Depressive symptoms are common among rural Malawian adolescents

BackgroundDepressive conditions cause about 25 million disability adjusted life years in low-income countries annually. The incidence of depression rises after puberty, and the young age distribution in these countries may cause a high burden of adolescent depression. We aimed to assess the prevalence of reported depressive symptoms among rural adolescents in Malawi. Additionally, we assessed the association between birth weight, childhood growth, gender, and pubertal maturity and depressive symptoms. MethodsWe followed 767 children from the foetal period until 15-years-of-age. We used the Short Mood and Feelings Questionnaire (SMFQ) to examine reported depressive symptoms at 15years. The questionnaire was translated to local language and then back-translated until inaccuracies were not detected. Anthropometry was conducted at 1, 24, 120, and 180months of age. We performed regression models with imputed data to assess associations between the independent variables and depressive symptoms. As a sensitivity analysis, we ran the same regression models with participants with no missing data. ResultsA total of 523 participants were seen at 15years. The mean SMFQ score was 15 with 90% (95%CI 87-92%) of the participants scoring 11 points, the traditional cut-off for screening for depression. Birth weight, growth, gender, and pubertal maturity were not associated with the SMFQ score in the primary imputed analyses. In the sensitivity analysis, birth weight was associated with the SMFQ score in all models. ConclusionsThe prevalence of reported depressive symptoms was high among the studied population. It is uncertain how well the traditional cut-off of 11 points identifies children with clinically significant depressive symptoms in our sample. Our data do not support a hypothesis of an association between growth, gender, or pubertal maturity and depressive symptoms. Nevertheless, our results highlight the importance of the awareness of mental health problems in low-income countries.Peer reviewe

The ConStratO model of handover: a tool to support technology design and evaluation

Handovers are a specific kind of multidisciplinary team meeting. Shift handovers and transfers are both regular features of hospital work but there is currently great variation in how such handovers are conducted, presenting a challenging for those seeking to develop technology to support handover. This paper presents the ConStratO model of handover, which captures aspects of the context that influence how the handover is conducted, a range of different handover strategies relating to different aspects of the handover, and possible outcomes of handover. The model is based on detailed data collection in a range of clinical settings. We present the model as a tool for developing and evaluating technology support for handover

ACCURACY OF FNAC IN FEMALE BREAST LESIONS

Background: Various breast lesions are common lesions in females with a wide range of variability from inflammatory lesions, benign and malignant breast lesions. FNAC is first diagnostic test, as it has high sensitivity and specificity. Lesions were categorized on FNA into inflammatory lesions, benign neoplastic lesions, malignant neoplastic lesions, and suspicious for malignancy. Methods: This was a retrospective study done in the Department of Pathology, P.D.U. Medical College, Rajkot, Gujarat State, India from Aug-2013 to July 2014. FNAC of 392 cases of breast lesions were done and reported by expert pathologist. The histopathological specimens when available were reported by other pathologist without prior knowledge of FNA diagnosis. Sensitivity, Specificity and Accuracy of FNA diagnosis were then analyzed. Results: A total of 392 cases of breast lesions were diagnosed on FNA, out of them histopathological correlation was available in 87 cases. Benign breast lesions are more common in younger patients in 21-30 yrs age group and malignant lesions are more common in old age group patients of 41-60 yrs with few exceptions. In our setup fibroadenoma is the most common benign breast lesion (26.53%) and ductal carcinoma (17.86%) is the most common malignant lesion. The sensitivity, specificity and accuracy of FNAC for malignant lesions were found to be 91.43%, 100% and 96.25% respectively. Conclusion: FNAC is an effective and valid tool as the first line diagnostic modality in the preoperative diagnosis of the malignant and benign breast lesions.KEYWORDS: FNAC; Breast lesions; Fibroadenoma; Ductal carcinoma

