<?xml version="1.0" encoding="UTF-8"?><!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.2 20190208//EN" "http://jats.nlm.nih.gov/publishing/1.2/JATS-journalpublishing1.dtd"><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" article-type="other" dtd-version="1.2" xml:lang="en">
    <front>
        <journal-meta>
            <journal-id journal-id-type="pmc">F1000Research</journal-id>
            <journal-title-group>
                <journal-title>F1000Research</journal-title>
            </journal-title-group>
            <issn pub-type="epub">2046-1402</issn>
            <publisher>
                <publisher-name>F1000 Research Limited</publisher-name>
                <publisher-loc>London, UK</publisher-loc>
            </publisher>
        </journal-meta>
        <article-meta>
            <article-id pub-id-type="doi">10.12688/f1000research.135264.1</article-id>
            <article-categories>
                <subj-group subj-group-type="heading">
                    <subject>Study Protocol</subject>
                </subj-group>
                <subj-group>
                    <subject>Articles</subject>
                </subj-group>
            </article-categories>
            <title-group>
                <article-title>To assess the knowledge and attitudes about depression in the general&#x00a0; population in the Wardha District, India.</article-title>
                <fn-group content-type="pub-status">
                    <fn>
                        <p>[version 1; peer review: awaiting peer review]</p>
                    </fn>
                </fn-group>
            </title-group>
            <contrib-group>
                <contrib contrib-type="author" corresp="no">
                    <name>
                        <surname>Thakare</surname>
                        <given-names>Srushti</given-names>
                    </name>
                    <role content-type="http://credit.niso.org/">Conceptualization</role>
                    <role content-type="http://credit.niso.org/">Formal Analysis</role>
                    <role content-type="http://credit.niso.org/">Writing &#x2013; Original Draft Preparation</role>
                    <uri content-type="orcid">https://orcid.org/0009-0002-3404-6915</uri>
                    <xref ref-type="aff" rid="a1">1</xref>
                </contrib>
                <contrib contrib-type="author" corresp="yes">
                    <name>
                        <surname>Mude</surname>
                        <given-names>Gaurav</given-names>
                    </name>
                    <role content-type="http://credit.niso.org/">Validation</role>
                    <role content-type="http://credit.niso.org/">Visualization</role>
                    <role content-type="http://credit.niso.org/">Writing &#x2013; Review &amp; Editing</role>
                    <xref ref-type="corresp" rid="c1">a</xref>
                    <xref ref-type="aff" rid="a2">2</xref>
                </contrib>
                <aff id="a1">
                    <label>1</label>Clinical Research, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India</aff>
                <aff id="a2">
                    <label>2</label>Pharmacology, Datta Meghe College of Pharmacy, Wardha, Maharashtra, India</aff>
            </contrib-group>
            <author-notes>
                <corresp id="c1">
                    <label>a</label>
                    <email xlink:href="mailto:gaurav.pharmacy@dmiher.edu.in">gaurav.pharmacy@dmiher.edu.in</email>
                </corresp>
                <fn fn-type="conflict">
                    <p>No competing interests were disclosed.</p>
                </fn>
            </author-notes>
            <pub-date pub-type="epub">
                <day>31</day>
                <month>8</month>
                <year>2023</year>
            </pub-date>
            <pub-date pub-type="collection">
                <year>2023</year>
            </pub-date>
            <volume>12</volume>
            <elocation-id>1071</elocation-id>
            <history>
                <date date-type="accepted">
                    <day>17</day>
                    <month>8</month>
                    <year>2023</year>
                </date>
            </history>
            <permissions>
                <copyright-statement>Copyright: &#x00a9; 2023 Thakare S and Mude G</copyright-statement>
                <copyright-year>2023</copyright-year>
                <license xlink:href="https://creativecommons.org/licenses/by/4.0/">
                    <license-p>This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
                </license>
            </permissions>
            <self-uri content-type="pdf" xlink:href="https://f1000research.com/articles/12-1071/pdf"/>
            <abstract>
                <p>
                    <bold>Background:</bold> Physical symptoms of depression, especially tiredness, pain, or disturbed sleep, are common. Some people may experience depression as a chronic condition, with more episodes increasing the risk of recurrence. Others may experience a single episode of depression in their lifetime. Given its great incidence and crippling consequences on development, early-onset depression is regarded as one of the most common mental illnesses in children and adolescents which can last into adulthood. The following categories can be used to classify the factors that affect depression susceptibility: genetics, familial environment, individual characteristics, and extreme stress. Gender, history of depression in the family, subclinical symptoms, poor cognitive style, and negative life events are also main risk factors.</p>
