The use of medicinal plants in health care practices by Rohingya refugees in a degraded forest and conservation area of Bangladesh

People in developing countries traditionally rely on plants for their primary healthcare. This dependence is relatively higher in forests in remote areas due to the lack of access to modern health facilities and easy availability of the plant products.We carried out an ethno-medicinal survey in Teknaf Game Reserve (TGR), a heavily degraded forest and conservation area in southern Bangladesh, to explore the diversity of plants used by Rohingya refugees for treating various ailments. The study also documented the traditional utilization, collection and perceptions of medicinal plants by the Rohingyas residing on the edges of this conservation area. We collected primary information through direct observation and by interviewing older respondents using a semi-structured questionnaire. A total of 34 plant species in 28 families were frequently used by the Rohingyas to treat 45 ailments, ranging from simple headaches to highly complex eye and heart diseases. For medicinal preparations and treating various ailments, aboveground plant parts were used more than belowground parts. The collection of medicinal plants was mostly from the TGR. © 2009 Taylor & Francis

A Novel Blended State Estimated Adaptive Controller for Voltage and Current Control of Microgrid against Unknown Noise

© 2013 IEEE. In this study, a novel blended state estimated adaptive controller is designed for voltage and current control of microgrid against unknown noise. The core feature of the microgrid (MG) is its ability to integrate more than one distributed energy resource into the main grid. The state of a microgrid may deteriorate due to many reasons, for example malicious cyber-attacks, disturbances, packet losses, etc. Therefore, it is necessary to achieve the true state of the system to enhance the control requirement and automation of the microgrid. To achieve the true state of a microgrid, this study proposes the use of an algorithm based on the unscented kalman filter (UKF). The proposed state estimator technique is developed using an unscented-transformation and sigma-points measurement technique capable of minimizing the mean and covariance of a nonlinear cost function to estimate the true state of a single-phase, three-phase single-source and three-phase multi-source microgrid system. The advantage of the proposed estimator over using extended kalman filter (EKF) is investigated in simulations. The results demonstrate that the use of the UKF estimator produces a superior estimation of the system compared with the use of the EKF. An adaptive PID controller is also developed and used in system conjunction with the estimator to regulate its voltage and current against the number of loads. Deviation in load parameters hamper the function of the MG system. The performance of the developed controller is also evaluated against number of loads. Results indicate the controller provides a more stable and high-tracking performance with the inclusion of the UKF in the system

Trauma-related emotions and radical acceptance in dialectical behavior therapy for posttraumatic stress disorder after childhood sexual abuse

Background: Posttraumatic Stress Disorder (PTSD) related to childhood sexual abuse (CSA) is often associated with a wide range of trauma-related aversive emotions such as fear, disgust, sadness, shame, guilt, and anger. Intense experience of aversive emotions in particular has been linked to higher psychopathology in trauma survivors. Most established psychosocial treatments aim to reduce avoidance of trauma-related memories and associated emotions. Interventions based on Dialectical Behavior Therapy (DBT) also foster radical acceptance of the traumatic event. Methods: This study compares individual ratings of trauma-related emotions and radical acceptance between the start and the end of DBT for PTSD (DBT-PTSD) related to CSA. We expected a decrease in trauma-related emotions and an increase in acceptance. In addition, we tested whether therapy response according to the Clinician Administered PTSD-Scale (CAPS) for the DSM-IV was associated with changes in trauma-related emotions and acceptance. The data was collected within a randomized controlled trial testing the efficacy of DBT-PTSD, and a subsample of 23 women was included in this secondary data analysis. Results: In a multilevel model, shame, guilt, disgust, distress, and fear decreased significantly from the start to the end of the therapy whereas radical acceptance increased. Therapy response measured with the CAPS was associated with change in trauma-related emotions. Conclusions: Trauma-related emotions and radical acceptance showed significant changes from the start to the end of DBT-PTSD. Future studies with larger sample sizes and control group designs are needed to test whether these changes are due to the treatment. Trial registration: ClinicalTrials.gov, number NCT0048100

