital may improve economic development, it can tragically hinder democratic governance in the process.
Background: While recent clinical trials have demonstrated immense efficacy of mechanical thrombectomy (MT) in the setting of acute stroke, there remains debate over the safety in performing this procedure under general anesthesia (GA). In the Saskatchewan Acute Stroke Pathway, all patients presenting with LVO have endovascular thrombectomy performed under GA. Methods: Data was retrospectively reviewed on 108 consecutive LVO in 2016-2017. All MT were done under GA. Anatomical location of LVO, pre-MT ASPECTS score, post-MT TICI scores and 90-day NIHSS and mRS were recorded. Results: Of 108 LVO, 103 went on to have MT. 44 were right anterior circulation, 50 were left anterior circulation and 9 were posterior circulation. Of 94 anterior circulation strokes, 47 (50.0%), 43 (45.7%) and 4 (4.3%) had good, moderate and poor collateral circulation respectively, and the average pre-MT ASPECTS was 8.6. The average pre-MT NIHSS was 14.7. 81/90 (90.0%) achieved thrombolysis in cerebral infarction (TICI) perfusion scale grade of 2b/3 after recanalization. Average documented 90-day NIHSS was 2.4 and mRS was 2.5. Overall mortality was 21/103 (20.4%). Conclusions: In the Saskatchewan acute stroke pathway, general anesthesia is a safe modality for MT. This adds to the body of evidence supporting GA as a viable option for sedation in MT.
Background: Previous studies have shown varied results with respect to the diagnostic utility of a positive nerve root sedimentation sign (SedSign) on MRI for symptomatic lumbar stenosis. The objective of this study was to analyze the clinical characteristics of SedSign utilizing a validated classification for low back and leg pain (Saskatchewan Spine Pathway classification; SSPc). Methods: This was a retrospective review of prospectively-collected data in 367 consecutive adult patients presenting to a spine surgeon with back and/or leg pain between January 1, 2012 and May 31, 2018. Inter- and intra-rater reliability for SedSign was 73% and 91%, respectively (3 examiners). Results: SedSign was positive in 111 (30.2%) and negative in 256 (69.8%) of patients. On the univariate analysis, a positive SedSign was correlated with age, male sex, several components of ODI, EQ5D mobility, cross-sectional area (CSA) of stenosis, and SSPc pattern 4 (intermitted leg dominant pain). On multivariate analysis, SedSign was associated with age, male sex, CSA stenosis and ODI sub-score for walking distance. The sensitivity and specificity of SedSign for neurogenic claudication was 50.3 and 82.9, respectively (positive predictive value 65.8%, negative predictive value 71.9%). Conclusions: The SedSign has high specificity for neurogenic claudication, but the sensitivity is poor.
Background: The nerve root sedimentation sign (SedSign) has been correlated with clinically significant lumbar spinal stenosis (LSS), and promoted as a possible prognostic indicator. However, diagnostic methods were not clearly defined in prior reports. In this study, the clinically validated Saskatchewan Spine Pathway enabled diagnosis of neurogenic claudication due to LSS. The objective was to compare the outcome of lumbar laminectomy for neurogenic claudication with respect to SedSign. Methods: This was a retrospective analysis of prospectively-collected data in patients with neurogenic claudication who underwent lumbar laminectomy. Outcome measures included Oswestry Disability Index, Visual Analogue Scale (VAS) for back and leg pain, and EuroQol 5-Dimension questionnaire. Results: Laminectomy was performed in 106 patients, and 60 were SedSign positive. Outcomes did not differ with respect to SedSign for all outcome measures, in non-instrumented and instrumented cohorts. Improvement in walking distance was associated with dural cross-sectional area of stenosis (p=0.02). VAS back and leg improvements were associated with back dominant (p=0.038) and leg dominant (p=0.0036) pain. Conclusions: This is the largest analysis of SedSign with respect to operative outcomes, and the only study with validated criteria for defining neurogenic claudication. Although other radiological and clinical factors are associated with improvements, SedSign did not correlate with laminectomy outcome.
Free convective flow and heat transfer of nanofluid close to the inclined plate immersed in the porous medium under the effects of uniform magnetic field and solar radiation has been studied. Boundary-layer approach, Boussinesq approximation and two-phase nanofluid model have been used for a formulation of the governing equations taking into account convective-radiative heat exchange with an environment. The local similarity method has been adopted for the analysis of the considered phenomenon. The obtained equations have been solved numerically using MATLAB software. The effects of control characteristics on profiles of velocity, temperature and nanoparticles volume fraction as well as Nusselt number have been studied in detail.
