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Delimiting the Aravalli mountain range in the east, the Great Boundary Fault (GBF) occurs as a crustal-scale tectonic lineament in the NW Indian Shield. The structural and tectonic characteristics of the GBF are, as yet, not well-understood. We attempt to fill this gap by using a combination of satellite image processing, high-resolution outcrop mapping and structural analysis around Chittaurgarh. The study area exposes the core and damage zone of the GBF. Three successive phases of folding, F1, F2 and F3, are associated with deformation in the GBF. The large-scale structural characteristics of the GBF core are: (i) a non-coaxial refolding of F1 folds by F2 folds; and (ii) the parallelism between the GBF and F2 axial traces. In addition, numerous metre-scale ductile shear zones cut through the rocks in the GBF core. The damage zone is characterized by the large-scale F1 folds and the mesoscopic-scale strike-slip faults, thrusts and brittle-ductile shear zones. Several lines of evidence, such as the inconsistent overprinting relationship between the strike-slip faults and thrusts, the occurrence of en échelon folds and the palaeostress directions suggest that the GBF is a dextral transpression fault zone. Structural geometry and kinematic indicators imply a wrench- and contraction-dominated deformation in the core and damage zone, respectively. We infer that the GBF is a strain-partitioned dextral transpression zone.
Cannabis is the most widely used illicit drug worldwide, and it is estimated that up to 30% of people who use cannabis will develop a cannabis use disorder (CUD). Demand for treatment of CUD is increasing in almost every region of the world and cannabis use is highly comorbid with mental disorders, where sustained use can reduce treatment compliance and increase risk of relapse. In this narrative review, we outline evidence for psychosocial and pharmacological treatment strategies for CUD, both alone and when comorbid with psychosis, anxiety or depression. Psychosocial treatments such as cognitive behavioural therapy, motivational enhancement therapy and contingency management are currently the most effective strategy for treating CUD but are of limited benefit when comorbid with psychosis. Pharmacological treatments targeting the endocannabinoid system have the potential to reduce cannabis withdrawal and cannabis use in CUD. Mental health comorbidities including anxiety, depression and psychosis hinder effective treatment and should be addressed in treatment provision and clinical decision making to reduce the global burden of CUDs. Antipsychotic medication may decrease cannabis use and cannabis craving as well as psychotic symptoms in patients with CUD and psychosis. Targeted treatments for anxiety and depression when comorbid with CUD are feasible.
Myasthenia gravis (MG) is an autoimmune disorder that frequently affects young women of reproductive age. The multidirectional interplay between MG, pregnancy, and fetal health poses a complex scenario for pregnant women with MG and the healthcare team. Here, we reviewed our local experience with MG, pregnancy, and outcomes.
We performed a retrospective chart review of patients with MG attending the Prosserman Family Neuromuscular Clinic from 2001 to 2019 and who were referred to a high-risk pregnancy clinic. MG status was defined as stable, better, or worse. Information was collected on the delivery route, pregnancy, and neonatal complications.
We identified 20 women with MG for a total of 28 pregnancies. Worsening was observed in 50% of pregnancies: 18% during pregnancy, 25% following delivery, and 7% during both. 66.7% of patients with MG duration of 2 years or less had worsening during pregnancy. Three patients who stopped immunosuppressive treatment during pregnancy worsened and one had a crisis. C-section was done in 29% of pregnancies. The rate of delivery complications was 7% and of neonatal MG was 7%.
A high proportion of MG patients worsened during pregnancy, particularly those with disease duration less than 2 years, and those who discontinued immunosuppression during pregnancy. However, pregnancy was largely unaffected, rate of neonatal MG was low, frequencies of C-section, delivery complications, and premature births were similar to the general population. While the study has limitations due to the retrospective nature, these insights provide some guidance when counseling young myasthenic women about family planning.
