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To determine the demographic pattern of juvenile-onset parkinsonism (JP, <20 years), young-onset (YOPD, 20–40 years), and early onset (EOPD, 40–50 years) Parkinson’s disease (PD) in India.
Materials and Methods:
We conducted a 2-year, pan-India, multicenter collaborative study to analyze clinical patterns of JP, YOPD, and EOPD. All patients under follow-up of movement disorders specialists and meeting United Kingdom (UK) Brain Bank criteria for PD were included.
A total of 668 subjects (M:F 455:213) were recruited with a mean age at onset of 38.7 ± 8.1 years. The mean duration of symptoms at the time of study was 8 ± 6 years. Fifteen percent had a family history of PD and 13% had consanguinity. JP had the highest consanguinity rate (53%). YOPD and JP cases had a higher prevalence of consanguinity, dystonia, and gait and balance issues compared to those with EOPD. In relation to nonmotor symptoms, panic attacks and depression were more common in YOPD and sleep-related issues more common in EOPD subjects. Overall, dyskinesias were documented in 32.8%. YOPD subjects had a higher frequency of dyskinesia than EOPD subjects (39.9% vs. 25.5%), but they were first noted later in the disease course (5.7 vs. 4.4 years).
This large cohort shows differing clinical patterns in JP, YOPD, and EOPD cases. We propose that cutoffs of <20, <40, and <50 years should preferably be used to define JP, YOPD, and EOPD.
Depression is an alarming burden in India causing substantial disability and cost to society. Recognizing depression is difficult because patients present predominantly with somatic symptoms or because attention is primarily focused on the co-morbid physical disorder. The cases of depression presenting in primary-care settings are either not identified or treated with inappropriate drugs or inadequate doses of anti-depressants.
To analyze current level of intervention done by non-psychiatrists to detect and manage depression in patients with chronic medical illnesses.
A panel of nine specialists (Cardiologists, Neurologists, Endocrinologists and Psychiatrists) discussed current Indian scenario of management of co-morbid depression by non-psychiatrists.
The panel agreed that
• Prevalence of co-morbid depression in India is not well-documented except for few regional studies.
• It is frequently witnessed but is hardly recognized or managed as a concurrent disease.
• There is a need to differentiate between depressive 'feeling” and 'disease”.
• The clinicians should increase duration of history-taking to include questions like, 'Do you feel sad/low? Are you disinterested?” in suspected cases.
• There is a need for developing Indian consensus to identify co-morbid depression, to decide when to start an antidepressant drug, in what dosage and duration with special focus on the when to refer to a psychiatrist.
Concrete steps are required towards large-scale data generation and development of Indian consensus on the management of co-morbid depression in patients with chronic medical illnesses for the non-psychiatrists to improvise patient health outcome.
There is strong public belief that polyunsaturated fats protect against and ameliorate depression and anxiety.
To assess effects of increasing omega-3, omega-6 or total polyunsaturated fat on prevention and treatment of depression and anxiety symptoms.
We searched widely (Central, Medline and EMBASE to April 2017, trial registers to September 2016, ongoing trials updated to August 2019), including trials of adults with or without depression or anxiety, randomised to increased omega-3, omega-6 or total polyunsaturated fat for ≥24 weeks, excluding multifactorial interventions. Inclusion, data extraction and risk of bias were assessed independently in duplicate, and authors contacted for further data. We used random-effects meta-analysis, sensitivity analyses, subgrouping and Grading of Recommendations, Assessment, Development and Evaluations (GRADE) assessment.
We included 31 trials assessing effects of long-chain omega-3 (n = 41 470), one of alpha-linolenic acid (n = 4837), one of total polyunsaturated fat (n = 4997) and none of omega-6. Meta-analysis suggested that increasing long-chain omega-3 probably has little or no effect on risk of depression symptoms (risk ratio 1.01, 95% CI 0.92–1.10, I2 = 0%, median dose 0.95 g/d, duration 12 months) or anxiety symptoms (standardised mean difference 0.15, 95% CI 0.05–0.26, I2 = 0%, median dose 1.1 g/d, duration 6 months; both moderate-quality evidence). Evidence of effects on depression severity and remission in existing depression were unclear (very-low-quality evidence). Results did not differ by risk of bias, omega-3 dose, duration or nutrients replaced. Increasing alpha-linolenic acid by 2 g/d may increase risk of depression symptoms very slightly over 40 months (number needed to harm, 1000).
