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A novel application of Best Worst Method (BWM) enables one to incorporate the complexity of specific sub-criteria of technological development to assess its maturity with the pre-established Technology Readiness Level (TRL) framework. It utilizes the concept of Multi-Criteria Decision Making (MCDM) methods to determine the cardinality of endpoint quantitative processes. The model is used to determine the maturity of Class II Ventilators and to detect the consistency aspects for their selection.
Patients with chronic schizophrenia require long term treatment. Attitude towards antipsychotic medications is a crucial determinant of medication adherence and is influenced by multiple factors.
The present study was conducted to investigate clinical and socio-demographic correlates of attitude of patients with schizophrenia to the antipsychotic medications and its correlation with psychopathology and insight.
A cross-sectional sample of 361 patients (194 males, 167 females) with schizophrenia diagnosed as per DSM IV, aged 16-55, having illness for ≤ 6 years and not having co morbid psychiatric, physical and substance use disorders, were assessed on Positive and Negative Syndrome Scale (PANSS) . The subjects were also assessed on drug attitude inventory -30 (DAI-30) and schedule for assessment of insight (SAI) to evaluate insight.
Mean age (±SD) of sample was 32.9 (SD 9.25) years and mean duration of illness was 286.39 (± 293.63) weeks. The subjects got a mean (±SD) score on PANSS, SAI and DAI 56.38 (± 17.04), 8.27 (±2.76) and 18.95 (±6.83) respectively. Most (92.8%) of patients had a positive attitude towards antipsychotic medications. A negative correlation (r= – 3.78, p=0.00) was observed between scores on DAI and PANSS and a positive correlation (0.06, p=0.00) was seen between scores on DAI and SAI. No correlation was observed between scores on DAI and other clinical and socio-demographic variables.
Majority of patients with chronic schizophrenia, who are on treatment, have positive attitude towards antipsychotic medications. There is a need for community based studies on the subject.
The aim of this study was to evaluate contact endoscopy in detecting local treatment failures post-radiotherapy in squamous cell carcinoma of the upper aerodigestive tract.
A total of 135 consecutive patients with suspected residual or recurrent cancer after definitive radiotherapy underwent contact endoscopy before biopsy. Contact endoscopy findings were compared with histopathological examination findings. Contact endoscopy could not be completed in 7 patients (5.9 per cent) and histopathological examination was inconclusive in 5 patients (3.7 per cent). The findings of the remaining 123 patients were compared.
The sensitivity, specificity and accuracy of contact endoscopy were 88.75, 88.72 and 86.99 per cent, respectively, with similar results across various sites of upper aerodigestive tract. Inter-observer kappa value was 0.86 (95 per cent confidence interval: 0.79–0.93). The intra-observer kappa value was 0.93 (95 per cent confidence interval: 0.87–1.00) for the first observer and 0.95 (95 per cent confidence interval: 0.90–1.00) for second and third observers.
Contact endoscopy showed the same high sensitivity and specificity with low inter- and intra-observer variability in detecting post-radiotherapy failures in cancer of the upper aerodigestive tract as has been shown in non-irradiated tissues in earlier studies.
The binary metal oxides are increasingly used as supercapacitor electrode materials in energy storing devices. Particularly NiCo2O4 has shown promising electrocapacitive performance with high specific capacitance and energy density. The electrocapacitive performance of these oxides largely depends on their morphology and electrical properties governed by their energy band-gaps and defects. The morphological structure of NiCo2O4 can be altered via the synthesis route, while the energy band-gap could be altered by doping. Also, doping can enhance crystal stability and bring in grain refinement, which can further improve the much-needed surface area for high specific capacitance. Given the above, this study evaluates the electrochemical performance of Ca-doped Ni1-xCaxCo2O4 (0 ≤ x ≤ 0.8) compounds. This stipulates promising applications for electrodes in future supercapacitors.
Suicide is a major global health concern. Bhutanese refugees resettled in the USA are disproportionately affected by suicide, yet little research has been conducted to identify factors contributing to this vulnerability. This study aims to investigate the issue of suicide of Bhutanese refugee communities via an in-depth qualitative, social-ecological approach.
