γ-Resistant Microporous CAU-1 MOF for Selective Remediation of Thorium.

A simple solvothermal method was used to synthesize a metal-organic framework (MOF) with an Al metal entity, viz., CAU-1 NH2. The synthesized MOF was characterized using different techniques like X-ray diffraction, Fourier transform infrared spectroscopy, thermogravimetric analysis, scanning electron microscopy (SEM), field emission SEM (FE-SEM), transmission electron microscopy, small-angle X-ray scattering, positron annihilation lifetime spectroscopy, and X-ray photoelectron spectroscopy. The radiation stability was evaluated by irradiating the material up to a cumulative dose of 2 MGy using 60Co for the first time. The studies showed a remarkable gamma irradiation stability of the material up to 1 MGy. The porosity and surface area of the synthesized MOF were determined by Brunauer-Emmett-Teller, which showed a high specific surface area of 550 m2/g. The pH dependence study of Th uptake from an aqueous solution was performed from pH 2-8, followed by adsorption isotherm and adsorption kinetics studies. These results revealed that the Langmuir and pseudo-second-order kinetic models can be well adapted for understanding the Th uptake and kinetics, respectively. The synthesized MOF exhibited an ∼404 mg/g thorium adsorption capacity. Selectivity studies of adsorption of Th w.r.t. to U and different metal ions such as Cu, Co, Ni, and Fe showed that Th gets adsorbed preferentially as compared to other metal ions. In addition, the MOF could be used multiple times without much deterioration.

Highly efficient functionalized MOF-LIC-1 for extraction of U(VI) and Th(IV) from aqueous solution: experimental and theoretical studies.

A set of four new functionalized MOFs, namely MOF-LIC-DPPC, MOF-LIC-GA, MOF-LIC-PCA and MOF-LIC-SA, were synthesized via the post-synthetic modification (PSM) strategy using MOF-LIC-1 for efficient extraction of U(VI) and Th(IV) from an aqueous medium. FTIR, powder XRD, TGA and SEM-EDX were employed for characterization of the functionalized MOFs. Sorption studies for U(VI) and Th(IV) were performed by monitoring the pH and contact time. Interestingly, the modified MOF-LIC-SA displayed rapid (∼5 min) and efficient extraction towards U(VI) and Th(IV) from an aqueous medium and modified MOF-LIC-DPPC displayed enhanced thermal stability (600 °C) compared with the parent MOF-LIC-1 (450 °C). These studies revealed that the grafted functionalities on MOF-LIC-1 possess enhanced sorption efficiency towards U(VI) and Th(IV) as well as thermal stability. MOF-LIC-SA exhibited the highest sorption capacity towards U(VI) and Th(IV), viz. 298 mg g-1 (pH 6) and 149 mg g-1 (pH 6), respectively. Leaching, recyclability, and radiation stability studies were also performed using MOF-LIC-1 MOFs. Additionally, we investigated the nature of U(VI) interactions on MOFs by applying density functional theory (DFT). PSM MOFs with various functionalities display high selectivity and efficient extraction of U(VI) and Th(IV) over a wide pH range (2-9) and also exhibit easy recovery of metal ions from MOFs. These studies reveal that U(VI) and Th(IV) can be extracted from aqueous streams in a pH range from 6 to 8 and potential applications of these MOFs include recovery of U(VI) and Th(IV) from mine water, sea water, etc. The studies reported in the present work also have extensive potential applications for environmental concerns as well as in the nuclear industry.

Systematic review of the use of debates in health professions education - does it work?

