Referral of Surgical Patients Abroad: A 5-years Review from a Tertiary Teaching Hospital in Addis Ababa Ethiopia

Background: The general objective of this review was to determine the reasons for referral abroad of surgical patients at Addis Ababa University Medical Faculty, Tikur Anbassa HospitalMethods: The referral slips of patients who were referred abroad from September 2005 – August 2009 by surgical Department were collected and reviewed.Results: The study reviewed a total of 331 patents in the 5 year period mentioned. An average of 66 patients was referred per year. There was an over all male preponderance 183(55.3 %), majority of patients were in the age group 26 - 50 years (173).Most were residents from the Capital, 232 (70 %). Neoplastic diseases both benign and malignant account for 155 cases. Primary brain tumors either malignant or benign account for 74 cases. 97 of the cases had at least one surgical intervention done prior to referral. The overall trend is showing some decrement. The main reason for referral was for better surgical intervention (249). Referral for MRI which accounted for 16 of the referrals in the first 2 years was virtually non existent in the next 3 years.Conclusion: Most cases were form the capital, Neurosurgical cases have been referred more than any other subspecialties, neoplastic changes constitute the main reason for referral, and the overall trend seems decreasing along the course

High energy-efficiency buildings

In cold, central European climates, hyper-insulated, heat-conserving buildings have proven a very effective way to reduce current energy consumption to 1/10 th of a traditional house. Using dry, stratified building techniques (Str/En) allows to obtain quite easily the required thermal and acoustical performances, also enhancing the construction process and allowing for the final recycling of the components. In a warmer climate – such as the Italian one – a heat-conserving strategy has to be balanced against the potential overheating problems. Among the possible solutions, the use of building-integrated Phase Change Materials, which could create a " light thermal inertia " (that is, without heavy mass), was also investigated

Identifying with the beautiful: Facial attractiveness effects on unisensory and multisensory self-other distinction

People tend to evaluate their own traits and abilities favourably and such favourable self-perceptions extend to attractiveness. However, the exact mechanism underlying this self-enhancement bias remains unclear. One possibility could be the identification with attractive others through blurring of self–other boundaries. Across two experiments, we used the enfacement illusion to investigate the effect of others’ attractiveness in the multisensory perception of the self. In Experiment 1 (N = 35), participants received synchronous or asynchronous interpersonal visuo-tactile stimulation with an attractive and non-attractive face. In Experiment 2 (N = 35), two new faces were used and spatial incongruency was introduced as a control condition. The results showed that increased ratings of attractiveness of an unfamiliar face lead to blurring of self–other boundaries, allowing the identification of our psychological self with another’s physical self and specifically their face, and this seems to be unrelated to perceived own attractiveness. The effect of facial attractiveness on face ownership showed dissociable mechanisms, with multisensory integration modulating the effect on similarity but not identification, an effect that may be purely based on vision. Overall, our findings suggest that others’ attractiveness may lead to positive distortions of the self. This research provides a psychophysical starting point for studying the impact of others’ attractiveness on self-face recognition, which can be particularly important for individuals with malleable, embodied self–other boundaries and body image disturbances

Identifying with the Beautiful: Facial attractiveness effects on unisensory and multisensory self-other distinction

People tend to evaluate their own traits and abilities favourably and such favourable self-perceptions extend to attractiveness. However, the exact mechanism underlying this self-enhancement bias remains unclear and one possibility could be the identification with attractive others through blurring of self-other boundaries. Across two experiments, we used the enfacement illusion to investigate the effect of the attractiveness of others in the multisensory perception of the self. In a first experiment (N=35), participants were stroked on the cheek while looking at an attractive vs. non-attractive face being stroked on the cheek in synchrony or asynchrony. In the second experiment (N=35), two new faces were used and spatial incοngruency was introduced as a control condition. The results showed that increased ratings of attractiveness of an unfamiliar face lead to blurring of self-other boundaries, allowing the identification of our psychological self with another's physical self, and specifically their face, and this seems to be unrelated to perceived own attractiveness. The effect of facial attractiveness on face ownership showed dissociable mechanisms, with multisensory integration modulating the effect on similarity but not identification, an effect that may be purely based on vision. Overall, our findings suggest that others’ attractiveness may lead to positive distortions of the self, identifying with the more rather than less attractive others. This research provides a psychophysical starting point for studying the impact of others' attractiveness on how we perceive the self, which can be particularly important for individuals with malleable, embodied self-other boundaries and body image disturbances

Dynamic interpersonal therapy for moderate to severe depression: A pilot randomized controlled and feasibility trial

