Differentiating pre-capillary and post-capillary pulmonary hypertension by Doppler echocardiography in a large realworld database

Background: Pulmonary hypertension (PH) is common, dangerous and has multiple causes. Vasodilator therapy has significantly improved the prognosis of patients with pulmonary arterial hypertension (PAH), but the diagnosis can be challenging, requiring right heart catheterisation (RHC). Differentiating pre-capillary PH (prePH) and postcapillary PH (postPH) and measuring pulmonary vascular resistance (PVR) are key steps for diagnosing PAH. A novel echocardiographic parameter, the pulmonary to left atrial ratio (ePLAR), which is derived from the tricuspid regurgitation velocity (TRV) divided by the ratio between the early diastolic filling velocity and the early mitral annulus velocity (E/e’), i.e., ePLAR=TRV/E/e’, has been described as a surrogate for RHC. This retrospective cohort study tests the ability of ePLAR to differentiate prePH and postPH, in a large real world database. Methods: The data from all RHC performed within a 5-year period (January 2010 to February 2015) were extracted from the hospital database. The closest corresponding echocardiograms (echos) were searched in the national echo database Australia (NEDA) using the identifiers from RHC data. The performance of ePLAR in differentiating two PH physiologies was compared against the gold standard RHC using various statistical methods. Results: 887 pairs of echos and RHCs were merged and analysed in our study. The median time difference between RHC and echocardiography was 7 (IQR 1-62) days. The ePLAR was calculable in 184 cases (21%). Median (IQR) ePLAR values were significantly different between prePH and postPH groups: 0.35 (0.13-0.50) m/s vs 0.17 (0.12-0.23) m/s (P=0.003), despite both groups having similar mean pulmonary artery pressures. The optimal ePLAR cut-off of 0.28m/s had a positive predictive value of 94% for postPH, with sensitivity of 83% and specificity of 67%. Conclusions: ePLAR helps to discriminate postPH from prePH and may be useful in evaluating these patients

The Sound of the Breath:Sunlun and Theinngu Meditation Traditions of Myanmar

This article explores the popular Sunlun and Theinngu meditation traditions in Myanmar. The founders, Sunlun Sayadaw Ven. U Kavi (1878–1952) and Theinngu Sayadaw Ven. U Ukkaṭṭha (1913–1973), both led a lay life until in their mid-40s and only then took up meditation, going on to become highly respected meditation teachers. Their meditation techniques are similarly distinctive in employing rapid, strong and rhythmic breathing. They combined this with the contemplation of the intense, usually unpleasant, bodily sensations that are thus induced. I document their techniques and application in detail, highlighting their complexity and diversity. I draw contrasts between the use of sati, mindfulness, in their methods and the way it is used in the modern Mindfulness movement. Finally, I discuss the ways in which the practices and experiences of both masters had to be authorised to survive where other meditation traditions have been outlawed. Senior members of the Burmese Sangha catechised both masters separately, using Pāli canonical and post-canonical texts as a benchmark to verify the popular belief amongst Burmese people that they were arahants. I locate this testing within the context of the concerns, sense of duty and status experienced by Burmese lay people in relation to defending Buddhism from decline

Social-Ecological Coevolution and its Implications for Protected Area Management: Case Study in Natma Taung National Park, Myanmar

The conflict between the protected area and local people is a major challenge for conservation in developing countries. The conventional top-down approach has failed mainly due to the exclusion of local people in conservation. A new management approach that promotes local participation and reduces conflicts is necessary to achieve both conservation and development objectives. Using the case of Natma Taung National Park (NTNP) in Myanmar, this study investigates the relationship between the protected area and local indigenous people living in and around the park. The social-ecological coevolution model is applied to explore the inter-linkages between the protected area and local people. The empirical analyses focus on three main thematic areas: local land tenure system, livelihood dependency on forest resources, and traditional ecological knowledge (TEK) of local people. The comparative study design is used to analyse similarities and differences among the three indigenous communities living inside, bordering, and outside the national park. Based on this information, four management scenarios are developed and evaluated by using multi-criteria decision analysis

Foundations of criticality:applications of traditional monastic pedagogy in Myanmar

