Computer aided Warship Stability Assessment

Computer aided warship stability assessment, software program effectively puts a ship stability expert onboard and provides ship board personnel with a rapid and accurate means to assess changes in vessel's stability. These changes may be :Routine - as the ship is loaded/unloaded in harbour or due to consumables enroute.Emergency - when the ship suffers collision/battle damage underway and begins to take on water.After assessing the stability status, the program helps the crew to determine the actions needed to restore optimum stability

Genetic evaluation of Kankrej bulls by different sire evaluation methods

The genetic evaluation of Kankrej bulls was done by using three different methods viz., BLUP, Wombat sire, and Wombat animal models. First lactation 305-days yields of 348 daughters born to 9 sires and calved from 2016 to 2020 were used for the analyses. For BLUP analysis, season and year of calving were considered as fixed effects, and sire was considered as random effect. The overall average estimate of 2414.40 kg was obtained in BLUP method while 2430.29 kg was obtained in both Wombat sire and animal models. The results revealed that the Wombat animal model discriminated against the sires to the maximum extent followed by Wombat sire and BLUP models. Based on the results, two Kankrej bulls viz., K.8.32 and K.8.62 can be selected as proven bulls for nominated mating for improving the milk productivity of Kankrej cattle.

Moving Beyond Christianity: Islam, Judaism, Hinduism and Mental Health

To date the literature on religion and mental health has focused upon Christianity. We cannot assume that these findings can be transposed onto other faith groups. In this paper I focus upon Islam, Judaism and Hinduism and discuss understandings of mental illness and the relationships between central beliefs and mental health. I discuss implications for clinical work and psychotherapy

Distinguishing emotional distress from mental disorder: A qualitative exploration of the Four-Dimensional Symptom Questionnaire (4DSQ).

BACKGROUND: Primary care clinicians see people experiencing the full range of mental health problems. Determining when symptoms reflect disorder is complex. The Four-Dimensional Symptom Questionnaire (4DSQ) uniquely distinguishes general distress from depressive and anxiety disorders. It may support diagnostic conversations and targeting of treatment. AIM: We aimed to explore peoples' experiences of completing the 4DSQ and their perceptions of their resulting score profile across distress, depression, anxiety and physical symptoms. DESIGN AND SETTING: A qualitative study conducted in the UK with people recruited from primary care and community settings. METHOD: Participants completed the 4DSQ then took part in semi-structured telephone interviews. They were interviewed about their experience of completing the 4DSQ, their perceptions of their scores across four dimensions, and the perceived utility if used with a clinician. Interviews were transcribed verbatim and data were analysed thematically. RESULTS: Twenty-four interviews were conducted. Most participants found the 4DSQ easy to complete and reported that scores across the four dimensions aligned well with their symptom experience. Distinct scores for distress, depression and anxiety appeared to support improved self-understanding. Some valued the opportunity to discuss their scores and provide relevant context. Many felt the use of the 4DSQ with clinicians would be helpful and likely to support treatment decisions, although some were concerned about time-limited consultations. CONCLUSION: Distinguishing general distress from depressive and anxiety disorders aligned well with people's experience of symptoms. Use of the 4DSQ as part of mental health consultations may support targeting of treatment and personalisation of care

Changes in expression of polyamines and ethylene biosynthesis genes in groundnut (Arachis hypogaea L.) genotypes during Sclerotium rolfsii infection

Stem rot disease caused by fungal pathogen, Sclerotium rolfsii Sacc., is potential threat to groundnut production in warm and humid condition. After host-pathogen interaction, a multitude of plant resistance associated reactions are initiated. In the present investigation we studied the role of polyamines and ethylene during host-pathogen interaction in stem rot tolerant (CS319, GG17 and GG31) and susceptible (TG37A) groundnut genotypes at 24, 48 and 72 h after infection. Stem rot tolerant genotypes showed higher expression of polyamine biosynthesis genes ornithine decarboxylase (Ordec), spermine synthase (Sms) and lipoxygenase1 (LOX1) gene at 72 h after infection than that of susceptible genotype TG37A. The expression analysis of ethylene biosynthesis genes (1-aminocyclopropane-1-carboxylate oxidase: ACCO and (ACCS) showed up regulation in stem rot susceptible genotype TG37A than that of tolerant genotypes after infection at all stages (24, 48 and 72 h after infection). The expression of amine oxidase (AMO) gene was observed highest in stem rot susceptible genotype TG37A while minimum in GJG31. Expression of this gene was remarkably induced in TG37A which may leads to higher accumulation of H2O2. Higher content of a polyamine, putrescine was found in the leaves of stem rot tolerant genotypes at 48 and 72 h after infection. These results implied that tolerant genotypes induced higher polyamine biosynthesis which may involve in plant defense and impart tolerance/ resistance. While, susceptible genotype (TG37A), utilized higher flux of S-Adenosyl methionine (SAM) for ethylene biosynthesis which may leads to necrosis of plants. Thus, stem rot resistant genotypes may be developed through genetic manipulation of polyamine biosynthesis pathway

