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Catatonia is a psychomotor dysregulation syndrome of diverse aetiology, increasingly recognised as a prominent feature of N-methyl-d-aspartate receptor antibody encephalitis (NMDARE) in adults. No study to date has systematically assessed the prevalence and symptomatology of catatonia in children with NMDARE. We analysed 57 paediatric patients with NMDARE from the literature using the Bush-Francis Catatonia Rating Scale. Catatonia was common (occurring in 86% of patients), manifesting as complex clusters of positive and negative features within individual patients. It was both underrecognised and undertreated. Immunotherapy was the only effective intervention, highlighting the importance of prompt recognition and treatment of the underlying cause of catatonia.
Recognition of the role of infectious agents in a range of both acute and chronic diseases is increasing. One key example is the potential epidemiological and neuropathological association between some cases of schizophrenia with the protozoan Toxoplasma gondii. T. gondii establishes persistent infection within the CNS and can alter host behaviour. Altered dopamine levels have been reported for both T. gondii infection and schizophrenia. Several medications used to treat schizophrenia demonstrate anti-T. gondii properties, and haloperidol, a dopamine antagonist, can prevent the development of T. gondii-altered behaviour in rodents. Furthermore, T. gondii may actually be a source of dopamine, as it encodes a copy of the mammalian enzyme tyrosine hydroxylase, which represents the rate-limiting step in dopamine synthesis.
Using the epidemiologically and clinically applicable rat-T. gondii model, and incorporating a battery of classical and novel non-invasive behavioural and physiological assays, we aim to further elucidate the impact of T. gondii on behaviour and the mechanisms involved.
T. gondii increases the rats’ propensity for predation risk through enhanced activity, visibility and manipulation of their perception of predation risk, turning innate aversion into a ‘suicidal’ feline attraction. There is little indication that T. gondii alters the rats generalized anxiety, nor potential to enhanced predation by non-definitive mammalian host species. Preliminary associative analyses into the relationship between individual behavioural alterations and neurotransmitter and brain cysts localisation profiles will be presented.
Our results provide further evidence for a role of T. gondii in the aetiology of some cases of schizophrenia.
Attention, working memory (WM), information processing and memory deficits are important features of schizophrenia. WM functions appear to be mediated by the dorsolateral prefrontal cortex (DLPFC). Functional imaging studies have shown a failure to activate the DLPFC during working memory tasks in patients with chronic schizophrenia. The primary aim of this study is to determine whether there are brain activation changes in the dorso-lateral prefrontal cortex (DLPFC) as a result of engaging in a randomized, controlled 12 week course of cognitive remediation therapy (CRT) in inpatients with chronic schizophrenia.
Patients with DSM IV schizophrenia are randomized to a 12 week trial of Cognitive Remediation (CR) using a Computerized CR program (COGPACK) or to a 12-week control condition. Patients receive at baseline and endpoint an fMRI scan with a cognitive task (N-back task), a neuropsychological test battery (MATRICS), functional and symptom assessments.
Preliminary results of this ongoing study show that patients after 12 weeks of CR showed (1) significantly more improvement in WM functions than patients who participated in the control group and (2) improvement in accuracy on the verbal letter 2-back task during the fMRI scan. Signal difference between 2-back and 0-back was not present or only present minimally at baseline (Pre-CR); however, at endpoint (Post-CR) there was signal difference present, which corresponds to an increase in activation in the areas of the DLPFC. This increase in activation pattern may be reflective of the effects of the exposure to the CR intervention.
Latent infection with the common intracellular protozoan parasite Toxoplasma gondii has been shown to result in altered behaviour of its host. This behaviour manipulation has been proposed to increase predation of the intermediate host (e.g. rodents and birds) enhancing parasite transmission. Other psychologicalsequalae have also been associated with latent toxoplasmosis including human affective disorders, as human are accidental hosts for Toxoplasma. During cyst stages of the life cycle found in the brain and other tissues, there is a complex interaction between the parasite and the host. Our research is concerned with the possibility that the parasite-induced behavioural changes are mediated by neurotransmitters. Potential factors in neurotransmitter levels include the location of the cyst, the host immune response, and direct parasite products. The cyst is found in many brain regions but elevated numbers have been reported in the hippocampus, amygdala, and nucleus accumbens. The host response involves interferon gamma suppressing growth through tryptophan degradation that could decrease serotonin levels. The parasite could directly manipulate the host brain through altering dopamine levels. We have found a change in dopamine associated with infection. Indeed, the parasite itself encodes the rate-limiting enzyme in dopamine synthesis, tyrosine hydroxylase. Dopamine's role is also supported by finding haloperidol, a dopamine antagonist, blocks manipulation of rodents by Toxoplasma. Our current investigations of alterations in neurotransmitter levels during chronic infection and association with brain cysts will be presented. Our data presents an interesting interplay with the ‘dopamine hypothesis’ that has postulated a link between elevated dopamine and schizophrenia.
