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Despite the hot climate and high humidity in the Jazan Region of Saudi Arabia, which increases risk for dehydration, no previous studies have assessed awareness of dehydration and fluid intake practice among adults in this region. Therefore, the aim of this cross-sectional study was to determine awareness of the dehydration state and fluid intake practices among 440 adults in the Jazan Region of Saudi Arabia. Out of the total, 51⋅8 % were male and 48⋅2 % were females. Good knowledge of dehydration definition and prevention and recommended minimum water intake was observed in 98, 95 and 75 % of the participants, respectively. Fifty-nine percent of the participants met the minimum daily requirement of 3 l or more per day. The age (95 % CI 1⋅003, 1⋅017, P value = 0⋅006), diabetes (95 % CI 1⋅028, 1⋅459, P value = 0⋅023) and prior hospitalisation due to dehydration (95 % CI 1⋅010, 1⋅378, P value = 0⋅037) were associated with higher water intake. Additional glasses of coffee (95 % CI 1⋅02, 1⋅115, P value = 0⋅004) and juice (95 % CI 1⋅039, 1⋅098, P value < 0⋅001) were associated with more water intake. The participants exhibited good knowledge of dehydration definition, symptoms and consequences. Intake of fluids such as ‘juice and coffee’ enhances more water intake. Although two-thirds of the participants met the recommended daily water intake, still one-third of them did not meet this level. Innovative approaches to enhance healthy drinking are warranted and may include partnering with patients to take an active role in hydration monitoring and increasing communication with the different healthcare providers.
The dosimetric and clinical advantages offered by implementation of pencil beam scanning (PBS) proton therapy for moving thoracic tumours is hindered by interplay effect. The purpose of this study is to evaluate the impact of large proton beam spot size along with adaptive aperture (AA) and various motion mitigation techniques on the interplay effect for a range of motion amplitudes in a three-dimensional (3D) respiratory motion phantom.
Materials and Methods:
Point doses using ionisation chamber (IC) and planner dose distributions with radiochromic film were compared against the corresponding treatment planning system (TPS) information. A 3D respiratory motion phantom was scanned either for static or 4D computed tomographic (CT) technique for 6-, 10- and 14-mm motion amplitudes in SI direction. For free breathing (FB) treatment, a tumour was contoured on maximum intensity projection scan and an average scan was used for treatment planning. Each FB treatment was delivered with one, three and five volumetric repaintings (VRs). Three phases (CT40–60%) were extracted from the 4D-CT scans of each motion amplitude for the respiratory-gated treatment and were used for the treatment planning and delivery. All treatment plans were made using AA and robustly optimised with 5-mm set-up and 3·5% density uncertainty. A total of 26 treatment plans were delivered to IC and film using static, dynamic and respiratory-gated treatments combinations. A percent dose difference between IC and TPS for the point dose and gamma indices for film–TPS planner dose comparison was used.
The dose profile of film and TPS for the static phantom matched well, and percent dose difference between IC and TPS was 0·4%. The percent dose difference for all the gated treatments were below 3·0% except 14-mm motion amplitude-gated treatment. The gamma passing rate was more than 95% for film–TPS comparison for all gated treatment for the investigated gamma acceptance criteria. For FB treatments, the percent dose difference for 6-, 10- and 14-mm motion amplitude was 1·4%, −2·7% and −4·1%, respectively. As the number of VR increased, the percent difference between measured and calculated values decreased. The gamma passing rate met the required tolerance for different acceptance criteria except for the 14-mm motion amplitude FB treatment.
The PBS technique for the FB thoracic treatments up to 10-mm motion amplitude can be implemented with an acceptable accuracy using large proton beam spot size, AA and robust optimisation. The impact of the interplay effect can be reduced with VR and respiratory-gated treatment and extend the treatable tumour motion amplitude.
Previous studies on the association between glycemic index (GI) and load (GL) in relation to breast cancer risk are contradictory. The aim of this study was to examine the association between dietary GI and GL and risk of breast cancer in Iranian women.
Population-based case-control. Dietary GI and GL were assessed using a validated Willett-format 106-item semi-quantitative food frequency questionnaire.
Cases were 350 patients with newly diagnosed stage I-IV breast cancer, for whom the status of breast cancer was confirmed by physical examination and mammography. Controls were 700 age-matched apparently healthy individuals who were randomly selected from general population.
After controlling for potential confounders, individuals in the highest tertile of dietary GI had 47% higher odds of breast cancer than women in the lowest tertile (OR: 1.47; 95% CI: 1.02-2.12). Stratified analysis by menopausal status showed such association among postmenopausal women (OR: 1.51; 95% CI: 1.02-2.23). We found no significant association between dietary GL and odds of breast cancer either before (OR: 1.35; 95% CI: 0.99-1.84) or after adjustment for potential confounders (OR: 1.24; 95% CI: 0.86-1.79). In addition, stratified analysis by menopausal status revealed no significant association between dietary GL and odds of breast cancer.
