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Objectives: Sickle cell disease (SCD) is a global health concern associated with high childhood morbidity and mortality; in Oman, the prevalence of SCD is 0.2%. Public awareness of SCD and the need for premarital screening (PMS) are essential to reduce the incidence of this disease. This study aimed to assess awareness of and beliefs regarding SCD and PMS among Omanis in a primary healthcare setting. Methods: This cross-sectional study took place in five health centres located in Al-Seeb Province, Muscat, Oman, between June and August 2015. A total of 500 Omanis aged ≥18 years old attending the clinics were invited to participate in the study. A previously described questionnaire by Gustafson et al. was used to measure awareness of and beliefs regarding SCD and PMS. Results: A total of 450 Omani adults completed the questionnaire (response rate: 90.0%). The majority (67.8%) were aware that SCD is genetically inherited and 85.1% believed in the value of PMS; however, only 24.4% reported having undergone PMS previously. Few participants were aware that SCD can be very painful (20.2%) and can cause strokes, infections and organ damage (20.0%). More than half (56.7%) reported that the availability of educational material on SCD or PMS in Oman was inadequate. Participants’ education levels were positively associated with accurate SCD knowledge (P

Objectives: This audit aimed to investigate the use of prescription drugs and investigations by trainee doctors in primary care settings in Oman and the UK. Methods: This audit took place between February and April 2015. The medical records of consecutive patients seen by five family medicine trainee doctors at a primary care setting in Oman were retrospectively reviewed. These data were compared to those gathered from two trainees at a general practice clinic in the UK as well as an experienced general practitioner (GP) who had practiced in both countries. Results: The average number of items prescribed per patient was 1.19, 0.43 and 0.24 and the rate of investigations was 20%, 21% and 11% for Omani trainees, UK trainees and the GP, respectively. Conclusion: This audit suggests that family medicine trainees in Oman prescribe almost three times as many drugs as trainees in the UK. The findings also point towards an over-investigation of the relatively young Omani patient population.

Ureolytic-type bacteria has been used to improve the strength of cement mortar by the precipitation of calcium carbonate. In the present study Bacillus sphaericus has been used to improve the properties of cement mortar such as setting time, compressive strength and sorptivity. The setting time is found to be unaffected by the presence of bacteria. It is found that compressive strength at both 7-days and 28-days of mortar cube increases with the increase of bacteria concentration. At the optimum bacteria dosage of 107 cells/ml, the average compressive strength increases by 58% (at 7 day) and 23% (at 28 day) over the control specimen. The sorpitivity coefficient decreases as the concentration of bacterial cells increases. The mineralogy and morphology of the calcium carbonate precipitation have been tested by XRD and FESEM.

Objectives: This study aimed to identify the prevalence of antenatal depression and the risk factors associated with its development among Omani women. No previous studies on antenatal depression have been conducted in Oman. Methods: This descriptive cross-sectional study was carried out between January and November 2014 in Muscat, Oman. Pregnant Omani women ≥32 gestational weeks who were attending one of 12 local primary care health centres in Muscat for routine antenatal care were invited to participate in the study (n = 986). An Arabic version of the validated self-administered Edinburgh Postnatal Depression Scale questionnaire was used to measure antenatal depression. A cut-off score of ≥13 was considered to indicate probable depression. Results: A total of 959 women participated in the study (response rate: 97.3%). Of these, 233 were found to have antenatal depression (24.3%). A bivariate analysis showed that antenatal depression was associated with unplanned pregnancies (P = 0.010), marital conflict (P = 0.001) and a family history of depression (P = 0.019). The adjusted odds ratio (OR) after logistic multivariate regression analysis showed that antenatal depression was significantly associated with unplanned pregnancies (OR: 1.37; 95% confidence interval [CI]: 1.02–1.86) and marital conflict (OR: 13.83; 95% CI: 2.99–63.93). Conclusion: The prevalence of antenatal depression among the studied Omani women was high, particularly in comparison to findings from other Arab countries. Thus, antenatal screening for depression should be considered in routine primary antenatal care. Couples should also be encouraged to seek psychological support should marital conflicts develop during pregnancy.

