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A negative association between blood Pb level (BPbL) and vitamin D metabolites in occupationally exposed populations has been reported, but data from the general population are scarce. Furthermore, the association between BPbL and vitamin D binding protein (DBP) and free 25-hydroxyvitamin D (25(OH)D) has not been reported. We investigated the association of BPbL with DBP, total and free 25(OH)D in healthy adolescents (n 1347; age range 11–16 years) cross-sectionally selected from all Governorates of Kuwait, utilising multi-stage cluster random sampling. Pb in whole blood was analysed by inductively coupled plasma MS, and DBP with ELISA. Plasma 25(OH)D was analysed by LC-MS/MS, and free 25(OH)D was calculated utilising the levels and binding affinities of DBP and albumin for 25(OH)D. DBP was positively associated with BPbL (β = 0·81; 95 % CI 0·14, 0·22; P < 0·001). A negative association between BPbL and total 25(OH)D was non-significant (P = 0·24) when BPbL was used as a continuous variable but was significant when used as quartiles (P = 0·02). The negative association between BPbL and free 25(OH)D was significant whether BPbL was used as continuous, as quartiles or as cut-off point of <5 µg/dl (0·24 µmol/l). In multinomial logistic regression, the odds of vitamin D insufficiency and deficiency were more than two-fold higher in the upper quartiles of BPbL compared with the lowest quartile. The negative correlation of BPbL with free 25(OH)D was more robust than its correlation with total 25(OH)D. Future studies must consider the levels of DBP when assessing the association between Pb and vitamin D metabolites.
A diverse set of 107 rice genotypes was evaluated for yield, shattering and dormancy traits. Analysis of variance revealed sizable variation while skewness and kurtosis values indicated near-normal distribution for most of the traits, thus quantitative nature controlled by many genes. A highly significant deviation from a normal distribution for dormancy and shattering % indicated their qualitative nature of inheritance. Four promising genotypes ‘IRGC1723’ (early with 65 days to flowering), ‘IRGC 11108’ and ‘RNR 15459’ (high grain number – 358 and low average shattering – <5%), ‘RNR 11718’ (high single plant yield – 56.73 g, low average shattering – <5% and dormancy period – 21 days) are identified. A significant positive correlation between shattering and dormancy confirms inter-relationship among domestication-related characteristics. The principal component analysis revealed the contribution of four PCs to maximum variability and hierarchical clustering grouped the genotypes into 18 divergent clusters. Five cultivars (Karimnagar Samba, Sheetal, PR 121, Pranahitha and Jagitial Samba) with a combination of low shattering ability (3.35–5.7%) and considerable dormancy period (13–20 days) falling in the same cluster can be used as donors for the improvement of rice genotypes with low shattering ability and incorporating a considerable period of dormancy so as to avoid pre-harvest sprouting due to delayed harvesting. Further, they can be crossed with ‘Pratyumna’ having less than 1 week dormancy period, a genotype of the cluster XVII with which they have a maximum genetic divergence of 51.4 and may serve as parents in the development of mapping populations for the identification of QTLs/genes for shattering and dormancy traits.
In chilli, farmer preferences for fruiting habit traits, namely fruit orientation (pendant erect) and fruits node−1 (solitary cluster), vary from region to region. For increased acceptability by farmers/consumers, cultivars should be bred with preferred fruiting habit traits in high green fruit yielding background. An investigation was carried out to study the influence of fruiting habit traits on green fruit yield and its component traits during the 2016 and 2017 rainy seasons. The F2, backcross populations and near-isogenic lines (NILs) derived from crosses involving parents differing for single or both the fruiting habit traits were grouped into fruiting habit classes (single and cluster fruiting; and clustered erect, clustered pendant, single erect and single pendant). Significance of differences in fruit yield and its component traits between/among different fruiting habit trait classes were examined using ‘t’/‘F’ tests. The significance of ‘t’/‘F’ tests was regarded as pieces of evidence for considerable effects of fruiting habit traits on fruit yield and its component traits. While results-based on F2 and backcross generations indicated a lack of effects, those based on NILs indicated significant effects of fruiting habit traits on fruit yield and its component traits. The plants bearing pendant fruits (irrespective of whether they are clustered or single) produced a large number of heavier and longer fruits than those bearing erect fruits. The results are discussed about the strategies to develop high yielding cultivars with farmer preferred fruiting habit traits.
