An all phosphorene lattice nanometric spin valve

Phosphorene is a unique semiconducting two-dimensional platform for enabling spintronic devices integrated with phosphorene nanoelectronics. Here, we have designed an all phosphorene lattice lateral spin valve device, conceived via patterned magnetic substituted atoms of 3d-block elements at both ends of a phosphorene nanoribbon acting as ferromagnetic electrodes in the spin valve. Through First-principles based calculations, we have extensively studied the spin-dependent transport characteristics of the new spin valve structures. Systematic exploration of the magnetoresistance (MR) of the spin valve for various substitutional atoms and bias voltage resulted in a phase diagram offering a colossal MR for V and Cr-substitutional atoms. Such MR can be directly attributed to their specific electronic structure, which can be further tuned by a gate voltage, for electric field controlled spin valves. The spin-dependent transport characteristics here reveal new features such as negative conductance oscillation and switching of the sign of MR due to change in the majority spin carrier type. Our study creates possibilities for the design of nanometric spin valves, which could enable integration of memory and logic elements for all phosphorene 2D processors.

Strain-controlled spin transport in a two-dimensional (2D) nanomagnet

Semiconductors with controllable electronic transport coupled with magnetic behaviour, offering programmable spin arrangements present enticing potential for next generation intelligent technologies. Integrating and linking these two properties has been a long standing challenge for material researchers. Recent discoveries in two-dimensional (2D) magnet shows an ability to tune and control the electronic and magnetic phases at ambient temperature. Here, we illustrate controlled spin transport within the magnetic phase of the 2D semiconductor CrOBr and reveal a substantial connection between its magnetic order and charge carriers. First, we systematically analyse the strain-induced electronic behaviour of 2D CrOBr using density functional theory calculations. Our study demonstrates the phase transition from a magnetic semiconductor → half metal → magnetic metal in the material under strain application, creating intriguing spin-resolved conductance with 100% spin polarisation and spin-injection efficiency. Additionally, the spin-polarised current-voltage (I-V) trend displayed conductance variations with high strain-assisted tunability and a peak-to-valley ratio as well as switching efficiency. Our study reveals that CrOBr can exhibit highly anisotropic behaviour with perfect spin filtering, offering new implications for strain engineered magneto-electronic devices.

Gender differences in COVID-19 knowledge, risk perception, and public stigma among the general community: Findings from a nationwide cross-sectional study in India

Introduction

Individual and community characteristics predictive of knowledge, perception, and attitude on COVID-19, specifically on gender, have not been adequately explored.

Objective

To examine the gender differences in COVID-19 knowledge, self-risk perception and public stigma among the general community and to understand other socio-demographic factors which were predictive of them.

Method

A nationally representative cross-sectional multi-centric survey was conducted among adult individuals(≥18 yrs) from the community member (N = 1978) from six states and one union territory of India between August 2020 to February 2021. The participants were selected using systematic random sampling. The data were collected telephonically using pilot-tested structured questionnaires and were analyzed using STATA. Gender-segregated multivariable analysis was conducted to identify statistically significant predictors (p < 0.05) of COVID-19-related knowledge, risk perception, and public stigma in the community.

Results

Study identified significant differences between males and females in their self-risk perception (22.0% & 18.2% respectively) and stigmatizing attitude (55.3% & 47.1% respectively). Highly educated males and females had higher odds of having COVID-19 knowledge (aOR: 16.83: p < 0.05) than illiterates. Highly educated women had higher odds of having self-risk perception (aOR: 2.6; p < 0.05) but lower public stigma [aOR: 0.57; p < 0.05]. Male rural residents had lower odds of having self-risk perception and knowledge [aOR: 0.55; p < 0.05 & aOR: 0.72; p < 0.05] and female rural residents had higher odds of having public stigma [aOR: 1.36; p < 0.05].

Conclusion

Our study findings suggest the importance of considering thegender differentials and their background, education status and residential status in designing effective interventions to improve knowledge and reduce risk perception and stigma in the community about COVID-19.

Factors associated with COVID-19 stigma during the onset of the global pandemic in India: A cross-sectional study

Objective

To assess factors associated with COVID-19 stigmatizing attitudes in the community and stigma experiences of COVID-19 recovered individuals during first wave of COVID-19 pandemic in India.

Methods

A cross-sectional study was conducted in 18 districts located in 7 States in India during September 2020 to January 2021 among adults > 18 years of age selected through systematic random sampling. Data on socio demographic and COVID-19 knowledge were collected from 303 COVID-19 recovered and 1,976 non-COVID-19 infected individuals from community using a survey questionnaire. Stigma was assessed using COVID-19 Stigma Scale and Community COVID-19 Stigma Scale developed for the study. Informed consent was sought from the participants. Univariate and multivariate binary logistic regression analysis were conducted.

