Prevalence and determinants of anxiety and depression in end stage renal disease (ESRD). A comparison between ESRD patients with and without coexisting diabetes mellitus

Objective: To compare anxiety and/or depressive symptoms between patients with end-stage renal disease with and without comorbid diabetes and identify factors associated with symptoms of distress in this population. Methods: Data from two studies (conducted between 2010 and 2014) were pooled. A total of 526 patients on hemodialysis (68.8% with diabetes) completed the Hospital Anxiety and Depression Scale (HADS). Elevated symptoms were defined as HADS-Anxiety or HADS-Depression ≥ 8. Univariate and multivariate logistic regressions were used to estimate associations between diabetic status, and other socio-demographic and clinical factors with baseline clinical anxiety and depression. Results: A total of 233 (45.4%) reported elevated anxiety symptoms and 256 (49.9%) reported elevated depressive symptoms sufficient for caseness. Rates were not different between patients with and without diabetes. Risk for clinical depression was higher in patients who were single/unpartnered (OR = 1.828), Chinese vs. Malay (OR = 2.05), or had lower albumin levels (OR = 0.932). None of the parameters were associated with anxiety caseness. Conclusion: Sociocultural factors rather than comorbid burden may help identify patients at risk for depression. The high rates of anxiety and depression underlie the importance for monitoring and intervention in dialysis care

Heated Motorized Stage for Nanoscale Thin Film Deposition

ME450 Capstone Design and Manufacturing Experience: Fall 2015Thin film deposition is a technology of applying a very thin film of material onto a substrate surface to be coated, or onto a previously deposited coating to form layers. As a modified Atomic Layer Deposition (ALD) method, Spatial ALD greatly improves the efficiency of the process by separating the half-reactions spatially instead of through the use of purge steps in convectional ALD. This paper proposes the use of heated motorized stage as a research prototype to further study the effect of deposition conditions such as gap size, gap alignment and substrate temperature on the SALD coating results. This strategy utilized three stepper motors and high precision non-contact gap sensors to control gap alignment and gap size between the substrate and the depositor. The details of the involved methodology, engineering analysis, validation of the final design and the design critiques are discussed in this paper.http://deepblue.lib.umich.edu/bitstream/2027.42/117338/1/ME450-F15-Project19-FinalReport.pd

Simple model for decay of superdeformed nuclei

Recent theoretical investigations of the decay mechanism out of a superdeformed nuclear band have yielded qualitatively different results, depending on the relative values of the relevant decay widths. We present a simple two-level model for the dynamics of the tunneling between the superdeformed and normal-deformed bands, which treats decay and tunneling processes on an equal footing. The previous theoretical results are shown to correspond to coherent and incoherent limits of the full tunneling dynamics. Our model accounts for experimental data in both the A~150 mass region, where the tunneling dynamics is coherent, and in the A~190 mass region, where the tunneling dynamics is incoherent.Comment: 4 page

Spreading Width for Decay out of a Superdeformed Band

The attenuation factor F responsible for the decay out of a superdeformed (SD) band is calculated with the help of a statistical model. This factor is given by 1/F = (1 + Gamma(down) / Gamma(S)). Here, Gamma(S) is the width for the collective E2 transition within the superdeformed band, and Gamma(down) is the spreading width which describes the mixing between a state in the SD band and the normally deformed (ND) states of equal spin. The attenuation factor F is independent of the statistical E1 decay widths Gamma(N) of the ND states provided that the Gamma(N) are much larger than both Gamma(down) and Gamma(S). This condition is generically met. Previously measured values of F are used to determine Gamma(down).Comment: Submitted to Physical Review Letter

Effect of different drying methods and solvent ratios on biological activities of Phyllanthus acidus extracts

The main purpose of this study was to evaluate the antioxidant and α-glucosidase inhibitory activities of Phyllanthus acidus. The P. acidus fruits were dried using three different methods, namely oven (OD), air (AD) and freeze (FD) dryings and extracted with ethanol at different ratios (50 and 100%). The proximate analysis and total phenolic content (TPC) as well as free radical scavenging and α-glucosidase inhibitory activities were determined. The proximate analysis of P. acidus fruit indicated that all the dried samples contained potential nutrient contents. The highest TPC value, α-glucosidase inhibitory and antioxidant activities were observed for 50% ethanolic extract from OD method with TPC value of 28.39 mg GAE/g dried extract, IC50 value of 12.394 μg/mL and 64.17% inhibition, respectively. The study revealed that phenolic compounds could be the main contributors to the antioxidant and α-glucosidase inhibitory activities based on the Pearson correlation coefficients with R values of 95.0 and 73.8%, respectively. The study could provide scientific evidence for some folk uses in the treatment of diseases related to the production of reactive oxygen species and oxidative stress

