Rajesh Varma
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Development of the Clinical Interview for Bipolar Disorder (CIBD) – Rational and experts’ panel evaluation
No full textBipolar Disorder (BD) is underdiagnosed, and the average time gap between the onset and diagnosis due to poor screening is 7 years. This study aims to describe the development of the semi-structured Clinical Interview for Bipolar Disorder (CIBD) for diagnosing bipolar spectrum disorders and assessing the impact of psychological interventions, using a mixed method approach of clinician and interviewee ratings, with a recovery approach. Methods: CIBD was based on DSM-5 and developed by a multidisciplinary team. Firstly, a research review on BD assessment was conducted, and published guidelines from international BD experts were incorporated into the interview. Secondly, an expert panel formed by 9 psychiatrists, 8 psychologists, a nurse, and a neuropsychologist with expertise in BD was asked to assess it for clarity, pertinence, and completeness.Results: CIBD structure and sections were rated with high scores (range: 0-80) regarding usefulness (78.63), clarity (74.53), and completeness (77.63). The expert panel gave suggestions to clarify, add and change some instructions in the introduction, suicide risk scale for BD, and the empowerment scale, and an index was also added to help navigate the interview.Conclusion: CIBD is an acceptable and comprehensive tool for assessing BD and related disorders contributing to a recovery perspective and might be useful for tracing intervention improvements. Experts highlight the CIBD’s unique contributions, including the suicidality scale encompassing BD-specific risk factors, BD specifiers, and the assessment of clients’ empowerment. Overall, the CIBD seems to be a promising innovative instrument for diagnosing and assessing BD.</p
Study of eban local garlic yield potential using sustainable cultivation technology in the North Central Timor District
No full textThis study aims to determine the effect of the best types of mulch and organic fertilizer on the growth and yield of local Eban garlic. This research was conducted from May to October 2022 on the land of the Melati Women Farmer Group (WFG), Salu Village, West Miomaffo District, North Central Timor Regency, East Nusa Tenggara, and the Laboratory of the Faculty of Agriculture, University of Timor. The experimental design used was a spit-plot design with three replications. The treatment consists of two factors: The first factor is the use of mulch, which consists of three levels, namely: TO = without mulch; T1 = organic mulch (rice straw mulch); and T2 = inorganic mulch (plastic mulch). The second factor was the use of cow manure, consisting of four levels, namely: P0 = no fertilizer (without treatment), P1 = cow manure (20 t/ha) + rice husk biochar, P2 = cow manure (20 t/ha) + biochar compost, and P3 = cow manure (20 t/ha) + biochar compost tea. The treatment combinations were T0P0, T0P1, T0P2, T0P3, T1P0, T1P1, T1P2, T1P3, T2P0, T2P1, T2P2, and T2P3 with 3 replications, so that 36 units were obtained. The results of the study showed that the combination treatment of straw mulch and cow manure (20 t/ha) plus rice husk biochar gave the best results on the local garlic yield index parameter eban (9.92).</p
Risk factors for COVID-19 infection in people with 4th dose of bivalent mRNA vaccines in general medicine from October 2022 to February 2023
No full textBackground: Risk factors of COVID-19 infection in people vaccinated with the 4th dose of mRNA COVID-19 vaccine remain the subject of debate.Objective: To identify risk and protective factors of COVID-19 in vaccinated people with 4th dose of bivalent mRNA vaccines.Location: General Practitioner consultation in Toledo (Spain).Methodology: Longitudinal and prospective study of cases and controls of adult patients with or without COVID-19 infection in vaccinated people with 4th dose of bivalent mRNA vaccines, from October 1, 2022, to February 28, 2023.Results: Five cases of COVID-19 infections in vaccinated people with 4th dose were included, which were compared with 52 controls (with 4th dose and without COVID-19 after the booster). The risk factors for COVID-19 infection with the 4th dose were: Women (RR = 1.67), Socio-Health Care Workers (RR = 10.39; p = 0.0349), Chronic Diseases of the blood (RR = 6.9. p = 0.0322), Chronic Diseases of Endocrine (RR = 2.72. p = 0.039425), and Chronic Diseases of Circulatory system (RR = 1.87).Conclusion: In the general practice setting in Toledo, Spain, being a socio-health care worker and having chronic diseases presumably associated with immunosuppression were statistically significant risk factors for COVID-19 infection in people vaccinated with the 4th dose of bivalent mRNA vaccines. The most exposed or immunosuppressed people continue to be at risk of becoming infected with SARS-CoV-2 despite having received the 4th dose of the mRNA COVID-19 vaccine, so other preventive methods in these groups are advisable.</p