Predicting and preventing relapse presents a crucial opportunity and first step to improve outcomes and reduce the care gap for persons living with schizophrenia. Using commercially available smartphones and smartwatches, technology now affords opportunities to capture real-time and longitudinal profiles of patients’ symptoms, cognition, physiology and social patterns. This novel data makes it possible to explore relationships between behaviours, physiology and symptoms, which may yield personalised relapse signals.
Smartphone Health Assessment for Relapse Prevention (SHARP), an international mental health research study supported by the Wellcome Trust, will inform the development of a scalable and sharable digital health solution to monitor personal risk of relapse. The resulting technology will be studied toward predicting and preventing relapse among individuals diagnosed with serious mental illness.
SHARP is a two-phase study with research sites in Boston, Massachusetts, and Bangalore and Bhopal, India. During phase 1, focus groups will be conducted at each study site to collect feedback on the design and features available on mindLAMP, a digital health platform. Individuals with serious mental illness will use mindLAMP for the duration of a year during phase 2.
The results of the research outlined in this protocol will guide the development of technology and digital tools to help address pervasive challenges in global mental health.
The digital tools developed as a result of this study, and participants’ experiences using them, may offer insight into opportunities to expand digital mental health resources and optimize their utilisation around the world.
The Health and Family Welfare Department of the Government of Gujarat is implementing a program called Technology for Community Health Operation (TeCHO+) to address the state's priority health issues. This paper details the protocol for using health technology assessment to assess the impact of the TeCHO+ program on data quality, service delivery coverage, rates of morbidity and mortality, and cost effectiveness.
This mixed-method study will be conducted in five districts. Data will be validated in a phased manner over a three-year period, along with an assessment of key outcome indicators. Additionally, key informant interviews will be conducted and cost data will be gathered.
Early implementation of TeCHO+ has highlighted mixed impact at an operational level, with gaps in implementation. Despite some gaps in the available evidence, TeCHO+ solutions can significantly improve health service delivery through increased accuracy of data management, high-risk identification, and quality and accessibility of care. However, implementation challenges require even greater efforts to establish comprehensive systems for troubleshooting and corrective measures for improving data quality. Positive experiences encourage grassroots teams for continuing the use of TeCHO+.
TeCHO+ is expected to improve service coverage and reduce rates of morbidity and mortality by improving the population's nutritional status, the timeliness of care for high-risk cases, and the non-communicable disease profile of the community.
We introduce a multivariate class of distributions with support I, a k-orthotope in
, which is dense in the set of all k-dimensional distributions with support I. We call this new class ‘multivariate finite-support phase-type distributions’ (MFSPH). Though we generally define MFSPH distributions on any finite k-orthotope in
, here we mainly deal with MFSPH distributions with support
. The distribution function of an MFSPH variate is computed by using that of a variate in the MPH
class, the multivariate class of distributions introduced by Kulkarni (1989). The marginal distributions of MFSPH variates are found as FSPH distributions, the class studied by Ramaswami and Viswanath (2014). Some properties, including the mixture property, of MFSPH distributions are established. Estimates of the parameters of a particular class of bivariate finite-support phase-type distributions are found by using the expectation-maximization algorithm. Simulated samples are used to demonstrate how this class could be used as approximations for bivariate finite-support distributions.
Cognitive impairments, which contribute to the profound functional deficits observed in psychotic disorders, have found to be associated with abnormalities in trial-level cognitive control. However, neural tasks operate within the context of sustained cognitive states, which can be assessed with ‘background connectivity’ following the removal of task effects. To date, little is known about the integrity of brain processes supporting the maintenance of a cognitive state in individuals with psychotic disorders. Thus, here we examine background connectivity during executive processing in a cohort of participants with first-episode psychosis (FEP).
The following fMRI study examined background connectivity of the dorsolateral prefrontal cortex (DLPFC), during working memory engagement in a group of 43 patients with FEP, relative to 35 healthy controls (HC). Findings were also examined in relation to measures of executive function.