Due to rapid construction, necessity for raw materials of concrete, especially coarse aggregate, tends to increase the danger of early exhaustion of the natural resources. An alternative source of raw materials would perhaps delay the advent of this early exhaustion. Recycled coarse aggregate (RCA) plays a great role as an alternative raw material that can replace the natural coarse aggregate (NCA) for concrete. Previous studies show that the properties of RCA concrete are inferior in quality compared to NCA concrete. This article attempts to study the improvement of properties of RCA concrete with the addition of bacteria named as Bacillus subtilis. The experimental investigation was carried out to evaluate the improvement of the compressive strength, capillary water absorption, and drying shrinkage of RCA concrete incorporating bacteria. The compressive strength of RCA concrete is found to be increased by about 20% when the cell concentration of B. subtilis is 106 cells/ml. The capillary water absorption as well as drying shrinkage of RCA are reduced when bacteria is incorporated. The improvement of RCA concrete is confirmed to be due to the calcium carbonate precipitation as observed from the microstructure studies carried out on it such as EDX, SEM, and XRD.

The glycemic response produced by a food depends on both the glycemic index of the food itself, and on how the body reacts to the food as it is consumed and digested, in turn dependent on sensory cues. Research suggests that taste stimulation can induce the cephalic phase insulin response before food has reached the digestion, priming the body for an incoming glucose load. This glycemic response can consequently affect the amount of food consumed in a subsequent meal. The aim of this study was to investigate the effects on satiety of four preloads that differed in caloric content and sensory properties, in a small group of female and male participants (n = 10). Water, sucrose, sucralose, and maltodextrin were used to represent 4 different conditions of the preload, with or without energy, and with or without sweet taste. Individual plasma glucose concentrations were sampled at baseline, 45 min after consuming the preload, and after consuming an ad-libitum test meal. Hunger, fullness, desire to eat, and thoughts of food feeling were assessed every 15 min using visual analog scales. Results in male participants when comparing two solutions of equal caloric content, maltodextrin and sucrose, showed that plasma glucose concentration spiked in the absence of taste input (p = 0.011). Maltodextrin, while providing calories does not have the sweet taste that can serve to trigger cephalic phase insulin release to attenuate an incoming glucose load, and was accompanied by significantly greater change in feelings of satiety than with the other preloads. Despite the difference in postprandial blood glucose, the energy consumed in the test meal across the treatments was not significantly different in either males or females. Results highlight the importance of taste in stimulating the body for the efficient and effective glucose homeostasis.

Describes the first series of secondary mania reported in children and adolescents. Clinical history of subjects with mania of hypomania; Discussion on phenomenology; Characteristics to be considered in the eventual possible validation of a disorder of post-traumatic mania in children and adolescents.

Focuses on the surprising paucity of changes in behavior and executive functioning following accidental gunshot injury in an adolescent. Review of neuropsychiatric aspects of major depression in the subject; Three dimensional reconstruction of the subject's brain; Presentation of selected neuropsychological tests.

Despite evidence that the ability to taste is weakened by obesity and can be rescued with weight loss intervention, few studies have investigated the molecular effects of obesity on the taste system. Taste bud cells undergo continual turnover even in adulthood, exhibiting an average life span of only a few weeks, tightly controlled by a balance of proliferation and cell death. Recent data reveal that an acute inflammation event can alter this balance. We demonstrate that chronic low-grade inflammation brought on by obesity reduces the number of taste buds in gustatory tissues of mice-and is likely the cause of taste dysfunction seen in obese populations-by upsetting this balance of renewal and cell death.

