bluuebunny/crossref_metadata_2025 huggingface dataset:
Physician Diagnosis and Knowledge of Mild Cognitive Impairment
Authors: Blair Emilie M. , Zahuranec Darin B. , Forman Jane , Reale Bailey K. , Langa Kenneth M. , Giordani Bruno , Fagerlin Angela , Kollman Colleen , Whitney Rachael T. , Levine Deborah A.
Published: November 2021

Background: Older adults with mild cognitive impairment (MCI) receive fewer guideline-concordant treatments for multiple health conditions than those with normal cognition. Reasons for this disparity are unclear. Objective: To better understand this disparity, we describe physician understanding and experience with patient MCI, particularly physician identification of MCI, ability to distinguish between MCI and dementia, and perspectives on education and training in MCI and dementia. Methods: As part of a mixed-methods study assessing the influence of patient MCI on physician recommendations for acute myocardial infraction and stroke treatments, we conducted a descriptive qualitative study using semi-structured interviews of physicians from three specialties. Key question topics included participants’ identification of MCI, impressions of MCI and dementia awareness within their practice specialty, and perspectives on training and education in MCI. Results: The study included 22 physicians (8 cardiologists, 7 neurologists, and 7 internists). We identified two primary themes: There is 1) a lack of adequate understanding of the distinction between MCI and dementia; and 2) variation in physician approaches to identifying whether an older adult has MCI. Conclusion: These findings suggest that physicians have a poor understanding of MCI. Our results suggest that interventions that improve physician knowledge of MCI are needed.
Adiponectin Ameliorates Cognitive Behaviors and in vivo Synaptic Plasticity Impairments in 3xTg-AD Mice
Authors: Yan Xu-Dong , Qu Xue-Song , Yin Jing , Qiao Jing , Zhang Jun , Qi Jin-Shun , Wu Mei-Na
Published: November 2021

Background: Cognitive deficit is mainly clinical characteristic of Alzheimer’s disease (AD). Recent reports showed adiponectin and its analogues could reverse cognitive impairments, lower amyloid-β protein (Aβ) deposition, and exert anti-inflammatory effects in different APP/PS1 AD model mice mainly exhibiting amyloid plaque pathology. However, the potential in vivo electrophysiological mechanism of adiponectin protecting against cognitive deficits in AD and the neuroprotective effects of adiponectin on 3xTg-AD mice including both plaque and tangle pathology are still unclear. Objective: To observe the effects of adiponectin treatment on cognitive deficits in 3xTg-AD mice, investigate its potential in vivo electrophysiological mechanism, and testify its anti-inflammatory effects. Methods: Barnes maze test, Morris water maze test, and fear conditioning test were used to evaluate the memory-ameliorating effects of adiponectin on 3xTg-AD mice. In vivo hippocampal electrophysiological recording was used to observe the change of basic synaptic transmission, long-term potentiation, and long-term depression. Immunohistochemistry staining and western blot were used to observe the activation of microglia and astroglia, and the expression levels of proinflammatory factors and anti-inflammtory factor IL-10. Results: Adiponectin treatment could alleviate spatial memory and conditioned fear memory deficits observed in 3xTg-AD mice, improve in vivo LTP depression and LTD facilitation, inhibit overactivation of microglia and astroglia, decrease the expression of proinflammatory factors NF- κB and IL-1β, and increase the expression level of IL-10 in the hippocampus of 3xTg-AD mice. Conclusion: Adiponectin could ameliorate cognitive deficits in 3xTg-AD mice through improving in vivo synaptic plasticity impairments and alleviating neuroinflammation in the hippocampus of 3xTg-AD mice.
Caregiver Tele-Assistance for Reduction of Emotional Distress During the COVID-19 Pandemic. Psychological Support to Caregivers of People with Dementia: The Italian Experience
Authors: Rotondo Emanuela , Galimberti Daniela , Mercurio Matteo , Giardinieri Giulia , Forti Sara , Vimercati Roberto , Borracci Vittoria , Fumagalli Giorgio G. , Pietroboni Anna M. , Carandini Tiziana , Nobili Alessandro , Scarpini Elio , Arighi Andrea
Published: November 2021

Background: COVID-19 pandemic worsened vulnerability of patients with dementia (PWD). This new reality associated with government restriction and isolation worsened stress burden and psychological frailties in PWD caregivers. Objective: To give tele-psychological support to caregivers and evaluate the effect of this intervention by quantifying stress burden and quality of life during the first COVID-19 lockdown. Methods: 50 caregivers were divided into two groups: “Caregiver-focused group” (Cg) and “Patient-focused group” (Pg). Both groups received telephone contact every 2 weeks over a 28-week period, but the content of the call was different: in Cg, caregivers answered questions about the state of the PWD but also explored their own emotional state, stress burden, and quality of life. In Pg instead, telephone contacts were focused only on the PWD, and no evaluation regarding the caregiver mood or state of stress was made. Psychometric scales were administered to evaluate COVID-19 impact, stress burden, and quality of life. Results: Considering the time of intervention, from baseline (W0) to W28, Zarit Burden Interview and Quality of Life-caregiver questionnaires remained unchanged in Cg as compared with baseline (p > 0.05), whereas they worsened significantly in Pg (p < 0.01), showing increased stress over time and decreased quality of life in this group. Moreover, Impact on Event Scale values improved over the weeks in Cg (p = 0.015), while they remained unchanged in Pg (p = 0.483). Conclusion: Caregivers who received telephone support about their mood and stress burden did not worsen their psychological state during the time of intervention, as did instead those who did not get such support.
Towards Accuracy Enhancement of Age Group Classification Using Generative Adversarial Networks
Authors: ELKarazle Khaled , Raman Valliappan , Then Patrick
Published: November 2021

