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The prospect of establishing extra-terrestrial habitats using in situ resource utilization (ISRU) constitutes a long-term goal of multiple space agencies around the world. In this work, we investigate furnace sintering as a potential route for making building blocks—termed synthetic space bricks—using in situ regolith material. By systematically evaluating sintering parameters using a numerical lattice model, coupled with experimental observations and post-sintering characterization, we propose a process protocol for two lunar simulants (lunar highland simulant (LHS-1) and lunar mare dust simulant (LMS-1)) and one Martian simulant (mars global simulant, MGS-1). The resulting bricks demonstrate compressive strengths of up to 45 MPa under uniaxial loading, depending on the simulant used. These strengths are much greater than those typically mandated for structural applications under reduced gravity. Taking recourse to classical ceramic sintering studies, we infer particle-level sintering mechanisms indirectly by measuring temporal evolution exponents of sample dimensions. For all three simulants, volume diffusion appears to be the primary mechanism for particle coalescence. Our results clearly make a strong case for the use of sintering as a potentially scalable method for consolidating regolith into brick-like structures for construction and load-bearing applications in extra-terrestrial settings. [ABSTRACT FROM AUTHOR]

In this article, we consider a particular type of coherent systems, in which, when the coherent system fails, either no active component remains or the remaining active components are connected in parallel. This work studies two coherent systems of such type with two components, four coherent systems with three components, and seven coherent systems with four components as examples. Lifetime as well as system signature of each of these coherent systems is given. We investigate the restart of such a coherent system using a single cold standby component. The reliability of a system is studied through the (reliability) characteristics such as reliability function, mean time to failure, mean residual life functions of the system. We compute signature-based exact expression for the reliability function of the considered coherent system, which is equipped with a cold standby component. Also, we obtain three different mean residual life functions of the system. So far, no attempt has been made to study such coherent systems in cold standby sparing; therefore, we have provided some new results. We illustrate the theoretical results by considering three particular coherent systems as examples. [ABSTRACT FROM AUTHOR]

Constructing habitable load-bearing structures on lunar and martian surfaces presents unique challenges, such as the ability to sustain extreme thermal fluctuations and frequent dust storms. A promising paradigm for effecting construction is via in situ resource utilization (ISRU), combined with sintering, wherein locally available regolith is consolidated at high temperatures to make load-bearing structures. This work investigates one route for effecting sintering via intermediate melting of a constituent mineral, termed liquid state sintering, to enhance consolidation in lunar regolith simulants. We work primarily with lunar highland simulant (LHS-1), with supporting comparative investigations of lunar mare dust simulant (LMS-1) and martian global simulant (MGS-1). We first establish a liquid-state sintering protocol above the melting point of the constituent basalt using a combination of differential scanning calorimetry (DSC) and post-consolidation Scanning electron microscopy (SEM). A numerical lattice-based model is used to explain several of the experimental observations, including complex pore-crack interactions in the consolidated bricks, potential strength anisotropy due to shrinkage, resulting crack patterns, and derive an exponential relation between strength and porosity. [ABSTRACT FROM AUTHOR]

Abstract.In industrial, environmental, and ecological investigations, ranked set sampling is a sample method that enables the experimenter to use the whole range of population values. The ranked set sampling process can be modified in two extremely helpful ways: maximum ranked set sampling with unequal samples and minimum ranked set sampling with unequal samples. They permit an increase in set size without too many ranking errors being introduced. In this article, we are defining general weighted extropy (GWJ) of minimum and maximum ranked set samples when samples are of unequal size (minRSSU and maxRSSU, respectively). Stochastic comparison and monotone properties have been studied under different situations. Additionally, we compare the extropy of these two sampling data with that of ranked set sampling data and simple random sampling data. Bounds of GWJ of minRSSU and maxRSSU have been obtained. Finally, we investigate the weighted discrimination information between simple random sampling, ranked set sampling, and minimum and maximum ranked set sampling with unequal sample sizes. Some results for equality of GWJ of minRSSU and maxRSSU under symmetric assumption are also obtained. [ABSTRACT FROM AUTHOR]