Hidden hunger is widespread in India. Individual dietary diversity score (IDDS) is a measure of the nutrient adequacy of the diet. The FAO has set guidelines for the measurement of dietary diversity: the IDDS and the minimum dietary diversity score for women (MDD-W) to assess nutritional deficiency, but validation against nutritional biomarkers is required. Using available data among rural youth (17 years) from the Pune Maternal Nutrition Study, the validity of DDS was assessed to measure deficiencies of vitamin B12, folate and Hb. Of the 355 boys and 305 girls, 19 % were classified as underweight, 57 % as vitamin B12 deficient (<150 pmol/l) and 22 % as anaemic (<120/130 g/l). Cereals, legumes and ‘other-vegetables’ were the most frequently consumed foods. More boys than girls consumed milk, flesh, eggs and micronutrient-dense foods. Median IDDS of 4 (interquartile range (IQR) 3–4) and MDD-W of 6 (IQR 5–7) were low. Youth with vitamin B12 deficiency had a higher likelihood of an IDDS ≤ 4 (1·89; 95 % CI 1·24, 2·87) or an MDD-W ≤ 5 (1·40; 95 % CI 1·02, 1·94). Youth with anaemia were more likely to have an IDDS ≤ 4 (1·76; 95 % CI 1·01, 3·14) adjusted for socio-economic scores, BMI, energy intake and sex. Folate deficiency was low (3 %) and was not associated with either score. Youth with lowest plasma vitamin B12 and Hb infrequently or never consumed dairy products/non-vegetarian foods. These rural Indian youth were underweight, had low DDS and consumed foods low in good-quality proteins and micronutrients. Associations of DDS with circulating micronutrients indicate that DDS is a valid measure to predict vitamin B12 deficiency and anaemia.
Case fatality rate (CFR) and doubling time are important characteristics of any epidemic. For coronavirus disease 2019 (COVID-19), wide variations in the CFR and doubling time have been noted among various countries. Early in the epidemic, CFR calculations involving all patients as denominator do not account for the hospitalised patients who are ill and will die in the future. Hence, we calculated cumulative CFR (cCFR) using only patients whose final clinical outcomes were known at a certain time point. We also estimated the daily average doubling time. Calculating CFR using this method leads to temporal stability in the fatality rates, the cCFR stabilises at different values for different countries. The possible reasons for this are an improved outcome rate by the end of the epidemic and a wider testing strategy. The United States, France, Turkey and China had high cCFR at the start due to low outcome rate. By 22 April, Germany, China and South Korea had a low cCFR. China and South Korea controlled the epidemic and achieved high doubling times. The doubling time in Russia did not cross 10 days during the study period.
This paper offers a framework for measuring global growth and inflation, built on standard index number theory, national accounts principles, and the concepts and methods for international macro-economic comparisons. Our approach provides a sound basis for purchasing power parity (PPP)- and exchange rate (XR)-based global growth and inflation measures. The Sato–Vartia index number system advocated here offers very similar results to a Fisher system but has the added advantage of allowing a complete decomposition with PPP or XR effects. For illustrative purposes, we present estimates of global growth and inflation for 141 countries over the years 2005 and 2011. The contribution of movements in XRs and PPPs to global inflation are presented. The aggregation properties of the method are also discussed.
Alcoholism has a high prevalence and impacts on morbidity, mortality, life quality, and the economy. Heritability estimates of alcohol dependence are 50-61%. Putative psychological, cultural, and genetic susceptibilities to alcoholism have been identified but understanding of the genetic components is still underdeveloped.
Identify genetic vulnerabilities predisposing individuals to alcoholism and co-morbid psychiatric disorders in the largest study of its kind.
