Effectiveness of Digital Learning in Community Mental Health Care Among Nurses in India

Background

Digital learning is a cost-effective and time-saving approach in higher education. The present study aimed to check the impact of continuing nursing education programs through digital learning by connecting Indian nurses to NIMHANS Digital Academy (NDA).

Materials and Methods

One group pre-test and post-test design was used for this study. Overall, 217 nurses registered for the course and 146 nurses were recruited on the basis of eligibility and their Expression of Interest (EoI) through the online registration portal. All the nurses who had access to the internet and enough internet literacy were included in the study. 64 nurses had not submitted the post-test due to various reasons within the stipulated time. Hence, the final sample achieved and calculated for the analysis was n = 82. The data for this study were collected through the retrospective chart review method.

Result

The findings of this study reveal that most of the nurses in India had willingness and readiness for digital learning. All the nurses who joined the NDA learning program stated that they would like to improve their knowledge regarding mental health and illness, to identify and manage mentally ill patients efficiently. The results indicated that the training provided through NDA positively impacted the nurses' knowledge and fulfilled their learning needs. Statistical analysis showed a significant difference between knowledge, practice, and confidence score changes for the two-time point period, i.e. before and after the training.

Conclusion

It can be concluded that conducting Continuing Nursing Education (CNE) through a digital learning program is an effective teaching-learning method in the nursing curriculum.

Stilbenoid compounds inhibit NF-κB-mediated inflammatory responses in the Drosophila intestine

Introduction

Stilbenoid compounds have been described to have anti-inflammatory properties in animal models in vivo, and have been shown to inhibit Ca2+-influx through the transient receptor potential ankyrin 1 (TrpA1).

Methods

To study how stilbenoid compounds affect inflammatory signaling in vivo, we have utilized the fruit fly, Drosophila melanogaster, as a model system. To induce intestinal inflammation in the fly, we have fed flies with the intestinal irritant dextran sodium sulphate (DSS).

Results

We found that DSS induces severe changes in the bacteriome of the Drosophila intestine, and that this dysbiosis causes activation of the NF-κB transcription factor Relish. We have taken advantage of the DSS-model to study the anti-inflammatory properties of the stilbenoid compounds pinosylvin (PS) and pinosylvin monomethyl ether (PSMME). With the help of in vivo approaches, we have identified PS and PSMME to be transient receptor ankyrin 1 (TrpA1)-dependent antagonists of NF-κB-mediated intestinal immune responses in Drosophila. We have also computationally predicted the putative antagonist binding sites of these compounds at Drosophila TrpA1.

Discussion

Taken together, we show that the stilbenoids PS and PSMME have anti-inflammatory properties in vivo in the intestine and can be used to alleviate chemically induced intestinal inflammation in Drosophila.

Deciphering the binding site and mechanism of new methylene blue with serum albumins: A multispectroscopic and computational investigation

Herein, the interaction mechanism of new methylene blue (NMB) with human serum albumin (HSA) and bovine serum albumin (BSA) was carefully investigated both experimentally and conceptually, employing experimental and insilico analysis. The steady-state emission spectral studies showed that the emission intensity of HSA and BSA was quenched significantly by NMB. The findings of the Stern-Volmer and double logarithmic plot revealed that the observed emission quenching process was through a static quenching mechanism and the measured binding constant values (K_b) for HSA-NMB and BSA-NMB are 2.766 and 1.187 × 10⁵ dm³ mol^-1 respectively. The time-resolved fluorescence lifetime measurement and UV-vis absorption investigation further verify the complex formation between NMB and HSA/BSA. The assessment of thermodynamic parameters disclosed the binding process was spontaneous driven by hydrogen bonds (H-bond) and van der Waals interactions, which contributed a significant role in the complexation. Moreover, the secondary structural conformation and microenvironment of HSA/BSA were modified in the presence of NMB, as evidenced by circular dichroism and synchronous fluorescence data. Molecular docking study predicted a plausible binding mode of NMB inside the binding pocket of HSA and BSA. These results demonstrated that the stabilized NMB is found at the Subdomain IIA (site I) of both the proteins and the results were correlated well with the competitive binding assay. Additionally, the principal components analysis revealed less variation of docked poses for HSA, while, more dispersed docked poses were observed for the BSA model. This also highlights the effects of docking towards a modeled protein (BSA). Molecular dynamic (MD) simulation based binding free energy (ΔG_mmgbsa) estimation obtained at 298, 303, 308 and 313 K, were in good agreement with our experimental (ΔG_bind) values.

Bias-force guided simulations combined with experimental validations towards GPR17 modulators identification

Glioblastoma Multiforme (GBM) is known to be by far the most aggressive brain tumor to affect adults. The median survival rate of GBM patient's is < 15 months, while the GBM cells aggressively develop resistance to chemo- and radiotherapy with their self-renewal capacity which suggests the pressing need to develop novel preventative measures. We have recently proved that GPR17 -an orphan G protein-coupled receptor- is highly expressed on the GBM cell surface and it has a vital role to play in the disease progression. Despite the progress made on GBM downregulation, there still remain difficulties in developing a promising modulator for GPR17, till date. Here, we have performed robust virtual screening combined with biased-force pulling molecular dynamic (MD) simulations to predict high-affinity GPR17 modulators followed by experimental validation. Initially, the database containing 1379 FDA-approved drugs were screened against the orthosteric binding pocket of the GPR17. The external bias-potentials were then applied to the screened hits during the MD simulations which enabled to predict a spectrum of rupture peak force values that were used to select four approved drugs -ZINC000003792417 (Sacubitril), ZINC000014210457 (Victrelis), ZINC000001536109 (Pralatrexate) and ZINC000003925861 (Vorapaxar)- as top hits. The hits selected turns out to demonstrate unique dissociation pathways, interaction pattern, and change in polar network over time. Subsequently the selected hits with GPR17 were measured by inhibiting the forskolin-stimulated cAMP accumulation in GBM cell lines, LN229 and SNB19. The ex vivo validations shows that Sacubitril drug can act as a full agonist, while Vorapaxar functions as a partial agonist for GPR17. The pEC₅₀ of Sacubitril was identified as 4.841 and 4.661 for LN229 and SNB19, respectively. Small interference of the RNA (siRNA)- silenced the GPR17 to further validate the targeted binding of Sacubitril with GPR17. In the current investigation, we have identified new repurposable GPR17 specific drugs which are likely to increase the opportunity to treat orphan deadly diseases.

