Surface Displacements under Harmonic Concentration

Expressions are obtained for the surface displacements over a thermodiffusive elastic half space in which the concentration is assumed to be a harmonic function. As expected, these expressions are found to be extensions of the classical results. Some special cases are also included and various simpler expressions for the displacements are obtained, with plausible applications to defence science

A PSYCHOLOGICAL STUDY ON THE NOVEL A CLOCKWORK ORANGE

Purpose of the study: This paper is a study on the novel A Clockwork Orange by Anthony Burgess. It is an analysis of Alex’s psychological condition and a study on the Ludovico experiment in relation to other popular experiments in psychology. The paper brings to light the dark and evil side of adolescence. Methodology: This study uses a psychological approach in analyzing the character of the protagonist Alex. Various psychological theories are applied in this paper to interpret this novel. Main Findings: Examining Alex’s depiction in the novel, he is presumed as a sociopath with a narcissistic personality disorder. The Ludovico experiment which stole the limelight in this novel is a behavioral modification technique, powered by negative reinforcement. Despite being a fictional experiment and a product of Burgess’s imagination, the Ludovico experiment is stemmed out of Ivan Pavlov’s classical conditioning. This experiment also complements Watson and Rayner’s ‘Little Albert’ experiment. The termination of Alex’s free will by the Ludovico experiment is reversed by the flooding method of desensitization. Applications of this study: The novel, A Clockwork Orange is brimming with psychological theories, hence a fascinating book to the psychologists. The protagonist Alex, continues to remain as a case-study amongst the scholars of psychology. Novelty/Originality of this study: The final chapter in the novel has various interpretations. The reversal of Alex’s condition is caused by the flooding method of desensitization. While the cause of reversal holds varied comprehension, the flooding method seems like the fitting one

"Candidatus Rickettsia kellyi," India

We report the first laboratory-confirmed human infection due to a new rickettsial genotype in India, "Candidatus Rickettsia kellyi," in a 1-year-old boy with fever and maculopapular rash. The diagnosis was made by serologic testing, polymerase chain reaction detection, and immunohistochemical testing of the organism from a skin biopsy specimen

Revising the WHO verbal autopsy instrument to facilitate routine cause-of-death monitoring.

OBJECTIVE: Verbal autopsy (VA) is a systematic approach for determining causes of death (CoD) in populations without routine medical certification. It has mainly been used in research contexts and involved relatively lengthy interviews. Our objective here is to describe the process used to shorten, simplify, and standardise the VA process to make it feasible for application on a larger scale such as in routine civil registration and vital statistics (CRVS) systems. METHODS: A literature review of existing VA instruments was undertaken. The World Health Organization (WHO) then facilitated an international consultation process to review experiences with existing VA instruments, including those from WHO, the Demographic Evaluation of Populations and their Health in Developing Countries (INDEPTH) Network, InterVA, and the Population Health Metrics Research Consortium (PHMRC). In an expert meeting, consideration was given to formulating a workable VA CoD list [with mapping to the International Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) CoD] and to the viability and utility of existing VA interview questions, with a view to undertaking systematic simplification. FINDINGS: A revised VA CoD list was compiled enabling mapping of all ICD-10 CoD onto 62 VA cause categories, chosen on the grounds of public health significance as well as potential for ascertainment from VA. A set of 221 indicators for inclusion in the revised VA instrument was developed on the basis of accumulated experience, with appropriate skip patterns for various population sub-groups. The duration of a VA interview was reduced by about 40% with this new approach. CONCLUSIONS: The revised VA instrument resulting from this consultation process is presented here as a means of making it available for widespread use and evaluation. It is envisaged that this will be used in conjunction with automated models for assigning CoD from VA data, rather than involving physicians

The peace that I wanted, I got: Qualitative insights from patient experiences of SMART DAPPER interventions for major depression and traumatic stress disorders in Kenya.