The FEP group relative to HC showed significantly lower background DLPFC connectivity with bilateral superior parietal lobule (SPL) and left inferior parietal lobule. Background connectivity between DLPFC and SPL was also positively associated with overall cognition across all subjects and in our FEP group. In comparison, resting-state frontoparietal connectivity did not differ between groups and was not significantly associated with overall cognition, suggesting that psychosis-related alterations in executive networks only emerged during states of goal-oriented behavior.
These results provide novel evidence indicating while frontoparietal connectivity at rest appears intact in psychosis, when engaged during a cognitive state, it is impaired possibly undermining cognitive control capacities in FEP.
Since the beginning of 2020, the COVID-19 pandemic has dramatically influenced almost every aspect of human life. Activities requiring human gatherings have either been postponed, cancelled, or held completely virtually. To supplement lack of in-person contact, people have increasingly turned to virtual settings on-line, advantages of which include increased inclusivity and accessibility and reduction of carbon footprint. However, emerging online technologies cannot fully replace, in-person scientific events. In-person meetings are not susceptible to poor internet connectivity problems, and they provide novel opportunities for socialization, creating new collaborations, and sharing ideas. To continue such activities, a hybrid model for scientific events could be a solution offering both in-person and virtual components. While participants can freely choose the mode of their participation, virtual meetings would most benefit those who cannot attend in-person due to the limitations. In-person portions of meetings should be organized with full consideration of prevention and safety strategies including risk assessment and mitigation, venue and environmental sanitation, participant protection and disease prevention, and promoting the hybrid model. This new way of interaction between scholars can be considered as a part of a resilience system which was neglected previously and should become a part of routine practice in scientific community.
Food insecurity (FI) is the lack of consistent access to enough food for an active and healthy life. Community-based hunger relief programs often serve as emergency food sources for families with FI. However, these programs may not provide foods that diverse populations of people prefer. We sought to evaluate the dietary patterns and preferences of families living in food-insecure neighborhoods and utilizing a community-based hunger relief program, in order to improve the utilization of local nutritional programs.
We examined the Help Our People Eat (HOPE) community-based mobile meal program. Free-listing interviews (n = 63) were conducted with English-(66%) and Spanish-speaking (34%) participants of the program. Participants were asked about FI risk, food preferences, and dietary behaviors at home.
The majority of participants (90%) had children in the household. About 60% reported not being able to afford the type of food they enjoyed. Most participants reported using stoves for cooking (80%). Participants overwhelmingly cooked with chicken, beef, and pork. The most common side dishes included potatoes, rice, and salad. Most participants reported no interest in cooking differently or learning new recipes.
A common theme throughout interviews was that families prefer similar meals, but may prepare them differently based on the language spoken. Food preferences consisted of a high intake of carbohydrate-rich meals, perhaps because these foods may be cheaper and easier to access. Notably, new recipes and cooking methods were not a priority for these families, possibly due to the time and effort needed to learn them.
In this study, an atmospheric pressure dielectric barrier discharge-based argon plasma jet has been modeled using COMSOL Multiphysics, which is based on the finite element method. The fluid dynamics and plasma modules of COMSOL Multiphysics code have been used for the modeling of the plasma jet. The plasma parameters, such as electron density, electron temperature, and electrical potential, have been examined by varying the electrical parameters, that is, supply voltage and supply frequency for both cases of static and with the flow of argon gas. The argon gas flow rate was fixed at 1 l/min. Ring electrode arrangement is subjected to a range of supply frequencies (10–25 kHz) and supply voltages (3.5–6 kV). The experimental results of the ring electrode configuration have been compared with the simulation analysis results. These results help in establishing an optimized operating range of the dielectric barrier discharge-based cold plasma jet in the glow discharge regime without arcing phenomenon. For the applied voltage and supply frequency parameters examined in this work, the discharge was found to be consistently homogeneous and displayed the characteristics of atmospheric pressure glow discharge.