Background: Bartonella quintana is a body louse-borne bacterium causing bacteremia and infective endocarditis. We aimed to describe B. quintana detection among arthropods and their hosts. Methods: We searched databases in PubMed Central/MEDLINE, Scopus, Embase, and Web of Science from January 1, 1915 (the year of B. quintana discovery) to January 1, 2024, to identify publications containing specific search terms relating to B. quintana detection among arthropods. Descriptive statistics and meta-analysis of pooled prevalence using random-effects models were performed for all arthropods and body and head lice. Results: Of 1265 records, 62 articles were included, describing 8839 body lice, 4962 head lice, and 1692 other arthropods, such as different species of fleas, bedbugs, mites, and ticks. Arthropods were collected from 37 countries, of which 28 had arthropods with B. quintana DNA. Among articles that reported B. quintana detection among individual arthropods, 1445 of 14,088 (0.1026, 95% CI [0.0976; 0.1077]) arthropods tested positive for B. quintana DNA, generating a random-effects model global prevalence of 0.0666 (95% CI [0.0426; 0.1026]). Fifty-six studies tested 8839 body lice, of which 1679 had B. quintana DNA (0.1899, 95% CI [0.1818; 0.1983]), generating a random-effects model pooled prevalence of 0.2312 (95% CI [0.1784; 0.2843]). Forty-two studies tested 4962 head lice, of which 390 head lice from 20 studies originating from 11 different countries had B. quintana DNA (0.0786, 95% CI [0.0713; 0.0864]). Eight studies detected B. quintana DNA exclusively on head lice. Five studies reported greater B. quintana detection on head lice than body lice; all originated from low-resource environments. Conclusions: Bartonella quintana is a vector-borne bacterium with a global distribution, disproportionately affecting marginalized populations. Bartonella quintana DNA has been detected in many different arthropod species, though not all of these arthropods meet criteria to be considered vectors for B. quintana transmission. Body lice have long been known to transmit B. quintana. A limited number of studies suggest that head lice may also act as possible vectors for B. quintana in specific low-resource contexts. [ABSTRACT FROM AUTHOR]

The general weighted cumulative residual extropy (GWCRJ) and general weighted cumulative past extropy (GWCPJ) are introduced in this article. There are some results in relation to GWCPJ and GWCRJ. We take into account GWCRJ-based uncertainty measures for the minimal ranked set sampling technique with unequal samples (minRSSU). Additionally, we take into account GWCPJ-based uncertainty measures for the maximum ranked set sampling technique with unequal samples (maxRSSU). Stochastic comparison for simple random sampling (SRS) is discussed. We looked at the monotone properties of minRSSU and maxRSSU as well as stochastic comparison. The empirical estimators of GWCPJ and GWCRJ are obtained and a simulation study for comparing the proposed estimator will be given involving the proposed ranked set sampling schemes under perfect ranking. [ABSTRACT FROM AUTHOR]

In the past few years, considerable attention has been given to the extropy measure. The extropy and weighted extropy of ranked set sampling were studied by several authors. The general weighted extropy and some results related to it are introduced in this paper. We provide general weighted extropy of ranked set sampling. We also studied characterization results, stochastic comparison and monotone properties of general weighted extropy. [ABSTRACT FROM AUTHOR]

Among a large number of nitrogen-containing heterocyclic compounds, pyrazole is a privileged scaffold with the molecular formula C3H3N2H. It consists of a five-membered ring with 3-carbon atoms and 2-nitrogen atoms which are present in adjacent positions. The nucleus has attracted synthetic interest due to numerous pharmacological activities. This molecule is used as one of the basic moieties for leads in the area of drug discovery and development and thereby plays a vital role in the field of medicinal chemistry. The present review article highlights the SAR studies of potent compounds of pyrazole and its derivatives (2015–2022) reported as anti-inflammatory, anticancer, antidiabetic, anticonvulsant, antimicrobial, antimycobacterial, antineurodegenerative and antioxidant. Furthermore, a patent application published in this period is also discussed. Google, PubMed, Cochrane, Scopus, ResearchGate, Google Scholar, and Science Direct were primarily used for article search, whereas the databases used for the pyrazole patent were Espacenet, Google Patent, and SciFinder. More than one hundred thirty papers were screened after which inclusion and exclusion criteria were applied to make this review article. We hope the current review article can pave the way for the future drug design and development of pyrazole derivatives as a potential drug candidate. [ABSTRACT FROM AUTHOR]