A novel low profile dual band patch antenna is presented. It consists of a composite right/left-handed transmission line (CRLH TL) unit cell gap coupled with the radiating edge of a rectangular patch antenna. The dual band behavior is achieved by coupling the zeroth order resonance mode of CRLH TL and TM10 mode of the patch antenna. It is shown that frequency ratio can be changed by varying the gap between the patch and CRLH TL unit cell. The proposed configuration enables frequency reconfigurability by changing the CRLH TL unit cell using a switch. A prototype of the antenna having frequency ratio f2/f1 = 1.08 is designed and fabricated. The proposed antenna shows measured S11 ≤ −10 dB bandwidth of 100 and 50 MHz at resonance frequencies of f1 = 4.84 and f2 = 5.22 GHz, respectively. A 2 × 2 dual band CRLH TL coupled patch array is also presented, showing more than 12.7 dBi gain at both resonance frequencies.
Pulmonary hypertension with transposition of the great arteries is associated with significant morbidity and mortality. At the worst end of the spectrum are patients who undergo extracorporeal support perioperatively. We describe our experience with three patients who received preoperative extracorporeal support and separated from cardiopulmonary bypass successfully on conventional postoperative care, with no significant deficits on follow-up.
Improving understanding of the pathogen-specific seasonality of enteric infections is critical to informing policy on the timing of preventive measures and to forecast trends in the burden of diarrhoeal disease. Data obtained from active surveillance of cohorts can capture the underlying infection status as transmission occurs in the community. The purpose of this study was to characterise rotavirus seasonality in eight different locations while adjusting for age, calendar time and within-subject clustering of episodes by applying an adapted Serfling model approach to data from a multi-site cohort study. In the Bangladesh and Peru sites, within-subject clustering was high, with more than half of infants who experienced one rotavirus infection going on to experience a second and more than 20% experiencing a third. In the five sites that are in countries that had not introduced the rotavirus vaccine, the model predicted a primary peak in prevalence during the dry season and, in three of these, a secondary peak during the rainy season. The patterns predicted by this approach are broadly congruent with several emerging hypotheses about rotavirus transmission and are consistent for both symptomatic and asymptomatic rotavirus episodes. These findings have practical implications for programme design, but caution should be exercised in deriving inferences about the underlying pathways driving these trends, particularly when extending the approach to other pathogens.
Poultry can be exposed to different kinds of immunosuppressive agents that impair health and welfare by destroying innate and acquired immunity leading to diminished genetic potential of poultry for efficient production. Immunosuppression is a condition characterised by humoral and cellular immune dysfunction that leads to increased susceptibility to secondary infections and vaccine failure. Immune dysfunction at the humoral level is largely due to change in soluble factors mediated by complement or chemokines for innate immunity or due to alterations in antibodies or cytokines for adaptive immunity. In contrast, immune dysfunctions at cellular levels include alterations in neutrophils, monocyte/macrophage, and natural killer cells for innate immunity or changes in B or T lymphocytes for adaptive immunity. In poultry, stress-induced immunosuppression is manifested by failure in vaccination, and increased morbidity and mortality of flocks. Immunosuppressive agents can have cytolytic effects on lymphocyte populations leading to atrophied and depleted lymphoid organs. Immunosuppression can be due to infectious agents or non-infectious agents or due to a combination of them. At present, several modern cellular and molecular approaches are being used to determine the status of the immune system during stress and disease. Comprehensive methodologies for the evaluation of immunosuppression by combined non-infectious and infectious aetiologies have not found general application. Currently, investigations are being developed in order to detect genetic expression of immunologic mediators and receptors by microarray technology. It is likely that this new technique will initiate the development of new strategies for the control and prevention of immunosuppression in poultry. A long term immunosuppression preventive approach involves genetic selection for resistance to immunosuppressive diseases. In general, intervention approaches for immunosuppressive diseases largely rely on minimising stress, reducing exposure to infectious agents through biosecurity, and increasing immune responses by vaccination against immunosuppressive agents.