One in ten children and adolescents experience mental health difficulties at any given time, yet only one third of those suffering access treatment. Untreated mental illness predisposes to longstanding individual difficulties, and presents a great public health burden. Large scale initiatives to reduce stigmatization of mental illness in children and adolescents, identified as a key deterrent to treatment, have had limited success, and research is scarce.
To gain a better understanding of the stigma experienced by children and adolescents with mental health difficulties.
We conducted a systematic review of the literature examining stigma and self-stigma towards children and adolescents with mental health difficulties, in order to better understand the extent and type of discrimination directed towards this particularly vulnerable group.
Following PRISMA guidelines, the databases Pubmed, PsychINFO and Cochrane were searched for original research published between 1980 and 2014, assessing public stigma (i.e. the reaction of the general public) and self-stigma (i.e. internalized public stigma) towards children and adolescents with mental health difficulties.
Thirty-seven studies were identified, confirming that stigmatization towards children and young people suffering mental health difficulties is a universal and disabling problem. There was some variation by diagnosis and gender, and stigmatization was for the most part unaffected by labelling. Self-stigmatization led to more secrecy and avoidance of interventions.
The findings confirm that stigmatization of mental illness is poorly understood due to a lack of evidence and methodological discrepancies. Implications of the findings are discussed, and suggestions made for future research.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Research on the impact of stigma associated with mental illness in children is scarce. Considering the known negative effects of stigma associated with mental illness in adults, it is crucial to explore the stigma experienced by children who access mental health treatment. However, no scale measuring self-stigmatization in younger children is available to date. This study aimed to develop and validate such a scale, the Paediatric Self-Stigmatization Scale (PaedS).
A total of 156 children (119 receiving outpatient and 37 receiving inpatient treatment), aged 8–12 years, completed the PaedS, the Self-Perception Profile for Children and the Pediatric Quality of Life Inventory (PedsQL – Child Report, ages 8–12). In addition, parents completed the PedsQL (Parent Report for Children, ages 8–12), the Strengths and Difficulties Questionnaire (SDQ) and a modified subscale of the PaedS measuring the children's rejection by others due to their mental health difficulties.
A confirmatory factor analysis showed that a four-factor structure, comprising Societal Devaluation, Personal Rejection, Self-Stigma and Secrecy scales, had excellent fit to the data (CFI = 0.95; TLI = 0.95; RMSEA = 0.05). Child-reported PaedS scores were positively correlated with parental-reported PaedS scores and negatively with PedsQL, the SDQ, and 5 out of 6 subscales of the Self-Perception Profile for Children, suggesting adequate convergent validity (all P-values < 0.05).
The PaedS is a valid instrument, which is hoped to advance the understanding of self-stigmatization in children with mental health difficulties and contribute to its prevention.
The study aimed to evaluate the shear bond strength (SBS) of metal brackets and adhesive properties of bonded irradiated and non-irradiated teeth.
Sixty-six extracted premolar samples were randomly divided into three groups—(a) Control group consisting of 22 non-irradiated, non-aged teeth (Group 1), (b) 22 non-irradiated, aged samples (Group 2) and (c) 22 irradiated, aged samples (Group 3). Irradiation was done using gamma irradiation with a fractionated dose of 60 Gy for 5 consecutive days per week over 6 weeks. Metal brackets were bonded on all samples with light cure adhesive and subjected to SBS test using universal testing machine. The samples were assessed under the scanning electron microscope to check for the adhesive remnant index (ARI) and tag depth.
There was a statistically significant decrease in the mean SBS of the irradiated samples compared to the non-irradiated teeth. The non-irradiated, aged samples showed a majority of ARI scoring 1 and 2. Whereas, the irradiated samples showed ARI scoring 2 and 3. Approximately, 77·3% of the non-irradiated samples showed no adhesive present on the tooth surface, and 27·2% of the irradiated samples had more than 50% adhesive present on the enamel surface.