Marine fouling: Factors affecting biofouling and future perspectives
No full textBiofouling of the hulls of ships and vessels, caused by the colonization of animals and plants, is an ongoing problem for the shipping industry. Biofouling evokes surface roughness, which results in higher fuel consumption, emissions, and operating costs. Mitigation of biofouling is a complex problem and the effectiveness of any given approach depends on many factors. Compared to complex anti-fouling technologies, the use of anti-fouling coatings presents the most viable solution, both in terms of cost and efficiency. Nevertheless, due to the modest performance of most modern antifouling hull coatings, frequent maintenance, and dry-docking intervals are still required. In addition, application costs are often not negligible. New antifouling technologies, such as low-drag antifouling paints with broad spectrum activity are urgently required in order to promote smoothness of the surface as well as provide adequate protection against biofilm formation. The development of innovative nanocomposite coating structures which combine low-drag film surfaces with antimicrobial components within water-soluble matrices may be a drastic solution to the above problem. Moreover, applying such structures directly on the hulls of ships and marine vessels without the use of primers is a long-awaited possibility, which could have a tremendous impact on reducing application costs.</p
The behavior of population dispersion employing various numerical techniques
No full textThe exploration of population diversity motivated us to present this paper. A mathematical model for the ecological process of population dispersion is finally considered by us to figure out the dispersion of population along the area. The dispersal from one's home site to the next is considered the most important phenomenon in the demographic and evolutionary dynamics of the population. The most important factor regarding dispersal is the spatial distribution of individuals. This dispersal may result in enhanced clamping, huge randomness, or even more spacing. The Adomian Decomposition method has opted to work out the problem analytically. Numerical schemes brought an approximate solution by incorporating the Forward-in-Time and Central-In-Space (FTCS) scheme, the Crank Nicolson (CN) scheme, and Numerov’s method. The validity and efficiency of schemes employed for the proposed model are supported by core properties like stability, consistency, and convergence. A comparison is made between the results calculated via schemes and the one analytically. </p
Open path theory: Pattern and structure in prime numbers
No full textThe Open Path theory, supported by experimental data, is presented. The main hypothesis proposes that Prime Numbers's positions are determined by previous Prime Numbers as well as their spacing, in a complex, but deterministic way. The concepts of Open Path, Perfect Space, and Primorial Perfect Space are introduced. The Open Path theory can predict prime gaps of any minimum predetermined size. Two rudimentary algorithms based on this theory are presented. The first algorithm returns a sample (a few hundredth of numbers) containing 25 % of Prime Numbers at distances above 1011. The mirrored sample gives a similar percentage of Prime Numbers. The algorithm execution time is of a few milliseconds. The second algorithm presented determines if a number belonging to a Perfect Space is a composite number or a Prime Number. </p
Something lurks in my baby’s gums
No full textA healthy Caucasian female neonate was born at 38 weeks and 3 days of gestation by elective cesarean delivery. She is the second child of a healthy mother, had a proper antenatal follow-up, and had no fetal anomalies in prenatal ultrasounds. </p
Strengthened primary health care for universal health coverage through improved community diagnosis and management of pneumonia in Zimbabwe
No full textPneumonia is the world’s leading infectious killer, claiming the lives of an estimated 2.5 million including more than 670,000 children under five years and 1.2 million adults in 2019 alone. Caused largely by viruses, and bacteria, COVID-19 also increased the pneumonia burden, while environmental factors, poor hygiene, sanitation and underlying conditions including malnutrition predispose. The latter translates into a considerable pneumonia burden that is preventable, provided the requisite provisions are made for community-level protection such as environmental management, water, sanitation and hygiene; and key persons are informed and educated on preventive and therapeutic measures, especially what to look for and what to do at home while seeking medical attention. Irked by the high numbers of under-five deaths against a