Long-chain omega-3 supplementation probably has little or no effect in preventing depression or anxiety symptoms.
Declaration of interest
L.H. and A.A. were funded to attend the World Health Organization Nutrition Guidance Expert Advisory Group (NUGAG) Subgroup on Diet and Health meetings and present review results. The authors report no other conflicts of interest.
Duck production has the potential to play a major role in agricultural economy. Asian countries alone contribute 84.2% of total duck meat produced in the world. Driven by the demand of processed foods among consumers, the global duck meat market is expected to grow at a steady pace, reaching a value of about $11.23 billion in the coming years. Duck meat has higher muscle fibre content in breast meat compared to chicken, and is considered as red meat. Moreover, due to a higher fat content (13.8%) than chicken and a stronger gamey flavour, duck meat can be less appreciated by the consumer. Development and diversification of ready-to-eat duck meat products is expected to increase consumption levels. Hence, the status of duck meat production, physicochemical properties, processing, including traditional products, and development of novel value-added ready-to-eat products from spent duck meat is discussed in detail to explore its importance as an alternative to chicken.
Staff training in positive behaviour support (PBS) is a widespread treatment approach for challenging behaviour in adults with intellectual disability.
To evaluate whether such training is clinically effective in reducing challenging behaviour during routine care (trial registration: NCT01680276).
We carried out a multicentre, cluster randomised controlled trial involving 23 community intellectual disability services in England, randomly allocated to manual-assisted staff training in PBS (n = 11) or treatment as usual (TAU, n = 12). Data were collected from 246 adult participants.
No treatment effects were found for the primary outcome (challenging behaviour over 12 months, adjusted mean difference = −2.14, 95% CI: −8.79, 4.51) or secondary outcomes.
Staff training in PBS, as applied in this study, did not reduce challenging behaviour. Further research should tackle implementation issues and endeavour to identify other interventions that can reduce challenging behaviour.
Chronic osteomyelitis, a bone infection caused by bacteria, requires extensive parenteral treatments. With an aim to develop bioactive glass with antibacterial properties to resist such infections, bioactive glasses with bismuth oxide as the dopant in various amounts up to 8 wt% were prepared. X-ray diffraction patterns and Fourier-transform infrared spectra of glass samples after immersion in simulated body fluid showed the presence of hydroxyapatite (HAp) and hydroxyl carbonate apatite for all samples except with the one having Bi2O3 substitution of 8 wt%. In vitro cell proliferation by MTT assay studies using a mouse fibroblast cell line (NIH3T3) have also been carried out. Primary antimicrobial activity of the glass particles was analyzed against Escherichia coli (E. coli) using broth microdilution method which exhibited bacteriostatic effects and bactericidal properties in selected samples. The combination of bioactivity, cell proliferation, and antibacterial properties of selected Bismuth-containing bioactive glasses could be exploited in treating bone-related infections.
We describe a study of the E–W-trending South Wagad Fault (SWF) complex at the eastern part of the Kachchh Rift Basin (KRB) in Western India. This basin was filled during Late Cretaceous time, and is presently undergoing tectonic inversion. During the late stage of the inversion cycle, all the principal rift faults were reactivated as transpressional strike-slip faults. The SWF complex shows wrench geometry of an anastomosing en échelon fault, where contractional and extensional segments and offsets alternate along the Principal Deformation Zone (PDZ). Geometric analysis of different segments of the SWF shows that several conjugate faults, which are a combination of R synthetic and R’ antithetic, propagate at a short distance along the PDZ and interact, generating significant fault slip partitioning. Surface morphology of the fault zone revealed three deformation zones: a 500 m to 1 km wide single fault zone; a 5–6 km wide double fault zone; and a c. 500 m wide diffuse fault zone. The single fault zone is represented by a higher stress accumulation which is located close to the epicentre of the 2001 Bhuj earthquake of Mw 7.7. The double fault zone represents moderate stress at releasing bends bounded by two fault branches. The diffuse fault zone represents a low-stress zone where several fault branches join together. Our findings are well corroborated with the available geological and seismological data.
