23 research outputs found
Management of a 3-year-old child with ambiguous genitalia
No full textTrue hermaphrodites have characteristics tissue both sex in the form of presence of vagina uterus, fallopian tubes and ovaries as in female and presence of testis seminiferous tubules but penis as in penoscrotal hypospadias and bifid scrotal sac confuses as well developed labia majora. Determination of sex as per parents view in our social set up. The case was provisionally diagnosed as intersex. Total abdominal hysterectomy, bilateral salphingo-oophorectomy and colpectomy were conducted. A 3-year-old child referred by a pediatrician to Nalanda Medical College, child surgical department for investigation and management of his ambiguous genitalia having following features like, urine was not passing from the tip of penis; penis along with apparently looking female genitalia was taken under treatment. Examination under general anesthesia showed a presence of both male/female internal genitalia and gonads with features of external genitalia of both sexes. After total abdominal hysterectomy and human chorionic gonadotrophin treatment growth of phallus and testicle was noted. The child was made male after extirpation of female genitals. This case illustrates that gender correction can be made as per patients consent in adult but at this stage social customs and parents consent dictated the treatment
Legal implications of Development Control Rules and Regulations for Buildings in Urban Areas of India
No full textNot availabl
Estabilizadores de tensão alternada para alimentação de cargas não-lineares: estudo de variações topológicas e métodos de controle
No full textTese (doutorado) - Universidade Federal de Santa Catarina, Centro Tecnológico. Programa de Pós-graduação em Engenharia ElétricaNeste trabalho aborda-se o estudo de estabilizadores de tensão alternada que possuem a capacidade de disponibilizar na saída uma tensão com amplitude e forma de acordo com uma referência pré-determinada. Através de uma ampla revisão bibliográfica dos conversores CA-CA faz-se uma classificação dos mesmos e generaliza-se o conceito de compensação série de tensão. Uma topologia de conversor CA-CA indireto sem elementos armazenadores de energia no barramento é escolhida e estudada em todos os seus detalhes, desde o estágio de potência até as possíveis formas de controle da mesma. Na metodologia de projeto do estágio de potência é levada em conta a modelagem da carga não-linear e da tensão de entrada distorcida. As implicações no controle do conversor na presença de impedância de linha são estudadas e, sugere-se a utilização de um filtro de entrada para possibilitar a utilização do controle por realimentação instantânea da tensão de saída, juntamente com um controlador com resposta dinâmica rápida. Os resultados experimentais validam os estudos teóricos realizados, além de corroborar algumas hipóteses discutidas no decorrer do trabalho
Author Correction: Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017
No full textCurcumin Conjugates And Metallocomplexes As Lead Compounds For Development Of Anticancer Agents - A Short Review
No full textThe plant kingdom is a rich source of compounds with anticancer activities. Curcumin [1,7-bis(4-hydroxy-3-methoxyphenyl)-1,6-heptadiene-3,5-dione] (1) is a secondary metabolite produced by rhizomes of Curcuma longa that has been used for centuries in traditional Medicine in Asia. Anticancer activity is one of the pharmacological properties of curcumin (1) that has been widely explored. Its targets include transcription factors, growth and angiogenesis regulators, apoptosis-related genes, adhesion-related molecules, and cellular signaling molecules. Some curcumin conjugates and metallocomplexes have been synthesized, characterized and evaluated for anticancer activity. In this mini-review, we discuss the mechanism of action by which curcumin (1) inhibits the progression of tumor growth and also the antiproliferative activity of curcumin conjugates and metallocomplexes on human cancer cells. 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Study of vector boson scattering and search for new physics in events with two same-sign leptons and two jets
No full textThis article is available under the terms of the Creative Commons Attribution 3.0 License. Further distribution of this work must maintain attribution to the author(s) and the published article’s title, journal citation, and DOI.A study of vector boson scattering in pp collisions at a center-of-mass energy of 8 TeV is presented. The data sample corresponds to an integrated luminosity of 19.4fb-1 collected with the CMS detector. Candidate events are selected with exactly two leptons of the same charge, two jets with large rapidity separation and high dijet mass, and moderate missing transverse energy. The signal region is expected to be dominated by electroweak same-sign W-boson pair production. The observation agrees with the standard model prediction. The observed significance is 2.0 standard deviations, where a significance of 3.1 standard deviations is expected based on the standard model. Cross section measurements for W±W± and WZ processes in the fiducial region are reported. Bounds on the structure of quartic vector-boson interactions are given in the framework of dimension-eight effective field theory operators, as well as limits on the production of doubly charged Higgs bosons
Search for displaced supersymmetry in events with an electron and a muon with large impact parameters
No full textThis article is available under the terms of the Creative Commons Attribution 3.0 License. Further distribution of this work must maintain attribution to the author(s) and the published article’s title, journal citation, and DOI.A search for new long-lived particles decaying to leptons is presented using proton-proton collisions produced by the LHC at s=8TeV. Data used for the analysis were collected by the CMS detector and correspond to an integrated luminosity of 19.7fb-1. Events are selected with an electron and muon with opposite charges that both have transverse impact parameter values between 0.02 and 2 cm. The search has been designed to be sensitive to a wide range of models with nonprompt e-μ final states. Limits are set on the "displaced supersymmetry" model, with pair production of top squarks decaying into an e-μ final state via R-parity-violating interactions. The results are the most restrictive to date on this model, with the most stringent limit being obtained for a top squark lifetime corresponding to cτ=2cm, excluding masses below 790 GeV at 95% confidence level