Results

Half of the participants (51.3%) from the community reported prevalence of severe stigmatizing attitudes toward COVID-19 infected while 38.6% of COVID-19 recovered participants reported experiencing severe stigma. Participants from the community were more likely to report stigmatizing attitudes toward COVID-19 infected if they were residents of high prevalent COVID-19 zone (AOR: 1.5; CI: 1.2-1.9), staying in rural areas (AOR: 1.5; CI:1.1-1.9), belonged to the age group of 18-30 years (AOR: 1.6; CI 1.2-2.0), were male (AOR: 1.6; CI: 1.3-1.9), illiterate (AOR: 2.7; CI: 1.8-4.2), or living in Maharashtra (AOR: 7.4; CI: 4.8-11.3). COVID-19 recovered participants had higher odds of experiencing stigma if they had poor knowledge about COVID-19 transmission (AOR: 2.8; CI: 1.3-6.3), were staying for 6-15 years (AOR: 3.24; CI: 1.1-9.4) in the current place of residence or belonged to Delhi (AOR: 5.3; CI: 1.04-26.7).

Conclusion

Findings indicated presence of stigmatizing attitudes in the community as well as experienced stigma among COVID-19 recovered across selected study sites in India during the first wave of COVID-19 pandemic. Study recommends timely dissemination of factual information to populations vulnerable to misinformation and psychosocial interventions for individuals affected by stigma.

Differentiating acute from chronic insomnia with machine learning from actigraphy time series data

Acute and chronic insomnia have different causes and may require different treatments. They are investigated with multi-night nocturnal actigraphy data from two sleep studies. Two different wrist-worn actigraphy devices were used to measure physical activities. This required data pre-processing and transformations to smooth the differences between devices. Statistical, power spectrum, fractal and entropy analyses were used to derive features from the actigraphy data. Sleep parameters were also extracted from the signals. The features were then submitted to four machine learning algorithms. The best performing model was able to distinguish acute from chronic insomnia with an accuracy of 81%. The algorithms were then used to evaluate the acute and chronic groups compared to healthy sleepers. The differences between acute insomnia and healthy sleep were more prominent than between chronic insomnia and healthy sleep. This may be associated with the adaptation of the physiology to prolonged periods of disturbed sleep for individuals with chronic insomnia. The new model is a powerful addition to our suite of machine learning models aiming to pre-screen insomnia at home with wearable devices.

Development & validation of scales to assess stigma related to COVID-19 in India

Background & objectives

COVID-19 pandemic has triggered social stigma towards individuals affected and their families. This study describes the process undertaken for the development and validation of scales to assess stigmatizing attitudes and experiences among COVID-19 and non-COVID-19 participants from the community.

Methods

COVID-19 Stigma Scale and Community COVID-19 Stigma Scale constituting 13 and six items, respectively, were developed based on review of literature and news reports, expert committee evaluation and participants' interviews through telephone for a multicentric study in India. For content validity, 61 (30 COVID-19-recovered and 31 non-COVID-19 participants from the community) were recruited. Test-retest reliability of the scales was assessed among 99 participants (41 COVID-19 recovered and 58 non-COVID-19). Participants were administered the scale at two-time points after a gap of 7-12 days. Cronbach's alpha, overall percentage agreement and kappa statistics were used to assess internal consistency and test-retest reliability.

Results

Items in the scales were relevant and comprehensible. Both the scales had Cronbach's α above 0.6 indicating moderate-to-good internal consistency. Test-retest reliability assessed using kappa statistics indicated that for the COVID-19 Stigma Scale, seven items had a moderate agreement (0.4-0.6). For the Community COVID-19 Stigma Scale, four items had a moderate agreement.

Interpretation & conclusions

Validity and reliability of the two stigma scales indicated that the scales were comprehensible and had moderate internal consistency. These scales could be used to assess COVID-19 stigma and help in the development of appropriate stigma reduction interventions for COVID-19 infected, and mitigation of stigmatizing attitudes in the community.

Effect of yoga on depression in hypothyroidism: A pilot study

Background

The prevalence of hypothyroidism among Indian women is 15.8%. Depression is frequently reported in hypothyroidism. Yoga is an effective intervention for depression. However, the influence of yoga on depression in patients with hypothyroidism has not been studied.

Aim

The present study investigated the effect of a 3-month integrated yoga intervention (3-IY) on depression, lipid indices, and serum thyroid-stimulating hormone (sTSH) levels among female patients having hypothyroidism, and mild-to-moderate depression.

Method

The present single-arm pre-post design study was conducted in thirty-eight women (average age 34.2 ± 4.7 years). Participants received a 3-IY comprising asanas, pranayama, and relaxation techniques for 60 min daily (5 days a week). Depression, sTSH, lipid profile indices, Body Mass Index (BMI), fatigue, anxiety, and stress were assessed at baseline and after 12 weeks. Thyroid medication was kept constant during the study period. Data were analysed using R Studio software.

Result

A significant (P < 0.05) reduction in depression (58%), sTSH (37%), BMI (6%), fatigue (64%), anxiety (57%), lipid profile indices (HLD increased significanty), and stress (55%) levels was observed after 3 months, compared with the corresponding baseline levels.

Conclusion

The 3-IY is useful for reducing depression, dyslipidemia, and sTSH in women with hypothyroidism and depression. Further studies with a larger sample size and a robust research design using objective variables must be conducted to strengthen the study findings.