Age estimation models can be employed in many applications, including soft biometrics, content access control, targeted advertising, and many more. However, as some facial images are taken in unrestrained conditions, the quality relegates, which results in the loss of several essential ageing features. This study investigates how introducing a new layer of data processing based on a super-resolution generative adversarial network (SRGAN) model can influence the accuracy of age estimation by enhancing the quality of both the training and testing samples. Additionally, we introduce a novel convolutional neural network (CNN) classifier to distinguish between several age classes. We train one of our classifiers on a reconstructed version of the original dataset and compare its performance with an identical classifier trained on the original version of the same dataset. Our findings reveal that the classifier which trains on the reconstructed dataset produces better classification accuracy, opening the door for more research into building data-centric machine learning systems.
Progress of graph model for conflict resolution in conflict analysis: A systematic review and bibliometrics research
Authors: Zhou Xinyu , Ma Xiaoqi
Published: November 2021

Conflict is an inevitable social phenomenon and the analysis of it can effectively resolve disputes, improve the position of decision makers (DMs), forecast compromise solutions as well. At present, the Graph Model for Conflict Resolution (GMCR), a completely non-quantitative decision support system (DSS) based on DM’s ordinal preference information, is constructed to combat conflict analysis complicated by multiple participant or multiple criteria or both. The purpose of the study is to introduce an overview of GMCR in conflict analyzing through bibliometrics. In order to achieve this goal, a systematic review of articles in leading journals of Web of Science Core Collection (WoSCC) during 1987–2019 is posed, referring to the distribution of countries, institutions, authors, subjects and journals, research topics and hotspots exploration as well as frontiers prediction, by utilizing VOSviewer and CiteSpace. The contributions of this study are not only providing a handy method to grasp generalized scientific research situation, but also demonstrating status quo and emerging trends of GMCR for researchers and everyone who interested in.
The effect of a multi-modal boxing exercise program on cognitive locomotor tasks and gait in persons with Parkinson disease
Authors: Shearin Staci , Braitsch Michael , Querry Ross
Published: November 2021

BACKGROUND: Parkinson disease (PD) is a progressive neurological disease resulting in motor impairments, postural instability, and gait alterations which may result in self-care limitations and loss of mobility reducing quality of life. OBJECTIVE: This study’s purpose was to determine the impact of a community-based boxing program on gait parameters, dual task and backwards walking in individuals with PD. METHODS: This study included 26 community dwelling individuals with PD who participated in 12-week boxing classes (1 hour, 2 times a week). The focus was on upper/lower extremity exercises using punching bags, agility drills, and strengthening activities. Pre/post testing was performed for dual task and gait parameters and was analyzed using t-tests. RESULTS: Analysis of the scores indicated participants performed significantly better at post-test compared to pre-test on self-selected walking velocity (P = 0.041), cadence (P = 0.021); backwards walking velocity (P = 0.003), step length (P = 0.022); dual task walking velocity (P = 0.044), step length (P = 0.023), and gait variability index (P = 0.008). No significant differences for fast walking. CONCLUSIONS: Multi-modal boxing produced improvements in gait velocity, dual task velocity, step length, and gait variability, as well as backwards walking velocity and step length. These improvements may impact independence with functional mobility and may improve safety but require further studies.
Assessing Acceptance Level of a Hybrid Clinical Decision Support Systems
Authors: Kopanitsa Georgy , Derevitskii Ilia V. , Savitskaya Daria A. , Kovalchuk Sergey V.
Published: November 2021

We present a user acceptance study of a clinical decision support system (CDSS) for Type 2 Diabetes Mellitus (T2DM) risk prediction. We focus on how a combination of data-driven and rule-based models influence the efficiency and acceptance by doctors. To evaluate the perceived usefulness, we randomly generated CDSS output in three different settings: Data-driven (DD) model output; DD model with a presence of known risk scale (FINDRISK); DD model with presence of risk scale and explanation of DD model. For each case, a physician was asked to answer 3 questions: if a doctor agrees with the result, if a doctor understands it, if the result is useful for the practice. We employed a Lankton’s model to evaluate the user acceptance of the clinical decision support system. Our analysis has proved that without the presence of scales, a physician trust CDSS blindly. From the answers, we can conclude that interpretability plays an important role in accepting a CDSS.
A Data-Driven Intervention Framework for Improving Adherence to Growth Hormone Therapy Based on Clustering Analysis and Traffic Light Alerting Systems
Authors: Araújo Matheus , van Dommelen Paula , Srivastava Jaideep , Koledova Ekaterina
Published: November 2021

