57 research outputs found
Academic Writing: A Handbook for International Students (second edition)
The book titled Academic Writing: A handbook for international students (2nd edition) is written by Stephen Bailey and published by Routledge Taylor & Francis group. Stephen Bailey’s book is one of the comprehensive books written on the academic writing skills by any local and foreign author. This book plays a fundamental role in developing the skills of academic writing to someone with less formal writing experience of English. Academic writing is divided into four parts. Each part deals with different features of academic writing and further divided into small sections and units dealing each aspect of the titled sections ..
A Tractable Handoff-aware Rate Outage Approximation with Applications to THz-enabled Vehicular Network Optimization
In this paper, we first develop a tractable mathematical model of the handoff
(HO)-aware rate outage experienced by a typical connected and autonomous
vehicle (CAV) in a given THz vehicular network. The derived model captures the
impact of line-of-sight (LOS) Nakagami-m fading channels, interference, and
molecular absorption effects. We first derive the statistics of the
interference-plus-molecular absorption noise ratio and demonstrate that it can
be approximated by Gamma distribution using Welch-Satterthwaite approximation.
Then, we show that the distribution of signal-to-interference-plus-molecular
absorption noise ratio (SINR) follows a generalized Beta prime distribution.
Based on this, a closed-form HO-aware rate outage expression is derived.
Finally, we formulate and solve a CAVs' traffic flow maximization problem to
optimize the base-stations (BSs) density and speed of CAVs with collision
avoidance, rate outage, and CAVs' minimum traffic flow constraint. The CAVs'
traffic flow is modeled using Log-Normal distribution. Our numerical results
validate the accuracy of the derived expressions using Monte-Carlo simulations
and discuss useful insights related to optimal BS density and CAVs' speed as a
function of crash intensity level, THz molecular absorption effects, minimum
road-traffic flow and rate requirements, and maximum speed and rate outage
limits.Comment: This paper has been accepted in the IEEE Global Communications
(GLOBECOM) 2023 conferenc
An Analysis of the Darkest Part of the Forest by Holy Black in Light of Wendy B. Faris’ Model of Narrative Techniques in Magical Realism
This research study focuses on the analysis of the narrative techniques of the text The Darkest Part of the Forest by Holy Black, an American novelist, in light of Wendy. B. Faris’ theory of narrative techniques in magical realism proposed in Ordinary Enchantment: Magical Realism and the Remystification of Narrative (2004) that serves as theoretical framework. In this context, the present research is a post-modernist analysis of the text since magical realism is mode of writing under Post Modernism. The study negotiates that text appears as a magical realist text because it shows several instances, settings, plot and characters which present it more than a fantasy. The plot revolves around the horned boy, a faerie prince, faeries, their encounter with human beings, magic, spell, and pastoral settings. The analysis of juxtaposition of realistic elements with fantasy or unrealistic happenings is the focus of this research. Wendy B. Faris has proposed five primary elements as the narrative building blocks of the binary opposition between realism and fantasy: the irreducible element, unsettling doubts, the phenomenal world, merging realms and, the distortion of time, space and identity. The researchers’ aim is to investigate whether Faris’ five elements may be successfully applied to the text under analysis. The findings of this research study amplify that this text is a post-modernist piece of writing and it truly exhibits the amalgamation of fantasy and real word occurrences. By discerning narrative elements in the text through discussion and textual references, the researchers have negotiated how these narrative elements served as building blocks of magical realism in the selected text. This research is qualitative and descriptive and adds to the body of Fantasy, American and Post-Modernist literature
Response of wheat varieties to salinity: growth, yield and ion analysis