Focus groups were conducted with 83 Bhutanese refugees (adults and children), to explore the perceived causes, and risk and protective factors for suicide, at individual, family, community, and societal levels. Audio recordings were translated and transcribed, and inductive thematic analysis conducted.
Themes identified can be situated across all levels of the social-ecological model. Individual thoughts, feelings, and behaviors are only fully understood when considering past experiences, and stressors at other levels of an individual's social ecology. Shifting dynamics and conflict within the family are pervasive and challenging. Within the community, there is a high prevalence of suicide, yet major barriers to communicating with others about distress and suicidality. At the societal level, difficulties relating to acculturation, citizenship, employment and finances, language, and literacy are influential. Two themes cut across several levels of the ecosystem: loss; and isolation, exclusion, and loneliness.
This study extends on existing research and highlights the necessity for future intervention models of suicide to move beyond an individual focus, and consider factors at all levels of refugees’ social-ecology. Simply focusing treatment at the individual level is not sufficient. Researchers and practitioners should strive for community-driven, culturally relevant, socio-ecological approaches for prevention and treatment.
To evaluate the survival outcomes and toxicities experienced by non-metastatic head and neck cancer (HNC) patients receiving modulated radiotherapy (RT).
Materials and methods
A total of 608 HNC patients treated consecutively from March 2010 to December 2014 with common subsites (oral cavity, oropharynx, hypopharynx, larynx and nasopharynx) of HNCs formed the study group. Eligible patients included those treated with radical or postoperative RT between March 2010 and December 2014. More than 90% patients received modulated RT [intensity-modulated radiotherapy (IMRT) or volumetric-modulated arc therapy (VMAT)] with concurrent chemotherapy as per stage guidelines. Demographic parameters and disease-related factors were analysed. Disease-free survival (DFS) was calculated from end date of RT till last follow-up or last date of disease control. Overall survival (OS) was calculated from date of registration to last follow-up date if alive. The primary endpoint was survival. The statistical analyses were performed using SPSS version 20.0 and Kaplan–Meier method was used for calculation survival.
Among the evaluable patients, the median age was 60 years (range: 16–93) with male preponderance (male:female – 513:95). Majority were squamous cell carcinoma 93·4% (568/608). The subsites treated were oral cavity 36·8% (224). oropharynx 26·4% (161), larynx 19·7% (120), hypopharynx 10% (62) and nasopharynx 6·4% (41). RT intent was radical in 63·5% (386) and postoperative in 36·5% (222), with 59·5% (362) receiving concurrent chemotherapy. At last follow-up, 348 (57·2%) patients were alive, 169 (27·7%) patients had succumbed to disease and 120 (24·6%) patients had recurrent disease. Out of 120 recurrent cases loco-regional recurrence, nodal recurrence and distant metastases were seen in 62 (51·7%), 25 (20·8%), 33 (27·5%), respectively. In the entire study cohort at 2 year OS and DFS was 80 and 79% whereas 3 years OS and DFS was 70 and 75%, respectively.
In our study, 2 years and 3 years OS and DFS rates are found comparable to the international data with acceptable toxicity profile with the use of modulated RT. It seems to be possible because of stringent departmental protocols and good medical physics support. Our data re-validates need and benefit of advanced RT techniques like IG-IMRT and VMAT for both postoperative and radical HNC treatment at the cost of minimal long-term side effects. Future stringent follow-up and quality of life issues are being considered in a prospective manner.
Background: Traditional neurosurgical techniques and/or stereotactic radiotherapy, although effective for solid tumors, can be associated with high morbidity and be relatively ineffective for long-term control of cystic sellar/parasellar tumors. The rationale of our study was to examine the efficacy and safety of stereotactic intracavitary instillation of 90yttrium colloid for the primary treatment of cystic tumors. Methods: As part of a Health Canada approved clinical trial, we have enrolled nine patients (6 females, 3 males; mean age 64, range 43 to 83 years) for treatment of symptomatic and/or enlarging cysts. Ten cystic sellar/parasellar lesions underwent right frontal stereotactic insertion of 90yttrium colloid to deliver a radiation dose of 200 Gy to the cyst wall. Results: Compared with pre-treatment cyst volumes (mean 4.6 cc; range 0.8-16.1 cc), the cysts decreased in size at 3 months (2.6 cc; 0.2-10 cc) with further shrinkage (n=5) at 9 months (1 cc; 0.1-2.7 cc). Of 9 patients with pre-operation visual field defects, 6 showed improvement. The single complication was a delayed (1 month) incomplete CNIII palsy. Conclusions: Our early experience indicates that 90yttrium colloid delivered to a cystic craniopharyngioma provides an efficacious alternative to open surgery for primary treatment of these cystic lesions.
