Magnetic Coupling in the Quiet Solar Atmosphere

Three kinds of magnetic couplings in the quiet solar atmosphere are highlighted and discussed, all fundamentally connected to the Lorentz force. First the coupling of the convecting and overshooting fluid in the surface layers of the Sun with the magnetic field. Here, the plasma motion provides the dominant force, which shapes the magnetic field and drives the surface dynamo. Progress in the understanding of the horizontal magnetic field is summarized and discussed. Second, the coupling between acoustic waves and the magnetic field, in particular the phenomenon of wave conversion and wave refraction. It is described how measurements of wave travel times in the atmosphere can provide information about the topography of the wave conversion zone, i.e., the surface of equal Alfv\'en and sound speed. In quiet regions, this surface separates a highly dynamic magnetic field with fast moving magnetosonic waves and shocks around and above it from the more slowly evolving field of high-beta plasma below it. Third, the magnetic field also couples to the radiation field, which leads to radiative flux channeling and increased anisotropy in the radiation field. It is shown how faculae can be understood in terms of this effect. The article starts with an introduction to the magnetic field of the quiet Sun in the light of new results from the Hinode space observatory and with a brief survey of measurements of the turbulent magnetic field with the help of the Hanle effect.Comment: To appear in "Magnetic Coupling between the Interior and the Atmosphere of the Sun", eds. S.S. Hasan and R.J. Rutten, Astrophysics and Space Science Proceedings, Springer-Verlag, Heidelberg, Berlin, 200

Stress and Its Association with the Academic Performance of Undergraduate Fourth Year Medical Students at Universiti Kebangsaan Malaysia

Introduction: Student can be stressed due to different stressors such as academic, financial, health related or loss of close family member or friend, etc. Stress is the bodies’ reaction both neurologically and physiologically to adapt to the new condition. Stress has a negative effect on the academic performance of the students. This study was aimed to explore the stress and stressors and also to determine the association between stress levels and the academic performances in terms of cumulative grade point average (CGPA) of undergraduate medical students. Methods: It was a cross-sectional study conducted among all 234 year-4 medical students of Universiti Kebangsaan Malaysia (UKM), session 2011-2012. Sample size comprised of 179 students after fulfilling all inclusion and exclusion criteria. A validated Medical Students’ Stressor Questionnaire (MSSQ) was used to collect the data. Stress level and its association with CGPA of semester-1 examination were analysed. Results: Response rate was 76.49%, where 72% were female and 69% resided in the hostel. Academic Related and Social-related Stressors caused for severe and high stress in 84% and 49% respondents respectively, with insignificant differences between gender and residency. Respondents with a high and severe stress level were observed to have higher CGPA. Conclusion: UKM medical students are highly resourceful to manage their stress well and thus denying the negative effect of stress towards their academic performance. Medical schools should train students exposing various personal and professional developmental activities that able to face the everyday challenges and manage stress well and thereby achieve better academic performance

A Case Study of the Ritual Space Construction of the Chinese Festival Series Program

TV festival gala is one important form of ritual communication of traditional Chinese festivals. The Chinese Festival Series Program innovate the ritual construction path of the program while maintaining the sense of ritual of the traditional festival galas, making the Chinese Festival Series Program a representative work of Chinese festival galas in recent years. This study aims to explore the ritual space construction of the Chinese Festival Series Program. It adopted the case study approach by taking Chinese Festival Series Program as the research object, and analyzed the text of the programs mainly from the physical space, media space, narrative space and the associated space of history and reality. The analysis results demonstrated that breaking the single physical space and building diverse scenes can make the narrative more hierarchical, and allow the audiences to experience a more realistic program space. The addition of new technology also brings richness to the narrative space. The convenient interactivity of the new media platform creates an exclusive media interaction space for the audiences. Through the ritual space construction, the Chinese Festival Series Program associate the past space with the present space, allowing the audiences to develop memory-related activities in the ritual space

Modelling of land use and land cover changes and prediction using CA-Markov and Random Forest

