Use of a Utility-Scale Solar Energy Facility by Avian Populations in Central California

With an ever-increasing demand for renewable energy in response to climate change, utility-scale solar energy (USSE) is on the rise, particularly in California. Although solar energy is viewed as an essential resource for transitioning from a fossil fuel economy, USSE installations can cover thousands of acres of habitat used by avian species. Little is known about the effects of USSE on avian populations, although some evidence suggests that USSE facilities may be leading to bird mortality. The lake-effect hypothesis suggests that birds may mistake solar arrays for large bodies of water resulting in injury or mortality. Though several studies describe the direct impacts of USSE on birds, far fewer evaluate indirect effects of USSE on birds. This study used point counts to contrast bird abundance, species richness, bird behavior and human disturbance at the Wright Solar Park (WSP), adjacent grasslands, and agricultural land. The USSE facility had lower bird abundances, species richness, and percent of birds foraging compared to both the grassland and the agricultural sites. These results indicate that USSE facilities should be placed in previously transformed locations especially urban settings that have little to no wildlife value

Effect of administration of antihelminthics for soil transmitted helminths during pregnancy

Background: Helminthiasis is infestation of the human body with parasitic worms and it is estimated to affect 44 million pregnancies, globally, each year. Intestinal helminthiasis is associated with blood loss and decreased supply of nutrients for erythropoiesis, resulting in iron deficiency anaemia. Over 50% of the pregnant women in low- and middle-income countries suffer from iron deficiency anaemia. Though iron deficiency anaemia is multifactorial, hook worm infestation is a major contributory cause in women of reproductive age in endemic areas. Antihelminthics are highly efficacious in treating hook worm but evidence of their beneficial effect and safety, when given during pregnancy, has not been established.Objectives: To determine the effects of administration of antihelminthics for soil transmitted helminths during the second or third trimester of pregnancy on maternal anaemia and pregnancy outcomes.Search strategy: We searched the Cochrane Pregnancy and Childbirth Group\u27s Trials Register (September 2008). Selection criteria: All prospective randomised controlled trials evaluating the effect of administration of antihelminthics during the second or third trimester of pregnancy. Data collection analysis: Two review authors independently assessed trial quality and extracted the data.Main results: Three studies (1329 women) were included in this review. Analysis showed that administration of a single dose of antihelminth in the second trimester of pregnancy is not associated with any impact on maternal anaemia in the third trimester (risk ratio (RR) 0.90, 95% confidence interval (CI) 0.68 to 1.19, random effects (2 studies, n = 1075)). Subgroup analysis on the basis of co-interventions other than antihelminthics which included iron supplementation given to both groups in the study by Larocque et al, and a subset of the study by Torlesse et al, showed that a single dose of antihelminth along with iron supplementation throughout the second and third trimester of pregnancy was not associated with any impact on maternal anaemia in the third trimester as compared to iron supplementation alone (RR 0.76, 95% CI 0.39 to 1.45, random-effects (2 studies, n = 1017)). No impact was found for the outcomes of low birthweight (RR 0.94, 95% CI 0.61 to 1.42 (1study, n = 950)), perinatal mortality (RR 1.10, 95% CI 0.55 to 2.22 (2 studies, n = 1089)) and preterm birth (RR 0.85, 95% CI 0.38 to 1.87 (1 study, n = 984)). Impact on infant survival at six months of age could not be evaluated because no data were available.Authors\u27Conclusion:The evidence to date is insufficient to recommend use of antihelminthics for pregnant women after the first trimester of pregnancy. More well-designed, large scale randomised controlled trials are needed to establish the benefit of antihelminthic treatment during pregnancy

Left atrial volumes and associated stroke subtypes.