The clinical and cost-effectiveness of corticosteroid injection versus night splints for carpal tunnel syndrome (INSTINCTS trial): an open-label, parallel group, randomised controlled trial

Background To our knowledge, the comparative effectiveness of commonly used conservative treatments for carpal tunnel syndrome has not been evaluated previously in primary care. We aimed to compare the clinical and cost-effectiveness of night splints with a corticosteroid injection with regards to reducing symptoms and improving hand function in patients with mild or moderate carpal tunnel syndrome. Methods We did this randomised, open-label, pragmatic trial in adults (≥18 years) with mild or moderate carpal tunnel syndrome recruited from 25 primary and community musculoskeletal clinics and services. Patients with a new episode of idiopathic mild or moderate carpal tunnel syndrome of at least 6 weeks' duration were eligible. We randomly assigned (1:1) patients (permutated blocks of two and four by site) with an online web or third party telephone service to receive either a single injection of 20 mg methylprednisolone acetate (from 40 mg/mL) or a night-resting splint to be worn for 6 weeks. Patients and clinicians could not be masked to the intervention. The primary outcome was the overall score of the Boston Carpal Tunnel Questionnaire (BCTQ) at 6 weeks. We used intention-to-treat analysis, with multiple imputation for missing data, which was concealed to treatment group allocation. The trial is registered with the European Clinical Trials Database, number 2013-001435-48, and ClinicalTrial.gov, number NCT02038452. Findings Between April 17, 2014, and Dec 31, 2016, 234 participants were randomly assigned (118 to the night splint group and 116 to the corticosteroid injection group), of whom 212 (91%) completed the BCTQ at 6 weeks. The BCTQ score was significantly better at 6 weeks in the corticosteroid injection group (mean 2·02 [SD 0·81]) than the night splint group (2·29 [0·75]; adjusted mean difference −0·32; 95% CI −0·48 to −0·16; p=0·0001). No adverse events were reported. Interpretation A single corticosteroid injection shows superior clinical effectiveness at 6 weeks compared with night-resting splints, making it the treatment of choice for rapid symptom response in mild or moderate carpal tunnel syndrome presenting in primary care

Treatment patterns and clinical outcomes

BACKGROUND: Treatment resistant depression (TRD) characterizes a subgroup of 10-30% of patients with major depressive disorder, and is associated with considerable morbidity and mortality. A consensus treatment for TRD does not exist, which often leads to wide variations in treatment strategies. Real-world studies on treatment patterns and outcomes in TRD patients in Europe are lacking and could help elucidate current treatment strategies and their efficacy. METHODS: This non-interventional cohort study of patients with TRD (defined as treatment failure on ≥2 oral antidepressants given at adequate dose and duration) with moderate to severe depression collected real-world data on treatment patterns and outcomes in several European countries. Patients were started on a new treatment for depression according to routine clinical practice. RESULTS: Among 411 patients enrolled, after 6 months, only 16.7% achieved remission and 73.5% showed no response. At Month 12, while 19.2% achieved remission and 69.2% showed no response, 33.3% of those in remission at Month 6 were no longer in remission. Pharmacological treatments employed were heterogenous; 54 different drugs were recorded at baseline, and the top 5 treatment types according to drug classes accounted for 40.0% of patients. Even though remission rates were very low, at Month 12, 60.0% of patients had not changed treatment since enrolment. CONCLUSIONS: The heterogeneity of treatments highlights a lack of consensus. Moreover, despite low response rates, patients often remained on treatments for substantial periods of time. These data further support existence of an unmet treatment need for TRD patients in Europe.publishersversionpublishe

Healthcare resource utilization

Background: Treatment resistant depression (TRD) is diagnosed when patients experiencing a major depressive episode fail to respond to ≥2 treatments. Along with substantial indirect costs, patients with TRD have higher healthcare resource utilization (HCRU) than other patients with depression. However, research on the economic impact of this HCRU, and differences according to response to treatment, is lacking. Methods: This multicenter, observational study documented HCRU among patients with TRD in European clinical practice initiating new antidepressant treatments. Data regarding access to outpatient consultations and other healthcare resources for the first 6 months, collected using a questionnaire, were analyzed qualitatively according to response and remission status. The economic impact of HCRU, estimated using European costing data, was analyzed quantitatively. Results: Among 411 patients, average HCRU was higher in non-responders, attending five times more general practitioner (GP) consultations and spending longer in hospital (1.7 versus 1.1 days) than responders. Greater differences were observed according to remission status, with non-remitters attending seven times more GP consultations and spending approximately three times longer in hospital (1.7 versus 0.6 days) than remitters. Consequently, the estimated economic impacts of non-responders and non-remitters were significantly greater than those of responders and remitters, respectively. Limitations: Key limitations are small cohort size, absence of control groups and generalizability to different healthcare systems. Conclusion: Patients with TRD, particularly those not achieving remission, have considerable HCRU, with associated economic impact. The costs of unmet TRD treatment needs are thus substantial, and treatment success is fundamental to reduce individual needs and societal costs.publishersversionpublishe