Building the bastard : confidence through preparation in Shakespeare\u27s King Lear.

This thesis is to chart my discovery that confidence is essential to an actor’s craft. This thesis focuses on my performance as Edmund in King Lear, as well as my production the previous summer playing Hussein in Ayad Akhtar’s Disgraced. I draw from a variety of sources, such as meditation and formal acting exercises, to achieve confidence. Most importantly, I distill my missteps as an actor for a better understanding of what hinders confidence when building a role for performance

Multilocus sequence typing (MLST) analysis of Vibrio cholerae O1 El Tor isolates from Mozambique that harbour the classical CTX prophage.

Vibrio cholerae O1 isolates belonging to the Ogawa serotype, El Tor biotype, harbouring the classical CTX prophage were first isolated in Mozambique in 2004. Multilocus sequence typing (MLST) analysis using nine genetic loci showed that the Mozambique isolates have the same sequence type (ST) as O1 El Tor N16961, a representative of the current seventh cholera pandemic. Analysis of the CTX prophage in the Mozambique isolates indicated that there is one type of rstR in these isolates: the classical CTX prophage. It was also found that the ctxB-rstR-rstA-rstB-phs-cep fragment was PCR-amplified from these isolates, which indicates the presence of a tandem repeat of the classical CTX prophage in the genome of the Mozambique isolates. The possible origin of these isolates and the presence of the tandem repeat of the classical prophage in them implicate the presence of the classical CTX phage

Effects of Hip and Ankle Moments on Running Stability: Simulation of a Simplified Model

In human running, the ankle, knee, and hip moments are known to play different roles to influence the dynamics of locomotion. A recent study of hip moments and several hip-based legged robots have revealed that hip actuation can significantly improve the stability of locomotion, whether controlled or uncontrolled. Ankle moments are expected to also significantly affect running stability, but in a different way than hip moments. Here we seek to advance the current theory of dynamic running and associated legged robots by determining how simple open-loop ankle moments could affect running stability. We simulate a dynamical model, and compare it with a previous study on the role of hip moments. The model is relatively simple with a rigid trunk and a springy leg to represent the effective stiffness of the knee. At the hip we use a previously established proportional and derivative controlled moment with pitching angle as feedback. At the ankle we use the simplest ankle actuation, a constant ankle torque as a rough approximation of the net positive work done by the ankle moment during human locomotion. Even in this simplified model, we find that ankle and hip moments can affect the center of mass (COM) and pitching dynamics in distinct ways. Analysis of the governing equations shows that hip moments can directly influence the upper body balance, as well as indirectly influence the center of mass translation dynamics. However, ankle moments can only indirectly influence both. Simulation of the governing equations shows that the addition of ankle moment has significant benefits to the quality of locomotion stability, such as a larger basin of attraction. We also find that adding the ankle moments generally expands the range of parameters and velocities for which the model displays stable solutions. Overall, these findings suggest that ankle moments would play a significant role in improving the quality and range of running stability in a system with a rigid trunk and a telescoping leg, which would be a natural extension of current springy leg robots. Further, these results provide insights into the role that ankle moments might play in human locomotion

Exploring the stability of Mahatiktaka Ghrita: A comprehensive study on Microbial Integrity

Background: The market for herbal, herbo-mineral, and traditional medicines has grown significantly in recent decades. However, a major challenge to their broader adoption is the limited information on their stability and shelf life. This study was conducted to assess the stability of Mahatiktaka Ghrita against microbial contamination when prepared and stored under different climatic conditions and temperatures. Aim: To evaluate the stability of Mahatiktaka Ghrita and monitor microbial contamination in the finished product at different time intervals and at different climatic conditions (different temperature and humidity set ups). Materials and Methods: Samples of Mahatiktaka Ghrita were studied to inspect microbial contamination at different climatic conditions. The study was conducted at Microbiology Laboratory, Institute of Teaching and Research in Ayurveda (ITRA), Jamnagar, Gujarat, India. Observations & Results: The microbiological study of Mahatiktaka Ghrita was carried out as per the samples utilized in clinical study. Further studies were carried out at regular time intervals up to 494 days. Conclusion: In microbiological study of Mahatiktaka Ghrita, growth of microorganisms either bacterial or fungal was not found till 494 days from the date of preparation, which shows its intact stability and good shelf life

Evaluation and use of surveillance system data toward the identification of high-risk areas for potential cholera vaccination: a case study from Niger.