Viscosity prediction of Pongamia pinnata (Karanja) oil by molecular dynamics simulation using GAFF and OPLS force field

The increasing concern on the harmful effects caused by mineral oil-based lubricants towards the environment has given impetus to the evolution of green-lubricants. Vegetable oils are highly biodegradable, renewable, and possesses good lubricating property. In the present study Pongamia pinnata, non-edible vegetable oil, also known as Karanja Oil (KO) was used as the base oil for a lubricant. The preliminary properties, such as fatty acid profile and viscosity, which has a vital role in governing the performance of lubricants were evaluated experimentally as per international standards. The shear viscosity of KO which constitutes 8 major fatty acids were predicted using non-equilibrium molecular dynamics (NEMD) and periodic perturbation (PP) method using Optimised Potentials for Liquid Simulations (OPLS) and Generalized Amber Force Field (GAFF). The shear viscosities were evaluated at temperatures ranging from 313K to 373 K and pressure P = 0.1 MPa. The experimental and simulation data of KO shear viscosity are in line with each other using OPLS. The kinematic viscosities were calculated using the shear viscosities and densities obtained from simulation. The variation between experimental and simulation data is less while using OPLS, while GAFF force fields resulted in higher deviations.

Spin-selective response tunability in two-dimensional nanomagnet

Recent reports on the two-dimensional (2D) material CrOCl revealed magnetic ordering and spin polarisation with Curie TemperatureTc∼ 160 K, values higher than most diluted magnetic semiconductors. Here, we investigate the uniaxial and biaxial strain-dependent electronic and transport properties of CrOCl monolayer using first-principles based calculations. The calculated Young's modulus indicates high mechanical flexibility for the application of high strain. Our study shows that strain can induce phase changes from a bipolar magnetic semiconductor → half metal → magnetic metal in the material, leading to interesting spin-resolved conductance with 100% spin filtering. Furthermore, the current-voltage (I-V) response showed conductance fluctuations, characterised by peak to valley ratio and switching efficiency offering high strain assisted tunability. Overall, CrOCl shows a highly anisotropic behaviour with the material displaying 100% spin polarisation in the tensile strain region. The electronic, transport and mechanical properties indicate that CrOCl is a versatile 2D material with multi-phase capabilities having promising applications for future nanospintronic devices.

Bi-stimuli assisted engineering and control of magnetic phase in monolayer CrOCl

Magnetic phase control and room temperature magnetic stability in two-dimensional (2D) materials are indispensable for realising advanced spintronic and magneto-electronic functions. Our current work employs first-principles calculations to comprehensively study the magnetic behaviour of 2D CrOCl, uncovering the impact of strain and electric field on the material. Our studies have revealed that uniaxial strain leads to the feasibility of room temperature ferromagnetism in the layer and also detected the occurrence of a ferromagnetic → antiferromagnetic phase transition in the system, which is anisotropic along the armchair and zigzag directions. Beyond such a strain effect, the coupling of strain and electric field leads to a remarkable enhancement of the Curie temperature (T_c) ∼ 450 K in CrOCl. These predictions based on our detailed simulations show the prospect of multi-stimuli magnetic phase control, which could have great significance for realizing magneto-mechanical sensors.

1048 Prevalence Of Positional Obstructive Sleep Apnea (OSA) In Patients With OSA-COPD Overlap Syndrome

Introduction

Positional OSA (non-supine apnea-hypopnea index [AHI] &lt; 5 events/hr) is present in 30% of patients with OSA. We demonstrated that in patients with OSA- COPD overlap syndrome the AHI inversely correlated with the degree of gas trapping, suggesting a stabilizing effect on the upper airway. We hypothesized that sleep position would be less important, resulting in a lower prevalence of positional OSA.

Methods

Patients underwent a polysomnogram that demonstrated OSA (AHI &gt; 5 events/hr). To confirm COPD, patients had spirometry performed and a chest computed tomography for measurements of percent gas trapping.

Results

Sixteen patients [6 (38%) males, 55±7 years/old, FEV1 1.2±0.5 L, FEV1 % Predicted 45±19%, FVC 2.3±0.8 L, FVC % Predicted 69±20%, FEV1/FVC 51±12%, BMI 33±9 kg/m2)] were diagnosed with OSA (AHI 15±12 events/hour). Four patients (25%) had positional OSA (AHI 13±6 events/hr, non-supine AHI 1±1 event/hr) compared to 12 patients who were non-positional [AHI 16±13 events/hr (p=0.95)]. There was no difference in age [52±8 and 56±7 yrs (p=0.3)] or severity of obstruction in those with and without positional OSA [FEV1 1.4±4 L and 1.1±0.5 L, (p=0.3), FEV1 % predicted 50±17% and 44±20%, (p=0.7), FVC 2.9±0.8 L and 2.1±0.8 L (p=0.1), FVC % predicted 78±21% and 66±20%, (p=0.3), and FEV1/FVC 50±11% and 51±12%, (p=0.8), respectively]. However, patients with positional OSA were less heavy than those with non-positional OSA [BMI 23±3 and 37±8 kg/m2, respectively (p=0.005)]. Finally, there was no difference in the CT-Derived % Gas Trapping in those with and without positional OSA [48±37% and 36±25%, (p=0.6), respectively].

Conclusion

The prevalence of positional OSA in patients with OSA-COPD overlap is similar to OSA patients without COPD. Despite the presence of obstructive disease and gas trapping that may affect upper airway stability, other factors including body position and BMI remain important determinants for developing OSA in patients with COPD.