ACCURACY OF FNAC IN FEMALE BREAST LESIONS

Background: Various breast lesions are common lesions in females with a wide range of variability from inflammatory lesions, benign and malignant breast lesions. FNAC is first diagnostic test, as it has high sensitivity and specificity. Lesions were categorized on FNA into inflammatory lesions, benign neoplastic lesions, malignant neoplastic lesions, and suspicious for malignancy. Methods: This was a retrospective study done in the Department of Pathology, P.D.U. Medical College, Rajkot, Gujarat State, India from Aug-2013 to July 2014. FNAC of 392 cases of breast lesions were done and reported by expert pathologist. The histopathological specimens when available were reported by other pathologist without prior knowledge of FNA diagnosis. Sensitivity, Specificity and Accuracy of FNA diagnosis were then analyzed. Results: A total of 392 cases of breast lesions were diagnosed on FNA, out of them histopathological correlation was available in 87 cases. Benign breast lesions are more common in younger patients in 21-30 yrs age group and malignant lesions are more common in old age group patients of 41-60 yrs with few exceptions. In our setup fibroadenoma is the most common benign breast lesion (26.53%) and ductal carcinoma (17.86%) is the most common malignant lesion. The sensitivity, specificity and accuracy of FNAC for malignant lesions were found to be 91.43%, 100% and 96.25% respectively. Conclusion: FNAC is an effective and valid tool as the first line diagnostic modality in the preoperative diagnosis of the malignant and benign breast lesions.KEYWORDS: FNAC; Breast lesions; Fibroadenoma; Ductal carcinoma

Intercalation-enhanced electric polarization and chain formation of nano-layered particles

Microscopy observations show that suspensions of synthetic and natural nano-layered smectite clay particles submitted to a strong external electric field undergo a fast and extended structuring. This structuring results from the interaction between induced electric dipoles, and is only possible for particles with suitable polarization properties. Smectite clay colloids are observed to be particularly suitable, in contrast to similar suspensions of a non-swelling clay. Synchrotron X-ray scattering experiments provide the orientation distributions for the particles. These distributions are understood in terms of competing (i) homogenizing entropy and (ii) interaction between the particles and the local electric field; they show that clay particles polarize along their silica sheet. Furthermore, a change in the platelet separation inside nano-layered particles occurs under application of the electric field, indicating that intercalated ions and water molecules play a role in their electric polarization. The resulting induced dipole is structurally attached to the particle, and this causes particles to reorient and interact, resulting in the observed macroscopic structuring. The macroscopic properties of these electro-rheological smectite suspensions may be tuned by controlling the nature and quantity of the intercalated species, at the nanoscale.Comment: 7 pages, 5 figure

The Selective Downregulation of Class I Major Histocompatibility Complex Proteins by HIV-1 Protects HIV-Infected Cells from NK Cells

AbstractTo avoid detection by CTL, HIV encodes mechanisms for removal of class I MHC proteins from the surface of infected cells. However, class I downregulation potentially exposes the virus-infected cell to attack by NK cells. Human lymphoid cells are protected from NK cell cytotoxicity primarily by HLA-C and HLA-E. We present evidence that HIV-1 selectively downregulates HLA-A and HLA-B but does not significantly affect HLA-C or HLA-E. We then identify the residues in HLA-C and HLA-E that protect them from HIV downregulation. This selective downregulation allows HIV-infected cells to avoid NK cell–mediated lysis and may represent for HIV a balance between escape from CTL and maintenance of protection from NK cells. These results suggest that subpopulations of CTL and NK cells may be uniquely suited for combating HIV

Improved flux limits for neutrinos with energies above 1022^{22} eV from observations with the Westerbork Synthesis Radio Telescope

Particle cascades initiated by ultra-high energy (UHE) neutrinos in the lunar regolith will emit an electromagnetic pulse with a time duration of the order of nano seconds through a process known as the Askaryan effect. It has been shown that in an observing window around 150 MHz there is a maximum chance for detecting this radiation with radio telescopes commonly used in astronomy. In 50 hours of observation time with the Westerbork Synthesis Radio Telescope array we have set a new limit on the flux of neutrinos, summed over all flavors, with energies in excess of $4\times10^{22}$ eV.Comment: Submitted to Phys. Rev. Let

A Nonperturbative Study of Inverse Symmetry Breaking at High Temperatures

The optimized linear $\delta$-expansion is applied to multi-field $O(N_1) \times O(N_2)$ scalar theories at high temperatures. Using the imaginary time formalism the thermal masses are evaluated perturbatively up to order $\delta^2$ which considers consistently all two-loop contributions. A variational procedure associated with the method generates nonperturbative results which are used to search for parameters values for inverse symmetry breaking (or symmetry nonrestoration) at high temperatures. Our results are compared with the ones obtained by the one-loop perturbative approximation, the gap equation solutions and the renormalization group approach, showing good agreement with the latter method. Apart from strongly supporting inverse symmetry breaking (or symmetry nonrestoration), our results reveal the possibility of other high temperature symmetry breaking patterns for which the last term in the breaking sequence is $O(N_1-1) \times O(N_2-1)$.Comment: 28 pages,5 eps figures (uses epsf), RevTeX. Only a small misprint in Eq. (2.10) and a couple of typos fixe