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Background: Suicide is a major public health concern and one of the leading causes of mortality worldwide. People with an at‐risk‐mental‐state (ARMS) for psychosis are more vulnerable to psychiatric co‐morbidity and suicide, however, there are limited data from low‐middle‐income countries. The present study aimed to identify the prevalence of depressive symptoms and suicidal ideation along with sociodemographic and clinical correlates of suicidal ideation in individuals with ARMS from Pakistan. Method: Participants between the age of 16 and 35 years who met the criteria for ARMS based on the Comprehensive Assessment of At‐Risk Mental State (CAARMS), were recruited from the community, general practitioner clinics and psychiatric units across Pakistan (n = 326). Montgomery and Asberg Depression Rating Scale (MADRS) and Social‐Occupational‐Functional‐Assessment‐Scale (SOFAS) were administered to participants. Results: The prevalence of depressive symptoms and suicidal thoughts in the sample at baseline were 91.1% (n = 297) and 61.0% (n = 199), respectively. There were significant mean differences between groups (mean difference [95% CI]; p‐value) without suicidal ideation and with suicidal ideation on measures of MADRS (−5.47 [−7.14, −3.81]; p <.001), CAARMS non‐bizarre ideas (−0.29 [−0.47, −0.11]; p =.002) and perceptual abnormalities (−0.23 [−0.41, −0.04]; p =.015). Conclusion: These findings indicate that suicidal ideation and depressive symptoms are highly prevalent in individuals with ARMS in Pakistan. Given the pivotal developmental stages that ARMS presents, and the poor outcomes associated with co‐morbid depression, there is an urgent need to prioritize the development of low‐cost and scalable evidence‐based interventions to address psychiatric comorbidity and suicidality in the ARMS population in Pakistan. [ABSTRACT FROM AUTHOR]

Chemiluminescence imaging of bioanalytes using spiroadamantane 1,2‐dioxetanes has gained significant attention due to improved signal‐to‐noise ratios and imaging depth compared to excitation‐based probes, as well as their modifiable scaffolds that offer analyte‐specific responses and tunable emissive properties. Among several strategies employed to amplify signals under aqueous conditions and to shift the emission into the bio‐relevant red region, energy transfer to an adjacent fluorophore is a popular and effective method. This Minireview highlights spiroadamantane 1,2‐dioxetane‐based probes that operate via an energy transfer mechanism to detect bioanalytes both in vitro and in vivo. Probes that display both non‐covalent and covalent interactions with fluorophores, as well as their applications in imaging specific analytes will be discussed. [ABSTRACT FROM AUTHOR]

Chemiluminescence imaging of bioanalytes using spiroadamantane 1,2‐dioxetanes has gained significant attention due to improved signal‐to‐noise ratios and imaging depth compared to excitation‐based probes, as well as their modifiable scaffolds that offer analyte‐specific responses and tunable emissive properties. Among several strategies employed to amplify signals under aqueous conditions and to shift the emission into the bio‐relevant red region, energy transfer to an adjacent fluorophore is a popular and effective method. This Minireview highlights spiroadamantane 1,2‐dioxetane‐based probes that operate via an energy transfer mechanism to detect bioanalytes both in vitro and in vivo. Probes that display both non‐covalent and covalent interactions with fluorophores, as well as their applications in imaging specific analytes will be discussed. [ABSTRACT FROM AUTHOR]

Dielectric, elastic, and piezoelectric constants, and their corresponding losses are defined under constant conditions of two categories; namely, intensive (i.e., E, electric field or T, stress), and extensive (i.e., D, dielectric displacement or x, strain) ones. So far, only the intensive parameters and losses could be measured directly in a k31 mode sample. Their corresponding extensive parameters could be calculated indirectly using the coupling factor and "K" matrix. However, the extensive loss parameters, calculated through this indirect method, could have large uncertainty, due to the error propagation in calculation. In order to overcome this issue, extensive losses should be measured separately from the measurable intensive ones in lead-zirconate-titanate (PZT) k31 mode rectangular plate ceramics. We propose a new mechanical-excitation methodology, using a non-destructive testing approach by means of a partial electrode configuration, instead of the conventional full electrode configuration. For this purpose, a non-electrode sample was prepared, where the electrode covered only 10% of the top and bottom surfaces at the center to actuate the whole sample, and also monitor the responding vibration. The admittance spectrum of this sample, corresponds to PZT properties under dielectric displacement D constant condition. Furthermore, ceramics with partial-electrodes were also prepared to create short and open circuit boundary conditions, attributing to resonance and anti-resonance modes. In the proposed way, we were able to measure both intensive and extensive elastic compliances and mechanical losses directly for the first time. The accuracy of this new method is compared with the conventional measurements by use of indirect calculations. The preliminary results (by neglecting the 10% actuator part difference at this point) were obtained, which were in good agreements (less than 3% difference) with the previous indirect method. [ABSTRACT FROM AUTHOR]