Recombinant human growth hormone (r-hGH) is an established therapy for growth hormone deficiency (GHD); yet, some patients fail to achieve their full height potential, with poor adherence and persistence with the prescribed regimen often a contributing factor. A data-driven clinical decision support system based on “traffic light” visualizations for adherence risk management of patients receiving r-hGH treatment was developed. This research was feasible thanks to data-sharing agreements that allowed the creation of these models using real-world data of r-hGH adherence from easypod™ connect; data was retrieved for 11,015 children receiving r-hGH therapy for ≥180 days. Patients’ adherence to therapy was represented using four values (mean and standard deviation [SD] of daily adherence and hours to next injection). Cluster analysis was used to categorize adherence patterns using a Gaussian mixture model. Following a traffic lights-inspired visualization approach, the algorithm was set to generate three clusters: green, yellow, or red status, corresponding to high, medium, and low adherence, respectively. The area under the receiver operating characteristic curve (AUC-ROC) was used to find optimum thresholds for independent traffic lights according to each metric. The most appropriate traffic light used the SD of the hours to the next injection, with an AUC-ROC value of 0.85 when compared to the complex clustering algorithm. For the daily adherence-based traffic lights, optimum thresholds were >0.82 (SD, <0.37), 0.53–0.82 (SD, 0.37–0.61), and <0.53 (SD, >0.61) for high, medium, and low adherence, respectively. For hours to next injection, the corresponding optimum thresholds were <27.18 (SD, <10.06), 27.18–34.01 (SD, 10.06–29.63), and >34.01 (SD, >29.63). Our research indicates that implementation of a practical data-driven alert system based on recognised traffic-light coding would enable healthcare practitioners to monitor sub-optimally-adherent patients to r-hGH treatment for early intervention to improve treatment outcomes.
Assessing Resolvability and Consistency in OBO Foundry Ontologies: Pilot Study
Authors: Zhang Shuxin , Benis Nirupama , Cornet Ronald
Published: November 2021

Ontologies listed in the OBO Foundry are often regarded as reliable choices to be reused but ontology interoperability of them remains unknown. This study evaluated the resolvability of URIs and consistency of axioms in the OBO Foundry library, BFO ontology, and CIDO ontology. All had nonresolvable URIs, but the OBO library and the CIDO had additional interoperability issues regarding the use of incorrect prefixes, mixing up with ontologies, and inconsistency in the use of property. These detected issues reflected the real-world common problems that were not significant from human beings’ point of view but hindered the machine-processability of ontologies. The assessment performed in this study was automated and enables scale-up against more metrics over more ontologies, which remains future work.
Reducing amount of contrast agent after compression of right brachial artery using a blood pressure cuff in computed tomography cerebrovascular angiography
Authors: Kim Gyeong Rip , Kim Sungho , Sung Soon Ki , Kim Chang Hyeun , Lee Sang Bong , Yoo Jang Seon , Kwak Jong Hyeok
Published: November 2021

OBJECTIVE: To invastgate feasibility of low-dose contrast agent in cerebral computed tomography angiography (CTA) to alleviate side effects. METHOD: Siemens’ Somatom Definition AS+CT scanner, Heine’s blood pressure monitor G7-M237 (BP cuff) and Ultravist contrast agent (370 mg Iodine/ml) are used. CTA is acquired using following scan parameters including slice thickness of 1mm, image acquisition parameters of 128×0.6 mm, pitch size of 0.8 mm, 175 effective mAs, 120 kVp tube voltage, scan delay time of 3 seconds, and the scan time of 4 seconds. This study is conducted by securing the IV route in the left antecubital vein before injection of contrast agent, wrapping BP cuff around the branchial artery of the opposite right arm after setting the pressure to 200 mmHg. Then, the injection rate of the contrast agent is fixed at 4.5 cc/sec and contrast agent was injected in three different amounts (70, 80, and 100 cc). Bp cuff is released from this moment when HU value reachs 100. RESULT: In this study, the mean HU values measured from common carotid artery are 412.45±5.89 when injecting 80cc contrast agent and using BP cuff and 399.64±5.51 when injecting 100 cc contrast agenet and not using BP cuff, respectively. In middle cerebral artery M1, the mean HU values are 325.23±38.29 when injecting 80cc contrast agent and using BP cuff and 325.00±30.63 when injecting 100cc contrast agent blood and not using pressure cuff, respectively. Difference of mean HU values is not statistically significant (p > 0.05) with and without using BP cuff. CONCLUSION: This study demonstrates that reducing amount of contrast agent is possible when the right brachial artery is compressed using BP cuff. Study results indicate that reducing 20% injection of contrast agent in CT cerebrovascular angiography can still yield comparable imaging results with conventional contrast angent usage, which implies that less side effects are expected with a contrast agent injection. Thus, this study can serve as a reference for potential reducing side effect during CT cerebrovascular angiography.
Back pain: easy is the new difficult?
Authors:   Volgograd State Medical University, Volgograd, Russian Federation, Kurushina O.V. , Barulin A.E. ,   Volgograd State Medical University, Volgograd, Russian Federation
Published: November 2021