Background: It is unavoidable for learners undergoing health professions training to encounter different complex clinical scenarios related to diagnoses, treatment and ethical dilemmas. The lack of standard answers to such clinical challenges can cause uncertainty in the process of teaching, learning and assessment as learners grapple with the need to critically appraise the specific context, past practices and extant literature to arrive at a thoughtful decision. In this aspect, debate can be a useful pedagogical tool to consider multiple, different perspectives regarding these issues. As the use of debate within the health professions education has not been reviewed, we conducted a systematic review of the current literature on the adoption of debate as a pedagogical tool to clarify the specific context of use as well as its effectiveness in the learning of skills and content within the health professions education. Methods: A systematic review was conducted on relevant published literature in English within journal databases until September 2018 that employed debate as a pedagogical tool within health professions education. Results: Out of 626 screened articles, 12 studies were finally included based on inclusion/exclusion criteria. The 12 studies (9 undergraduate, 3 postgraduate) covered a diverse range of disciplines and debate in health professions education was adopted for acquisition of skills (such as critical thinking, communication skills, teamwork), or learning of specific topics (such as patient safety, ethical issues, teaching of new topics) as well as to examine evidence based practice. In the majority of studies (10 of 12 studies, 83.3%), debate has been deemed by the learners to be effective in facilitating the learning of new content and skills such as communication and critical thinking, which are related to processes aligned with adult learning, motivational, reflective and social learning theories. Conclusion: Overall, sparse studies to date with relatively low risk of bias found debate to be effective in enabling the learning of skills and content within health professions education. Future studies may want to incorporate more objective measures of the learning outcomes of learners following the adoption of debate as a teaching tool as well as to examine the combinatorial use of debate with other pedagogical tools and their longitudinal impact on learners and learning.

Randomized Controlled Trials of Psychoeducation Modalities in the Management of Bipolar Disorder: A Systematic Review.

OBJECTIVE: This review sought to summarize the extant literature on the efficacy of 4 modalities of psychoeducation (individual, group, family, internet- based) in the management of patients with bipolar disorder. DATA SOURCES: We searched the digital databases (Science Direct, Scopus, PubMed/MEDLINE) for relevant randomized controlled trials (RCTs) pertaining to psychoeducation in bipolar disorder from inception to February 2017. Keywords and combinations used included psychoeducation, bipolar disorder, individual, family, group, and internet. Reference lists of review articles were also used for retrieval of relevant articles. STUDY SELECTION: We retrieved 48 studies and ultimately reviewed 40 RCTs meeting inclusion criteria. Studies were included if they were in English, were RCTs of different psychoeducation modalities managing patients with bipolar disorder, and used standardized assessment of outcomes of psychoeducation. DATA EXTRACTION: We examined each of the selected publications for relevant data. RESULTS: The majority of psychoeducation RCTs (28 of 40 studies, 70.0%) focused on group and family psychoeducation, with positive benefits reported in clinical outcomes, treatment, and functioning measures. Group psychoeducation was associated with reduced illness recurrences, decreased number and duration of hospitalizations, increased time to illness relapse, better treatment adherence, higher therapeutic lithium levels, and reduced stigma. Family psychoeducation was associated with reductions in illness recurrence, hospitalization rates, and better illness trajectory as well as increased caregiver knowledge, skills, support, and sense of well-being and reduced caregiver burden. There are fewer RCTs on individual and internet-based psychoeducation, with findings being inconsistent or negative. CONCLUSIONS: Future studies may include direct comparisons of different psychoeducation modalities to elucidate specific benefits of unique psychoeducation interventions at different phases of bipolar disorder.

Neurocognitive functioning and quality of life in patients with and without deficit syndrome of schizophrenia.

Deficit syndrome of schizophrenia is a subtype of schizophrenia characterized by primary and enduring negative symptoms. This study examined the differences in neurocognitive functioning and quality of life (QOL) between deficit and non-deficit patients, and specific predictors of both clinical measures. Overall, 344 subjects (175 patients with non-deficit schizophrenia (NDSZ), 58 patients with deficit schizophrenia (DSZ) and 111 healthy controls) were evaluated on severity of psychopathology, QOL and a smaller subset of 198 subjects (104 NDSZ, 27 DSZ, 67 healthy controls) underwent neurocognitive assessments. Multivariate analyses were used to determine differences in outcomes between subject groups and predictors of clinical measures. Both DSZ and NDSZ had significantly worse QOL compared with healthy controls. DSZ had more extensive cognitive deficits compared with healthy controls and performed worse on semantic fluency task compared to NDSZ. Multiple linear regression analysis found that DSZ, shorter duration of illness were associated with poorer QOL whereas fewer years of education, lower premorbid intelligence were associated with poorer overall neurocognitive functioning. The poorer QOL, greater extent of neurocognitive deficits especially semantic fluency associated with DSZ behoves the need for greater attention during clinical evaluation and treatment planning of this subgroup of individuals with schizophrenia.

