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The concept of digital psychiatry, encompassing technologies such as mental health apps, Virtual Reality (VR), Artificial Intelligence (AI), and telepsychiatry, emerges as a potential solution to bridge the existing gaps in the mental health system of Pakistan. However, one of the major barriers to the implementation of these technologies is hesitancy to adopt digital tools by psychiatrists.
Objectives
This study aims to explore the current understanding of digital psychiatry, the barriers faced by psychiatrists in its’ widespread implementation, and their willingness to adopt these services in clinical practice.
Methods
This cross-sectional study surveyed psychiatrists’ knowledge, attitudes, and practices on digital psychiatry from 39 public hospitals across Pakistan using an online validated questionnaire from January to July 2023. Participants included psychiatry residents, fellows, and consultants practicing in Pakistan. Responses were analyzed with Raosoft software, Quirkos, and SPSS 26 using thematic analysis and correlation.
Results
A total of 200 participants responded to the questionnaire, primarily in the age range of 20-30 years (56%). The gender distribution was 55% male (N = 111) and 45% female (N = 89). Among the professional roles, 23% were consultants, 7% were registrars, 54% were psychiatry residents, and 17% were medical officers. Respondents came from both rural (N = 148, 74%) and urban (N = 52, 26%) practice settings. Regarding telepsychiatry, 46% strongly agreed that they are familiar with telepsychiatry, while 58% agreed that telepsychiatry can save time and money. Additionally, 22% strongly agreed that it’s a viable approach for patient care. Concerning perspectives on Artificial Intelligence (AI) in digital psychiatry readiness, only 40% of participants had received AI training. However, 55% expressed interest in collaborating with international centers on AI-related projects. In terms of mental health apps, 62% of respondents reported limited familiarity with them. Nevertheless, 65% believed that these apps could potentially save time and money for psychiatric health systems. Lastly, concerning Virtual Reality (VR) in psychiatric care, 57% of participants were familiar with VR technology, but only 43% were acquainted with its applications in psychiatry. Notably, 71% did not view VR as a viable replacement for in-person psychiatric management.
Conclusions
This is the first study conducted on understanding digital psychiatry in Pakistan’s healthcare system, which revealed multiple challenges to digital health competency among psychiatrists. This emphasizes on the need for formal training and funding towards resources to overcome obstacles in utilizing mental health technologies.
We explore predictions of two models of one-dimensional capillary rise in rigid and partially saturated porous media. One is an existing one from the literature and the second is a free-boundary model based on Richards’ equation with two moving boundaries of the evolving partially saturated region. Both models involve the specification of saturation-dependent functions for local capillary pressure and permeability and connect to classical models for saturated porous media. Existing capillary-rise experiments show two notable regimes: (i) an early-time regime typically well-described by classical capillary-rise theory in a fully saturated porous media, and (ii) a long-time regime that has anomalous dynamics in which the capillary-rise height may scale with a non-classical power law in time or have more complicated dynamics. We demonstrate that the predictions of both models compare well with experimental capillary-rise data over early- and long-time regimes gathered from three independent studies in the literature. The model predictions also shed light on recent scaling laws that relate the capillary pressure and permeability of the partially saturated media to the capillary-rise height. We use these models to probe computationally observed permeability relationships to capillary-rise height. We demonstrate that a recently proposed permeability scaling for the anomalous capillary-rise regime is indeed realized and is particularly apparent in the lower portion of the partially saturated media. For our free-boundary model we also compute capillary pressure measures and show that these reveal the linear relation between the capillary pressure and capillary-rise height expected for a capillarity–gravity balance in the upper portion of the partially saturated porous media.
Blood-culture overutilization is associated with increased cost and excessive antimicrobial use. We implemented an intervention in the adult intensive care unit (ICU), combining education based on the DISTRIBUTE algorithm and restriction to infectious diseases and ICU providers. Our intervention led to reduced blood-culture utilization without affecting safety metrics.