Chemiluminescent iridium‐based sensors which demonstrate oxygen dependent responses have been developed. The molecular probes, named IrCL‐1, IrCL‐2 and IrCL‐3 consist of oxygen‐sensitive iridium complexes attached to a spiroadamantane 1,2 dioxetane and operate via energy transfer from the chemiexcited benzoate to the corresponding iridium(III) complex. Complexing the iridium(III) center with π‐extended ligands results in emission in the biologically relevant, near‐infrared (NIR) region. All probes demonstrate varying oxygen tolerance, with IrCL‐1 being the most oxygen sensitive. These probes have been further utilized for in vitro ratiometric imaging of oxygen, as well as for intraperitoneal, intramuscular and intratumoral imaging in live mice. To our knowledge, these are the first iridium‐based chemiluminescent probes that have been employed for in vitro ratiometric oxygen sensing, and for in vivo tumor imaging. [ABSTRACT FROM AUTHOR]

Chemiluminescent iridium‐based sensors which demonstrate oxygen dependent responses have been developed. The molecular probes, named IrCL‐1, IrCL‐2 and IrCL‐3 consist of oxygen‐sensitive iridium complexes attached to a spiroadamantane 1,2 dioxetane and operate via energy transfer from the chemiexcited benzoate to the corresponding iridium(III) complex. Complexing the iridium(III) center with π‐extended ligands results in emission in the biologically relevant, near‐infrared (NIR) region. All probes demonstrate varying oxygen tolerance, with IrCL‐1 being the most oxygen sensitive. These probes have been further utilized for in vitro ratiometric imaging of oxygen, as well as for intraperitoneal, intramuscular and intratumoral imaging in live mice. To our knowledge, these are the first iridium‐based chemiluminescent probes that have been employed for in vitro ratiometric oxygen sensing, and for in vivo tumor imaging. [ABSTRACT FROM AUTHOR]

Abstract: Production of sustainable fuels, such as hydrogen, is currently limited by expensive metal catalysts, and while precious‐metal‐free alternatives have been developed, price to performance is still not sufficient for practical usage. Herein, multiple activated carbons (ACs) were investigated as water‐reducing catalysts (WRCs) in photo‐driven hydrogen evolution with an Ir light harvester. Features necessary for AC catalytic activity were probed using model catalysts of various polyacrylonitrile (PAN) derived carbons, with different N content, graphitic domain size, and pore structure. N content and microporosity were found to be determining features of activity in PAN‐based carbons. The ACs initially tested as WRCs were further characterized, revealing a dependence on N content and surface area consistent with PAN‐based carbons. These results are encouraging for the use of ACs as WRCs and point to possible improvements to catalytic activity by increasing N content and microporosity. [ABSTRACT FROM AUTHOR]

Acoustic microfluidic devices encompass mechanical, fluidic, and electromechanical domains. Complicated multidomain interactions require the consideration of each individual material domain, as well as coupled behaviors to achieve optimal performance. Herein, we report the co-optimization of components comprising an ultrasonic droplet generator to achieve the high-efficiency liquid atomization for operation in the 0.5–2.5-MHz frequency range. Due to the complexity of the real system, simplified 2-D representations of the device are investigated using an experimentally validated finite element analysis model. Ejection modes (i.e., frequencies at which droplet generation is predicted) are distinguished by maxima in the local pressure at the tips of an array of triangular nozzles. Resonance behaviors of the transducer assembly and fluid-filled chamber are examined to establish optimal geometric combinations concerning the chamber pressure field. The analysis identifies how domain geometries affect pressure field uniformity, broadband operation, and tip pressure amplitude. Lower frequency modes are found to focus the acoustic energy at the expense of field uniformity within the nozzle array. Resonance matching yields a nearly threefold increase in maximum attainable tip pressure amplitude. Significantly, we establish a set of design principles for these complex devices, which resembles a classical half-wave transducer, quarter-wave matching layer, and half-wave chamber layered system. [ABSTRACT FROM AUTHOR]

Abstract: This paper concludes that the deterioration of the mechanical quality factor Qm when operated under high power, can be recovered by externally applying positive DC bias field. Material constants for piezoelectric ceramics are generally characterized under low‐power conditions. However, high‐power properties deviate significantly from the ones measured under low‐power conditions (Qm degrades by a factor of ~2). DC Bias field helps to recover the properties of the ceramic under high‐power conditions. The DC bias field of 200 V/mm exhibits an almost equivalent “opposite” change rate to the vibration velocity of 0.1 m/s. It is also notable that the piezoelectric loss tan θ’ can be decreased most effectively under positive DC bias field (1.9% per 100 V/mm for the hard PZT and 3.1% per 100 V/mm for the soft PZT), in comparison with the elastic or dielectric losses. This report presents a comprehensive analysis on the low‐ and high‐power piezoelectric properties of hard and soft Lead Zirconate Titanates (PZT's) under externally applied DC bias field in the k31 resonance mode (transverse extensional). [ABSTRACT FROM AUTHOR]