Interval-Valued Model Level Fuzzy Aggregation-Based Background Subtraction.

In a recent work, the effectiveness of neighborhood supported model level fuzzy aggregation was shown under dynamic background conditions. The multi-feature fuzzy aggregation used in that approach uses real fuzzy similarity values, and is robust for low and medium-scale dynamic background conditions such as swaying vegetation, sprinkling water, etc. The technique, however, exhibited some limitations under heavily dynamic background conditions, as features have high uncertainty under such noisy conditions and these uncertainties were not captured by real fuzzy similarity values. Our proposed algorithm is particularly focused toward improving the detection under heavy dynamic background conditions by modeling uncertainties in the data by interval-valued fuzzy set. In this paper, real-valued fuzzy aggregation has been extended to interval-valued fuzzy aggregation by considering uncertainties over real similarity values. We build up a procedure to calculate the uncertainty that varies for each feature, at each pixel, and at each time instant. We adaptively determine membership values at each pixel by the Gaussian of uncertainty value instead of fixed membership values used in recent fuzzy approaches, thereby, giving importance to a feature based on its uncertainty. Interval-valued Choquet integral is evaluated using interval similarity values and the membership values in order to calculate interval-valued fuzzy similarity between model and current. Adequate qualitative and quantitative studies are carried out to illustrate the effectiveness of the proposed method in mitigating heavily dynamic background situations as compared to state-of-the-art.

Frequency and pattern of radiological and laboratory investigations in patients with mental illnesses: A study from North Rajasthan.

BACKGROUND: There are widespread perceptions that excessive and unnecessary investigations are done in many patients with mental illnesses. There are no studies from India looking into this issue. AIMS: (i) To study the frequency and pattern of various investigations such as electroencephalography (EEG), computerized tomography (CT) scan of head, magnetic resolution imaging (MRI) scan of brain, and blood investigations carried out by the previous doctors on patients seeking treatment in three different settings. (ii) To study the socio-demographic and clinical correlates of investigations carried out on these patients. STUDY DESIGN AND SETTINGS: A cross-sectional study in a community outreach clinic, a district level psychiatric hospital, and psychiatry outpatient clinic of a medical college. MATERIALS AND METHODS: 160 newly registered patients seeking treatment at these settings were assessed using a semi-structured pro forma regarding various investigations that they had undergone before seeking the current consultation. Frequency of investigations was analyzed. RESULTS: About 47.5% of patients had at least one of the three brain investigations done. EEG, CT head, and MRI brain had been done in 37.5%, 20.0%, and 8.8% of the patients, respectively. Only 1.8% of the patients had blood tests done before current consultation. CONCLUSION: This study results raise question whether certain investigations such as EEG and CT head were carried out excessively and blood investigations were done infrequently. Further studies on larger samples with prospective study design to evaluate the appropriateness of current practices of carrying out investigations in patients presenting with psychiatric symptoms are required.

Shared and divergent neurocognitive impairments in adult patients with schizophrenia and bipolar disorder: Whither the evidence?

Recent data from genetic and brain imaging studies have urged rethinking of bipolar disorder (BD) and schizophrenia (SCZ) as lying along a continuum of major endogenous psychoses rather than dichotomous disorders. We systematically reviewed extant studies (from January 2000 to July 2015) that directly compared neurocognitive impairments in adults with SCZ and BD. Within 36 included studies, comparable neurocognitive impairments were found in SCZ and BD involving executive functioning, working memory, verbal fluency and motor speed. The extent and severity of neurocognitive impairments in patients with schizoaffective disorder, and BD with psychotic features occupy positions intermediate between SCZ and BD without psychotic features, suggesting spectrum of neurocognitive impairments across psychotic spectrum conditions. Neurocognitive impairments correlated with socio-demographic (lower education), clinical (more hospitalizations, longer duration of illness, negative psychotic symptoms and non-remission status), treatment (antipsychotics, anti-cholinergics) variables and lower psychosocial functioning. The convergent neurocognitive findings in both conditions support a continuum concept of psychotic disorders and further research is needed to clarify common and dissimilar progression of specific neurocognitive impairments longitudinally.