Support

R01-HL089856, R01-HL089897

0567 Hypoxic Burden and Apnea-Hypopnea Duration in Patients with Positional Obstructive Sleep Apnea

Introduction

Recently, the measurement of the hypoxic burden and apnea-hypopnea duration has been shown to correlate with mortality in patients with obstructive sleep apnea (OSA). We hypothesized that in patients with mild positional OSA (apnea-hypopnea index [AHI] &lt; 5 events/hr in the non-supine position) the hypoxic burden would be increased and apnea-hypopnea duration shortened and similar to patients with non-positional OSA.

Methods

Fourteen patients with positional OSA and 24 patients non-positional OSA with similar severity of OSA based on the respiratory event index (REI) were included. All patients had a home sleep apnea test for suspected OSA. The hypoxic burden was calculated by the multiplication of REI and the mean area under the desaturation curves.

Results

Thirty-eight patients [12 (35%) males, 50±12 yrs, BMI 35±7 kg/m2, Epworth Sleepiness Scale (ESS) 11±8, REI 10±3 events/hr, apnea-hypopnea duration 19±4 sec, mean SaO2 94±2%, lowest SaO2 79±8%, % total sleep time (TST) SaO2 &lt; 90% 11±16%, hypoxic burden 30±17 %min/hr] completed the study. Fourteen patients [9 (64%) males, 46±14 yrs, BMI 31±6 kg/m2, ESS 7±5, REI 9±3 events/hr, mean SaO2 94±2%, lowest SaO2 81±6%, %TST SaO2 &lt; 90% 4±6%] had positional OSA (supine REI 16±7 events/hr, non-supine REI 3±1 events/hr) and 24 patients had non-positional OSA [3 (13%) males, 52±10 yrs, BMI 38±7 kg/m2, ESS 12±9, REI 10±3 events/hr, mean SaO2 94±2%, lowest SaO2 77±9%, %TST SaO2 &lt; 90% 14±19%]. The hypoxic burden was elevated in both the positional and non-positional OSA patients with no difference between the groups (26±19 %min/hr and 32±15 %min/hr, respectively, p=0.13). The apnea-hypopnea duration was similar in positional and non-positional OSA patients (20±3 sec and 18±4 sec, respectively, p=0.08 sec).

Conclusion

In patients with mild positional OSA the hypoxic burden, which has been associated with cardiovascular mortality, is elevated and similar to patients with non-positional OSA.

Support

None

0610 Prevalence of Positional Obstructive Sleep Apnea Based on 3% Vs 4% Oxygen Desaturation Using Home Sleep Apnea Testing

Introduction

Approximately 30% of patient with obstructive sleep apnea (OSA) have positional OSA [non-supine apnea-hypopnea index (AHI) &lt; 5 events/hr]. However, the prevalence is based on variable definitions for hypopneas related to the degree of oxygen desaturation. In addition, use of a home sleep apnea test (HSAT) to identify positional OSA is limited. We hypothesized that in patients evaluated with an HSAT, using a definition for hypopneas based on 4% compared to 3% oxygen desaturation will significantly decrease the percentage diagnosed with positional OSA.

Methods

Fourteen patients with positional OSA based on a non-supine respiratory event index (REI) &lt; 5 events/hr were included. The initial diagnosis was determined based on a hypopnea definition of ≥ 3% oxygen desaturation. The studies were reanalyzed using a hypopnea definition of ≥ 4% oxygen desaturation.

Results

Fourteen patients [9 (64%) males, 46±14 yrs, BMI 31±6 kg/m2, ESS 7±5, REI 9±3 events/hr, mean SaO2 94±2%, lowest SaO2 81±6%, %TST SaO2 &lt; 90% 4±6%] were identified with positional OSA (supine REI 16±7 events/hr, non-supine REI 3±1 events/hr) using a hypopneas definition of ≥ 3% oxygen desaturation. When reanalyzed using a hypopnea ≥ 4% oxygen desaturation there was a significant decrease in the REI to 7±2 events/hr (p&lt;0.001). Three patients (21%) no longer were considered to have OSA. These patients were younger (32±14 vs. 50±11yrs, p=0.03) and had less severe OSA (REI 6±1 vs. 9±3 events/hr (p=0.04), but there was no difference in BMI (32±11 vs. 31±5 kg/m2, p=0.9) or mean and lowest SaO2 (96±0.4 vs. 94±2%, p=0.13, and 82±8 vs. 81±6%, p=0.9, respectively).

Conclusion

In patients with mild positional OSA, using a hypopnea definition of at least 4% vs. 3% oxygen desaturation on a HSAT will have a significant effect on the overall REI and often exclude patients who would otherwise be treated for OSA.

Support

None.

High efficiency spin filtering in magnetic phosphorene

We present high efficiency spin filtering behaviour in magnetically rendered phosphorene, doped with various 3d block elements. A phase diagram was obtained depicting the presence of various electronic and magnetic states.

Two-dimensional C3N based sub-10 nanometer biosensor

The current observation demonstrates the usefulness of the two-dimensional C₃N system as a next generation bio-sensor for the sequencing of various nucleobases, offering new leads for future developments in bioelectronics, superior sensing architectures and sustainable designs.

