The loose end: neurology without rehabilitation

In recent years, successive therapies for previously untreatable neurological conditions have been introduced in clinical practice and these advance interventions have remarkably changed the landscape of neurosciences1,2 .But, rehabilitation of the functional impairments caused by neurological diseases is often overlooked or sometimes even neglected. In other words, the role of a comprehensive and early multidisciplinary rehabilitation in neurological disease is unrecognized and poorly understood even among neurologists and neurosurgeons. Usually, lifesaving neurosurgical management or solving a diagnostic riddle in neurology is attributed to successful patient management; however in reality, this is the first step in establishing a care plan for improving quality of life of these patients. The outcomes of neurological disorders are often related with disability, psychological dysfunction and social incapacitations3. Comprehensive rehabilitation completes the management of patients with neurological disorders as it focuses on minimizing disability, maximizing functional independence, improving quality of life and decreasing the complications of prolonged immobility4. Unfortunately, the understanding of rehabilitation is usually limited to provision of physical therapy in many parts of the world5

Will Islamic Banking make the World less risky? An Empirical Analysis of Capital Structure, Risk Shifting and Financial Stability

We use a classic Merton credit risk framework to argue that Islamic Banking Institutions (IBIs) face less incentive to take on risks than Conventional Banking Institutions (CBI). IBIs have less incentive for risk shifting both in and outside of distress situations. We test and confirm this prediction in an empirical analysis based on a dataset covering all CBIs, IBIs, and Islamic and conventional subsidiaries of mixed banking institutions in Pakistan. We find that full-fledged Islamic banks (IBs) are indeed more stable than conventional banking institutions (CBIs), and are better capitalized than their conventional counterparts. IBIs also have less volatile asset returns, less non-performing loans (NPLs) and lower loan loss provisioning. Similar results obtain for Islamic windows of mixed banks compared with conventional windows. The analysis suggests that the loss absorption capacity of Islamic banks leads to less risk taking and a more stable banking system

Prevalence of anxiety and depressive symptoms and their association with multimorbidity and demographic factors: a community-based, cross-sectional survey in Karachi, Pakistan

Objective: This study aimed to estimate the prevalence of anxiety and depressive symptoms and their association with multimorbidity and the demographic characteristics of adults aged 30 years and above in Karachi, Pakistan. Design: Observational cross-sectional study. Study setting and participants: The study was carried out among a general population aged 30 years and above residing in the Gulshan-e-Iqbal town of Karachi, Pakistan. The study participants were recruited using the systematic random sampling approach based on the inclusion criteria. The data collected from 2867 participants were analysed. Main outcome measures: The primary outcome of the study was the prevalence of anxiety and depressive symptoms, measured with the Aga Khan University Anxiety Depression Scale. The secondary outcome was the association of anxiety and depressive symptoms with multimorbidity as well as with the sociodemographic characteristics of the participants, using binary logistic regression. Results: Out of 2867 individuals, 27.4% reported having anxiety and depressive symptoms. The multivariate logistic regression model revealed that the presence of multimorbidity (adjusted OR (AOR)=1.33, 95% CI 1.11 to 1.58), female gender (AOR=2.40, 95% CI 2.01 to 2.87), illiteracy (AOR=1.51, 95% CI 1.09 to 2.07), more children (AOR=0.74, 95% CI 0.59 to 0.93) and visiting a faith healer (AOR=2.29, 95% CI 1.82 to 2.88) were the significant factors associated with anxiety and depressive symptoms. Conclusion: This study revealed a moderately high prevalence of anxiety and depressive symptoms among adults aged 30 years and above in Karachi, Pakistan. The key variables associated with anxiety and depressive symptoms were multimorbidity, female gender, lower level of education, more children and visiting faith healers

Potent Implications of miRNA in Cancer Biology – A Brief Review

Groundbreaking findings through high-throughput technologies have deepened our understanding on an intricate interplay between products of coding sequences and noncoding RNAs. Increasingly it is being realized that miRNA, produced from what was previously considered as "genomic trash" have revolutionized the field of molecular and translational oncology. Overwhelmingly accumulating in-vitro and in-vivo studies have demonstrated that miRNA are key players involved in post-transcriptional regulation of gene network in numerous human pathologies including cancer. In this review we have attempted to provide recent advancements related to multifaceted roles played by miRNA in modulation of oncogenes and tumor suppressor genes

Effect of Convergent Angle on different Flow Parameters of a Convergent-Divergent Nozzle