In this note we study the emergence of Hamiltonian Berge cycles in random r-uniform hypergraphs. For
we prove an optimal stopping time result that if edges are sequentially added to an initially empty r-graph, then as soon as the minimum degree is at least 2, the hypergraph with high probability has such a cycle. In particular, this determines the threshold probability for Berge Hamiltonicity of the Erdős–Rényi random r-graph, and we also show that the 2-out random r-graph with high probability has such a cycle. We obtain similar results for weak Berge cycles as well, thus resolving a conjecture of Poole.
Deep learning has pushed the scope of digital pathology beyond simple digitization and telemedicine. The incorporation of these algorithms in routine workflow is on the horizon and maybe a disruptive technology, reducing processing time, and increasing detection of anomalies. While the newest computational methods enjoy much of the press, incorporating deep learning into standard laboratory workflow requires many more steps than simply training and testing a model. Image analysis using deep learning methods often requires substantial pre- and post-processing order to improve interpretation and prediction. Similar to any data processing pipeline, images must be prepared for modeling and the resultant predictions need further processing for interpretation. Examples include artifact detection, color normalization, image subsampling or tiling, removal of errant predictions, etc. Once processed, predictions are complicated by image file size – typically several gigabytes when unpacked. This forces images to be tiled, meaning that a series of subsamples from the whole-slide image (WSI) are used in modeling. Herein, we review many of these methods as they pertain to the analysis of biopsy slides and discuss the multitude of unique issues that are part of the analysis of very large images.
OBJECTIVES/GOALS: Early age at menopause has been linked to increased risk of cardiovascular disease; however, there is limited evidence for a relationship between early menopause and heart failure (HF). We examined whether early menopause is associated with incident HF among women in the southeastern United States. METHODS/STUDY POPULATION: The Southern Community Cohort Study enrolled ~86,000 low-income black and white adults from 2002 to 2009. Participants for this analysis were 11,948 women who were postmenopausal at enrollment, had no history of HF, and were on Medicaid or Medicare. HF events were ascertained using ICD-9 codes 428.x via linkage of the cohort with CMS Research Identifiable Files through December 31, 2010. Early menopause was defined as self-reported age at menopause less than 45 years. Hazard ratios (HRs) and 95% confidence intervals (CIs) were computed from multivariable Cox regression models, overall and by race, adjusting for demographic, lifestyle, and reproductive factors, including reason for menopause. RESULTS/ANTICIPATED RESULTS: At baseline, mean age was 58±9 years, and 65% of participants were black. Among women with early menopause, 76% (n = 4,836) had menopause due to hysterectomy or oophorectomy. In women with later menopause, 74% (n = 4,102) reported natural menopause. During a median follow-up of 5.0 years (range 3.1-6.7), 2,157 incident HF events occurred. Compared with women with later onset of menopause, those with early menopause had increased HF risk (HR: 1.27, 95% CI: 1.10–1.47). Risk of HF associated with early menopause was similar in white and black women (p-value for interaction: 0.13). DISCUSSION/SIGNIFICANCE OF IMPACT: In this largely low-income population, early menopause was associated with an increased risk of developing HF. Women with early menopause represent a potential target population for future interventions to decrease risk of HF and cardiovascular risk factors.
The effect of fluid on the natural frequencies of a vertical rectangular lock gate is investigated. The fluid is assumed to be inviscid and incompressible having an irrotational flow field. The far boundary of fluid domain is truncated near the lock gate structure by solving the Laplace equation using Fourier half range cosine series expansion. The formulation of lock gate structure is governed using Mindlin’s plate theory. The coupled interaction between the fluid domain and the lock gate structure is established using finite element method (FEM) and a computer code is written using FORTRAN. Convergence study and validation of the formulation are carried out to minimise the computational error. The natural frequencies of lock gate coupled with and without fluid are determined for undisturbed and linearised free surface conditions. By varying extent of fluid domain, the effect on the natural frequencies of lock gate is evaluated. The results of natural frequencies obtained may be useful to the designer when the reservoir lock gate structure is exposed to the natural disasters.
