In-Depth Comparison of Genetic Variants Demonstrates a Close Relationship Between Invasive and Intraductal Components of Prostate Cancer.

Intraductal carcinoma (IDC) of the prostate is often associated with concurrent high-grade invasive prostate cancer (PCa) and poor clinical outcomes. In this context, IDC is thought to represent the retrograde spread of invasive prostatic adenocarcinoma into the acini and ducts. Prior studies have demonstrated a concordance of PTEN loss and genomic instability between the IDC and high-grade invasive components of PCa, but larger genomic association studies to solidify our understanding of the relationship between these 2 lesions are lacking. Here, we evaluate the genomic relationship between duct-confined (high-grade prostatic intraepithelial neoplasia and IDC) and invasive components of high-grade PCa using genetic variants generated by whole exome sequencing. High-grade prostatic intraepithelial neoplasia and IDC were laser-microdissected, and PCa and nonneoplastic tissue was manually dissected from 12 radical prostatectomies. A targeted next-generation sequencing panel was used to identify disease-relevant variants. Additionally, the degree of overlap between adjacent lesions was determined by comparing exome-wide variants detected using whole exome sequencing data. Our results demonstrate that IDC and invasive high-grade PCa components show common genetic variants and copy number alterations. Hierarchical clustering of genome-wide variants suggests that in these tumors, IDC is more closely related to the high-grade invasive components of the tumor compared with high-grade prostatic intraepithelial neoplasia. In conclusion, this study reinforces the concept that, in the context of high-grade PCa, IDC likely represents a late event associated with tumor progression.

Selective time-dependent changes in activity and cell-specific gene expression in human postmortem brain.

As a means to understand human neuropsychiatric disorders from human brain samples, we compared the transcription patterns and histological features of postmortem brain to fresh human neocortex isolated immediately following surgical removal. Compared to a number of neuropsychiatric disease-associated postmortem transcriptomes, the fresh human brain transcriptome had an entirely unique transcriptional pattern. To understand this difference, we measured genome-wide transcription as a function of time after fresh tissue removal to mimic the postmortem interval. Within a few hours, a selective reduction in the number of neuronal activity-dependent transcripts occurred with relative preservation of housekeeping genes commonly used as a reference for RNA normalization. Gene clustering indicated a rapid reduction in neuronal gene expression with a reciprocal time-dependent increase in astroglial and microglial gene expression that continued to increase for at least 24 h after tissue resection. Predicted transcriptional changes were confirmed histologically on the same tissue demonstrating that while neurons were degenerating, glial cells underwent an outgrowth of their processes. The rapid loss of neuronal genes and reciprocal expression of glial genes highlights highly dynamic transcriptional and cellular changes that occur during the postmortem interval. Understanding these time-dependent changes in gene expression in post mortem brain samples is critical for the interpretation of research studies on human brain disorders.

A small-scale study of plant orientation in treatment performance of vertical flow constructed wetland in continuous flow.

In constructed wetland (CW) ecology, plants play a vital role in wastewater treatment. The plants provide an adequate surface to various microorganisms, transfers oxygen and uptake nutrients to treat wastewater. This study deals with the treatment of greywater by using vertical flow constructed wetland system (VFCW). In the present study, two reactors were prepared for two different orientations in monoculture (S-1) and mixed culture (S-2) by using four types of macrophytes (Canna indica, Colocasia, Hymenocallis littoralis, and Phragmites australis). The reactors were operated in continuous mode for 90 days by maintaining the 10 mL/min flow rate and 1-day retention time. The mean removal efficiency of S-1 is 40.70, 33.69, 27.13, 48.17, 66.76, and 50.82% for ammonia, total kjeldahl nitrogen (TKN), phosphate, sulfate, turbidity, and chemical oxygen demand (COD), respectively. The mean removal efficiency of S-2 CW is 53.06, 34.54, 37.49, 48.64, 69.26, and 58.26% for ammonia, TKN, phosphate, sulfate, turbidity, and COD, respectively. ANOVA showed significant differences among both VFCWs in removal efficiency for all measured parameters. The performance of the two systems was compared with each other with the significance level of p = 0.05. The results indicated that the orientation of plant plays a major role in the removal of various physicochemical parameters.