We conducted a longitudinal assessment in 466 underweight and 446 normal-weight children aged 6–24 months living in the urban slum of Dhaka, Bangladesh to determine the association between vitamin D and other micronutrient status with upper respiratory tract infection (URI) and acute lower respiratory infection (ALRI). Incidence rate ratios of URI and ALRI were estimated using multivariable generalized estimating equations. Our results indicate that underweight children with insufficient and deficient vitamin D status were associated with 20% and 23–25% reduced risk of URI, respectively, compared to children with sufficient status. Underweight children, those with serum retinol deficiency were at 1·8 [95% confidence interval (CI) 1·4–2·4] times higher risk of ALRI than those with retinol sufficiency. In normal-weight children there were no significant differences between different vitamin D status and the incidence of URI and ALRI. However, normal-weight children with zinc insufficiency and those that were serum retinol deficient had 1·2 (95% CI 1·0–1·5) times higher risk of URI and 1·9 (95% CI 1·4–2·6) times higher risk of ALRI, respectively. Thus, our results should encourage efforts to increase the intake of retinol-enriched food or supplementation in this population. However, the mechanisms through which vitamin D exerts beneficial effects on the incidence of childhood respiratory tract infection still needs further research.
We quantified the prevalence of vitamin D status in 6–24-month-old underweight and normal-weight children and identified the socio-economic and dietary predictors for status.
Cross-sectional, baseline data from a nutritional intervention study were analysed. Multinomial logistic regression was used to estimate the odds of being vitamin D deficient or insufficient with the reference being vitamin D sufficient.
Urban slum area of Mirpur field site, Dhaka, Bangladesh.
Underweight (weight-for-age Z-score <−2·00) and normal-weight (weight-for-age Z-score ≥−1·00) children aged 6–24 months.
Among 468 underweight children, 23·1 % were sufficient, 42·3 % insufficient, 31·2 % deficient and 3·4 % severely vitamin D deficient. Among 445 normal-weight children, 14·8 % were sufficient, 39·6 % insufficient and 40·0 % deficient and 5·6 % severely deficient. With adjusted multinominal regression analysis, risk factors (OR (95 % CI)) for vitamin D deficiency in underweight children were: older age group (18–24 months old; 2·9 (1·5–5·7)); measurement of vitamin D status during winter (3·0 (1·4–6·4)) and spring (6·9 (3·0–16·1)); and maternal education (≥6 years of institutional education; 2·2 (1·0–4·9)). In normal-weight children, older age group (3·6 (1·2–10·6)) and living in the richest quintile (3·7 (1·1–12·5)) were found to be significantly associated with vitamin D insufficiency.
The study demonstrates a significant burden of vitamin D insufficiency and deficiency in both underweight and normal-weight children <2 years of age from an urban slum of Bangladesh. Identification of risk factors may help in mitigating the important burden in such children.
Following the removal of antibiotic growth promoters in animal feed, various products have been suggested as alternatives to the poultry feed industry. Among these products some types of clay or derivatives were used as a natural supply in order to optimise performance. Clay is indeed abundant naturally, cheap, widely used by hens raised outdoors voluntarily or by ingesting earthworms and soil fauna insects. As an indication it was estimated that a laying hen kept outdoors consumes 10g of soil, 7g of plant and 20g of insects and worms per day. In further studies it was reported that soil ingestion can reach 30% of dry matter intake. Considering their specific absorption capacities of ions, clays are considered real molecular sieves. Various studies have concluded that clays promote a hygienic digestive tract, increase food retention time and contribute to improving water retention and reducing the moisture content of droppings. The use of clays was accompanied by positive responses in nutrient digestibility, weight gain and feed conversion ratio. Also the addition of clay enhances meat sensorial value and organoleptic characteristics, the cutting yield and meat processing abilities. The antimicrobial and antitoxic properties of clay were shown to improve the appetite and weight gain of chickens eating food containing aflatoxins. In laying hens literature states that the use of clay improves egg size, egg internal qualities, shell strength and wet droppings. Clay use is also reported to reduce mite infestation in hens and improve ambient conditions in animal husbandry with substantially lower levels of NH3 and CH4.
A growing trend for nutraceutical and gluten-free cereal-based products highlights the need for development of new products. Buckwheat is one of the potential candidates for such products and the present paper reviews the functional and nutraceutical compounds present in common buckwheat (Fagopyrum esculentum) and tartary buckwheat (Fagopyrum tataricum). The vital functional substances in buckwheat are flavonoids, phytosterols, fagopyrins, fagopyritols, phenolic compounds, resistant starch, dietary fibre, lignans, vitamins, minerals and antioxidants, which make it a highly active biological pseudocereal. Cholesterol-lowering effects that lessen the problems of constipation and obesity are important health benefits that can be achieved through the functional substances of buckwheat.