This research article discusses composite panel manufacturers' challenges in finding an optimum pressing time to achieve a trade-off between the panel's performance and the production cost. Real-time cure monitoring techniques, such as dielectric analysis (DEA), have been developed to overcome the limitations of trial-and-error methods, which have been in use for a long time for the same purpose. DEA measures changes in the dielectric properties of the material during the cross-linking reactions in resin and provides necessary information for the cure state of the material. In this study, paper sensors based on interdigitated electrodes were employed to measure the curing behavior of phenol formaldehyde resin-impregnated paper. The paper sensors were found to be better than commercially available sensors in terms of compatibility, thinness, biodegradability, low cost, flexibility, and non-heterogeneity. The study compared the results obtained from DEA with those from differential scanning calorimetry (DSC) and found that DEA can be a good candidate for predicting curing behavior. The average enthalpy of the curing measured using DSC for the B-stage resin-impregnated PF resin was 35.28 J g−1. Moreover, it was observed from the rate of cure that at a higher temperature of 180 °C, the reaction follows an autocatalytic kinetic type as the reaction rate passes through a maximum. However, at lower temperatures, the autocatalytic reaction regime seems to be followed by a decelerating type. Further research on the effect of pressure and other parameters on the curing behavior of PF resin-impregnated paper can be done in the future. [ABSTRACT FROM AUTHOR]

Background Bartonella quintana is a louse-borne bacterium that remains a neglected cause of endocarditis in low-resource settings. Our understanding of risk factors, clinical manifestations, and treatment of B. quintana endocarditis are biased by older studies from high-income countries. Methods We searched Pubmed Central, Medline, Scopus, Embase, EBSCO (CABI) Global Health, Web of Science and international trial registers for articles published before March 2023 with terms related to Bartonella quintana endocarditis. We included articles containing case-level information on B. quintana endocarditis and extracted data related to patient demographics, clinical features, diagnostic testing, treatment, and outcome. Results A total of 975 records were identified, of which 569 duplicates were removed prior to screening. In total, 84 articles were eligible for inclusion, describing a total of 167 cases. Infections were acquired in 40 different countries; 62 cases (37.1%) were acquired in low- and middle-income countries (LMICs). Disproportionately more female and pediatric patients were from LMICs. More patients presented with heart failure (n = 70/167 [41.9%]) than fever (n = 65/167 [38.9%]). Mean time from symptom onset to presentation was 5.1 months. Also, 25.7% of cases (n = 43/167) were associated with embolization, most commonly to the spleen and brain; 65.5% of antimicrobial regimens included doxycycline. The vast majority of cases underwent valve replacement surgery (n = 154/167, [98.0%]). Overall case fatality rate was 9.6% (n = 16/167). Conclusions B. quintana endocarditis has a global distribution, and long delays between symptom onset and presentation frequently occur. Improved clinician education and diagnostic capacity are needed to screen at-risk populations and identify infection before endocarditis develops. [ABSTRACT FROM AUTHOR]

Abstract.This article focuses on a specific type of coherent system in which, when the coherent system fails, either no active component remains or the remaining active components are connected in parallel. Roy and Gupta (2023) also considered the same type of coherent systems. We observe the restart of such a coherent system using two cold standby components. In our study, standbys are not placed into action simultaneously. They are put into action one by one. We compute the reliability function of the considered coherent system, which is equipped with two cold standby components. In addition, we show that when we use a stronger standby component (in the sense of failure rate order) at first, we get a longer system lifetime. Also, we compute three different mean residual life functions of the system. We have presented a few numerical results to illustrate the importance of our analysis. [ABSTRACT FROM AUTHOR]

This article discusses the presence of a reversed halo sign (RHS) in patients with melioidosis, a tropical infection, and poorly controlled diabetes. The study presents eight cases of pulmonary melioidosis with RHS, with patients ranging in age from 30 to 80 years. The patients were treated with antibiotics and most recovered well, except for two who died. The article emphasizes the importance of considering melioidosis as a differential diagnosis in patients with RHS and poorly controlled diabetes, particularly in individuals from South Asia. [Extracted from the article]

By combining blockchain technology (BT) and reinforcement learning (RL), the proposed work addresses the difficulties associated with vaccine recommendations. The need for individualized recommendations is obvious as vaccine schedules become more complicated and there are more vaccines available. The proposed work presents a novel approach that combines the adaptability of RL with the security, privacy, and transparency of BT. Layers for data processing, application, consensus, and smart contracts are included in the system architecture. It provides user‐managed secure access, individualized vaccine recommendations, and decentralized data storage. The system aims to improve public health outcomes by using smart contracts to automate procedures and RL to improve recommendations. Using 10‐fold cross‐validation on the Vaccine Adverse Event Reporting System (VAERS) dataset, the experimental study verifies the performance of the system. The study focuses on metrics like accuracy, sensitivity, specificity, and F‐measure when contrasting the proposed model with current solutions. The ability of proposed model to offer precise and well‐informed vaccine recommendations is demonstrated by its consistent outperformance of competitors in accuracy and sensitivity. [ABSTRACT FROM AUTHOR]