Back pain is one of the most common pain syndromes affecting significantly working capacity and quality of life. In the future, back pain is predicted to grow due to a higher rate of comorbidities and conditions (i.e., obesity, smoking, sedentary lifestyle) and population aging. Therefore, back pain relief is an essential issue for various specialists. However, despite a growing body of studies and published data, the issue of the management of patients with back pain is far from being resolved. This paper discusses the efficacy and safety of various therapeutic strategies for back pain treatment, focusing on B vitamins. Analgesic properties plus the enhancement of painkiller effects and lower risk of pain chronicity (as a result of reduced peripheral and central sensitization) favor including B vitamins into treatment regimens for back pain. The authors also address non-pharmacological approaches to back pain and emphasize that a long-lasting effect of analgesics cannot be achieved without switching from reducing acute pain to preventing future exacerbations. KEYWORDS: back pain, B vitamins, biopsychosocial model, adjuvant treatment, manual therapy. FOR CITATION: Kurushina O.V., Barulin A.E. Back pain: easy is the new difficult? Russian Medical Inquiry. 2021;5(10):642–647 (in Russ.). DOI: 10.32364/2587-6821-2021-5-10-642-647.
Duloxetine for chronic pain
Authors:   Academy of Postgraduate Education of the Federal Scientific and Clinical Center of the Federal Medical Biological Agency of Russian Federation, Moscow, Russian Federation, Ekusheva E.V. ,   Belgorod State National Research University, Belgorod, Russian Federation
Published: November 2021

Chronic pain is still a critical medical issue in modern society that results in severe deadaptation and reduces the quality of life in 15–40% of people in developed countries. Neuropathic pain is an essential issue characterized by recurrent course and the presence of comorbidities, e.g., depression. Duloxetine is particularly important among drugs with established efficacy prescribed for neuropathic pain. This agent significantly affects serotoninergic and noradrenergic systems and significant pathogenic mechanisms of the development of chronic pain, i.e., processes of disinhibition, thereby increasing the functional activity of the descending system of pain inhibition. The analgesic effect of duloxetine occurs much earlier and is independent of its antidepressant effect. Duloxetine is prescribed for many conditions that are often challenging for practitioners and associated with chronic pain. In addition, duloxetine has a significant effect on comorbid anxiety, depression, and sleep disorders. KEYWORDS: chronic pain, neuropathic pain, chronic pain syndrome, duloxetine. FOR CITATION: Ekusheva E.V. Duloxetine for chronic pain. Russian Medical Inquiry. 2021;5(10):687–693 (in Russ.). DOI: 10.32364/2587- 6821-2021-5-10-687-693.
Homocysteine, pituitary and thyroid hormones in children with different physical development levels after forest fires in the Chornobyl exclusion zone
Authors:   Ecology and Health Coordination and Analytical Centre, Ivankov, Bandazhevskyi Yu.I. , Dubova N. F. ,   Shupyk National Healthcare University of Ukraine
Published: November 2021

Objective We performed a comparative assessment of the blood levels of homocysteine, pituitary and thyroid hormones in children with different levels of physical development before and after forest fires in the Chornobyl exclusion zone (ChEZ) in 2015. Methods: We used immunochemical, instrumental, mathematical and statistical methods. Results: The analysis of variable dynamics was performed in 336 adolescents of the Polisskyi and the Ivankivskyi districts of Kyiv region. An association was found between homocysteine (Нсу), hormones of the pituitary-thyroid axis and physical development of children. A statistically significantly higher level of Нсу was observed in the adolescents from the Ivankivskyi district in comparison with the children from the Polisskyi district. Forest fires in the spring and summer of 2015 in the ChEZ should be considered the main cause for the increase in Нсу in the blood of the adolescents. The increased level of Т3 in the peripheral tissues induced by Нсy and TSH contributed to a decrease in the physical development index values. Due to a decrease in the intensity of the Т4 deiodination process, the insufficient formation of Т3 in the peripheral tissues was recorded in the group of children with a disharmonious high physical development.
REVITALISASI KOMUNIKASI ANALOG DI KOMUNITAS KELUARGA MUDA INDONESIA
Authors: Ifadhah Nurul , Irwansyah Irwansyah
Published: November 2021

