Equally Distributed Research Articles

Exploring Mental Health Literacy and Its Associated Factors: A National Cross-Sectional Study in Saudi Arabia, 2023.

The aim of this study is to examine, for the first time, the mental health literacy of the Saudi general population. Additionally, we aim to identify demographic factors associated with elevated mental health literacy scores. A cross-sectional study using a phone interview survey with quota sampling was conducted for equal distribution of sexes, age and administrative regions. Mental health literacy was assessed by the previously validated mental health literacy scale (MHLS). The MHLS ranges from 35 to 160, and a higher score indicates greater level of mental health literacy. In this study, 4,547 (70.2%) agreed to complete the interview. The sample was equally distributed across Saudi Arabia's 13 administrative regions with 50.1% female and mean age 35.9 (SD: ±12.8). In terms of education, 55.1% have a bachelor's degree or above. The nationally weighted score on the original MHLS was 110.75. the MHLS Saudi validation score was influenced by various variables including: marital status, healthcare-related job, sex, education level, and proximity to individuals with mental health issues. The study offers data for the first time on Saudi Arabian mental health literacy status. The high MHLS score reflects good societal awareness and understanding of mental health related concepts and issues in the Saudi population. The results of this study set the baseline for mental health literacy in Saudi Arabia. Future research may focus on utilizing the validated MHLS and the method used in this study to explore the effect of other social and individual factors on mental health literacy.

Histological classification of Japanese IgA nephropathy with a small number of glomeruli using Bayes’ theorem

In Japan an original pathological classification of IgA nephropathy was used, while Oxford classification of IgA nephropathy was used globally. The Oxford classification requires ≥ 8 glomeruli while the Japanese classification requires ≥ 10. Ninety-nine patients diagnosed with IgA nephropathy were included. To determine the accuracy of histological staging, we calculated the posterior probability using Bayes' theorem and adopted three model of prior distribution. First, the actual staging distribution was reclassified using the beta distribution (reclassified distribution). Second a model with the same distribution (actual distribution) as the actual staging was used. Third, a model assuming that all cases are equally distributed (equal distribution) was used. The median number of collected glomeruli was 12 (8–19). There were 33 cases (33%) wherein the glomerular count was ≤ 9. When only cases with ≥ 10 glomeruli were included, the median posterior probability was 91% (74–99) (actual distribution, 90% [74–98]; equal distribution, 85% [73–96]). Even among the 33 cases with ≤ 9 glomeruli, there were approximately 7 cases in which the posterior probability was ≥ 90% for each model. Using Bayesian probabilistic analysis, it was possible to evaluate the histologic classification of IgA nephropathy, even when the number of obtained glomeruli was ≤ 9.