Background: Improving Access to Psychological Therapies (IAPT) services treat most patients in England who present to primary care with major depression. Psychodynamic psychotherapy is one of the psychotherapies offered. Dynamic Interpersonal Therapy (DIT) is a psychodynamic and mentalization-based treatment for depression. 16 sessions are delivered over approximately 5 months. Neither DIT's effectiveness relative to low-intensity treatment (LIT), nor the feasibility of randomizing patients to psychodynamic or cognitive-behavioural treatments (CBT) in an IAPT setting has been demonstrated. Methods: 147 patients were randomized in a 3:2:1 ratio to DIT (n = 73), LIT (control intervention; n = 54) or CBT (n = 20) in four IAPT treatment services in a combined superiority and feasibility design. Patients meeting criteria for major depressive disorder were assessed at baseline, mid-treatment (3 months) and post-treatment (6 months) using the Hamilton Rating Scale for Depression (HRSD-17), Beck Depression Inventory-II (BDI-II) and other self-rated questionnaire measures. Patients receiving DIT were also followed up 6 months post-completion. Results: The DIT arm showed significantly lower HRSD-17 scores at the 6-month primary end-point compared with LIT (d = 0.70). Significantly more DIT patients (51%) showed clinically significant change on the HRSD-17 compared with LIT (9%). The DIT and CBT arms showed equivalence on most outcomes. Results were similar with the BDI-II. DIT showed benefit across a range of secondary outcomes.ConclusionsDIT delivered in a primary care setting is superior to LIT and can be appropriately compared with CBT in future RCTs

The ad-libitum alcohol 'taste test': secondary analyses of potential confounds and construct validity

RATIONALE: Motivation to drink alcohol can be measured in the laboratory using an ad-libitum 'taste test', in which participants rate the taste of alcoholic drinks whilst their intake is covertly monitored. Little is known about the construct validity of this paradigm. OBJECTIVE: The objective of this study was to investigate variables that may compromise the validity of this paradigm and its construct validity. METHODS: We re-analysed data from 12 studies from our laboratory that incorporated an ad-libitum taste test. We considered time of day and participants' awareness of the purpose of the taste test as potential confounding variables. We examined whether gender, typical alcohol consumption, subjective craving, scores on the Alcohol Use Disorders Identification Test and perceived pleasantness of the drinks predicted ad-libitum consumption (construct validity). RESULTS: We included 762 participants (462 female). Participant awareness and time of day were not related to ad-libitum alcohol consumption. Males drank significantly more alcohol than females (

Visceral leishmaniasis patients display altered composition and maturity of neutrophils as well as impaired neutrophil effector functions

Immunologically, active visceral leishmaniasis (VL) is characterised by profound immunosuppression, severe systemic inflammatory responses and an impaired capacity to control parasite replication. Neutrophils are highly versatile cells, which play a crucial role in the induction as well as the resolution of inflammation, the control of pathogen replication and the regulation of immune responses. Neutrophil functions have been investigated in human cutaneous leishmaniasis, however, their role in human visceral leishmaniasis is poorly understood. In the present study we evaluated the activation status and effector functions of neutrophils in patients with active VL and after successful anti-leishmanial treatment. Our results show that neutrophils are highly activated and have degranulated; high levels of arginase, myeloperoxidase and elastase, all contained in neutrophils’ granules, were found in the plasma of VL patients. In addition, we show that a large proportion of these cells are immature. We also analysed effector functions of neutrophils that are essential for pathogen clearance and show that neutrophils have an impaired capacity to release neutrophil extracellular traps, produce reactive oxygen species and phagocytose bacterial particles, but not Leishmania parasites. Our results suggest that impaired effector functions, increased activation and immaturity of neutrophils play a key role in the pathogenesis of VL

Response of the Pacific Sector of the Southern Ocean to wind stress variability from 1995 to 2017

AbstractDrifter, satellite, expendable bathythermograph (XBT), and Argo float data are used to study the response of the Pacific Sector of the Southern Ocean (PSSO) to the wind stress field in the period 1995–2017, in terms of eddy field, water mass transport, and heat fluxes at large and regional scales. Increasing wind stress over the PSSO in those two decades led to a growth of the Eddy Kinetic Energy (EKE) in the region of the Antarctic Circumpolar Current (ACC). Increases of the EKE occur with delays of 1–4 years with respect to peaks in the zonal component of the wind stress. The persistent ACC meander located south of New Zealand (between 150°E and 180°W and 50°S to 66°S) responds to the interannual wind variations earlier than the entire ACC branch in the PSSO. In the same area, an estimate of the ACC transport based on in situ data shows interannual variability but no significant decadal trend over the study period. The effects of the EKE variability on the meridional eddy heat fluxes are significant on interannual scales. The strengthening of the EKE field leads to a local increase in the poleward meridional eddy heat fluxes in the PSSO, especially in the ACC band. The weakening of the EKE field defines an area of equatorward meridional eddy heat fluxes in the middle of the PSSO (south of 40°S, between 130°W and 160°W) and prevalent poleward fluxes in the further western and eastern regions