Background: Cardio embolism and cerebrovascular atherosclerosis are two major mechanisms of stroke. Studies investigating associations between advanced echocardiographic parameters and stroke mechanisms are limited. Methods: This study is a standardized review of 633 patients admitted to the stroke service of a tertiary care hospital following a standardized stroke investigation and management pathway. Stroke subtypes were characterized using the Causative Classification System, using the hospitals online radiologic archival system with CCS certified stroke investigators. Patients with two mechanisms were excluded. Results: Patients with cardioembolic stroke had a higher proportion of atrial fibrillation (p \u3c 0.001), acute myocardial infarction (p \u3c 0.001) and ischemic heart disease (p \u3c 0.001). On electrocardiogram (ECG) and transthoracic Echo (TTE), patients with cardioembolic stroke had a greater atrial fibrillation (p \u3c .00), left ventricular thrombus (p \u3c .00), left ventricular ejection fraction \u3c30% (p \u3e\u3c .00) and global hypokinesia (p \u3c .00) Patients with cardioembolic stroke had higher mean left atrial volume indices (LAVi) (p \u3c 0.001), mean left ventricular mass indices (LVMi) (p \u3c 0.05) and mean left atrial diameters (LAD) (p \u3c 0.05). At LAVi of 29–33 ml/m2 , the risk of atherothrombotic stroke increased. The risk of cardioembolic stroke increased with LAVi of 34 ml/m2 and above. Conclusion: Left atrial volume indices may be linked to specific stroke phenotype. At mild increases in left atrial dimensions, the risks of atherosclerotic stroke are high, and probably reflect hypertension as the unifying mechanism. Further increases in left atrial dimensions shifts the risk towards cardioembolic stroke

Incidence of Colorectal Carcinoma in the Remote Area of Sindh, Pakistan

Background: Colorectal carcinoma (CRC) is the third most common cancer in the world that show malignant growth in the colon, rectum, and or appendix. CRC is the second most common malignancy in females and third in males. This study aimed to ascertain the incidence of colorectal carcinoma (CRC) in a population in a remote area of Sindh, Pakistan, and also compared and correlated the sociodemographic characteristics and different parameters such as diagnosis, grade, and histopathology of the CRC cases.Methods: The study was conducted from February 2012 to 2019 at Pakistan Atomic Energy Cancer Hospital (NORIN) Nawabshah Sindh, Pakistan. All cases were evaluated through a detailed history, clinical examination, radiological examination, and histopathology-proven cases. The sociodemographic parameters, diagnosis grades, and histopathology of the CRC were statistically compared and correlated by SPSS version 21.Results: Out of a total of 10,848 reported patients, 424 (3.9%) were of CRC. The CRC was further comprised of 63.9% males and 36.1% females. We classified our patients into two age groups, ≤ 40 years (Group-A), and > 40 years (Group B). Group-A comprised 41% of patients, and their mean age was 28±6.98 years, while Group B comprised 59% of patients with a mean age of 43±8.3 years. Histological specimens divulged that most of the common specimens were of adenocarcinoma. Early diagnosis was very strenuous due to no signs and symptoms. Thus, the majority of the patients, approximately 39%, were found to be of grade 2 carcinoma.Conclusion: Our study unveils an increased number of patients with CDC at an age of <40 belonging to rural areas. Further studies are needed to elucidate the cause of this high incidence with a particular focus on genetic and molecular risk factors.Keywords: Active lifestyle, Colorectal Carcinoma; Age group; Colorectal Adenocarcinoma

A randomized controlled behavioral intervention trial to improve medication adherence in adult stroke patients with prescription tailored Short Messaging Service (SMS)-SMS4Stroke study.

Background: The effectiveness of mobile technology to improve medication adherence via customized Short Messaging Service (SMS) reminders for stroke has not been tested in resource poor areas. We designed a randomized controlled trial to test the effectiveness of SMS on improving medication adherence in stroke survivors in Pakistan. Methods: This was a parallel group, assessor-blinded, randomized, controlled, superiority trial. Participants were centrally randomized in fixed block sizes. Adult participants on multiple medications with access to a cell phone and stroke at least 4 weeks from onset (Onset as defined by last seen normal) were eligible. The intervention group, in addition to usual care, received reminder SMS for 2 months that contained a) Personalized, prescription tailored daily medication reminder(s) b) Twice weekly health information SMS. The Health Belief Model and Social Cognitive theory were used to design the language and content of messages. Frontline SMS software was used for SMS delivery. Medication adherence was self-reported and measured on the validated Urdu version of Morisky Medication Adherence Questionnaire. Multiple linear regression was used to model the outcome against intervention and other covariates. Analysis was conducted by intention-to-treat principle. Results: Two hundred participants were enrolled. 38 participants were lost to follow-up. After 2 months, the mean medication score was 7.4 (95 % CI: 7.2–7.6) in the intervention group while 6.7 (95 % CI: 6.4–7.02) in the control group. The adjusted mean difference (Δ) was 0.54 (95 % CI: 0.22–0.85). The mean diastolic blood pressure in the intervention group was 2.6 mmHg (95 % CI; −5.5 to 0.15) lower compared to the usual care group. Conclusion: A short intervention of customized SMS can improve medication adherence and effect stroke risk factors like diastolic blood pressure in stroke survivors with complex medication regimens living in resource poor areas

