Perceptions of trekking tourism and social and environmental change in Nepal's Himalayas

The Himalayas are among the world’s youngest mountain ranges. In addition to the geologic processes of mountain building and erosion, they are also highly vulnerable to human influenced change, occurring at local, national, regional, and international scales. A photo-elicitation methodology is employed to show how residents perceive those changes from historical perspectives, as well as their current conditions and impacts on their daily lives. Nepal’s Khumbu region has undergone major social and environmental transformations since the 1960s when international trekking first began to influence the area's economy. The current perceptions of Khumbu residents of these changes is assessed through photo-elicitation interviews. Their responses are placed in the historical context of: (i) institutional and political changes, much of which have been driven by national government policies; (ii) social and economic changes, for which the tourism economy has been central; and (iii) environmental changes, reflecting the impacts of resource management and climate change. The mostly positive perceptions of Khumbu residents toward how their region has changed reflects general improvements in the physical and cultural landscapes of the Khumbu over time, as well as its continuing geographic isolation, which has helped to slow the rate of globalization, while also keeping the region a dynamic and popular tourist destination

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Full season navigation and control of ultra-compact autonomous ag-bot in GPS denied environment

This thesis describes perception and an autonomous navigation system for an ultra-lightweight ground robot in agricultural fields. The system is designed for reliable navigation under cluttered canopies using only a 2-D Hokuyo UST-10LX LiDAR and an RTK GPS as the primary sensors for navigation. Its purpose is to ensure that the robot can navigate through rows of crops without damaging the plants in narrow row-based and high-leaf-cover semi-structured crop plantations, such as corn (Zea mays), sorghum (Sorghum bicolor) and soybean (Glycine max). The fundamental contributions of this work are a GPS-INS based reliable localization system for the robot and a LiDAR-based navigation algorithm capable of rejecting outlying measurements in the point-cloud due to plants in adjacent rows, low-hanging leaf cover, or weeds. Finally, this work describes a behavior-based navigation architecture that enables the system to autonomously traverse a breeding field throughout the planting season

Autophagy in Virus Infection: A Race between Host Immune Response and Viral Antagonism

Virus-infected cells trigger a robust innate immune response and facilitate virus replication. Here, we review the role of autophagy in virus infection, focusing on both pro-viral and anti-viral host responses using a select group of viruses. Autophagy is a cellular degradation pathway operated at the basal level to maintain homeostasis and is induced by external stimuli for specific functions. The degradative function of autophagy is considered a cellular anti-viral immune response. However, autophagy is a double-edged sword in viral infection; viruses often benefit from it, and the infected cells can also use it to inhibit viral replication. In addition to viral regulation, autophagy pathway proteins also function in autophagy-independent manners to regulate immune responses. Since viruses have co-evolved with hosts, they have developed ways to evade the anti-viral autophagic responses of the cells. Some of these mechanisms are also covered in our review. Lastly, we conclude with the thought that autophagy can be targeted for therapeutic interventions against viral diseases

Full season navigation and control of ultra-compact autonomous ag-bot in GPS denied environment

This thesis describes perception and an autonomous navigation system for an ultra-lightweight ground robot in agricultural fields. The system is designed for reliable navigation under cluttered canopies using only a 2-D Hokuyo UST-10LX LiDAR and an RTK GPS as the primary sensors for navigation. Its purpose is to ensure that the robot can navigate through rows of crops without damaging the plants in narrow row-based and high-leaf-cover semi-structured crop plantations, such as corn (Zea mays), sorghum (Sorghum bicolor) and soybean (Glycine max). The fundamental contributions of this work are a GPS-INS based reliable localization system for the robot and a LiDAR-based navigation algorithm capable of rejecting outlying measurements in the point-cloud due to plants in adjacent rows, low-hanging leaf cover, or weeds. Finally, this work describes a behavior-based navigation architecture that enables the system to autonomously traverse a breeding field throughout the planting season.LimitedAuthor requested closed access (OA after 2yrs) in Vireo ETD syste

Removal of a Self-Sxpanding Metallic Y Stent in the Management of Reversible Central Airway Obstruction Due to Mediastinal Lymphoma

In adults, central airway obstruction (CAO) can occur due to several benign and malignant etiologies either due to an endobronchial growth or extrinsic compression [...

Autophagy in Virus Infection: A Race between Host Immune Response and Viral Antagonism

Virus-infected cells trigger a robust innate immune response and facilitate virus replication. Here, we review the role of autophagy in virus infection, focusing on both pro-viral and anti-viral host responses using a select group of viruses. Autophagy is a cellular degradation pathway operated at the basal level to maintain homeostasis and is induced by external stimuli for specific functions. The degradative function of autophagy is considered a cellular anti-viral immune response. However, autophagy is a double-edged sword in viral infection; viruses often benefit from it, and the infected cells can also use it to inhibit viral replication. In addition to viral regulation, autophagy pathway proteins also function in autophagy-independent manners to regulate immune responses. Since viruses have co-evolved with hosts, they have developed ways to evade the anti-viral autophagic responses of the cells. Some of these mechanisms are also covered in our review. Lastly, we conclude with the thought that autophagy can be targeted for therapeutic interventions against viral diseases