12 centres including 10 trainees are currently collecting blood and clinical samples. Nearly 1700 of 2000 cases of ICD-10/DSM-IV alcohol dependence have been collected; 500 with standardized assessments of alcohol use and comorbdity; and 2000 ancestrally-matched supernormal controls from UCL/collaborators. Genomic DNA will be isolated following standard procedures. Genotyping will be performed using the Affymetrix Gene Chip Human Mapping 1M Array to type up to 1 million single nucleotide polymorphism (SNP) and copy number variant (CNV) markers. Chi-square analysis of allelic association for the alcoholic sample versus controls will occur.
n=65; 57% male; mean age 45years; mean age onset harmful alcohol use 19years; mean age onset withdrawals 32y; mean alcohol intake 21 units; primary depression 27%; secondary depression 49%; antisocial personality disorder 14%. The candidate gene approach in this sample has shown that the GABA receptor B1 (GABRB1) and the tachykinin receptor 1 (TACR1) are involved in genetic susceptibility to alcoholism. The D2 dopamine receptor is next.
Preliminary data suggests high psychiatric comorbidity in a clinical alcohol dependence sample and implicated candidate genes. Next is genomewide analysis of markers, sequencing and biological pathway/systems alterations.
Pervasive Refusal Syndrome (PRS) is a relatively new diagnostic concept, that describes a rare and potentially life threatening condition, in which children refuse to walk.
talk, eat, drink, engage in self care, and take part in day to day activities (Lask et al, 1991).
PRS is not included in any of the psychiatric classification systems (ICD 10, DSM IV), although consensus exists within the literature as to its existence. Lask comments in his paper on Pervasive Refusal Syndrome that he has consulted on only 50 cases worldwide (Lask, 2004).
The authors will share their clinical experience of treating seven new cases of PRS in a Regional CAMHS inpatient hospital. Patients with PRS often require hospital admission for assessment and exclusion of other medical, neurological and psychiatric disorders. However, because of the rarity many medical and psychiatric professionals have little experience of the treatment and rehabilitation required.
The specific MDT management approach necessary to meet the complex needs of patients with PRS will be discussed, as treatment is often counterintuitive, and some approaches can result in deterioration rather than improvement.
In terms of improvement and recovery from the disorder, less is known about long term follow-up, as only a few studies have reported on immediate outcome. The authors have undertaken a long term follow-up (in press) and will discuss issues relating to prognosis.
A specific MDT treatment approach for PRS will be discussed, alongside the clinical decisions and dilemmas involved in following this approach.
First Rank Symptoms (FRS) - a group of intriguing experiences characterized by striking breach of ‘self versus non-self’ boundaries - have had a critical influence on the diagnosis of schizophrenia. Inferior Parietal Lobule is implicated in the pathogenesis of FRS in Schizophrenia. However, the role of Planum Parietale (PP) in the genesis of FRS is yet to be examined.
Aims & objectives
This first time study (to the best of our knowledge), aims to examine antipsychotic-naïve schizophrenia patients for the effect of FRS status on volume of PP.
In this study we examined the volume of PP in antipsychotic-naïve schizophrenia patients (n = 32; M:F = 16:16) in comparison with age, sex, and handedness matched (as a group) healthy comparison subjects (n = 34; M:F = 16:18) using valid method with good inter-rater reliability.
Female Schizophrenia patients showed significant volume reduction in right PP in comparison with female healthy controls (F = 7.2; p = 0.01). However, male patients did not. There was a significant effect of schneiderian FRS in female patients in that those who had FRS had significantly smaller volume of right PP than healthy controls (F = 3.8; p = 0.03); where those female patients who were FRS negative did not differ. Left PP volume did not differ between patients and controls.
Current study supports previous studies which have implicated the role of parietal lobe in pathogenesis of FRS. Specific role of PP in FRS generation and possible implication of sex differences needs further systematic studies.