#5114 THE GENOTYPE DISTRIBUTION IN A SINGLE-CENTRE COHORT OF PATIENTS WITH POLYCYSTIC KIDNEY DISEASE

Abstract Background and Aims Polycystic kidney disease (PKD) is one of the most common causes of chronic kidney disease (CKD) and could lead to the end-stage kidney disease (ESKD) both in adulthood and in childhood. In the last few years many genes were discovered to be associated with PKD beyond the classical genes PKD1 and PKD2, that account for the majority of patients with ADPKD (Autosomal Dominant Polycystic Kidney Disease), and PKHD1 and DZIPIL that are responsible of ARPKD (Autosomal Recessive Polycystic Kidney Disease). The new genes are associated with different type of extra-renal involvement and with variable chance to develop CKD or ESKD. Thus, it is important for clinicians to define what mutation is involved in each patient to improve care in a context of precision medicine. We here describe a cohort of 65 consecutive patients followed at our PKD outpatient clinic who underwent the genetic analysis. Method We conducted a retrospective study of patients followed at our PKD outpatient clinic who underwent a genetic test for clinical reasons. We recorded why test was performed, with which modality and what was the result. If the analysis was positive we analyzed if only one or more genes were found mutated and if they belong to new genes described as being involved in PKD or if they are usually described in association with different diseases. Then, we collected demographic and clinical information (age, sex, renal function/presence of absence of ESKD) and the radiological description of kidneys in order to distinguish between typical and atypical PKDs. Results Among the 65 patients of our cohort 28 (43%) were males and 37 (57%) were females, the mean age was 56±18.6 years old; 20% had ESKD. They underwent genetic analysis for different reasons: 31 because of atypical PKD forms, 6 to define a suspected de novo mutation, 14 as a familiar screening and 14 for a better prognosis definition or when they approached the kidney transplant. The genetic analysis was conducted in two main ways: sequencing of PKD1 and PKD2 genes according to modern standards or exome sequencing. The first type of analysis was used for typical ADPKD forms whereas the second type was used when patients displayed an atypical presentation for both cysts distribution and kidney diameter (usually not enlarged kidneys with multiple bilateral cysts) and in two patients in which PKD1 and PKD2 sequencing was negative despite the PKD phenotype. We found that 25% of patients were negative, and the others are almost equally distributed between typical gene mutations and mutations in other genes (40% and 35% respectively) (Figure 1A). Of those with typical mutation, 81% was PKD1 positive and 19% PKD2 positive, a distribution that reflects that of literature (Figure 1B). Of those with other genes positivity: 52% had a DNAJB11 mutation, 17% a mutations in other PKD genes (ALG8, LRP5, PKHD1, COL4A1, IFT140), 32% had a mutation in genes usually associated with CAKUT (congenital anomalies of kidney and urinary tract) or with syndromic or extra-renal diseases (Figure 1C). 18 patients presented with multiple mutations, usually 2, in one case three and in another 4. Of them, the 22% had a double PKD1 mutation, while the others showed mutations in different genes associated with syndromic or extra-renal diseases (Figure 1D). Conclusion Our cohort revealed a wide variety of genetic mutations and also an almost equal distribution between typical genes and atypical/other genes. This could be the result of the small number of patients involved and of the monocentric design of the study (we have a cluster of patients with DNAJB11 belonging to the same small geographical area), but also of the larger inclusion of patients presenting with atypical PKDs. Unfortunately a 25% of patients remained genetically unresolved despite the use of exome sequencing.

Equal distribution of lipid droplets in daughter cells is regulated by microtubules

ABSTRACT During eukaryotic cell division, organelles are distributed between daughter cells through a dynamic process to ensure that cells can differentiate and perform their functions correctly. Uncovering the mode of lipid droplet (LD) distribution may help reveal the mechanism of membrane remodeling during cell division and lipid droplet function. Our results showed that LDs were equally distributed in both daughter cells during cytokinesis. Further experiments demonstrated that the key factor regulating the movement of LDs is the microtubule (MT)-resident protein KIF5B. Because the KIF5B structure lacks a hydrophilic region, we believe that there are proteins that mediate the interaction between LDs and KIF5B. Mass spectrometric detection of KIF5B-interacting proteins on the surface of LDs demonstrated that LDs were first wrapped by intermediate filaments forming a meshwork and then contacted with MTs to mediate lipid droplet movement during cytokinesis. Disruption of the homogeneous distribution of LDs may hinder cell proliferation and even lead to apoptosis.

Responsible Citizens, Irresponsible States: Should Citizens Pay for Their State’s Wrongdoings?

<i>Responsible Citizens, Irresponsible States: Should Citizens Pay for Their State’s Wrongdoings?</i>

Oral Prevalence of Akkermansia muciniphila Differs among Pediatric and Adult Orthodontic and Non-Orthodontic Patients.

