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Charolais × and Suffolk × Mule lambs of less than one week of age were castrated and tail docked using a standard rubber ring technique. After these procedures, their behaviour was monitored for I h. Their respiration rates and scrotal sac measurements were also recorded. Both breeds of lamb exhibited abnormal behaviour patterns following these procedures. The recumbent behaviour pattern of both breeds was remarkably similar but their standing behaviour differed markedly. The Charolais × lambs were significantly more active and had significantly higher respiration rates compared with the Suffolk × lambs. They also took a greater amount of time to recover to a normal posture. Their abnormal behavioural responses suggested that both breeds of lamb experienced acute pain following castration and tail docking, but the type of behaviour exhibited was breed-dependent. The findings suggest that different breeds of lamb may experience different levels of distress in response to the same husbandry procedure. Alternatively, they may simply reflect a difference in the character and temperament of the breeds studied.
This paper presents a multi-mode resonator (MMR) for next-generation wireless systems that achieves single and dual-band bandpass filter (BPF) responses using a split-ring dual-path structure. The proposed BPF design is realized by employing two pairs of parallel couple lines and two symmetrical step-impedance open-circuited stubs (SIOCS). SIOCS are used to improve selectivity and increase the number of transmission zeros/poles. The proposed single-band BPF exhibits an ultra-wideband (UWB) response having a center frequency of 7.5 GHz, a minimum insertion loss of less than 0.48 dB, and a maximum return loss of 25.35 dB. The proposed UWB BPF has a stopband suppression of 39.34 dB up to 18 GHz and a 3 dB fractional bandwidth of 48.23%. Moreover, a dual-band BPF has been accomplished by utilizing the same architecture while slightly changing the MMR structure and adding more coupling. The center frequency (bandwidth) of the dual broadband BPF is 7.40 GHz (2.40 GHz) and 14.15 GHz (1.7 GHz), respectively. The measured minimum insertion loss is less than 0.23 dB and a return loss of less than 16.8 dB with 3 dB FBWs of 32.4 and 12.1%. Finally, two prototypes are fabricated to validate the proposed characteristics. The BPF's simulated and measured results are in good agreement.
The National Institute for Health and Care Research Innovation Observatory (IO) is a horizon scanning centre based at Newcastle University, United Kingdom. The IO provides horizon scanning intelligence on new and innovative medicinal products to the National Institute for Health and Care Excellence (NICE) as technology briefing notifications (TBNs). We present an analysis of how TBNs produced between April 2017 and October 2021 feed into the NICE HTA process and used to inform their Technology Appraisal (TA) programme.
TBNs were mapped to relevant published NICE TA guidance and time from horizon scanning identification to NICE recommendation was studied. For mapping technologies undergoing appraisal, provisional guidance-in-development (GID) identification numbers (IDs) were used. For technologies that had not reached the NICE scoping stage yet, the NICE Topic Selection decision and ID was used.
Six hundred and ninety-three TBNs were submitted to NICE between April 2017 and October 2021; 653 were prioritised for TA. Of those, eleven percent mapped to a published NICE TA guidance; forty-three percent to a GID, twenty-two percent were undergoing consultation, and three percent were not traced. Further twenty-one percent mapped to a suspended or terminated TA. Reasons for this included HTA timeliness, regulatory issues or companies unwilling to submit evidence to NICE. Time from technology identification to TA guidance publication ranged from twenty-two to 115 months. The average time from TBN submission to NICE recommendation was thirty months.
Timely notification is key in achieving TA recommendation aligned with market authorization but not the only influencing factor. After issuing a TBN, the NICE appraisal process might be terminated, suspended or withdrawn due to unforeseen factors. Horizon scanning plays a key role triggering the NICE TA process; understanding factors that influence the successful TA completion would streamline processes and find efficiencies.
Mycotic pseudoaneurysm secondary to infective endocarditis is an uncommon complication in CHD with conduit placement. We report a case of late presentation of bacterial infective endocarditis with pseudoaneurysm in an 8-year-old girl with underlying pulmonary atresia with ventricular septal defect, post Rastelli procedure done at the age of 3 years old.
One fundamental strategy to address the public health threat of antimicrobial resistance (AMR) is improved awareness among the public, prescribers, and policy makers with the aim of engaging these groups to act. World Antimicrobial Awareness Week is an opportunity for concerted and consistent communication regarding practical strategies to prevent and mitigate AMR. We highlight 10 ways for antimicrobial stewards to make the most of World Antimicrobial Awareness Week.