This document discusses the latest advancements in therapeutic care for Attention-Deficit Hyperactivity Disorder (ADHD). It highlights the history and effectiveness of stimulant medications, such as amphetamines and methylphenidate, as well as non-stimulant medications like atomoxetine. The document also explores recent innovations in pharmacotherapy, including new stimulant preparations like Lisdexamfetamine dimesylate and extended-release methylphenidate hydrochloride. Additionally, it mentions the development of transdermal patches and non-stimulant drugs like Viloxazine ER and centanafadine. The document also discusses the emergence of digital therapeutics, such as the Monarch external Trigeminal Nerve Stimulation system and the EndeavorRx video game. It concludes by emphasizing the need for newer medications and devices in India to support individuals with ADHD and their families. Ongoing research efforts are also mentioned, including the search for biological markers and the exploration of neuromodulation techniques. [Extracted from the article]

Objective(s): Despite significant progress in the field of nuclear medicine, basic nuclear medicine awareness and understanding among clinicians remains unsatisfactory, leading to under utilization of nuclear medicine modalities. To evaluate the awareness and knowledge regarding nuclear medicine and appropriate use of Nuclear medicine modalities, among medical students and faculty members. Method: In this descriptive cross sectional study, a self timer limited objective questionnaire based on Google forms was distributed to the study population and scores obtained by the participants were analyzed. Results: Percent scores range for intern, residency trainees, and senior resident/faculty groups for general awareness were 16-46%, 37-58% and 62-91% and for knowledge and appropriate use were 7-21%, 28-43%, and 35-85% respectively. Overall, 61% of the participants had poor awareness and knowledge regarding nuclear medicine modalities. None of the participants had received nuclear medicine exposure or education during their academics or training. Only 49% of the participants considered utilizing nuclear medicine modalities for their patient management. Conclusion: Undergraduate interns and residency trainees had a poor to fair level of awareness and knowledge regarding nuclear medicine. Hence creating more awareness in early stages of their career by incorporating Nuclear medicine basic education in medical undergraduate curriculum is required. The senior residents/faculty members had a moderate to good level of awareness and knowledge but still improvement in their knowledge would lead to a more appropriate and better utilization of nuclear medicine modalities for optimum patient management in a variety of clinical settings. [ABSTRACT FROM AUTHOR]

Introduction: Scrub typhus is a bacterial mite-borne disease associated with poor clinical outcomes if not treated adequately. The study aimed to compare the time to defervescence, clinical failure, mortality and treatment-related adverse effects of two common drugs (doxycycline and azithromycin) used for its treatment. Methodology: This was a systematic review and meta-analysis. All studies up to 20.03.2023 were screened for eligibility in Pubmed and Embase using a search string containing terms related to scrub typhus, doxycycline and azithromycin. After two phases of screening, all comparative studies where doxycycline and azithromycin were used to treat scrub typhus were included. The studies were critically appraised using standardised tools, and a meta-analysis was performed for time to defervescence (primary outcome), clinical failure, mortality and treatment-related adverse effects. Results: Of 744 articles from two databases, ten were included in the meta-analysis. All but two studies had a high risk of bias. The meta-analysis for time to defervescence had a high heterogeneity and did not show any significant difference between doxycycline and azithromycin arms [Mean difference of -3.37 hours (95%CI: -10.31 to 3.57), p=0.34]. When the analysis was restricted to studies that included only severe scrub typhus, doxycycline was found to have a shorter time to defervescence [mean difference of -10.15 (95%CI: -19.83 to -0.46) hours, p=0.04]. Additionally, there was no difference between the two arms concerning clinical failure, mortality and treatment-related adverse effects. Conclusion: The current data from studies with a high risk of bias did not find statistically significant differences in clinical outcomes between doxycycline and azithromycin for scrub typhus [ABSTRACT FROM AUTHOR]