Exploring Prehistoric Tuberculosis in Britain: A Combined Macroscopic and Biomolecular Approach
No full textTuberculosis (TB) is a bacterial, infectious disease, currently responsible for millions of deaths worldwide. Although the aetiology of the disease in its current form is well documented in the clinical literature, little is known of the form the disease took in earlier times, or the time at which it first entered Britain. This study aimed to test the hypotheses that TB was present in British prehistory, (as it was in Europe), prior to that previously identified in the Iron Age (Mays and Taylor, 2003) and that the infection was caused by both M. tuberculosis and M. bovis; the latter most commonly contracted from cattle. The objective of the project was to use ancient DNA (aDNA) from human skeletons to study the bacteria responsible for TB (M. tuberculosis complex) in order to then study the origin and evolution of the strains of the bacteria causing TB in prehistoric Britain. Thirteen individuals from Neolithic, Bronze and Iron Age sites in the south of England (comprising inhumations of reasonable preservation), were selected for inclusion in the project, based on non-specific evidence of infection, potentially representative of early tuberculous skeletal involvement. A biocultural approach was employed in order to better understand the environmental and social context from which the samples originated. The geographical area under study was limited to the south of Britain, (with the exception of Wetwang Slack in Yorkshire) because of the direct contact between Britain and the continent in this region. Biomolecular analysis did not produce positive results for TB, the reasons for which may include poor preservation of pathogen aDNA, and thus, no conclusive evidence was found of the presence of TB in prehistoric Britain prior to that already identified. Problems encountered during the project were highlighted in an effort to improve efficiency of future projects, with suggestions as to how this study may be extended in order to allow development of a much more comprehensive history of TB in Britain to be formed; its origins, spread and possible impact on ancient British populations
Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016
No full textBackground The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of risk factor exposure and attributable burden of disease. By providing estimates over a long time series, this study can monitor risk exposure trends critical to health surveillance and inform policy debates on the importance of addressing risks in context. Methods We used the comparative risk assessment framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2016. This study included 481 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk (RR) and exposure estimates from 22 717 randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources, according to the GBD 2016 source counting methods. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. Finally, we explored four drivers of trends in attributable burden: population growth, population ageing, trends in risk exposure, and all other factors combined. Findings Since 1990, exposure increased significantly for 30 risks, did not change significantly for four risks, and decreased significantly for 31 risks. Among risks that are leading causes of burden of disease, child growth failure and household air pollution showed the most significant declines, while metabolic risks, such as body-mass index and high fasting plasma glucose, showed significant increases. In 2016, at Level 3 of the hierarchy, the three leading risk factors in terms of attributable DALYs at the global level for men were smoking (124.1 million DALYs [95% UI 111.2 million to 137.0 million]), high systolic blood pressure (122.2 million DALYs [110.3 million to 133.3 million], and low birthweight and short gestation (83.0 million DALYs [78.3 million to 87.7 million]), and for women, were high systolic blood pressure (89.9 million DALYs [80.9 million to 98.2 million]), high body-mass index (64.8 million DALYs [44.4 million to 87.6 million]), and high fasting plasma glucose (63.8 million DALYs [53.2 million to 76.3 million]). In 2016 in 113 countries, the leading risk factor in terms of attributable DALYs was a metabolic risk factor. Smoking remained among the leading five risk factors for DALYs for 109 countries, while low birthweight and short gestation was the leading risk factor for DALYs in 38 countries, particularly in sub-Saharan Africa and South Asia. In terms of important drivers of change in trends of burden attributable to risk factors, between 2006 and 2016 exposure to risks explains an 9.3% (6.9-11.6) decline in deaths and a 10.8% (8.3-13.1) decrease in DALYs at the global level, while population ageing accounts for 14.9% (12.7-17.5) of deaths and 6.2% (3.9-8.7) of DALYs, and population growth for 12.4% (10.1-14.9) of deaths and 12.4% (10.1-14.9) of DALYs. The largest contribution of trends in risk exposure to disease burden is seen between ages 1 year and 4 years, where a decline of 27.3% (24.9-29.7) of the change in DALYs between 2006 and 2016 can be attributed to declines in exposure to risks. Interpretation Increasingly detailed understanding of the trends in risk exposure and the RRs for each risk-outcome pair provide insights into both the magnitude of health loss attributable to risks and how modification of risk exposure has contributed to health trends. Metabolic risks warrant particular policy attention, due to their large contribution to global disease burden, increasing trends, and variable patterns across countries at the same level of development. GBD 2016 findings show that, while it has huge potential to improve health, risk modification has played a relatively small part in the past decade. Copyright (C) The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Population and fertility by age and sex for 195 countries and territories, 1950-2017: a systematic analysis for the Global Burden of Disease Study 2017