It is well documented in scholarship that standardized, non-secularised monastic examinations in Myanmar have resulted in an education system that focuses on rote learning. Through a multidisciplinary study of monastic education in Myanmar and modern educational theories, this article investigates how Burmese monks and nuns study Buddhist texts in formal monastic curricula and what pedagogical and learning approaches are applied in their study of Buddhist texts. I shall give particular attention to the process of acquiring expert knowledge through the use of mnemonic techniques. This article demonstrates that the textual expertise developed through memorisation and detailed study of both canonical and exegetical Buddhist texts in fact provides a basis for criticality, i.e. a practice encompassing analytical skills, logical thinking skills and the ability to think anew. In order to explore the Burmese pedagogical and learning approaches, I shall discuss the significance of scriptural learning within the socio-political climate of Myanmar and pedagogical philosophy of teaching monasteries and nunneries. Along the way, I shall point out, albeit only briefly, some differences between teaching and learning approaches used in Higher Education in the UK and those of monastic teaching institutions of Myanmar

Individual Characteristics and Job Satisfaction: Measuring Relationships Described in a Job Satisfaction Tripod Framework

The present paper is concerned with the study of job satisfaction;specifically,job satisfaction of employees who are working for an Australian telecommunications company in Western Australia.As the title suggests, the specific focus of the paper is on the analysis of the relationships between an individual's characteristics and the level of job satisfaction.By the term 'individual's characteristics' is meant the personal characteristics of an individual such as age, gender and educational level. The current research emphasises the relationships between specific individual characteristics and the level of job satisfaction measured by two instruments,viz.,the Minnesota Satisfaction Questionnaire (MSQ) and this study, the author proposes a conceptual framework for analysing the determinants of job satisfaction. This conceptual framework - which the author has named the Job Satisfaction Tripod (JST) model - attempts to identify factors affecting the level of job satisfaction. Using the Job Satisfaction Tripod model as a framework for the analysis, the study is designed to explore the strength and the significance of relationships between independent variables such as age, gender, educational level, organisational tenure, managerial rank, and the dependent variable, job satisfaction level

In the Midst of Imperfections:Burmese Buddhists and Business Ethics

This article looks at interpretations by Buddhists in Burma of right livelihood (sammā-ājīva) and documents the moral reasoning that underlies their business activities. It explores different ways in which Buddhists in Burma, through the use of Buddhist ethics and practices, resolve moral dilemmas that they encounter whilst pursuing their livelihood. I give a brief summary of the existing scholarship on Buddhist economics and on economic action in Burma, exemplified by the work of E. F. Schumacher and Melford Spiro respectively. In so doing, I wish to highlight a difference between the approaches of the existing scholarship and that of this article: the existing scholarship analyzes economic issues from the perspective of normative ethics; this research analyzes them from the perspective of descriptive ethics, looking at how Buddhists interpret and apply Buddhist ethics in their business activities, in the midst of moral, social and economic imperfections. The research presented draws on semi-structured interviews and fieldwork conducted in Burma in the summer of 2010 and relates the interpretations given to the relevant Buddhist literature, the textual authorities for doctrines such as morality (sīla)

Effects of Tourism on Sustainable Livelihoods in a Heritage Town, Bagan (Pyi Phyoe Lin, 2022)

Tourism has the potential to contribute to economic growth and job creation. The tourist resources in Bagan are abundant and diversified, and they are dispersed across the city. If these natural resources are used effectively to attract visitors, tourism creates a significant amount of livelihood opportunities and stable income for residents. The objective of the study is to examine the effects of tourism on the sustainable livelihoods of residents in Bagan. To get the primary data, the survey data gathered in Bagan with a total of 150 sample sizes are questioned by using a simple random sampling method. The questionnaire survey gathered data from respondents which featured a five-point Likert scale design. The findings indicate that the study's highest value is the economic effect and then followed by the environmental effect. Then, social effect lead-in before the human resource development effect and the lowest factor is the institutional effect. The results showed that the residents thought tourism improved family standards of living, boosted household income, and provided jobs. Tourism stimulates the economy while creating thousands of employment, enhancing a country's infrastructure, and promoting intercultural understanding. According to the results, the recommendations are that local authorities should collaborate well with all tourism institutions and motivate residents to participate in tourism sustainable activities. Local government should consider providing various jobs created by tourism for the residents, including those for tour guides and hotel workers for the community's members' livelihoods. Lastly, the residents need to improve their living standards and participate in environmental sustainability

Liquid Surfaces with Chaotic Capillary Waves Exhibit an Effective Surface Tension

The influence of chaotic capillary waves on the time-averaged shape of a liquid volume is studied experimentally and theoretically. In that context, a liquid film containing a stable hole is subjected to Faraday waves. The waves induce a shrinkage of the hole compared to the static film, which can be described using the Young-Laplace equation by incorporating an effective capillary length. In the regime of chaotic Faraday waves, the presented theory explains the hole shrinkage quantitatively, linking the effective capillary length to the wave energy. The effect of chaotic Faraday waves can be interpreted as a dynamic surface force that acts against surface tension