Background: Alzheimer’s disease (AD) is an emerging public health crisis and biomarkers are playing a large role in AD research. Magnetic Resonance Imaging (MRI) holds advantages over existing biomarkers for AD. This project aims to measure subfield thickness throughout the hippocampal long axis using HippUnfold, a novel open-source automated hippocampal segmentation software. Methods: High resolution (0.39×0.39×2mm) Hippocampal MR Images [control, n= 16, mild cognitive impairment (MCI, n =16), and AD, (n = 16)] acquired by the Alzheimer’s Disease Neuroimaging Initiative (ADNI) were analyzed with an automated segmentation software (HippUnfold) to compute thickness measurements. ADNI data such as Positron Emission Tomography (PET) biomarkers, Cerebrospinal Fluid biomarkers, and cognitive scores such as Mini-Mental State Exam (MMSE), Montreal Cognitive Assessment (MoCA), Alzheimer’s Disease Assessment Scale (ADAS13), and Rey Auditory Verbal Learning Test (RAVLT), were correlated to thickness along the hippocampal long axis using linear regression models. Results: We found significant cluster correlations (p < 0.05) throughout the long axis between hippocampal subfield thickness to MoCA scores, ADAS13 scores, PET phosphorylated tau levels, and PET beta-amyloid levels. Conclusions: Subfield atrophy throughout the hippocampal long axis is associated with disease severity (as measured with existing biomarkers and cognitive testing) in patients with MCI and AD.
Three-dimensional (3D) food printing is a rapidly emerging technology offering unprecedented potential for customised food design and personalised nutrition. Here, we evaluate the technological advances in extrusion-based 3D food printing and its possibilities to promote healthy and sustainable eating. We consider the challenges in implementing the technology in real-world applications. We propose viable applications for 3D food printing in health care, health promotion and food waste upcycling. Finally, we outline future work on 3D food printing in food safety, acceptability and economics, ethics and regulations.
Continuous rotation of rice with wheat in rice–wheat system has resulted in stagnant yields and reduced profit margins while deteriorating the soil health. Legume incorporation in existing rice–wheat rotations might be a viable option to improve soil health and productivity. We investigated the influence of puddled transplanted flooded rice and direct-seeded rice on weed dynamics, soil health, productivity, and profitability of post-rice wheat and chickpea grown under zero tillage and conventional tillage. The previous direct-seeded rice crop was either sown alone or intercropped with sesbania as brown manure. The experiment comprised different rice–wheat and rice–chickpea systems which had been in place for two years: with and without rice residue retention. The initial soil analysis indicated that the plots with sesbania brown manuring in direct-seeded rice had the lowest soil bulk density (17.2%) and highest soil porosity (19.3%). Zero tillage in wheat or chickpea in the plots previously cultivated with co-culture of sesbania and direct-seeded rice increased total soil organic carbon by 13–22% in both years. The plots with sesbania brown manuring in direct-seeded rice followed by zero till or conventional till wheat and the plots with direct-seeded rice followed by zero till wheat with rice residue retention recorded the greater concentrations of total nitrogen, available phosphorus, and exchangeable potassium. Zero tillage in wheat and chickpea in post-rice sesbania brown manuring plots produced 41% and 43% more grain yield than those in the puddled transplanted flooded rice with conventional tillage and had the highest profitability. Overall, the rice–chickpea systems had better soil health and profitability than rice–wheat cropping systems. In conclusion, direct-seeded rice intercropped with sesbania followed by wheat and chickpea under zero tillage suppressed weed flora and improved soil physical properties, nutrient availability, productivity, and profitability.
Depression is globally a crucial communal psychiatric disorder, which is more common in older adults. The situation is considerably worse among millions of older (forcibly displaced Myanmar nationals or FDMNs) Rohingya adults, and the coronavirus disease-2019 (COVID-19) pandemic may exacerbate the already existing precarious situation. The present study investigated depressive symptoms and their associated factors in older adult Rohingya FDMNs in Cox Bazar, Bangladesh, during the COVID-19 pandemic.