We recently identified three novel thioredoxin-like genes in the genome of the protozoan parasite Plasmodium that belong to the Phosducin-like family of proteins (PhLP). PhLPs are small cytosolic proteins hypothesized to function in G-protein signaling and protein folding. Although PhLPs are highly conserved in eukaryotes from yeast to mammals, only a few representatives have been experimentally characterized to date. In addition, while PhLPs contain a thioredoxin domain, they lack a CXXC motif, a strong indicator for redox activity, and it is unclear whether members of the PhLP family are enzymatically active. Here, we describe PbPhLP-3 as the first phosducin-like protein of a protozoan organism, Plasmodium berghei. Initial transcription analysis revealed continuous low-level expression of pbphlp-3 throughout the complex Plasmodium life cycle. Attempts to knockout pbphlp-3 in P. berghei did not yield live parasites, suggesting an essential role for the gene in Plasmodium. We cloned, expressed and purified PbPhLP-3 and determined that the recombinant protein is redox active in vitro in a thioredoxin-coupled redox assay. It also has the capacity to reduce the organic compound tert-Butyl hydroperoxide (TBHP) in vitro, albeit at low efficiency. Sequence analysis, structural modeling, and site-directed mutagenesis revealed a conserved cysteine in the thioredoxin domain to be the redox active residue. Lastly, we provide evidence that recombinant human PhLP-3 exhibits redox activity similar to that of PbPhLP-3 and suggest that redox activity may be conserved in PhLP-3 homologs of other species. Our data provide new insight into the function of PhLP-3, which is hypothesized to act as co-chaperones in the folding and regulation of cytoskeletal proteins. We discuss the potential implications of PhLP-3 as a thioredoxin-target protein and possible links between the cellular redox network and the eukaryotic protein folding machinery.

Vitamin B12 deficiency is common in developing countries and should be suspected in patients with unexplained anaemia or neurological symptoms. Dermatological manifestations associated with this deficiency include skin hyper- or hypopigmentation, angular stomatitis and hair changes. We report a case of a 28-year-old man who presented to the Sultan Qaboos University Hospital in Muscat, Oman, in November 2013 with localised hyperpigmentation of the palmar and dorsal aspects of both hands of two months’ duration. Other symptoms included numbness of the hands, anorexia, weight loss, dizziness, fatigability and a sore mouth and tongue. There was no evidence of hypocortisolaemia and a literature search revealed a possible B12 deficiency. The patient had low serum B12 levels and megaloblastic anaemia. An intrinsic factor antibody test was negative. A gastric biopsy revealed chronic gastritis. After B12 supplementation, the patient’s symptoms resolved. Family physicians should familiarise themselves with atypical presentations of B12 deficiency. Many symptoms of this deficiency are reversible if detected and treated early.

This paper will deal with the changing soundscape of a particular community in the University of the Philippines Diliman Campus, focusing on the weekly Monday morning flag raising ceremony. The paper will compare how it was celebrated in the past, using earwitness accounts, to how it has been rendered more recently based on a soundscape recording taken in February of 2013. As ritual, flag-raising has devolved over the years. This can be traced to the increase in the level of keynote sounds in and around the campus, the malfunctioning and lack of coordination in the use of the sound devices deployed in the original ritual, and the changes in the soundscapes that index the campus community.

As competition on super market shelves is higher than ever, the importance of product concepts, communicated through labels, can dictate a product’s success or failure. However, it is possible for labels to affect a consumer’s experience, changing the overall response to the product. In this study, we tested samples of vanilla yogurt with one of four commonly used labeling concepts (high-protein, low-fat, made with stevia and all-natural) on sensory perception, consumer liking, expected consumption amount, and willingness to pay (WTP) in a consumer test (n = 108). Each participant evaluated five samples of the same vanilla yogurt identified with one of the labels, or an unlabeled control. Results showed panelists liked the samples labeled with low-fat and high-protein to the greatest degree, with all-natural scoring the lowest. Those more concerned with protein content found the samples less satiating, dependent on sex. Sweetness was also perceived more highly in younger panelists, with panelists WTP dependent on their liking of the labels. Results highlight the importance of labeling as an extrinsic cue affecting liking ratings, with potential ramification for ultimate product success. Understanding consumers’ response to labels, as well as their attitudes, has broad implications for food marketing, as well as public health and the study of eating habits.

