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Estimates of depression in suicidal behavior in South Asia would help to formulate suicide prevention strategies in the region that hasn't been assessed yet.
We aimed to systematically assess the prevalence of depression in fatal and non-fatal attempts of suicide in eight South Asian countries.
We searched Medline, Embase, and PsychINFO by specific search terms to identify articles assessing depression in fatal and non-fatal attempts of suicide in South Asian countries published between 2001 and 2020. Two separate meta-analyses were conducted for fatal and non-fatal attempts. Due to the high heterogeneity of studies (96–98%), random-effects models were used to calculate pooled prevalence rates.
A total of 38 studies was identified from five south Asian countries (India , Pakistan , Sri Lanka , Nepal , and Bangladesh ). The majority of studies (n = 27) were published after 2010. Twenty-two studies reported non-fatal attempts, and sixteen reported suicide. The prevalence of depression among non-fatal attempts ranged from 14% to 78% where the pooled prevalence rate was 32.7% [95% CI 26–39.3%]. The prevalence of depression among suicides ranged from 8% to 79% where the pooled prevalence estimate was 37.3% [95% CI 26.9–47.6%].
This review revealed the pooled prevalence of depression among fatal and non-fatal suicidal attempts in South Asian countries, which seems to be lower when comparedto the Western countries. However, a cautious interpretation is warranted due to the heterogeneity of study methods, sample size, and measurement of depression.
Optimal mechanical design, model-based control, and robot dynamic calibration mainly rely on the analytical formulation of robot dynamics. In this paper, the kinematics equations of a general 3-UPU translational parallel manipulator (TPM) are derived, and then, by using the principle of the virtual work theorem, the full implicit dynamic model is derived. Furthermore, by making some modifications, the explicit dynamic formulation of the robot is attained, which is the basis of a wide range of advanced model-based controllers. To validate the proposed formulation, a prototype of the 3-UPU TPM is modeled in MSC-ADAMS® software, and the results of the dynamic formulation are validated using this model. The results show the high accuracy of the proposed dynamic formulation presented in this article.
Relapse and recurrence of depression are common, contributing to the overall burden of depression globally. Accurate prediction of relapse or recurrence while patients are well would allow the identification of high-risk individuals and may effectively guide the allocation of interventions to prevent relapse and recurrence.
To review prognostic models developed to predict the risk of relapse, recurrence, sustained remission, or recovery in adults with remitted major depressive disorder.
We searched the Cochrane Library (current issue); Ovid MEDLINE (1946 onwards); Ovid Embase (1980 onwards); Ovid PsycINFO (1806 onwards); and Web of Science (1900 onwards) up to May 2021. We included development and external validation studies of multivariable prognostic models. We assessed risk of bias of included studies using the Prediction model risk of bias assessment tool (PROBAST).
We identified 12 eligible prognostic model studies (11 unique prognostic models): 8 model development-only studies, 3 model development and external validation studies and 1 external validation-only study. Multiple estimates of performance measures were not available and meta-analysis was therefore not necessary. Eleven out of the 12 included studies were assessed as being at high overall risk of bias and none examined clinical utility.
Due to high risk of bias of the included studies, poor predictive performance and limited external validation of the models identified, presently available clinical prediction models for relapse and recurrence of depression are not yet sufficiently developed for deploying in clinical settings. There is a need for improved prognosis research in this clinical area and future studies should conform to best practice methodological and reporting guidelines.
Research on addictive behavior change has highlighted the importance of assessing and monitoring contextual features surrounding substance use. This chapter summarizes contextual, substance-involved, and substance-free measurement procedures that are used in human research and practice. These measures are guided by behavioral economic theory and comprise techniques to assess the interaction of the environment and the person, including aspects of enjoyment and contextual situations associated with drug-taking, rating scale measures of drug and drug-free rewards, and relative reinforcement value measures. The approaches summarized demonstrate the importance of focusing on substance use contexts, the behavioral economic factors that support continued substance use, and the availability of substance-free reinforcement. These factors should be an integral feature of substance-related assessment and interventions to reduce harmful substance use and promote recovery from alcohol and other substance use disorders.