Quantification of picric acid on nanosphere polypyrrole modified electrode by stripping voltammetric method

The electrochemical studies of picric acid were carried out in acidic, neutral and basic buffer media at bare glassy carbon (GC) and polypyrrole modified GC electrode. Cyclic Voltammogram (CV) of picric acid exhibited three reduction peaks at -0.4, -0.8 and -1.5V (vs. Ag/AgCl) and two oxidation peaks at 0.8 and 1.4V (vs. Ag/AgCl). Among the various pH studied, highly sensitive response was observed at pH 1.0. The effect of scan rate was studied between 25 and 500 mVs-1 at the optimal pH.CV results revealed the adsorption-controlled reaction at the electrode surface. The GC electrode was modified with polypyrrole conducting polymer film to enhance the electrocatalytic activity of the reductive species. Atomic force microscopy (AFM) images showed the nanosphere morphology of the polypyrrole film, which was coated uniformly on the electrode surface. Under optimum experimental conditions, the influence of concentration on the stripping signal was studied. The linear range of detection was found between 50 ppb and 250 ppb with the lower limit of detection of 10±3 ppb.

CHANGES IN IRISIN RELEASE IN RESPONSE TO PERIPHERAL KISSPEPTIN-10 ADMINISTRATION IN HEALTHY AND OBESE ADULT MEN

Context

Kisspeptin role in metabolism has been implicated recently. However, the nature of the signals that may connect body fat/muscle tissues with the central nervous system governing energy homeostasis remains to be elucidated.

Objective

The present study was designed to investigate the effects of peripheral kisspeptin-10 administration on irisin release in human males.

Subjects and methods

Kisspeptin-10 was administered to normal weight (n=8) and obese (n=8) men. Sequential blood sampling was performed for 30 minutes pre and 210 minutes post kisspeptin injection at 30 minutes interval. ELISA kit was used to detect plasma irisin levels.

Results

There is a significant (P<0.0001) effect of Kisspeptin-10 administration on irisin release in both normal weight and obese participants. Mean irisin levels (96.24 ± 1.351 ng/mL) at 210 minutes were significantly (P<0.0001) enhanced as compared to pre-kisspeptin (59.18 ± 4.815 ng/mL) in normal weight subjects. In obese subjects mean irisin levels (75.76 ± 4.06 ng/mL) were significantly (P<0.0001) elevated at 180 minutes post-kisspeptin when compared with pre-kisspeptin irisin levels (41.28 ± 2.89 ng/mL).

Conclusion

Our findings suggest that kisspeptin may have a novel therapeutic potential to induce irisin release in humans which may have anti-obesity effects.

Effectiveness of TB sensitization initiatives in improving the involvement of self help group members in rural TB control in south India

Background

The 'End TB strategy' has highlighted the importance of inter-sectoral collaboration and community mobilization for achieving zero TB deaths by 2020.

Objective

The aim of the study was to develop and test a model TB sensitization programme involving self help groups (SHGs).

Methodology

This experimental study was conducted in two blocks (intervention and control), in Tiruvallur district. The intervention content included short-lecture, musical story telling activity, role play, short film on TB. The impact was compared at baseline, third and sixth months in terms of SHGs' awareness, promotion of awareness, identification and referral of presumptive TB cases and provision of TB treatment.

Results

A total of 764 vs 796 SHGs were enrolled in control and intervention groups, respectively. The knowledge attitude, and practice score (lower score indicated a better attitude and practice), from baseline to 6 months was significantly reduced (29 to 24) in the intervention group. Similarly, a significant difference was observed in identification and referral of chest symptomatics in the intervention group at 3 and 6 months. During the 3 month follow-up a significantly higher proportion of SHG members were involved in TB awareness activities in the intervention (623/748 [83.3%]) vs control group (471/728 [64.7%]; p<0.001).

Conclusions

Findings from this study highlight the feasibility of involving SHGs through a model TB sensitization program for strengthening TB prevention and control activities.

National service for adolescents and adults with severe obsessive–compulsive and body dysmorphic disorders

Aims and Method

National guidelines for the assessment and treatment of obsessive–compulsive disorder (OCD) and body dysmorphic disorder were published in 2005 by the National Institute for Health and Clinical Excellence (NICE). Local services are unable to treat a small but significant number of the most severely ill patients successfully, and the guidelines recommend that such patients should have access to highly specialised care. From 1 April 2007, the Department of Health decided to centrally fund treatment services for severe, chronic, refractory OCD and BDD. We describe a new National Service for Refractory OCD; its rationale, treatments offered, referral criteria and expected clinical outcomes.

Results

Initial results from one centre show an average 42% reduction in OCD symptoms at the end of treatment.

Clinical Implications

The operational challenges and potential generalisability of this model of healthcare delivery are discussed. We present a summary of the progress made so far in establishing a new, coherent National Service for Refractory OCD, 18 months after the NICE guideline was published. the aim of the paper is to educate clinicians about the service and describe its rationale, treatments offered, referral criteria and expected clinical outcomes.

Community model in treating obsessive–compulsive and body dysmorphic disorders

Aims and Method

In November 2005, the National Institute for Health and Clinical Excellence published guidelines for the treatment of obsessive–compulsive disorder (OCD) and body dysmorphic disorder. These guidelines incorporated a stepped care approach with different interventions advised throughout the patient pathway. South West London and St George's Mental Health NHS Trust devised a system of expert clinicians with special expertise in OCD/body dysmorphic disorder to help deliver this model of care. To aid the delivery of service it was decided to operationalise the definitions of severity of OCD/body dysmorphic disorder at each of the stepped-care levels. Examples are given as to how this has been applied in practice. Outcome is presented in terms of clinical hours in the first year of operation.