Effect of Electric Field on α-Synuclein Fibrils: Revealed by Molecular Dynamics Simulations

The self-association of amylogenic proteins to the fibril form is considered a pivotal factor in the pathogenesis of neurodegenerative diseases, including Parkinson’s disease (PD). PD causes unintended or uncontrollable movements in its common symptoms. α-synuclein is the major cause of PD development and thus has been the main target of numerous studies to suppress and sequester its expression or effectively degrade it. Nonetheless, to date, there are no efficient and proven ways to prevent pathological protein aggregation. Recent investigations proposed applying an external electric field to interrupt the fibrils. This method is a non-invasive approach that has a certain benefit over others. We performed molecular dynamics (MD) simulations by applying an electric field on highly toxic fibrils of α-synuclein to gain a molecular-level insight into fibril disruption mechanisms. The results revealed that the applied external electric field induces substantial changes in the conformation of the α-synuclein fibrils. Furthermore, we show the threshold value for electric field strength required to completely disrupt the α-synuclein fibrils by opening the hydrophobic core of the fibril. Thus, our findings might serve as a valuable foundation to better understand molecular-level mechanisms of the α-synuclein fibrils disaggregation process under an applied external electric field.

Allosteric regulation of DNA binding and target residence time drive the cytotoxicity of phthalazinone-based PARP-1 inhibitors

Allosteric coupling between the DNA binding site to the NAD⁺-binding pocket drives PARP-1 activation. This allosteric communication occurs in the reverse direction such that NAD⁺ mimetics can enhance PARP-1's affinity for DNA, referred to as type I inhibition. The cellular effects of type I inhibition are unknown, largely because of the lack of potent, membrane-permeable type I inhibitors. Here we identify the phthalazinone inhibitor AZ0108 as a type I inhibitor. Unlike the structurally related inhibitor olaparib, AZ0108 induces replication stress in tumorigenic cells. Synthesis of analogs of AZ0108 revealed features of AZ0108 that are required for type I inhibition. One analog, Pip6, showed similar type I inhibition of PARP-1 but was ∼90-fold more cytotoxic than AZ0108. Washout experiments suggest that the enhanced cytotoxicity of Pip6 compared with AZ0108 is due to prolonged target residence time on PARP-1. Pip6 represents a new class of PARP-1 inhibitors that may have unique anticancer properties.

Multispectroscopic and Computational Investigations on the Binding Mechanism of Dicaffeoylquinic Acids with Ovalbumin

Recently, studies on the interactions between ovalbumin (OVA) and polyphenols have received a great deal of interest. This study explored the conformational changes and the interaction mechanism of the binding between OVA and chlorogenic acid (CGA) isomers such as 3,4-dicaffeoylquinic acids (3,4-diCQA), 4,5-dicaffeoylquinic acids (4,5-diCQA), and 3,5-dicaffeoylquinic acids (3,5-diCQA) using multispectroscopic and in silico analyses. The emission spectra show that the diCQAs caused strong quenching of OVA fluorescence under different temperatures through a static quenching mechanism with hydrogen bond (H-bond) and van der Waals (vdW) interactions. The values of binding constants (OVA-3,4-diCQA = 6.123 × 10⁵, OVA-3,5-diCQA = 2.485 × 10⁵, OVA-4,5-diCQA = 4.698 × 10⁵ dm³ mol^-1 at 298 K) suggested that diCQAs had a strong binding affinity toward OVA, among which OVA-3,4-diCQA exhibits higher binding constant. The results of UV-vis absorption and synchronous fluorescence indicated that the binding of all three diCQAs to OVA induced conformational and micro-environmental changes in the protein. The findings of molecular modeling further validate the significant role of vdW force and H-bond interactions in ensuring the stable binding of OVA-diCQA complexes. Temperature-dependent molecular dynamics simulation studies allow estimation of the individual components that contribute to the total bound free energy value, which allows evaluation of the nature of the interactions involved. This research can provide information for future investigations on food proteins' physicochemical stability and CGA bioavailability in vitro or in vivo.

Mechanistic Insights into SARS-CoV-2 Main Protease Inhibition Reveals Hotspot Residues

The main protease (M^pro) is a key enzyme responsible for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) replication that causes the spread of the global pandemic novel coronavirus (nCOVID-19) infection. In the present study, multiple computational approaches such as docking, long-range molecular dynamics (MD) simulations, and binding free-energy (BFE) estimation techniques were employed to investigate the mechanistic basis of the high-affinity inhibitors─GC-376, Calpain XII, and Calpain II (hereafter Calpain as Cal) from the literature─binding to M^pro. Redocking GC-376 and docking Cal XII and Cal II inhibitors to M^pro were able to reproduce all crucial interactions like the X-ray conformation. Subsequently, the apo (ligand-free) and three holo (ligand-bound) complexes were subjected to extensive MD simulations, which revealed that the ligand binding did not alter the overall M^pro structural features, whereas the heatmap analysis showed that the residues located in subsites S1 and S2, the catalytic dyad, and the ⁴⁵TSEDMLN⁵¹ loop in M^pro exhibit a conformational deviation. Moreover, the BFE estimation method was used to elucidate the crucial thermodynamic properties, which revealed that Coulomb, solvation surface accessibility (Solv_SA), and lipophilic components contributed significant energies for complex formation. The decomposition of the total BFE to per-residue showed that H41, H163, M165, Q166, and Q189 residues contributed maximum energies. The overall results from the current investigation might be valuable for designing novel anti-M^pro inhibitors.

'Unheard voices': Perceptions of women with mental illness on nurses screening routinely for domestic violence: A qualitative analysis

OBJECTIVES

To explore women's experiences of violence and their opinion on routine screening for domestic violence by nursing professionals in mental health care settings.

METHODS

This qualitative narrative research design was carried out among 20 asymptomatic women with mental illness at a tertiary care centre in Bangalore, India.

RESULTS

Narrative content analysis was performed, and five dominant themes have emerged: 1. Understanding the nature and signs of violence (subtheme: Meaning of violence), 2. Abusive experiences of women with mental illness (subthemes: Physical violence, psychological violence, social violence, sexual violence and financial violence), 3. Experiences on disclosure of violence (subthemes: Identification of violence by nursing professionals, Experiences of disclosure of violence), 4. Barriers for disclosure of abuse(subthemes: Fear of consequences, the hectic schedule of nursing staff, helplessness and hopelessness, perceived poor family support). 5.Routine screening for violence by nursing professionals (subthemes: reasons for routine inquiry of violence, nature of inquiry by the nursing professionals).