Malnutrition among adolescents is often associated with inadequate dietary diversity (DD). We aimed to explore the prevalence of inadequate DD and its socio-economic determinants among adolescent girls and boys in Bangladesh. A cross-sectional survey was conducted during the 2018–19 round of national nutrition surveillance in Bangladesh. Univariate and multivariable logistic regression was performed to identify the determinants of inadequate DD among adolescent girls and boys separately. This population-based survey covered eighty-two rural, non-slum urban and slum clusters from all divisions of Bangladesh. A total of 4865 adolescent girls and 4907 adolescent boys were interviewed. The overall prevalence of inadequate DD was higher among girls (55⋅4 %) than the boys (50⋅6 %). Moreover, compared to boys, the prevalence of inadequate DD was higher among the girls for almost all socio-economic categories. Poor educational attainment, poor maternal education, female-headed household, household food insecurity and poor household wealth were associated with increased chances of having inadequate DD in both sexes. In conclusion, more than half of the Bangladeshi adolescent girls and boys consumed an inadequately diversified diet. The socio-economic determinants of inadequate DD should be addressed through context-specific multisectoral interventions.
A non-iterative analytical approach is investigated to plan the safe wire tension distribution along with the cables in the redundant cable-driven parallel robots. The proposed algorithm considers not only tracking the desired trajectory but also protecting the system against possible failures. This method is used to optimize the non-negative wire tensions through the cables which are constrained based on the workspace conditions. It also maintains both actuators’ torque and cables’ tensile strength boundary limits. The pseudo-inverse problem solution leads to an n-dimensional convex problem, which is related to the robot degrees of redundancy. In this paper, a comprehensive solution is presented for a 1–3 degree(s) of redundancy in wire-actuated robots. To evaluate the effectiveness of this method, it is verified through an experimental study on the RoboCab cable robot in the infinity trajectory tracking task. As a matter of comparison, some standard methods like Active-set and sequential quadratic programming are also presented and the average elapsed time for each method is compared to the proposed algorithm.
Catatonia, a severe neuropsychiatric syndrome, has few studies of sufficient scale to clarify its epidemiology or pathophysiology. We aimed to characterise demographic associations, peripheral inflammatory markers and outcome of catatonia.
Electronic healthcare records were searched for validated clinical diagnoses of catatonia. In a case–control study, demographics and inflammatory markers were compared in psychiatric inpatients with and without catatonia. In a cohort study, the two groups were compared in terms of their duration of admission and mortality.
We identified 1456 patients with catatonia (of whom 25.1% had two or more episodes) and 24 956 psychiatric inpatients without catatonia. Incidence was 10.6 episodes of catatonia per 100 000 person-years. Patients with and without catatonia were similar in sex, younger and more likely to be of Black ethnicity. Serum iron was reduced in patients with catatonia [11.6 v. 14.2 μmol/L, odds ratio (OR) 0.65 (95% confidence interval (CI) 0.45–0.95), p = 0.03] and creatine kinase was raised [2545 v. 459 IU/L, OR 1.53 (95% CI 1.29–1.81), p < 0.001], but there was no difference in C-reactive protein or white cell count. N-Methyl-d-aspartate receptor antibodies were significantly associated with catatonia, but there were small numbers of positive results. Duration of hospitalisation was greater in the catatonia group (median: 43 v. 25 days), but there was no difference in mortality after adjustment.
In the largest clinical study of catatonia, we found catatonia occurred in approximately 1 per 10 000 person-years. Evidence for a proinflammatory state was mixed. Catatonia was associated with prolonged inpatient admission but not with increased mortality.
A spectral method is developed to study the steady and unsteady flow of fluid into a line sink from a horizontally confined aquifer, and the results are compared to solutions obtained implementing the finite element package COMSOLTM. The aquifer or drain is considered to be confined below so that the solutions are fundamentally unsteady. Comparison is made between the two methods in determining the drawdown of the surface.