Results

In total, 108 patients were referred to the service in the first year. Many of these patients were treated by offering advice and support and joint working with the community mental health team and psychotherapy in primary care teams who had referred. Sixty-eight patients were treated by a member of the specialist service alone and 57 of these suffered from severe OCD. Outcome data from these 57 patients is presented using an intention-to-treat paradigm. They showed a clinically and statistically significant reduction in OCD symptoms after 24 weeks of cognitive–behavioural therapy comprising graded exposure and self-imposed response prevention. the mean Yale–Brown Obsessive Compulsive Scale score dropped from 28 (severe OCD) to 19 (considerable OCD). Depressive symptoms on the Beck Depression Inventory also decreased by an average 24% over the same period.

Clinical Implications

The feasibility of extending this model of service organisation to other areas and other diagnoses is discussed.

Seasonal plasticity in the peptide neuronal systems: potential roles of gonadotrophin-releasing hormone, gonadotrophin-inhibiting hormone, neuropeptide Y and vasoactive intestinal peptide in the regulation of the reproductive axis in subtropical Indian weaver birds

Two experiments examined the expression of gonadotrophin-releasing and inhibiting hormones (GnRH-I, GnRH-II and GnIH), neuropeptide Y (NPY) and vasoactive intestinal peptide (VIP) in subtropical Indian weaver birds, which demonstrate relative photorefractoriness. Experiment 1 measured peptide expression levels in the form of immunoreactive (-IR) cells, percentage cell area and cell optical density in the preoptic area (GnRH-I), midbrain (GnRH-II), paraventricular nucleus (GnIH), mediobasal hypothalamus [dorsomedial hypothalamus (DMH), infundibular complex (INc), NPY and VIP] and lateral septal organ (VIP) during the progressive, breeding, regressive and nonbreeding phases of the annual reproductive cycle. GnRH-I was decreased in the nonbreeding and VIP was increased in INc in the breeding and regressive states. GnRH-II and NPY levels did not differ between the testicular phases. Double-labelled immunohistochemistry (IHC) revealed a close association between the GnRH/GnIH, GnRH/NPY, GnRH/VIP and GnIH/NPY peptide systems, implicating them interacting and playing roles in the reproductive regulation in weaver birds. Experiment 2 further measured these peptide levels in the middle of day and night in weaver birds that were maintained under short days (8 : 16 h light /dark cycle; photosensitive), exposed to ten long days (16 : 8 h light /dark cycle; photostimulated) or maintained for approximately 2 years on a 16 : 8 h light /dark cycle (photorefractory). Reproductively immature testes in these groups precluded the possible effect of an enhanced gonadal feedback on the hypothalamic peptide expression. There were group differences in the GnRH-I (not GnRH-II), GnIH, NPY and VIP immunoreactivity, albeit with variations in immunoreactivity measures in the present study. These results, which are consistent with those reported in birds with relative photorefractoriness, show the distribution and possibly a complex interaction of key neuropeptides in the regulation of the annual reproductive cycle in Indian weaver birds.

Iatrogenic Perforation of Stomach--A Case Report

Gastric lavage is a routine procedure done in many cases of poisoning and it has been advocated by many as a lifesaving procedure. There may be some instances, where it might be unnecessary, ineffective or even detrimental to life. A 35 year old man walked into a casualty, 2 hours after having ingested 15 benzodiazepine tablets. Lavage was done by an unqualified person using Ewald's tube, leading to iatrogenic perforation. The unwarranted use of the procedure proved to be fatal.

Life at a different pace: annual itineraries are conserved in seasonal songbirds

The duration of life history state (LHS) reflects the adaptive strategy a species has evolved to cope with a changing environment. Inhabitants at different latitudes may thus have significant differences in the rates of metabolic and physiological processes underlying LHSs. Birds, in order to maximize their fitness in the environment in which they live, seasonally switch from one LHS to another during the year. The present study investigated whether an annual itinerary of a species would determine its rate of reaction to inductive long days. We compared the photoinduced cycles of changes in body mass and testes, as indices of migratory and reproductive LHSs, between two long day breeding species, the migratory redheaded bunting and non-migratory Indian weaverbird. Changes in body mass and testis size were measured in photosensitive buntings and weaverbirds (n = 7 each) on short days (LD 8:16) subjected first to 0.5 h weekly light increments until the light period was 13 h per day, and then maintained on LD 13:11 for another 32 weeks. A similar observation was recorded on a group of buntings (n = 14) and weaverbirds (n = 9) maintained on increasing natural day lengths (NDL; Lucknow, 26°55' N, 80°59' E) for 47 weeks. As predicted, the rates of induction of seasonal cycles under an identical inductive photoperiod were significantly faster in temperate buntings with five annual LHSs than in the subtropical weaverbirds with three annual LHSs. This suggests that annual itineraries of songbirds with which they may have evolved with at their breeding latitudes, determine their response to the external photoperiodic environment.

Topographical anatomy of the profunda femoris artery and the femoral nerve: normal and abnormal relationships

BACKGROUND AND OBJECTIVE

Femoral nerve (FN) is the largest branch of lumbar plexus. It lies lateral to femoral artery (FA) and it is located outside the femoral sheath. Profunda femoris artery (PFA) is a branch of the FA. The present study aimed to observe the topographical anatomy and relationship of the PFA and the FN.

