Indefinite Morse 2-functions; broken fibrations and generalizations

A Morse 2-function is a generic smooth map from a smooth manifold to a surface. In the absence of definite folds (in which case we say that the Morse 2-function is indefinite), these are natural generalizations of broken (Lefschetz) fibrations. We prove existence and uniqueness results for indefinite Morse 2-functions mapping to arbitrary compact, oriented surfaces. "Uniqueness" means there is a set of moves which are sufficient to go between two homotopic indefinite Morse 2-functions while remaining indefinite throughout. We extend the existence and uniqueness results to indefinite, Morse 2-functions with connected fibers.Comment: 74 pages, 41 figures; further errors corrected, some exposition added, other exposition improved, following referee's comment

Intra- and Extra-articular Features of Temporomandibular Joint Ankylosis in the Cat (Felis catus).

Temporomandibular joint (TMJ) ankylosis is an uncommon clinical entity in human and veterinary medicine. However, the condition is severely debilitating and is life-limiting if not treated. This study sought to characterize the intra- and extra-articular features of naturally occurring TMJ ankylosis in cats. TMJs from client-owned cats (n = 5) that underwent bilateral TMJ gap arthroplasty were examined and compared with TMJs from healthy, age-matched feline cadavers (n = 2) by cone-beam computed tomography (CBCT), micro-computed tomography (μCT) and histologically. Features of bilateral intra- and extra-articular ankylosis compounded by degenerative joint lesions were identified radiographically and histologically in all affected cats. Features of TMJ 'true' ankylosis included variable intracapsular fibro-osseous bridging, degeneration of the disc and the articular surfaces, narrowing of the joint space and flattening of the condylar process of the mandible. Extra-articular features of TMJ ankylosis included periarticular bone formation and fibro-osseous bridging between the mandible, zygomatic arch and coronoid process. In addition, subchondral bone loss or sclerosis, irregular and altered joint contours and irregularly increased density of the medullary bone characterized the degenerative changes of the osseous components of the TMJ. Complex radiological and histological features of both ankylosis and pseudoankylosis were identified that clinically manifested in complete inability to open the mouth

Health seeking behaviour and health service utilization in Pakistan: challenging the policy makers

There is a growing literature on health seeking behaviours and the determinants of health services utilization especially in the context of developing countries. However, very few focused studies have been seen in Pakistan in this regard. This paper presents an extensive literature review of the situation in developing countries and relates the similar factors responsible for shaping up of a health seeking behaviour and health service utilization in Pakistan. The factors determining the health behaviours may be seen in various contexts: physical, socio-economic, cultural and political. Therefore, the utilization of a health care system, public or private, formal or non-formal, may depend on socio-demographic factors, social structures, level of education, cultural beliefs and practices, gender discrimination, status of women, economic and political systems environmental conditions, and the disease pattern and health care system itself. Policy makers need to understand the drivers of health seeking behaviour of the population in an increasingly pluralistic health care system. Also a more concerted effort is required for designing behavioural health promotion campaigns through inter-sectoral collaboration focusing more on disadvantaged segments of the population

Health seeking behaviour and health services utilization trends in national health survey of Pakistan: what needs to be done?

In developing countries, health seeking behaviours and health care services utilization patterns have been studied and the determinants have been classified in physical, socio-economic, cultural and political contexts. This paper is based on a systematic review of peer-reviewed literature on the relationship of factors affecting health service utilization and the focus has been on Pakistan. For this purpose, National Health Survey (NHS) of Pakistan, conducted in 1990-1994, has been critically reviewed. The review reveals specific behaviours following gender differences, socio-cultural milieu, disease patterns, household economics etc. Thus it becomes imperative to design evidence based policies by developing the understanding of health behaviours and health care utilization trends and to give enough credence to all determinants in the background. Health sector reforms therefore necessitate developing mechanisms to deliver more need based and quality services, considering thoughtfully users\u27 concerns and perspectives. The advent of decentralization in Pakistan provides a unique opportunity for tackling multi-faceted issues by multisectoral approaches

Schrijver graphs and projective quadrangulations

In a recent paper [J. Combin. Theory Ser. B}, 113 (2015), pp. 1-17], the authors have extended the concept of quadrangulation of a surface to higher dimension, and showed that every quadrangulation of the $n$-dimensional projective space $P^n$ is at least $(n+2)$-chromatic, unless it is bipartite. They conjectured that for any integers $k\geq 1$ and $n\geq 2k+1$, the Schrijver graph $SG(n,k)$ contains a spanning subgraph which is a quadrangulation of $P^{n-2k}$. The purpose of this paper is to prove the conjecture

Potential Benefits on Impairment of Endothelial Function after a High-Fat Meal of 4 Weeks of Flavonoid Supplementation

Studies with foods high in flavonoids have demonstrated improvement in endothelial function. We investigated whether 4 weeks of flavonoid supplementation would prevent an adverse impact on endothelial function of a high-fat meal. Endothelial function was measured by reactive hyperemia peripheral arterial tonometry (RH-PAT). The RH-PAT index was measured both before and 3 h after a high-fat meal, in 23 healthy volunteers. Subjects were randomized in a double-blind, cross-over design to 4 weeks of daily supplementation with OPC-3, or a matching placebo. RH-PAT index before and after the high-fat meal was measured at the beginning and end of each 4-week treatment phase. The high-fat meal caused a decline in endothelial function at baseline in the placebo (-10.71%, P = .006) and flavonoid [-9.97% (P = .077)] groups, and there was no difference in decline between arms (P = .906). The high-fat meal produced a decline after 4 weeks of placebo [-12.37% (P = .005)], but no decline after 4 weeks of flavonoid supplement [-3.16% (P = .663)], and the difference between the two responses was highly significant (P < .0001). Within-group comparisons revealed no difference in endothelial function decline in the placebo arm between baseline and 4 weeks [-10.71% versus -12.37% (P = .758)]. In the flavonoid supplement arm, the difference in endothelial function decline between baseline and 4 weeks was -9.97% versus -3.16%, but did not reach statistical significance (P = .451). These results suggest that the flavonoid supplement used in this study mitigates the impairment of endothelial function caused by a high-fat meal. Whether certain subpopulations derive greater or lesser benefit remains unclear