The 23-Hour Observation Unit Admissions Within the Emergency Service at a National Tertiary Psychiatric Hospital: Clarifying Clinical Profiles, Outcomes, and Predictors of Subsequent Hospitalization.

OBJECTIVE: We examined health care utilization, clinical profiles (such as sociodemographic features, clinical severity), and outcomes (inpatient admission, revisit within 24 hours of discharge) of patients who were admitted to a 23-hour observation unit within the emergency service of a tertiary psychiatric hospital and hypothesized that a specific clinical profile (greater clinical severity, lower psychosocial functioning) predicted subsequent inpatient hospitalization. METHOD: The medical records of all patients admitted to the observation unit from February 5, 2007, to February 4, 2012 (N = 2,158) were assessed for relevant data. Clinical severity and level of psychosocial functioning were assessed using Clinical Global Impressions-Severity (CGI-S) and Global Assessment of Functioning (GAF) scales, respectively. RESULTS: Overall, the patients seen were predominantly Chinese males > 36 years old who had diagnoses including stress-related, anxiety, affective spectrum, and psychotic disorders. The clinical severity score (CGI-S) improved significantly following discharge from the observation unit (t 1,1848 = 23.316; P < .001). Logistic regression analyses revealed that self-referred (P = .001), older patients (P = .007) with past psychiatric history (P = .019), lower GAF scores (P = .025), and less improvement of CGI-S scores (P = .001) were associated with inpatient admission after a 23-hour stay in the observation unit. CONCLUSIONS: Our study findings affirmed our hypothesis and supported the utility of the observation unit in monitoring the overall clinical status of patients, which was linked with subsequent inpatient admissions. Better management of these patients at the outpatient level can potentially decrease unnecessary hospitalization and reduce health care cost as well as illness burden on patients and caregivers.

Neighborhood Supported Model Level Fuzzy Aggregation for Moving Object Segmentation.

We propose a new algorithm for moving object detection in the presence of challenging dynamic background conditions. We use a set of fuzzy aggregated multifeature similarity measures applied on multiple models corresponding to multimodal backgrounds. The algorithm is enriched with a neighborhood-supported model initialization strategy for faster convergence. A model level fuzzy aggregation measure driven background model maintenance ensures more robustness. Similarity functions are evaluated between the corresponding elements of the current feature vector and the model feature vectors. Concepts from Sugeno and Choquet integrals are incorporated in our algorithm to compute fuzzy similarities from the ordered similarity function values for each model. Model updating and the foreground/background classification decision is based on the set of fuzzy integrals. Our proposed algorithm is shown to outperform other multi-model background subtraction algorithms. The proposed approach completely avoids explicit offline training to initialize background model and can be initialized with moving objects also. The feature space uses a combination of intensity and statistical texture features for better object localization and robustness. Our qualitative and quantitative studies illustrate the mitigation of varieties of challenging situations by our approach.

Detection of moving objects using multi-channel kernel fuzzy correlogram based background subtraction.

In this paper, we examine the suitability of correlogram for background subtraction, as a step towards moving object detection. Correlogram captures inter-pixel relationships in a region and is seen to be effective for modeling the dynamic backgrounds. A multi-channel correlogram is proposed using inter-channel and intra-channel correlograms to exploit full color information and the inter-pixel relations on the same color planes and across the planes. We thereafter derive a novel feature, termed multi-channel kernel fuzzy correlogram, composed by applying a fuzzy membership transformation over multi-channel correlogram. Multi-channel kernel fuzzy correlogram maps multi-channel correlogram into a reduced dimensionality space and is less sensitivity to noise. The approach handles multimodal distributions without using multiple models per pixel unlike traditional approaches. The approach does not require ideal background frames for background model initialization and can be initialized with moving objects also. Effectiveness of the proposed method is illustrated on different video sequences.

Glucose-6 phosphate dehydrogenase deficiency and psychotic illness.