Introduction: Scrub typhus is a bacterial mite-borne disease associated with poor clinical outcomes if not treated adequately. The study aimed to compare the time to defervescence, clinical failure, mortality and treatment-related adverse effects of two common drugs (doxycycline and azithromycin) used for its treatment. Methodology: This was a systematic review and meta-analysis. All studies up to 20.03.2023 were screened for eligibility in Pubmed and Embase using a search string containing terms related to scrub typhus, doxycycline and azithromycin. After two phases of screening, all comparative studies where doxycycline and azithromycin were used to treat scrub typhus were included. The studies were critically appraised using standardised tools, and a meta-analysis was performed for time to defervescence (primary outcome), clinical failure, mortality and treatment-related adverse effects. Results: Of 744 articles from two databases, ten were included in the meta-analysis. All but two studies had a high risk of bias. The meta-analysis for time to defervescence had a high heterogeneity and did not show any significant difference between doxycycline and azithromycin arms [Mean difference of -3.37 hours (95%CI: -10.31 to 3.57), p=0.34]. When the analysis was restricted to studies that included only severe scrub typhus, doxycycline was found to have a shorter time to defervescence [mean difference of -10.15 (95%CI: -19.83 to -0.46) hours, p=0.04]. Additionally, there was no difference between the two arms concerning clinical failure, mortality and treatment-related adverse effects. Conclusion: The current data from studies with a high risk of bias did not find statistically significant differences in clinical outcomes between doxycycline and azithromycin for scrub typhus [ABSTRACT FROM AUTHOR]

In this paper, we define general weighted cumulative residual extropy (GWCRJ) and general weighted negative cumulative extropy (GWNCJ). We obtain simple estimators for complete and right censored data. We obtain some results on GWCRJ and GWNCJ. We establish its connection to reliability theory and coherent systems. We also propose empirical estimators of GWNCJ. GWCRJ based on first-order statistics has been studied. Proposed estimators are calculated through data analysis. A new test of uniformity is proposed and analysed based on GWNCJ. [ABSTRACT FROM AUTHOR]

Introduction: Thyroid surgeries are routinely performed in day-to-day practice. However, parathyroid surgery is a rarely performed surgery that calls upon the highest level of skill and knowledge on the part of the surgeon to perform a complication-free surgery. Parathyroid adenomas are the most common tumors of parathyroid glands leading to hyperparathyroidism. Most of these patients are primarily seen by orthopedic surgeons or physicians and are then referred to the ENT Department for surgery. Aim and objective: To present the clinic-radiological - pathological profile of parathyroid adenoma patients. Materials and methods: Study design: Prospective observation study. Setting: Tertiary Care Centre and Government Medical College. Subjects: Clinico-radiological-pathological profile of 47 consecutive patients who underwent parathyroidectomy for adenomas during a 5-year period from 2016 to 2020 in our institute which is a Tertiary Care Hospital and Medical College excluding patients operated for parathyroid carcinoma. Results: Findings were suggestive of adenomas in left inferior parathyroid (18), right inferior parathyroid (11), left superior parathyroid (9), right superior parathyroid (7) and in one patient there were 2 parathyroid adenomas. Conclusion: We conclude that accurate diagnosis and thorough knowledge of anatomy is the key to carry out a successful parathyroid surgery. [ABSTRACT FROM AUTHOR]

Measles poses a significant global health threat, exacerbated by the COVID-19 pandemic. Despite the efficacy of two vaccine doses, under-5 mortality rates persist, with over 61 million delayed measles vaccinations worldwide. Nepal, striving to eliminate measles by 2023, faces a resurgence, attributing 1013 cases to inadequate vaccination and healthcare accessibility issues. Compounded by disruptions from the COVID-19 pandemic, the outbreak highlights the urgent need for vaccination promotion, improved healthcare access, and misinformation mitigation. This situation underscores the critical role of global collaboration and healthcare infrastructure investment to safeguard children's lives in Nepal and similar vulnerable regions. [ABSTRACT FROM AUTHOR]