Global dispersal and adaptive evolution of domestic cattle: a genomic perspective

Domestic cattle have spread across the globe and inhabit variable and unpredictable environments. They have been exposed to a plethora of selective pressures and have adapted to a variety of local ecological and management conditions, including UV exposure, diseases, and stall-feeding systems. These selective pressures have resulted in unique and important phenotypic and genetic differences among modern cattle breeds/populations. Ongoing efforts to sequence the genomes of local and commercial cattle breeds/populations, along with the growing availability of ancient bovid DNA data, have significantly advanced our understanding of the genomic architecture, recent evolution of complex traits, common diseases, and local adaptation in cattle. Here, we review the origin and spread of domestic cattle and illustrate the environmental adaptations of local cattle breeds/populations

Left atrial volumes and associated stroke

Background: Cardio embolism and cerebrovascular atherosclerosis are two major mechanisms of stroke. Studies investigating associations between advanced echocardiographic parameters and stroke mechanisms are limited. Methods: This study is a standardized review of 633 patients admitted to the stroke service of a tertiary care hospital following a standardized stroke investigation and management pathway. Stroke subtypes were characterized using the Causative Classification System, using the hospitals online radiologic archival system with CCS certified stroke investigators. Results: Patients with cardioembolic stroke had a higher proportion of atrial fibrillation (p \u3c 0.001), acute myocardial infarction (p \u3c 0.001) and ischemic heart disease (p \u3c 0.001). On electrocardiogram (ECG) and transthoracic Echo (TTE), patients with cardioembolic stroke had a greater atrial fibrillation (p \u3c .00), left ventricular thrombus (p \u3c .00), left ventricular ejection fraction \u3c30% (p \u3c .00) and global hypokinesia (p \u3c .00) Patients with cardioembolic stroke had higher mean left atrial volume indices (LAVi) (p \u3c 0.001), mean left ventricular mass indices (LVMi) (p \u3c 0.05) and mean left atrial diameters (LAD) (p \u3c 0.05). At LAVi of 29–33 ml/m2, the risk of atherothrombotic stroke increased. The risk of cardioembolic stroke increased with LAVi of 34 ml/m2 and above. Conclusion: Left atrial volume indices may be linked to specific stroke phenotype. At mild increases in left atrial dimensions, the risks of atherosclerotic stroke are high, and probably reflect hypertension as the unifying mechanism. Further increases in left atrial dimensions shifts the risk towards cardioembolic stroke. Keywords: Stroke, Left atrial volume, Echo, Atherosclerosi

Confronting challenges: an inductive thematic analysis of barriers and solutions to undergraduate medical research in Pakistan

Objectives: To qualitatively analyse the barriers in pursuing undergraduate research, and to propose solutions for the problems identified. Method: The qualitative study was conducted from May to October 2021 after approval from the institutional ethics review board of the Dow University of Health Sciences, Karachi, and comprised undergraduate students of either gender at various public and private medical universities across Pakistan having some level of research experience and good communication skills. Data triangulation was employed to collect qualitative data through open-ended survey, face-to-face interviews and focus group discussions. Using the information of one method to inform the rest, linked trajectories were established that allowed validation of information at each level. Data was coded manually by two researchers independently. Data was subjected to inductive thematic analysis. Results: Of the 33 subjects, 17(51.5%) were males, 17(51.5%) were from private medical colleges, 18(54.5%) were from Karachi, and 11(33.3%) were in the final year of medical school. Overall, 13(39.4%) students completed the open-ended survey, 6(18.2%) completed face-to-face interviews, and 14(42.4%) participated in focus group discussions. Thematic anlsysis showed that students were interested in research to improve their career prospects, but not all were passionate about it. Students were not satisfied with the quality of research being conducted Pakistan in the country. Dearth of motivated faculty, unavailability of well-maintained and digitalised data registries, ineffective research methodology teaching and lack of access to medical journals and research software were the major barriers in undergraduate research. Time constraint was a projecting problem which challenged the students. Frequent research workshops and conferences, strong networking, reorienting curriculum to provide early exposure to research and student-led initiatives were suggested to improve undergraduate research in Pakistan. Conclusion: Students’ lack of initiative coupled with administrative and faculty-related issues pose a serious threat to the future of evidence-based medicine. Proposed solutions offer a ray of hope to the future of undergraduate research in Pakistan. Key Words: Undergraduate medical education, Qualitative research, Focus groups, Interview, Pakistan