Handwritting into book is the most ancient form of analog communication and a means of remote communication that was first present in human life. However, just like any other communication product, writing on books (journaling) slowly begins to be eroded by technology dermination. The culture of analog writing shifts to typing. The decline in interest analog writing is seen from the results of research and regulations in some countries that no longer require the younger generation to have certain skills of writing. In fact, analog writing activities are scientifically proven to be mentally healthy. The situation in Indonesia is slightly different from the presence of the government that requires handwritten classes for elementary children, and the growing writing market in young family communities. Journaling in the millenial mother community is a process to get a more conscious lifestyle. This research aims to understand the revitalization process of an analog communication to remain favored by people who have become accustomed to consuming communication information technology. Through the Case Study it was found that journaling as analog communication is able to maintain its existence because of the revitalization of ideas through interdisciplinary and multidisciplinary collaboration in the scope of communication science.
АНАЛІЗ МОЖЛИВОСТЕЙ РЕАЛІЗАЦІЇ МОДУЛЬНОГО ПРИНЦИПУ СТВОРЕННЯ МОДИФІКАЦІЙ ПОВІТРЯНИХ СУДЕН ТА ЇХ ЕФЕКТИВНОЇ ЕКСПЛУАТАЦІЇ В СИСТЕМІ ВІТЧИЗНЯНИХ АВІАПЕРЕВЕЗЕНЬ
Authors: Гайдачук В. Е. , Серебрянникова В. Ю.
Published: November 2021

It is known that an aircraft generates income for the operating airline only when it is in the air. Being on the ground, at the airport, airlines incur high costs for aerodrome maintenance of the aircraft. The longer the aircraft is stationary on the ground, the shorter the actual flight time of the aircraft. In this regard, the possibility of implementing one of the promising principles for the creation and effective operation of modifications of aircraft of the transport category - the modular principle - has been analyzed. The prospects for the implementation of modular modifications in domestic airlines in the context of further development of the market economy are considered. Modifications based on the implementation of the modular principle are classified into two types - created in the form of autonomous modules placed in the fuselage during aircraft operation and in the form of a removable modular compartment of the aircraft fuselage. A review and analysis of existing projects of these types of modular constructive and technological solutions, a comparison of their advantages and disadvantages in the technical and economic aspects of the prospects for their feasibility are carried out. The possibility of effective implementation of the modular principle of modifications of aircraft of the transport category was assessed, for which a generalized analysis of domestic and foreign information related to the state of the problem under discussion was carried out, on the basis of which an enlarged block diagram of a comprehensive methodology for analyzing the efficiency of operation of modular modifications in the air transportation system was synthesized in comparison with traditional (existing). The key aspects of the content of the main blocks of the scheme are revealed, including the main provisions of the maintenance and repair of aircraft in modern conditions of their operation, based on foreign experience, as well as the main aspects of the content of the blocks for accounting for weight losses in the design and implementation of traditional and modular modifications of aircraft. The generalized information related to the implementation of the synthesized block diagram, focused on subsequent addition, should form the basis of compliance methods and regulatory documentation in the design and implementation of promising domestic modifications of aircraft of the transport category.
ПРИНЦИПИ ПРОЕКТУВАННЯ ЛЮДИНО-МАШИННОЇ ВЗАЄМОДІЇ У ЦИФРОВОМУ СЕРЕДОВИЩІ
Authors: Protasenko O. , Mygal G. , Mykhailova E.
Published: November 2021

Modern society life is inextricably linked with the digital environment. A consequence is the transformation of ergatic systems into digital ones. The result is the emergence of new types of man-machine interaction. The essential feature of such interaction is to minimise human involvement in the ergatic system functioning. According to this, the issues of organising the safe and effective functioning of digital ergatic systems have priority importance. In this regard, the aim was to study the features of man-machine interaction in an actual digital ergatic system. We chose an ergatic system for research. The main elements of the system were students (70 people of the first-year study) and teachers (5 people) of the Simon Kuznets Kharkiv National University of Economics, as well as the digital system “Personal training systems the Simon Kuznets Kharkiv National University of Economics” (PTS). This digital system is an adapted model of the Moodle digital system. The study found out that the key components that determine the safety and efficiency of the digital ergatic system are the operator's digital mindset, digital tools and digital devices. The study of these components in the system made it possible to establish that it had a balanced state. It is substantiated the optimal form of man-machine interaction in the system. It is mixed learning. It is shown that the tendency to minimise the human role in a digital ergatic system does not always have the expected positive result, which determines the need for further research on this issue. In addition, we analysed the difficulties arising in the design of digital systems. The main reason for this is a lack of developers awareness of the ergonomic and cognitive aspects of man-machine interaction. It is shown that the development of critical thinking and intuition in students is closely related to the individual trajectory of learning. For this, it is essential to update interdisciplinary knowledge. In this case, it is necessary to familiarise students with current concepts and system-forming principles, which are the basis of human factors engineering. It was substantiated that the application of current concepts and system-forming principles in training will allow optimising man-machine interaction. The positive results will be evidence even at the stage of designing digital systems
International Counseling Students’ Practicum Experience in a Counseling Program in the United States
Authors: Xiong Yiying , Bonner Matthew , Travis Sterling , Xing Feng , Zhang Qingyun
Published: November 2021

Limited attention has been given to international counseling students (ICSs) enrolled in U.S. counseling programs. This phenomenological study examined the lived experiences of six ICSs in a U.S. counseling program regarding factors that impacted their practicum experience. The study identified three themes: learning and growth process, positive impacting factors, and negative impacting factors. It also provided stakeholder recommendations
First-episode psychosis research in India: A review
Authors: Raghavan Vijaya , Mohan Greeshma , Jaiswal Seema , Rangaswamy Thara
Published: November 2021