Akkermansia muciniphila (AM) is one of many highly abundant intestinal microbes that influences homeostasis and metabolic disorders and may also play a role in oral disorders. However, there is little evidence regarding the oral prevalence of this organism. Based upon this lack of evidence, the primary goal of this project is to survey an existing saliva repository to determine the overall prevalence of this organism and any associations with demographic or patient characteristics (age, sex, body mass index, race/ethnicity, orthodontic therapy). Using an approved protocol,, a total n = 141 pediatric samples from an existing saliva repository were screened using qPCR revealing 29.8% harbored AM with nearly equal distribution among males and females, p = 0.8347. Significantly higher percentages of pediatric, non-orthodontic patients were positive for AM (42.3%) compared with age-matched orthodontic patients (14.3%)-which were equally distributed among non-orthodontic males (42.1%) and non-orthodontic females (42.5%). In addition, analysis of the adult samples revealed that nearly equal percentages of males (18.2%) and females (16.7%) harbored detectable levels of salivary AM, p = 0.2035. However, a higher proportion of non-orthodontic adult samples harbored AM (21.3%) compared to orthodontic samples (12.8%, p = 0.0001), which was equally distributed among males and females. These results suggest that both age and the presence of orthodontic brackets may influence microbial composition and, more specifically, are associated with reduction in AM among both pediatric and adult populations from their baseline levels.

Validity of CHA2DS2-VASc score in patients with malignancies

Abstract Introduction Anticoagulation for patients with atrial fibrillation/flutter (AF) after risk stratification based on CHA2DS2-VASc score (congestive heart failure, hypertension, age group, Diabetes Mellitus, prior stroke, transient ischemic attack or thromboembolism, prior heart attack, peripheral artery disease or aortic plaque and patient's gender) has been the gold standard practice to prevent cerebrovascular accidents (CVA). Purpose Since patients with malignancies are at increased risk of thrombophilia, we tried to study if cancer patients with atrial fibrillation are at increased risk for CVA beyond what should be expected based on their comorbidities. Methods We used the Nationwide Readmissions Database (NRD) database for the years 2016–2019. First, we extracted all cases with a diagnosis of atrial fibrillation/flutter. Exclusion criteria included patients younger than 18-year-old. We studied the comorbidities and calculated CHA2DS2-VASc score. Then, we compared the risk for admission with an acute CVA in patients with and without any diagnosis of malignancies (solid cancer, leukemia, lymphoma or metastatic disease). Patients with carcinoma in situ were considered non-cancer patients. Corrected logistic regression and Chi-square tests using survey procedures in SAS 8.1 were applied to accommodate for complex sampling (Rao-Scott design). Results We identified 1,748,619 weighted admissions with AF equally distributed across the years. 5% were patients with malignancies. The mean age was 74-year-old for cancer patients and 71-year-old for non-cancer patients with quite equal gender distribution (43–49% were female). Patients with a diagnosis of cancer has high inpatient mortality (13%). Every additional point in CHA2DS2-VASc score was associated with increased odds of admission with CVA. Having a diagnosis of cancer was not associated with increased odds of admission with CVA (odd ratio for 95% confidence interval 1.0 [0.95–1.1]). Patients with history of VTE (assuming they are on anticoagulation) or who are on chronic anticoagulation have lower risk of admission with acute CVA if they have AF. Conclusions Although malignancies is associated with hypercoagulable status including higher risk for stroke, deep venous thrombosis and pulmonary embolism, our cross-sectional study indicates that CHA2DS2-VASc score is still a reliable tool for risk stratification in patients with atrial fibrillation. More longitudinal studies are needed. Funding Acknowledgement Type of funding sources: None.

Progression From Subclinical Inflammation to Overt Spondyloarthritis in First-Degree Relatives of Patients in Association With HLA-B27: The Pre-Spondyloarthritis Cohort.