Epilepsy is a common neurological condition. It affects around 1% of the global population. This study aims to evaluate the knowledge and attitudes toward epilepsy.
This is a cross-sectional observational study. An online questionnaire was distributed to medical students in their clinical and preclinical years and interns at Riyadh’s four public universities. Then a comparison was made to see whether attending more courses in medical school would influence the students’ knowledge and attitudes.
In the present study, 95% of medical students had heard about epilepsy or convulsive seizures (a significantly larger proportion of clinical students had heard about epilepsy than preclinical students (99.0% versus 92%, P-value = 0.000)). Furthermore, 34.0% believed that epilepsy could be treated. Moreover, 79.1% of those polled claimed that brain disease originated from epilepsy, followed by genetic factors (64.1%) and convulsions (92.3%) as the most common symptoms.
Regarding medical students’ awareness of epilepsy, it turns out that it is good and better than reported in other research, especially among clinical students rather than preclinical students, who have a negative attitude toward epileptic patients. Consequently, there is a need to further development of their knowledge throughout future campaigns and conferences, and curricula that should be tailored to help improve awareness and attitudes toward epilepsy.
The unsteady hydrodynamics of two pitching foils arranged in a side-by-side (parallel) configuration is examined for a range of Strouhal numbers, phase differences, oscillation amplitudes and separation distances. Three distinct vortex patterns are identified in the wake maps, which include separated wake, merged wake and transitional-merged wake. Furthermore, a novel model is introduced based on fundamental flow variables including velocity, location and circulation of dipole structures to quantitatively distinguish vortex patterns in the wake. The physical mechanism of the wake merging process is also elucidated. When an oscillating foil experiences the jet deflection phenomenon, secondary structures separated from the primary street traverse in the other direction by making an angle with its parent vortex street. For in-phase pitching parallel foils, secondary structures from the vortex street of the lower foil interact with the primary vortex street of the upper foil under certain kinematic conditions. This interaction triggers the wake merging process by influencing circulation of coherent structures in the upper part of the wake. It is unveiled that merging of the wakes leads to enhancements in propulsive efficiency by increasing thrust generation without a significant alteration in power requirements. These are attributed to the formation of a high-momentum jet by the merged vortex street, which possesses significantly larger circulation due to the amalgamation of the vortices, and major alterations in the evolution of leading edge vortices. Thus, flow physics, which is thoroughly explored here, is crucial in providing novel insights for the future development of flow control techniques for efficient designs of bio-inspired underwater propulsors.
A new species in the genus Phaeophyscia is described from Azad Jammu and Kashmir, Pakistan, supported by nrITS sequences, morphology and chemistry. The taxon is characterized by a green to greyish green thallus, usually narrow (0.5–2 mm), flat to convex lobes with abundant marginal soralia, black, dense small rhizines, small Physcia-type ascospores 18–22 × 8–10 μm and an absence of pycnidia. Differences from related species are discussed.
High venous pressures and associated hepatic congestion are important drivers for Fontan-associated liver disease. The prognostic significance of hepatomegaly as a marker of congestion however is not well defined and is further explored in this research study.
Fontan patients who have had liver ultrasound scans were identified from the Prince Sultan Cardiac Centre Fontan Database and had their anatomic, surgical, clinical histories abstracted from the electronic medical records following institutional ethics approval. Liver volumes were determined retrospectively from reviewing individual US images, and these, divided into tertiles, were analysed in the context of the predefined endpoints of (i) Primary – death or heart or liver transplantation, or (ii) Secondary – combined endpoint of death, transplantation, arrhythmia, or protein-losing enteropathy.
Mean indexed liver volumes for the entire cohort (n = 199) were 1065.1 ± 312.1 ml/m2, range 387 to 2071 ml/m2. Patients with the largest liver volumes (highest tertile) were less likely to have a functioning fenestration compared to those in the lowest tertile 44% versus 56% p = 0.016 and experienced the highest burden of mortality and heart or heart–liver transplantation, p = 0.016, and were more likely to reach the composite endpoint of death, protein-losing enteropathy, arrhythmia, or transplantation, p = 0.010. Liver volumes had an overall predictive accuracy for the combined outcome of 61% (CI 53%, 67%, p = 0.009).
Liver volumetry may serve as a potentially important congestion biomarker for adverse outcomes after the Fontan operation.
In this chapter, the strengths and challenges of small group teaching are outlined. Indications for small group teaching are presented and different types of small groups are discussed. The importance of setting out ground rules are highlighted and the role of the facilitator explored. Practical tips to improve the learning environment are given, potential pitfalls are identified, and tips to address them are detailed.
