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To determine the prevalence and severity of anxiety and depression among health care professionals in Khyber Pakhtunkhwa and the impact of gender and professional roles on mental health outcomes.
Methodology
A cross-sectional study was conducted between March and November 2023 using stratified random sampling among health care professionals, including doctors, nurses, paramedics, and emergency staff, across multiple hospitals. The Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) were used to assess anxiety and depression. Data were analyzed using R/RStudio, employing descriptive statistics, chi-square tests, independent t-tests, Mann-Whitney U tests, and Pearson’s correlation coefficient.
Results
Among 651 participants, 65% were male. Anxiety prevalence was significant, with 42% experiencing minimal anxiety, 35% mild, 16% moderate, and 7.7% severe. Depression prevalence included 10% with no depression with 7.8% moderately severe and 5.9% severe depression. Nurses (40%) and doctors (34%) had the highest depression rates. Females exhibited significantly higher anxiety and depression scores. Anxiety prevalence varied across hospitals (P = 0.024). A strong positive correlation was observed between GAD-7 and PHQ-9 scores.
Conclusion
Mental health challenges among frontline health care workers in Khyber Pakhtunkhwa are substantial, with anxiety and depression particularly prevalent among nurses and doctors. Female workers experience greater psychological distress. We recommend implementation of hospital-based mental health support systems, prioritizing interventions for female staff and high-burden departments. Policies ensuring regular psychological screening and peer support mechanisms are urgently needed.
The 2017 French Law on the Duty of Vigilance of Parent and Lead Companies has been hailed as a pioneering national legislation to hold corporations accountable for human rights and environmental abuses. Most lawsuits brought under this law have faced a plethora of admissibility objections, and so far, only one case has resulted in a decision on the merits. Initial formalistic court decisions on admissibility have now been mostly dismissed. However, critical questions around the role and powers entrusted to judges under the law remain contested.
The last decades have seen great scholarly interest in the fate of Roman temples and cult statues during the Christianisation of the Roman Empire. The surge of studies on spatiality and lived religion in Roman studies have demonstrated that ancient religious practice was not confined to sanctuaries but rather infused into all spheres of everyday life. Informed by these studies, I argue that the Christianisation effort was not confined to temples and cult statues in sanctuaries, despite the narrow focus on these monuments in legal and patristic sources. The spaces where people most frequently moved, lived, and practised religion in their everyday lives were equally important religious arenas. In this article I venture out of the temples and into the streets of late antique Ephesus to the Triodos intersection to highlight an array of subtle transformations that are unassuming in isolation, but together effectively Christianised the streetscape. I demonstrate that streetscapes were arenas of material Christianisation alongside monumental sanctuaries. The Triodos is used as a point of departure to show how the Roman streetscapes functioned as more-than-material religious assemblages. Human–material interaction in ritual and everyday movement and practices made the streetscapes active participants in the Christianisation process.
Three-translation (3T) redundant actuated Delta/Par4-like manipulators with closed-loop units (CLU) are widely used in logistics sorting, industrial packaging, and other applications due to their superior load-carrying capacity and dynamic performance. However, compared to conventional 3T parallel mechanisms (PMs), there are fewer configurations of 3T redundant actuated PMs with CLU, and the existing CLU are of a single configuration. This paper introduces a method for synthesizing a 3T redundant actuated PM with CLU based on the atlas method. First, the degrees of freedom (DOF) line diagrams and constraint line diagrams of the moving platform are determined sequentially. By applying the dual rule, the constraint diagrams are decomposed, yielding six dual DOF spaces. The equivalent DOF line diagrams are expanded using the principle of line equivalence, which synthesizes a variety of novel 4- and 5-DOF branched chains with CLU. Second, considering the geometrically symmetric distribution criterion of the branched chains, two assembly schemes for redundant actuated 3T PMs with CLU are proposed, yielding at least 432 and 324 novel configurations, respectively. Finally, two representative novel mechanisms are selected, and their DOF properties are verified using screw theory, which demonstrates the feasibility and applicability of the synthesized method. This method systematically synthesizes novel redundant actuated 3T PMs with CLU, laying the foundation for further research into innovative CLU configurations.
Redistricting is often a hotly contested affair within states as the party in power attempts to maximize its chances for electoral success through injecting partisanship into the process. Previous works have evaluated how different redistricting practices can influence elections, but little is known about how redistricting can impact citizen attitudes toward government. Using an original survey with a unique experiment, we evaluate the relationship between how redistricting is performed and how satisfied citizens are with the state of democracy in the United States. We find that the mere perception of redistricting being done in a partisan manner leads to decreased levels of system support. Furthermore, our models show that independent redistricting commissions tend to reduce the perceived prevalence of gerrymandering and boost citizens’ evaluations of the democratic process.
For full shifts on finite alphabets, Coelho and Quas [Criteria for $\overline {d}$-continuity. Trans. Amer. Math. Soc.350(8) (1998), 3257–3268] showed that the map that sends a Hölder continuous potential $\phi $ to its equilibrium state $\mu _\phi $ is $\overline {d}$-continuous. We extend this result to the setting of full shifts on countable (infinite) alphabets. As part of the proof, we show that the map that sends a strongly positive recurrent potential to its normalization is continuous for potentials on mixing countable state Markov shifts.