• An overview of solar photovoltaic (PV) power generation in respect of all the other renewable energy sources (RES) have been presented on cumulative basis. • The different solar PV configurations, international/ national standards and grid codes for grid connected solar PV systems have been highlighted. • The state-of-the-art features of multi-functional grid-connected solar PV inverters for increased penetration of solar PV power are examined. • The various control techniques of multi-functional grid-connected solar PV inverters are reviewed comprehensively. The installed capacity of solar photovoltaic (PV) based generating power plants has increased significantly in the last couple of decades compared to the various renewable energy sources (VRES). As a result, the increased penetration of solar PV-based generating units leads to several issues related to power quality, system stability, and reliability. In view of these concerns, various international standards and grid codes have been amended to address such critical issues. Therefore, most solar PV-based generating units have undergone several changes in operational and control structure. Subsequently, varieties of solar PV configurations and control structures have been proposed by several researchers to augment the desired operational features. This paper presents a comprehensive review of various solar PV configurations, control strategies, and ancillary services with multifunctional features within this context. The utilization and benefits of various configurations and their practical aspects have been discussed thoroughly for all the configurations and architectures. Apart from this, the control aspects of grid-connected solar PV systems are categorized into two important segments, namely, a) DC-side control and b) AC-side control. This article covers the important features, utilization, and significant challenges of this controller and summarizes the advanced control techniques available in the literature. Further, the various control techniques have been compared concerning different operational parameters, such as controller gains, duties, and selector quantities in tabular form with ready references. Furthermore, the concerns related to power quality, stability, and reliability of various techniques have been included for understanding the applicability of grid-connected PV systems. In the end, a detailed comparison of some available industrial inverters concerning their power ratings, voltage ratings, configurations, and advanced functions incorporated are also presented, which will help the researchers, academicians, and practicing engineers. [ABSTRACT FROM AUTHOR]

Cognitive radio networks allow opportunistic spectrum access to the unlicensed users, which rely on effective spectrum sensing. Recently, cooperative sensing has been found to improve sensing reliability. However, sometimes the selfish users do not cooperate, and therefore, different incentive design mechanisms like contract theory have been proposed recently, where the cooperation is encouraged by offering appropriate reward to the sensing participants. However, still no secure structure exists for the reward distribution after a successful contract completion, and a user may also deny sensing even after accepting the contract. This work proposes the use of blockchain-based smart contracts, which are based upon a permissioned blockchain that helps in making the transactions private among the participants. Further, the efficiency of this approach is improved by introducing a reputation parameter for the users. This measures the trustworthiness of a particular user based upon the accuracy of their recent sensing results. Further, a money locking approach is proposed from which a penalty is deducted if the user denies or fails to submit a correct reading. Performance analysis of the proposed scheme is done to show the superiority of the scheme. [ABSTRACT FROM AUTHOR]

A number of recent works have argued that quantum complexity, a well-known concept in computer science that has re-emerged recently in the context of the physics of black holes, may be used as an efficient probe of novel phenomena such as quantum chaos and even quantum phase transitions. In this article, we provide further support for the latter, using a 1-dimensional p-wave superconductor — the Kitaev chain — as a prototype of a system displaying a topological phase transition. The Hamiltonian of the Kitaev chain manifests two gapped phases of matter with fermion parity symmetry; a trivial strongly-coupled phase and a topologically non-trivial, weakly-coupled phase with Majorana zero-modes. We show that Krylov-complexity (or, more precisely, the associated spread-complexity) is able to distinguish between the two and provides a diagnostic of the quantum critical point that separates them. We also comment on some possible ambiguity in the existing literature on the sensitivity of different measures of complexity to topological phase transitions. [ABSTRACT FROM AUTHOR]

Suicide is the second leading cause of death among adolescents in the age group of 15 to 19 years. As per the National Crime Record Bureau, India loses 1 student to suicide every hour. The COVID pandemic saw an alarming rise in the number of children/adolescents attempting suicide. The state of Kerala lost 173 children in the age group of 10 to 18 years, during the first wave of the pandemic (March-October 2020). This review article has been written with the aim of exploring causes of aggression, suicide, and self-harm in children and adolescents. It also strives to bring forth the various interventions which can be taken in order to reduce the rate of suicide and self-harm in children and adolescents. [ABSTRACT FROM AUTHOR]