Computation tools for the combat of cardiovascular heart disease

The paper discusses two potential applications of computational technologies to combat cardiovascular heart disease in Singapore. The first application involves the exploitation of neural networks for the risk prediction of coronary heart disease. The second application involves the potential integration of artificial intelligence and high performance modelling with clinical biology for the analysis and visualisation of atherosclerosis related structure. The implementation of these computation tools in phases constitutes initial efforts in the development of a digital clinical atherosclerosis laboratory to assist in the prevention and treatment of cardiovascular heart disease

Genetic diversity affects seedling survival but not growth or seed germination in the Bornean endemic dipterocarp Parashorea tomentella

Background: Logging and habitat fragmentation of tropical rain forests may disrupt patterns of gene flow and genetic diversity. Consequently, inbreeding in tree populations may reduce fitness and increase extinction risks, especially among species that are predominantly outcrossing, dependent on biotic pollination and/or display limited seed dispersal such as species of the Dipterocarpaceae. Aims: To test the hypothesis that heterozygosity of individual progeny affects their likelihood of germination and the growth and survival of seedlings. Methods: Standardised measure of multilocus heterozygosity (sMLH) was estimated from seven microsatellite loci for individual progeny collected from 18 mother trees of the large dipterocarp Parashorea tomentella. The relationships among sMLH, germination and seedling growth and survival were determined for the progeny. Results: Seedling survival over 18 months increased with greater sMLH and fresh fruit weight. This result was expressed under all experimentally controlled combinations of light and nutrient availability in the nursery and in the shaded understorey of primary forest where survival overall was much lower than in the nursery. sMLH did not affect the probability of germination or seedling growth rate in any experimental treatment. Conclusions: These results provide evidence that reduced heterozygosity is associated with reduced seedling survival in a tropical forest tree species

First report of citrus bent leaf viroid in Malaysia

Leaf samples of citrus species such as calamondin (Citrofortunella microcarpa), kaffir lime (Citrus hystrix), key lime (Citrus aurantifolia [C. aurantiifolia]), mandarin orange (Citrus reticulata), pomelo (Citrus maxima) and sweet orange (Citrus sinensis) with stunting, leaf yellowing and epinasty were collected from different states in Malaysia. The rootstocks of these samples were not known. Total nucleic acids were extracted from leaves around the tree canopy and tested by RT-PCR with two sets of primers, CBLV-CM/ CBLV-CP and the newly designed YI4F/YI4R. Altogether, 21 of 133 citrus samples were positive for Citrus bent leaf viroid (CBLVd). The resulting amplicons of 328 bp and 234 bp in size were cloned. Sequence analysis revealed 95-99% identity with CBLVd isolate Jp (accession No. AB006734), confirming the presence of CBLVd (KU194472, KX823338-KX823343) in the tested samples. No particular symptoms were observed in the test samples correlated with the presence of CBLVd, thus the observed symptoms may not be induced by this viroid. This is thought to be the first report of CBLVd in Malaysia

The combined diabetes and renal control trial (C-DIRECT) - a feasibility randomised controlled trial to evaluate outcomes in multi-morbid patients with diabetes and on dialysis using a mixed methods approach

Background: This cluster randomised controlled trial set out to investigate the feasibility and acceptability of the “Combined Diabetes and Renal Control Trial” (C-DIRECT) intervention, a nurse-led intervention based on motivational interviewing and self-management in patients with coexisting end stage renal diseases and diabetes mellitus (DM ESRD). Its efficacy to improve glycaemic control, as well as psychosocial and self-care outcomes were also evaluated as secondary outcomes. Methods: An assessor-blinded, clustered randomised-controlled trial was conducted with 44 haemodialysis patients with DM ESRD and ≥ 8% glycated haemoglobin (HbA1c), in dialysis centres across Singapore. Patients were randomised according to dialysis shifts. 20 patients were assigned to intervention and 24 were in usual care. The C-DIRECT intervention consisted of three weekly chair-side sessions delivered by diabetes specialist nurses. Data on recruitment, randomisation, and retention, and secondary outcomes such as clinical endpoints, emotional distress, adherence, and self-management skills measures were obtained at baseline and at 12 weeks follow-up. A qualitative evaluation using interviews was conducted at the end of the trial. Results: Of the 44 recruited at baseline, 42 patients were evaluated at follow-up. One patient died, and one discontinued the study due to deteriorating health. Recruitment, retention, and acceptability rates of C-DIRECT were generally satisfactory HbA1c levels decreased in both groups, but C-DIRECT had more participants with HbA1c < 8% at follow up compared to usual care. Significant improvements in role limitations due to physical health were noted for C-DIRECT whereas levels remained stable in usual care. No statistically significant differences between groups were observed for other clinical markers and other patient-reported outcomes. There were no adverse effects. Conclusions: The trial demonstrated satisfactory feasibility. A brief intervention delivered on bedside as part of routine dialysis care showed some benefits in glycaemic control and on QOL domain compared with usual care, although no effect was observed in other secondary outcomes. Further research is needed to design and assess interventions to promote diabetes self-management in socially vulnerable patients