Abstract: A new methodology is proposed to measure the dielectric constant and loss of a piezoelectric at the resonance frequency range based on the burst excitation method. Using a k31 type soft PZT rectangular specimen, we investigated the “force” and “voltage” factors carefully under the short‐ and open‐circuit conditions of the burst method, in terms of the ratio of the ring‐down current and voltage with the plate end vibration velocity and the displacement, and their phase lags. We provide the obtained material properties, including loss parameters, in particular, dielectric properties at the resonance frequency range. [ABSTRACT FROM AUTHOR]

BackgroundEvidence-based psychosocial treatments for schizophrenia founded on Western belief systems and values may not be efficacious in different cultures without adaptation. This systematic review analyses the nature and outcomes of culturally-adapted psychosocial interventions in schizophrenia, examining how interventions have been adapted, their efficacy and what features drive heterogeneity in outcome.MethodArticles identified by searching electronic databases from inception to 3 March 2016, reference lists and previous reviews were independently screened by two authors for eligible controlled trials. Data on the nature of adaptations was analysed inductively using thematic analyses. Meta-analyses were conducted using random effects models to calculate effect sizes (Hedges’ g) for symptoms.ResultsForty-six studies with 7828 participants were included, seven adapted for minority populations. Cultural adaptations were grouped into nine themes: language, concepts and illness models, family, communication, content, cultural norms and practices, context and delivery, therapeutic alliance, and treatment goals. Meta-analyses showed significant post-treatment effects in favour of adapted interventions for total symptom severity (n = 2345, g: −0.23, 95% confidence interval (CI) −0.36 to −0.09), positive (n = 1152, g: −0.56, 95% CI −0.86 to −0.26), negative (n = 855, g: −0.39, 95% CI −0.63 to −0.15), and general (n = 525, g: −0.75, CI −1.21 to −0.29) symptoms.ConclusionsThe adaptation process can be described within a framework that serves as a benchmark for development or assessment of future adaptations. Culturally adapted interventions were more efficacious than usual treatment in proportion to the degree of adaptation. There is insufficient evidence to show that adapted interventions are better than non-adapted interventions. Features of context, intervention and design influenced efficacy. Investigating whether adaptation improves efficacy, most importantly amongst ethnic minorities, requires better designed trials with comparisons against unadapted interventions. [ABSTRACT FROM AUTHOR]

We evaluated the occurrence of thoracic outlet syndrome (TOS) and 30-day postoperative outcomes. Patients undergoing cervical/first rib resection surgery were identified in the American College of Surgeons National Surgical Quality Improvement Program database (2005-2013). Thoracic outlet syndrome types were then examined. Propensity score matching was performed to account for potential confounders; 1180 patients were explored during the study period, 1007 (85.3%) were of the neurogenic TOS (NTOS), 32 (2.7%) patients had arterial TOS (ATOS), and 141 (12.0%) patients had venous TOS (VTOS). Patients with ATOS were significantly older (median age [interquartile range, IQR]--NTOS: 34 [25-44], ATOS: 49.5 [42.5-57], VTOS: 34 [23-43]; P < .001). Median operating time was significantly longer for patients with ATOS. Median in-hospital stay was also longer for patients with ATOS (median length of in-hospital stay [LOS; IQR]--NTOS: 2 [1-4]; ATOS: 6 [3-7]; and VTOS: 5 [2-7] days; P < .001). Patients with VTOS showed twice longer LOS when compared to NTOS after matching. Presentation and treatment of TOS have been studied extensively at highly experienced centers. [ABSTRACT FROM AUTHOR]

Model updating is concerned about the correction of finite element models by processing the record of dynamic response from test structures in order to have an accurate model for any simulated analysis. Finite element model updating had emerged years ago as an important subject in structural dynamics. It has been used frequently and has been successfully applied to many fields especially in detecting the dynamic stiffness of a structure. The purpose of this study is to perform model updating of a go-kart chassis structure in order to reduce the percentage of error between the experimental modal analysis (EMA) and finite element analysis (FEA). Modal properties (natural frequency, mode shapes, and damping ratio) of the go-kart chassis structure were determined using both EMA and FEA. Correlation of the modal parameters gathered in FEA and EMA was carried out before optimizing the data from finite element. By adjusting the selective parameters, incongruities between those two analyses are generally reduced. The sensitivity of selected parameters is also obtained. The significant reduction in percentage of error before and after model updating procedure was carried out in this study clearly shows that model updating technique is a reliable method in reducing the discrepancies between EMA and FEA. Therefore, in cases of high discrepancies between analytical and actual test data, model updating can be considered as an option in order to obtain better correlation between those two sets of data. [ABSTRACT FROM AUTHOR]