We used the Cellular Automata Markov (CA-Markov) integrated technique to study land use and land cover (LULC) changes in the Cholistan and Thal deserts in Punjab, Pakistan. We plotted the distribution of the LULC throughout the desert terrain for the years 1990, 2006 and 2022. The Random Forest methodology was utilized to classify the data obtained from Landsat 5 (TM), Landsat 7 (ETM+) and Landsat 8 (OLI/TIRS), as well as ancillary data. The LULC maps generated using this method have an overall accuracy of more than 87%. CA-Markov was utilized to forecast changes in land usage in 2022, and changes were projected for 2038 by extending the patterns seen in 2022. A CA-Markov-Chain was developed for simulating long-term landscape changes at 16-year time steps from 2022 to 2038. Analysis of urban sprawl was carried out by using the Random Forest (RF). Through the CA-Markov Chain analysis, we can expect that high density and low-density residential areas will grow from 8.12 to 12.26 km2 and from 18.10 to 28.45 km2 in 2022 and 2038, as inferred from the changes occurred from 1990 to 2022. The LULC projected for 2038 showed that there would be increased urbanization of the terrain, with probable development in the croplands westward and northward, as well as growth in residential centers. The findings can potentially assist management operations geared towards the conservation of wildlife and the eco-system in the region. This study can also be a reference for other studies that try to project changes in arid are as undergoing land-use changes comparable to those in this study

Depression, sleeping pattern, and suicidal ideation among medical students in Bangladesh: a cross-sectional pilot study

© 2020, Springer-Verlag GmbH Germany, part of Springer Nature. Background: Depression is a major morbidity and the most common mental disorder among the medical students in medical schools globally. Undergraduate students suffer stress more due to their academic curriculum than the students of other faculties. In low-resource settings like Bangladesh, there is a dearth in research on the mental health of undergraduate medical students. This pilot study was conducted to add to the existing limited evidence by reporting the prevalence of depression and describing sleeping pattern and suicidal tendencies among medical students. Relevantly, we have investigated the overall mental health status among the medical students in Bangladesh. Methods: This cross-sectional study was conducted in two medical colleges of Dhaka between July 2013 and December 2013, among 221 Bangladeshi medical students from first to fifth year. By the convenience sampling technique, data were collected by a pretested, structured, self-administered questionnaire and analysis was done by SPSS version 18.0. Depression was assessed by the validated Patient Health Questionnaire-9 (PHQ-9) tool among the respondents. Goldberg’s General Health Questionnaire (GHQ-28) was used for assessing overall mental health status. Results: Depression was found in 38.9% of participants, with 3.6%, 14.5%, and 20.8% being severe, moderate, and mild depression, respectively. 17.6% of medical students had suicidal tendency or attempted suicide at least once after attending medical school. The sleeping hours were inadequate and altered after starting this stressful academic course. 33.5% of medical students had poor mental health status. There was a statistically significant association between poor mental health status in the age group less than 22 years old and initial academic study year (1st to 3rd of MBBS). Conclusion: The findings are suggestive of a higher prevalence of depression among early-year medical students and marginal predominance in males. Suicidal tendency is also higher. This calls for further investigation with situation analysis, qualitative explorations, and surveys to explore the burden of such disorders in Bangladesh

Antimicrobial Resistance in Aquaculture Environments: Unravelling the Complexity and Connectivity of the Underlying Societal Drivers

This is the final version. Available on open access from the American Chemical Society via the DOI in this recordFood production environments in low- and middle-income countries (LMICs) are recognized as posing significant and increasing risks to antimicrobial resistance (AMR), one of the greatest threats to global public health and food security systems. In order to maximize and expedite action in mitigating AMR, the World Bank and AMR Global Leaders Group have recommended that AMR is integrated into wider sustainable development strategies. Thus, there is an urgent need for tools to support decision makers in unravelling the complex social and environmental factors driving AMR in LMIC food-producing environments and in demonstrating meaningful connectivity with other sustainable development issues. Here, we applied the Driver-Pressure-State-Impact-Response (DPSIR) conceptual framework to an aquaculture case study site in rural Bangladesh, through the analysis of distinct social, microbiological, and metagenomic data sets. We show how the DPSIR framework supports the integration of these diverse data sets, first to systematically characterize the complex network of societal drivers of AMR in these environments and second to delineate the connectivity between AMR and wider sustainable development issues. Our study illustrates the complexity and challenges of addressing AMR in rural aquaculture environments and supports efforts to implement global policy aimed at mitigating AMR in aquaculture and other rural LMIC food-producing environments.UK Government ODA-funded projectEngineering and Physical Sciences Research Council (EPSRC)Biotechnology and Biological Sciences Research Council (BBSRC)Natural Environment Research Council (NERC)Global Challenges Research Fund (GCRF

Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease

Background: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P = 0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P = 0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P = 0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P = 0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P = 0.31). Conclusions: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846.