A possible role of the APC/beta-catenin pathway in the pathogenesis of sporadic juvenile nasopharyngeal angiofibroma has been suggested. This paper presents its current status and clinical association in our patients.
A prospective observational study was conducted at King George Medical University and Central Drug Research Institute, in Lucknow, India. Western blot analysis was undertaken in 16 cases to examine beta-catenin expression. The clinical details were recorded along with follow up observations, to determine associations.
Up-regulation of beta-catenin expression was seen in 69 per cent of cases. The clinical variables did not reveal significant differences between patients with extremes of expression (extreme under- vs over-expression). However, absent expression was shown exclusively in young adults aged over 18 years, while enhanced expression was associated with an altered facial profile.
Although a beta-catenin association was seen in a subset of our sporadic juvenile nasopharyngeal angiofibroma cases, its expression was not homogeneous. This is in contrast to the Western literature that suggests a universal (homogenous) enhanced expression in the majority. Hence, further research is required to better define its molecular cascade.
The aluminum doped SrFe12O19 hexaferrite samples were prepared via co-precipitation method using cetyltrimethyl ammonium bromide (CTAB) as a surfactant. The effects of CTAB content (x = 0, 1, 3, 6 and 9 wt. %) on the structure, morphology, and electrocapacitive behavior of the SrFe10Al2O19 nanoparticles were investigated. The use of CTAB was observed to be effective in eliminating α-Fe2O3 phase from samples. Morphological changes including grain and crystallite size was noticed with the increase in the CTAB content. With the increase in CTAB, powder particles grew in size and thickness. A concomitant increase in magnetization due to crystal growth was observed. Electrochemical performance of supercapacitors was evaluated by cyclic voltammetry (CV). Highest power density of 368.09 WKg-1 and energy density of 0.916 WhKg-1 was observed for 3% and 1% CTAB samples, respectively.
A facile hydrothermal method was used to synthesize molybdenum disulfide (MoS2) microspheres. The effect of hydrothermal reaction time on morphology and electrochemical properties of MoS2 microspheres was evaluated. X-ray diffraction showed presence of crystalline MoS2 structure, where content of crystalline phase was observed to increase with hydrothermal reaction time. Electrochemical properties of MoS2 were evaluated using cyclic voltammetry (CV) and galvanostatic charge-discharge in 3M KOH solution. Specific capacitance of nanostructured MoS2 was observed to be between 68 F/g and 346 F/g at different scan rates along with excellent cyclic stability. High power density (∼1200 W/kg) and energy density (∼5 Wh/kg) was observed for MoS2 sample synthesized for 24 hours of hydrothermal reaction time. Overall optimal electrocapactive performance was observed for sample prepared for 24 hours of reaction time. It is demonstrated that the obtained MoS2 microspheres with three-dimensional architecture has excellent electrochemical performances as electrode materials for supercapacitor applications.
The physical mechanisms responsible for electrically-induced parametric degradation in GaN-based high electron mobility transistors are examined using a combination of experiments, device simulation, and first-principles defect analysis. A relatively simple formulation is developed under the assumption that the hot-electron scattering cross-section is independent of the electron energy. In this case, one can relate the change in defect concentration to the operational characteristics of a device, such as the spatial and energy distribution of electrons (electron temperature), electric field distribution, and electron energy loss to the lattice.
To study the presence of bacterial biofilm on the sinus mucosa of healthy individuals (controls) and patients with chronic rhinosinusitis with or without nasal polyposis.
An analytical, prospective and observational study was conducted. Tissue samples were obtained from the sinus mucosa. The bacteria were isolated and typified, and the material was examined for biofilm formation using tissue culture plate, Congo red agar detection and tube methods.
A total of 100 cases were analysed for the presence of biofilm. Bacterial biofilm was present in 26 of 50 disease group cases (52 per cent) and in 4 of 50 control group cases (8 per cent) (p < 0.01).
