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A novel flexible radio frequency (RF) sensor is designed to facilitate the accurate testing of various samples used in the biomedical industry at the industrial, scientific and medical (ISM) frequency band. The proposed RF biosensor comprises a liquid channel-loaded interdigitated capacitor, which is integrated on a coplanar waveguide structure. The prototype of the sensor is fabricated on a 0.13 mm thin biodegradable polyethylene terephthalate polyester film to perform the testing of various bio-graded samples by recording the corresponding resonant frequency. It is observed that there is a noticeable change between the measured resonant frequencies of these samples, which primarily occurs due to the difference in their dielectric properties. The designed sensor was used to monitor and investigate the quality of glycerol, which is the most commonly used raw ingredient in the biomedical and food industry. The determination of glucose concentration in base fluids is considered to ease the challenges faced by doctors and biochemists regarding the monitoring of glucose concentration. It is found that the proposed sensor can quantify the glycerol purity up to the minimum specified adulteration level of 2 and 1% corresponding to toxic contaminants diethylene glycol and ethylene glycol, respectively, and the glucose concentration of 0.5 mg/ml.
The aim of this feasibility trial was to evaluate the feasibility and acceptability of the locally adapted Group Problem Management Plus (PM+) intervention for women in the conflict affected settings in Swat, Pakistan.
This mixed-methods study incorporated a quantitative component consisting of a two arm cluster randomised controlled feasibility trial, and qualitative evaluation of the acceptability of the Group PM+ to a range of stakeholder groups. For the quantitative component, on average from each of the 20 Lady Health Workers (LHWs) catchment area (20 clusters), six women were screened and recruited for the trial with score of >2 on the General Health Questionnaire and score of >16 on the WHO Disability Assessment Schedule. These LHW clusters were randomised on a 1 : 1 allocation ratio using a computer-based software through a simple randomisation method to the Group PM+ intervention or Enhanced Usual Care. The Group PM+ intervention consisted of five weekly sessions of 2 h duration delivered by local non-specialist females under supervision. The primary outcome was individual psychological distress, measured by levels of anxiety and depression on the Hospital Anxiety and Depression Scale at 7th week after baseline. Secondary outcomes include symptoms of depression, post-traumatic stress disorder (PTSD), general psychological profile, levels of functioning and generalised psychological distress. Intervention acceptability was explored through in-depth interviews.
The results show that lay-helpers with no prior mental health experience can be trained to achieve the desired competency to successfully deliver the intervention in community settings under supervision. There was a good intervention uptake, with Group PM+ considered useful by participants, their families and lay-helpers. The outcome evaluation, which was not based on a large enough study to identify statistically significant results, indicated statistically significant improvements in depression, anxiety, general psychological profile and functioning. The PTSD symptoms and depressive disorder scores showed a trend in favour of the intervention.
This trial showed robust acceptance in the local settings with delivery by non-specialists under supervision by local trained females. The trial paves the way for further adaptation and exploration of the outcomes through larger-scale implementation and definitive randomised controlled trials in the local settings.
Development disorders and delays are recognised as a public health priority and included in the WHO mental health gap action programme (mhGAP). Parents Skills Training (PST) is recommended as a key intervention for such conditions under the WHO mhGAP intervention guide. However, sustainable and scalable delivery of such evidence based interventions remains a challenge. This study aims to evaluate the effectiveness and scaled-up implementation of locally adapted WHO PST programme delivered by family volunteers in rural Pakistan.
The study is a two arm single-blind effectiveness implementation-hybrid cluster randomised controlled trial. WHO PST programme will be delivered by ‘family volunteers’ to the caregivers of children with developmental disorders and delays in community-based settings. The intervention consists of the WHO PST along with the WHO mhGAP intervention for developmental disorders adapted for delivery using the android application on a tablet device. A total of 540 parent-child dyads will be recruited from 30 clusters. The primary outcome is child's functioning, measured by WHO Disability Assessment Schedule – child version (WHODAS-Child) at 6 months post intervention. Secondary outcomes include children's social communication and joint engagement with their caregiver, social emotional well-being, parental health related quality of life, family empowerment and stigmatizing experiences. Mixed method will be used to collect data on implementation outcomes. Trial has been retrospectively registered at ClinicalTrials.gov (NCT02792894).
This study addresses implementation challenges in the real world by incorporating evidence-based intervention strategies with social, technological and business innovations. If proven effective, the study will contribute to scaled-up implementation of evidence-based packages for public mental health in low resource settings.
Registered with ClinicalTrials.gov as Family Networks (FaNs) for Children with Developmental Disorders and Delays. Identifier: NCT02792894 Registered on 6 July 2016.
This study aimed to determine the prevalence of hearing impairment in Bangladeshi people of all ages.
A nationally representative cross-sectional survey was carried out in 2013. A total of 4260 subjects (1774 males and 2486 females), with a mean age of 32 years, participated. Hearing impairment was determined by pure tone audiometry and otoacoustic emissions testing.
Disabling hearing loss (greater than 40 dB loss in adults, and greater than 30 dB loss in children younger than 15 years, in their better hearing ears) was present in 9.6 per cent (95 per cent confidence interval, 8.5–10.8 per cent) of the respondents. Hearing loss was more prevalent in socio-economically deprived people and in those older than 60 years. Multiple logistic regression analysis identified age, socio-economic deprivation, family history, impacted ear wax, chronic suppurative otitis media, otitis media with effusion, and otitis externa as the significant predictors of disabling hearing loss.
Deafness prevention should focus mainly on chronic suppurative otitis media, otitis media with effusion, and impacted ear wax prevention, integrated within the primary healthcare system and addressing the equity issue.