This systematic review examines the effectiveness and cost-effectiveness of behavioural health integration into primary healthcare in the management of depression and unhealthy alcohol use in low- and middle-income countries. Following PRISMA guidelines, this review included research that studied patients aged ≥18 years with unhealthy alcohol use and/or depression of any clinical severity. An exploration of the models of integration was used to characterise a typology of behavioural health integration specific for low- and middle-income countries.
Fifty-eight articles met inclusion criteria. Studies evidenced increased effectiveness of integrated care over treatment as usual for both conditions. The economic evaluations found increased direct health costs but cost-effective estimates. The included studies used six distinct behavioural health integration models.
Behavioural health integration may yield improved health outcomes, although it may require additional resources. The proposed typology can assist decision-makers to advance the implementation of integrated models.
Hairy fleabane [Conyza bonariensis (L.) Cronquist] is a problematic weed in Australian no-till cropping systems. Consequently, a study was conducted to examine the effect of temperature, light, salt stress, osmotic stress, burial depth, and sorghum crop residue on germination and emergence in two populations (C and W: collected from chick pea [Cicer arietinum L.] and wheat [Triticum aestivum L.] fields, respectively) of C. bonariensis. Both populations were able to germinate over a wide range of alternating day/night temperatures (15/5 to 35/25 C); however, the C population had optimum (and similar) germination over the range of 20/10 and 30/20 C, while the W population showed maximum germination at 25/15 C. A negative relationship was observed between osmotic potential and germination, with 31% and 14% germination of the C and W populations at −0.6 MPa, respectively. These observations suggest that population C was more tolerant to higher osmotic potentials than population W. Seeds of both populations germinated when exposed to a wide range of sodium chloride levels (NaCl, 0 to 200 mM); however, beyond 200 mM NaCl, no germination was observed in either population. Maximum germination of the C (70%) and W (41%) populations was observed on the soil surface with no emergence from a burial depth of 1 cm. The application of sorghum residue at an amount of 6,000 kg ha−1 reduced emergence of the C and W populations by 55% and 58%, respectively, compared with the no-residue treatment. Knowledge gained from this study suggests that the following strategies could be used for more efficacious management of C. bonariensis: (1) a shallow-tillage operation to bury weed seeds in conventional tillage systems, and (2) retention of sorghum residue on the soil surface in no-till systems.
Indian society, from time immemorial, has nurtured a thinking civilization. It never lived an isolated existence and never displayed xenophobic tendencies until recently. Techno-scientific tradition in India has largely been a synthetic tradition, continuously evolving as a result of each politico-cultural interaction with the outside world and social change within the region. In pre-modern times, the Indian subcontinent was known for its contribution to astronomy, medicine, and mathematics. But it was during the post-Renaissance epoch (that of Descartes and Newton) that Europe began to outdistance all other culture-areas.
Research in developmental neuropsychiatric conditions has revealed morphological and functional divergences in the brain. In some cases, the divergences occur due to one or two highly penetrant genomic mutations. In case such as autism, mutations in varied sets of genes may produce a convergent autism behavioral phenotype. It is thus likely that there may be other forms of non-genomic regulation of gene expression during development affecting behavioral outcome. Epigenetic gene regulation is one such mechanism that can permanently switch on or switch off gene expression, and these epigenetic changes can be inherited from one cell stage to another during differentiation, mimicking the effects of genomic mutations. Epigenetic gene regulation occurring during early developmental stages of cellular differentiation, which are highly sensitive to environmental cues, is the primary mechanism responsible for the phenomenon known as evolutionary development or “evo-devo.” This chapter discusses these mechanisms in the context of autism and the environmental factors that influence it.