A new cyclometalating ligand, featuring nitrile moieties to enhance the photophysical and consequently photocatalytic properties of bis-cyclometalated Ir(iii) complexes, was synthesized. Nitrile moieties were selected to replace expensive and environmentally problematic fluoride moieties commonly employed for synthetic tuning of chromophores. Two new chromophores bearing the new nitrile-decorated ligand were synthesized with strong electron-donating and electron-withdrawing ancillary ligands to probe extremes of the complexes’ tunability. These complexes possessed rich and drastically different electrochemical and photophysical properties. One chromophore possessed a particularly long lifetime of approximately 8 μs; it was also a remarkably efficient triplet emitter with a quantum yield of 63%. The complexes were finally assessed as photosensitizers of water reduction with Pt colloids, where both complexes produced hydrogen with optimized conditions reaching 2000 and 1400 turnovers. [ABSTRACT FROM AUTHOR]

The synthesis and characterization of electron-poor thiophene 1,1-dioxides bearing cyanated phenyl groups are reported. The electron-accepting nature of these compounds was evaluated by cyclic voltammetry, and highly reversible and facile reductions were observed for several derivatives. Moreover, some of the reduced thiophene dioxides form colorful anions, which were investigated spectroelectrochemically. Photoluminescence spectra of the electron-deficient sulfones were measured in CH2Cl2, and they emit in the blue-green region with significant variation in the quantum yield depending on the aryl substituents. By expanding the degree of substitution on the phenyl rings, quantum yields up to 34 % were obtained. X-ray diffraction data are reported for two of the thiophene 1,1-dioxides, and the electronic structure was probed for all synthesized derivatives through DFT calculations. The dioxides were also examined as electron relays in a photocatalytic water reduction reaction, and they showed potential to boost the efficiency. [ABSTRACT FROM AUTHOR]

Background In practice, nonalcoholic fatty liver disease (NAFLD) is diagnosed based on elevated liver enzymes and confirmatory liver biopsy or abdominal imaging. Neither method is feasible in identifying individuals with NAFLD in a large-scale healthcare system. Aim To develop and validate an algorithm to identify patients with NAFLD using automated data. Methods Using the Veterans Administration Corporate Data Warehouse, we identified patients who had persistent ALT elevation (≥2 values ≥40 IU/mL ≥6 months apart) and did not have evidence of hepatitis B, hepatitis C or excessive alcohol use. We conducted a structured chart review of 450 patients classified as NAFLD and 150 patients who were classified as non-NAFLD by the database algorithm, and subsequently refined the database algorithm. Results The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) for the initial database definition of NAFLD were 78.4% (95% CI: 70.0-86.8%), 74.5% (95% CI: 68.1-80.9%), 64.1% (95% CI: 56.4-71.7%) and 85.6% (95% CI: 79.4-91.8%), respectively. Reclassifying patients as having NAFLD if they had two elevated ALTs that were at least 6 months apart but within 2 years of each other, increased the specificity and PPV of the algorithm to 92.4% (95% CI: 88.8-96.0%) and 80.8% (95% CI: 72.5-89.0%), respectively. However, the sensitivity and NPV decreased to 55.0% (95% CI: 46.1-63.9%) and 78.0% (95% CI: 72.1-83.8%), respectively. Conclusions Predictive algorithms using automated data can be used to identify patients with NAFLD, determine prevalence of NAFLD at the system-wide level, and may help select a target population for future clinical studies in veterans with NAFLD. [ABSTRACT FROM AUTHOR]

We report the photocatalytic dehydrogenation of alcohols with a Rh catalyst and I− in an acidic medium. The catalyst screening of a structurally diverse family of Rh complexes found [RhIII(dtbbpy)2(OSO2CF3)2](CF3SO3) ( Rh7; dtbbpy=4,4′-di- tert-butyl-2,2′-bipyridine) to be the best catalyst. All components ( Rh7, HI, alcohol, and light) were found to be essential for the dehydrogenation to occur. Under optimal conditions, generation of both H2 and acetone (for isopropyl alcohol) was observed, which increased linearly for 4 days with no significant decrease in activity. The proposed mechanism involves the formation of [RhIII(dtbbpy)2(I)2]+ [ Rh7( a)] followed by the generation of photoinduced I3− via a ligand (I−) to metal (RhIII) charge transfer. The resulting RhI species reduces H+ and I3− oxidizes the alcohol, which completes the catalytic cycle. Supporting evidence for the catalytic mechanism was obtained by using UV/Vis spectroscopy, electrospray ionization mass spectrometry, cyclic voltammetry and time-dependent DFT calculations. [ABSTRACT FROM AUTHOR]