The eating experience is multimodal. As we consume a dish, we perceive much more than that which initially activates the senses, including influences from our surroundings. Foods sampled in experimental settings are largely evaluated within a sensory booth, an environment designed to be devoid of such external or non-standardized stimuli, so that participants can focus solely on the sample itself. In natural experiences, we rarely consume food in such isolation—context is actually key to many dining experiences and can have an integral role in how we perceive the foods we eat. Using virtual reality to artificially provide this context, we tested how the setting in which a beverage was consumed influenced perception of two different samples. Virtual environments were formed by processing custom-recorded 360 degree videos and overlaying audio, text, and sensory scales to simulate a typical sensory evaluation. Participants were asked to taste two alcoholic beverages, a beer and a sparkling wine, in two virtual contexts, a bar and a winery. The results indicated that participants’ willingness to pay for, and overall enjoyment of the sparkling wine increased when placed in the winery context, with no change between the two virtual contexts for the beer sample. This occurred without alteration of the samples’ sensory properties or the ability of panelists to identify the beverage they were drinking; however, perceived appropriateness of the samples for the setting was strongly influenced by the context in which they were sampled, suggesting that perceived appropriateness for a surrounding may play a role in the degree to which we enjoy a food. Results provide further proof that artificially-applied context, such as that provided by virtual reality, can further the sensory testing of foods.

Objectives: To explore the public’s awareness of cancer symptoms and the barriers to seeking medical help among Omani adults attending primary care settings in Muscat governorate, the capital city of Oman. Methods: The Cancer Awareness Measure (CAM) questionnaire (translated into Arabic) was used to collect data from a total of 12 randomly selected local health centers (LHCs) in Muscat governorate, the capital city of Oman. Omani adults aged 18 years and above attending LHCs during the study period were invited to participate in the study. Statistical Package for the Social Sciences (SPSS version 22) was used to analyze the data. Results: A total of 999 participants completed the CAM questionnaire from 1200 invitations (response rate = 83%). The overall recognition of common cancer symptoms was less than 50% except for an unexplained lump/swelling, which was 71%. Multinomial logistic regression showed that women recognized more cancer symptoms than men (odds ratio [OR] = 1.79; 95% confidence interval [CI]: 1.27-2.51), that more highly educated participations recognized more cancer symptoms than less educated participants (OR = 39; 95% CI: 0.23-0.69). The majority of participants (91.2%) agreed that the right time to seek medical help for possible cancer symptom was within 2 weeks. Multinomial logistic regression showed that women rather than men were more likely to perceive barriers to seeking medical help (OR = 2.10; 95% CI: 1.60-2.76). Also the less educated participants, rather than more educated, were more likely to perceive barriers to seeking medical help (OR = 2.17; 95% CI: 1.16-4.05). Conclusion: Levels of awareness of cancer symptoms are low in Oman. More national CAMs are needed in Oman to increase public knowledge of cancer symptoms. Also, more public awareness is needed to overcome the barriers to seeking timely medical help particularly among groups of women and the unmarried, widowed, divorced, or separated if delays in presentation are to be minimized.

Por medio de dos imágenes de satélite adquiridas en 1985 (Landsat TM) y 2000 (Landsat ETM+), se analizan cuantitativamente los patrones de cambio de cobertura y uso del suelo ocurridos entre 1985 y 2000 en la laguna de Barra de Navidad, Jalisco, México y su cuenca de drenaje. El análisis de las imágenes se realizó mediante una clasificación supervisada y verificación en campo de seis categorías de uso/cobertura de suelo: lagunar, agricultura, selva seca tropical, manglar y sin vegetación. Los cambios espaciales en la composición del uso del suelo fueron evaluados utilizando una matriz de transición y los cambios de configuración se interpretaron utilizando la métrica del paisaje. Los resultados mostraron que las áreas urbanas y turísticas se expandieron, a costa de la selva baja y suelos sin cobertura. También el manglar mostró un gran decremento (-39%) experimentando una severa fragmentación. Estos cambios parecen estar relacionados con el incremento de la sedimentación, resultado de la erosión del suelo aguas arriba y a la progradación de un abanico dentro de la laguna de Barra de Navidad. Los resultados obtenidos pueden servir como un modelo de comparación de otros sistemas que experimentan múltiples factores estresantes, especialmente cambios relacionados con el turismo y la intensificación del uso del suelo.