MATERIALS AND METHODS

A total of 12 embalmed cadaveric lower limbs (7 lefts and 5 rights) were taken and the thighs were dissected in detail. The relationship of PFA and FN were observed. Appropriate measurements were taken and the specimens were photographed.

RESULTS

The PFA originated from the FA in all the 12 specimens (100%). In 10 specimens (83.3%), the PFA was found to originate lateral to the FA while in 2 specimens, the origin of PFA was posterior to the FA (16.7%). The PFA originated from the FA at a distance of 6.5 + 1.5 cm with regard to the midinguinal point. All FN were found to lie outside the femoral sheaths. Out of the 12 specimens, only 2 specimens (16.7%) exhibited the FN to lie posterior to the PFA, while in 10 specimens (83.3%), the FN was found to lie anterior to the PFA.

CONCLUSION

Prior anatomical knowledge of structures in the anterior compartment of thigh may be helpful for surgeons performing nerve block, cannulation and catheterization. Knowledge of abnormal anatomy of the FN and PFA is important in order to prevent any inadvertent injury to the PFA or FN.

Cytological evaluation of Apiaceae Lindl. from Western Himalayas

The present paper deals with cytological studies on 31 populations covering 17 species belonging to 10 genera of Apiaceae from Western Himalayas. The chromosome numbers in the two species as Chaerophyllum capnoides (n = 11) and Heracleum brunonis (n = 11), along with additional cytotypes for Pimpinella acuminata (n = 9) and Sium latijugum (n = 12) have been reported for the first time on world-wide basis. The genus Pleurospermum, although cytologically worked out earlier from outside India, its species densiflorum (n = 11) makes first representation of the genus from India. Besides, the chromosome number in Chaerophyllum aromaticum (n = 11) have been worked out for the first time from India. The course of meiosis varies from normal to abnormal in different populations of Chaerophyllum villosum, Pimpinella achilleifolia and Sium latijugum while abnormal meiotic course has been observed in all the studied populations of Chaerophyllum acuminatum, C. aromaticum, C. capnoides, Pimpinella acuminata, P. diversifolia, Pleurospermum densiflorum and Vicatia coniifolia. Such taxa are marked with meiotic abnormalities in the form of cytomixis, chromatin stickiness, formation of laggards and bridges resulting into abnormal microsporogenesis. The occurrence of structural heterozygosity has been recorded in the Chaerophyllum acuminatum and C. aromaticum. The effect of these abnormalities is clearly seen on the pollen size and fertility.

An appraisal of service users' structured activity requirements in an Irish forensic setting

Participating in purposeful and structured daily activities is an important factor contributing to the health and well-being of forensic service users. A survey was carried out in an Irish forensic mental health setting to identify whether service users meet the standard of 25-h weekly activities, a standard set by the Quality Network for Forensic Mental Health Services, London. The findings indicate that 57 (61%) out of 93 service users fully meet the criteria. Furthermore, service users within the medium- and low-security environments appear to be engaging to an increased number of structured activities in comparison to those in acute units.

Exosomes are involved in mediating radiation induced bystander signaling in human keratinocyte cells

There is much evidence supporting the existence of bystander effects in cells that were never exposed to radiation. Directly irradiated cells and bystander cells can communicate with each other using gap junctional intercellular communication or by releasing soluble factors into the surrounding medium. Exosomes and microvesicles are also known to mediate communication between cells. The main aim of this study is to establish whether exosomes and microvesicles are involved in radiation induced bystander signaling. Human keratinocytes, HaCaT cells, were irradiated (0.005, 0.05 and 0.5 Gy) using γ rays produced from a cobalt 60 teletherapy unit. After irradiation, the cells were incubated for 1 h and the irradiated cell conditioned medium (ICCM) was harvested. Exosomes were isolated from the ICCM using ultracentrifugation. Exosomes were characterized using light scattering analysis (LSA) and scanning transmission electron microscopy (STEM). Cytotoxicity and reactive oxygen species assays and real time calcium imaging were performed either with ICCM from which exosomes and microvesicles were removed or with the exosome fraction resuspended in cell culture media. The characterization data showed a particle size distribution indicative of both exosomes (30-100 nm) and microvesicles (>100 nm) and the light scattering analysis showed increased concentration of both exosomes and microvesicles with increasing dose. Western blotting confirmed the presence of an exosomal protein marker, TSG 101. Treatment of unirradiated cells with ICCM in which exosomes and microvesicles were removed resulted in abrogation of ICCM induced effects such as reduction in viability, calcium influx and production of reactive oxygen species. Addition of exosomes to fresh media produced similar effects to complete ICCM. These results suggest a role for exosomes and microvesicles in radiation induced bystander signaling.