To determine the presence of cardiovascular (CV) risk (CVR) factors in university students and evaluate how these factors are affected from the knowledge, attitudes, and habits of the individuals regarding healthy lifestyle.
Starting from early ages, lifestyle habits such as lack of physical activity, unhealthy eating, and inappropriate drug use increase CV and metabolic risks of individuals.
In April–May 2018, sociodemographic characteristics of 770 undergraduate students, in addition to their knowledge, attitudes, and habits regarding their nutrition and physical activity status were obtained through face-to-face questionnaires. CVR factors were determined according to blood pressure, blood glucose, total cholesterol levels, and anthropometric measurements. Collected data were compared by CVR factor presence (CV[+] or CV[−]) in students.
The mean age of the participants was 22.3 ± 2.6 years. 59.6% were female and 71.5% were students of non-health sciences. In total, 274 individuals (35.9%) belonged to CV(+) group (mean risk number: 1.3 ± 0.5) with higher frequency in males (42.1% versus 31.6%, P < 0.05). The most common CVR factors were smoking (20.6%), high total cholesterol (7.5%), and hypertension/high blood pressure (6.0%). 15.5% of the participants regularly used at least one drug/non-pharmaceutical product. 11.3% complied the Mediterranean diet well. 21.9% of CV(+) stated consuming fast food at lunch compared to 14.3% of CV(−) (P < 0.05). 44.6% stated exercising below the CV-protective level.
This study showed one-third of university students was at CVR, independent of their sociodemographic characteristics. Furthermore, the students appear to perform below expectations in terms of nutrition and physical activity. Extensive additional measures are needed to encourage young individuals for healthy nutritional and physical activity habits.
Camber morphing is an effective way to control the lift generated by any aerofoil and potentially improve the range (as measured by the lift-to-drag ratio) and endurance (as measured by
). This can be especially useful for fixed-wing Unmanned Aerial Vehicles (UAVs) undergoing different flying manoeuvres and flight phases. This work investigates the aerodynamic characteristics of the NACA0012 aerofoil morphed using a Single Corrugated Variable-Camber (SCVC) morphing approach. Structural analysis and morphed shapes are obtained based on small-deformation beam theory using chain calculations and validated using finite-element software. The aerofoil is then reconstructed from the camber line using a Radial Basis Function (RBF)-based interpolation method (J.H.S. Fincham and M.I. Friswell, “Aerodynamic optimisation of a camber morphing aerofoil,” Aerosp. Sci. Technol., 2015). The aerodynamic analysis is done by employing two different finite-volume solvers (OpenFOAM and ANSYS-Fluent) and a panel method code (XFoil). Results reveal that the aerodynamic coefficients predicted by the two finite-volume solvers using a fully turbulent flow assumption are similar but differ from those predicted by XFoil. The aerodynamic efficiency and endurance factor of morphed aerofoils indicate that morphing is beneficial at moderate to high lift requirements. Further, the optimal morphing angle increases with an increase in the required lift. Finally, it is observed for a fixed angle-of-attack that an optimum morphing angle exists for which the aerodynamic efficiency becomes maximum.
Attachment styles play important role in managing health behavior. It has been observed in researches that attachment style have relationship with health behavior (Schlack, 2003). If attachment styles are left the way they form habitually it can be harmful, in a study with diabetic patients, people with avoidant attachment style were expected to die within 5 years of disease diagnosis (Ciechanowski et al., 2010).
To assess effect of adult attachment styles on health behavior?
Sample comprised of 300 university students from different private and government universities of Karachi with age range 18 – 35 years. Assessment tools used are relationship questionnaire and wellness behavior inventory scale. Relationship questionnaire is used to identify the dimension of attachment style (Bartholomew & Horowitz, 1991). Wellness behavior inventory was used to identify consistency of healthy behavior activities done on regularly basis (Sirois, 2001). Statistical tests used for descriptive analysis were frequency and percentage and for inferential statistics regression analysis test was used.