background of limited case management caused by the system-wide collapse of the health services in the country, we sought to utilize the opportunity offered by world pneumonia day 2022 to go down to the community and elicit both the disease burden and strategies to address pneumonia that can be applied within the home and community. We also wanted to hear from the community their experiences with and functionality of the referral system. This paper presents the findings, challenges and suggestions for improving primary healthcare implementation to address the current high morbidity and mortality attributable to pneumonia. We found the Goromonzi community to be literate in many health issues but need more information and training to better manage pneumonia. They were knowledgeable about pneumonia, tuberculosis, and the recent COVID-19 through their interactions with the local clinic staff, the media, and interpersonal communication. Some were members of the health center committee or were village health workers or local leaders. We had limitations of resources and time for a detailed study, but conclude that the community visited had a sound understanding of health, primary health care and pneumonia, but lacked the comprehensive education and support to effectively manage pneumonia at home. More work needs to be done to quantify the pneumonia burden, the contribution of each intervention, (environment, vaccination, exclusive breastfeeding, safe water, sanitation, hand hygiene, reduced smoke and case management) the benefit of home and community management alongside an effective referral chain. </p
The clinical role of probiotic and prebiotic supplementations in preterm infants
No full textBackground: For over two decades we have been trying to study and demonstrate the role of the gut microbiota in the onset of cardiovascular, autoimmune, infectious and neurobiological diseases and more generally the clinical efficacy. Aims: To study the clinical efficacy of the integrative use of prebiotics and probiotics in the prenatal population.Materials and methods: All clinical trials and randomized controlled trials were selected through January 6, 2023, for a useful total of 32 studies and a cohort of more than 37,000 infants, of which just under half are term infants in the control groups.Results: In the neonatal literature, studies on the clinical use of prebiotics and probiotics focus on specific topics of investigation, starting from the intestinal microbial composition and then extending the object of analysis to the effects of antibiotics on the microbiota, to the biochemical integration of these products, the use of breast milk or artificial or donor milk, the alleged claim to intervene on pathological processes arising from opportunistic infections of the respiratory tract, and also in relation to autoimmune, gastrointestinal and dermatological pathologies, up to food intolerances.Conclusions: Significant evidence emerges in the literature that supports the therapeutic use for clinical purposes of prebiotics and probiotics even in neonatology; however, most of the published studies have structural and functional criticalities that often invalidate the research design and therefore the outcome obtained and published, risking to affect negatively the significance eventually detected. Further studies are needed that can confirm and expand scientific knowledge in this particular area.</p
The way of future through voluntary selection
No full textThis article is a follow-up on the recent publication introducing the concept of “Voluntary Selection” which allows for engineering the phenotypic profile of a population by adopting the reproductive cells of donors rather than couples themselves. Foreseeing a genetically converging world through Voluntary Selection, and looking from a Middle Eastern and North African perspective, the article focuses on five major themes where improvements are necessary to allow for maintaining stability and achieving a minimum level of living standards despite matters such as different levels of access to environmental resources, global warming and depleting fossil fuel resources. These themes are namely the provision of evolutionary explanation for religions, women’s rights, generating wealth in the form of living atmospheres, distributed workload across society and distributed food production. The following discussions illustrate how by changing the way we look at the world, utilizing our available but neglected resources, dreaming, believing, and acting, we can solve some of the most fundamental global problems. The provided solutions are protective of individual freedoms, facilitate the convergence of lifestyles to a pleasant, practical, elegant, sustainable and modern model and protect the fabric of society as the foundation for higher-level achievements necessary for the maintenance and improvement of our living standards.</p