Clostridium difficile was recovered from 33 (34%) of 98 rooms of patients who were excretors compared with 36 (49%) of 73 rooms of patients with active infection. Not all laboratory algorithms can distinguish between these 2 groups, yet both may be a significant source for ongoing transmission.
The present work demonstrates the synthesis of Cu–10 wt% TiB2 composites with a theoretical density of more than 90% by tailoring the spark plasma sintering (SPS) conditions in the temperature range of 400–700 °C. Interestingly, 10 wt% Pb addition to Cu–10 wt% TiB2 lowers the sinter density and the difference in the densification behavior of the investigated compositions was discussed in reference to the current profile recorded during a SPS cycle. The sintering kinetics and phase assemblage were also discussed in reference to surface melting of the constituents prior to bulk melting temperature, temperature dependent wettability of Pb on Cu, diffusion kinetics of Cu as well as the formation of various oxides. An important result is that a high hardness of around 2 GPa and relative density close to 92% ρtheoretical was achieved for the Cu–10 wt% TiB2–10 wt% Pb composite, and such a combination has never been achieved before using any conventional processing route.
We describe a simple drop-cast processing method to synthesize multicomponent polymer-based nanocomposites for carbon dioxide (CO2) capture and conversion into stable carbonates. These multicomponent nanocomposites are made of combination of different metal oxide nanoparticles and catalysts in a porous polymer matrix. The formulation includes the combination of titanium dioxide and magnesium oxide, ruthenium oxide, and iron oxide where each metal oxide exhibits its own catalytic function of trapping carbon dioxide. Such a material system provides numerous localized catalytically active hot reaction spots generated by the dispersed multifunctional oxide nanoparticles that react with CO2 when exposed to the gas stream and instantaneously convert the captured carbon into carbonates. Finally, we discuss our ongoing work on the possibility of converting captured-carbon-formed-carbonate into useful products/commodities such as methane, methanol and formic acid. The integration of polymer materials with catalytically active nanomaterials shows a promising strategy for CO2 capture and conversion into useful products towards achieving a sustainable energy future.
All photosynthetic organisms contain light-harvesting antenna complexes and electron transfer complexes called reaction centers. Some photosynthetic bacteria contain large (~100 MDa) peripheral antenna complexes known as chlorosomes. Chlorosomes lose their reaction center when they are extracted from organisms. Lead sulfide (PbS) quantum dots (QDs) were used for artificial reaction centers. Successive ionic layer adsorption and reaction (SILAR) allows different sizes of PbS QDs with different cycles to be easily deposited onto the nanostructured columnar titanium dioxide (TiO2) film with single crystal. Chlorosomes were sequentially deposited onto the PbS QDs surface by electrospray. Compared to the typical PbS QD sensitized solar cells, overall energy conversion efficiency increased with the Förster resonance energy transfer (FRET) effect between PbS QDs and chlorosomes.
Comparative studies have been carried out on the performance of the photovoltaic devices with dissimilar shapes of the InN nanostructures fabricated on p-Si (100). The devices fabricated with the nanodots show a superior performance compared to the devices fabricated with the nanorods. The discussions have been carried out on the superior junction property, larger effective junction area and inherent random pyramidal topographical texture of the cell fabricated with nanodots. Such single junction devices exhibit a promising fill factor and external quantum efficiency of 38% and 27%, respectively, under concentrated AM1.5 illumination.