                <p>
                    <bold>Methods:</bold> This protocol is for an observational study, which will take place over a four month period in the Wardha district. Participants will be recruited via the Acharya Vinoba Bhave Rural Hospital (AVBRH) as a medical center from the general population. A piloted questionnaire with a Likert scale will be completed by the participants enrolled in the study with assistance from interviewers. Frequency percentage, mean, and SD will be calculated to understand the relationship between various demographic variables and knowledge. Chi-square tests will also be used.</p>
                <p>
                    <bold>Distribution:</bold> The data collection of this study is supposed to be completed August 2023 and the results will be communicated to the external funding body through formal report. In addition, the trial results will be communicated to the public through publishing as dataset and original research published in the relevant scientific journals.</p>
            </abstract>
            <kwd-group kwd-group-type="author">
                <kwd>Depression</kwd>
                <kwd>dysthymia</kwd>
                <kwd>clinical</kwd>
                <kwd>observational</kwd>
                <kwd>awareness</kwd>
            </kwd-group>
            <funding-group>
                <funding-statement>The author(s) declared that no grants were involved in supporting this work.</funding-statement>
            </funding-group>
        </article-meta>
    </front>
    <body>
        <sec id="sec1" sec-type="intro">
            <title>Introduction</title>
            <p>Depression can appear in several forms including major, persistent, perinatal, seasonal, and clinical depression. This can be a difficult but basic condition for many. It can lead to genuine indications that make it troublesome for individuals to perform everyday schedules such as resting, eating, and working. Side effects need to be present for at least two weeks before the diagnosis of depression. There are many diverse sorts of depression, a few of which are caused by particular situations.
                <sup>
                    <xref ref-type="bibr" rid="ref1">1</xref>
                </sup> Some of the types and symptoms of depression may include:
                <list list-type="bullet">
                    <list-item>
                        <label>&#x2022;</label>
                        <p>Major depressive disorder, more often than not caused by delayed depression, which influences a person&#x2019;s ability to work, rest, consider, and eat.</p>
                    </list-item>
                    <list-item>
                        <label>&#x2022;</label>
                        <p>Dysthymia, additionally known as persistent depressive disorder, which is characterized by persistent depressive indications lasting up to two years.
                            <sup>
                                <xref ref-type="bibr" rid="ref2">2</xref>
                            </sup>
                        </p>
                    </list-item>
                    <list-item>
                        <label>&#x2022;</label>
                        <p>Perinatal depression (postpartum depression) in ladies who may experience extreme depression amid pregnancy or after childbirth.</p>
                    </list-item>
                    <list-item>
                        <label>&#x2022;</label>
                        <p>Seasonal affective disorder (SAD), which can be regularly depressive episodes that, as a rule, shows up in late harvest time and winter and are significantly reduced in spring and summer.
                            <sup>
                                <xref ref-type="bibr" rid="ref3">3</xref>
                            </sup>
                        </p>
                    </list-item>
                    <list-item>
                        <label>&#x2022;</label>
                        <p>Major discouragement with insane indications such as visualizations (anxiety, daydreams) or mental trips (hearing or seeing things that other people cannot see or listen to). Individuals who have bipolar illnesses (once known as hyper misery or manic-depressive illness) often go through depressive scenes, amid which they feel down and have exceptionally small vitality. But an individual with bipolar clutter also has hyper scenes, which are times when their dispositions are very high.
                            <sup>
                                <xref ref-type="bibr" rid="ref4">4</xref>
                            </sup>
                        </p>
                    </list-item>
                </list>
            </p>
            <p>A drawn-out sense of pity and misfortune in an individual can also be indications of depression or a disposition of illness.
                <sup>
                    <xref ref-type="bibr" rid="ref5">5</xref>
                </sup> Clinical depression, also known as major depressive disorder, influences your feelings, considerations, and conduct and can cause several emotional, mental, and physical issues such as headaches, fatigue, digestive problems, anxiety, insomnia, restlessness, and difficulty in concentrating.