The presence of biofilm on the mucosa of chronic rhinosinusitis patients offers a possible cause for the persistent inflammation, and for antibiotics resistance and antimicrobial therapy failure. These findings could change the approach to treatment.
Large amplitude ion-acoustic double layer (IADL) is studied using Sagdeev's pseudo-potential technique in collisionless unmagnetized plasma comprising hot and cold Maxwellian population of electrons, warm adiabatic ions, and dust grains. Variation of both Mach number (M) and amplitude |φm| of large amplitude IADL with charge, concentration, and mass of heavily charged massive dust grains is investigated for both positive and negative dust in plasma. Our numerical analysis shows that system supports only rarefactive large amplitude IADL for the selected set of plasma parameters. Our investigations for both negative and positive dust grains reveal that ion temperature increases the mobility of ions, resulting in increase in the Mach number of IADL. The larger mobility of ions causes leakage of ions from localized region, resulting into decrease in the amplitude of IADL. Other parameters, e.g. temperature ratio of hot to cold electrons, charge, concentration, mass of heavily charged massive dust grains also play significant role in the properties and existence of double layers. Since it is well established that both positive and negative dust are found in space as well as laboratory plasma, and double layers have a tremendous role to play in astrophysics, we have included both positive and negative dust in our numerical analysis for the study of large amplitude IADL. Further data used for negative dust are close to experimentally observed data. Hence, it is anticipated that our parametric studies for heavily charged (both positive and negative) dust may be useful in understanding laboratory plasma experiments, identifying nonlinear structures in upper part of ionosphere and lower part of magnetosphere structures, and in theoretical research for the study of properties of nonlinear structures.
Long-term tillage and fertilizer experiments were conducted in rice in kharif followed by lentil in dry subhumid Inceptisols at Varanasi and Faizabad; horse gram at Phulbani and linseed at Ranchi in moist subhumid Alfisols in rabi during 2001 to 2010. The study was conducted to assess the effect of conventional tillage (CT), low tillage + interculture (LT1) and low tillage + herbicide (LT2) together with 100% N (organic) (F1), 50% N (organic) + 50% N (inorganic) (F2) and 100% N (inorganic) (F3) on productivity, profitability, rainwater and energy use efficiencies. The results at Varanasi revealed that CT was superior with mean yield of 2389 kg ha−1, while F1 was superior with 2378 kg ha−1 in rice. At Faizabad, CT was superior with mean rice yield of 1851 kg ha−1 and lentil yield of 977 kg ha−1, while F1 was superior with 1704 and 993 kg ha−1 of rice and lentil, respectively. At Phulbani, F2 was superior with rice yield of 1170 kg ha−1. At Ranchi, F2 with rice yield of 986 kg ha−1 and F3 with linseed yield of 224 kg ha−1 were superior. The regression model of crop seasonal rainfall and yield deviations indicated an increasing trend in rice yield over mean (positive deviation) with increase in rainfall at all locations; while a decreasing trend (negative deviation) was found for lentil at Faizabad, horse gram at Phulbani and linseed at Ranchi. Based on economic analysis, CTF1 at Varanasi and Faizabad, CTF2 at Phulbani and LT2F2 at Ranchi were superior.
In India, rotavirus infections cause the death of 98621 children each year. In urban neighbourhoods in Delhi, children were followed up for 1 year to estimate the incidence of rotavirus gastroenteritis and common genotypes. Infants aged ⩽1 week were enrolled in cohort 1 and infants aged 12 months (up to +14 days) in cohort 2. Fourteen percent (30/210) gastroenteritis episodes were positive for rotavirus. Incidence rates of rotavirus gastroenteritis episodes in the first and second year were 0·18 [95% confidence interval (CI) 0·10–0·27] and 0·14 (95% CI 0·07–0·21) episodes/child-year, respectively. The incidence rate of severe rotavirus gastroenteritis in the first year of life was 0·05 (95% CI 0·01–0·10) episodes/child-year. There were no cases in the second year. The common genotypes detected were G1P (27%) and G9P (23%). That severe rotavirus gastroenteritis is common in the first year of life is relevant for planning efficacy trials.