CONCLUSIONS

Women with mental illness were undergoing more than one form of violence, and most of the participants supported routine screening by nursing professionals. Nurses play an essential role in identifying and supporting abused women in mental health care settings.

Mapping the Molecular Architecture Required for Lipid-Binding Pockets Using a Subset of Established and Orphan G-Protein Coupled Receptors

G-protein coupled receptors (GPCRs) sense a wide variety of stimuli, including lipids, and transduce signals to the intracellular environment to exert various physiological responses. However, the structural features of GPCRs responsible for detecting and triggering responses to distinct lipid ligands have only recently begun to be revealed. 14,15-epoxyeicosatrienoic acid (14,15-EET) is one such lipid mediator that plays an essential role in the vascular system, displaying both vasodilatory and anti-inflammatory properties. We recently reported multiple low-affinity 14,15-EET-binding GPCRs, but the mechanism by which these receptors sense 14,15-EET remains unclear. Here, we have taken a combined computational and experimental approach to identify and confirm critical residues and properties within the lipid-binding pocket. Furthermore, we generated mutants to engineer selected GPCR-predicted binding sites to either confer or abolish 14,15-EET-induced signaling. Our structure-function analyses indicate that hydrophobic and positively charged residues of the receptor-binding pocket are prerequisites for recognizing lipid ligands such as 14,15-EET and possibly other eicosanoids.

Wnt/β-catenin Antagonists: Exploring New Avenues to Trigger Old Drugs in Alleviating Glioblastoma Multiforme

BACKGROUND

Glioblastoma multiforme is one of the most heterogenous primary brain tumor with high mortality. Nevertheless, of the current therapeutic approaches, survival rate remains poor with 12 to 15 months following preliminary diagnosis, this warrants the need for effective treatment modality. Wnt/β-catenin pathway is presumably the most noteworthy pathway up-regulated in almost 80% GBM cases contributing to tumor-initiation, progression and survival. Therefore, therapeutic strategies targeting key components of Wnt/β-catenin cascade using established genotoxic agents like temozolomide and pharmacological inhibitors would be an effective approach to modulate Wnt/β-catenin pathway. Recently, drug repurposing by means of effective combination therapy has gained importance in various solid tumors including GBM, by targeting two or more proteins in a single pathway, thereby possessing the ability to overcome the hurdle implicated by chemo-resistance in GBM.

OBJECTIVE

In this context, by employing computational tools, an attempt has been carried out to speculate the novel combinations against Wnt/β-catenin signaling pathway.

METHODS

We have explored the binding interactions of three conventional drugs namely temozolomide, metformin, chloroquine along with three natural compounds viz., epigallocatechin gallate, naringenin and phloroglucinol on the major receptors of Wnt/β-catenin signaling.

RESULTS

It was noted that all the experimental compounds possessed profound interaction with the two major receptors of Wnt/β-catenin pathway.

CONCLUSION

To the best of our knowledge, this study is the first of its kind to characterize the combined interactions of the afore-mentioned drugs on Wnt/β-catenin signaling in silico and this will putatively open up new avenues for combination therapies in GBM treatment.

Investigation into the site-specific binding interactions between chlorogenic acid and ovalbumin using multi-spectroscopic and in silico simulation studies

The binding interactions of bioactive compounds with proteins are of great importance in the food, biochemistry and pharmaceutical fields. Herein, the binding mechanisms between 5-O-caffeoylquinic acid (5-CQA) and ovalbumin (OVA) were investigated by multi-spectroscopic studies combined with docking and molecular dynamics (MD) simulations. The emission intensity of OVA was quenched by 5-CQA and Stern-Volmer analysis indicated the existence of a static suppression by OVA-5-CQA complex formation. Thermodynamic parameters revealed that the formation of complex was spontaneously driven by electrostatic and hydrogen-bonding interactions. Circle dichroism analyses showed that 5-CQA decreased the α-helix content of OVA structure from 58.05% to 54.32% upon increased OVA:5-CQA ratio to 1:3. Molecular docking results suggested 5-CQA forms hydrogen bond interactions with N88, T91, K92, N94, S98, F99, S100 and L101 residues of OVA. The experimental values were in good agreement with the calculated binding free energy values obtained by MD simulation (R² = 0.89).Communicated by Ramaswamy H. Sarma.

Social media use and health promoting lifestyle: an exploration among Indian nursing students

OBJECTIVES

To evaluate the use of social media and the health promoting lifestyle profile of indian nursing students.

METHODS

A cross-sectional study was carried out with 125 students (89 undergraduate and 36 graduate) from various Nursing universities in India, who provided information on their sociodemographic data, the Bergen Social Media Addiction Scale (BSMAS) and the Health Promoting Lifestyle Profile (HPLP-II).

RESULTS

Regarding the BSMAS, the participants had an average of 12.8 (maximum possible = 30); 42% reported they frequently delayed their sleep due to using social media; 9% had excessive use of social media; by gender, men had higher total score than women. With respect to the health promoting lifestyle profile, the total average was 126.9 (maximum possible = 208); no difference was observed by gender in the total score and men scored better in the domain of physical activity; students living with their families had higher scores in the domain of health responsibility than those living alone; and graduate students had better scores than undergraduate students in the scale total and in the domains of health responsibility, spiritual relations, and interpersonal relations.

CONCLUSIONS

There is excessive use of social media, especially among male students. This study also revealed lower scores than those desired in the domains of Health Promoting Lifestyle, especially for physical activity, health responsibility, stress management, and nutrition. Thereby, the findings may be used to improve health literacy on social media, as well as promote a positive lifestyle among nursing students.

Mobile phone use screening test: Development, validation, and implications for screening excessive mobile use

BACKGROUND

Early identification for the addictive use of smartphones would enable timely intervention to minimize suffering from compromised functioning and associated psychological problems. This study is the first such attempt to develop a test for addictive/excessive use of the mobile phone in the Indian context. The present study aims to develop and validate the mobile phone use screening test (MUST) for the Indian subcontinent.