Our findings showed a significant positive association between dietary GI and odds of breast cancer. However, we observed no significant association between dietary GL and odds of breast cancer.
Apricot is considered an ecologically and economically important tree species of the stone-fruit crops that is widely grown in temperate regions of the world. Very few studies on apricot genetic diversity assessment have been carried out from the regions of Kashmir and Ladakh. In this backdrop, the present study was carried out to analyse the genetic diversity and population structure of 120 apricot genotypes collected from both the regions using 21 SSR markers. A total of 52 alleles were amplified with average values of marker index (MI) = 0.7084, resolving power (RP) = 2.8690, polymorphism information content (PIC) = 0.3132, Na = 2.317, Ne = 1.720, I = 0.572, Ho = 0.284, He = 0.360 and an average polymorphism of 91.2% per assay indicating high level of genetic diversity. The neighbour-joining (NJ) dendrogram generated three main clusters among selected apricot genotypes independent of their geographical locations. Interestingly, the result of the dendrogram coincides with the results of structure analysis which showed that the 120 apricot genotypes could be assigned to three (K = 3) sub-populations and the grouping of genotypes did not follow their geographical location suggesting that they share the same genetic pool. Moreover, analysis of molecular variance showed that 73% of the variation was attributed to differences within the individuals, 25% among individuals while only 2% of the variation was observed among the populations. The present study represents the most comprehensive analysis of the genetic diversity and population structure of apricot genotypes in Kashmir and Ladakh regions of India.
The COVID-19 (SARS-CoV-2) pandemic has profoundly impacted almost every aspect of healthcare systems worldwide, placing the health and safety of frontline healthcare workers at risk, and it still continues to remain an important public health challenge. Several hospitals have put in place strategies to manage space, staff, and supplies in order to continue to deliver optimum care to patients while at the same time protecting the health and safety of staff and patients. However, the emergence of the second and third waves of the virus with the influx of new cases continue to add an additional level of complexity to the already challenging situation of containing the spread and lowering the rate of transmission, thus pushing healthcare systems to the limit. In this narrative review paper, we describe various strategies including administrative controls, environmental controls, and use of personal protective equipment, implemented by occupational health and safety departments for the protection of healthcare workers, patients, and visitors from SARS-CoV-2 virus infection. The protection and safeguard of the health and safety of healthcare workers and patients through the implementation of effective infection control measures, adequate management of possible outbreaks and minimization of the risk of nosocomial transmission is an important and effective strategy of SARS-CoV-2 pandemic management in any healthcare facility. High quality patient care hinges on ensuring that the care providers are well protected and supported so they can provide the best quality of care to their patients.
Neck circumference (NC) is currently used as an embryonic marker of obesity and its associated risks. But its use in clinical evaluations and other epidemiological purposes requires sex and age-specific standardised cut-offs which are still scarce for the Pakistani paediatric population. We therefore developed sex and age-specific growth reference charts for NC for Pakistani children and adolescents aged 2–18 years.
The dataset of 10 668 healthy Pakistani children and adolescents aged 2–18 years collected in MEAS were used. Information related to age, sex and NC were taken as study variables. The lambda–mu–sigma (LMS) and quantile regression (QR) methods were applied to develop growth reference charts for NC.
The 5th, 10th, 25th, 50th, 75th, 90th and 95th smoothed percentile values of NC were presented. The centile values showed that neck size increased with age in both boys and girls. During 8 and 14 years of age, girls were found to have larger NC than boys. A comparison of NC median (50th) percentile values with references from Iranian and Turkish populations reveals substantially lower NC percentiles in Pakistani children and adolescents compared to their peers in the reference population.
The comparative results suggest that the uses of NC references of developed countries are inadequate for Pakistani children. A small variability between empirical centiles and centiles obtained by QR procedure recommends that growth charts should be constructed by QR as an alternative method.
