Community intervention for cardiovascular disease risk factors in Kalutara, Sri Lanka.

BACKGROUND:The effectiveness of a 2015-17 community intervention to reduce cardiovascular disease (CVD) and type 2 diabetes (T2DM) risk factors is assessed in a Sri Lanka adult population, using a before-and-after study design. METHODS:Four contiguous Public Health Midwife (PHM) areas in Kalutara district (Western Province) were exposed to a Sri Lankan designed community health promotion initiatives (without screening) to lower CVD and T2DM risk factors. Pre- and post-intervention surveys (2014, n=1,019; 2017, n=908) were of 25-64 year males (M) and females (F) from dissimilar randomly selected clusters (villages or settlements) from PHMs, with probability of selection proportional to population size, followed by household sampling, then individual selection to yield equal-probability samples. Differences in resting blood pressure (BP), fasting plasma glucose (FPG), total cholesterol, body mass index and tobacco smoking, adjusting for cluster sampling, age and socio-economic differences, were examined. RESULTS:Hypertension prevalence declined from 25% to 16% (F) (p<.0001), and 21% to 17% (M). Both mean systolic and diastolic BP declined. T2DM declined from 18% to 13% (F), and 18% to 15% (M), as did mean fasting plasma glucose. Elevated total cholesterol declined from 21% to 15% in women (p=0.003) and mean cholesterol declined. Frequency distributions, medians and means of these continuous CVD risk factors shifted to lower levels, and were mostly statistically significant (p< 0.05). CONCLUSIONS:Community health promotion can lower key CVD and T2DM risk factors. Lowering tobacco consumption in males and obesity remain challenges in Sri Lanka

Complete genome sequence of the Medicago microsymbiont Ensifer (Sinorhizobium) medicae strain WSM419

Ensifer (Sinorhizobium) medicae is an effective nitrogen fixing microsymbiont of a diverse range of annual Medicago (medic) species. Strain WSM419 is an aerobic, motile, non-spore forming, Gram-negative rod isolated from a M. murex root nodule collected in Sardinia, Italy in 1981. WSM419 was manufactured commercially in Australia as an inoculant for annual medics during 1985 to 1993 due to its nitrogen fixation, saprophytic competence and acid tolerance properties. Here we describe the basic features of this organism, together with the complete genome sequence, and annotation. This is the first report of a complete genome se-quence for a microsymbiont of the group of annual medic species adapted to acid soils. We reveal that its genome size is 6,817,576 bp encoding 6,518 protein-coding genes and 81 RNA only encoding genes. The genome contains a chromosome of size 3,781,904 bp and 3 plasmids of size 1,570,951 bp, 1,245,408 bp and 219,313 bp. The smallest plasmid is a fea-ture unique to this medic microsymbiont

Basic Rules of Aristotelian logic and Induction

We study comprehensive analysis of the inductive arguments done by various researchers. These researchers have surveyed the basic concepts in logic such as statement, argument, premise, conclusion, deductive argument, inductive argument, primitive terms and axioms. The fundamental laws of Aristotelian logic and Hume's critique of induction are briefly discussed. We argue that all the basic rules of Aristotelian logic are inductively obtained generalized abstract statements. Existence of undefined terms is also analyzed. We conclude that every argument based on Aristotelian logic is a result of induction

Methods of Reasoning in Scientific Discovery

In this paper, we briefly discuss the forms of arguments and the methods of reasoning in scientific experiments, namely, inductive reasoning, abductive reasoning and deductive reasoning. We find that generalization is in human nature, and it is only a conception without any perception. The short comings of the applications of deductive reasoning and inductive reasoning are analyzed using examples. It is observed that deductive reasoning and inductive reasoning methods are invalid in scientific reasoning. We discuss the vulnerability of the foundation of science that is based on the methods of inductive reasoning and deductive reasoning. We find that it is by abductive reasoning that theories are constructed to explain empirical observations. Abductive reasoning is only the reasoning method that can be applied for the observations in the empirical world. Finally, we conclude that the best and the most effective method of reasoning is the abductive reasoning for scientific experiments

n-Fold m-Valued Logic

In this paper, the basic concepts of two valued logic, many valued logic and catuskoti logic are discussed. We comprehensively analyzed the statement in different branches of logic. We define a ‘fold’ and a ‘statement’ in catuskoti. We further defined a ‘fold’ in general, a ‘multi valued statement’ and ‘ fold   valued logic’ (where  are integers greater than or equal to two). We identify that every branch of logic could be expressed in the form of fold  valued logic. We explain the problem of drawing a tangent to a curve and Zeon's arrow paradox by using the fold  valued logic. Truth tables for negation, conjunction, disjunction and implication in the fold  valued logic are discussed in this paper