MATERIALS AND METHODS

Five hundred individuals aged 18-40 years, residing in the South Indian city of Bangalore participated in the study. The sociodemographic datasheet and the newly developed test were administered on these individuals to gather demographic information and patterns of excessive mobile phone use.

RESULTS

The developed test has 18-items which use a self-report Likert-type scale format. The test-retest reliability was 0.93 and the Cronbach's alpha was found to be 0.86. The scoring criterion for the overall score was: <30 = mild use; 31-49 = moderate use; and 50 and above = excessive/addictive smartphone use. The scale has four components: craving, loss of control, coping, and consequences.

CONCLUSIONS

The MUST can be used for the identification of addictive/excessive use of mobile phone among adolescents and young adult groups.

Disruption of conserved polar interactions causes a sequential release of Bim mutants from the canonical binding groove of Mcl1

Mcl1 is an important anti-apoptotic member of the Bcl2 family proteins that are upregulated in several cancer malignancies. The canonical binding groove (CBG) located at the surface of Mcl1 exhibits a critical role in binding partners selectively via the BH3-domain of pro-apoptotic Bcl2 family members that trigger the downregulation of Mcl1 function. There are several crystal structures of point-mutated pro-apoptotic Bim peptides in complex with Mcl1. However, the mechanistic effects of such point-mutations towards peptide binding and complex stability still remain unexplored. Here, the effects of the reported point mutations in Bim peptides and their binding mechanisms to Mcl1 were computationally evaluated using atomistic-level steered molecular dynamics (SMD) simulations. A range of external-forces and constant-velocities were applied to the Bim peptides to uncover the mechanistic basis of peptide dissociation from the CBG of Mcl1. Although the peptides showed similarities in their dissociation pathways, the peak rupture forces varied significantly. According to simulations results, the disruption of the conserved polar contacts at the complex interface causes a sequential release of the peptides from the CBG of Mcl1. Overall, the results obtained from the current study may provide valuable insights for the development of novel anti-cancer peptide-inhibitors that can downregulate Mcl1's function.

Synthesis and Evaluation of Anisomelic acid-like Compounds for the Treatment of HPV-Mediated Carcinomas

The vast majority of cervical and 75% of oropharyngeal carcinomas are triggered by infection with a type of high-risk oncogenic human papillomavirus (HPV). It is well-known that E6 and E7 oncoproteins are critical for viral-induced cancer, and hence, they represent valuable targets for therapeutic intervention in HPV-mediated cancers. Our earlier research on the cembranoid, anisomelic acid (AA) showed that, AA has the potential to induce apoptosis in HPV cells by the depletion of E6 and E7 oncoproteins. The present study describes the structure-activity relationship and the evaluation of synthetic AA like compounds, i.e simplified cembranoid-like structures, as HPV inhibitors against some papilloma cell lines. Both from experimental and computational results, we observed that these compounds induced apoptosis by the same E6/E7-based mechanism as AA, but at earlier time points, thus being far more effective than AA. Further, the data indicated that only part of the structure of AA is required for the molecular action. Based on these results, we identified some novel and potential compounds for specific treatment of HPV-associated carcinomas.

Potential for Increased Epilepsy Awareness: Impact of Health Education Program in School on Teachers and Children

Background Although epilepsy is a common disorder, it is highly stigmatized. Not only public but even teachers are not free from stigmatization and cultural barriers. Under this condition, children with epilepsy are more vulnerable for stigmatization, social isolation, lack of support, and psychological and emotional problems. At the same time, there is an immediate need of literature focusing on intervention studies to change the attitudes of school teachers and children.

Materials and Methods The study was conducted with the objectives to evaluate knowledge, attitude, and practices about epilepsy among school teachers and children; provide educational training program to teachers; and check the efficacy of training program imparted by teacher and trainer.

Results Repeated measure of analysis of variance shows that knowledge (F = 1134.875, p < 0.001), attitude (F = 2429.909, p < 0.001), and practice (F = 2205.122, p < 0.001) are significantly different between pre- and posttest indicated by Pillai’s trace test. Similarly, from the Pillai’s test knowledge (F = 49.317, p < 0.001), attitude (F = 125.304, p < 0.001) and practice (F = 178.697, p < 0.001) are significantly different among the teachers, trainer imparted training group of children, and teachers imparted training group of children groups. It is seen that knowledge, attitude, and practice scores significantly differ between two time points and across three groups. Among all the groups, teachers imparted training group children had high level of practice.

Conclusion Inclusion of health education programs in the textbooks and health education schemes for teachers and school children is a crucial way to bring a change in their attitude, behavior, and practices.

Perceived stress and resilience and their relationship with the use of mobile phone among nursing students

OBJECTIVES

The study sought to explore the relationship between levels of stress and resilience with the use of the mobile phone in nursing students.

METHODS

Cross-sectional study conducted with 102 nursing students from several Nursing schools in India who were invited to participate in the research. The data were gathered by using the following instruments: Perceived Stress Scale (PSS) by Cohen, The Connor-Davidson Resilience scale (CD-RISC), and Mobile Phone Involvement Questionnaire (MPIQ) by Walsh.

RESULTS

Most of the participants were women (94.1%), studying in the undergraduate (70.6%), with a mean age of 25.2 years. In all, 77.5% of the students had stress perception between moderate and high, 20.6% had high resilience capacity, and 25.5% were frequent mobile phone users. Perceived stress was correlated significantly and negatively with age and resilience capacity. Graduate students had greater capacity to recover than undergraduate students.

CONCLUSIONS

This study indicates the negative relation of resilience capacity with stress and the use of mobile phones among nursing students. Hence, it is necessary for institutions preparing nurses to develop intervention strategies to enhance the resilience capacity, improve skills to manage stress, and healthy use of the mobile phone.

Urban and rural pattern of Internet use among youth and its association with mood state

Introduction:

The problematic use of internet is associated with dysfunction life style. The emerging evidence do also suggest its impact on user's mood profile. There is need to establish the urban and rural difference in relation to internet use as well as its association with mood states and its implications for primary care setting.

Methods:

The present work explored the pattern of internet use in Urban and Rural area and its impact on mood states. 731 individuals (403 males and 328 females) in the age group of 18-25 years from urban and rural areas were approached for the study. The internet addiction test and Depression Anxiety Stress Scale were administered in group setting. Results indicated no significant difference in term of internet use as well as in term for gender. Significant difference was seen for internet use and mood states.