In 2008, Africa accounted for 94% of the cholera cases reported worldwide. Although the World Health Organization currently recommends the oral cholera vaccine in endemic areas for high-risk populations, its use in Sub-Saharan Africa has been limited. Here, we provide the principal results of an evaluation of the cholera surveillance system in the region of Maradi in Niger and an analysis of its data towards identifying high-risk areas for cholera

HIV and depression in a primary care clinic in Johannesburg, South Africa

As rapidly expanding HIV care and treatment programs are implemented in sub-Saharan Africa, maintaining engagement in HIV care is proving to be a significant operational challenge. Depression is highly prevalent among HIV-infected people in sub-Saharan Africa and predicts a range of poor HIV-related clinical outcomes including faster disease progression and increased morbidity and mortality. Depression is strongly associated with non-adherence to anti-retroviral treatment (ART), and may also impact engagement in HIV care. Recognizing and treating depression among HIV-infected patients seeking care in primary health care settings, where most HIV testing and treatment takes place, could increase access to mental health services and may help to target patients at risk for negative outcomes. An observational study was conducted between September 2012 and April 2013 among 1683 randomly selected adult patients undergoing routine, opt-out HIV counseling and testing (HCT) at Witkoppen Health and Welfare Center (WHWC), a high-HIV burden primary care clinic in Johannesburg, South Africa. Patients were screened for depression immediately prior to HCT using the Patient Health Questionnaire-9 (PHQ-9), a 9-item brief screening tool administered by lay health workers. A subset of 400 patients was included in a blinded diagnostic validation study of the PHQ-9 (Aim 1). Sensitivity and specificity of the PHQ-9 were calculated with the Mini International Neuropsychiatric Interview (MINI) as the reference standard, and receiver operating characteristic (ROC) curve analyses were performed. Patients who tested positive for HIV were followed and linkage to care, defined as returning to WHWC within 3 months to obtain a CD4 count result, was assessed (Aim 2). Among patients who collected a CD4 count, ART initiation within 3 months was assessed. Multivariable Poisson regression with a robust variance estimator was used to assess the association between depression and linkage to care or ART initiation. Nearly all patients completed depression screening and 82% (n=1386) subsequently tested for HIV. Of the patients who tested for HIV and were of unknown HIV status prior to testing, 26% (n=340) were found to be HIV-infected. Nearly a quarter of all patients (22%) were depressed. Similar to other studies, depression was more common among patients who tested positive for HIV compared to those who tested negative for HIV (30.3% versus 19.7%, p<0.0001). In the validation sample included in Aim 1, the prevalence of depression was 11.8% and one-third of participants tested positive for HIV. Using the standard cut-off score of &#8805;10, the PHQ-9 demonstrated a sensitivity of 78.7% (95% CI: 64.3-89.3) and specificity of 83.4% (95% CI: 79.1-87.2) for identifying major depressive disorder. The area under the ROC curve was 0.88 (95% CI: 0.83-0.92). Test characteristics did not vary by HIV status or language and in sensitivity analyses, reference test bias associated with the MINI appeared unlikely. The PHQ-9 was easily implemented by lay health workers. The instrument performed reasonably well and may be a useful depression screening tool in high HIV-burden sub-Saharan African primary health care settings. Of the HIV-infected patients included in Aim 2, 30% were depressed. The proportion who linked to care was 80% among depressed patients and 73% among patients who were not depressed (Risk ratio: 1.08; 95% confidence interval: 0.96, 1.23). Of the participants who linked to care, 81% initiated ART within 3 months in both depressed and not depressed groups (Risk ratio: 0.99; 95% confidence interval: 0.86, 1.15). Conducting this study in a clinic-based population may have selected for patients who are high-utilizers of health care and unlikely to be at high risk for loss to HIV care. These unexpected results highlight the importance of population selection and the timing of HIV testing relative to depression screening when studying the complex relationship between depression and engagement in HIV care.Doctor of Philosoph