There is a statistically significant decrease in SBS of irradiated enamel compared to that of non-irradiated teeth. However, the SBS observed in the three groups was well above the ideal SBS for orthodontic bonding, that is, 5·6–6·8 MPa. The adhesive remnant was found on all samples of the irradiated group. Deeper adhesive resin tags were found in the irradiated group in the resin–enamel interface.
This study assessed the tobacco smoking-associated risk for tuberculous pleural effusion (TPE) in India. Ninety-two patients with TPE and 184 controls were randomly selected and assessed regarding their tobacco-smoking status and type, quantity and duration of tobacco used. Odds ratios (ORs) for the association of smoking cigarette, beedi and cigarette or beedi with TPE were 19.22 (p < 0.0001), 2.89 (p = 0.0006) and 4.57 (p < 0.0001) respectively. ORs for developing TPE increased with an increase in beedi/cigarette consumption, duration and pack years of smoking (p < 0.001 each). TPE was significantly associated with confounding risk factors viz., regular alcohol use (OR = 1.89, p = 0.019), history of contact with tuberculosis (TB) patient (OR = 8.07, p < 0.0001), past history of TB (OR = 22.31, p < 0.0001), family history of TB (OR = 9.05, p = 0.0002) and underweight (OR = 3.73, p = 0.0009). Smoking (OR = 3.07, p < 0.001), regular alcohol use (OR = 2.10, p = 0.018), history of contact with TB patient (OR = 4.01, p = 0.040), family history of TB (OR = 10.80, p = 0.001) and underweight (OR = 5.04, p < 0.001) were independently associated with TPE. Thus, both cigarette- and beedi-smoking have a significant association with TPE. The risk for TPE in tobacco smokers is dose- and duration-dependent.
The effects of silicon incorporation on the in vitro and in vivo properties of magnesium phosphate (MgP) bioceramics were studied. Samples were prepared by conventional solid state synthesis method. Scanning electron microscopy and micro-computed tomography (µ-CT) analysis showed that Si doping reduces degradability of MgP. In vitro studies have shown that MG63 cells can attach and proliferate on MgP samples. Live/dead imaging showed that MgP–0.5Si sample had highest cell proliferation, which was also quantitatively confirmed by alamar blue assay. In vivo biocompatibility of MgP ceramics was assessed after implantation in rabbit model. Detailed µ-CT analysis showed new bone tissue formation around the implant after 30 and 90 days. MgP–0.5Si ceramics had 84% bone regeneration compared with 56% for pure MgP ceramics, as confirmed by oxytetracycline labeling. Our finding suggests that Si doping can alter physicochemical properties of MgP ceramics and promotes osseointegration, which can be a useful choice for bone tissue engineering.
Oral arginine supplements are popular mainly for their presumed vasodilatory benefit. Arginine is a substrate for at least four enzymes including nitric oxide synthase (NOS) and arginase, but the impact of oral supplements on its different metabolic pathways is not clear. Deficiencies of arginine-metabolising enzymes are associated with conditions such as hyperammonaemia, endothelial dysfunction, central nervous system and muscle dysfunction, which complicate the use of oral arginine supplements. We examined the effect of l-arginine (l-Arg) and d-arginine (d-Arg), each at 500 mg/kg per d in drinking water administered for 4 weeks to separate groups of 9-week-old male Sprague–Dawley rats. We quantified the expression of enzymes and plasma, urine and organ levels of various metabolites of arginine. l-Arg significantly decreased cationic transporter-1 expression in the liver and the ileum and increased endothelial NOS expression in the aorta and the kidney and plasma nitrite levels, but did not affect the mean arterial pressure. l-Arg also decreased the expression of arginase II in the ileum, arginine:glycine amidinotransferase in the liver and the kidney and glyoxalase I in the liver, ileum and brain, but increased the expression of arginine decarboxylase and polyamines levels in the liver. d-Arg, the supposedly inert isomer, also unexpectedly affected the expression of some enzymes and metabolites. In conclusion, both l- and d-Arg significantly affected enzymes and metabolites in several pathways that use arginine as a substrate and further studies with different doses and treatment durations are planned to establish their safety or adverse effects to guide their use as oral supplements.
