This paper moves across the ecological assemblages of the Periyar basin in Kerala. It argues that the connectivities and unintentional designs that emerge bespeak the Anthropocene in its regional and ...political peculiarities. The river has never been a conduit of water alone. The narrative builds broadly on ecological relations entrenched in history, most visibly as hydrological regimes. Such regimes are significant because of the riparian densities that articulate the geo‐morphology. The different entanglements in ecology, as well as the successive productions of natures, gain significance as ‘recognitions’ during rupture events like the large floods. In contemporary contexts, the versatile flows of capital dissolve markers and boundaries and reconfigure regions in terms of capital. Vikasanam or new urban reforms, apart from political policies, are also ecological designs that normalise exceptions, otherwise reserved for special economic zones. The frictions with new materiality, post dam floods and hydrological controls, during developmental and neoliberal post developmental phases, become moments of recognition, making and unmaking sense of place.
Short
This paper moves across the ecological assemblages of the Periyar basin in Kerala. It argues that the connectivities and unintentional designs that emerge bespeak the anthropocene in its regional and political peculiarities. The frictions with new materiality, post dam floods and hydrological controls, during developmental and neoliberal post developmental phases, become moments of recognition, making and unmaking sense of place.
Summary At the First WHO Ministerial Conference on Global Action Against Dementia in March, 2015, 160 delegates, including representatives from 80 WHO Member States and four UN agencies, agreed on a ...call for action to reduce the global burden of dementia by fostering a collective effort to advance research. To drive this effort, we completed a globally representative research prioritisation exercise using an adapted version of the Child Health and Nutrition Research Initiative method. We elicited 863 research questions from 201 participants and consolidated these questions into 59 thematic research avenues, which were scored anonymously by 162 researchers and stakeholders from 39 countries according to five criteria. Six of the top ten research priorities were focused on prevention, identification, and reduction of dementia risk, and on delivery and quality of care for people with dementia and their carers. Other priorities related to diagnosis, biomarkers, treatment development, basic research into disease mechanisms, and public awareness and understanding of dementia. Research priorities identified by this systematic international process should be mapped onto the global dementia research landscape to identify crucial gaps and inform and motivate policy makers, funders, and researchers to support and conduct research to reduce the global burden of dementia. Efforts are needed by all stakeholders, including WHO, WHO Member States, and civil society, to continuously monitor research investments and progress, through international platforms such as a Global Dementia Observatory. With established research priorities, an opportunity now exists to translate the call for action into a global dementia action plan to reduce the global burden of dementia.
Summary
Nouy and Clement introduced the stochastic extended finite element method to solve linear elasticity problem defined on random domain. The material properties and boundary conditions were ...assumed to be deterministic. In this work, we extend this framework to account for multiple independent input uncertainties, namely, material, geometry, and external force uncertainties. The stochastic field is represented using the polynomial chaos expansion. The challenge in numerical integration over multidimensional probabilistic space is addressed using the pseudo‐spectral Galerkin method. Thereafter, a sensitivity analysis based on Sobol indices using the derived stochastic extended Finite Element Method solution is presented. The efficiency and accuracy of the proposed novel framework against conventional Monte Carlo methods is elucidated in detail for a few one and two dimensional problems.