Borderline Personality Disorder (BPD) describes pervasive and stable impairments in personal identity and interpersonal functioning with pathological personality traits. Most patients are prescribed multiple psychoactive medications despite none being indicated for BPD. Current evidence proposes long-term, BPD-appropriate psychotherapy as the most efficacious treatment
A residential BPD patient cohort was evaluated to determine whether BPD-focused psychotherapy reduced prescribing and BPD and co-morbid symptom severity
The pattern of psychotropic drug utilization at admission, discharge and one year follow-up was measured. Changes in the utilisation of pharmacotherapy were examined in the context of improvements in BPD and/or co-morbid disorder symptom severity
There were 74 female participants, most with more than one Personality Disorder diagnosis and co-morbid mood disorders. Residential treatment included individual and group psychotherapy for BPD. Self-reported use of psychotropic medications was ascertained at admission (T1); discharge from the program (3 to 6 months; T2), and one year post discharge (T3). The SCID (Structured Clinical Interview for DSM-IV) was used to confirm the BPD diagnosis and associated co-morbid conditions. The Beck Depression Inventory was completed at each time point
A significant reduction in the prescription of psychoactive medications was accompanied by significant decreases in the incidence and severity of self-rated depression as well as clinician assessed personality disorder, including BPD. These were most pronounced 12 months after discharge
Three to six months of BPD-specific psychotherapy provided lasting benefit for a range of mental health problems and reduced prescription medication use
Depression is known to be associated with low serum Brain-Derived Neurotrophic Factor (BDNF) and elevated levels of cortisol. Yoga has been shown to be associated with significant antidepressant effect as well as increase in serum BDNF levels and reduction in serum cortisol levels in these patients.
Aims and Objectives
We examined the association between serum cortisol and BDNF levels in patients with depression who were on treatment with antidepressants, yoga therapy, and both in combination.
Fifty-one consenting drug-naive outpatients (29 males) aged between 18-55 years, diagnosed with Major Depression received antidepressant medication alone (n=15), yoga therapy with (n=18), or without (n=18) concurrent antidepressants. Subjects in the yoga groups practiced a specific Yoga module for three months. Depression was assessed using the Hamilton Depression Rating Scale (HDRS). Serum BDNF & cortisol levels were obtained before and after three months using sandwich ELISA method. The group differences were analyzed using one-way ANOVA. Correlations between Serum BDNF & cortisol levels were analyzed using Pearson's correlation.
Significant negative correlations were observed between baseline BDNF & cortisol levels in the Yoga+Medication group (r=0.569*; P=0.01), and between change in BDNF and cortisol level in the Yoga alone group (r=0.582*; P=0.01). No other significant correlations were found.
There is a significant association between serum cortisol and BDNF levels in patients with depression who underwent Yoga with or without antidepressants. This suggests that Yoga may have stress reduction and neuroplastic effects alone or in combination with medications in depressed patients.
There are a number of good standard practices available for prescribing long acting antipsychotics. Adherence to these guidelines will minimise any harm to the service users.
To compare depot antipsychotic prescribing practice with good standard practice guidelines of BNF, Trust and Maudsley guidelines.
To compare practice with standards in the areas of:
– licensed indication;
– dose/frequency range;
– avoiding poly-pharmacy;
– regular review of clinical and side effects.
Case notes of a randomly selected sample of 30 patients from the depot clinic at the City East Adult Community Mental Health Team Leicester, UK were retrospectively investigated. The data collected was analysed and the results were produced. Compliance with the best practice guidelines was calculated and recommendations made based on the findings.
One hundred percent compliance was noticed in licensed indications and dose/frequency within BNF range. However, 14% patients received poly-pharmacotherapy, 86% had regular outpatient review, but only 46% had review of side effects.
Better quality of documentations by the clinicians, improvised technology to elicit automatic review reminders, introduction of checklist for clinics to include review of all clinically important information, wider dissemination of the findings of this investigation, and re-auditing practice to explore impact of this investigation was recommended.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
We propose the use of a machine learning algorithm to improve possible COVID-19 case identification more quickly using a mobile phone–based web survey. This method could reduce the spread of the virus in susceptible populations under quarantine.
The Indian subcontinent is prone to tropical cyclones that used to originate in the North Indian Ocean. Through this study, an inventory of disease outbreaks for the tropical cyclone-affected regions from 2010 to 2018 has been compiled. This inventory is used to assess the success of recent sanitation intervention, Swachh Bharat Mission, also known as the Clean India Mission.
Meteorological parameters from the Indian satellites were used to demarcate the cyclone-affected area. Disease outbreaks and epidemics during the tropical cyclones were compiled from the Integrated Disease Surveillance Program and other relevant sources. The inventory has been used to track the effect of recent sanitation interventions on disease outbreaks.