Results:

The results indicate no significant difference in terms of internet use pattern and gender in relation to urban and rural areas. However, a significant difference exists with respect to Internet use and its relation to depression, anxiety and stress.

Conclusions:

It implies the development of early brief intervention for Primary Physicians to enable them to screening psychological conditions along with internet use as well as help users to have healthy use of technology.

Sexting and Self-Esteem Among Youth: Preliminary Trend for Building Cyberliteracy

Objectives: Online activities have influenced the expression and indulgence in sexual behavior. Sexting has become one of the modality to express sexual behavior. The present study explored sexting in the Indian context as well as its relationship with self-esteem.

Methods: 300 young adults in the age group of 17 to 20 years were assessed for sexting behaviors.

Results: Studies showed that males engaged more in sexting and that there was absence of a significant difference in self-esteem and sexting.

Conclusions: It has implications for screening sexting behavior among youth as well as for enhancing cyberliteracy among youth for sexting behaviors.

Patient experiences and health system responsiveness among internal migrants: A nationwide study in 13 Indian cities

OBJECTIVE

To report various components of health system responsiveness among poor internal migrants who availed the government health facilities in 13 Indian cities.

MATERIALS AND METHODS

Cluster random sampling was used to select 50,806 migrant households, of which 14,263 households avail the government health facility in last six months. In addition, 5072 women, who sought antenatal care and 3946 women who had delivery in government health facility during last six months were also included. Data on different domains of health system responsiveness were collected using an interviewer-administered questionnaire, developed based on the World Health Survey of WHO.

RESULTS

Of the eight domains of responsiveness, namely, autonomy, communication, confidentiality, dignity, choice, quality of basic facilities, prompt attention and access to family and community, seven domains, except the 'choice', are assessed, and they are moderate. Only about 30% of participants said that doctor discussed on treatment options (autonomy). And 50-60% of participants said positively for questions of clarity of communication. About 59% of participants acknowledged the confidentiality. Not more than 40% of participants said they were treated with dignity, and privacy is respected (dignity). The responses to quality basic amenities, prompt attention and access to family and community domains are fairly satisfactory.

CONCLUSIONS

This study has implications as many urban poor, including migrants do not utilize the services of public healthcare facilities. Hence, a responsive health system is required. There should be a policy in place to train and orient healthcare workers on some of the domains of health system responsiveness.

Exploring knowledge, attitude, and practices in relation to epilepsy among undergraduates for effective health promotion: Initial evaluation

BACKGROUND

The condition of epilepsy has a considerable effect on a person's social and personal life. Currently, a knowledge gap exists regarding the knowledge, attitude, and perception towards epilepsy among graduate students. The objectives of the study were to initially explore the knowledge, attitude, practices and to examine their inter-relationship among graduate students.

MATERIALS AND METHODS

A total of 300 3^rd year Bachelor of Science graduate students from colleges near Hombegowda nagar, Bangalore, Karnataka were included from three colleges. To achieve the objective mentioned, an instrument was framed and approved by specialists in the field.

RESULTS

About 26% believed that epilepsy is a mental illness, 64% reported that it is not a disease of the brain, 96% believed it to be a hereditary disease. Attitude shows that 29%, 33%, and 49% believed that Epilepsy can disturb anybody's normal life, education, and occupation, respectively. About 31% reported that if they see a person with epileptic attack they ran away. Knowledge score have significantly (P < 0.001) positive correlation of r = 0.810 and r = 0.794 with both attitude and practice, respectively. Attitude and practice also have significantly (P < 0.001) positive correlation (0.856) with practice. This clearly shows that if knowledge increases, persons will have positive attitude and good practices whereas less knowledge leads to faulty attitude and practices.

CONCLUSIONS

There is a need to include health education programs for school children and college students irrespective of streams, as it is crucial to bring an alteration in the presently observed perspective, behavior, and practice.

Cognitive behavioral skill-based training program for enhancing anger control among youth

BACKGROUND

Anger expression and its control among youth is a major concern for the health professionals. There is dearth of intervention-based study in Indian context. The present work aims to evolve an intervention module for management of anger among youth in India.

MATERIALS AND METHODS

The present module has been validated on 100 individuals with inclusion criteria of age from 18 to 25 years and the individuals with dependence on psychoactive drugs and refusal to participate were excluded from the study. The Anger data sheet, Buss-Perry Aggression Questionnaire, and State Trait Anger Expression Inventory were administered at baseline as well as at 1-month interval after 6 sessions of intervention. The 82 participants completed postassessment and 18 participants were dropouts of the follow-up sessions.

RESULTS

Pre-post cognitive therapy based anger management intervention program showed the difference in the domains of resilience; clinical anger, state and trait anger and anger control in.

CONCLUSIONS

The study implies the need for community-based sensitization for issues related to anger expression and facilitation of approaches to promote adaptive anger control among youth.

Prediction of Hot Spots at Myeloid Cell Leukemia-1-Inhibitor Interface Using Energy Estimation and Alanine Scanning Mutagenesis

Myeloid cell leukemia 1 (Mcl1) is an antiapoptotic protein that plays central role in apoptosis regulation. Also, Mcl1 has the potency to resist apoptotic cues resulting in up-regulation and cancer cell protection. A molecular probe that has the potential to specifically target Mcl1 and thereby provoke its down-regulatory activity is very essential. The aim of the current study is to probe the internal conformational dynamics of protein motions and potential binding mechanism in response to a series of picomolar range Mcl1 inhibitors using explicit-solvent molecular dynamics (MD) simulations. Subsequently, domain cross-correlation and principal component analysis was performed on the snapshots obtained from the MD simulations. Our results showed significant differences in the internal conformational dynamics of Mcl1 with respect to binding affinity values of inhibitors. Further, the binding free energy estimation, using three different samples, was performed on the MD simulations and revealed that the predicted energies (ΔG_mmgbsa) were in good correlation with the experimental values (ΔG_expt). Also, the energies obtained using all sampling models were efficiently ranked. Subsequently, the decomposition energy analysis highlighted the major energy-contributing residues at the Mcl1 binding pocket. Computational alanine scanning performed on high energy-contributing residues predicted the hot spot residues. The dihedral angle analysis using MD snapshots on the predicted hot spot residue exhibited consistency in side chain conformational motion that ultimately led to strong binding affinity values. The findings from the present study might provide valuable guidelines for the design of novel Mcl1 inhibitors that might significantly improve the specificity for new-generation chemotherapeutic agents.