To investigate antihyperglycemic and antihyperlipidemic potential of safrole in rodents by in-vivo and in-vitro study

In the present investigation anti-diabetic and in-vitro antioxidant potential of safrole were evaluated (100 and 200 mg/kg p.o.) in acute and chronic Streptozotocin-nicotinamide (STZ) induced antihyperglycemic rat model. The oral administration of safrole for 30 days affects the level of blood glucose, glycosylated hemoglobin (HbA1C), total cholesterol (TC), triglycerides (TG), phospholipids, high density lipoprotein (HDL), body weight, insulin level, liver glycogen content, antioxidant parameters, lipase, α-amylase in normal and STZ induced diabetic rats. The oral administration of safrole at dose 100 & 200 mg/kg p.o. significantly improve the diabetic condition in Streptozotocin-induced diabetic rats. In enzymatic assay, the IC50 value of the safrole for α-amylase and lipase was found to be 702.78 and 861.35 μg/ml respectively which was found comparable with the standard drug (ascorbic acid) as 252.12 μg/ml. Further studies can be performed on safrole for mechanistic and toxicological aspects so that it can be investigated as a new substance for the management of various diseases.

Anomalous structures of the liver: an anatomical insight

BACKGROUND AND AIMS

Anomalous structures of the liver are incidentally detected during autopsies or during routine cadaveric dissection. The present study aimed to observe the abnormal shapes of quadrate lobe, accessory sulci and ligamentum teres of the liver.

MATERIALS AND METHODS

A total of 20 formalin fixed cadaveric livers (n=20), irrespective of the sex, were taken for this study. These specimens belonged to cadavers of unknown origins. The presence of accessory sulci and abnormalities related to the quadrate lobe and ligamentum teres were studied in detail. Morphometric measurements were taken for the abnormal accessory sulci and abnormal quadrate lobes.

RESULTS

Variable shapes of the quadrate lobes were observed with 8 (40%) being rectangular, 6 (30%) being pear-shaped, 4 (20%) being triangular and another 2 specimens (10%) which were square in shape. The presences of accessory sulci on the diaphragmatic surface of the liver were observed in 2 specimens (10%). Ligamentum teres traversed the groove in 18 (90%) while in 2 (10%) specimens, the ligamentum teres was embedded in the groove and it was covered by parenchymatous tissue of the liver it from the side of the quadrate lobe.

CONCLUSION

Prior anatomical knowledge of the presence of the anomalous structures in the liver with may be helpful for the radiologist and surgeons for correct interpretation of radiographs and planning appropriate hepatobiliary surgeries.

Cytological studies of Brassicaceae burn. (Cruciferae juss.) from Western Himalayas

Cytological studies have been carried out on 12 species of Brassicaceae Burn. on population basis from different geographical areas of Kashmir and Himachal Pradesh in the Western Himalayas. Variable chromosome reports for Barbaraea intermedia (n = 16), Cardamine loxostemonoides (n = 8), Nasturtium officinale (n = 8), Sisymbrium orientale (n = 14) on world-wide basis have been added to the previous reports of these species. The chromosome numbers in seven species as Barbaraea intermedia (n = 8), B. vulgaris (n = 8), Capsella bursa-pastoris (n = 8), Descuriania sophia (n = 10), Rorippa islandica (n = 8), Sisymbrium strictum (n = 7) and Thlaspi alpestre (n = 7) have been worked out for the first time from India. The meiotic course in the populations of seven species such as Barbaraea intermedia, Capsella bursa-pastoris, Coronopus didymus, Descuriania sophia, Nasturtium officinale, Sisymbrium orientale and S. strictum varies from normal to abnormal while all the populations of two species Barbaraea vulgaris and Sisymbrium irio show abnormal meiotic course. Meiotic abnormalities are in the form of cytomixis, chromosomal stickiness, unoriented bivalents, inter-bivalent connections, formation of laggards and bridges, all resulting into abnormal microsporogenesis. Heterogenous sized fertile pollen grains and reduced reproductive potentialities have invariably been observed in all the meiotically abnormal populations. However, the meiotic course in all the populations of Cardamine loxostemonoides, Rorippa islandica and Thalspi alpestre is found to be normal with high pollen fertility.

A multi-method evaluation of a training course on dual diagnosis

A training course on dual diagnosis was developed within the Irish forensic mental health service, to bridge the gap in the lack of training on dual diagnosis in Ireland. The course was designed for service providers within mental health and addiction services. Twenty participants involving nursing, social work, police and social welfare disciplines attended the first training course. A mixed methodology research design was adapted to describe participants' evaluation of the training course. Data were collected using multiple methods: pre- and post-test, daily evaluation and focus group interviews. Quantitative data were analysed using the spss Version 16.0 and qualitative data were analysed thematically. Findings from the pre- and post-test suggest an increase in participants' knowledge of dual diagnosis and an increase in confidence in conducting groups. Daily evaluation indicates that the course content largely met participants' needs. Finally, three themes emerged from the focus group interview: increased confidence, the training course/teaching methods and personal/organizational challenges. This study implies that service providers within mental health and addiction services benefit from inter-professional, needs and skills based courses incorporating a variety of teaching methods. The way forward for future dual diagnosis training course developments would be working in partnership with service users and carers.

Service user involvement in mental health practitioner education in Ireland

In recent years, there is an ever increasing call to involve people who use mental health services in the development, delivery and evaluation of education programmes. Within Ireland, there is very little evidence of the degree of service user involvement in the educational preparation of mental health practitioners. This paper presents the findings on service user involvement in the education and training of professionals working in mental health services in Ireland. Findings from this study indicate that in the vast majority of courses curricula are planned and delivered without consultation or input from service users. Currently the scope of service user involvement is on teaching, with little involvement in curriculum development, student assessment and student selection. However, there is evidence that this is changing, with many respondents indicating an eagerness to move this agenda forward.