                <sup>
                    <xref ref-type="bibr" rid="ref6">6</xref>
                </sup> Individuals may discover it troublesome to carry out standard day-to-day assignments and might sometimes think life isn&#x2019;t worth living thus leading to suicidal thoughts. Depression can strike anybody at any age, but it most regularly begins in a person&#x2019;s teens, twenties, or thirties. Although women are more likely to look for treatment, there are more women than men who are diagnosed with depression. Depression may be a genuine ailment that can have negative impacts on you and your family.
                <sup>
                    <xref ref-type="bibr" rid="ref7">7</xref>
                </sup>
            </p>
            <p>Everyone can experience sadness and loss, but not everyone will experience clinical depression. Clinical depression is different from grief in that it contains a variety of additional symptoms, such as poor self-esteem, pessimistic worries about the future, and hallucinations.
                <sup>
                    <xref ref-type="bibr" rid="ref8">8</xref>
                </sup>
            </p>
            <p>Since the Wardha district is a rural and semi-urban area in India, there are many issues with survival and finding a source of daily income, which can increase the number of people suffering from depression. In addition, there are many chances for teenagers to experience depression due to family pressure, tension, or the pressure of school, but there are also many chances for adults to experience depression as well due to poverty, homelessness, limited access to mental health services, loneliness, social stressors, and a lack of awareness about depression.
                <sup>
                    <xref ref-type="bibr" rid="ref9">9</xref>
                </sup>
            </p>
            <p>This study will entirely concentrate on the ratio of people who are presently experiencing depression or who are feeling as though they are on the verge of becoming depressed and raise awareness among the population.
                <sup>
                    <xref ref-type="bibr" rid="ref10">10</xref>
                </sup>
            </p>
            <sec id="sec2">
                <title>Objectives</title>
                <p>
                    <list list-type="bullet">
                        <list-item>
                            <label>&#x2022;</label>
                            <p>To assess the general public&#x2019;s knowledge and awareness of depression in the Wardha district.</p>
                        </list-item>
                    </list>
                </p>
            </sec>
        </sec>
        <sec id="sec3" sec-type="methods">
            <title>Methods</title>
            <sec id="sec4">
                <title>Ethics</title>
                <p>This study has received approval from the Institutional Ethics Committee Ref. No. DMIHER (DU)/IEC/2023/598 of Datta Meghe Institute of Higher Education and Research (DMIHER) Sawangi (M) Wardha &#x2013; 442107, Maharashtra, India. Informed written consent will be collected from all participants.</p>
            </sec>
            <sec id="sec5">
                <title>Study design</title>
                <p>This study will be a cross-sectional observational study, utilizing a standardized questionnaire amongst the inhabitants of the Wardha district, India. The observational cross-sectional study of awareness and attitude towards screening will be done by using standardized tools or face-to-face interviews. The awareness of depression and perception of depression screening will be measured by using a standardized questionnaire tool. The duration of the study will be four months from April 2023 to August 2023.</p>
            </sec>
            <sec id="sec6">
                <title>Sample size</title>
                <p>This study will use the Daniel formula to calculate the sample size required.
                    <sup>
                        <xref ref-type="bibr" rid="ref11">11</xref>
                    </sup>
                    <disp-formula id="e1">
                        <mml:math display="block">
                            <mml:mi>n</mml:mi>
                            <mml:mo>=</mml:mo>
                            <mml:mfrac>
                                <mml:mrow>
                                    <mml:msub>
                                        <mml:mi>Z</mml:mi>
                                        <mml:mrow>
                                            <mml:mi mathvariant="normal">a</mml:mi>
                                            <mml:mo>/</mml:mo>
                                            <mml:msup>
                                                <mml:mn>2</mml:mn>
                                                <mml:mn>2</mml:mn>
                                            </mml:msup>
                                        </mml:mrow>
                                    </mml:msub>
                                    <mml:mo>&#x00d7;</mml:mo>
                                    <mml:mi>P</mml:mi>
                                    <mml:mfenced close=")" open="(">
                                        <mml:mrow>
                                            <mml:mn>1</mml:mn>
                                            <mml:mo>&#x2212;</mml:mo>
                                            <mml:mi>P</mml:mi>
                                        </mml:mrow>
                                    </mml:mfenced>
                                </mml:mrow>
                                <mml:msup>
                                    <mml:mi>d</mml:mi>
                                    <mml:mn>2</mml:mn>
                                </mml:msup>
                            </mml:mfrac>
                        </mml:math>
                        <label>(1)</label>
                    </disp-formula>
                </p>
                <p>where, 
                    <italic toggle="yes">Z</italic>
                    <sub>a/2</sub> is the level of significance at 5% i.e., 95% Confidence interval = 1.96. P = Prevalence = 0.43</p>
                <p>d = Definite error of margin = 0.05.