Districts in the eastern coast of India are frequently affected due to tropical cyclones that have originated from the North Indian Ocean. Infectious diseases like the acute diarrheal diseases, vector-borne diseases, viral fevers, enteric fevers, and food poisoning have recursively occurred during the cyclonic events and persisted up to 2 weeks from the cyclonic episode. The effectiveness of the Clean India Mission is evident during the recent cyclones, Ockhi, Titli, and Gaja, where a significantly lower number of infectious disease outbreaks were recorded.
The Clean India Mission has exhibited positive results on the public health consequences associated with tropical cyclones.
Choice of the most appropriate breeding method hinges on mode of action of genes controlling expression of target traits. Pungency (capsaicin) and colour (oleoresin) are most important fruit quality traits in chilli. Genetics of fruit quality traits was unravelled using a combination of first and second degree statistics. An additive-dominance model was inadequate to explain the inheritance of fruit yield and quality traits. Magnitude of additive genetic effects [a] and their variances [σ2A] were higher than those of dominance genetic effects [d] and dominance genetic variances [σ2D] suggesting predominance of additive effect genes in the inheritance of both oleoresin and capsaicin contents. These results are discussed in relation to appropriate selection strategy to be followed for genetic improvement of chilli for oleoresin and capsaicin contents.
SGA devices have been used successfully in patients of all ages in various clinical scenarios, including primary airway management under general anesthesia in the operating room, and resuscitation and emergent airway management in the emergency department (ED) and prehospital settings. SGA devices have been used as alternatives to face-mask ventilation and tracheal intubation by healthcare providers with proficient airway management skills, but also by those with less experience, to successfully oxygenate and ventilate the lungs. The clinical efficacy of SGA devices in children has been proven in a large number of clinical studies. Pediatric SGA devices have undergone an evolution in design since their introduction 30 years ago. These newer design features have improved the use of SGA devices to provide positive-pressure ventilation and facilitate fiberoptic-guided tracheal intubation. The evolution, versatility, and utility of the SGA device will be discussed in detail in this chapter.
Thirty-one accessions of Oryza glaberrima were evaluated to study the genetic variability, correlation, path, principal component analysis (PCA) and D2 analysis. Box plots depicted high estimates of variability for days to 50% flowering and grain yield per plant in Kharif 2016, plant height, productive tillers, panicle length and 1000 seed weight in Kharif 2017. Correlation studies revealed days to 50% flowering, plant height, panicle length, number of productive tillers, spikelets per panicle having a high direct positive association with grain yield, while path analysis identified the number of productive tillers having the maximum direct positive effect on grain yield. Days to 50% flowering via spikelets per panicle, productive tillers and plant height via spikelets per panicle exhibited high positive indirect effects on grain yield per plant. PCA showed that a cumulative variance of 54.752% from yield per plant, days to 50% flowering, spikelets per panicle and panicle length, contributing almost all the variation of traits while D2 analysis identified days to 50% flowering and grain yield per plant contributing maximum to the genetic diversity. Therefore, selection of accessions with more number of productive tillers and early maturity would be most suitable for yield improvement programme. The study has revealed the utility of African rice germplasm and its potential to utilize in the genetic improvement of indica rice varieties.
The design of high energy Li-ion batteries (LIBs) by coupling high voltage LiNi0.5Mn1.5O4 (LNMO) cathode and Li4Ti5O12 (LTO) anode ensures effective and safe energy-storage. LTO–LNMO full-cells (FCs) with difference in electrode grain sizes and presence of excess Mn3+ in cathode were studied using micron-sized commercial LTO, nanostructured LTO donuts (LTOd), P4332 LNMO nanopowders, and nanostructured Fd3m LNMO caterpillars (LNMOcplr). Among the studied FCs, LTOd–LNMOcplr was detected with a stable capacity of 69 mA h/g (1C rate), 99% coulombic efficiency, and 87% capacity retention under 200 cycles of continuous charge–discharge studies. The superior electrochemical performance observed in LTOd–LNMOcplr FC was due to the low charge transfer resistance, which is corroborated to the effect of grain sizes and the longer retention of Mn3+ in the electrodes. An effective and simple FC design incorporating both nanostructuring and in situ conductivity in electrode materials would aid in developing future high-performance LIBs.