Stressful and Traumatic Experiences among Women with Alcohol Use Disorders in India

AIM

The aim of the present study was to examine lifetime stressful and traumatic experiences among women with alcohol use disorders (AUDs).

METHODS

The sample comprised of two groups: a clinical group of 35 women with a diagnosis of AUD and a comparison group of 60 women drawn from the community. After screening out, the participants were administered Life Stressor Checklist-Revised.

RESULTS

On an average, clinical group was exposed to 7.57 (standard deviation [SD] = 4.14) stressful events and comparison group was exposed to 4.03 (SD = 2.80) stressful events across the lifespan (t = 4.976; P < 0.001). Clinical group reported a high number of childhood abuse and interpersonal traumas across lifespan than comparison group. The relationship between adverse life experiences and alcohol abuse among women was bidirectional.

CONCLUSION

Understanding the nature and experiences of trauma in this group has implications for planning gender-sensitive treatment programs for women seeking help for AUDs in India.

Relationship of Anger with Alcohol use Treatment Outcome: Follow-up Study

BACKGROUND

Anger is seen as comorbid condition in psychiatric conditions. It has an impact on one's quality of life. It leads to variation in the treatment outcome. The present study is going to explore the relationship of anger with treatment outcome among alcohol users after 1 year of treatment. The data for the present study were taken from the project work on correlates of anger among alcohol users, funded by center for addiction medicine, NIMHANS, Bengaluru, Karnataka, India.

MATERIALS AND METHODS

A total of 100 males (50 alcohol-dependent and 50 abstainers) in the age range of 20-45 years with a primary diagnosis of alcohol dependence were taken for the study. They were administered a semi-structured interview schedule to obtain information about sociodemographic details, information about alcohol use, its relationship with anger and its effects on anger control and the State-Trait Anger Expression Inventory.

RESULTS

68% of the dependent and abstainers perceived anger as negative emotion and 76% in control perceived it as negative. The presence of significant difference was seen for relapsers group in relation to trait anger and state anger. The group who remained abstinent from the intake to follow-up differs significantly from the dependent group in relation to state anger and anger control out. Mean score was higher on trait anger for the dependent group.

CONCLUSIONS

It has implication for anger management intervention/matching of treatment with users attributes and helping the users to develop the behavioral repertoires to manage anger.

Deciphering the crucial residues involved in heterodimerization of Bak peptide and anti-apoptotic proteins for apoptosis

B-cell lymphoma 2 (Bcl-2) family proteins are the central regulators of apoptosis, functioning via mitochondrial outer membrane permeabilization. The family members are involved in several stages of apoptosis regulation. The overexpression of the anti-apoptotic proteins leads to several cancer pathological conditions. This overexpression is modulated or inhibited by heterodimerization of pro-apoptotic BH3 domain or BH3-only peptides to the hydrophobic groove present at the surface of anti-apoptotic proteins. Additionally, the heterodimerization displayed differences in binding affinity profile among the pro-apoptotic peptides binding to anti-apoptotic proteins. In light of discovering the novel peptide/drug molecules that contain the potential to inhibit specific anti-apoptotic protein, it is necessary to understand the molecular basis of recognition between the protein and its binding partner (peptide or ligand) along with its binding energies. Therefore, the present work focused on deciphering the molecular basis of recognition between pro-apoptotic Bak peptide binding to different anti-apoptotic (Bcl-xL, Bfl-1, Bcl-W, Mcl-1, and Bcl-2) proteins using advanced Molecular Dynamics (MD) approach such as Molecular Mechanics-Generalized Born Solvent Accessible. The results from our investigation revealed that the predicted binding free energies showed excellent correlation with the experimental values (r² = .95). The electrostatic (ΔG_ele) contributions are the major component that drives the interaction between Bak peptides and different anti-apoptotic peptides. Additionally, van der Waals (ΔG_vdw) energies also play an indispensible role in determining the binding free energy. Furthermore, the decomposition analysis highlighted the comprehensive information about the energy contributions of hotspot residues involved in stabilizing the interaction between Bak peptide and different anti-apoptotic proteins.

Technology Addiction among Treatment Seekers for Psychological Problems: Implication for Screening in Mental Health Setting

BACKGROUND

Technology usage has seen an increase among users. The usage varies from social, personal, and psychological reasons. Users are frequently using to overcome mood states as well as to manage the other psychological states. This work is going to explore the information technology use among subjects with a psychiatric disorder.

MATERIALS AND METHODS

A total of 75 subjects were assessed using background data sheet, internet addiction impairment index, video game use pattern, pornography addiction screening tool and screening for mobile phone use, from in-patient and out-patient setting of tertiary mental health setting.

RESULTS

It showed the presence of addiction to mobile, internet, video game, and pornography. Age was found to be negatively correlated with this addiction. Average usage time had been associated with management of mood states. The addiction to information technology had been associated with a delay in initiation of sleep.

CONCLUSION

This work has implication for screening technology addiction among subjects seeking treatment for psychological problems and motivate them to develop the healthy use of technology.

Probing the binding mechanism of mercaptoguanine derivatives as inhibitors of HPPK by docking and molecular dynamics simulations

6-Hydroxymethyl-7,8-dihydropterin pyrophosphokinase (HPPK) is a promising antimicrobial target involved in the folate biosynthesis pathway. Although, the results from crystallographic studies of HPPK have attracted a great interest in the design of novel HPPK inhibitors, the mechanism of action of HPPK due to inhibitor binding remains questionable. Recently, mercaptoguanine derivatives were reported to inhibit the pyrophosphoryl transfer mechanism of Staphylococcus aureus HPPK (SaHPPK). The present study is an attempt to understand the SaHPPK-inhibitors binding mechanism and to highlight the key residues that possibly involve in the complex formation. To decipher these questions, we used the state-of-the-art advanced insilico approach such as molecular docking, molecular dynamics (MD), molecular mechanics-generalized Born surface area approach. Domain cross correlation and principle component analysis were applied to the snapshots obtained from MD revealed that the compounds with high binding affinity stabilize the conformational dynamics of SaHPPK. The binding free energy estimation showed that the van der Waals and electrostatic interactions played a vital role for the binding mechanism. Additionally, the predicted binding free energy was in good agreement with the experimental values (R² = .78). Moreover, the free energy decomposition on per-residue confirms the key residues that significantly contribute to the complex formation. These results are expected to be useful for rational design of novel SaHPPK inhibitors.