Anxiety and Depression during COVID-19 Pandemic among Medical Students in Nepal.

Background Medical students' psychological response to societal lockdown during the COVID-19 pandemic has not been studied much. Objective To assess levels of anxiety and depression among medical students during initial stages of COVID-19 pandemic in Nepal and relate their distress to relevant variables. Method A cross-sectional study with online questionnaire was conducted among medical students at different colleges in Nepal. Hospital Anxiety and Depression Scale (HADS) detected 'anxiety' and 'depression'. The covariates were explored by logistic regression analyses. Result A total 416 medical students [mean age: 22.2 (2.1); males 57.7%, females 42.3%] participated. HADS-anxiety scores [mean: 7.1(4.3)] were significantly and positively correlated with HADS-depression [mean: 5.9 (4.1)] (r=0.695; p < 0.001). Point prevalence of total HADS caseness (HADS-T) was 26.7%. Specific HADS-defined caseness were: anxiety (HADS-A) 11.8%, depression (HADS-D) 5.5%, and comorbid anxiety and depression (HADS-cAD) 9.4%. All four types of caseness were significantly more prevalent among students with a history of mental problems (AOR=4.7, 3.2, 2.6, and 3.2 respectively). HADS-T was higher among those with a concurrent physical illness (AOR=2.4). HADS-T, HADS-A and HADS-D scores were higher among the age group > 22 years (AOR= 2.2, 2.5 and 4.4 respectively). HADS-cAD was almost threetimes higher among those with a possible COVID-19 exposure (AOR=2.8). Conclusion A significant number of medical students in Nepal suffered from high levels of anxiety and depression during the COVID-19 shut-down. The students in the higher (> 22 years) age group, those with past mental disorders, possible COVID-19 exposure, and concurrent physical illness showed elevated levels of anxiety and/or depression.

The Study of Burden of Family Caregivers of Patients Living with Psychiatric Disorders in Remote Area of Nepal.

Background Family caregivers of psychiatric disorders likely to face burden. There is a paucity of data regarding the caregiver burden in psychiatric disorders in context of Nepal. Objective To study the caregiver burden in families with psychiatric illness and to find association between socio-demographic variables and caregiver burden in families with psychiatric illness. Method This is an analytical cross-sectional study. The participants (n=96) were caregiver of patients visiting outpatient department of two government of Nepal primary health care centers namely, Panchkhal Primary Health Care Center (PHC) Kavre District and Barhabise Health Care Center Sindhupalchowk district. The sample size has been determined by using statistical formula. Family burden assessment schedule (FBIS) was used for the study. Result The majority of the caregivers were females 56.3%. Most of the caregivers were aged below 45 years 54.2%. The large number of participants were single or separated 74%. The mean score of family burden assessment schedule was 27 ± 9.8 (range 0 to 48) with positive rate of 59.4%.Among the objective burden domains disruption of family leisure 61.5% was the most frequently reported burden. The subjective burden was reported in 95%. There were significant differential demographic associations with different domains of caregivers' burden. Conclusion Caregivers of Psychiatric patients experience different kind of burden of care. Our findings highlight the support to the family members to reduce their burden.

Sustainability and performance analysis of constructed wetland for treatment of greywater in batch process.

In the current scenario, there is a rising interest in the treatment of greywater to be used for non-potable purposes. However, there is a need to understand the role of plants in the treatment process. In this context, this paper addresses the comparison of the treatment efficiency of planted systems with the unplanted system. Thus, three gravel-based constructed wetlands were made, i.e., one without plants and two with plants (Typha latifolia and Phragmites australis). The wetland system was used in batch mode operation. The results suggested that the efficacy of the planted system was better than the unplanted system. The removal efficiency of different physicochemical parameters (Chemical oxygen demand, Biochemical oxygen demand, Solids and Total kjeldahl nitrogen) were observed to be more in planted system(61, 43,23 and 25% respectively for plant-1(P-1) system and; 51, 29, 23, and 27% respectively for plant-2 (P-2) system) as compared to the unplanted system(38, 15, 18, and 14% respectively). In addition, it was also observed that P. australis cannot sustain for a longer time in the treatment process but it recovers after some time.