Background: With the growth of early intervention services for psychosis worldwide, it is imperative to understand the current knowledge on first-episode psychosis (FEP) from Indian context. Hence, the purpose of this review is to comprehensively examine the research studies on FEP from India. This would help to compare and contrast with other countries, develop specialist early intervention services and enlist research priorities pertaining to FEP. Methods: A Boolean search of articles published from January 1990 to March 2018 in electronic database of PubMed and Google Scholar was carried out and original research studies done on first-episode psychosis in India were incorporated in the current review. Case reports and review articles were excluded. Results: A total of 31 research studies were included for the review and classified into different subheadings of convenience. Conclusion: Even though the number of studies in Indian context pertaining to FEP is comparatively less than other western literature, the available results indicate certain characteristic similarities and differences in FEP from other parts of the world. We have also discussed on the importance of early intervention in FEP and the necessity for the creation of specialist early intervention services for mental health disorders.
Challenges in management of Major Depression in patients with co-morbid medical conditions
Authors: Menon Vikas , Kuppili Pooja Patnaik
Published: November 2021

Depression is a heterogeneous illness and depression with co-morbid physical illness may represent a phenotype of depression. Concurrent medical illness in depression is associated with greater functional and social impairment and significantly higher health care costs. A variety of mechanisms including lifestyle factors, immune-inflammatory pathways, medications and psychological factors have been proposed to explain the association between depression and physical illness. However, each of these pathways engenders unique challenges in managing such patients. Of utmost importance is to establish the nature of the underlying medical or psychological cause(s) which will inform customized management plans. This article initially reviews the prevalence of depression in medical conditions and vice versa. Subsequently, we move on to discuss specific approaches to diagnosis of depression in the context of medical co-morbidity. Finally, we describe evidence based pharmacological and psychosocial intervention strategies with some recommendations for common clinical scenarios. Evidence based care models to manage depression with physical illness are described which may be adapted for use in low resource settings.
Elderly Mental Health in Developing Countries
Authors: Vaitheswaran Sridhar , Ramanujam Vaishnavi
Published: November 2021

Geriatric Psychiatry deals with specific issues and challenges that arise in the assessment and management of mental health problems in elderly. As a specialty it has not received much attention in developing countries until recently. Elderly will soon be major consumers of mental health care in developing countries. Common psycho-social issues among the elderly and their impact on the mental health in the developing regions of the world and the complex interplay between physical health and mental health in the elderly are described. Dementia and depression are described in some detail focussing on relevant research to highlight the challenges in developing countries. Potential solutions to address the challenges of elderly mental health in developing countries are discussed.
School and Community - based Youth Mental Health Intervention Studies in India: A Scoping Review
Authors: Gopalan Ragaviveka , Sangeetha C , Ramakrishnan P , Raghavan Vijaya
Published: November 2021

BACKGROUND About 70% of mental disorders emerge in late childhood and young peo-ple bear the burden of these disorders throughout life. Yet, to date there has been com-paratively little research on mental health interventions for young people in India and not many attempts have been made to collate the existing literature. This systematic review aims to synthesize the available evidence on school- and community-based mental health interventions for young people in India. METHODS A range of major electronic databases were searched systematically, and the abstracts of relevant papers were independently examined for possible inclusion. Selected papers were read in full text and a standardized set of data items were extracted. RESULTS Four papers met inclusion criteria for the analysis; two studies of school-based interventions for adolescents and two studies evaluating out-of-school community interventions for youth were reviewed. The quality of evidence from the interventions in Indian school and community settings were poor. While two studies evidence the effectiveness of a school-based life skills programme and a community based multicomponent intervention designed to promote youth health, two other studies do not offer sufficient data. CONCLUSION The review findings indicate that the number of interventional studies conducted in India to address youth mental health issues are very limited. Hence, it is extremely difficult to ensure the feasibility and effectiveness of school and community-based interventions in India. Further research is warranted to establish whether interventions promoting youth mental health people can be implemented effectively in Indian settings with positive mental health outcomes. Given the possibility of a huge population of young people at-risk or experiencing mental disorders, evidence for the efficacy of youth mental health interventions is crucial.
Association between severity and repetitive behaviours among children with autism spectrum disorder and anxiety and depression among their primary caregivers
Authors: Rita J. Anu , Kannan P. P. , Raghavan Vijaya , Nambi Shanthi
Published: November 2021