The ability to organize materials in two or three dimensional structures forms the basis for approach worldwide to construct nanometer sized arrangements. Here we show the interaction of 200 MeV silver ions with a Si( 100) single crystal lattice which has been studied to look for defects with atomic resolution. Employing scanning tunnelling microscopy (STM), we demonstrate that the deposited energy is not stored as random defected arrangements at the irradiation site but as spatially extended structures at predetermined locations. These artificially reordered structures consist of random Si atoms, placed atomically sharp next to the single crystalline lattice.
A Monte Carlo model has been developed to describe the gas phase formation and sintering of nanoclusters. Sintering was incorporated into the model by modifying Kadanoff's algorithm  for random particle walks on the surface of the cluster. The effect of restructuring and sintering on cluster-cluster aggregation have been investigated via 2d simulations. In the initial stages the sintering process results in clusters which are compact on small length scales. As time progresses and the clusters become larger, the sintering process slows down and the fractal dimension of the clusters is decreased. The model shows the effect of time and temperature on the specific surface area and size distribution of clusters.
Nanoindentation has been established as an effective method to measure the mechanical properties of bone tissue at the micron and sub-micron length scale. Although it is well-documented that the mechanical properties of macroscopic bone specimens vary depending on whether the samples are tested dry or wet, nanoindentation is generally conducted on dehydrated bone tissue at room temperature, primarily because nanoindentation systems are extremely sensitive to changes in environmental conditions such as humidity and temperature. In this study, these problems were overcome by using a specially constructed liquid cell with an extension piece that allowed the indenter tip to be submerged under 5 mm of liquid. The custom setup was used to test cortical bovine bone and cancellous human bone specimens in three distinct conditions – dehydrated, rehydrated in simulated body fluid (SBF) at 20°C, and rehydrated in SBF at 37.5°C. A heating element with a temperature control unit was used to test at 37.5°C. The hardness and elastic modulus of the bone samples were found to decrease when dry specimens were rehydrated and tested in physiological conditions. It is suggested that nanoindentation in physiological conditions gives a better estimate of the mechanical properties of the microstructural components of bone in vivo rather than nanoindentation under conventional conditions.
This study looked at patient aggressive behaviour on an Irish psychiatric intensive care unit, and whether it was related to diagnosis, patient's insight and symptomatology. Each aggressive incident was recorded throughout the patient's stay using the Staff-Observed Aggression Scale.
Ninety-nine individuals were admitted to the unit during the study. We recorded 82 aggressive incidents, with most occurring during the daytime and on weekdays. There was no statistical difference in BPRS scores between the aggressive and non-aggressive groups. the aggressive patient group had a lower insight score than the non-aggressive group (P < 0.05) as measured on the Schedule of the Assessment of Insight. However, when gender and verbal aggression only were included in the analysis, the difference in insight was less significant (P=0.07).
Aggression is common on a psychiatric intensive care unit. Low levels of insight in patients may increase the risk of aggression.
A case control study was conducted to identify the association of therapeutic injections with acute hepatitis B virus (HBV) infection in Karachi, Pakistan. We enrolled 67 cases of acute HBV infection (IgM anti-HBc positive) and 247 controls (anti-HBc negative) from four hospitals of Karachi during July 2000–June 2001. Exposure to various risk factors during the period relevant to the incubation period of HBV was recorded both from cases and controls using a structured questionnaire. Multivariate logistic regression analysis of the data showed that cases were more likely to have received one injection (OR=4·0; 95% CI 1·4, 11·1), or more than one injection (OR=6·3; 95% CI 3·2, 12·4) compared to controls. The estimated population attributable risk (PAR) for therapeutic injections was 53%. Also the cases compared to controls were more likely to have household size of seven or more (OR=1·9; 95% CI 0·95, 3·9). This study showed that unsafe therapeutic injections appear to be the major risk factor for acute HBV infection and needs immediate focus from public health stand point.
Diffuse idiopathic skeletal hyperostosis (DISH), or Forestier’s disease, is an ossifying condition frequently encountered in otolaryngology as it affects 12–28 per cent of the adult population. This form of hyperostosis can manifest clinically with dysphagia, food impaction, hoarseness, stridor, myelopathies and other neurological problems. Judicious management of severe dysphagia proves challenging. The failure of conservative care often leaves surgery as the only option. In this report an anterolateral transcervical surgical approach to the confluent osteophytes is discussed and the value of videofluoroscopic swallow highlighted
Surgical emphysema is a relatively rare complication of dental surgery. Many cases go unrecognized or are misdiagnosed. Although the majority of cases resolve spontaneously, some can lead to potentially lifethreatening complications requiring emergency intervention. A case of surgical emphysema following a routine restorative dental procedure is presented. The differential diagnosis and management of this condition is discussed.
Caffeine is considered to be a dehydrating agent with detrimental effects on the quality of voice of persons ingesting it. This has led medical personnel dealing with voice disorders, especially in the case of professional voice users, to give advice against the use of caffeine. Yet this is an anecdotal truth as an extensive Medline literature search did not reveal any scientific evidence of caffeine being proven to have adverse effects on the vocal folds. We, therefore, initiated this pilot study to ascertain the connection between caffeine and voice quality on a laboratory basis. Two hundred and fifty mg of caffeine were provided to eight volunteers in tablet form, and blood levels along with laryngograph readings were recorded to document the changes produced. Analysing the irregularities of frequencies in a) free speech b) a reading passage and c) singing ‘Happy Birthday’, substantial changes were seen to authenticate the fact that caffeine does produce alterations in voice quality but these alterations have considerable intrasubject variability. A full study with wider parameters is to be performed on this subject as we consider it to be of importance in the management of voice disorders.
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