Nozzle is defined as a device which is being used to convert the pressure energy into the kinetic energy. It basically controls the mass flow rate, pressure and velocity of the fluid stream. Consisting of three sections convergent, throat and divergent section, this device basically converts subsonic flow into supersonic flow. An extensive study have been conducted by the authors in the past about the divergent angle effect on flow parameters of a C-D (Convergent-Divergent) nozzle. In this paper, detailed study have been done to find the most optimum value of convergent angle of a C-D nozzle for the best flow parameters. Convergent angles under consideration are 15°, 20°, 25°, 30° and 35°

Artificial neural network based adaptive control of single phase Dual Active Bridge with finite time disturbance compensation

Single phase Dual Active Bridge (DAB) has found numerous applications in modern energy architectures such as direct current (DC) microgrid, electrical vehicle charging and high voltage direct current (HVDC) system. Due to the model complexities of DAB, this work proposes a model free adaptive control method based on artificial neural network (AANN) which is capable of adjusting the weights online in finite time. The finite time learning property of the proposed controller makes it perfectly robust for the compensation of the disturbances due to source and load side variations. A proportional integral (PI) controller is used to stabilize the nominal dynamics of the system along with the AANN controller. The structure of the proposed controller is as simple as PID controller and as robust as any nonlinear control method. The AANN-PI controller is implemented on TI Launchpad (TMS320F28379D) with a 50 Watts laboratory scale DAB test bench. Finally, the performance of the AANN-PI method is compared experimentally with classical PI and sliding mode controllers

Coping styles in patients with anxiety and depression

Different individuals use different coping styles to cope with their problems. In patients with anxiety and/or depression, these have important implications. The primary objective of our study was to estimate the frequency of different coping mechanisms used by patients with symptoms of anxiety and depression. A descriptive, cross-sectional survey was conducted and patients with symptoms of anxiety and depression were identified using the Aga Khan University\u27s Anxiety and Depression Scale (AKUADS). Coping styles were determined by using the 28-item Brief COPE inventory. We were able to recruit 162 people. The prevalence of anxiety and depression was found to be 34%. Females were more than 2 times likely to have anxiety and depression (P value = 0.024, OR = 2.62). In patients screening positive for AKUADS, religion was the most common coping mechanism identified. Acceptance , Use of instrumental support , and Active coping were other commonly used coping styles. Our findings suggest that religious coping is a common behavior in patients presenting with symptoms anxiety and depression in Pakistan. Knowledge of these coping styles is important in the care of such patients, as these coping methods can be identified and to some extent modified by the treating clinician/psychiatrist

A computationally efficient robust voltage control for a single phase dual active bridge

This paper proposes fractional and integer order sliding mode controllers (SMC) for the high voltage (HV) bridge control in a bidirectional dual active (DAB) converter. The proposed controllers are derived based on nonlinear model of DAB converter and the closed loop stability is ensured using integer and fractional order Lyapunov theorems. Fractional order controllers offer more degree of freedom to adjust the desired response of the system, however the implementation issues of such controllers are rarely explored. Both variants of control schemes are implemented on a DSP control card, and hardware-in-the-loop (HIL) and processor-in-the-loop (PIL) experiments are conducted using rapid control prototyping technique. In order to choose the most suitable robust controller, experimental data for the two performance indices namely robustness and computational resources utilization is compared for both integer and fractional order control schemes. The experimental results demonstrate that the integer order SMC utilizes reduced computational resources as compared to the fractional order SMC. Moreover it is further verified that integer order SMC exhibits comparable robustness as fractional order SMC under all test conditions

Treat me well and I may leave you kindly: A configurational approach to a buyer’s relationship exit strategy

Research shows that the choice of relationship exit strategy by the instigator of exit can have significant negative consequences for the party that is being dropped. In this study we focus on what we coin as kind exit, where the risk of harm to the supplier as a result of the buyer’s relationship termination is low. In line with current research, which is suggesting that the characteristics of a buyer-supplier relationship play a critical role in the instigator’s choice of exit strategy, we examine the link between the buyer’s perception of its relationship with the supplier and the manner in which the buyer-supplier relationship ends. We posit that this phenomenon is causally complex and context dependent, and as such, there will be multiple types of buyer-supplier relationships that will lead to a kind exit. To uncover these types, we examine 315 terminated buyer-supplier relationships in manufacturing and service sectors in the UK, employing fuzzy set qualitative comparative analysis (fsQCA). Our results show that contrary to extant literature, there is not one relationship type that leads to a kind exit; instead, we uncover four alternative equifinal configurations of relationship dimensions and two exogenous factors