Radiofrequency catheter ablation of ventricular arrhythmias, originating from the left ventricular summit, is challenging due to epicardial localisation of the substrate, surrounded by coronary arteries. This paper highlights the successful elimination of LVOT summit ventricular arrhythmia which was ablated from the aortic cusp and aortic mitral continuity in two paediatric patients.
Case Report:
Ventricular tachycardia arising from the basal region of the left ventricular summit was identified in two male patients aged 9 and 13 years. Electroanatomic mapping of ventricular arrhythmia revealed the earliest ventricular signal within the left coronary artery which was successfully ablated from the left coronary cusp. The second patient with exactly similar ECG of ventricular arrhythmia was treated by delivering energy to the aorta-mitral continuity beneath the aortic valve. No recurrences were observed during the follow-up period of 20 months.
Conclusion:
Ventricular tachycardia arising from the basal region of the left ventricular summit is very rarely observed in paediatric patients. Utilising radiofrequency catheter ablation in proximity to the source can effectively and safely eliminate tachycardia.
The Scytho-Siberian ‘animal style’ encapsulates a broad artistic tradition, which was widespread across the Eurasian Steppe in the first millennium BC, but the scarcity of secure contexts limits the exploration of temporal and regional trends. Here, the authors present animal-style items excavated from a late-ninth-century BC kurgan, Tunnug 1, in Tuva Republic. The limited range of animals and the utilitarian associations of the artefacts suggest a narrow symbolic focus for early Scythian art, yet stylistic diversity evidences the co-operation of multiple social groups in the construction and funerary ritual activities of monumental burial mounds in the Siberian Valley of the Kings.
This paper studies a distributed fixed-time dynamic event-triggered formation control framework for a group of hypersonic gliding vehicles (GHGVs) suffering from internal uncertainties and non-affine properties. The main challenge is strong coupling of non-affine nonlinear dynamic with hypervelocity characteristics and multi-source uncertainties make it difficult to design the control protocol. Firstly, by integrating the distributed consensus control strategy, fractional order control theory and dynamic event-triggered mechanism, a framework of fixed-time formation control for GHGVs system is constructed. Secondly, to mitigate the issue of ‘explosion of complexity’ (EI), a fixed-time command filter (FCF) is proposed and a compensative strategy is formulated to tackle the impact of filtering errors. Thirdly, an additional auxiliary differential equation (ADE) is developed to decouple the control input from the status variable. Several radial base function neural networks (RBFNN) are utilised to handle the unknown internal uncertainties. Furthermore, a unique dynamic event-triggered mechanism (DTEM) is introduced for each follower, facilitating seamless transitions between two distinct dynamic threshold strategies. Analysis based on Lyapunov function illustrates that the output tracking error of followers exponentially converges to a small range within a fixed time, and Zeno behaviour is prevented. Finally, several numerical simulations are presented to demonstrate the practicability and meliority of the suggested approach.
A non-uniqueness phase for infinite clusters is proven for a class of marked random connection models (RCMs) on the d-dimensional hyperbolic space, ${\mathbb{H}^d}$, in a high volume-scaling regime. The approach taken in this paper utilizes the spherical transform on ${\mathbb{H}^d}$ to diagonalize convolution by the adjacency function and the two-point function and bound their $L^2\to L^2$ operator norms. Under some circumstances, this spherical transform approach also provides bounds on the triangle diagram that allows for a derivation of certain mean-field critical exponents. In particular, the results are applied to some Boolean and weight-dependent hyperbolic RCMs. While most of the paper is concerned with the high volume-scaling regime, the existence of the non-uniqueness phase is also proven without this scaling for some RCMs whose resulting graphs are almost surely not locally finite.
Arabinoxylans (AX), the primary hemicellulose found in cereals and grasses, play a crucial role in regulating immunity, metabolism and various physiological processes, underscoring their value as essential components in dietary nutrition. Considering the extensive research on AX in piglet nutrition, this paper systematically reviews their impacts on gut health and microbiota in piglets, as well as the underlying mechanisms of action. AX have been shown to mediate gut barrier fortification through tight junction protein upregulation and orchestrate mucosal immunity homeostasis, consequently ameliorating early-weaning-associated diarrheal pathogenesis in piglets. Additionally, AX function as microbial ecological modulators through selective enrichment of beneficial commensal microbiota (e.g. Bifidobacterium spp. and Lactobacillus spp.), while simultaneously stimulating microbial biosynthesis of SCFA and ferulic acid exhibiting potent antioxidant and anti-inflammatory activity, thereby maintaining the intestinal health of piglets. This review offers valuable insights into their potential as a dietary intervention to support gut health and immune function in early-weaned piglets. However, most studies focus on single-source AX such as wheat or maize, with limited exploration of novel sources or comparative effects of source combinations. Future research should systematically investigate the molecular mechanisms of AX action, provide data-driven guidance for selecting AX sources in feed formulations and establish optimal inclusion levels in practical feeding regimens. Such efforts will further solidify the precision nutrition potential of AX in promoting sustainable and healthy growth in piglets.