SHELF-LIFE ASSESSMENT OF EUPHORBIA ANTIQUORUM LINN., EUPHORBIA CADUCIFOLIA HAINES, EUPHORBIA NIVULIA BUCH. HAM AND EUPHORBIA TIRUCALLI LINN. LATEX

Objective: In the present study, an attempt was made to assess the shelf life of the Snuhi latex which is frequently used in fresh condition for the preparation of Ksharasutra, a medicated thread, used in Ayurveda. Methods: The latex of E. antiquorum, E. caducifolia, E. nivulia and E. tirucalli were collected individually and stored in air tight glass vials during the month of May, 2018. Physical attributes like Colour, odour, appearances, pH and microbial load of all four samples were assessed as per standard protocol. Assessment was made every day, 9 AM, for 7 d in room temperature and for 10 d in refrigerated samples. Results: Result shows that, pH range (start-end day) was 4.25-5.18, 4.79-5.12, 4.48-4.76 and 4.40-5.42 in case of E. antiquorum, E. caducifolia, E. nivulia and E. tirucalli at room temperature. It was found that, Aspergillus niger was found in Euphorbia antiquorum, Euphorbia caducifolia whereas Candida albicans was found in Euphorbia tirucalli latex in fungal culture on the 7th day after collection, when the samples were stored at room temperature. All the samples were free from microbial growth up to 10thday when stored at 4-5 °C in a refrigerator. Conclusion: Temperature, and moisture affects the quality of fresh snuhi latex. The latex remains free from microbial growth up to six days in room temperature and up to 10 d under at refrigerated temperature (4-5 °C)

Neural, renal and retinal hamartomas with cutis vertis gyrata a rare presentation in tuberous sclerosis complex

Tuberous sclerosis complex characterised by multiple benign tumours, is caused by mutation in the genes TSC1 and TSC2 coding for Hamartin and Tuberin respectively. We report a case of a 17 year old female patient who presented with classical Vogt’s triad characterized by seizures, mental retardation and adenoma sebaceous. She presented with Cutis Vertis Gyrata in addition to multiple retinal astrocytic hamartomas in her right eye with retinal pigment epithelium changes in both eyes and a normal anterior segment examination.  Magnetic resonance imaging (MRI) of the brain showed subependymal giant cell astrocytomas and cortical tubers. Ultrasound of the abdomen showed bilateral renal angiomyoliposis. We are presenting this case as retinal hamartomas with five Major criteria are seen along with secondary Cutis Vertis Gyrata which is an extremely rare presentation of Tuberous sclerosis. Absence of most of the Minor criteria is not to be excluded

The biochemical basis of disease

Understanding Biochemistry is an essential online resource for post-16 students, teachers and undergraduates, providing up-to-date overviews of key concepts in biochemistry and molecular biosciences. The Understanding Biochemistry issues of Essays in Biochemistry are Open Access publications, meaning that these issues are freely available online to readers This article gives the reader an insight into the role of biochemistry in some of the current global health and disease problems. It surveys the biochemical causes of disease in an accessible and succinct form while also bringing in aspects of pharmacology, cell biology, pathology and physiology which are closely aligned with biochemistry. The discussion of the selected diseases highlights exciting new developments and illuminates key biochemical pathways and commonalities. The article includes coverage of diabetes, atherosclerosis, cancer, microorganisms and disease, nutrition, liver disease and Alzheimer’s disease, but does not attempt to be comprehensive in its coverage of disease, since this is beyond its remit and scope. Consequently there are many fascinating biochemical aspects of diseases, both common and rare, that are not addressed here that can be explored in the further reading cited. Techniques and biochemical procedures for studying disease are not covered in detail here, but these can be found readily in a range of biochemical methods sources