According to the attachment styles A, B, C and D most of the study participants fell in healthy weight range, a few were in obese range which is considered unhealthy. Result of regression analysis estimated there is no effect of attachment style on health behavior as p-value was greater than 0.05.
Attachment style is not a good predictor of health behavior solely. As per a few researches in order to study impact of attachment styles other mediating variables that can have effect on health behavior should also be observed such as self-esteem.
ECT is a potentially life-saving treatment for patients with severe or treatment resistant depression. Cognitive function disturbances following ECT are generally transient, but could be of longer duration in some cases
To assess the cognitive side effects in patients with affective disorders treated with a course of electroconvulsive therapy (ECT).
Cognitive functions of patients who undergo ECT was assessed prior to start of treatment, midway of the course of treatment and after end of the course of treatment using Montreal Cognitive Assessment (MoCA). We did a retrospective analysis of MoCA scores of 15 patients who received bilateral ECT in 2017-2018. In order to assess the efficacy of ECT in the treatment of their illness, we did a retrospective analysis of Montgomery Asberg Depression Rating Scale (MADRS) scores of 18 patients who received bilateral ECT in 2017-2018
Only 7% of the patients who underwent ECT in our sample did have significant cognitive decline as per their MoCA scores. 28% of patients achieved complete remission in their depressive symptomes. 22% of patients continued on maintenance treatment. 95% of patients showed significant improvement in their symptoms following treatment with ECT where there symptoms reduced to either mild or minimal depressive symptoms.
Cognitive side effect was not a significant side effect in our sample of patients. We did see an improvement in cognitive function in a significant number of the sample of patients as they progressed with treatment, which coincided with improvement in their affective symptoms.
Wernicke’s encephalopathy is a potentially fatal neurological emergency caused by thiamine deficiency. Although it is often associated with chronic alcoholism, it can also occur in all situations that lead to a thiamine deficiency such as undernutrition and exclusive artificial feeding.
In this work, we propose to study the clinical and treatment concerns of Wernicke’s encephalopathy complicating catatonic schizophrenia.
We retrospectively report the case of a patient who developed a Wernicke’s encephalopathy in the aftermath of catatonic schizophrenia.
Mr H.L, a 47-year-old-male has been followed in psychiatric hospital since the age of 27 for catatonic schizophrenia. He has been hospitalized in July 2020 because of oral intake refusal, social isolation and lack of self-care with a poor compliance to treatment. Examination of the patient revealed catalepsy, mutism and negativism. He was treated with antipsychotics drugs, benzodiazepines and parenteral nutrition. About six weeks after his hospitalization, the patient developed horizontal nystagmus and ataxic gait. Magnetic resonance imaging was consistent with Wernicke encephalopathy. Vitamin B1 dosage was 32nmol/l. Parenteral thiamine replacement therapy was initiated with clinical improvement
Catatonic schizophrenia can be associated with severe malnutrition and thus with thiamine deficiency and Wernicke’s encephalopathy. An early intervention by supplying prophylactic thiamine given parenterally in high-risk patients is crucial to avoid Korsakoff syndrome, as well as cardiovascular and neuropsychiatric complications associated with thiamine deficiency.
Going abroad for employment is one of the common social problems which have been faced by the young males of developing countries. This included both highly qualified individuals as well as the labor class.
To determine the difference in the presence of depressive symptoms among pregnant women with husbands living abroad and those with husbands living with them in Azad Jammu and Kashmir
The sample population comprised of pregnant women reporting for ante natal checkup at Amna hospital Rawalakot. Cases constituted the pregnant women with husbands living abroad while controls were the pregnant women with husbands living with them.PHQ-9 was used to record the presence and severity of depressive symptoms. Age, gestation, parity, rural or urban origin, education, level of family income, daily contact hours on telephone or what’s app, previous pregnancy loss or complications, number of years abroad and visits to home per year were associated with depressive symptoms.