Method
A total of 416 older adults aged 60 years and above residing in Rohingya camps situated in the South Eastern part of Bangladesh were interviewed using a 15-item Geriatric Depression Scale (GDS-15) in Bengali language. Chi-square test was performed to compare the prevalence of depressive symptoms within different categories of a variable and a binary logistic regression model was performed to determine the factors associated with depressive symptoms.
Results
More than 41% of Rohingya older adults had depressive symptoms (DS). Socio-demographic and economic factors such as living alone, dependency on family for living, poor memory, feelings of being left out, difficulty in getting medicine and routine medical care during COVID-19, perception that older adults are at highest risk of COVID-19 and pre-existing non-communicable chronic conditions were found to be significantly associated with developing DS. Higher DS was also evident among older female Rohingya FDMNs.
Conclusion
DS are highly prevalent in older Rohingya FDMNs during COVID-19. The findings of the present study call for immediate arrangement of mental health care services and highlight policy implications to ensure the well-being of older FDMNs.
Inorganic perovskite photodetector with chromium interdigitated electrodes is investigated. The active material is a solution processed CsPbI3 synthesized by one step deposition. The α-phase of this material is unstable at room temperature and it converts to the δ-phase at temperatures below 320°C. The stabilization of the α-phase was conducted in nitrogen environment by adding 5% weight ratio of polyethylene oxide to the equimolar mixture of PbI2 and CsI in dimethyl sulfoxide. The absorbance spectrum of the CsPbI3 with polyethylene oxide showed the emergence of a second peak at ∼ 690 nm related to the α-phase in addition to the peak at 420 nm of the δ phase. The peak in the visible range was also observed in the μ-photoluminescence spectrum at 690 nm. The interdigital structure was prepared by photolithography method to deposit 80 nm of chromium interdigitated electrodes on glass substrate with 10 μm channel width. The detector's on/off ratio and the detectivity were calculated from the current voltage curve under 100 mW/cm2 to be 9.64×103 and 9.2×109 Jones respectively.
A compact planar ultra-wideband (UWB) antenna with WiMAX and WLAN notched band is presented in this paper. The presented antenna consists of a rectangular patch and slotted partial ground plane and fed by a microstrip feed line. The volumetric size of the antenna is 30 mm × 22 mm × 1.6 mm. Method of moment-based simulation technology is used to simulate and analyze the characteristics of the antenna. To generate two notch bands at WiMAX and WLAN, a pair of parasitic resonator is placed beneath the radiating patch. The presented antenna achieves an operating band (VSWR ≤2) ranging from 2.98 to 12 GHz with an average gain of 3.95 dBi along with considerable efficiency and symmetric radiation patterns. Moreover, the antenna exhibits two notch bands at 3.5 and 5.45 GHz and is able to avoid possible interference with pre-existing narrow band services. The proposed antenna is low cost and low profile and is modeled to be used as a transceiver in UWB communication applications.
Newcastle Disease (ND) is regarded as one of the major diseases of poultry because of the devastating losses that the virulent form of the ND virus can impose on both commercial and domestic chickens. However, the disease can be controlled through the administration of effective vaccines. Almost all the commercially available ND vaccines require refrigeration and begin to deteriorate rapidly after 1-2 hours if left at room temperature (around 25°C). Subsequently, because maintaining an adequate supply of refrigerated facilities may be a difficult task in many countries with unreliable electrical supplies, the development and large scale production of an effective thermostable ND vaccine seems imperative to support the poultry industry. Such vaccines should be resilient to damage associated with either very cold or hot environments so there are no concerns about the viability of the vaccine in response to temperatures fluctuations that can occur in extreme environments when the difference in temperature during cold and warm seasons can vary greatly. In the following review paper, the development of such a vaccine is discussed, including molecular characterisation, organ tropism of vaccine strains, production, as well as administration methods and their efficacy. It addition, the potential payback has been calculated alongside opportunities provided by removing vaccines from cold chain storage.