Plasma Protein Binding of Anisomelic Acid: Spectroscopy and Molecular Dynamic Simulations

Anisomelic acid (AA) is a macrocyclic cembranolide compound extracted from Anisomeles herbal species. Recently, we have shown that AA possesses both anticancer and antiviral activity. However, to date, the plasma protein binding properties of AA are unknown. Here, we describe the molecular interactions of AA with two serum proteins, human serum albumin (HSA) and bovine serum albumin (BSA), adopting multiple physicochemical methods. Besides, molecular docking and dynamics simulations were performed to predict the interaction mode and the dynamic behavior of AA with HSA and BSA. The experimental results revealed that hydrophobic forces play a significant part in the interaction of AA to HSA and BSA. The outcomes of the principal components analysis (PCA) of the poses based on root-mean-squared distances showed less variation in AA-HSA, opposed to what is seen for BSA-AA. Furthermore, binding free energies estimated for AA-HSA and AA-BSA complexes at different temperatures (298, 303, 308, and 313 K) based on molecular mechanics-generalized Born surface area (MMGBSA) approaches were well correlated with our experimental results.

Mindfulness-Based Program for Management of Aggression Among Youth: A Follow-up Study

BACKGROUND

Youth have shown indulgence in various high-risk behaviors and violent activities. Yoga-based approaches have been used for the management of psychological problems. The present work explores the role of mindfulness-based program in the management of aggression among youth.

MATERIALS AND METHODS

Sociodemographic information schedule, Buss-Perry Aggression Questionnaire, and World Health Organization quality of life were administered on 50 subjects in the age range of 18-25 years at pre- and post-mindfulness-based program level.

RESULTS

It revealed the presence of feeling of well-being and ability to relax themselves; changes in score of anger, hostility, physical, and verbal aggression; and enhancement of quality of life in the physical and environment domains at 1 month follow-up.

CONCLUSIONS

Mindfulness-based program has shown changes in aggression expression/control and implies integration of it in available program for the management of aggression among youth.

Bridging the gap in 1(st) year dental material curriculum: A 3 year randomized cross over trial

Background:

Case-oriented small group discussions (COSGDs) can help students to correlate and integrate the basic science of dental materials into clinical application. We used COSGDs along with didactic lectures in dental material curriculum and hypothesized that case-oriented group discussions would be more effective than traditional lecture alone in terms of performance of students, student perception on the above two teaching methodologies and the feasibility in classes of 2010, 2011 and 2012.

Methods:

A total of 170 students were taught using both COSGD and didactic lecture in a randomized controlled crossover trial design. Their performance was assessed through multiple-choice questions (MCQs) as part of the formative assessment, and their perception was assessed through Likert scale questionnaire.

Results:

The mean difference in the scores between case-oriented group discussions with lecture and didactic lecture showed significant difference only in few topics. Around 94–96% of students perceived COSGD with didactic lecture help them understand theory better; 76–92% of students feel more comfortable asking questions in a group discussion; 89–98% of students feel such discussions motivate them and 91–100% of students agree that discussions make the subject interesting in the respective years of 2010, 2011 and 2012.

Conclusion:

Effectiveness of COSGD in terms of scores through MCQs is comparable to traditional lecture. However, most of the students perceive COSGD help them understand the theory better; co-relate clinically; more motivating and interesting than a traditional lecture. Feasibility in institution needs more time and resources to conduct COSGD within the dental material curriculum.

Internet use at workplaces and its effects on working style in indian context: An exploration

Background:

Internet use has revolutionized the pattern of working style at the workplace. It led to an increased use for nonprofessional activities at the workplace. It has been shown to affect productivity at the workplace. There is a dearth of literature from the Indian context in this area.

Aim:

This study was conducted to explore the pattern of Internet use at the workplace and its dysfunctions.

Setting and Design:

The present study was a cross-sectional prospective study.

Materials and Methods:

The objective of the study was to assess the pattern of technology use at the workplace. Two hundred and fifty employees having experience of Internet use for more than a year of various Government/Private sector organizations in Bengaluru were assessed using background data sheet. Users who were unwilling to participate were excluded from the study.

Results:

29.6% of the participants used mobile phone exclusively. 58.8% of the participants used mobile along with other devices such as desktop, laptop, and tablet at home as well as at work. 64% of the participants reported change in their productivity due to nonwork-related Internet use at the workplace. 42% of the participants acknowledgemed postponement of their work due to Internet activities. 3–5% reported preference for Internet to work, meals, personal hygiene, sleep, and interaction with family members. WhatsApp was the most used application followed by Facebook and Gmail. Gaming applications and messenger applications such as hike and hangouts were used less frequently. Overall, delay in going to sleep was 1.6 hours and early morning awakening was 1.5 hours due to Internet use.

Conclusions:

The present study has implications for evolving psychoeducational modules for the promotion of healthy use of technology.

Neuropsychological markers of mild cognitive impairment: A clinic based study from urban India

Background:

Mild cognitive impairment (MCI) is a transitional stage between normal aging and dementia. Persons with MCI are at higher risk to develop dementia. Identifying MCI from normal aging has become a priority area of research. Neuropsychological assessment could help to identify these high risk individuals.

Objective:

To examine clinical utility and diagnostic accuracy of neuropsychological measures in identifying MCI.

Materials and Methods:

This is a cross-sectional study of 42 participants (22 patients with MCI and 20 normal controls [NC]) between the age of 60 and 80 years. All participants were screened for dementia and later a detailed neuropsychological assessment was carried out.

Results:

Persons with MCI performed significantly poorer than NC on word list (immediate and delayed recall), story recall test, stick construction delayed recall, fluency and Go/No-Go test. Measures of episodic memory especially word list delayed recall had the highest discriminating power compared with measures of semantic memory and executive functioning.

Conclusion:

Word list learning with delayed recall component is a possible candidate for detecting MCI from normal aging.

Age, education and gender effects on neuropsychological functions in healthy Indian older adults

It is essential to use culturally appropriate, sensitive and specific tests that reflect true cognitive performance. However, several factors including age, education and gender can influence neuropsychological test performance.

Objective

To examine the effects of age, education and gender on neuropsychological function in older adults using measures of global cognitive screening, attention, working memory, executive functions, memory, construction, language and parietal focal signs.