In this research, a unique approach for characterizing mechanical loss in piezoelectric materials is developed. Instead of characterizing mechanical loss through electrical measurements, thermal and mechanical measurements are used. A comprehensive heat transfer model has been developed to describe the temperature rise due to heat generation in piezoelectric materials in resonance conditions. Using this model, along with experimental temperature and vibration measurements, the mechanical quality factor can be calculated. Advantages of this method over electrical impedance methods include high sensitivity to change in losses due to precise temperature and vibration measurements and evaluation of losses from a single frequency (versus a frequency sweep). This method has been applied to a hard PZT ceramic at several frequencies near its fundamental resonance at a tip vibration velocity of 300 mm/s RMS. In these high power conditions, the standard deviation of the mechanical quality factor resulting from the impedance data was 15%, while those resulting from the new method are less than 2.5%. The results from the impedance measurements using a constant vibration velocity sweep agree with the magnitude of the quality factor calculated from new method, giving evidence to its validity. [ABSTRACT FROM AUTHOR]

BackgroundCognitive remediation (CR) preceding cognitive–behavioural therapy for psychosis (CBTp) was trialled within routine clinical services, with the hypothesis that following first-episode non-affective psychosis CR would enhance CBTp efficacy by improving neuropsychological performance.MethodA total of 61 patients with DSM-IV non-affective psychoses waiting for routine CBTp were randomized to computerized CR over 12 weeks, supported by a trained support worker, or time-matched social contact (SC). Primary outcome was the blind-rated Psychotic Symptoms Rating Scale (PSYRATS). Secondary outcomes included measures of CBTp progress, cognition, symptoms, insight and self-esteem: all at baseline, after CR (12 weeks) and after CBTp (42 weeks). PSYRATS and global neuropsychological efficacy were tested using mixed-effects models with a group × time interaction term. Measures of CBTp progress and some neuropsychological measures were modelled by regression.ResultsThere was no significant difference between the CR and SC groups in PSYRATS (group × time coefficient 0.3, 95% confidence interval −0.4 to 1.1, p = 0.39). However, after CR CBTp was shorter [median 7 sessions, interquartile range (IQR) 2–12 after CR; median 13, IQR 4–18 after SC; model p = 0.011] and linked to better insight (p = 0.02). Global cognition did not improve significantly more after CR (p = 0.20) but executive function did (Wisconsin Card Sort, p = 0.012).ConclusionsCBTp courses preceded by CR were far shorter but achieved the same outcome as CBTp preceded by an active control, consistent with neuropsychological improvement enhancing CBTp. CR was delivered by staff with minimal training, offering the potential to reduce the costs of CBTp considerably. [ABSTRACT FROM AUTHOR]

BackgroundCognitive remediation (CR) preceding cognitive–behavioural therapy for psychosis (CBTp) was trialled within routine clinical services, with the hypothesis that following first-episode non-affective psychosis CR would enhance CBTp efficacy by improving neuropsychological performance.MethodA total of 61 patients with DSM-IV non-affective psychoses waiting for routine CBTp were randomized to computerized CR over 12 weeks, supported by a trained support worker, or time-matched social contact (SC). Primary outcome was the blind-rated Psychotic Symptoms Rating Scale (PSYRATS). Secondary outcomes included measures of CBTp progress, cognition, symptoms, insight and self-esteem: all at baseline, after CR (12 weeks) and after CBTp (42 weeks). PSYRATS and global neuropsychological efficacy were tested using mixed-effects models with a group × time interaction term. Measures of CBTp progress and some neuropsychological measures were modelled by regression.ResultsThere was no significant difference between the CR and SC groups in PSYRATS (group × time coefficient 0.3, 95% confidence interval −0.4 to 1.1, p = 0.39). However, after CR CBTp was shorter [median 7 sessions, interquartile range (IQR) 2–12 after CR; median 13, IQR 4–18 after SC; model p = 0.011] and linked to better insight (p = 0.02). Global cognition did not improve significantly more after CR (p = 0.20) but executive function did (Wisconsin Card Sort, p = 0.012).ConclusionsCBTp courses preceded by CR were far shorter but achieved the same outcome as CBTp preceded by an active control, consistent with neuropsychological improvement enhancing CBTp. CR was delivered by staff with minimal training, offering the potential to reduce the costs of CBTp considerably. [ABSTRACT FROM AUTHOR]

This paper deals with experimental investigations of fibre metal laminates (FMLs) based on kenaf/epoxy under static indentation loading. Tests were conducted on 2/1 lay-up and 3/2 lay-up of FMLs that fabricated by using vacuum infusion process and hydraulic pressing technique. Indentation tests of FMLs were conducted with loading rate of 10 mm/min. The front and rear surfaces of indentation-loaded FMLs were examined to identify the failure mechanisms at different configurations. It was found that, the failure was happened on the surface of pure kenaf by increasing the indentation depth. However, debonding between the aluminium sheet and kenaf/epoxy is occurred only for 3/2 lay-up of FMLs. The contact force-displacement curves and energy absorption-displacement curves were analysed. The resistance to deform and damage was increase by increasing the number of layers and thickness of aluminium alloy sheet. [ABSTRACT FROM AUTHOR]

The article presents a case study of 58-year-old female who was presented with gas embolism, dilation of the intrahepatic bile ducts that indicates presence of cholangiocellular carcinoma. It mentions that complications started after she underwent endoscopic retrograde cholangiopancreatography (ERCP) treatment measures for treatment of certain problem associated with biliary and pancreatic ductal systems. It also presents images depicting computed tomography reports of bile ducts.