Summary Background Observational evidence suggests that community-based services for people with schizophrenia can be successfully provided by community health workers, when supervised by ...specialists, in low-income and middle-income countries. We did the COmmunity care for People with Schizophrenia in India (COPSI) trial to compare the effectiveness of a collaborative community-based care intervention with standard facility-based care. Methods We did a multicentre, parallel-group, randomised controlled trial at three sites in India between Jan 1, 2009 and Dec 31, 2010. Patients aged 16–60 years with a primary diagnosis of schizophrenia according to the tenth edition of the International Classification of Diseases, Diagnostic Criteria for Research (ICD-10-DCR) were randomly assigned (2:1), via a computer-generated randomisation list with block sizes of three, six, or nine, to receive either collaborative community-based care plus facility-based care or facility-based care alone. Randomisation was stratified by study site. Outcome assessors were masked to group allocation. The primary outcome was a change in symptoms and disabilities over 12 months, as measured by the positive and negative syndrome scale (PANSS) and the Indian disability evaluation and assessment scale (IDEAS). Analysis was by modified intention to treat. This study is registered as an International Standard Randomised Controlled Trial, number ISRCTN 56877013. Findings 187 participants were randomised to the collaborative community-based care plus facility-based care group and 95 were randomised to the facility-based care alone group; 253 (90%) participants completed follow-up to month 12. At 12 months, total PANSS and IDEAS scores were lower in patients in the intervention group than in those in the control group (PANSS adjusted mean difference −3·75, 95% CI −7·92 to 0·42; p=0·08; IDEAS −0·95, −1·68 to −0·23; p=0·01). However, no difference was shown in the proportion of participants who had a reduction of more than 20% in overall symptoms (PANSS 85 51% in the intervention group vs 44 51% in the control group; p=0·89; IDEAS 75 48% vs 28 35%). We noted a significant reduction in symptom and disability outcomes at the rural Tamil Nadu site (−9·29, −15·41 to −3·17; p=0·003). Two patients (one in each group) died by suicide during the study, and two patients died because of complications of a road traffic accident and pre-existing cardiac disease. 18 (73%) patients (17 in the intervention group) were admitted to hospital during the course of the trial, of whom seven were admitted because of physical health problems, such as acute gastritis and vomiting, road accident, high fever, or cardiovascular disease. Interpretation The collaborative community-based care plus facility-based care intervention is modestly more effective than facility-based care, especially for reducing disability and symptoms of psychosis. Our results show that the study intervention is best implemented as an initial service in settings where services are scarce, for example in rural areas. Funding Wellcome Trust.
Luteolin (C15H10O6) is an important flavonoid found in many fruits, plants, medicinal herbs, and vegetables exhibiting many pharmacological properties. The anticancer, antitumor, antioxidant, and ...anti-inflammatory activities of luteolin have been reported. The pharmacological action of small molecules is dependent upon its interaction with biomacromolecules. The interactions of small molecules with DNA play a major role in the transcription and translation process. In this work, we explored the energetic profile of DNA–luteolin interaction by isothermal titration calorimetry (ITC). The effect of temperature and salt concentration on DNA binding was examined by UV-Vis method. The mode of interaction was further probed by UV melting temperature analysis and differential scanning calorimetry. An atomic level insight on the recognition of luteolin with DNA was achieved by employing molecular dynamics (MD) simulation on luteolin in complex with AT- and GC-rich DNA sequences. AMBER force field proves to be appropriate in providing an understanding on the binding mode and specificity of luteolin with duplex DNA. MD results suggest a minor groove binding of luteolin with DNA and the binding free energy obtained is in agreement with the experimental results.
Fanconi anemia (FA) is an inherited bone marrow failure disorder. In patients with FA, there is a high incidence of head and neck squamous cell carcinoma (HNSCC). As there is a defective DNA repair ...mechanism, radiotherapy (RT) or chemotherapy has an increased risk of toxicity in FA patients with HNSCC. We report the radiation treatment for oropharyngeal carcinoma in a FA patient. Our patient was treated with RT to a total dose of 60 Gy in 30 fractions. She developed grade 3 oral mucositis, grade 3 neutropenia, and thrombocytopenia at 20 Gy which resulted in treatment break of 11 days. She again developed grade 3 mucositis, grade 2 dermatitis, grade 3 thrombocytopenia, worsening of odynophagia at 44 Gy which resulted in a treatment break of 19 days. She completed RT and is now disease-free for 1 year with a good quality of life.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Abstract Purpose Our study determined the potential for osseous regeneration of platelet rich fibrin (PRF) in mandibular third molar impaction sockets along with its soft tissue healing potential. ...Patients and Methods We designed the study to be carried out as a prospective in-vivo study. Following extraction, randomization was done. On one side, the socket was sutured primarily (control site) and on the other, autologous PRF gel, was placed and sutured (test site/PRF site). Post operatively, grid periapical radiographs were obtained, at periodic intervals (1st week, 4th week, 16th week) and digitalized. The grey level values were measured at 3 different regions of the socket (RNFB – Regions of Newly Formed Bone), compared with natural bone area (NBA); using HL Image++ software, and calculation of percentage bone fill was made. Clinical evaluation of soft tissue healing was done using Landry Turnbull & Howley index at the specific intervals. Results 30 healthy subjects, both male & female (age 18 – 35 years) with bilaterally impacted mandibular third molars were enrolled in this study. It was found that, in general, there was significantly greater bone formation in sockets treated with PRF (P value < 0.05). In the PRF group, the average grey level values at cervical, middle and apical regions were 61.85 (SD ± 25.186), 64.54 (SD ± 24.831) & 67.80 (SD ± 23.946), respectively, with a mean value of 64.73 (SD ± 24.411). In the control group, these values were 51.58 (SD ± 15.286), 54.30 (SD ± 16.274) &57.53 (SD ±16.187) respectively with a mean of 53.67 (SD ± 16.528). The average percentage bone fill of PRF category patients was 57.90 (SD ± 26.789) and that of the non PRF patients, 46.74 (SD ± 17.713) (P<0.05). The soft tissue healing as evaluated by Landry Turnbull & Howley healing index also was found to be better on the (PRF) test site and it was statistically significant (P<0.05). Conclusions There was evidence for better osseous regeneration & soft tissue healing occurring in response to PRF. Further investigations to evaluate the application of PRF in other areas of oral and maxillofacial surgery is imperative.
