Reliability analysis of moment redistribution in reinforced concrete beams

Design codes allow a limited amount of moment redistribution in continuous reinforced concrete beams and often make use of lower bound values in the procedure for estimating the moment redistribution factors. Here, based on the concept of demand and capacity rotation, and by means of Monte Carlo simulation, a probabilistic model is derived for the evaluation of moment redistribution factors. Results show that in all considered cases, the evaluated mean and nominal values of moment redistribution factor are greater than the values provided by the ACI code. On the other hand, the 5th percentile value of moment redistribution factor could be lower than those specified by the code. Although the reduction of strength limit state reliability index attributable to uncertainty in moment redistribution factors is not large, it is comparable to the reduction in reliability index resulting from increasing the ratio of live to dead load

On the Thermodynamic Geometry and Critical Phenomena of AdS Black Holes

In this paper, we study various aspects of the equilibrium thermodynamic state space geometry of AdS black holes. We first examine the Reissner-Nordstrom-AdS (RN-AdS) and the Kerr-AdS black holes. In this context, the state space scalar curvature of these black holes is analysed in various regions of their thermodynamic parameter space. This provides important new insights into the structure and significance of the scalar curvature. We further investigate critical phenomena, and the behaviour of the scalar curvature near criticality, for KN-AdS black holes in two mixed ensembles, introduced and elucidated in our earlier work arXiv:1002.2538 [hep-th]. The critical exponents are identical to those in the RN-AdS and Kerr-AdS cases in the canonical ensemble. This suggests an universality in the scaling behaviour near critical points of AdS black holes. Our results further highlight qualitative differences in the thermodynamic state space geometry for electric charge and angular momentum fluctuations of these.Comment: 1 + 37 Pages, LaTeX, includes 31 figures. A figure and a clarification added

Hyperhomocysteinemia and Low Folate and Vitamin B12 Are Associated with Vascular Dysfunction and Impaired Nitric Oxide Sensitivity in Morbidly Obese Patients.

There is a high prevalence of hyperhomocysteinemia that has been linked to high cardiovascular risk in obese individuals and could be attributed to poor nutritional status of folate and vitamin B12. We sought to examine the association between blood homocysteine (Hcy) folate, and vitamin B12 levels and vascular dysfunction in morbidly obese adults using novel ex vivo flow-induced dilation (FID) measurements of isolated adipose tissue arterioles. Brachial artery flow-mediated dilation (FMD) was also measured. Subcutaneous and visceral adipose tissue biopsies were obtained from morbidly obese individuals and non-obese controls. Resistance arterioles were isolated in which FID, acetylcholine-induced dilation (AChID), and nitric oxide (NO) production were measured in the absence or presence of the NO synthase inhibitor, L-NAME, Hcy, or the superoxide dismutase mimetic, TEMPOL. Our results demonstrated that plasma Hcy concentrations were significantly higher, while folate, vitamin B12, and NO were significantly lower in obese subjects compared to controls. Hcy concentrations correlated positively with BMI, fat %, and insulin levels but not with folate or vitamin B12. Brachial and arteriolar vasodilation were lower in obese subjects, positively correlated with folate and vitamin B12, and inversely correlated with Hcy. Arteriolar NO measurements and sensitivity to L-NAME were lower in obese subjects compared to controls. Finally, Hcy incubation reduced arteriolar FID and NO sensitivity, an effect that was abolished by TEMPOL. In conclusion, these data suggest that high concentrations of plasma Hcy and low concentrations of folate and vitamin B12 could be independent predictors of vascular dysfunction in morbidly obese individuals

Perceptions on Awareness, Knowledge and Confidence in Providing Information and Management of Snake-related Injuries by Medical Students in Sarawak, Malaysia