No full text© 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Background: Population estimates underpin demographic and epidemiological research and are used to track progress on numerous international indicators of health and development. To date, internationally available estimates of population and fertility, although useful, have not been produced with transparent and replicable methods and do not use standardised estimates of mortality. We present single-calendar year and single-year of age estimates of fertility and population by sex with standardised and replicable methods. Methods: We estimated population in 195 locations by single year of age and single calendar year from 1950 to 2017 with standardised and replicable methods. We based the estimates on the demographic balancing equation, with inputs of fertility, mortality, population, and migration data. Fertility data came from 7817 location-years of vital registration data, 429 surveys reporting complete birth histories, and 977 surveys and censuses reporting summary birth histories. We estimated age-specific fertility rates (ASFRs; the annual number of livebirths to women of a specified age group per 1000 women in that age group) by use of spatiotemporal Gaussian process regression and used the ASFRs to estimate total fertility rates (TFRs; the average number of children a woman would bear if she survived through the end of the reproductive age span [age 10–54 years] and experienced at each age a particular set of ASFRs observed in the year of interest). Because of sparse data, fertility at ages 10–14 years and 50–54 years was estimated from data on fertility in women aged 15–19 years and 45–49 years, through use of linear regression. Age-specific mortality data came from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 estimates. Data on population came from 1257 censuses and 761 population registry location-years and were adjusted for underenumeration and age misreporting with standard demographic methods. Migration was estimated with the GBD Bayesian demographic balancing model, after incorporating information about refugee migration into the model prior. Final population estimates used the cohort-component method of population projection, with inputs of fertility, mortality, and migration data. Population uncertainty was estimated by use of out-of-sample predictive validity testing. With these data, we estimated the trends in population by age and sex and in fertility by age between 1950 and 2017 in 195 countries and territories. Findings: From 1950 to 2017, TFRs decreased by 49·4% (95% uncertainty interval [UI] 46·4–52·0). The TFR decreased from 4·7 livebirths (4·5–4·9) to 2·4 livebirths (2·2–2·5), and the ASFR of mothers aged 10–19 years decreased from 37 livebirths (34–40) to 22 livebirths (19–24) per 1000 women. Despite reductions in the TFR, the global population has been increasing by an average of 83·8 million people per year since 1985. The global population increased by 197·2% (193·3–200·8) since 1950, from 2·6 billion (2·5–2·6) to 7·6 billion (7·4–7·9) people in 2017; much of this increase was in the proportion of the global population in south Asia and sub-Saharan Africa. The global annual rate of population growth increased between 1950 and 1964, when it peaked at 2·0%; this rate then remained nearly constant until 1970 and then decreased to 1·1% in 2017. Population growth rates in the southeast Asia, east Asia, and Oceania GBD super-region decreased from 2·5% in 1963 to 0·7% in 2017, whereas in sub-Saharan Africa, population growth rates were almost at the highest reported levels ever in 2017, when they were at 2·7%. The global average age increased from 26·6 years in 1950 to 32·1 years in 2017, and the proportion of the population that is of working age (age 15–64 years) increased from 59·9% to 65·3%. At the national level, the TFR decreased in all countries and territories between 1950 and 2017; in 2017, TFRs ranged from a low of 1·0 livebirths (95% UI 0·9–1·2) in Cyprus to a high of 7·1 livebirths (6·8–7·4) in Niger. The TFR under age 25 years (TFU25; number of livebirths expected by age 25 years for a hypothetical woman who survived the age group and was exposed to current ASFRs) in 2017 ranged from 0·08 livebirths (0·07–0·09) in South Korea to 2·4 livebirths (2·2–2·6) in Niger, and the TFR over age 30 years (TFO30; number of livebirths expected for a hypothetical woman ageing from 30 to 54 years who survived the age group and was exposed to current ASFRs) ranged from a low of 0·3 livebirths (0·3–0·4) in Puerto Rico to a high of 3·1 livebirths (3·0–3·2) in Niger. TFO30 was higher than TFU25 in 145 countries and territories in 2017. 33 countries had a negative population growth rate from 2010 to 2017, most of which were located in central, eastern, and western Europe, whereas population growth rates of more than 2·0% were seen in 33 of 46 countries in sub-Saharan Africa. In 2017, less than 65% of the national population was of working age in 12 of 34 high-income countries, and less than 50% of the national population was of working age in Mali, Chad, and Niger. Interpretation: Population trends create demographic dividends and headwinds (ie, economic benefits and detriments) that affect national economies and determine national planning needs. Although TFRs are decreasing, the global population continues to grow as mortality declines, with diverse patterns at the national level and across age groups. To our knowledge, this is the first study to provide transparent and replicable estimates of population and fertility, which can be used to inform decision making and to monitor progress. Funding: Bill & Melinda Gates Foundation