The design of a circular-shaped differential wideband band pass filter (BPF) is described. The proposed filter is compact and provides good common mode (CM) suppression. It consists of four ports with a circular-shaped differential mode (DM). The analysis of the filter has been carried out by bisecting it into identical two-port networks along the symmetry plane, resulting in a band stop or band pass response under CM or DM excitations, respectively. The length and width of the stubs can be tuned to obtain the desired pass band and stop band of the differential BPF. The proposed design is fabricated and measured. The results obtained using measurements are in close agreement with those obtained using simulations.
Linear quadratic regulator (LQR), a popular technique for designing optimal state feedback controller, is used to derive a mapping between continuous and discrete time inverse optimal equivalence of proportional integral derivative (PID) control problem via dominant pole placement. The aim is to derive transformation of the LQR weighting matrix for fixed weighting factor, using the discrete algebraic Riccati equation (DARE) to design a discrete time optimal PID controller producing similar time response to its continuous time counterpart. Continuous time LQR-based PID controller can be transformed to discrete time by establishing a relation between the respective LQR weighting matrices that will produce similar closed loop response, independent of the chosen sampling time. Simulation examples of first/second order and first-order integrating processes exhibiting stable/unstable and marginally stable open loop dynamics are provided, using the transformation of LQR weights. Time responses for set-point and disturbance inputs are compared for different sampling times as fraction of the desired closed loop time constant.
A trauma registry is a disease-specific data collection composed of a file of uniform data elements that describe the injury even, demographics, prehospital information, diagnosis, care, outcomes, and costs of treatment for injured patients.
To establish a trauma registry system on an electronic platform enabling data capturing through Android phones.
A software has been developed for the registry data collection for road traffic injury patients arriving at JPNATC, AIIMS, New Delhi. The software has been designed to use in the Emergency Department on Android phones/laptops with internet access.
A detailed registry data set has been prepared to enter prehospital, in-hospital, and post-discharge details of all the admitted patients. This includes demographic data, prehospital data, injury event data, vital signs within 24-hrs of arrival, ED disposition (date and time), operative procedures within 48 hours of arrival, chest x-ray (date and time), CT (date and time), ventilation days, ICU-stay days, hospital disposition (date and time), injury coding data (region, severity level, ISS, AIS, ICD-10) and Others, e.g., first neurosurgical consultation (date and time) and first blood transfusion (date and time). There are two panels for this software; one for user panel and another for the administrative panel. User panel is being used for data collection by the trained data collectors 24/7 at the emergency department on a rotation basis. The administrative panel is accessible to only the investigator or other authorized persons. The administrative panel and user panels are password protected. The entered data is being saved in a spreadsheet in the backend and can be used for periodic data quality check and data analysis.
There is no trauma registry in India so far for the road traffic injury patients. Present innovation would lay the foundation of national Trauma Registry in India.
G-protein-coupled receptor 142 (GPR142) belongs to rhodopsin family. GPR142 and GPR119, both Gq-coupled receptors, are expressed in pancreatic β cells of pancreas; their activation eventually leads to triggering of insulin secretion. In this paper, through a systems and synthetic biology approach, the effect of a common hit compound has been investigated in GPR142 and GPR119 pathways. This hit that has the potential to be developed as a lead for nanodrug was obtained through high-throughput virtual screening. The hit compound was further docked with nanoparticles (GOLD, SPION, and CeO2). The probable effect of this potential hit on insulin secretion in type 2 diabetes and its dynamic behavior was explored. Kinetic simulation was performed for cross-validation of its role in both the pathways. This study opens up a probable avenue in therapy of type 2 diabetes through regulation of GPR142 and GPR119 receptors. The biological circuit constructed may further have an application as a modulator to control the up- and downregulation of the biochemical pathway and can be implemented as sensors or nanochips for therapy.
Numerous studies have reported that amyloid-beta 42 (Aβ-42) protein is a high-profile risk factor associated with the onset and progression of Alzheimer’s disease (AD). Accumulation of extracellular senile plaques, synaptic degeneration, and intracellular neurofibrillary tangles were recorded as essential features that facilitate the onset of Aβ-42, resulting in AD. Hence, we attempted a new screening technique to discover potential inhibitors against Aβ-42 using an in silico deep neural network approach. We screened PubChem compounds library and found wgx-50 as a potential inhibitor of Aβ-42. Also, synergistic effects of wgx-50–gold nanoparticles (AuNPs) complex induced significant inhibition of Aβ-42, compared with those of wgx-50 alone. Further, molecular docking analysis, systems biology approach, and time course simulation confirmed that synergistic effects of wgx-50–AuNPs complex have potential application in the treatment for AD. Additionally, we proposed the biological circuit for AD induced by Aβ-42 that can be used to monitor the effect of drugs on AD.