Background: Autism spectrum disorder (ASD) is one of the most common pervasive developmental disorder and present with varied severity and clinical presentation. The diagnosis of ASD in the children has a huge psychological impact among their primary caregivers, leading to distress and mental health issues. The aim of our study was to assess the association between the severity and repetitive behaviours in children with autism spectrum disorder and anxiety and depression levels among their primary caregivers. Materials and methods: Children with autism spectrum disorder and their primary caregivers were recruited from the child psychiatry unit of large tertiary children hospital in south India, after informed consent. Severity of ASD was assessed by Childhood Autism Rating Scale – 1 (CARS-1) and repetitive behaviour by Repetitive behaviour scale - Revised (RBS-R). Among the caregivers, anxiety levels were assessed by Hamilton rating scale for Anxiety (HAM-A) and depression levels were assessed by Hamilton rating scale for Depression (HAM-D). Results: We recruited 100 children with ASD and their mothers (primary caregivers) in the study. The prevalence of anxiety and depression among mothers of children with ASD was 44% and 30%. Statistically significant correlation was observed between CARS scores and HAM-A (p=0.002) and HAM-D (p less than 0.001) scores. Among the repetitive behaviours, self-injurious behaviour was found to be significantly associated with anxiety (p less than 0.001) and depression (p less than 0.001) scores, while stereotyped (P =0.002) and compulsive (p=0.004) behaviours were associated with depression scores. Conclusion: There is a significant association between severity of autism spectrum disorder and anxiety and depression among their mothers.
Artists down the alcohol spiral
Authors: Somasundaram O. , Murthy Tejus , Raghavan Vijaya
Published: November 2021

Explorations of the relationship between psychopathology and creativity, especially with respect to alcoholism, is very sparse in our Indian psychiatric literature. The habits of two of our prominent artists of the twentieth century, one a Carnatic musician and another a film actor and singer, along with a few others are described in this article.
A Case Series of Children with Developmental Disabilities with Suicidality
Authors: Vangili Arun
Published: November 2021

Introduction: Children with developmental disorders are more prone for mental disorders and suicidality. Suicidality often indicates a psychiatric emergency and it is crucial to have an understanding for more effective and efficient inter-vention. However there is scant literature on the prevalence, risk factors and other characteristics associated with sui-cidality in this population all over the world and especially in India. Content: In this article we highlight the factors related to suicidality in 3 children with developmental disabilities who were admitted to a tertiary care inpatient psychi-atric facility (NIMHANS). Discussion; All three children had multiple psychiatric diagnoses and greater psychosocial adversities. Conclusion: there is a need for reliable screening instruments and routine screening and clinician awareness on this aspect of caring for children with DD.
A cross-sectional study of factors associated with anti-depressant medication adherence in women attending an out patient psychiatry department
Authors:   SRM Medical College and Hospital, Chennai, Reddy Mrinalini , Abhilasha Pallavi , Manikam Thirunavukarasu , Ramanathan Rajkumar , Kumar Suresh
Published: November 2021

Introduction: Treatment adherence and illness may not be related only by the severity of the illness but by so many other factors which impact on seeking and continuing treatment; yet severity of the illness will be one of the major factors influencing treatment adherence. Methods: Female patients attending the psychiatric OPD, diagnosed with depression as per ICD-10 guidelines and provided informed consent participated in this questionnaire-based study. A total of 135 patients who attended the OPD in 9 months were assessed for the severity of depression and medication adherence by administering scales to assess the severity of depression and medication adherence was assessed by questioning about the drug taking and hospital attending behaviour. Out of this, thirty-one were attending for the first episode and hence were excluded from the analysis. Results: Out of the 104 female patients diagnosed with depression of more than one episode, 44 (42.3%) had mild depression, 52 (50%) had moderate depression and 8 (7.7%) had severe depression. Twenty-nine women (27.9%) were on medications and 75 (72.1%) women were not taking their medications. While greater proportion of women with mild depression were adherent to medication (51.7%), more women with moderate depression didn’t adhere to medication (54.7%), even though such difference was statistically not significant. Older age, having a paid work and married status were significantly associated with medication (antidepressants) adherence. Conclusions: Our results indicate that medication adherence is associated with factors other than severity of depression. Work and marital status played a significant role in determining the adherence to antidepressant medications among women.
Epigenetics in Psychiatry
Authors:   Department of Psychiatry, Yenepoya Medical College, Mahatme Nupur , Shettar Manoj ,   Department of Psychiatry, SDM Medical College, Kakunje Anil ,   Department of Psychiatry, Yenepoya Medical College, Mahatme Nupur
Published: November 2021

Epigenetics is defined as the changes in gene expression that lead to predictable, stable and possibly heritable alterations in cell function that are not due to changes in DNA sequence. It is of major relevance in psychiatry since environmental factors like stress or substance abuse, significant contribute in causing psychiatric pathologies like depression, anxiety, depression, etc. Epigenetics research in psychiatry would give an opportunity to extend the outlook and approach towards psychiatric pathologies. Hence timely interventions would be sought for. This would also allow gaining access to ‘brain tissue’ from live patients with mental illness and predicting occurrence of or vulnerability to psychiatric illnesses by evaluation of biomarkers, thus preventing, reversing or atleast curbing the progress at an initial stage. There are evidences of work done in the field of epigenetics both in pre-clinical as well as clinical settings. It is remarkable to see how the DNA methylation at various sites can result in alteration of the mental health of an individual and also how this can affect as early as during the first week of life. This is an exciting frontier in psychiatry, providing long sought biomarkers for predicting complex and devastating human behaviours as well as mental illnesses.
Early use of electroconvulsive therapy in individuals with first episode psychosis: A case series
Authors:   (SCARF) Schizophrenia Care and Research Foundation, Chandan Antra , Raghavan Vijaya ,   Schizophrenia Care and Research Foundation (SCARF)
Published: November 2021