Depression, Alcohol Use, Antiretroviral Therapy Adherence and HIV Status among HIV-infected from Multiple Antiretroviral Therapy Clinics in Nepal.

Background Depression and alcohol use disorder are very common among people living with HIV infection, these disorders are not only common among HIV patients but also associated with antiretroviral therapy (ART) non adherence, morbidity and mortality. Objective The objective of our study is to study the prevalence of Depression, Alcohol use, and ART treatment adherence. Method This is a analytical cross-sectional study. Total of 221 participants were included in the study. Convenient method of sampling was used to collect the data from three district Kathmandu, Lalitpur and Kavre ART (Antiretroviral treatment) clinics. Beck Depression Inventory (BDI) was used for the assessment of depression, Alcohol use disorders identification test (AUDIT) was used for alcohol related problems and Visual analogue scale (VAS) was used for treatment adherence. Chi square test and multiple linear regression analysis were conducted for testing bivariate and multivariate relationship of sociodemographic and clinical factors with depression and treatment adherence. Result The 40% participants found to have depression. Variables associated with depression significantly after multiple regression analysis were employment (p value=0.04) and mode of transmission (p value= 0.003). More than half, 56% of the participant's CD4+ cells count was < 500 per cubic millimetre and 71% participant's viral load was undetectable. Clinical variables mode of transmission (pvalue=0.000), duration of illness (p value=0.03) and duration of treatment (p value=0.01) were significantly associated with depression. ART treatment adherence was significantly associated with CD4 cell (p value=0.02) and viral load (p value= 0.05). Conclusion Depression is very prominent among HIV positive patients. Low CD4+ cell count and high viral load has been seen among patients who are not adherent to antiretroviral treatment. It is suggested that clinicians should carefully assess the possibility of depressive symptoms in their patients on ART treatment.

Biotransformation of flower waste composting: Optimization of waste combinations using response surface methodology.

Flower waste (FW) is disposed off in the rivers or mixed with solid waste for landfilling that pollutes the environment and causes harmful effects on human health and aquatic life. It is rich in nutrient content and easily converted into the compost. Therefore, the objective of the present research was to optimize the combinations of flower waste and cow dung during agitated pile composting using response surface methodology. Thirteen different agitated piles were used for composting using the central composite design. The optimum combination from central composite design was 65 kg floral waste, 25 kg cattle dung and 10 kg sawdust having 7.10 pH, 3.31 mS cm-1 electrical conductivity, 32.98% total organic carbon and 14 Carbon to Nitrogen ratio during the end phase of the composting period. The nutrient concentrations into the final compost were within the acceptable limit and also found to be beneficial for the growth of plants.

Role of sawdust and cow dung on compost maturity during rotary drum composting of flower waste.

Flower waste is the good source of organic matter which is beneficial for the growth of plants. It can be extracted from the abundant flower waste resources. The present study was carried out to examine the role of sawdust and cow dung on the compost maturity from six different combinations of waste mixture. Role of cow dung was significant, however, saw dust played a critical role to arrest the leachate and also to maintain the aerobic condition. Addition of sawdust is crucial as flower waste may get converted into a lump (ball like structure) without adding the bulking agent. At the completion of composting period, the concentration of macro and micronutrients, CO2 evolution and C/N ratio showed the stable matured compost which is useful for the purpose of agriculture.

Effectiveness of Mannheim Peritonitis Index in Predicting the Morbidity and Mortality of Patients with Hollow Viscus Perforation.