                    <disp-formula id="e2">
                        <mml:math display="block">
                            <mml:mi mathvariant="normal">n</mml:mi>
                            <mml:mo>=</mml:mo>
                            <mml:mfrac>
                                <mml:mrow>
                                    <mml:msup>
                                        <mml:mn>1.96</mml:mn>
                                        <mml:mn>2</mml:mn>
                                    </mml:msup>
                                    <mml:mo>&#x00d7;</mml:mo>
                                    <mml:mn>0.43</mml:mn>
                                    <mml:mfenced close=")" open="(">
                                        <mml:mrow>
                                            <mml:mn>1</mml:mn>
                                            <mml:mo>&#x2212;</mml:mo>
                                            <mml:mn>0.43</mml:mn>
                                        </mml:mrow>
                                    </mml:mfenced>
                                </mml:mrow>
                                <mml:msup>
                                    <mml:mn>0.05</mml:mn>
                                    <mml:mn>2</mml:mn>
                                </mml:msup>
                            </mml:mfrac>
                        </mml:math>
                        <label>(2)</label>
                    </disp-formula>
                    <disp-formula id="e3">
                        <mml:math display="block">
                            <mml:mi mathvariant="normal">n</mml:mi>
                            <mml:mo>=</mml:mo>
                            <mml:mfrac>
                                <mml:mrow>
                                    <mml:mn>3.8416</mml:mn>
                                    <mml:mo>&#x00d7;</mml:mo>
                                    <mml:mn>0.43</mml:mn>
                                    <mml:mo>&#x00d7;</mml:mo>
                                    <mml:mn>0.57</mml:mn>
                                </mml:mrow>
                                <mml:mn>0.0025</mml:mn>
                            </mml:mfrac>
                        </mml:math>
                        <label>(3)</label>
                    </disp-formula>
                </p>
                <p>n = 376.63</p>
                <p>n = 400 participants were needed in the sample.</p>
                <p>The study will however try to include a larger sample to improve its precision.
                    <sup>
                        <xref ref-type="bibr" rid="ref11">11</xref>
                    </sup>
                </p>
            </sec>
            <sec id="sec7">
                <title>Participation selection</title>
                <p>Participants will be recruited via the Acharya Vinoba Bhave Rural Hospital (AVBRH) as a medical center under DMIHER. Recruitment for participants for this study will be from the general population in the Wardha district using the following criteria:</p>
                <p>
                    <bold>Inclusion criteria:</bold>
                    <list list-type="bullet">
                        <list-item>
                            <label>&#x2022;</label>
                            <p>The general population living in the Wardha district (confirmed via the participant&#x2019;s adhaar/voter ID card).</p>
                        </list-item>
                        <list-item>
                            <label>&#x2022;</label>
                            <p>Both females and males will be included.</p>
                        </list-item>
                    </list>
                </p>
                <p>
                    <bold>Exclusion criteria:</bold>
                    <list list-type="bullet">
                        <list-item>
                            <label>&#x2022;</label>
                            <p>People who do not give consent to participate</p>
                        </list-item>
                        <list-item>
                            <label>&#x2022;</label>
                            <p>People having comorbid psychiatric conditions.</p>
                        </list-item>
                        <list-item>
                            <label>&#x2022;</label>
                            <p>Persons having a low intellectual deficiency. The participants will be asked if they are having problems while rolling over, sitting up, talking late or trouble in talking, slow in dressing or feeding. The person with these symptoms will be excluded under the exclusion criteria and will not be contacted for the interview.
