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Mental health stigma is a multidimensional concept that encompasses many different themes and definitions. Public stigma is defined as the degree to which the general public holds negative views and discriminates against a specific group.
To understand the context and correlates of stigma in multi-ethnic Singapore.
The current study aimed to (i) explore the factor structure of the Depression Stigma Scale and the Social Distance Scale using an exploratory structural equation modelling approach and (ii) examine the correlates of the identified dimensions of stigma in the general population of Singapore.
Data for the current study came from a larger nation-wide cross-sectional study of mental health literacy conducted in Singapore. All respondents were administered the Personal and Perceived scales of the Depression Stigma Scale and the Social Distance scale to measure personal stigma and social distance respectively.
The findings from the factor analysis revealed that personal stigma formed two distinct dimensions comprising “Weak-not-Sick” and “Dangerous/Unpredictable” components while social distance stigma items loaded strongly into a single factor. Those of Malay and Indian ethnicity, lower education, lower income status and those who were administered the depression and alcohol abuse vignette were significantly associated with higher weak-not-sick scores. Those of Indian ethnicity, 6 years of education and below, lower income status and those who were administered the alcohol abuse vignette were significantly associated with higher dangerous/unpredictable scores.
There is a need for well-planned and culturally relevant anti-stigma campaigns in this population.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Pharyngocutaneous fistulae are dreaded complications following total laryngectomy. This paper presents our experience using 3–5 ml gastrografin to detect pharyngeal leaks following total laryngectomy, and compares post-operative videofluoroscopy with clinical follow-up findings in the detection of pharyngocutaneous fistulae.
A retrospective case–control study was conducted of total laryngectomy patients. The control group (n = 85) was assessed clinically for development of pharyngocutaneous fistulae, while the study group (n = 52) underwent small-volume (3–5 ml) post-operative gastrografin videofluoroscopy.
In the control group, 24 of 85 patients (28 per cent) developed pharyngocutaneous fistulae, with 6 requiring surgical correction. In the study group, 24 of 52 patients (46 per cent) had videofluoroscopy-detected pharyngeal leaks; 4 patients (8 per cent) developed pharyngocutaneous fistulae, but all cases resolved following non-surgical management. Patients who underwent videofluoroscopy had a significantly lower risk of developing pharyngocutaneous fistulae; sensitivity and specificity in the detection of pharyngocutaneous fistulae were 58 per cent and 100 per cent respectively.
Small-volume gastrografin videofluoroscopy reliably identified small pharyngeal leaks. Routine use in total laryngectomy combined with withholding feeds in cases of early leaks may prevent the development of pharyngocutaneous fistulae.
For the first time, we report the identification of NUV bright red clump (RC) stars and the extension of RC stars over two magnitudes both in color and magnitude axis in NUV vs (NUV – optical) color magnitude diagram. We find that the extension of RC is not due to photometric uncertainties. We suggest that the extension could be an effect of field star contamination. We also suggest that if it is an intrinsic property of the cluster then age and/or metallicity spread within the cluster could be the possible reasons for extended RC.
The second Singapore Mental Health Study (SMHS) – a nationwide, cross-sectional, epidemiological survey - was initiated in 2016 with the intent of tracking the state of mental health of the general population in Singapore. The study employed the same methodology as the first survey initiated in 2010. The SMHS 2016 aimed to (i) establish the 12-month and lifetime prevalence and correlates of major depressive disorder (MDD), dysthymia, bipolar disorder, generalised anxiety disorder (GAD), obsessive compulsive disorder (OCD) and alcohol use disorder (AUD) (which included alcohol abuse and dependence) and (ii) compare the prevalence of these disorders with reference to data from the SMHS 2010.
Door-to-door household surveys were conducted with adult Singapore residents aged 18 years and above from 2016 to 2018 (n = 6126) which yielded a response rate of 69.0%. The subjects were randomly selected using a disproportionate stratified sampling method and assessed using World Health Organization Composite International Diagnostic Interview version 3.0 (WHO-CIDI 3.0). The diagnoses of lifetime and 12-month selected mental disorders including MDD, dysthymia, bipolar disorder, GAD, OCD, and AUD (alcohol abuse and alcohol dependence), were based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria.
The lifetime prevalence of at least one mood, anxiety or alcohol use disorder was 13.9% in the adult population. MDD had the highest lifetime prevalence (6.3%) followed by alcohol abuse (4.1%). The 12-month prevalence of any DSM-IV mental disorders was 6.5%. OCD had the highest 12-month prevalence (2.9%) followed by MDD (2.3%). Lifetime and 12-month prevalence of mental disorders assessed in SMHS 2016 (13.8% and 6.4%) was significantly higher than that in SMHS 2010 (12.0% and 4.4%). A significant increase was observed in the prevalence of lifetime GAD (0.9% to 1.6%) and alcohol abuse (3.1% to 4.1%). The 12-month prevalence of GAD (0.8% vs. 0.4%) and OCD (2.9% vs. 1.1%) was significantly higher in SMHS 2016 as compared to SMHS 2010.