As first-degree relatives (FDRs) of HLA-B27-positive patients with axial spondyloarthritis (SpA) have an increased risk of developing axial SpA, the objectives were 1) to evaluate the presence of highly specific imaging features as well as clinical signs of SpA at baseline and after 1 year of follow-up, and 2) to describe the evolution toward clinical disease within 1 year of follow-up in a cohort of seemingly healthy FDRs of HLA-B27-positive axial SpA patients. The Pre-SpA cohort is a 5-year prospective inception cohort of seemingly healthy FDRs of HLA-B27-positive axial SpA patients. Clinical and imaging features were collected and recorded. At baseline, 19% of the FDRs reported inflammatory back pain, 32% current arthralgia, 3% arthritis (ever), 5% enthesitis (ever), and 1% dactylitis (ever), and 3% had an extraarticular manifestation. C-reactive protein level was elevated in 16%, and erythrocyte sedimentation rate was elevated in 7%. On magnetic resonance imaging (MRI) views of sacroiliac joints, 10% had a Spondyloarthritis Research Consortium of Canada score of ≥2, 4% had a score of ≥5, and 4% had deep lesions. In total, 1% fulfilled the modified New York criteria for radiographic sacroiliitis. Clinical, MRI, and acute phase findings were equally distributed between HLA-B27-positive and -negative FDRs. After 1 year of follow-up, clinical parameters did not change on the group level, but 6% of the FDRs were clinically diagnosed with axial SpA, of whom 86% were HLA-B27-positive. Features associated with SpA or imaging abnormalities were found in up to 32% of seemingly healthy FDRs, with an equal distribution between HLA-B27-positive and -negative FDRs. Progression to clinical axial SpA within 1 year of follow-up was mainly observed in HLA-B27-positive FDRs.

Maldistribution on a Vertical Manifold With Guide Vanes

Abstract Wall-Modeled Large Eddy Simulation (WMLES) has been used to study a subsonic vertical manifolds (VMs) in terms of maldistribution, i.e., how much the flow splitting deviates from an equal flow distribution between the outlets. The analyzed configuration is characterized by a wide-angle plane diffuser and by four outlets and it has been studied at high Reynolds number (Re*=10000, with Re*=u*Dh/ν, where u* is the friction velocity at the inlet, Dh=4A/P is the hydraulic diameter with A the cross-sectional area at the inlet and P the perimeter, ν is the kinematic viscosity). In the basic configuration, a jet flow develops in the diffuser with two stable flow separation regions at the inclined walls, which prevent an equal flow distribution at the outlets, and determine a maldistribution around ε=37%, where ε is a parameter that quantifies the flow rate deviation from an equal distribution. To increase the equal flow distribution between the outlets, guide vanes have been used. A conceptual model to reduce the maldistribution has been developed using the momentum and the mechanical energy conservation laws. The model uses as main parameter the relative distance between the guide vanes, and it allows to minimize ε. Taking advantage of this method, the maldistribution has been reduced from ε=11.20%, for the case of equally distributed guide vanes, to ε=0.32% in the optimized configuration. The methodology is of general use also for hydraulic systems.

Distribution Patterns of Primary Health Care Centers in Osun State, Southwestern Nigeria: Implications for Sustainable Development Goals and Containment of COVID-19 Pandemic.

This article examines the distribution patterns of primary health care centers (PHCC) in the 30 Local Government Areas (LGAs) of Osun State, Nigeria, using secondary data. The study focused on the problem of inequality and inadequacy in the distribution pattern of PHCCs among the population. The provision of PHCCs in the state was analyzed using three criteria: among the three senatorial districts; among the 30 LGAs; and on the basis of population per PHCC. Findings revealed that although PHCCs were almost equally distributed among senatorial districts, disparities exist in distribution patterns among the LGAs and within each senatorial district and in terms of population ratio per PHCC in the state. Sixty percent (60%) of the LGAs had fewer than 26 PHCCs, which is the expected average number of PHCCs in the state. The inequalities observed in the study favored rural areas against urban areas. The study further revealed inadequacies in the provision of PHCCs in terms of the population ratio per PHCCs. The study concluded that to achieve the Sustainable Development Goals (SDGs) by 2030—and to contain the COVID-19 pandemic—there is a need for government intervention in the provision of PHCCs in Osun State for equal and adequate distribution.