Methods

This is a cross sectional normative study of 180 community-dwelling normal older adults. All participants were screened with the Hindi Mental Status Examination (HMSE), Everyday Activities Scale for India (EASI), Edinburgh handedness inventory (EDI) and MINI Screen, and followed by a detailed neuropsychological assessment.

Results

Stepwise regression analysis revealed that education was associated with better performance on all the neuropsychological tests. Females performed significantly better on measures of memory. Further, most of the illiterate subjects, including low educated participants, refused to cooperate on measures of executive functioning.

Conclusion

Education was found to be the strongest determinant of neuropsychological test performance followed by age and gender. Our study demonstrates that Indian healthy normal older adults with low education perform poorly on measures of planning and working memory. Traditional measures of planning and working memory should be avoided or used cautiously in the presence of low education. There is an urgent need to develop tasks for measuring executive functions, especially in low educated Indian older adults.

Vanadium-mediated suppression of diethylnitrosamine-induced chromosomal aberrations in rat hepatocytes and its correlation with induction of hepatic glutathione and glutathione S-transferase

Vanadium, a dietary micronutrient, has recently been found to possess a potent antitumor activity during chemically induced rat liver carcinogenesis. In the present study, attempts have been made to understand the basic mechanism of the antitumor response of vanadium by monitoring its effect on chromosomal aberrations (CA) in rat liver cells during the early preneoplastic steps of diethylnitrosamine (DENA)-induced hepatocarcinogenesis. Supplementary vanadium at 0.5 ppm was found to afford a unique protection against DENA-evoked CA 96 h after DENA injection. Concurrent administration of glutathione (GSH) at 200 mg/kg 2 h before DENA treatment potentiated the suppressive effect of vanadium against CA when the rats were sacrificed 96 h after the carcinogenic insult. Pretreatment nf rate with buthionine sulfoximine (890 mg/kg) and/or diethylmaleate (600 mg/kg) 0.5 or 2 h prior to DENA injection resulted in a significant inhibition of vanadium-mediated protection of CA with a concomitant fall in hepatic GSH level. Rats given injection of bromosulfophthalein (250 mg/kg), a substrate inhibitor of glutathione S-transferase (GST), 0.5 h before DENA treatment displayed a prominent suppression of the protective effect of vanadium on DENA-induced CA. Long-term supplementation of vanadium also triggered protective effect against the induction of CA 15, 30 or 45 days following DENA treatment which was maximally observed on structural aberrations followed by numerical aberrations. At these time points, vanadium was found to lower the mitotic index of hepatic cells which was otherwise elevated with DENA alone. Vanadium restored DENA-dependent decrement in the ratio of polychromatic erythrocytes (PCE) to normochromatic erythrocytes (NCE) in rat liver cells. The DENA-induced increased frequency of micronucleated PCE as well as NCE was also attenuated following vanadium supplementation. The anticlastogenic effect of vanadium was found to be parallel to its ability to induce the activity of hepatic GST with a concurrent induction of hepatic GSH pool which were rather decreased in DENA control group. The results of this study, thus, provide evidence that vanadium-dependent induction of GSH-mediated GST-catalyzed detoxificational capacity of the host is presumably related to its suppressive effect against CA. This may explain, in part, the antitumor efficacy of this trace element.

Efficacy of a fish protein hydrolysate in malnourished children

Protein hydrolysates are good nutritional supplements as their bioactive ingredients can be easily absorbed and utilized for various metabolic activities. A fish protein hydrolysate (Amizate), prepared by a unique process of hydrolysis has the advantage of high di/tri peptide content (<10 kDa) along with essential and non essential amino acids, micronutrients and vitamins. The effect of Amizate on malnourished children (6-8 years, a total of 438) of Grade I and II (Gomez's classification) with respect to immunoglobulins, CD4/CD8 ratios and hemoglobin was examined. Measurement of these parameters during the user trial study (at the beginning and the end after 4 months) indicated that the levels of the immunological parameters were not significantly altered by the Amizate treatment. The values of immunoglobulins and CD4/CD8 ratios of malnourished children (India) are in the normal range and are in accordance with the reported values of various ethnic groups.

ELECTRONIC SUPPLEMENTARY MATERIAL

The online version of this article (doi:10.1007/s12291-011-0145-z) contains supplementary material, which is available to authorized users.

General morbidity prevalence in the delhi slums

Research Question:

What is the sickness prevalence in the slums of a metropolitan city?

Objectives:

To estimate the morbidity prevalence with reference to a socio-economic and demographic perspective of the slum population of Delhi.

Study Design:

A cross-sectional study was conducted and data were collected by a two-stage random sampling method. In the first stage, slum locations were selected and in the second stage households were selected.

Participants:

Data were collected from 1049 households consisting of 5358 individuals' information.

Results:

The overall morbidity prevalence is 15.4%. It is 14.7 and 16.3% for males and females, respectively but the differences are not statistically significant. The reported higher morbidity prevalence and the illiteracy status are significantly associated. Diseases of the respiratory system appear to be very high among slum dwellers.

Conclusion:

From this study, it can be concluded that the number of years of staying in the slum area, presence of a separate kitchen, type of house, it being Pucca or Kuccha, types of toilet pits or open defecation are the important environmental factors for the reports of higher morbidity patterns from the slum area.

Pre-donation deferral of blood donors in South Indian set-up: An analysis

Background:

It is well known that quite a large number of apparently healthy donors are not able to donate blood successfully because of varied reasons.

Aim:

We want to analyze the rate and various reasons for deferrals.

Materials and Methods:

A retrospective analysis of records of the donors, for 3 years, from January 2005 to December 2007 was done, in order to find out the rate and causes of deferral in four categories of age groups, both in male and female, in our Transfusion Medicine Centre, Bangalore, India.

Result:

There were 16,706 donors, of which 976 donors were deferred (5.84%) for various reasons. Of the 16,706 donors registered for donation, females constituted only 11.27%. And deferral rate was about five times more for female (19.85%) compared to male (4.06%). The three most common reasons for deferral in female were low hemoglobin levels, low body weight, and hypotension. The deferral rate was higher in the age group of 18-25 years and most common cause was low hemoglobin level. In male, the three most common reasons for deferral were hypertension, under weight, and low hemoglobin levels. The deferral rate varied from 4 to 15% as reported in the literature. The most common cause of deferral in our study and in several studies available in the literature is the same.