The high prevalence of OCD and the increase across the two surveys needs to be tackled at a population level both in terms of creating awareness of the disorder and the need for early treatment. Youth emerge as a vulnerable group who are more likely to be associated with mental disorders and thus targeted interventions in this group with a focus on youth friendly and accessible care centres may lead to earlier detection and treatment of mental disorders.
Elderly patients have been consistently shown to receive suboptimal therapy for cancers of the head and neck. This study was performed to determine the peri-operative outcomes of these patients and compare them with those of younger patients.
In this retrospective analysis, 115 patients aged 70 years or more undergoing major surgery for head and neck cancers were matched with 115 patients aged 50–60 years, and univariate analysis was performed.
Elderly patients had a reduced performance status (p < 0.001) and more co-morbid illnesses (p = 0.007), but a comparable intra-operative course. They had a longer median hospital stay (p = 0.016), longer intensive care unit stay (p = 0.04), longer median tracheostomy dependence (p = 0.04) and were more often discharged with feeding tubes (p < 0.001). They also had a higher incidence of post-operative non-fatal cardiac events (p = 0.045).
Elderly patients with good performance status should receive curative-intent surgery. Although hospital stay and tube dependence are longer, morbidity and mortality are comparable with younger patients.
We use particle-resolved direct numerical simulation (PR-DNS) as a model-free physics-based numerical approach to validate particle acceleration modelling in gas-solid suspensions. To isolate the effect of the particle acceleration model, we focus on point-particle direct numerical simulation (PP-DNS) of a collision-free dilute suspension with solid-phase volume fraction
in a decaying isotropic turbulent particle-laden flow. The particle diameter
in the suspension is chosen to be the same as the initial Kolmogorov length scale
) in order to overlap with the regime where PP-DNS is valid. We assess the point-particle acceleration model for two different particle Stokes numbers,
and 100. For the high Stokes number case, the Stokes drag model for particle acceleration under-predicts the true particle acceleration. In addition, second moment quantities which play key roles in the physical evolution of the gas–solid suspension are not correctly captured. Considering finite Reynolds number corrections to the acceleration model improves the prediction of the particle acceleration probability density function and second moment statistics of the point-particle model compared with the particle-resolved simulation. We also find that accounting for the undisturbed fluid velocity in the acceleration model can be of greater importance than using the most appropriate acceleration model for a given physical problem.
GLP-1 (abnormal germline proliferation) is a Notch-like receptor protein that plays an essential role in pharyngeal development. In this study, an orthologue of Caenorhabditis elegans glp-1 was identified in Meloidogyne incognita. A computational analysis revealed that the orthologue contained almost all the domains present in the C. elegans gene: specifically, the LIN-12/Notch repeat, the ankyrin repeat, a transmembrane domain and different ligand-binding motifs were present in orthologue, but the epidermal growth factor-like motif was not observed. An expression analysis showed differential expression of glp-1 throughout the life cycle of M. incognita, with relatively higher expression in the egg stage. To evaluate the silencing efficacy of Mi-glp-1, transgenic Arabidopsis plants carrying double-stranded RNA constructs of glp-1 were generated, and infection of these plants with M. incognita resulted in a 47–50% reduction in the numbers of galls, females and egg masses. Females obtained from the transgenic RNAi lines exhibited 40–60% reductions in the transcript levels of the targeted glp-1 gene compared with females isolated from the control plants. Second-generation juveniles (J2s), which were descendants of the infected females from the transgenic lines, showed aberrant phenotypes. These J2s exhibited a significant decrease in the overall distance from the stylet to the metacorpus region, and this effect was accompanied by disruption around the metacorporeal bulb of the pharynx. The present study suggests a role for this gene in organ (pharynx) development during embryogenesis in M. incognita and its potential use as a target in the management of nematode infestations in plants.
The current study aimed to: (i) describe the extent of overall stigma as well as the differences in stigma towards people with alcohol abuse, dementia, depression, schizophrenia and obsessive compulsive disorder, as well as (ii) establish the dimensions of stigma and examine its correlates, in the general population of Singapore, using a vignette approach.
Data for the current study came from a larger nation-wide cross-sectional study of mental health literacy conducted in Singapore. The study population comprised Singapore Residents (Singapore Citizens and Permanent Residents) aged 18–65 years who were living in Singapore at the time of the survey. All respondents were administered the Personal and Perceived scales of the Depression Stigma scale and the Social Distance scale to measure personal stigma and social distance, respectively. Weighted mean and standard error of the mean were calculated for continuous variables, and frequencies and percentages for categorical variables. Exploratory structural equation modelling and confirmatory factor analysis were used to establish the dimensions of stigma. Multivariable linear regressions were conducted to examine factors associated with each of the stigma scale scores.