This article explores authoritarian populist mobilisation and media strategies that political elites who ran in the election advanced and their consequences on journalistic freedom in an emerging democracy. It focuses on Indonesia's democracy and examines the following questions: what types of authoritarian populist mobilisation and media strategies did Joko Widodo and Prabowo Subijanto adopt when contesting Indonesia's 2019 presidential election? To what degree did these adaptations impact the journalistic freedom of those who worked for Indonesian mainstream media, particularly Indonesian private TV news channels? In-depth interviews with four senior journalists associated with Indonesian TV news channels (Kompas TV, CNN Indonesia, TV One, and INews TV) and two senior journalists working for mainstream media owned by influential Indonesian oligarchs used qualitative and thematic content analyses to reveal the following findings. Jokowi and Prabowo adopted secular nationalist and Islamic authoritarian populist mobilisation during the election. However, Prabowo developed Islamic authoritarian populist mobilisation far more than Jokowi. Jokowi advanced an oligarchic authoritarian populist media strategy, while Prabowo established an intensive Islamic anti-oligarchic authoritarian populist media strategy. As authoritarian populist mobilisation and media strategies evolved during their campaigns, the journalistic freedom of those associated with Indonesian mainstream media declined substantially. This article introduces four faces of authoritarian populism — secular nationalist and Islamic authoritarian populist mobilisation and oligarchic and anti-oligarchic authoritarian populist media strategies — as new concepts enriching political elites’ authoritarian populism literature.
Parasitoid wasps are key agents for controlling insect pests in integrated pest management programs. Although many studies have revealed that the behavior of parasitic wasps can be influenced by insecticides, the strategies of patch time allocation and oviposition have received less attention. In the present study, we forced the endoparasitoid Meteorus pulchricornis to phoxim exposure at the LC30 and tested the foraging behavior within patches with different densities of the host, the larvae of the tobacco cutworm Spodoptera litura. The results showed that phoxim treatment can significantly increase the patch-leaving tendency of female wasps, while host density had no impact. The number of oviposition and the number of previous patch visits also significantly influenced the patch time allocation decisions. The occurrence of oviposition behavior was negatively affected by phoxim exposure; however, progeny production was similar among patches with different host densities. Phoxim exposure shaped the offspring fitness correlates, including longer durations from cocoon to adult wasps, smaller body size, and shorter longevity. The findings of the present study highlight the sublethal effects that reduce the patch residence time and the fitness of parasitoid offspring, suggesting that the application of phoxim in association with M. pulchricornis should be carefully schemed in agroecosystems.
We aimed to assess the individual and joint association of serum vitamin D and cardiorespiratory fitness (CRF) with obesity and metabolic syndrome (MetSyn). In this cross-sectional study 270 adults with an age range of 18 years and older were recruited from health centers from five districts in Tehran, Iran. CRF was assessed with Bruce protocol. MetSyn was defined based on International Diabetes Federation 2009. The odds ratio (OR) and 95 % confidence interval (CI) of obesity and MetSyn across tertiles of serum vitamin D and CRF were estimated with control for confounders. The results indicated that neither 25(OH)D nor 1,25(OH)D was associated with obesity and MetSyn. There was a strong inverse association between CRF and general (P-trend < 0.001) and abdominal adiposity (P-trend: 0.001). The joint association of vitamin D and CRF indicated that the inverse association of CRF with obesity was stronger in those with high serum vitamin D than those with low serum vitamin D and this joint association remained after considering age and diet quality. There was a significant inverse association for those with low serum 25(OH)D and high CRF (OR: 0.12, 95 % CI: 0.04–0.81; P = 0.02) compared to those with low serum 25(OH)D and low CRF in the crude model. Also, the OR of general obesity was 0.17 (95 % CI: 0.02–0.79; P = 0.03) for those with high CRF and low serum 1,25(OH)D compare with the reference group. Our findings indicated a strong inverse association between CRF and obesity, especially in those with high serum vitamin D.
Schizophrenia is a heterogeneous disorder with substantial heritability. The use of endophenotypes may help clarify its aetiology. Measures from the smooth pursuit and antisaccade eye movement tasks have been identified as endophenotypes for schizophrenia in twin and family studies. However, the genetic basis of the overlap between schizophrenia and these oculomotor markers is largely unknown. Here, we tested whether schizophrenia polygenic risk scores (PRS) were associated with oculomotor performance in the general population.
Analyses were based on the data of 2956 participants (aged 30–95) of the Rhineland Study, a community-based cohort study in Bonn, Germany. Genotyping was performed on Omni-2.5 exome arrays. Using summary statistics from a recent meta-analysis based on the two largest schizophrenia genome-wide association studies to date, we quantified genetic risk for schizophrenia by creating PRS at different p value thresholds for genetic markers. We examined associations between PRS and oculomotor performance using multivariable regression models.
Higher PRS were associated with higher antisaccade error rate and latency, and lower antisaccade amplitude gain. PRS showed inconsistent patterns of association with smooth pursuit velocity gain and were not associated with saccade rate during smooth pursuit or performance on a prosaccade control task.
There is an overlap between genetic determinants of schizophrenia and oculomotor endophenotypes. Our findings suggest that the mechanisms that underlie schizophrenia also affect oculomotor function in the general population.
The Saudi Red Crescent Authority (SRCA) plays a major role in the event of disasters and crisis, as it is the main pre-hospital health-care provider. This study reports on the attitude and perceptions of SRCA medical staff concerning their knowledge of disaster management and response.
