THE CURIOUS CASE OF ‘PSYCHO-OPHTHALMOLOGY’: A NARRATIVE REVIEW OF OPHTHALMOLOGICAL ASPECTS OF PSYCHIATRIC DISORDERS

Consultation Liaison Psychiatry (CLP) deals with the interface shared between psychiatry and various other disciplines of medicine. The interface shared by psychiatry and ophthalmology is among the lesser discussed ones in the field of CLP, despite the fact that it holds clinical relevance in the evaluation, management and outcomes of both psychiatric and ophthalmological disorders. This narrative review focusses on the ophthalmological aspects of psychiatric disorders, with respect to their manifestations, assessment, and management. Psychiatric disorders, including schizophrenia, affective disorders, ‘functional’ disorders, and substance use disorders, have numerous ophthalmic manifestations, which can have clinical implications for the patients. Even the psychotropic drugs given for psychiatric disorders can lead to side effects affecting the eye, but these are among the lesser-discussed side effects. Some psychiatric disorders can be investigated using various ophthalmic functions, the assessments ranging from simple physical examination to the use of instruments like a fundoscope, which can be useful for a psychiatrist in their routine practice. Lastly, eye functions can also be used in the treatment of psychiatric conditions, as is seen in eye movement desensitization and reprocessing. This review reiterates the fact that more attention needs to be given to the field of ‘psycho-ophthalmology’, which holds great promise in the coming days

Association of HADHA expression with the risk of breast cancer: targeted subset analysis and meta-analysis of microarray data

<p>Abstract</p> <p>Background</p> <p>The role of n-3 fatty acids in prevention of breast cancer is well recognized, but the underlying molecular mechanisms are still unclear. In view of the growing need for early detection of breast cancer, Graham et al. (2010) studied the microarray gene expression in histologically normal epithelium of subjects with or without breast cancer. We conducted a secondary analysis of this dataset with a focus on the genes (n = 47) involved in fat and lipid metabolism. We used stepwise multivariate logistic regression analyses, volcano plots and false discovery rates for association analyses. We also conducted meta-analyses of other microarray studies using random effects models for three outcomes--risk of breast cancer (380 breast cancer patients and 240 normal subjects), risk of metastasis (430 metastatic compared to 1104 non-metastatic breast cancers) and risk of recurrence (484 recurring versus 890 non-recurring breast cancers).</p> <p>Results</p> <p>The <it>HADHA </it>gene [hydroxyacyl-CoA dehydrogenase/3-ketoacyl-CoA thiolase/enoyl-CoA hydratase (trifunctional protein), alpha subunit] was significantly under-expressed in breast cancer; more so in those with estrogen receptor-negative status. Our meta-analysis showed an 18.4%-26% reduction in <it>HADHA </it>expression in breast cancer. Also, there was an inconclusive but consistent under-expression of <it>HADHA </it>in subjects with metastatic and recurring breast cancers.</p> <p>Conclusions</p> <p>Involvement of mitochondria and the mitochondrial trifunctional protein (encoded by <it>HADHA </it>gene) in breast carcinogenesis is known. Our results lend additional support to the possibility of this involvement. Further, our results suggest that targeted subset analysis of large genome-based datasets can provide interesting association signals.</p

Reliability Risk Evaluation during the Conceptual Design Phase

I (Relative Reliability Risk Index) is calculated and the idea of concept functionality graphs is presented.  This method is applied on the example of seat suspensions for an off highway vehicle and the results are discussed. The findings help to sort out the concepts that are relatively strong in terms of reliability.

Intracrystalline deformation and nanotectonic processes in magnetite from a naturally deformed rock

Although experimental studies have shown dislocation creep to be an important deformation mechanism in magnetite at medium to high temperature, evidence of intracrystalline deformation in magnetite remains to be established in natural tectonically deformed rocks. In this study we investigate intracrystalline deformation features and nanostructures in elongated magnetite from a naturally deformed rock (mylonitized mica schist deformed in a large-scale shear zone of the Seve nappe, Swedish Caledonides). The magnetite grains have very high aspect ratios (up to 10.40) that result in very high degree of magnetic anisotropy in the rock. We show low and high angle grain boundaries (LAGB and HAGB) in magnetite using a combination of electron backscatter diffraction and high-resolution transmission electron microscopy (HRTEM) analysis. HRTEM studies on lamellae excavated perpendicular to the LAGB and HAGB reveal translational and rotational Moiré fringes, respectively. Dislocations, slip bands, stacking faults, twins and recrystallized domains are observed in the vicinity of the grain boundaries, thus providing unequivocal evidence of intracrystalline deformation of magnetite. Our study also reveals the presence of biotite inclusions intergrown epitaxially with magnetite that show no evidence of lattice defects, thus suggesting that the intracrystalline deformation of magnetite took place under wet conditions. The movement at the grain boundaries is interpreted as a response to regional tectonics with a top-to-NW transport direction. It is established that at the nanoscale, the LAGB and HAGB were favourably oriented to accommodate strain dominantly by translation and rotation, respectively. Thus, the nanotectonic processes are consistent with the regional tectonic reference frame. The importance of evaluating ductile behaviour of magnetite from deformed polymineralic rocks in petrofabric analysis and modeling the relation between strain and rock magnetic anisotropy is discussed