Background Peritonitis due to hollow viscus perforation is one of common surgical emergency. Its accurate diagnosis and management is a challenge to every surgeon. This led to the development of disease severity grading systems that would aid in management and appropriately predict possible outcome. Objective Evaluation of Mannheim Peritonitis Index (MPI) score for predicting the morbidity and mortality in patients with peritonitis due to hollow viscus perforation. Method Prospective study of 126 patients operated for perforation peritonitis in Manipal College of Medical Sciences, Pokhara, Nepal from May 2015 to April 2018. Mannheim Peritonitis Index score was calculated for each patient. Data was analysed for predicting mortality and morbidity using SPSS 20. Pearson's Chisquare was used as a statistical test and considered as significant difference if p ≤ 0.05. Result Perforated appendix (35.7%), peptic ulcer perforation (31%) and truma (19%) were common causes of perforation peritonitis. Mean score was 18.55. The overall mortality and morbidity was 9% and 43% respectively with Mannheim Peritonitis Index scores of ≤ 20, 21-29, and ≥ 30 had a mortality of 0%, 14%, and 46% respectively. Presence of generalized peritonitis, organ failure at time of admission, type of intra peritoneal exudate carried more significance in predicting the mortality and morbidity in the post op period than other variables. Conclusion Mannheim Peritonitis Index is a simple and specific scoring system for predicting the mortality in patients with secondary peritonitis. Increasing scores are associated with poorer prognosis, needs intensive management.

Study of Adherence Pattern of Antidepressants in Patients with Depression.

Background Depression is one of the leading psychiatric disorders of the world affecting a person's mood, physical health and behavior. It is not permanent and is neither a character flaw nor a lack in discipline for a person to be ashamed of. It is a disorder that is reliably diagnosed and successfully treated. Antidepressants are the standard and the most efficacious approach to treating people with depression. However, adherence to treatment is necessary for achieving effectiveness. The result of nonadherence is severe and may cause therapeutic failure resulting in poor quality of life. Objective To determine the medication adherence pattern in patients with depression and assess the factors associated with non-adherence to the prescribed antidepressant therapy. Method Patients meeting the inclusion criteria who were diagnosed with depression were taken for the study. Informed consent was taken from the patients or from their relatives in case of their incapability. They were then interviewed using structured questionnaire. Result Among the 60 patients included in the study, 78% of them were females. Most of the patients 43% (n=26) were prescribed with atypical antidepressants. Less number (37%) of the patients were adherent to the antidepressant therapy. 68% of the females were non adherent. 82% of housewives were not adherent to therapy. Forgetfulness was the main reason for missing dose in majority (50%) of the nonadherent patients. Conclusion Majority of the patients with depression were non-adherent to medication. Forgetfulness was the major reason for missing dose in these patients.

Study of Depression, Anxiety and Stress among the Medical Students in two Medical Colleges of Nepal.

Background Medical education is intended to prepare graduates for a promoting health and caring for the sick. Medical students are confronted with significant academic, psychological and existential stressors. There is insufficient information regarding psychological morbidity among Nepalese medical students. Objective To determine the prevalence of depression, anxiety and stress, among the medical students in Nepal, and its association with sociodemographic characteristics. Method A cross-sectional questionnaire based study was conducted including all students from first to fifth year of student using convenience method of sampling from Kathmandu University Medical School (KUSMS), Dhulikhel and Manipal College of Medical Sciences (MCOMS), Pokhara, Nepal. Depression, Anxiety and stress were assessed using Depression Anxiety and Stress Scale (DASS). Additional questions regarding demographic variables were also included in the survey. Data analysis was done on Statistical Package for the Social Sciences SPSS version 16. Result A total of 538 students participated in the study giving a response rate of 89.6%. Aamong them 56.5% were from age group 21-25 years, 42.2% were below 20 years and only 1.3% were above 25 years of age. Among them 52% were female and 48% were male. Our study found that the overall prevalence of depression was 29.9%, anxiety was 41.1% and stress was 27% among all participated medical students. Depression was significantly associated (OR 2.23, 95% CI 1.43-3.47, p<0.001) with living condition (living in hostel or rented house). Conclusion The higher level of psychiatric morbidity depression 29.9%, anxiety 41.1% and stress 27% among undergraduate medical students warrants needs for strategic plans to alleviate depression anxiety and the stressors right from the time they join medical school and has to be continued till they finish the course.

Characteristics and treatment of greywater--a review.