Development of Novel Eating Error Scoring Tool to Evaluate Adult Eating Behavior Anomalies Among the United Arab Emirates Population.

IntroductionMaladaptive eating behaviors are emerging as the most significant determinants of obesity with a promising role in intervention. In the absence of a standardized tool to assess eating variations, an Eating Error Score (EES) tool was devised which comprised five zones for evaluating the severity of obesogenic behaviors as well as the specific area(s) with the highest susceptibility. This pilot study was aimed at evaluating the effectiveness of the EES in quantitating the eating behavior errors associated with excess weight and identifying the most affected zones.MethodsThe EES questionnaire was designed to explore potential disturbances in five zones of eating behavior related to the impetus to eat (Munger), meal choices and attentiveness to cravings (Impulsive), consumption speed (Speed feeding), cues to stop ingestion (Indulgent) and the social aspect of eating (Relationship). The questionnaire was conducted on adults with varying body mass index (BMI) attending governmental outpatient clinics. The correlation between EES and BMI was determined through Pearson Coefficient.ResultsA total of 204 participants completed the EES questionnaire. There were 72 males and 132 females with a mean BMI of 27.63 ± 6.16 kg/m2 and with nearly equal distribution between normal weight (37.2%), overweight (32.4%), and obese (29.4%) individuals. Nearly 75% of our cohort had a moderate total EES, and the remainder was equally distributed between the mild and severe ranges.A weak but significant correlation was observed between total EES and BMI (r=0.275, p<0.001) suggesting increasing obesogenic styles in participants with excess weight. In addition, a similar weak but significant correlation was noted between Body Mass Index and the Munger and Impulsive zones (r=0.266 and 0.258 and p<0.001, respectively) suggesting more severe maladaptive eating behaviors in these areas. No correlation was found with the Speed feeding, Indulgent, and Relationship zones.ConclusionThe EES may be a useful tool for assessing the extent of maladaptive eating behaviors, which predispose individuals to weight gain and sabotage their weight loss efforts. Undoubtedly, the utility of the tool needs to be corroborated in large population studies. Further, identifying the specific operant zones may show promise as many of these habits are potentially modifiable and can be targeted for weight control, most notably those associated with the Munger and Impulsive zones.

Presenting Symptoms of Undiagnosed Autism Spectrum Disorder Among Young Boys and Girls in Community CAMHS Between 2018–2019

AimsThough Autism Spectrum Disorder (ASD) is a common childhood neurodevelopmental disorders, the literature on presentation of undiagnosed ASD in Consultant Child and Adolescent Mental Health Services, (CAMHS) is scarce. The aim of the study was to look at symptoms at presentation among boys and girls in CAMHS, compare the symptom profile between the two genders, establish the main referral and assessment pathways and interventions employed after diagnosisMethodsThis was a retrospective review of patients’ files referred to ASD Walsall CAHMS Clinic conducted in February 2021. A random sample size of 44 boys and girls equally distributed from the ASD database was selected randomly from the completed ASD assessment list, the equal distribution between genders was intentional. We looked at presenting symptoms reported on the referral letters, assessments in CAMHS, and interventions outlined from ASD outcome letters of all subjects with completed ASD assessment, in age groups 7–18 years.ResultsAcross genders, most patients presented in the teenage years with common age of presentation seen at ages 15 and 17, both at 15.9% and mean age being 13 years. Ninety-five percent of patients were in school at the time of referral. Only 4.5% of patient were referred through crisis and the rest through local GP. A variety of presenting symptoms were seen, with the majority of the patients presenting with social and communication difficulties (77.3%), under /overreaction to sensory stimuli (63.6%) and anxiety (61.4%). 9.1% of patients had a family history of ASD. 100% of assessments included ADOS, SALT and neurodevelopmental assessment. 77.3% of patients were referred to support groups like living with ASD parent support groups. Along with CAMHS, education (97.7%) was the main agency involved in the care of these patients. In 44.2% of patients, EHCP was requested or already in place. The in between gender comparison also showed that although most symptoms were similar in both groups, some such as self-harm were higher among girls (27.3%) as compared to boys (13.6%) as well as obsessional symptoms which were more common in boys (63.3%) as compared to girls (27.3%).ConclusionUndiagnosed ASD presents with a wide variety of symptoms amongst boys and girls. Previous UK studies have shown an earlier presentation of ASD and which is contrary to our findings demonstrating a much later presentation. Therefore, we recommend referrers to be aware of the varied presentations and have a lower threshold for referral to secondary services to aid quicker ASD diagnosis and management.