SMART DAPPER is an implementation science study responding to mental health treatment gaps for depression and trauma-related disorders in Sub-Saharan Africa (SSA). We report on patient experiences in a study using a Sequential, Multiple Assignment Randomized Trial (SMART) design to test first and second line non-specialist treatment using psychotherapy (Interpersonal Psychotherapy [IPT] or medication (fluoxetine [FLX]), integrated within public sector primary care in western Kenya. An embedded qualitative study conducted in-depth interviews (n = 17) and three (n = 3) focus group discussions with participants (May to October 2021). Audio-recorded interviews were transcribed and translated into English; we deductively and inductively analyzed transcripts guided by grounded theoretical approaches and content analysis. We drew on the health belief model and socio-ecological framework to present findings, including perceived severity (motivations for taking part in the intervention), impacts of the intervention at the individual, interpersonal, and community and health systems levels as well as barriers and facilitators. Participants discussed family and marital conflict, loss of a child, loss of income or a job, and traumatic events such as a death or illness. Impacts at the individual level included reduced headaches, improved appetite and weight management, increased energy, improved sleep, better self-efficacy, and improved concentration, which was reported to lead to increased economic opportunities. At the interpersonal level, participants noted a reduction in conflict, better conflict management and resolution, increased harmony with family and community members, and improved relationships with their partners and children. Perceived challenges included balancing the intervention with livelihoods, preference for traditional medicines, actual or anticipated side effects with medication (FLX), mental health stigma, major life events, and perceived inadequate counseling and challenges with providers. The findings demonstrate the potential of the SMART DAPPER intervention for depression and trauma-related disorder treatments and underscore the challenges and barriers that must be addressed when scaling similar interventions. Trial registration: ClinicalTrials.gov identifier: NCT03466346

Cue acquisition:A feature of malawian midwives decision making process to support normality during the first stage of labour

ObjectiveTo explore Malawian midwives decision making when caring for women during the first stage of labour in the hospital setting.Design and methodsThis focused ethnographic study examined the decision making process of 9 nurse-midwives with varying years of clinical experience in the real world setting of an urban and semi urban hospital from October 2013 to May 2014.This was done using 27 participant observations and 27 post-observation in-depth interviews over a period of six months. Qualitative data analysis software, NVivo 10, was used to assist with data management for the analysis. All data was analysed using the principle of theme and category formation.FindingsAnalysis revealed a six-stage process of decision making that include a baseline for labour, deciding to admit a woman to labour ward, ascertaining the normal physiological progress of labour, supporting the normal physiological progress of labour, embracing uncertainty: the midwives’ construction of unusual labour as normal, dealing with uncertainty and deciding to intervene in unusual labour. This six-stage process of decision making is conceptualised as the ‘role of cue acquisition’, illustrating the ways in which midwives utilise their assessment of labouring women to reason and make decisions on how to care for them in labour. Cue acquisition involved the midwives piecing together segments of information they obtained from the women to formulate an understanding of the woman's birthing progress and inform the midwives decision making process. This understanding of cue acquisition by midwives is significant for supporting safe care in the labour setting. When there was uncertainty in a woman's progress of labour, midwives used deductive reasoning, for example, by cross-checking and analysing the information obtained during the span of labour. Supporting normal labour physiological processes was identified as an underlying principle that shaped the midwives clinical judgement and decision making when they cared for women in labour.Key conclusions and implications for practiceThe significance of this study is in the new understanding and insight into the process of midwifery decision making. Whilst the approach to decision making by the midwives requires further testing and refinement in order to explore implications for practice, the findings here provide new conceptual and practical clarity of midwifery decision making. The work contributes to the identified lack of knowledge of how midwives working clinically, in the ‘real world setting. These findings therefore, contribute to this body of knowledge with regards to our understanding of decision making of midwives

Chromosome Xq23 is associated with lower atherogenic lipid concentrations and favorable cardiometabolic indices

AbstractAutosomal genetic analyses of blood lipids have yielded key insights for coronary heart disease (CHD). However, X chromosome genetic variation is understudied for blood lipids in large sample sizes. We now analyze genetic and blood lipid data in a high-coverage whole X chromosome sequencing study of 65,322 multi-ancestry participants and perform replication among 456,893 European participants. Common alleles on chromosome Xq23 are strongly associated with reduced total cholesterol, LDL cholesterol, and triglycerides (min P = 8.5 × 10−72), with similar effects for males and females. Chromosome Xq23 lipid-lowering alleles are associated with reduced odds for CHD among 42,545 cases and 591,247 controls (P = 1.7 × 10−4), and reduced odds for diabetes mellitus type 2 among 54,095 cases and 573,885 controls (P = 1.4 × 10−5). Although we observe an association with increased BMI, waist-to-hip ratio adjusted for BMI is reduced, bioimpedance analyses indicate increased gluteofemoral fat, and abdominal MRI analyses indicate reduced visceral adiposity. Co-localization analyses strongly correlate increased CHRDL1 gene expression, particularly in adipose tissue, with reduced concentrations of blood lipids.Abstract Autosomal genetic analyses of blood lipids have yielded key insights for coronary heart disease (CHD). However, X chromosome genetic variation is understudied for blood lipids in large sample sizes. We now analyze genetic and blood lipid data in a high-coverage whole X chromosome sequencing study of 65,322 multi-ancestry participants and perform replication among 456,893 European participants. Common alleles on chromosome Xq23 are strongly associated with reduced total cholesterol, LDL cholesterol, and triglycerides (min P = 8.5 × 10−72), with similar effects for males and females. Chromosome Xq23 lipid-lowering alleles are associated with reduced odds for CHD among 42,545 cases and 591,247 controls (P = 1.7 × 10−4), and reduced odds for diabetes mellitus type 2 among 54,095 cases and 573,885 controls (P = 1.4 × 10−5). Although we observe an association with increased BMI, waist-to-hip ratio adjusted for BMI is reduced, bioimpedance analyses indicate increased gluteofemoral fat, and abdominal MRI analyses indicate reduced visceral adiposity. Co-localization analyses strongly correlate increased CHRDL1 gene expression, particularly in adipose tissue, with reduced concentrations of blood lipids