Solar spectral splitting technologies have been investigated over the years as alternatives to improve the efficiencies obtained from photovoltaic devices by splitting the incident solar light into its respective wavelengths, and aligning a series of photovoltaic cells arranged next to each other as opposed to being physically stacked on top of each other as is the case with multijunction cells. Limitations previously posed by multijunction cells like current matching and lattice matching are circumvented through this approach, allowing for a broader and potentially cheaper pool of candidate cells to be used for energy conversion. In this study, we design and gauge the performance of a single optical element capable of splitting the light and concentrating it simultaneously unto a bed of photovoltaics, each illuminated by the part of the spectrum that corresponds best to its relevant properties such as the bandgap and the external quantum efficiency. The prismatic structure constituting the device relies on the device’s transmission in the visible region and its dispersion. Presented in this study is the mathematical framework used in designing the structure for a specific merit function; in particular, the study focuses on minimizing optical losses at the interfaces of the structure with the ambient air. Variables like the index of refraction of the material used, the angle of incidence on the surface, the exit angle of the light out of the structure factor into the optical center’s design. Compared to alternative splitting technologies like dichroic mirrors, the model splits the incident polychromatic light into a continuous band of wavelengths as opposed to discrete wavelengths that can be adapted on to different sets of single junction cells. The device is an improvement to our published 1-axis linear concentrator reported earlier in the year for its point-focus output yielding in even higher concentration and potentially lowers costs.
Zn supplementation has shown inconsistent effects on respiratory morbidity in young children in developing countries. Few studies have focused on upper respiratory tract infection (URTI), a frequent cause of morbidity in this group, and potential benefit from Zn supplementation or factors that influence its efficacy. We investigated the effects of Zn supplementation on URTI before and after vitamin A supplementation. This randomised double-blinded controlled Zn supplementation study was conducted on 826 children aged 2–5 years. Placebo or Zn (10 mg/d) was given in syrup daily for 4 months, with 200 000 IU vitamin A (60 mg retinol) given to all children at 2 months. Health workers visited children every 3 d for compliance and morbidity information. We found that 84 % of children experienced URTI during the study. Zn supplementation reduced the percentage of days with URTI (12 % reduction; P = 0·09), with greater impact following vitamin A supplementation (20 % reduction; P = 0·01). Vitamin A supplementation was associated with a decreased number but an increased duration of URTI episodes. We conclude that Zn combined with vitamin A supplementation significantly reduced the percentage of days with URTI in a population of preschool Indonesian children with marginal nutritional status. The results suggest that vitamin A status modifies the efficacy of Zn supplementation on URTI.
The present study was conducted to show that dietary supplementation with a fungus, Aspergillus awamori, modifies muscle fatty acid profiles in broiler chickens. A total of thirty chicks, selected from a group of 100 chicks aged 15 d, were divided into a control group and two treatment groups (ten birds per treatment). The control group was fed a basal diet, and the treatment groups were fed basal diets supplemented with A. awamori at levels of 0·05 and 0·2 %. From the start of the study at 15 d, the birds were raised for an additional 12 d, and growth and the muscle fatty acid profile were evaluated. Although feed intake was decreased by the fungus, body-weight gain and breast muscle weight were increased, and thus, feed efficiency was improved. Abdominal fat and plasma cholesterol and TAG were decreased, while plasma HDL-cholesterol and breast muscle fat content were increased. Interestingly, muscle α-tocopherol content was increased and muscle thiobarbituric acid-reactive substances were decreased by A. awamori. Furthermore, there was an observed decrease in SFA and an increase in unsaturated fatty acids in the muscle fat due to the fungus feeding. The mRNA of fatty acid synthase, acetyl-CoA carboxylase and Δ-6 desaturase in the muscle were all increased, while the mRNA of 3-hydroxyl-3-methylglutaryl-CoA reductase and carnitine palmitoyl transferase 1A were decreased by the fungus. In conclusion, the present study clearly shows that the muscle lipid profile could be modified by the addition of A. awamori to the diet.
Given their political incentives, governments in more autocratic polities can strategically channel unearned government and household income in the form of foreign aid and remittances to finance patronage, which extends their tenure in political office. I substantiate this claim with duration models of government turnover for a sample of 97 countries between 1975 and 2004. Unearned foreign income received in more autocratic countries reduces the likelihood of government turnover, regime collapse, and outbreaks of major political discontent. To allay potential concerns with endogeneity, I harness a natural experiment of oil price–driven aid and remittance flows to poor, non–oil producing Muslim autocracies. The instrumental variables results confirm the baseline finding that authoritarian governments can harness unearned foreign income to prolong their rule. Finally, I provide evidence of the underlying causal mechanisms that governments in autocracies use aid and remittances inflows to reduce their expenditures on welfare goods to fund patronage.