Safe and sufficient quantity of water is necessary for a healthy growth of human beings. The gap between water demand and available water supply is increasing day by day. Proper sanitation, especially decentralized approach, can solve the problem of water supply and wastewater management and that can be done by reuse of greywater. Typically, from a household, greywater (GW) flow is around 65 % of the total wastewater flow. Further light greywater is around 50 % of the total GW. Hence, GW has a high potential for recycle and reuse. The aim of this article is to reveal the present state of art in GW treatment and to identify the further scope for research. Present article contains a review on per capita GW generation, GW characteristics, and its treatment. Around 22 treatment systems comprising different treatment processes are discussed in detail for removal efficiency of pollutants, effluent concentrations and their compliance with wastewater reuse guidelines and standards. Constructed wetland and filtration were found efficient in the removal of most of the reuse parameters compared to other technologies. Anaerobic followed by aerobic system with post-disinfection unit may be a sustainable option for GW treatment for reuse. There is a need to develop the technologies for GW treatment at household level to increase the reuse practises at grass root level. Further, there is need of development of flow diagram with different technologies by targeting the type of reuse (flushing, gardening, agriculture, etc.).

Variation in temperature during composting of food and vegetable waste.

Composting is one of the suitable method for disposal of organic waste and convert it in to organic fertilizer. For effective composting, role of temperature within the composting heap is important. Variation of temperature in the composting heap is the indicator of type of microbial biomass present during the composting. Present study was conducted to find out the minimum volume of waste for effective composting. The present study was conducted in two phases. The first phase of study was conducted to monitor the temperature variation in different volume of composting heap and second phase of study was conducted to study the leachate production in food and vegetable waste. The results of the present study revealed that minimum 80 and 100 kg of food and vegetable waste required maintaining the thermophilic and mesophilic stage. To attain the thermophilic stage the minimum volume should be around 0.5 m3 and minimum height 0.6m. Leachate was produced at initial stage of degradation and it was more in vegetable waste compared to food waste.

Vermicomposting of source-separated human faeces by Eisenia fetida: effect of stocking density on feed consumption rate, growth characteristics and vermicompost production.

The main objective of the present study was to determine the optimum stocking density for feed consumption rate, biomass growth and reproduction of earthworm Eisenia fetida as well as determining and characterising vermicompost quantity and product, respectively, during vermicomposting of source-separated human faeces. For this, a number of experiments spanning up to 3 months were conducted using soil and vermicompost as support materials. Stocking density in the range of 0.25-5.00 kg/m(2) was employed in different tests. The results showed that 0.40-0.45 kg-feed/kg-worm/day was the maximum feed consumption rate by E. fetida in human faeces. The optimum stocking densities were 3.00 kg/m(2) for bioconversion of human faeces to vermicompost, and 0.50 kg/m(2) for earthworm biomass growth and reproduction.

Vermicomposting of source-separated human faeces for nutrient recycling.

The present study examined the suitability of vermicomposting technology for processing source-separated human faeces. Since the earthworm species Eisenia fetida could not survive in fresh faeces, modification in the physical characteristics of faeces was necessary before earthworms could be introduced to faeces. A preliminary study with six different combinations of faeces, soil and bulking material (vermicompost) in different layers was conducted to find out the best condition for biomass growth and reproduction of earthworms. The results indicated that SVFV combination (soil, vermicompost, faeces and vermicompost - bottom to top layers) was the best for earthworm biomass growth indicating the positive role of soil layer in earthworm biomass growth. Further studies with SVFV and VFV combinations, however, showed that soil layer did not enhance vermicompost production rate. Year-long study conducted with VFV combination to assess the quality and quantity of vermicompost produced showed an average vermicompost production rate of 0.30kg-cast/kg-worm/day. The vermicompost produced was mature as indicated by low dissolved organic carbon (2.4+/-0.43mg/g) and low oxygen uptake rate (0.15+/-0.09mg O(2)/g VS/h). Complete inactivation of total coliforms was noted during the study, which is one of the important objectives of human faeces processing. Results of the study thus indicated the potential of vermicomposting for processing of source-separated human faeces.