The mean age of the respondents was 40.9 years and gender was equally represented (50.9% were males). The findings from the factor analysis revealed that personal stigma formed two distinct dimensions comprising ‘weak-not-sick’ and ‘dangerous/unpredictable’ while social distance stigma items loaded strongly into a single factor. Those of Malay and Indian ethnicity, lower education, lower income status and those who were administered the depression and alcohol abuse vignette were significantly associated with higher weak-not-sick scores. Those of Indian ethnicity, 6 years of education and below, lower income status and those who were administered the alcohol abuse vignette were significantly associated with higher dangerous/unpredictable scores. Those administered the alcohol abuse vignette were associated with higher social distance scores.
This population-wide study found significant stigma towards people with mental illness and identified specific groups who have more stigmatising attitudes. The study also found that having a friend or family member with similar problems was associated with having lower personal as well as social distance stigma. There is a need for well-planned and culturally relevant anti-stigma campaigns in this population that take into consideration the findings of this study.
Salinity gradient is an enormous source of clean energy. A process for potential generation from an ionic concentration gradient produced in single and multicell assembly is presented. The ionic gradient is created using a fuel cell type cell with a micro-porous ion exchange membrane, both anionic (AEM) and cationic (CEM). Various salinity gradients, Salt : Fresh, from 100 : 0 to 16000 : 0 was established using NaCl solution, in the electrode chambers. A potential of 20 mV/cm to 25 mV/cm can be realized at ambient temperatures and pressures for a bipolar AEM/CEM cell. The performance was optimized for various static and dynamic flow rates of the saline and fresh water. The cell performance can further be optimized for Membrane Electrode System (MES) morphology. A multicell unit was assembled and the results presented for various conditions like concentration gradients, flow rates and pressure. The thermodynamic and electrical efficiency needs to be evaluated for various gradients and flow rates. The relation with number of valance electrons/ ion and the potential generated changes for various dynamic condition of salinity. The higher the salinity gradient the larger is the potential generated. This is limited by the membrane characteristics. There exists a monotonic relation between the number of valence electron/ion/unit time and the potential generated up to about 16000 concentration. The membrane characteristics have been studied for optimal ion crossover for various gradients and flow. The graph between ln (gradient) versus Voltage provides insights into this process. This presents a very cost effective and clean process of energy conversion.
Direct Methanol Fuel Cell, DMFC, technology, can be used for fabrication of sensors for volatile organic compounds like alcohols. A fundamental limitation in DMFC is methanol crossover. In this process methanol diffuses from the anode through the electrolyte to the cathode, where it reacts directly with the oxygen and produces no electrical current from the cell. This also results in poisoning of the cathode catalysts. The designed and fabrication of the sensor is by means of micro electro mechanical systems (MEMS) fabrication technology with electrochemical inputs. To achieve this we have used a passive mode design protocol using COMSOL Multiphysics. The design and simulation would involve optimization of various parameters, in the construction of the cell. We can optimize the overall power density and hence the sensitivity of the sensor by the modification of various parameters like the area of the working electrodes, separation distance and the electrode-electrolyte interface. A passive mode design protocol, for a cm cell area, using various parametric functions, and interfacing Darcy’s law of fluidic flow through a porous medium, under specific pressure and temperature, was applied. The designing involves the construction of gas diffusion layers using carbon cloth for anode and cathode with various parametric variations. Nafion membrane was selected as proton exchange membrane for the construction with different interface structure to analyze the sensor’s performance. Platinum and various alloy catalysts like Pt-Ru, Pt-Fe, Pt-Sn and Pt-Mo was chosen as the working catalysts. The parametric functions of the cell were optimized for ampherometric detection. It is proposed to design a MEMS based sensor with microfludic interconnects and its response characteristics will be studied.
Electrochemical Double Layer Capacitors, EDLC, using Cobalt sulfide- Graphene (CoSG) composite electrodes, were fabricated and the storage process was studied. CoSG composite was prepared by a simple chemical route. X-ray diffraction (XRD), Fourier Transform Infrared Spectroscopy (FTIR), Thermogravimetric Analysis (TGA) and Field Emission Scanning Electron microscopy (FESEM) were used to characterized the as prepared composites which indicated formation of Co S phase. Solutions of perfluorosulfonic acid and Polyvinylidene Fluoride (PVDF) were used as electrode binding material. The storage capacitance of the composites were studied in 1M KCl and 6M KOH electrolytes using standard electrochemical techniques like cyclic voltammetry, CV, electrochemical impedance spectroscopy, EIS, and discharge profiles. The capacitance was estimated for various binder concentrations for both the electrolytes. The concentration of perflurosulfonic acid binder of 0.8 wt% and PVDF of 0.04 wt% showed optimized specific capacitances of 657.8 F/gm and 1418.8 F/g, respectively. Some of the problems in storage density in activated carbon, like varying micro or meso pores, poor ion mobility due to varying pore distribution, low electrical conductivity, can be overcome by using Graphene and composites of Graphene. Graphene in various structural nomenclatures have been used by different groups for charge storage. Optimization of the electrode structure in terms of blend percentage, binder content and interface character in the frequency and time domain provides insights to the double layer interface structure.