Editor’s Note : These papers are contributions to the ‘Policy Debate’ section of International Development Policy. In this section, academics, policy-makers and practitioners engage in a dialogue on global development challenges. Papers are copy-edited but not peer-reviewed. Instead, the initial thematic contribution is followed by critical comments and reactions from scholars and/or policy-makers. The initial paper takes the form of a structured interview with Inge Kaul, conducted by Graduate Institute Research Fellow Robin Davies, on the topic of Global vs. National Public Goods in the post-2015 international development framework. Kaul argues that for the good of developing countries and the world as whole, support from developed countries for the provision of global public goods (GPGs), such as climate change mitigation and communicable disease surveillance and control, should be conceived as an international extension of their domestic policies. Financing for GPGs constitutes payment for services rendered, not aid. Likewise, primary responsibility for the production of GPGs should rest with issue- and outcome-oriented ‘tsars’ at both the national and global levels, rather than with overstretched treaty- or country-oriented multilateral organisations. It follows from this that the distinction within the SDG framework between global and national goals is not merely one of level, but one of kind. Global goals call for distinctive financing and implementation arrangements. The initial paper is followed two critical comments, (1) by Robert Glasser, Executive-in-Residence, Geneva Centre for Security Policy, and (2) by Michael Gerber, Ambassador and Special Envoy for Global Sustainable Development, Swiss Federal Department of Foreign Affairs with Luca Etter, Policy Advisor at the Swiss Agency for Development and Cooperation (SDC).

Background: During caesarean section spinal anaesthesia may provoke maternal hypotension that we prevent by administration of phenylephrine and/or ephedrine. Phenylephrine is however reported to reduce the near infrared spectroscopy-determined frontal lobe oxygenation (ScO2) but whether that is the case for patients exposed to spinal anaesthesia is not known.Objectives: To evaluate the impact of phenylephrine vs. ephedrine on ScO2 during caesarean section with spinal anaesthesia in a single centre, open-label parallel-group study with balanced randomization of 24 women (1:1). Secondary aims were to compare the effect of the two drugs on maternal haemodynamics and foetal heart rate.Intervention: Ephedrine (0.8-3.3 mg/min) vs. phenylephrine infusion (0.02-0.07 mg/min).Results: For the duration of surgery, administration of ephedrine maintained ScO2 (compared to baseline +2.1± 2.8%;mean ± SE, while phenylephrine reduced ScO2 (-8.6 ± 2.8%; p = 0.005) with a 10.7% difference in ScO2 between groups (p=0.0106). Also maternal heart rate was maintained with ephedrine (+3 ± 3 bpm) but decreased with phenylephrine (-11 ± 3 bpm);difference 14 bpm (p=0.0053), but no significant difference in mean arterial pressure (p = 0.1904) or CO (p=0.0683) was observed between groups. The two drugs also elicited an equal increase in foetal heart rate (by 19 ± 3 vs. 18 ± 3 bpm; p=0.744).Conclusion: In the choice between phenylephrine and ephedrine for maintenance of blood pressure during caesarean section with spinal anaesthesia, ephedrine maintains frontal lobe oxygenation and maternal heart rate with a similar increase in foetal heart rate as elicited by phenylephrine.Trial registration: Clinical trials NCT 01509521 and EudraCT 2001 006103 35

In this study, changes in land cover and land use patterns that occurred between 1985 and 2000 in the surrounding basin of the Barra de Navidad coastal lagoon in Jalisco, Mexico are quantified and explained. Two satellite images from 1985 (Landsat TM) and 2000 (Landsat ETM+) were analyzed with supervised classification and ground truthing to evaluate changes in six land use/cover categories: lagoon, agriculture, urban/tourist, tropical dry forest, mangrove and bare substratum. Changes in land use composition were evaluated using a transition matrix and changes to configuration were interpreted using landscape metrics. Results show that urban and tourist areas expanded between 1985 and 2000, mostly at the expense of forested and bare land. Mangroves showed a large relative decrease in area (-39%) and experienced fragmentation. These changes appear to be related to increased sedimentation a fan progradation into Barra de Navidad lagoon. These results may serve as a model for comparison in other systems experiencing multiple stressors, especially changes related to tourism and the intensification of resource extraction.