Mean age of the study participants was 29.73±5.395 years. 66 (66%) had significant depression in the case group while 14 (14%) had in the control group (p-value<0.001). Education and rural background had significant difference among the case and control group. Less number of visits per year of husband was strongly linked with presence of depressive symptoms among the cases.
This study showed a high frequency of depressive symptoms among pregnant women with husbands abroad as compared to those with husbands living with them. Special attention should be paid to the women whose husband had lesser number of visits to the country
In this paper, forward/inverse dynamics of a continuum robotic arm is developed using a data-driven approach, which could tackle uncertainties and extreme nonlinearities to obtain reliable solutions. By establishing a direct mapping between the actuator and task spaces, the unnecessary mappings of actuator-to-configuration then configuration-to-task are eliminated, to reduce extra computational cost. The proposed approach is validated through simulation (based on Cosserat rod theory) and experimental tests on RoboArm. Next, path tracking in the presence/absence of obstacles as well as load carrying maneuver are investigated. Finally, the obtained results concerning repeatability, scalability, and disturbance rejection performance of the approach are discussed.
The World Health Organization set a target of a 15% relative reduction in the prevalence of insufficient physical activity (IPA) by 2025 among adolescents and adults globally. In Bangladesh, there are no national estimates of the prevalence of IPA among adolescents. The aim of this study was to estimate the prevalence of and risk factors associated with IPA among adolescent girls and boys. Data for 4865 adolescent girls and 4907 adolescent boys, collected as a part of a National Nutrition Surveillance in 2018–19, were analysed for this study. A modified version of the Global Physical Activity Questionnaire (GPAQ) was used to collect physical activity data. The World Health Organization recommended cut-off points were used to estimate the prevalence of IPA. Bivariate and multivariable logistic regression was performed to identify factors associated with IPA. Prevalences of IPA among adolescent girls and boys were 50.3% and 29.0%, respectively, and the prevalence was significantly higher among early adolescents (10–14 years) than late adolescents (15–19 years) among both boys and girls. The IPA prevalence was highest among adolescents living in non-slum urban areas (girls: 77.7%; boys: 64.1%). For both boys and girls, younger age, non-slum urban residence, higher paternal education and increased television viewing time were significantly associated with IPA. Additionally, residing in slums was significantly associated with IPA only among the boys. Higher maternal education was associated with IPA only among the girls. This study identified several modifiable risk factors associated with IPA among adolescent boys and girls in Bangladesh. These factors should be addressed through comprehensive public health interventions to promote physical activity among adolescent girls and boys.
The Arabian Shield of Saudi Arabia represents part of the Arabian–Nubian Shield and forms an exposure of juvenile continental crust on the eastern side of the Red Sea rift. Gabbroic intrusions in Saudi Arabia constitute a significant part of the mafic magmatism in the Neoproterozoic Arabian Shield. This study records the first detailed geological, mineralogical and geochemical data for gabbroic intrusions located in the Gabal Samra and Gabal Abd areas of the Hail region in the Arabian Shield of Saudi Arabia. Geological field relations and investigations, supported by mineralogical and geochemical data, indicate that the gabbroic intrusions are generally unmetamorphosed and undeformed, and argue for their post-collisional emplacement. Their mineralogical and geochemical features reveal crystallization from hydrous, mainly tholeiitic, mafic magmas with arc-like signatures, which were probably inherited from the previous subduction event in the Arabian–Nubian Shield. The gabbroic rocks exhibit sub-chondritic Nb/U, Nb/Ta and Zr/Hf ratios, revealing depletion of their mantle source. Moreover, the high ratios of (Gd/Yb)N and (Dy/Yb)N indicate that their parental mafic melts were derived from a garnet-peridotite source with a garnet signature in the mantle residue. This implication suggests that the melting region was at a depth exceeding ∼70–80 km at the garnet stability field. They have geochemical characteristics similar to other post-collisional gabbros of the Arabian–Nubian Shield. Their origin could be explained by adiabatic decompression melting of depleted asthenosphere that interacted during ascent with metasomatized lithospheric mantle in an extensional regime, likely related to the activity of the Najd Fault System, at the end of the Pan-African Orogeny.