Reliability and realizability risk evaluation of concept designs

This thesis addresses the improvement in quality of decision making in design through the use of decomposed design evaluation. The research reported in this thesis is supported by the Design Research Methodology. To perform decomposed decision making, it is necessary to identify criteria that are deemed important for this activity. Questionnaire surveys, literature review and interviews with industry helped to identify these criteria. Reliability and realizability are two criteria that are selected for research in this thesis. The questionnaire surveys are discussed in chapter 2. A review of literature on decision making, reliability and realizability is reported in chapters 3 and 4. Methodologies for evaluating reliability and physical realizability are discussed in chapter 5. Relative reliability risk assessment methodology is applied to various examples consisting of university and industry projects in chapter 6. The application helps to reveal the strengths of the methodology and is termed ‘Verification of the methodology’. Validation issues of both the methodologies are dealt with in chapter 7 using the controlled experimental design. It is found that both the methodologies help to improve the quality of decision making during design evaluation. Relative reliability risk evaluation methodology helps to improve the quality of decision making to a substantial extent but physical realizability evaluation methodology shows only a little improvement in quality of decision making. Finally, it is suggested that the decomposed design evaluation methodology helps to improve the quality of decision making and is therefore proposed to be used by both novice and experienced designers

Metals and Disease: A Global Primary Health Care Perspective

Metals are an important and essential part of our daily lives. Their ubiquitous presence and use has not been without significant consequences. Both industrial and nonindustrial exposures to metals are characterized by a variety of acute and chronic ailments. Underreporting of illnesses related to occupational and environmental exposures to chemicals including metals is of concern and presents a serious challenge. Many primary care workers rarely consider occupational and environmental exposures to chemicals in their clinical evaluation. Their knowledge and training in the evaluation of health problems related to such exposures is inadequate. This paper presents documented research findings from various studies that have examined the relationship between metal exposures and their adverse health effects both in developing and developed countries. Further, it provides some guidance on essential elements of a basic occupational and environmental evaluation to health care workers in primary care situations

Impact of videoconferencing applications on mental health

Under the circumstances of the current COVID-19 pandemic, videoconferencing applications (apps) have come into the mainstream across the world. Owing to their easy availability and cost-effectiveness, they are used in personal as well as professional lives to communicate. They have been very helpful for students and professionals to ensure that their routine work did not halt when various countries imposed lockdown rules restricting travel, social gatherings and other measures that resulted in reduced in-person meetings. However, they have their own set of disadvantages, aptly called 'Zoom gloom/fatigue', named after a popular videoconferencing platform. Users are also noted to have anxiety while using these apps. Therefore, immediate attention is warranted to ensure cautious usage and to reduce the distress associated with videoconferencing apps while maintaining the obvious advantages that these methods have rapidly spread all over the world

Association of Urinary Phthalates with Self-Reported Eye Affliction/Retinopathy in Individuals with Diabetes: National Health and Nutrition Examination Survey, 2001-2010

Background. An epidemiological association between exposure to phthalates and type 2 diabetes (T2D) is known. However, the potential role of environmental phthalates in the complications of T2D is unknown. Methods. Using data from the National Health and Nutrition Examination Survey (NHANES) 2001-2010, we studied the association of 12 urinary phthalate metabolites with self-reported eye affliction/retinopathy in 1,004 participants with diabetes. Data from retinal imaging was used to validate this outcome. Independence of the phthalates→T2D association was studied by adjusting for age, sex, race, marital status, educational attainment, poverty income ratio, physical activity, glycated hemoglobin levels, total serum cholesterol, serum high-density lipoprotein cholesterol, serum triglycerides, blood pressure, duration of diabetes, total calorie intake, and obesity. Results. Self-reported eye affliction/retinopathy had 82% accuracy with Cohen\u27s kappa of 0.31 (p \u3c 0.001). Urinary mono-n-octyl phthalate (MOP) was independently associated with the likelihood of self-reported eye affliction/retinopathy in subjects with T2D after accounting for all the confounders. This significance of this association was robust to the potential misclassification in cases and controls of retinopathy. Further, a significant dose-response relationship between MOP and self-reported eye affliction/retinopathy was demonstrable. Conclusions. We show a novel epidemiological link between the environment and diabetic complications in NHANES 2001-2010 participants

Association of Urinary Phthalates with Self-Reported Eye Affliction/Retinopathy in Individuals with Diabetes: National Health and Nutrition Examination Survey, 2001-2010

Background. An epidemiological association between exposure to phthalates and type 2 diabetes (T2D) is known. However, the potential role of environmental phthalates in the complications of T2D is unknown. Methods. Using data from the National Health and Nutrition Examination Survey (NHANES) 2001-2010, we studied the association of 12 urinary phthalate metabolites with self-reported eye affliction/retinopathy in 1,004 participants with diabetes. Data from retinal imaging was used to validate this outcome. Independence of the phthalates→T2D association was studied by adjusting for age, sex, race, marital status, educational attainment, poverty income ratio, physical activity, glycated hemoglobin levels, total serum cholesterol, serum high-density lipoprotein cholesterol, serum triglycerides, blood pressure, duration of diabetes, total calorie intake, and obesity. Results. Self-reported eye affliction/retinopathy had 82% accuracy with Cohen\u27s kappa of 0.31 (p \u3c 0.001). Urinary mono-n-octyl phthalate (MOP) was independently associated with the likelihood of self-reported eye affliction/retinopathy in subjects with T2D after accounting for all the confounders. This significance of this association was robust to the potential misclassification in cases and controls of retinopathy. Further, a significant dose-response relationship between MOP and self-reported eye affliction/retinopathy was demonstrable. Conclusions. We show a novel epidemiological link between the environment and diabetic complications in NHANES 2001-2010 participants