India, with its rapidly aging population, faces an alarming burden of dementia. We implemented DSM-5 criteria in large-scale, nationally representative survey data in India to characterize the ...prevalence of mild and major Neurocognitive disorder.
The Harmonized Diagnostic Assessment of Dementia for the Longitudinal Aging Study in India (LASI-DAD) (N = 4,096) is a nationally representative cohort study in India using multistage area probability sampling methods. Using neuropsychological testing and informant reports, we defined DSM-5 mild and major neurocognitive disorder, reported its prevalence, and evaluated criterion and construct validity of the algorithm using clinician-adjudicated Clinical Dementia Ratings (CDR)®.
The prevalence of mild and major neurocognitive disorder, weighted to the population, is 17.6% and 7.2%. Demographic gradients with respect to age and education conform to hypothesized patterns. Among N = 2,390 participants with a clinician-adjudicated CDR, CDR ratings and DSM-5 classification agreed for N = 2,139 (89.5%) participants.
The prevalence of dementia in India is higher than previously recognized. These findings, coupled with a growing number of older adults in the coming decades in India, have important implications for society, public health, and families. We are aware of no previous Indian population-representative estimates of mild cognitive impairment, a group which will be increasingly important in coming years to identify for potential therapeutic treatment.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Introduction: Concurrent chemoradiation therapy (CCRT) is the standard of care in the management of cervical cancer (International Federation of Gynecology and Obstetrics FIGO 2008 Stages IB2-IVA). ...Apart from the myelotoxic effects of chemotherapy, irradiation of pelvic bone marrow (BM) in the radiation field, can also contribute to hematological toxicity.
Objectives: We examined the relationship of irradiated BM volume and neutropenia in cervical cancer patients undergoing CCRT.
Materials and Methods: This prospective study was conducted in a tertiary cancer center with a longitudinal study design. A total of 43 patients undergoing CCRT for cervical cancer were included. Using auto bone segmentation, the external contour of pelvic bones from L4 vertebral body to ischial tuberosities were delineated as BM. The volume of BM receiving 10, 20, 40, 50 Gy was calculated. Complete blood counts were done weekly to evaluate the neutropenia and were graded according to Common Terminology Criteria for Adverse Events, version 3.0. The risk of developing neutropenia was analyzed using logistic regression.
Results: Twenty-seven patients (62.8%) received 5 cycles of chemotherapy, 14 patients (32.6%) received 4 cycles of chemotherapy and 2 patients (4.7%) received 3 cycles of chemotherapy. Overall, 22 patients (51.2%) experienced acute neutropenia. On multivariate analysis increased BM V50Gy had a statistically significantly odds of developing any grade of neutropenia (odds ratio OR =1.43; 95% confidence interval CI, 1.03-1.97; P = 0.028). When comparing patients receiving BM V40Gy ≥40% with BM V40Gy <40% odds of any grade of neutropenia was increased (OR = 2.03; 95% CI, 0.55-7.42; P = 0.28). Moreover, when comparing patients receiving BM V50Gy ≥15% with BM V50Gy <15% odds of any grade of neutropenia was increased (OR = 2.13; 95% CI, 0.57-7.97; P = 0.26).
Conclusions: High-dose irradiation to the larger volume of BM prevents compensatory hyperplasia which leads to neutropenia in patients undergoing CCRT for cervical cancer.
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