In recent years, the wearing of Islamic dress in public spaces and elsewhere has generated widespread controversy all over Europe. The wearing of the hijab and other Islamic veils has been the subject of adjudication before the European Court of Human Rights (ECtHR) on many occasions. The most recent case before the ECtHR as to the prohibition on wearing the hijab is Lachiri v Belgium. In this case, the ECtHR held that a prohibition on wearing the hijab in the courtroom constitutes an infringement of Article 9 of the European Convention on Human Rights (ECHR), which guarantees the right to freedom of religion or belief. From the perspective of religious freedom, the ruling of the Strasbourg Court in Lachiri is very significant for many reasons. The purpose of this comment is critically to analyse the ECtHR's decision in Lachiri from the standpoint of religious liberty.
To explore the possibility for a statistically appropriate value of mid-upper arm circumference (MUAC) to identify the state of severe undernutrition, based on very low BMI, among adult Indian slum dwellers.
Cross-sectional study on adults. Height and MUAC were recorded and BMI was computed. Chronic energy deficiency (CED) was determined using the WHO international guidelines as BMI<18·5 kg/m2 and normal as BMI≥18·5 kg/m2. Besides calculating mean, sd and 25th, 50th and 75th percentile values, multiple linear regression analysis was undertaken to assess the associations between age, MUAC and BMI. Receiver-operating characteristic curve analysis was performed to determine the best MUAC cut-off to identify CED status. The χ2 test was used to assess significance of the difference in CED prevalence across MUAC categories.
An urban slum in Midnapore town, West Bengal State, India.
Male (n 467) and female (n 488) Indian slum dwellers.
MUAC of 22·7 and 21·9 cm, respectively, in males and females were the best cut-off points to differentiate CED from non-CED.
Results supported the validity of the WHO-recommended MUAC cut-offs for adults. There is still a need to establish statistically appropriate MUAC cut-offs to predict undernutrition and morbidity.
Currently, energy evaluation of fish feeds is performed on a digestible energy basis. In contrast to net energy (NE) evaluation systems, digestible energy evaluation systems do not differentiate between the different types of digested nutrients regarding their potential for growth. The aim was to develop an NE evaluation for fish by estimating the energy efficiency of digestible nutrients (protein, fat and carbohydrates) and to assess whether these efficiencies differed between Nile tilapia and rainbow trout. Two data sets were constructed. The tilapia and rainbow data set contained, respectively, eight and nine experiments in which the digestibility of protein, fat and energy and the complete energy balances for twenty-three and forty-five diets was measured. The digestible protein (dCP), digestible fat (dFat) and digestible carbohydrate intakes (dCarb) were calculated. By multiple regression analysis, retained energy (RE) was related to dCP, dFat and dCarb. In tilapia, all digestible nutrients were linearly related to RE (P<0·001). In trout, RE was quadratically related to dCarb (P<0·01) and linearly to dCP and dFat (P<0·001). The NE formula was NE=11·5×dCP+35·8×dFAT+11·3×dCarb for tilapia and NE=13·5×dCP+33·0×dFAT+34·0×dCarb–3·64×(dCarb)2 for trout (NE in kJ/(kg0·8×d); dCP, dFat and dCarb in g/(kg0·8×d)). In tilapia, the energetic efficiency of dCP, dFat and dCarb was 49, 91 and 66 %, respectively, showing large similarity with pigs. Tilapia and trout had similar energy efficiencies of dCP (49 v. 57 %) and dFat (91 v. 84 %), but differed regarding dCarb.
Magnetic field has been used to trigger biofilm formation. Iron oxide nanoparticles were attached to bacterial cells and cells were aggregated by application of magnetic field. Artificial cellular crowding triggered quorum sensing and led to the formation of biofilm at the sub-threshold population. Aggregation process was monitored by studying temporal dynamics of capacitance and conductance profiles. Capacitive profile exhibited a plateau upon introduction of magnetic field which was retained even after field was removed. This hysteresis property signified biofilm initiation in response to artificial crowding. This work demonstrates how synthetic biology is enabled by including nanoparticles in the interactome.