                                <sup>
                                    <xref ref-type="bibr" rid="ref9">9</xref>
                                </sup>
                            </p>
                        </list-item>
                    </list>
                </p>
            </sec>
            <sec id="sec8">
                <title>Data collection</title>
                <p>Participants who met the inclusion criteria will be contacted via phone call through AVBRH medical center. Data collection will be conducted with face-to-face interviews in the Hindi, Marathi, or English language at the participants home to avoid imperfect completion of the questions. Any questions that arise while filling out the questionnaires will be answered during the interview. The answers will be recorded by hand using a paper hard copy by the participants but if the participant is illiterate or doesn&#x2019;t understand the questionnaire then the interviewer will translate and ask the question and note the answer on the same form given to all participants. This whole process will take place at the same time at the participants home.
                    <sup>
                        <xref ref-type="bibr" rid="ref12">12</xref>
                    </sup>
                </p>
            </sec>
            <sec id="sec9">
                <title>Data collection instruments</title>
                <p>Researchers have prepared a structured questionnaire consisting of multiple choice questions with the Likert scale which was piloted already.
                    <sup>
                        <xref ref-type="bibr" rid="ref23">23</xref>
                    </sup> The questionnaire was previously piloted in the Psychiatric department of the ABVRH and permission for the reuse of this tool was granted by the head of the department. The pilot was conducted from 25
                    <sup>th</sup> December 2022 to 6
                    <sup>th</sup> January 2023. For the pilot, participants were recruited under the same criteria and then asked to provide feedback on the tool. Pilot participants will be excluded from the main study.</p>
            </sec>
            <sec id="sec10">
                <title>Steps of data collection</title>
                <p>
                    <bold>Step 1:</bold> Ethical approval has been obtained from the ethics committee prior to the data collection.</p>
                <p>
                    <bold>Step 2:</bold> Introduction between the participants and the researcher.</p>
                <p>
                    <bold>Step 3:</bold> Informed written consent will be taken from the participants who are willing to participate, after explaining the study purpose.</p>
                <p>
                    <bold>Step 4:</bold> Standardized questionnaire will be filled by the subjects with the help of face-to-face interviews.
                    <sup>
                        <xref ref-type="bibr" rid="ref13">13</xref>
                    </sup>
                </p>
            </sec>
            <sec id="sec11">
                <title>Data analysis</title>
                <p>Frequency percentage, mean, and SD will be calculated and to understand the relationship between various demographic variables and knowledge the chi-square test will be used.</p>
            </sec>
            <sec id="sec12">
                <title>Dissemination</title>
                <p>The data collection of this study is supposed to be completed August 2023 and the results will be communicated to the external funding body through formal report. In addition, the trial results will be communicated to the public through publishing as dataset and original research published in the relevant scientific journals.
                    <sup>
                        <xref ref-type="bibr" rid="ref14">14</xref>
                    </sup>
                </p>
            </sec>
            <sec id="sec13">
                <title>Study status</title>
                <p>The study is ongoing, as it began in April 2023.</p>
            </sec>
        </sec>
        <sec id="sec14" sec-type="discussion">
            <title>Discussion</title>
            <p>Depression affects one&#x2019;s mood, making them sad and losing interest in things, people, and events, which can lead to both physical and emotional issues. If it continues, treatment&#x2014;which can include medication and psychotherapy&#x2014;might be necessary in the long run.
                <sup>
                    <xref ref-type="bibr" rid="ref15">15</xref>
                </sup>
            </p>
            <p>Depression is a widespread mental health issue in the general population, as claimed by Lim 
                <italic toggle="yes">et al.</italic>, (2018). It is strongly linked to melancholy, low self-esteem, poor focus, worry, losing interest, and a sensation of being a quitter. Discouragement, a common reaction within the common populace, is seen indeed more habitually in common restorative settings and is related with the individual and family enduring a greater hazard of suicide, utilitarian resistance, and a financial toll in well-being care costs and misplaced efficiency.
                <sup>
                    <xref ref-type="bibr" rid="ref16">16</xref>
                </sup> Symptomatic criteria are well built up, and several screening apparatuses exist for utilization in symptomatic patients. Psychopharmacologic and psychotherapeutic medicines are also accessible. Most cases of depression seen in common therapeutic settings are milder shapes of the sickness than are regularly seen in claim-to-fame settings, and they are frequently amenable to treatment within the essential care setting by those with suitable expertise.