Epstein-Barr virus (EBV) has been shown to be associated with gastric cancer. However, inconsistent findings have been reported regarding the EBV reactivation in gastric cancer and non-carcinomatous gastric epithelium. Therefore, the aim of the study was to investigate the effect of clinicopathological findings on the expression of different transcripts of EBV in patients with gastric cancer, peptic ulcer, and dyspepsia. A total of 200 adult patients (dyspepsia [120], peptic ulcer [30], gastric cancer [50]) undergoing upper gastrointestinal endoscopy were enrolled. EBV infection was diagnosed with non-polymorphic Epstein-Barr nuclear antigen1 (EBNA1) gene based PCR and confirmed by real-time PCR. The transcripts of EBV were detected by real-time RT-PCR. In patients with gastric cancer and peptic ulcer, EBV DNA was detected more often than in those with dyspepsia ( P < 0.05). EBNA1 transcript was detected in all EBV positive cases and its expression was neither associated with disease nor with histopathological findings. The expression of BZLF1 was significantly associated with gastric cancer and peptic ulcer compared to dyspepsia ( P < 0.01). BZLF1 expression was also found to be higher in Helicobacter pylori infected patients ( P = 0.058). Expression of BARF1 and BcLF1 were significantly higher in gastric epithelium of patients having severe grade chronic inflammation ( P = 0.05) and gastric atrophy ( P = 0.02), respectively. In conclusion, increased expression of lytic transcripts in patients with gastric cancer, peptic ulcer, gastric atrophy, chronic inflammation and H. pylori infection suggests the association of these factors with EBV reactivation. J. Med. Virol. 84: 1289-1297, 2012. © 2012 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

BackgroundThe reasons for the high prevalence of depressive disorders in women of Pakistani origin living in the UK are not clear. The aim of this study was to determine the relative importance of life events, chronic social difficulties and acculturation in a population-based sample of British Pakistani women.MethodA cross-sectional and prospective cohort study of 18- to 65-year-old Pakistani women in UK was carried out. The Schedule for Clinical Assessment in Neuropsychiatry for diagnosis, the Life Events and Difficulties Schedule for social stress and an acculturation questionnaire were used.ResultsDepressive disorder at baseline was associated with older age, social isolation and marked difficulties involving health and close relationships. Depressive disorder at follow-up was associated with severity of depression at baseline, difficulties in close relationships and two aspects of acculturation, especially less acculturation in relation to use of the English language.ConclusionsLack of acculturation, especially less familiarity with the English language, is an independent predictor of persistence of depression in Pakistani women in UK. This needs to be taken into consideration when planning treatment, which also needs to address the personal difficulties associated with persistent depression. The implication of this work is that women of Pakistani origin with depression should be encouraged to receive help in the use of English as one part of treatment that may prevent relapse. [ABSTRACT FROM PUBLISHER]

Rationale: Survivors of acute lung injury (ALI) frequently have substantial depressive symptoms and physical impairment, but the longitudinal epidemiology of these conditions remains unclear.Objectives: To evaluate the 2-year incidence and duration of depressive symptoms and physical impairment after ALI, as well as risk factors for these conditions.Methods: This prospective, longitudinal cohort study recruited patients from 13 intensive care units (ICUs) in four hospitals, with follow-up 3, 6, 12, and 24 months after ALI. The outcomes were Hospital Anxiety and Depression Scale depression score greater than or equal to 8 ("depressive symptoms") in patients without a history of depression before ALI, and two or more dependencies in instrumental activities of daily living ("impaired physical function") in patients without baseline impairment.Measurements and Main Results: During 2-year follow-up of 186 ALI survivors, the cumulative incidences of depressive symptoms and impaired physical function were 40 and 66%, respectively, with greatest incidence by 3-month follow-up; modal durations were greater than 21 months for each outcome. Risk factors for incident depressive symptoms were education 12 years or less, baseline disability or unemployment, higher baseline medical comorbidity, and lower blood glucose in the ICU. Risk factors for incident impaired physical function were longer ICU stay and prior depressive symptoms.Conclusions: Incident depressive symptoms and impaired physical function are common and long-lasting during the first 2 years after ALI. Interventions targeting potentially modifiable risk factors (e.g., substantial depressive symptoms in early recovery) should be evaluated to improve ALI survivors' long-term outcomes. [ABSTRACT FROM AUTHOR]