This is a descriptive cross-sectional study performed in Riyadh, Saudi Arabia. An Arabic version of the Disaster Preparedness Evaluation Tool (DPET), a self-administered Likert-scale survey, was used to obtain data from SRCA medical staff to evaluate the current status of disaster preparedness.
The population surveyed consisted of 302 participants; 20.9% had participated in a drill exercise or practical application of a regular disaster or emergency plan in their workplaces. Most of participants (85.3%) had incentives to extend their education regarding their role, scope of practice, and skills as medical staff in disaster situations.
Results indicate a lack of regular disaster drills available to prehospital care providers, although most of them are willing to participate in more training and education programs regarding preparedness for disaster management, especially concerning their role in a disaster situation.
Previous investigations have mostly studied an individual methyl donor nutrient in relation to psychological disorders and the findings were inconsistent. We investigated the association of methyl donor micronutrients (folate, B6, B12, choline, betaine and methionine) with psychological disorders in Iranian adults. In this cross-sectional study, dietary intakes of 3299 adults were collected using a validated food frequency questionnaire. Methyl donor micronutrient score (MDMS) was calculated based on energy-adjusted deciles of each nutrient. Hospital Anxiety and Depression Scale (HADS) and General Health Questionnaire (GHQ), validated for Iranians, have been applied to assess depression, anxiety and psychological distress. Participants had a mean age of 36·3 ± 7·9 years, of whom 58·5 % were women. After considering potential confounders, adults in the top quartile of MDMS, compared to the bottom one, had decreased odds of anxiety (OR: 0·53, 95 % CI: 0·37, 0·75), depression (OR: 0·75, 95 % CI: 0·58, 0·97) and psychological distress (OR: 0·61, 95 % CI: 0·46, 0·80). Among women, the top quartile of MDMS was protectively associated with anxiety (OR: 0·60, 95 % CI: 0·40, 0·90), depression (OR: 0·68, 95 % CI: 0·50, 0·93) and psychological distress (OR: 0·53, 95 % CI: 0·38, 0·74). Overweight and obese subjects in the highest quartile of MDMS had a 67 %, 35 % and 53 % lower odds of anxiety (95 % CI: 0·20, 0·56), depression (95 % CI: 0·44, 0·94) and psychological distress (95 % CI: 0·31, 0·70), respectively. We found that high consumption of methyl donor micronutrients was related to a reduced odds of psychological disorders, especially in women and overweight or obese individuals.
In this paper, we propose a frequency-reconfigurable antenna structure consisting of a dielectric resonator (DR) topped by a superstrate material. Two metasurfaces (MSs) are placed upon the DR and the superstrate, where these two MSs are utilized to synthesize a localized reduction of the dielectric constant of the DR. By placing switches into one of the MSs, the distribution of dielectric constant of the DR can be switched to one of two predefined distributions, which is equivalent to switching the DR length to two different lengths. Consequently, the frequency response of the proposed structure can be tuned to one of two operating bands. The excited modes inside the proposed antenna were obtained analytically and through simulations. Also, the dielectric constant value of substrates topped by MSs was analyzed. The antenna was fabricated and measured, and good agreement between simulation and measurement was attained. The antenna bandwidths are 7–8.1 GHz (14.7%) and 8.5–9.2 GHz (8%) and the gains are 5.1 and 7.8 dB, in the cases of having switches off and on, respectively.
Street working children are often poor, deprived of love and care, and lack supervision by responsible adults. The Kurdistan region of Iraq has experienced war conflicts for decades. Many families have been displaced and their children forced into the streets. However, little is known about mental health among the street working children in this region.
To explore mental health and trauma among street working boys in Duhok.
A cross sectional study was conducted on street working boys (n=100), eight to 16 years old in Duhok. A control group of age-matched school boys (n=100) were recruited. The Child Behaviour Checklist 6-18 was used for assessment of the children’s competences and behavioural problems. Mental disorders were assessed by using the Mini-International Neuropsychiatric Interview for Children and Adolescence. Experienced trauma was assessed by the Harvard-Uppsala Trauma Questionnaire for Children.
Sixty-one percent of the street working boys had at least one psychiatric disorder (57 % anxiety disorders). Street working boys reported more traumatic events than school boys, 96% vs 64% (X²= 32, p < 0.001), the largest effect size was found for torture (OR 28.4) and the smallest effect size for maltreatment or assault (OR 2.7). Also, they reported higher levels of internalising symptoms, T-score 59.4 (8.2). There was a significantly increased risk of more externalising symptoms with increasing working hours, OR 2.90 [95% CI 1.02; 8.29].
Internalizing symptoms, anxiety disorders and trauma were more common in street working boys compared to school boys. More working hours increased the risk for more externalising symptoms.