Selenium (Se) is an essential micronutrient for human and animal health. Globally, more than one billion people are Se deficient due to low dietary Se. Low dietary intake of Se can be improved by Se supplementation, food fortification and biofortification of crops. Lentil (Lens culinaris Medikus subsp. culinaris) is a popular cool-season food legume in many parts of the world; it is naturally rich in Se and therefore has potential for Se biofortification. An Se foliar application experiment at two locations and a multi-location trial of 12 genotypes at seven locations were conducted from April to December 2011 in South Australia and Victoria, Australia. Foliar application of a total of 40 g/ha of Se as potassium selenate (K2SeO4) – 10 g/ha during full bloom and 30 g/ha during the flat pod stage – increased seed Se concentration from 201 to 2772 μg/kg, but had no effect on seed size or seed yield. Consumption of 20 g of biofortified lentil can supply all of the recommended daily allowance of Se. After Se foliar application, cultivars PBA Herald XT (3327 μg/kg), PBA bolt (3212) and PBA Ace (2957 μg/kg) had high seed Se concentrations. These cultivars may be used in lentil biofortification. In the genotypic evaluation trial, significant genotype and location variation was observed for seed Se concentration, but the interaction was not significant. In conclusion, foliar application of Se as K2SeO4 is an efficient agronomic approach to improve seed Se concentration for lentil consumers and there is also scope for genetic biofortification in lentil.
During epidemics of cholera in two rural sites (Bakerganj and Mathbaria), a much higher proportion of patients came for treatment with severe dehydration than was seen in previous years. V. cholerae O1 isolated from these patients was found to be El Tor in its phenotype, but its cholera toxin (CT) was determined to be that of classical biotype. Whether the observed higher proportion of severe dehydration produced by the El Tor biotype was due to a shift from El Tor to classical CT or due to other factors is not clear. However, if cholera due to strains with increased severity spread to other areas where treatment facilities are limited, there are likely to be many more cholera deaths.
This paper examines a comprehensive set of data on the prevalence and correlates of psychological distress in a sample of 1038 adolescent students in a major urban area of a Canadian prairie province. About 27% of the students reported 6 or more symptoms of psychological distress on the GHQ-30. The frequency of symptoms varied with age, grade level and average marks, with sex being the most significant variation. ‘Anxiety’ and ‘social dysfunction’ were the most frequent symptom dimensions reported. More detailed analysis of possible predictors of mental health showed that the nature and quality of family life strongly affected adolescent mental health. Adolescents' positive evaluation of their school atmosphere and peer group life and their locus of control orientation also positively influenced their psychological well-being.
On-farm participatory varietal selection (PVS) trials are often of two types: mother trials (with all of the entries) and baby trials (each having one, or very few of the entries from the mother trials). We conducted PVS trials on 17 wheat varieties in 12 villages of four districts of Bangladesh over three years but the data were highly unbalanced. Both quantitative and qualitative traits were measured in the on-farm trials. The factors in the trials were both fixed effects (varieties and districts) and random (years and farmers). We used the residual or restricted maximum likelihood (REML) analysis for the mixed model for quantitative traits. For qualitative data on farmers' perceptions, logistic regression procedures were used that are equally applicable to balanced and unbalanced data sets. The REML analysis provided adjusted mean values for quantitative traits for all the varieties, for the mother and baby trials separately, using the data from all years and all locations. It identified varieties BAW 1006 and BAW 1008 that yielded 19–30% more than the control Kanchan and also had a higher 1000-grain weight, were at least as early to flower and had a high overall ranking by farmers in the mother trials. The logistic regression analysis of perception data agreed with the results of the REML analysis as these varieties were most preferred by farmers for grain yield, earlier maturity and better chapatti making quality. The less labour-intensive method of recording qualitative perceptions can usefully replace actual yield measurements, particularly when validated by other participatory measures such as intended and actual adoption. In 2005, BAW 1006 was released as BARI Gom 23 or Bijoy and BAW 1008 as BARI Gom 24 or Prodip for the whole of Bangladesh. The validity of the results of the REML analysis was confirmed by the high early adoption trends of the identified varieties. Since REML is an effective analysis for unbalanced PVS trial data using a mixed model, its wider use by researchers would increase the value of the PVS process.