Mr. T, a 28-year-old unmarried male, a diagnosed case of Glucose-6 Phosphate Dehydrogenase (G6PD) deficiency since childhood, presented with 13 years of psychotic illness and disturbed biological functions. He showed poor response to antipsychotics and mood stabilizers and had three prior admissions to Psychiatry. There was a family history of psychotic illness. The General Physical Examination and Systemic Examination were unremarkable. Mental Status Examination revealed increased psychomotor activity, pressure of speech, euphoric affect, prolixity, delusion of persecution, delusion of grandiosity, delusion of control, thought withdrawal and thought insertion, and second and third person auditory hallucinations, with impaired judgment and insight. A diagnosis of schizophrenia paranoid type, with a differential diagnosis of schizoaffective disorder manic subtype, was made. This case is being reported for its rarity and atypicality of clinical presentation, as well as a course of psychotic illness in the G6PD Deficiency state,with its implications on management.

Risperidone induced periorbital oedema.

Antipsychotic medications are associated with adverse cutaneous reactions (ACRs) in approximately 2-3% of patients. We present three cases of possible risperidone induced periorbital oedema in the absence of any other systemic or local cause responsible for the oedema. The development of periorbital oedema after the initiation of risperidone therapy, and disappearance after the discontinuation of this drug, suggests a possible causal relationship between periorbital oedema and risperidone. To our knowledge, there are very few reports of risperidone therapy and development of periorbital oedema. Risperidone is a valid and effective choice amongst antipsychotic medications, but these cases call for caution regarding ACRs at the time of prescribing.

Psychopathology, insight and compliance in schizophrenia.

Abstraact Objective: A four-week longitudinal study was conducted to assess the relationship between insight, psychopathology and treatment compliance in schizophrenia. METHOD: The study was conducted using Insight and Treatment Attitude Questionnaire (ITAQ), Positive and Negative Syndrome Scale (PANSS) and Medication Adherence Rating Scale (MARS). The sample comprised 50 patients with schizophrenia diagnosed according to research criteria of the International Classification of Diseases (ICD-10), with a mean duration of illness of 5.32 years. RESULTS: Substantial psychopathology was observed at intake and it improved significantly at the end of four weeks. Similar changes were observed in the score of insight and of compliance over four weeks. The insight and the compliance were positively correlated to each other at the beginning and at the end of four weeks. Both of these were negatively correlated with psychopathology scores on both occasions. CONCLUSION: Insight and psychopathology remain important determinants of treatment compliance in schizophrenia over short term and long term follow up.

Semantic Concept Mining Based on Hierarchical Event Detection for Soccer Video Indexing.

In this paper, we present a novel automated indexing and semantic labeling for broadcast soccer video sequences. The proposed method automatically extracts silent events from the video and classifies each event sequence into a concept by sequential association mining. The paper makes three new contributions in multimodal sports video indexing and summarization. First, we propose a novel hierarchical framework for soccer (football) video event sequence detection and classification. Unlike most existing video classification approaches, which focus on shot detection followed by shot-clustering for classification, the proposed scheme perform a top-down video scene classification which avoids shot clustering. This improves the classification accuracy and also maintains the temporal order of shots. Second, we compute the association for the events of each excitement clip using a priori mining algorithm. We pro- pose a novel sequential association distance to classify the association of the excitement clip into semantic concepts. For soccer video, we have considered goal scored by team-A, goal scored by team-B, goal saved by team-A, goal saved by team-B as semantic concepts. Third, the extracted excitement clips with semantic concept label helps us to summarize many hours of video to collection of soccer highlights such as goals, saves, corner kicks, etc. We show promising results, with correctly indexed soccer scenes, enabling structural and temporal analysis, such as video retrieval, highlight extraction, and video skimming.

Diagnosis of depression in general practice.

Depression is well recognized as a public health problem that usually runs the risk of becoming chronic, disabling and life threatening if left untreated. Unfortunately depression remains largely under diagnosed in primary care although more than one in ten cases seen in primary care suffers from this condition. Primary care physicians are strategically placed to detect and treat depression early and thus contribute in secondary prevention of this disorder. This article highlights the problems in diagnosis, the ways depressed patients present to the clinicians, the diagnostic criteria, the detailed interview techniques to arrive at a diagnosis of depression. The article also offers an outline of management of depression in primary care.