Exploring the frequency of various risk Factors and its association with types of cerebal palsy in patients visiting NIRM Islamabad

Background: Cerebral palsy (CP) is a set of permanent movement disorders which are caused by non-progressive lesions of the developing brain. Other disorders concerning (CP) are disturbances of sensation, cognition, and/or seizure disorder. The current study intended to compare the frequency of factors associated with risk in cerebral palsy and their link with the type of cerebral palsy.Methods: Case-control study was conducted to collect the data through a structured questionnaire. Data was collected from the mother of the CP child and from the mother of healthy individuals at the National Institute of Rehabilitation and Medicine Islamabad. Sample of 400 individuals selected through purposive sampling technique and divided in two groups. 100 were in the case group and 300 were in the control group. For statistical significance, SPSS 20 was used. Results: An aggregate of 400 patients selected in this study among which 100 were assigned as a case group and 300 as a control group. male and female children were equally distributed with N=150 in the control group, similarly equal gender distribution (N=50 for male and female each) was adopted for the case group. Among the risk factors leading to CP development, the most prevalent was maternal infection (56%) followed by poor socioeconomic status (45%), delayed crying(48%) after birth, and high-grade fever with fits leading to spastic CP(44%) and was significantly higher in case group as compared to control(p‹0.05). A higher frequency of CP children with a p-value of 0.00 was found in mothers having pregnancy in the age group 35-40 years. Conclusions: Our study concludes that among the risk factors associated with CP, the most frequent is maternal infection followed by delayed crying, low socioeconomic status and high-grade fever with fits and mother age of pregnancy above 35 years.

The future of AI in our hands? To what extent are we as individuals morally responsible for guiding the development of AI in a desirable direction?

Artificial intelligence (AI) is becoming increasingly influential in most people’s lives. This raises many philosophical questions. One is what responsibility we have as individuals to guide the development of AI in a desirable direction. More specifically, how should this responsibility be distributed among individuals and between individuals and other actors? We investigate this question from the perspectives of five principles of distribution that dominate the discussion about responsibility in connection with climate change: effectiveness, equality, desert, need, and ability. Since much is already written about these distributions in that context, we believe much can be gained if we can make use of this discussion also in connection with AI. Our most important findings are: (1) Different principles give different answers depending on how they are interpreted but, in many cases, different interpretations and different principles agree and even strengthen each other. If for instance ‘equality-based distribution’ is interpreted in a consequentialist sense, effectiveness, and through it, ability, will play important roles in the actual distributions, but so will an equal distribution as such, since we foresee that an increased responsibility of underrepresented groups will make the risks and benefits of AI more equally distributed. The corresponding reasoning is true for need-based distribution. (2) If we acknowledge that someone has a certain responsibility, we also have to acknowledge a corresponding degree of influence for that someone over the matter in question. (3) Independently of which distribution principle we prefer, ability cannot be dismissed. Ability is not fixed, however and if one of the other distributions is morally required, we are also morally required to increase the ability of those less able to take on the required responsibility.