The World Health Organization (WHO) has categorised snake-related injuries as a neglected tropical disease which can cause permanent disability, or worse, can lead to death if not treated timely and appropriately. Medical students are exposed to snakebite patients predominantly in their clinical years and depending on the location of their medical postings. This study aimed to determine the perceived awareness, knowledge and confidence level of medical students in providing information and managing snake-related injuries. A quantitative cross-sectional study was designed and the data were collected using a Likert scale questionnaire. The perceived awareness, knowledge and confidence level between pre-clinical and clinical students were tested by an independent sample t-test. A p-value of ≤ .05 was interpreted as statistically significant. Analysis revealed a statistically significant difference of perceived knowledge (p= .009) and perception of confidence level (p= .025) between clinical and pre-clinical students. However, no difference was found in terms of perceived awareness (p> .05). Clinical medical students have a better perception of knowledge and confidence level in providing information and managing snake-related injuries than pre-clinical students. An indepth study on this topic should be conducted to include all medical students in Malaysia. Steps should be taken to improve the knowledge and confidence level of medical students in managing snake-related injuries in Malaysia

Prevalence and Correlates of Common Mental Disorders among Mothers of Young Children in Kilimanjaro Region of Tanzania.

Although poor maternal mental health is a major public health problem, with detrimental effects on the individual, her children and society, information on its correlates in low-income countries is sparse. This study investigates the prevalence of common mental disorders (CMD) among at-risk mothers, and explores its associations with sociodemographic factors. This population-based survey of mothers of children aged 0-36 months used the 14-item Shona Symptom Questionnaire (SSQ). Mothers whose response was "yes" to 8 or more items on the scale were defined as "at risk of CMD." Of the 1,922 mothers (15-48 years), 28.8% were at risk of CMD. Risk of CMD was associated with verbal abuse, physical abuse, a partner who did not help with the care of the child, being in a polygamous relationship, a partner with low levels of education, and a partner who smoked cigarettes. Cohabiting appeared to be protective. Taken together, our results indicate the significance of the quality of relations with one's partner in shaping maternal mental health. The high proportion of mothers who are at risk of CMD emphasizes the importance of developing evidence-based mental health programmes as part of the care package aimed at improving maternal well-being in Tanzania and other similar settings

Thermodynamic Geometry and Phase Transitions in Kerr-Newman-AdS Black Holes

We investigate phase transitions and critical phenomena in Kerr-Newman-Anti de Sitter black holes in the framework of the geometry of their equilibrium thermodynamic state space. The scalar curvature of these state space Riemannian geometries is computed in various ensembles. The scalar curvature diverges at the critical point of second order phase transitions for these systems. Remarkably, however, we show that the state space scalar curvature also carries information about the liquid-gas like first order phase transitions and the consequent instabilities and phase coexistence for these black holes. This is encoded in the turning point behavior and the multi-valued branched structure of the scalar curvature in the neighborhood of these first order phase transitions. We re-examine this first for the conventional Van der Waals system, as a preliminary exercise. Subsequently, we study the Kerr-Newman-AdS black holes for a grand canonical and two "mixed" ensembles and establish novel phase structures. The state space scalar curvature bears out our assertion for the first order phase transitions for both the known and the new phase structures, and closely resembles the Van der Waals system.Comment: 1 + 41 pages, LaTeX, 46 figures. Discussions, clarifications and references adde

Thermodynamical Metrics and Black Hole Phase Transitions

An important phase transition in black hole thermodynamics is associated with the divergence of the specific heat with fixed charge and angular momenta, yet one can demonstrate that neither Ruppeiner's entropy metric nor Weinhold's energy metric reveals this phase transition. In this paper, we introduce a new thermodynamical metric based on the Hessian matrix of several free energy. We demonstrate, by studying various charged and rotating black holes, that the divergence of the specific heat corresponds to the curvature singularity of this new metric. We further investigate metrics on all thermodynamical potentials generated by Legendre transformations and study correspondences between curvature singularities and phase transition signals. We show in general that for a system with n-pairs of intensive/extensive variables, all thermodynamical potential metrics can be embedded into a flat (n,n)-dimensional space. We also generalize the Ruppeiner metrics and they are all conformal to the metrics constructed from the relevant thermodynamical potentials.Comment: Latex, 25 pages, reference added, typos corrected, English polished and the Hawking-Page phase transition clarified; to appear in JHE