Association between chorionicity and preterm birth in twin pregnancies: a systematic review involving 29 864 twin pregnancies

Background The perinatal mortality and morbidity among twins vary by chorionicity. Although it is considered that monochorionicity is associated with an increased risk of preterm birth in twin pregnancies, no systematic review exists evaluating this association. Objectives This systematic review was undertaken to assess the association between preterm birth and chorionicity in twin pregnancies. Search strategy We searched the electronic databases from January 1990 to July 2019 without language restrictions. Selection criteria All studies on twin pregnancies where chorionicity and preterm birth were evaluated were included. Data collection and analysis Findings are reported as odds ratios with 95% confidence intervals. The estimates are pooled using random‐effects meta‐analysis. Main results From 13 156 citations, we included 39 studies (29 864 pregnancies). Monochorionicity was significantly associated with increased risk of preterm birth at ≤28, ≤32, ≤34 and <37 weeks in women asymptomatic and symptomatic for preterm labour (odds ratio [OR] 2.14, 95% CI 1.52–3.02, I2 = 46%, OR 1.55, 95% CI 1.27–1.89 I2 = 68%, OR 1.47, 95% CI 1.27–1.69, I2 = 60%, OR 1.66, 95% CI 1.43–1.93, I2 = 65%, respectively). Among those asymptomatic for preterm labour, significantly increased odds of preterm birth were seen for monochorionicity at gestations ≤34 weeks (OR 1.85, 95% CI 1.42–2.40, I2 = 25%) and <37 weeks (OR 1.75, 95% CI 1.22–2.53, I2 = 61%). Sensitivity analysis showed significantly increased odds of spontaneous preterm birth at ≤34 and <37 weeks for monochorionicity (OR 1.25, 95% CI 1.01–1.55, I2 = 0% and OR 1.41, 95% CI 1.13–1.78, I2 = 0%). Conclusions Monochorionicity is significantly associated with preterm birth at all gestations

Maternal and perinatal outcomes in twin pregnancies following assisted reproduction: a systematic review and meta-analysis involving 802 462 pregnancies.

BACKGROUND: ART is associated with higher rates of twin pregnancies than singleton pregnancies. Whether twin pregnancies conceived following ART have additional maternal and neonatal complications compared with non-ART twin pregnancies is not known. OBJECTIVE AND RATIONALE: The objective was to quantify the risk of adverse maternal and perinatal outcomes among twin pregnancies conceived following ART compared with non-ART and natural conception. Existing reviews vary in the reported outcomes, with many studies including triplet pregnancies in the study population. Therefore, we aimed to perform an up-to-date review with an in-depth analysis of maternal and perinatal outcomes limited to twin pregnancies. SEARCH METHODS: We searched electronic databases MEDLINE and EMBASE from January 1990 to May 2023 without language restrictions. All cohort studies reporting maternal and perinatal outcomes following ART compared with non-ART twin pregnancies and natural conception were included. Case-control studies, case reports, case series, animal studies, and in vitro studies were excluded. The Newcastle-Ottawa Scale was used to assess the methodological quality of the studies. Using random-effects meta-analysis, the estimates were pooled and the findings were reported as odds ratios (OR) with 95% CI. OUTCOMES: We included 111 studies (802 462 pregnancies). Twin pregnancies conceived following ART were at higher risk of preterm birth at 25% (OR 1.31, 95% CI 1.05-1.63, 7 studies, I2 = 0%)), respiratory distress syndrome (OR 1.32, 95% CI 1.09-1.60, 16 studies, I2 = 61%), and neonatal intensive care unit admission (OR 1.24, 95% CI 1.14-1.35, 32 studies, I2 = 87%) compared with non-ART twins. When comparing ART with natural conception, the risk of respiratory distress syndrome, intensive care admissions, and birthweight discordance >25% was higher among the ART group. Perinatal complications, such as stillbirth (OR 0.83, 95% CI 0.70-0.99, 33 studies, I2 = 49%), small for gestational age <10th centile (OR 0.90, 95% CI 0.85-0.95, 26 studies, I2 = 36%), and twin-twin transfusion syndrome (OR 0.45, 95% CI 0.25-0.82, 9 studies, I2 = 25%), were reduced in twin pregnancies conceived with ART versus those without ART. The above perinatal complications were also fewer amongst the ART group than natural conception. WIDER IMPLICATIONS: ART twin pregnancies are associated with higher maternal complications than non-ART pregnancies and natural conception, with varied perinatal outcomes. Women seeking ART should be counselled about the increased risks of ART twin pregnancies and should be closely monitored in pregnancy for complications. We recommend exercising caution when interpreting the study findings owing to the study's limitations