Time Series Forecasting Model Based on Intuitionistic Fuzzy Set via Equal Distribution of Hesitancy De-I-Fuzzification

The fuzzy time series forecasting model is a powerful tool in forecasting the time series data. The nature of the fuzzy set exhibits its role in handling the uncertainty of the data. The intuitionistic fuzzy set (IFS) is a generalization of a fuzzy set that makes the forecasting process more precise and accurate. This paper proposes a new fuzzy forecasting model based on IFS via the de-i-fuzzification approach, namely equal distribution of hesitancy. The proposed model consists of four main parts; the fuzzification of historical data; the establishment of the IFS; the de-i-fuzzification; and the defuzzification. For the fuzzification, the historical data is partitioned into 14 intervals using the frequency density-based method and trapezoidal fuzzy numbers are used to fuzzify the data. The data are then converted into IFS. The data in IFS form is reduced to fuzzy set using equally distributed with the degree of hesitancy approach. The arithmetic rules based on centroid defuzzification is used to calculate the forecasted output. The proposed model shows a better performance than the existing forecasting models based on IFS, indicating that the equal distribution of hesitancy de-i-fuzzification managed to handle the non-determinism in the forecasting with simplified procedure. In the future, an improved method will be proposed to defuzzify the IFS into crisp values without going through the de-i-fuzzification process, yet preserving the nature of IFS.

Completely fair energy scheduling mechanism in a smart distributed multi-microgrid system

In this paper, we have proposed a completely fair energy scheduling mechanism for a smart distributed multi-microgrid system which guarantees that the energy is scheduled fairly among all the buyer microgrids (MGs). It is a non-priority based starvation free mechanism as all the buyers are treated equal and every buyer MG gets at least some portion of its energy requirement fulfilled through the internal trading. The energy scheduling is done in two phases: during phase I, energy is equally distributed among all the buyer MGs. Because of this equal distribution of energy, the buyer MGs are benefited as they are not required to purchase their entire energy requirement from utility grid at higher price. During phase II, Vickrey auction scheme is used to schedule the remaining energy amongst the buyer MGs whose energy requirements were not fulfilled during the first phase. We have evaluated the proposed mechanism for a sample instance of microgrid network by simulating the environment. The simulation demonstrates that using the proposed mechanism the total energy buying cost for all buyer MGs is reduced greatly compared with the schemes where only auctioning is used for internal trading.

The Capacity Load Model of K-Uniform Hyper-Network based on Equal Load Distribution

Cascading failures occur frequently in many network systems. In this paper, we propose a hyper-network Capacity Load Model based on hyper-edge degrees load to explore the influence of cascading failures on some K-uniform hyper-networks. In simulation, we attack the hyper-edge which has largest hyper-edge degree. When the hyper-edge fails, its load will be equally distributed to adjacent hyper-edges. Through simulation analysis, we get the relationship between the capacity-load model parameters and the robustness of the k-uniform hyper-network. The results show the robustness of the hyper-networks is enhanced with the increase of its hyper-edge capacity. In addition, simulation result show that the robustness of K-uniform hyper-networks is strongest at α=1.

The relationship between cardiac surgeon experience and average patient risk profile: CA and NY statewide analysis.

It is unknown how high and low-risk cases are distributed among cardiac surgeons of different experience levels. The purpose of this study was to determine if high and low-risk coronary artery bypass grafting (CABG) cases are distributed among surgeons in such a way that would optimize outcomes in light of recent studies that show mid-career surgeons may obtain better patient outcomes on more complex cases. We performed a cross-sectional study using aggregated New York (NY) and California (CA) statewide surgeon-level outcome data, including 336 cardiac surgeons who performed 43,604 CABGs. The surgeon observed and expected mortality rates (OMR and EMR) were collected and the number of years-in-practice was determined by searching for surgeon training history on online registries. Loess and linear regression models were used to characterize the relationship between surgeon EMR and surgeon years-in-practice. The median number of surgeon years-in-practice was 20 (interquartile range [IQR] 11-28) with a median annual case volume of 46 (IQR 19, 70.25). The median surgeon observed to expected mortality (O:E) ratio was 0.87 (IQR 0.19-1.4). Median EMR for CA surgeons was 2.42% and 1.44% for NY surgeons. Linear regression models showed EMR was similar across years in practice. Regression models also showed surgeon O:E ratios were similar across years-in-practice. High and low-risk CABG cases are relatively equally distributed among surgeons of differing experience levels. This equal distribution of high and low-risk cases does not reflect a triaging of more complex cases to more experienced surgeons, which prior research shows may optimize patient outcomes.