What do patients want from their psychiatrist? A cross- sectional questionnaire based exploratory study from Karachi

<p>Abstract</p> <p>Background</p> <p>The aspects of consultation that are important for psychiatric patients have always remained a less acknowledged area. The aim of this study was to identify these aspects.</p> <p>Methods</p> <p>A Cross-sectional, questionnaire based study was carried out in a psychiatry outpatient clinic of two tertiary care hospitals in a developing country. The patients were asked to fill out the questionnaire containing a total of 11 close-ended questions plus 1 open-ended question. They graded them as not important, important, very important or do not know. Non-psychotic patients aged 18 and above, visiting the clinic were recruited into the study before they went in for their first consultation.</p> <p>Results</p> <p>The response rate of patients was 84%. More than 90% wanted the doctor to tell them the cause of their illness, talk to them about their condition, provide symptomatic relief, let them know that how long their illness would last and make the final decision about their treatment plan. Less than 20% wanted to be part of a support network. A significant 82% wanted talking therapy as part of their treatment plan.</p> <p>Conclusion</p> <p>The three issues, most important for patients were: the doctor should listen to them, make the final decision about treatment and provide symptomatic relief. Only 20% wanted to be a part of patients' support group.</p

Educating and Informing Patients Receiving Psychopharmacological Medications: Are Family Physicians in Pakistan up to the Task?

Introduction: Studies have shown a high prevalence of psychiatric illnesses among Patients in primary health care settings. Family physicians have a fundamental role in managing psychiatric illness with psychopharmacological medications. Providing information about the disease, its management and the potential adverse effects of the medications is an important part of the management of mental illnesses. Our objective was to determine if Patients who were prescribed psychopharmacological drugs by family physicians at a community health center in Karachi, Pakistan were provided adequate education about their disease and its management. Methods: A cross-sectional study was conducted at the Community Health Centre (CHC), Aga Khan University Hospital Karachi, Pakistan. Details about the prescriptions and Patient education were acquired from the Patients after their consultations. Results: A total of 354 adult Patients were interviewed during 3 days. Among them, 73 (20.6%) were prescribed psychopharmacological medications. Among Patients receiving psychopharmacological medicines, 37 (50.7%) did not know their diagnosis, 50 (68.5%) were unaware of the disease process, 52 (71.2%) were unaware of alternative treatments, 63 (86.3%) were not cautioned about the potential adverse effects of the drugs, 24 (32.9%) were unaware of the duration of treatment and in 60 (82.2%) of the participants an appropriate referral had not been discussed. For all aspects of education, Patients prescribed psychopharmacological medications knew less as compared to those Patients that were prescribed other medications. Discussion: The practice of imparting information to Patients who receive psychopharmacological medications seems to be inadequate in Pakistan. We have hypothesized about the possible reasons for our findings, and identified a need for further research to determine the cause for such findings and to address them accordingly. At the same time there is a need to educate family physicians in Pakistan about the special importance of providing adequate information to such Patients

Ears of the Armadillo: Global Health Research and Neglected Diseases in Texas

Neglected tropical diseases (NTDs) have\ud been recently identified as significant public\ud health problems in Texas and elsewhere in\ud the American South. A one-day forum on the\ud landscape of research and development and\ud the hidden burden of NTDs in Texas\ud explored the next steps to coordinate advocacy,\ud public health, and research into a\ud cogent health policy framework for the\ud American NTDs. It also highlighted how\ud U.S.-funded global health research can serve\ud to combat these health disparities in the\ud United States, in addition to benefiting\ud communities abroad