Development of thermally stable polymer electrolyte membranes with higher proton conductivity as well as mechanical stability is a key challenge in commercializing PEM fuel cells operating above 100 °C. Polybenzimidazole membranes are one of the promising candidates in this category although with limited mechanical stability and moderate proton conductivity. Here the incorporation of functionalized MWCNT is shown to increase both these key parameters of the polybenzimidazole membranes. Further, formation of a domain like structure after the incorporation of phosphonated MWCNTs (P-MWCNTs) in phosphoric acid doped polybenzimidazole membranes is demonstrated. The enhanced performance has been attributed to the formation of proton conducting networks that formed along the sidewalls of P-MWCNTs with a domain size of 17 nm as estimated from the small angle X-ray scattering measurements. Membrane electrode assembly (MEA) impedance measurements further reveal that the activation energy of oxygen reduction reaction (ORR) reduced for the composite membranes with enhanced proton conductivity. In addition, the mechanical strength measurements reveal a significant improvement in the yield strength and ultimate strength. Also, the mechanical strength of the composite membrane has been increased significantly as indicated by the improvement in the ultimate strength from 65 MPa to 100 MPa for the pristine and composite membranes, respectively. The optimum loading of P-MWCNTs is found to be 1% as inferred from the polarization measurements carried out using pure hydrogen and oxygen. Thus, this study provides a unique opportunity to tune the properties of polymer electrolytes to prepare application oriented hybrid membranes using CNTs with tailor-made functional groups. [ABSTRACT FROM AUTHOR]

Background : Till date there is no published multi-institutional data regarding the epidemiological profile of pediatric brain tumors in India. Aim : The present retrospective study analyses the histological spectrum of pediatric age group brain tumors in seven tertiary care hospitals in India. Material and Methods : Data regarding frequencies of various primary brain tumors (diagnosed according to the World Health Organization (WHO) classification), in 3936 pediatric patients (<18 yrs of age), was collected from seven tertiary care hospitals in India.Results : The most common primary pediatric brain tumors were astrocytic tumors (34.7%), followed by medulloblastoma and supratentorial primitive neuro-ectodermal tumors (22.4%), craniopharyngiomas (10.2%) and ependymal tumors (9.8%). The most common astrocytic tumor was pilocytic astrocytoma. In comparison to adults, oligodendrogliomas and lymphomas were rare in children. Conclusions : Our study is the first such report on the histological spectrum of brain tumors in children in India. Except for a slightly higher frequency of craniopharyngiomas, the histological profile of pediatric brain tumors in India is similar to that reported in the Western literature. [ABSTRACT FROM AUTHOR]

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Background Programmes that promote early psychological development of children in the developed world have been found to be beneficial. However, such programmes are rare in underprivileged parts of the developing world. We adapted one such parent-based programme (Learning Through Play) for a rural Pakistani population and aimed to study if: (1) it was acceptable to community health workers; (2) the programme led to an improvement, after a period of 6 months, in mothers' knowledge and attitudes about early infant development; (3) it led to a reduction in the levels of maternal mental distress in the post-natal period. Methods Using a cluster randomized design with villages as unit of randomization, 163 mothers from 24 villages in a rural sub-district of Rawalpindi, Pakistan, received the ‘Learning Through Play’ programme, whereas 146 mothers from 24 villages acted as controls. Twenty-four community health workers were trained to carry out the programme. Assessments were conducted using a specially developed 15-item Infant Development Questionnaire and the 20-item Self-Reporting Questionnaire (SRQ). Results Over 80% of the community health workers trained found the programme to be relevant and were able to integrate it into their routine work. There was a significant increase in mothers' knowledge and positive attitudes about infant development in the intervention group, compared with the control group. Women in the intervention group answered correctly 4.3 (95% CI 3.7–14.9, P < 0.001) more questions than the control group. There was no difference in levels of mental distress measured by the SRQ. Conclusions The ‘Learning Through Play’ programme was successfully integrated into the existing health system and accepted by community health workers. The programme succeeded in improving the knowledge and attitudes of mothers about infant development. [ABSTRACT FROM AUTHOR]