In plants, development, growth and yield most severely affected through saline soil/water in growth medium, ultimately cause severe threat to global food production for human being. Wheat (Triticum aestivum) is the most edible crop in Pakistan. Production of this crop can be improved through using marginal areas with the help of growing salt-tolerant varieties. The present investigation is carried out to screen out six local wheat varieties (F.Sarhad, Insaf, Lalma, Tatora, Bathoor and Barsat) with reference to their vegetative and reproductive growth, different physiological parameters [relative water content (RWC), electrolyte-leakage (EL) and leaf water loss (LWL)] and ionic status of plants. Present experiment designed in completely randomized manner (CRD) and 54 pots were arranged in the Botanical Garden, Department of Botany. These pots arranged in 6 lines with 9 pots/line and each line was irrigated with non-saline (control), 50 mM and 150 mM NaCl solution. The data from present research revealed that application of salt cause significant reduction in plant-height, root-length, fresh-biomass, dry-biomass, seed number/plant, seed weight/plant, spike-weight, relative water content, leaf water loss, and different ions of plants. Similarly at same applied doses of salt weight of 100 seeds, spike-length, electrolyte-leakage, Na+ and Cl- ions become increased. It has been concluded from the results of present study that varieties F. Sarhad, Insaf and Lalma exhibited more salt tolerance as compare to other varieties. So, these recommended for growing on moderately salt affected soil/water to achieve more yield of wheat from such affected lands of Khyber Pakhtunkhwa, Pakistan
People who use drugs show no increase in pre-existing T-cell cross-reactivity toward SARS-CoV-2 but develop a normal polyfunctional T-cell response after standard mRNA vaccination
People who use drugs (PWUD) are at a high risk of contracting and developing severe coronavirus disease 2019 (COVID-19) and other infectious diseases due to their lifestyle, comorbidities, and the detrimental effects of opioids on cellular immunity. However, there is limited research on vaccine responses in PWUD, particularly regarding the role that T cells play in the immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Here, we show that before vaccination, PWUD did not exhibit an increased frequency of preexisting cross-reactive T cells to SARS-CoV-2 and that, despite the inhibitory effects that opioids have on T-cell immunity, standard vaccination can elicit robust polyfunctional CD4+ and CD8+ T-cell responses that were similar to those found in controls. Our findings indicate that vaccination stimulates an effective immune response in PWUD and highlight targeted vaccination as an essential public health instrument for the control of COVID-19 and other infectious diseases in this group of high-risk patients
Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial
Background
Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage.
Methods
In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283.
Findings
Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group.
Interpretation
Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset.
Funding
London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation
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Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
Abstract
Background
Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods
This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries.
Results
In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
Conclusion
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries
An Analysis of the Darkest Part of the Forest by Holy Black in Light of Wendy B. Faris’ Model of Narrative Techniques in Magical Realism
This research study focuses on the analysis of the narrative techniques of the text The Darkest Part of the Forest by Holy Black, an American novelist, in light of Wendy. B. Faris’ theory of narrative techniques in magical realism proposed in Ordinary Enchantment: Magical Realism and the Remystification of Narrative (2004) that serves as theoretical framework. In this context, the present research is a post-modernist analysis of the text since magical realism is mode of writing under Post Modernism. The study negotiates that text appears as a magical realist text because it shows several instances, settings, plot and characters which present it more than a fantasy. The plot revolves around the horned boy, a faerie prince, faeries, their encounter with human beings, magic, spell, and pastoral settings. The analysis of juxtaposition of realistic elements with fantasy or unrealistic happenings is the focus of this research. Wendy B. Faris has proposed five primary elements as the narrative building blocks of the binary opposition between realism and fantasy: the irreducible element, unsettling doubts, the phenomenal world, merging realms and, the distortion of time, space and identity. The researchers’ aim is to investigate whether Faris’ five elements may be successfully applied to the text under analysis. The findings of this research study amplify that this text is a post-modernist piece of writing and it truly exhibits the amalgamation of fantasy and real word occurrences. By discerning narrative elements in the text through discussion and textual references, the researchers have negotiated how these narrative elements served as building blocks of magical realism in the selected text. This research is qualitative and descriptive and adds to the body of Fantasy, American and Post-Modernist literature
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