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

Effective Treatment Strategies for the Removal of Antibiotic-Resistant Bacteria, Antibiotic-Resistance Genes, and Antibiotic Residues in the Effluent From Wastewater Treatment Plants Receiving Municipal, Hospital, and Domestic Wastewater: Protocol for a Systematic Review.

BACKGROUND: The widespread and unrestricted use of antibiotics has led to the emergence and spread of antibiotic-resistant bacteria (ARB), antibiotic-resistance genes (ARGs), and antibiotic residues in the environment. Conventional wastewater treatment plants (WWTPs) are not designed for effective and adequate removal of ARB, ARGs, and antibiotic residues, and therefore, they play an important role in the dissemination of antimicrobial resistance (AMR) in the natural environment. OBJECTIVE: We will conduct a systematic review to determine the most effective treatment strategies for the removal of ARB, ARGs, and antibiotic residues from the treated effluent disposed into the environment from WWTPs that receive municipal, hospital, and domestic discharge. METHODS: We will search the MEDLINE, EMBASE, Web of Science, World Health Organization Global Index Medicus, and ProQuest Environmental Science Collection databases for full-text peer-reviewed journal articles published between January 2001 and December 2020. We will select only articles published in the English language. We will include studies that measured (1) the presence, concentration, and removal rate of ARB/ARGs going from WWTP influent to effluent, (2) the presence, concentration, and types of antibiotics in the effluent, and (3) the possible selection of ARB in the effluent after undergoing treatment processes in WWTPs. At least two independent reviewers will extract data and perform risk of bias assessment. An acceptable or narrative synthesis method will be followed to synthesize the data and present descriptive characteristics of the included studies in a tabular form. The study has been approved by the Ethics Review Board at the International Centre for Diarrhoeal Disease Research, Bangladesh (protocol number: PR-20113). RESULTS: This protocol outlines our proposed methodology for conducting a systematic review. Our results will provide an update to the existing literature by searching additional databases. CONCLUSIONS: Findings from our systematic review will inform the planning of proper treatment methods that can effectively reduce the levels of ARB, ARGs, and residual antibiotics in effluent, thus lowering the risk of the environmental spread of AMR and its further transmission to humans and animals. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/33365

Metagenomic assessment of the diversity and ubiquity of antimicrobial resistance genes in Bangladeshi aquaculture ponds

This is the final version. Available on open access from Elsevier via the DOI in this recordData Availability: Raw sequencing reads were deposited in the ENA under BioProject PRJEB53918. Scripts for all bioinformatic processes are available on GitHub (https://github.com/ash-bell/Bangladesh_ARG_analysis/).In Bangladesh, fish provide over 60% of animal-source food with 56.2% of this coming from aquaculture produced predominantly in rural freshwater ponds. Increasing demand for fish products is driving intensification and resulting in higher disease prevalence, posing a risk to food security. Biosecurity is often absent in rural aquaculture practices in Bangladesh and antibiotics are commonly used to treat and prevent disease outbreaks. Antibiotics are often administered incorrectly - a key factor associated with the development of antimicrobial resistance (AMR). AMR can be disseminated rapidly within microbial ecosystems via mobile genetic elements, posing a risk for humans and animals infected with AMR pathogens as treatments with antibiotics become ineffective. Early AMR detection and understanding of the spread of antimicrobial resistance genes (ARGs) in rural aquaculture practices is critical for both food security, human health protection and food safety. Here, we apply a metagenomic approach to assess the ARG composition in pond water from six finfish (tilapia and pangasius) farms in the Mymensingh division of North-central Bangladesh. We found microbial communities within the ponds had similar alpha and beta diversities, with multiple ARGs predicted to confer resistance to eighteen different classes of antimicrobials. The most common ARGs conferred resistance to aminoglycosides and sulphonamides and were present in taxa associated with both fish and human pathogens. This ARG diversity potentially confers resistance to a wide variety of antibiotic classes and questions the effectiveness of current and future treatment of diseases with antibiotics in earthen aquaculture ponds. The microbial and ARG compositions between fish ponds within each farm were similar, which may relate to parallels in farming practices creating similar microbial selection pressures and thus comparable microbial populations. Without a more controlled approach towards antibiotic usage, we will inevitably further exacerbate the challenges in treating and preventing disease outbreaks as aquaculture production intensifies in Bangladesh.Biotechnology & Biological Sciences Research Council (BBSRC)Natural Environment Research Council (NERC