Surgical Trial in Lobar Intracerebral Haemorrhage (STICH II) Protocol

<p>Abstract</p> <p>Background</p> <p>Within the spectrum of spontaneous intracerebral haemorrhage there are some patients with large or space occupying haemorrhage who require surgery for neurological deterioration and others with small haematomas who should be managed conservatively. There is equipoise about the management of patients between these two extremes. In particular there is some evidence that patients with lobar haematomas and no intraventricular haemorrhage might benefit from haematoma evacuation. The STICH II study will establish whether a policy of earlier surgical evacuation of the haematoma in selected patients will improve outcome compared to a policy of initial conservative treatment.</p> <p>Methods/Design</p> <p>an international multicentre randomised parallel group trial. Only patients for whom the treating neurosurgeon is in equipoise about the benefits of early craniotomy compared to initial conservative treatment are eligible. All patients must have a CT scan confirming spontaneous lobar intracerebral haemorrhage (≤1 cm from the cortex surface of the brain and 10-100 ml in volume). Any clotting or coagulation problems must be corrected and randomisation must take place within 48 hours of ictus. With 600 patients, the study will be able to demonstrate a 12% benefit from surgery (2p < 0.05) with 80% power.</p> <p>Stratified randomisation is undertaken using a central 24 hour randomisation service accessed by telephone or web. Patients randomised to early surgery should have the operation within 12 hours. Information about the status (Glasgow Coma Score and focal signs) of all patients through the first five days of their trial progress is also collected in addition to another CT scan at about five days (+/- 2 days). Outcome is measured at six months via a postal questionnaire to the patient. Primary outcome is death or severe disability defined using a prognosis based 8 point Glasgow Outcome Scale. Secondary outcomes include: Mortality, Rankin, Barthel, EuroQol, and Survival.</p> <p>Trial Registration</p> <p>ISRCTN: <a href="http://www.controlled-trials.com/ISRCTN22153967">ISRCTN22153967</a></p

Inapparent infections and cholera dynamics

In many infectious diseases, an unknown fraction of infections produce symptoms mild enough to go unrecorded, a fact that can seriously compromise the interpretation of epidemiological records. This is true for cholera, a pandemic bacterial disease, where estimates of the ratio of asymptomatic to symptomatic infections have ranged from 3 to 100 (refs 1-5). In the absence of direct evidence, understanding of fundamental aspects of cholera transmission, immunology and control has been based on assumptions about this ratio and about the immunological consequences of inapparent infections. Here we show that a model incorporating high asymptomatic ratio and rapidly waning immunity, with infection both from human and environmental sources, explains 50 yr of mortality data from 26 districts of Bengal, the pathogen's endemic home. We find that the asymptomatic ratio in cholera is far higher than had been previously supposed and that the immunity derived from mild infections wanes much more rapidly than earlier analyses have indicated. We find, too, that the environmental reservoir(5,6) (free-living pathogen) is directly responsible for relatively few infections but that it may be critical to the disease's endemicity. Our results demonstrate that inapparent infections can hold the key to interpreting the patterns of disease outbreaks. New statistical methods(7), which allow rigorous maximum likelihood inference based on dynamical models incorporating multiple sources and outcomes of infection, seasonality, process noise, hidden variables and measurement error, make it possible to test more precise hypotheses and obtain unexpected results. Our experience suggests that the confrontation of time-series data with mechanistic models is likely to revise our understanding of the ecology of many infectious diseases.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/62519/1/nature07084.pd

A building classification scheme of housing stock in Malawi for earthquake risk assessment

This study presents a building classification scheme for residential houses in Malawi by focusing upon informal construction, which accounts for more than 90% of housing in the country, which has the highest urbanisation rate in the world. The proposed classification is compatible with the Prompt Assessment of Global Earthquakes for Response (PAGER) method and can be used for seismic vulnerability assessments of building stock in Malawi. To obtain realistic proportions of the building classes that are prevalent in Malawi, a building survey was conducted in Central and Southern Malawi between 10th and 20th July 2017. The results from the survey are used to modify the PAGER-based proportions of main housing typologies by reflecting actual housing construction in the surveyed areas. The results clearly highlight the importance of using realistic building stock data for seismic risk assessment in Malawi; relying on global building stock information can result in significant bias of earthquake impact assessment

Role of BRCA gene dysfunction in breast and ovarian cancer predisposition

Tumor suppressor genes that perform apparently generic cellular functions nonetheless cause tissue-specific syndromes in the human population when they are mutated in the germline. The two major hereditary breast/ovarian cancer predisposition genes, BRCA1 and BRCA2, appear to participate in a common pathway that is involved in the control of homologous recombination and in the maintenance of genomic integrity. How might such functions translate into the specific suppression of cancers of the breast and ovarian epithelia? Recent advances in the study of BRCA1 and BRCA2, discussed herein, have provided new opportunities to address this question