The use of electroconvulsive therapy (ECT) in various neuropsychiatric disorders has been well accepted. ECT has been proven to be safe and effective in adolescents and in old age. However, only a handful of literature is available on its effectiveness in first episode psychosis (FEP). In this case series, individuals with FEP who received ECT in their 1st month of treatment for various indications were described. During follow-up, subjects showed considerable improvement in their psychopathology and functional outcomes. None of them had any adverse events during or after ECT sessions. Thus, the present case series highlights the usefulness and safety of early use of ECT in individuals with first episode psychosis and its effectiveness in reducing the acute symptoms leading to remission and better outcomes.
Bilateral tapia syndrome after maxillomandibular advancement surgery
Authors: Silva Alexandre Augusto Ferreira da , Rocha Roberto de Oliveira , Mariano Ronaldo Célio
Published: November 2021

Lesions of the hypoglossal and laryngeal nerve, recurrent in its unilateral or bilateral extracranial pathways, cause a motor deficit in the tongue with transient, partial or total loss of speech, which may be associated with mild or severe dysphagia, characterizing Tapia syndrome. This unusual condition is usually related to airway manipulation during anesthetic-surgical surgery, and few cases in the literature are correlated with maxillofacial surgeries, which partly explains the ignorance of this complication by a significant number of professionals. We describe a case report of bilateral Tapia syndrome established after a procedure for maxillomandibular advancement. This is a 55-year-old male patient diagnosed with retrognatism and retromaxillism. The patient underwent a maxillomandibular advancement with nasotracheal intubation. He evolved with bilateral Tapia syndrome, recovering from the signs and symptoms of this complication, being reoperated to correct aesthetic results obtained in the first intervention that was below acceptable, not evolving after this second surgery with the syndrome. We conclude that preventive measures should be taken, such as avoiding sudden movements in the head region and prolonged hyperextension of the neck during surgery, minimizing the trauma of the tracheal cannula on the tissues covering the hypoglossal and recurrent laryngeal nerves.
Gute Ideen zu wirtschaftlicher Inklusion: Zugang zu Bankgeschäften
Authors: Khan Omar
Published: November 2021

Gute Ideen zu wirtschaftlicher Inklusion: Zugang zu Bankgeschäften ist der erste Bericht
in einer Reihe, in der Themen und gute Praxis im Zusammenhang mit der
wirtschaftlichen Integration und Inklusion von Zuwanderern in den Stadtteilen,
Geschäftsstraßen und Arbeitsstätten heutiger Kommunen untersucht werden.
Inclusion of Migrants with Irregular Status
Authors: Spencer Sarah
Published: November 2021

Sarah Spencer explains why cities in Europe, like their North American counterparts, are increasingly exploring ways to enable irregular (‘undocumented’) migrants to have access to essential services, and tells us some of the creative ways that they have found to do so. She draws on the work of the City Initiative on Migrants with Irregular Status in Europe, a two-year learning-exchange project involving 11 European cities, chaired by the City of Utrecht, which she facilitates with her Oxford colleague, Nicola Delvino.
EFFICIENCY EVALUATION OF THE TRANSPORT OPERATIONS OF SHIPMENT DELIVERY, INCLUDING THE EXTERNAL ENVIRONMENT IMPACT
Authors: Galkin A. , Tkachenko I. , Hriekova O.
Published: November 2021

The article considered the issue of the effectiveness of the organization of the transport process for the delivery of packaged unit cargo, considering the impact on the external environment. It has been established that transport is one of the most important elements of the urban economy. But on the other hand, and one of the main environmental pollutants. The deterioration of transport problems in cities is associated, first of all, with an increase in the level of motorization and a significant increase in on-line commerce and delivery of goods under quarantine conditions. In such conditions, there is a high concentration of pollutants (NOx, CO, CH, etc.), a decrease in the speed of movement of vehicles, an increase in travel time along the main highways of the city. Many countries have begun to take this important factor into account when making decisions. Today, there are tariffs that are imposed on vehicle owners. The value in monetary terms depends on the type of fuel used, the carrying capacity of vehicles, etc. These tariffs are approved in European countries. Also, the impact of transport on the external environment can be calculated as costs in monetary terms. The modern paradigm of sustainable development of transport systems indicates not only the feasibility of minimizing the costs of organizing the transport process, but also the need to reduce the impact of transport on the environment. The total costs (direct and indirect costs) for transportation are insufficiently estimated in the modern conditions of the organization of the transport process. This fact should be taken into account by the participants in the supply chains. It should be noted that when calculating the cost of transportation of unitized cargo, only the cost parameter is considered. We cannot ignore the fact that transport affects the environment, infrastructure, etc. Therefore, when calculating the total cost of transportation of goods, it is necessary to add “external” costs to the logistics costs. The so-called environmental costs, which contain indicators such as the amount of emissions of harmful substances, an assessment of the impact on infrastructure, and others.