ABSTRACT IMPACT: Better understanding of the factors impacting disease severity and immunological response of MS patients on disease modifying therapy will enable better recommendations for vaccination options and risk mitigation strategies OBJECTIVES/GOALS: The Coronavirus Disease 2019 (COVID-19) and global health crisis has raised health concerns for patients with multiple sclerosis (MS). We aim to study the clinical characteristics, immunological laboratory data, and immunoglobulin response in patients with MS and COVID-19, to identify factors impacting disease severity and immune response. METHODS/STUDY POPULATION: Database search was done using DataDirect to search for MS patients who had tested positive for COVID-19 at the University of Michigan hospital. Patients with a positive nasopharyngeal swab polymerase chain reaction (PCR) for COVID-19 between March 1 and September 2020 were included. The primary outcome was the immunological laboratory data and immunoglobulin levels and the secondary outcome was their disease severity. We collected demographics, neurological history, MS treatment, Expanded Disability Scale Score (EDSS), comorbidities, and COVID-19 characteristics. A 7-point ordinal scale previously used to assess disease severity was used. Univariate and multivariate analyses will be performed to assess relationships between the collected variables. RESULTS/ANTICIPATED RESULTS: A total of 17 patients, mean age 53 (SD 11.6) years, mean disease duration, 6.2(SD 4.1) years were analyzed. 41% of patients had relapsing remitting multiple sclerosis, 17% had primary progressive MS. (88%) patients were on Disease Modifying Therapy (DMT) at the time of COVID-19 diagnosis. 2 patients died from COVID-19 complications. There was a higher proportion of patients with higher disease severity receiving Ocrelizumab. Only one patient showed positive IgG to SARS-CoV-2 after the resolution of infection. CBC with differential was obtained and a longitudinal follow-up of labs will be done. Regression analysis will be done to check the association between the use of DMT, immunological response, and COVID disease severity in them. The impact of COVID-19 on MS relapse, EDSS, and MRI activities will also be studied. DISCUSSION/SIGNIFICANCE OF FINDINGS: Recommendations to continue current DMT have been made, however, the immune response has not been correlated with the individual’s risk profile. Certain therapies may interfere with mounting a protective immune response of COVID-19 and this knowledge is crucial when advising patients regarding the choice of vaccine and risk mitigation strategies.
Bovine respiratory disease (BRD) is the leading natural cause of death in US beef and dairy cattle, causing the annual loss of more than 1 million animals and financial losses in excess of $700 million. The multiple etiologies of BRD and its complex web of risk factors necessitate a herd-specific intervention plan for its prevention and control on dairies. Hence, a risk assessment is an important tool that producers and veterinarians can utilize for a comprehensive assessment of the management and host factors that predispose calves to BRD. The current study identifies the steps taken to develop the first BRD risk assessment tool and its components, namely the BRD risk factor questionnaire, the BRD scoring system, and a herd-specific BRD control and prevention plan. The risk factor questionnaire was designed to inquire on aspects of calf-rearing including management practices that affect calf health generally, and BRD specifically. The risk scores associated with each risk factor investigated in the questionnaire were estimated based on data from two observational studies. Producers can also estimate the prevalence of BRD in their calf herds using a smart phone or tablet application that facilitates selection of a true random sample of calves for scoring using the California BRD scoring system. Based on the risk factors identified, producers and herd veterinarians can then decide the management changes needed to mitigate the calf herd's risk for BRD. A follow-up risk assessment after a duration of time sufficient for exposure of a new cohort of calves to the management changes introduced in response to the risk assessment is recommended to monitor the prevalence of BRD.