This research set out to find ways to increase wheat production in Bangladesh. The approaches were (1) to increase the area planted to wheat, concentrating on developing a suitable management system for the very hot, often saline and hitherto largely untested fallow lands of the south; and (2) to increase economic and sustainable yield of wheat in the traditional rice-wheat zones. Five mechanized reduced tillage and planting systems were compared. They were used to enable 200 co-operating farmers at 11 locations to plant on time and avoid the reduction in yield that accompanies delays, found in this study to average 2 % d−1. Methods that placed seeds in rows were zero tillage, full or strip surface shallow till, and raised beds. A partially mechanized version of the traditional manual system called New Conventional, in which seeds and fertilizers were broadcast, was also tested. Farmers' wheat yields averaged more than 3.5 t ha−1 for the two seasons of the study. Farmers in the untested lands averaged more than 2.5 t ha−1 on their farms, well above the 0.5 t ha−1 needed to cover all costs and equal to normal production levels in traditional wheat areas. Surprisingly, full and strip till did not produce higher yields overall than New Conventional in either season. Reasons for the lack of difference are discussed in relation to other aspects of management and variation between the farmers themselves. Farmers had varying opinions and mixed success with zero till and beds. The economic consequences to farmers of using the different systems are also discussed with the suggestion that the low-tech New Conventional method will be preferable for novice wheat farmers in the historically fallow lands where the study indicated potential production is 1 million tonnes.
Theoretical studies have been performed on the interaction of short
laser pulse with metals. The results of the theoretical model indicate
that heat conduction would not be uniform from focal spot or crater at the
surface of target metal, when an ultra short laser will interact with the
metal. The electromagnetic radiations of laser induce electric field
inside the target that is responsible for the induction of current
density, which causes electronic heat conduction in the direction of
current density. Such an effect is dominant for laser pulse having
duration less than of the order of sub-picoseconds. This mode will open a
new significant field of study to discuss laser metal interaction for
ultra short laser pulses.
During 1989–2002, we studied the antimicrobial resistance of 3928 blood culture isolates of Salmonella enterica serotype Typhi (S. Typhi) in Dhaka, Bangladesh. Overall 32% (1270) of the strains were multidrug-resistant (MDR, resistant to chloramphenicol, ampicillin and trimethoprim–sulphamethoxazole); first detected in 1990 (rate of 8%), increased in 1994 (44%), declined in 1996 (22%, P<0·01 compared to 1994) and re-emerged in 2001 (36%) and 2002 (42%, P<0·01 compared to 1996). An increased MIC of ciprofloxacin (0·25 μg/ml) indicating decreased susceptibility to ciprofloxacin was detected in 24 (18·2%) out of 132 randomly selected strains during 1990–2002; more frequently in MDR than susceptible strains (46·3% vs. 5·5%, P<0·001), and the proportion of them rose to 47% in 2002 from 8% in 2000 (P<0·01). Ciprofloxacin (5 μg) disk diffusion zone diameters of [les ]24 mm as break-point had 98% sensitivity and 100% specificity when compared with a ciprofloxacin MIC of 0·25 μg/ml as break-point for decreased susceptibility; being a useful and easy screen test. All strains were susceptible to ceftriaxone. The emergence of MDR S. Typhi with decreased ciprofloxacin susceptibility will further complicate the therapy of typhoid fever because of the lack of optimum treatment guidelines.
A case of difficult diagnostic rigid bronchoscopy is described. However, flexible fibrescopy could be easily performed through a laryngeal mask airway despite complete lack of experience by the operator. Excellent visualization of the larynx and bronchial tree with minimal haemodynamic disturbance accompanied the technique.
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