Previous studies have found no female predominance in irritable bowel syndrome (IBS) in non-Western countries. The aim of the study was to assess the prevalence and correlates of Rome II (IBS) in both sexes in Pakistan. A Population-based survey in a low-income inner city area using questionnaires to diagnose Rome II IBS and assess distress, disability and stressful life events. Data were collected from 880/938 (93%) randomly selected residents. 13.4% of women and 13.1% men met criteria for Rome II IBS; 34 (3.9%) had diarrhoea-predominant, 59 (6.7%) had constipation-predominant IBS and 24 (2.7%) had ‘mixed IBS’. In logistic regression analysis, IBS was associated in men with high income (OR = 1.56; 95% CI: 1.05–2.3) and few years of education (OR = 2.17; 95% CI: 1.2–3.9) and in women with being married (OR = 3.6; 95% CI: 1.1–11.9) and stressful life events score (OR = 1.14; 95% CI: 1.01–1.3). Disability was associated with constipation-predominant IBS (OR = 1.99; 95% CI: 1.1–3.6), distress (OR = 1.19; 95% CI: 1.14–1.23) and stressful life events (OR = 1.19; 95% CI: 1.1–1.3). Investigations were more likely in men (54%) than in women (27%) ( P = 0.003). These findings suggest that the equal sex ratio of IBS in urban Pakistan could result from a close association between marked distress and IBS in men similar to that found in women in western studies. [ABSTRACT FROM AUTHOR]

Ethnicity is reported to be an important, but often ignored factor in psychopharmacology. However, recent advances in molecular biology and the vision of 'personalised medicine' have spurred a debate on the role of ethnicity in this field. This paper reviews literature on the role of race and ethnicity in psychopharmacology. Despite considerable controversy on what the concepts of ethnicity and race actually measure, they are considered as important proxies for a person's culture, diet, beliefs, health behaviours and societal attitudes. Research has shown ethnic differences in the clinical presentation, treatment, clinical response and outcome of mental illnesses. A number of ethnically specific variations have been found in the genetic and non-genetic mechanisms affecting pharmacokinetics and dynamics of psychotropic drugs, which might underlie the previously mentioned differences in drug use and response across ethnicities. Although some of these ethnic differences could be partially explained by genetic factors, a number of ethnically based variables like culture, diet and societal attitudes could potentially have a significant, but as yet unquantified influence as well. Future research needs to address the problems with defining and accurately measuring 'ethnicity', as well as focus upon conducting studies that could guide treatments for people from diverse backgrounds. [ABSTRACT FROM AUTHOR]

We describe three cases of parotid gland lipoma, a relatively rare, asymptomatic, slow growing, freely movable, soft tissue mass. Preoperative clinical diagnosis is generally difficult but MRI using fat saturation techniques provides accurate diagnostic information regarding this benign parotid gland tumor, enabling better treatment planning. [ABSTRACT FROM AUTHOR]

Objective. Various approaches including endoscopy have been used for the treatment of intraventricular and cisternal NCC. We present our technique of Neuro-endoscopic management of intraventricular NCC. Methods. Twenty-one cases, 13 females and 8 males (age range 12–50 years; mean, 25.7 years), of intraventricular NCC [lateral ( n = 6), third ( n = 6), fourth ( n = 10) ventricles including a patient with both lateral and third ventricular cysts] producing obstructive hydrocephalus formed the group of study. Gaab Universal Endoscope System along with 4 mm 0° and 30° rigid telescopes were used through a frontal burr-hole for removal of intraventricular including intra-fourth ventricular ( n = 10) NCC. Endoscopic third ventriculostomy (ETV) was done for internal cerebrospinal fluid (CSF) diversion. Average follow up was 18 months. Results. Complete ( n = 18) or partial ( n = 2) removal of NCC was done in 20 patients, while a cyst located at foramen of Monro slipped and migrated to occipital or temporal horn in 1 patient. Thirty-degree 4-mm rigid telescope provided excellent image quality with ability to address even intra-fourth ventricular NCC through the dilated aqueduct using a curved tip catheter. No patient required further surgery for their hydrocephalus. There was no operative complication and post-operative ventriculitis was not seen in any case despite partial removal of NCC. Conclusion. Neuro-endoscopic surgery is an effective treatment modality for patients with intraventricular NCC. It effectively restores CSF flow and is capable of removing cysts completely or partially from accessible locations causing mass effect. Partial removal or rupture of the cyst does not affect the clinical outcome of the patients. [ABSTRACT FROM AUTHOR]

Background: Depression is common in Pakistan but no research on this subject has been reported from the North West Frontier Province (NWFP), host to numerous Afghan refugees.Aims: To measure depressive symptoms and associated features in a population-based sample.Method: A Pushto translation of the Self Reporting Questionnaire (SRQ) was administered to 471 adults living in a village in one of the federally administered tribal areas. Respondents were also assessed with a life events checklist for social problems, a social support questionnaire and the Brief Disability Questionnaire.Results: Sixty per cent (95/158) of women and 45% (140/313) of men scored 9 or more on the SRQ. High SRQ score was associated with few years of education, higher social problem score, less social support and greater disability. High social problem score was the strongest correlate.Conclusions: This population reports more depressive symptoms than other communities in Pakistan and this probably reflects the very high degree of social stress experienced in the NWFP, which has been affected by years of turmoilin neighbouring Afghanistan. [ABSTRACT FROM AUTHOR]