In Sudan, a deep economic crisis in the 1990s initially facilitated the consolidation of an Islamist-commercial elite that forged an alliance with a segment of the military and capture the state. Having gained control of the state, the Islamists marginalized rival groups in civil society, while continuing to recruit more jihadist elements among poorer segments of the population. In addition to their control over the economy, Sudanese Islamists also consolidated their rule by taking over the civil service in a systematic fashion. However, with the steep decline in labor remittances as a result of a regional recession, and the loss of access to revenues from oil resulting from the secession of South Sudan, the Islamist authoritarian regime lost the financial basis that underpinned its patronage networks. This chapter explains how the latter gradually resulted in popular protests and the demise of the Islamist authoritarian regime in Sudan.
In Egypt, by the mid-1980s, as a result of a deep economic crisis, thousands of Islamic voluntary associations managed to develop a parallel economy and a parallel welfare system. In some instances, these modes of informal organizations translated into an Islamist-inspired challenge to the state. The rise in political influence of the Islamic Investment Houses dominated by the Muslim Brotherhood aided that organization in its recruitment programs that expanded its membership. Moreover, where radical Islamic groups were able to exploit informal financial networks and procure informal labor contracts for their supporters, particularly in the informal settlements around Cairo, they used these as bases of power and influence. Using private sources to establish social networks in defiance of state regulations, organizations such as the militant Islamic Group (al-jama’at al-Islamiyya) have sought to build, literally, a “state within a state.”
The emergence, and proliferation, of Islamist militant organizations, ranging from the Islamic State of Iraq and Syria (ISIS) and Al-Shabbaab in Somalia, to Boko Haram in Nigeria and other parts of West Africa, has once again demonstrated that political Islam is an important global political issue. It has also highlighted a number of challenging, but increasingly crucial analytical questions: How popular a force is militant Islam, and how is it distinguishable from more conservative and moderate forms of Islamic activism? Does the rise of Islamic militancy across many regions of the Muslim world represent a “clash of civilizations,” or is its emergence a result of locally embedded, but globally linked, economic and social forces? And, finally, given the considerable diversity of socioeconomic formations within Muslim societies when, and under what conditions, do religious rather than ethnic cleavages serve as the most salient source of political identification?
Chapter 7 explains how militant Islamist leaders adapted “traditional” Egyptian rural norms in ways that allowed them both to supplant the political power of local notables, while simultaneously institutionalizing extortion practices and implementing their own brand of “law and order.” Islamic militants exploited the high levels of social and economic uncertainty in Cairo’s informal housing areas. An important reason behind the popularity of radical Islamists among local residents is due to the ways in which their leaders have utilized highly coercive methods to settle local disputes and enforce informal labor contracts for their members, while simultaneously preaching against the ills of conspicuous consumption in their sermons and imposing strict Islamic modes of conduct. The chapter shows how the socio-economic conditions that have served, as a “recruiting ground” for Islamist radicals was made possible as result of economic change at both the international as well as domestic level.
In Sudan the era of the oil boom resulted in a flood in labor remittances that circumvented official financial institutions, thereby undercutting the state’s fiscal and regulatory capacity and fueling the expansion of the informal foreign currency trade. Initially, developments in Sudan paralleled those in Egypt as the boom witnessed the rise of an Islamist-commercial class that formed as a result of its successful monopolization of informal financial markets. However, in contrast to Egypt, by 1989 Sudanese Islamists were able to take over the levers of the state via a military-coup. This development was made possible by Sudan’s weaker state capacity and the extreme weakness of its formal banking system. As a result, the financial power of the Muslim Brotherhood continued to increase in relationship to the state as they continued to profit from participation in the lucrative speculation in black market transactions and advantageous access to import licenses.
In Egypt migrant remittances and the flow of petrodollars in the era of the oil boom provided capitalization of Islamic banks and a host of Islamic investment companies that operated outside the system of state regulation. Such bankers drew on the rapidly growing wealth of those businessmen with long-standing connections in the Gulf, including, most importantly, members and sympathizers with the Muslim Brotherhood (MB). This boom in labor export and remittance flows also helped shape Egyptian national economic functions, out-migration and the burgeoning informal economy afforded the Egyptian state enough “relative autonomy” to allow it to expand the private sector and begin to decentralize the country’s economic system. It enabled the Egyptian state to relax foreign exchange regulations to stimulate a foreign capital influx. However, the unintended consequences of these policies were opening the door for Islamic financial institutions, which helped finance and popularize the middle class-based Islamic movement.