Loneliness and Mental Health Amongst Indians Working in Abu Dhabi, UAE

The high prevalence of loneliness has been evidenced to be directly associated with the risk of acquiring mental health disorders such as anxiety, depression and even susceptibility to suicide ideation if not address with long term mitigation practices. The risk of loneliness and mental health disorders have been evidenced to be higher across individuals living away from their native homelands. The Indian population has been estimated to comprise of one of the largest communities of expatriates residing in the UAE. It has been postulated that expatriates, though living a seemingly prosperous life, often encounter a range of adverse circumstances such as, loneliness, occupational distress, and concerns on occupational security which in turn, pave the way for increase prevalence of mental illnesses such as depression, stress and anxiety. Thus, the followed research aimed to evaluate the prevalence of loneliness, state of mental health and the subsequent risk of mental health disorders across Indians working in Abu Dhabi, UAE. To address the same, a quantitative cross-sectional design, coupled with data collection on demographics, mental health and social functioning were collected, using self-reported questions such as the General Health Functioning-28 and Social Functioning Questionnaire. Based on such findings, the sample was found to be equally distributed with respect to their risk of mental health illnesses and high level of social functioning, possibly due to equal inclusion of both participants who were living alone as well as not living alone. Additionally, the equal distribution of such risk as well as high levels of social functioning may also be attributed to demographic factors like age, education and occupational levels. There is thus a need to conduct further research on the role of specific demographic factors in influencing mental health status and social functioning across Indian expatriates residing in the UAE.

Virulence characterization and comparative genomics of Listeria monocytogenes sequence type 155 strains

BackgroundListeria (L.) monocytogenes strains show a high diversity regarding stress tolerance and virulence potential. Genome studies have mainly focused on specific sequence types (STs) predominantly associated with either food or human listeriosis. This study focused on the prevalent ST155, showing equal distribution among clinical and food isolates. We evaluated the virulence potential of 20 ST155 strains and performed comparative genomic analysis of 130 ST155 strains isolated from food, food processing environments and human listeriosis cases in different countries and years.ResultsThe in vitro virulence assays using human intestinal epithelial Caco2 and hepatocytic HEPG2 cells showed an impaired virulence phenotype for six of the 20 selected ST155 strains. Genome analysis revealed no distinct clustering of strains from the same source category (food, food processing environment, and clinical isolates). All strains harbored an intact inlA and inlB locus, except four strains, which had an internal deletion in the inlA gene. All strains harbored LIPI-1, but prfA was present in a longer variant in six strains, all showing impaired virulence. The longer PrfA variant resulted in lower expression of inlA, inlB, and prfA, and no expression of hly and actA.Regarding stress-related gene content, SSI-1 was present, whereas qacH was absent in all strains. 34.6% of the strains harbored a plasmid. All but one ST155 plasmids showed high conservation and harbored cadA2, bcrABC, and a triphenylmethane reductase.ConclusionsThis study contributes to an enhanced understanding of L. monocytogenes ST155 strains, being equally distributed among isolates from humans, food, and food processing environments. The conservation of the present genetic traits and the absence of unique inherent genetic features makes these types of STs especially interesting since they are apparently equally adapted to the conditions in food processing environments, as well as in food as to the human host environment. However, a ST155-specific mutation resulting in a longer PrfA variant impaired the virulence potential of several ST155 strains.