Genital and urinary tract infections in pregnancy in southern India : Diagnosis, management and impact om perinatal outcome

Background: Prevalence of sexually transmitted infections varies in different parts of the world. These infections, occurring during pregnancy, can result in adverse outcome. There is paucity of information on the prevalence, effects and management of such infections in pregnancy in India. Similarly, urinary tract infection (UTI) is a common medical problem in pregnancy. But, very little is known about the patterns and mechanism of antimicrobial resistance among bacteria causing UTI and the prescription practices for this condition. Diagnostic methods, used for early onset sepsis (EOS) in the new-born also need evaluation. Methods: Endocervical samples from consecutive pregnant women at 26 to 36 weeks of gestation were tested to detect infection with Chlamydia trachomatis. Association of this infection with adverse pregnancy outcome was determined In another retrospective cohort study, information related to pregnancy and outcome was collected from pregnant women with reactive Venereal Disease Research Laboratory (VDRL) test, which was done as part of antenatal care. Data on susceptibility patterns of bacteria isolated in significant counts from urine of pregnant women suspected to have urinary infection were collected. To understand the mechanism of resistance, the prevalence of integrons among these E. coli were determined Prescribing patterns for these infections were ascertained using a questionnaire and based on antibiotics dispensed to pregnant women. To evaluate the use of CRP in diagnosing EOS, CRP levels in cord blood and neonatal blood at 24 hrs were estimated in two groups of neonates, one at risk of developing infection and the other at low risk of infection. Results: Prevalence of C trachomatis infection was 3.3% and this infection did not contribute significantly to adverse pregnancy outcome. Prevalence of syphilis was also low. However, fetal loss occurred in 32% of the infected women. The difference in outcome between those receiving antenatal care and those without was significant (P = 0.01; RR 7.53 95% Cl 1.1 - 51.9). In 2002, > 90% of E. coli causing UTI was susceptible to nitrofurantoin, a relatively inexpensive and safe drug. However, less than 25% of doctors used it for treatment of cystitis. The choice and duration of therapy varied greatly. Resistance to ampicillin (p< 0.001), nalidixic acid (p = 0.001), chloramphenicol (p = 0.02), tetracycline (p = 0.004), and gentamicin (p = 0.02) were significantly more common in isolates with integrons. Several intrapartum risk factors can cause elevation in CRP levels. At 24 hours, elevated CRP levels were associated with primiparity (p= 0.006), more than three vaginal examinations after membrane rupture (p=0.02), meconium staining of amniotic fluid (p =0.02) and amnioinfusion (p =0.02). In the group at risk of infection, 10 (4%) babies developed EOS. The negative predictive value for elevated CRP levels for diagnosing EOS at 24 hrs was 99%. Discussion: The prevalence of STIs among antenatal women is low. However, syphilis is an unrecognised cause of pregnancy loss in the area. There are several lacunae in the diagnosis and treatment of infections in pregnancy - both UTI and STIs. A major reason probably is the lack of locally relevant uniform guidelines for the diagnosis and management of these conditions. There is also complacency because of low prevalence of STIs in pregnancy. We also observed that auditing the management of syphilis in pregnancy could be an effective and simple tool to assess the quality of antenatal care. High prevalence of resistance among E coli is associated with integrons. Since CRP levels rise in babies without infection, this test may be useful only in excluding infection

On elastodiffusive vibrations of a cylinder

In this paper, a solution to the problem of elastodiffusive vibrations of a circular cylinder, in the form of an infinite series, is developed and analysed to find the modifications to the classical Pochhammer-Chree velocity. These are obtained as rational approximations involving quadratic factors. Numerical investigations carried out reflect salient features in some common metals