We show a novel, bioengineered, moldable platform for bone regeneration composed of porous bionanocomposite scaffolds made of components that are normally found in bone tissue (calcium, collagen, carbonate, sodium, and phosphorous). To accommodate high- or low-stress environments, the hardness and modulus (stiffness) of these scaffolds can be tuned in a wide range in Megapascal (MPa) to Gigapascal (GPa) regions, while maintaining the required viscoelasticity. Our approach to control the mechanical properties is based on a new formulation of mineralized bioscaffolds by incorporation of calcium carbonate in which, calcium and phosphorous are in the form of calcite, calcium polyphosphate (CPP) and hydroxyapatite (HAP). The variation in the calcium carbonate concentration allows tuning of calcite/CPP contents in the bioscaffold to tailor the degree of mineralization and mechanical and viscoelastic properties that closely match those of natural bone. Our results demonstrate an ideal framework for new bone scaffold designs for advanced bone substitute applications.
In the development of novel materials for enhanced photovoltaic (PV) performance, it is critical to have quantitative knowledge of the initial performance, as well as the performance of these materials over the required 25-year lifetime of the PV system. Lifetime and degradation science (L&DS) allows for the development of new metrology and metrics, coupled to degradation mechanisms and rates. Induced absorbance to dose (IAD), a new metric being developed for solar radiation durability studies of solar and environmentally exposed photovoltaic materials, is defined as the rate of photodarkening or photobleaching of a material as a function of total absorbed solar radiation dose. In a reliability engineering framework, these quantitative degradation rates can be determined at various solar irradiances making possible real time and accelerated testing. The potential to predict power losses in a photovoltaic system over time caused by the accumulation of this kind of degradation can be calculated for real time applications or extrapolated for accelerated exposure conditions. Three formulations of poly (methyl methacrylate) (PMMA) used for mirror augmented PV systems were analyzed for the changes in IAD after accelerated testing.
The effect of silver nanoparticles showing localised plasmonic resonances on the efficiency of thin film silicon solar cells is studied. Silver (Ag) nanodiscs were deposited on the surface of silicon cells grown on highly doped silicon substrates, through hole-mask colloidal lithography, which is a low-cost and bottom-up technique. The cells have no back reflector in order to exclusively study the effect of the front surface on their properties. Cells with nanoparticles were compared with both bare silicon cells and cells with an antireflection coating. We optically observe a resonance showing an absorption increase controllable by the disc radius. We also see an increase in efficiency with respect to bare cells, but we see a decrease in efficiency with respect to cells with an antireflection coating due to losses at wavelengths below the plasmon resonance. As the material properties are not notably affected by the particles deposition, the loss mechanism is an important absorption in the nanoparticles. We confirm this by numerical simulations.
Rabies is a major public health problem in Bangladesh, where most of the population live in rural areas. However, there is little epidemiological information on rabies in rural Bangladesh. This study was conducted in 30 upazilas (subdistricts) covering all six divisions of the country, to determine the levels of rabies and animal bites in Bangladesh. The total population of these upazilas was 6 992 302. A pretested questionnaire was used and data were collected by interviewing the adult members of families. We estimated that in Bangladesh, 166 590 [95% confidence interval (CI) 163 350–170 550] people per year are bitten by an animal. The annual incidence of rabies deaths in Bangladesh was estimated to be 1·40 (95% CI 1·05–1·78)/100 000 population. By extrapolating this, we estimated that 2100 (95% CI 1575–2670) people die annually from rabies in Bangladesh. More than three-quarters of rabies patients died at home. This community-based study provides new information on rabies epidemiology in Bangladesh.
Unprecedented high rates of anthrax outbreaks have been observed recently in cattle and humans in Bangladesh, with 607 human cases in 2010. By enrolling 15 case and 15 control cattle smallholdings in the spatial zone in July–September 2010, we conducted a case-control study, data of which were analysed by matched-pair analysis and multivariable conditional logistic regression. Feeding animals with uprooted and unwashed grass [odds ratio (OR) 41·2, 95% confidence interval (CI) 3·7–458·8, P=0·003], and feeding water hyacinth (Eichhornia crassipes) (OR 22·2, 95% CI 1·2–418·7, P=0·039) were independent risk factors for anthrax in cattle.