                <sup>
                    <xref ref-type="bibr" rid="ref17">17</xref>
                </sup>
            </p>
            <p>Depression as often as possible co-occurs with a number of inveterate common therapeutic ailments, and such comorbidity may complicate the acknowledgment of another depressive ailment. Co-occurring depression frequently disables persistent adherence to restorative care and may genuinely decline the course and forecast of both conditions. Subsequently, it is fundamental to analyze and treat such co-occurring depression.
                <sup>
                    <xref ref-type="bibr" rid="ref18">18</xref>
                </sup>
            </p>
            <p>Only approximately half of all cases of depression are recognized and analyzed in essential care settings, even though such unrecognized cases for the most part are milder and more self-limited.
                <sup>
                    <xref ref-type="bibr" rid="ref15">15</xref>
                </sup> Making strides acknowledgment by doctors is to a great extent related to states of mind almost discouragement and the utilization of certain particular meeting abilities. Indeed, when cases are recognized, both pharmacologic and psychotherapeutic medications given frequently drop brief of existing rules. When rules are adhered to, the results are very good.
                <sup>
                    <xref ref-type="bibr" rid="ref19">19</xref>
                </sup>
            </p>
            <p>Barriers to diagnosing and treating discouragement in common therapeutic settings incorporate those related to shame; understanding somatization and dissent; time; quiet adherence to treatment; doctor information and aptitude shortages; need of accessibility of suppliers and particular medications; restrictions of third-party scope; and confinements on master, medicate, and psychotherapeutic care.
                <sup>
                    <xref ref-type="bibr" rid="ref20">20</xref>
                </sup> Several programs are beneath way to diminish these obstructions, but undertreatment remains a genuine issue. Depression is the leading contributor to illness-related disabilities worldwide. Since depression is frequently connected with children and adolescents, the study concentrated on this population. Additionally, it offers a summary of diseases affecting children and adolescents as well as an analysis of the beliefs that create and explain depression.
                <sup>
                    <xref ref-type="bibr" rid="ref21">21</xref>
                </sup> The authors of this study came to the conclusion that there is no difference between adult and child depression in terms of mental development, and as a result, the theory of explanation is heavily used to further explain depression. According to the research, prevention and therapy should take into account multiple factors. Additionally, universal programs may be more effective, according to estimates.
                <sup>
                    <xref ref-type="bibr" rid="ref22">22</xref>
                </sup>
            </p>
        </sec>
    </body>
    <back>
        <sec id="sec17" sec-type="data-availability">
            <title>Data availability</title>
            <sec id="sec18">
                <title>Underlying data</title>
                <p>No data are associated with this article.</p>
            </sec>
            <sec id="sec19">
                <title>Extended data</title>
                <p>Zenodo: To assess the knowledge and attitudes about depression in the general population in the Wardha District, India. 
                    <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.5281/zenodo.8229749">https://doi.org/10.5281/zenodo.8229749</ext-link>.
                    <sup>

                        <xref ref-type="bibr" rid="ref23">23</xref>
</sup>
                </p>
                <p>This project contains the following extended data:
                    <list list-type="bullet">
                        <list-item>
                            <label>&#x2022;</label>
                            <p>MARATHI LANGUAGE QUESTIONNAIRE.docx. (Blank copy of the questionnaire in Marathi, Hindi, and English).</p>
                        </list-item>
                    </list>
                </p>
                <p>Data are available under the terms of the 
                    <ext-link ext-link-type="uri" xlink:href="https://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution 4.0 International license</ext-link> (CC-BY 4.0).</p>
            </sec>
        </sec>
        <ref-list>
            <title>References</title>
            <ref id="ref1">
                <label>1</label>
                <mixed-citation publication-type="journal">
                    <person-group person-group-type="author">

                        <name name-style="western">
                            <surname>Jain</surname>
                            <given-names>A</given-names>
                        </name>

                        <name name-style="western">
                            <surname>Jhirwal</surname>
                            <given-names>OP</given-names>
                        </name>

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