Self-injurious behavior is a common symptom in neurodevelopmental disorders which is often the least understood and difficult to treat. In this narrative review, we intend to focus on the symptomatology, causal and risk factors for SIBs along with the nonpharmacological and pharmacological management of SIBs in NDD. A manual search was done using the electronic databases of Pubmed, Google scholar on relevant publications or cross-references till December 2022 and the data was then collated to give the prevalence, epidemiology, risk factors, treatment and management of SIB in NDD. Results showed that the behaviors begin in developmental phase and are seen in nearly 30% of children with NDD. Many SIBs become chronic over time and are characterized by being repetitive in nature, compulsive or episodic. They could be superficial or deep and are best treated by nonpharmacological methods using functional behavior assessment (FBA). Despite lack of robust evidence for psychotropics some second-generation antipsychotics have been approved for pharmacological treatment of SIB. We can conclude that until more data are available, clinicians must continue to rely upon the limited available evidence, clinical judgement, and expertise, and carefully monitored response(s) to therapy when managing SIBs in children. SIB is outcome of multiple factors that initiate and maintain the behavior. Judicious use of various groups of pharmacological agents is advised. Physician preferences, history of response and safety are part of pharmacological interventions. [ABSTRACT FROM AUTHOR]

REBT is an evidence-based approach that helps people manage cognitive, emotional, and behavioral disturbances in sustainable, healthy ways. It takes a holistic view of emotional disturbances, including depression. In keeping with the concept of psychological interactionism, REBT views depression as a thinking-feeling-behaving pattern and not a diagnostic label alone. Depressive thinking-feeling-behaving is a common consequence in teens in response to such adversities and can manifest in different ways. Some may want to resign to their fate and let others make these choices for them, some may want to gain more control by trying to make perfect choices, and some may want to escape the conflict by hurting themselves, overly consuming online content, binge eating junk food, and so on, and others may want to rebel and make extreme choices. Most of these ways prove to be short-term ways of coping with or managing these challenges and may be in fact harmful in the long term. REBT argues that therapy can teach teenagers to identify, practice, and internalize healthy, long-term ways of coping which they can eventually use independently across different situational contexts. [ABSTRACT FROM AUTHOR]

Eating disorders (EDs) are increasingly recognized in children and adolescents. Anorexia nervosa (AN) and bulimia nervosa (BN) are less common in children and adolescents than adults, but both disorders can occur in this age group. Binge-eating disorder (BED) is the most common ED in children and adolescents and is more prevalent in females than males. EDs may present differently in children and adolescents than in adults, and parents or caregivers may be the first to notice changes in eating patterns or body weight. Diagnostic criteria for EDs in children and adolescents include disturbances in eating behavior, weight or shape concerns, and significant distress or impairment in social, academic, or occupational functioning. Multidisciplinary approaches are recommended for treating EDs in children and adolescents, including medical management, nutritional counseling, and psychological interventions. Evidence-based treatments for AN and BN include family-based therapy, cognitive-behavioral therapy, and interpersonal psychotherapy. Cognitive-behavioral therapy and interpersonal psychotherapy are recommended for children and adolescents with BED. Hospitalization may be necessary in severe cases. Early identification and intervention are crucial for improving treatment outcomes and reducing the risk of long-term complications. Treatment approaches should be tailored to developmental and cultural needs and involve a multidisciplinary team. Continued research is needed to improve early detection, prevention strategies, and treatments for this vulnerable population. EDs in children and adolescents are a significant public health concern that can have serious physical and psychological consequences. It is important for healthcare providers and caregivers to be aware of the signs and symptoms of EDs in young people and to seek prompt and appropriate treatment [ABSTRACT FROM AUTHOR]

Research in psychopharmacology in children and adolescents is an area of growing interest with numerous newer modalities becoming available in recent years. Nevertheless, it still lags significantly behind research in adult psychopharmacology although, in the last decade, the gap is beginning to be bridged with FDA approval for newer agents for the paediatric age group. The purpose of this selective narrative review is to examine the latest advances in psychopharmacology in the last decade and their safety, tolerability and applicability in children and adolescents. In methodology, we identified 4 main areas of recent advances in psychopharmacology, viz. Ketamine, Nitrous Oxide, Cannabidiol and cannabis derivates and the area of pharmacogenomics. We then conducted a comprehensive search of the literature using PubMed, Embase and Ovid databases to identify the most recent updates in these areas, especially focussed on the paediatric population. The search was limited to English language studies and focussed on recent updates in these four areas. In the results, it was seen that all the four identified areas have potential applicability in children and adolescents with some studies evaluating their safety and tolerability in the paediatric population. However, literature on the long-term safety and efficacy of these newer modalities in the paediatric population is limited and none of the identified agents are currently recommended for routine clinical use in children and adolescents. Overall, it could be concluded that the results of this selective narrative review suggest that newer modalities in psychopharmacology offer promising treatments for psychiatric disorders in children and adolescents. However, further research is needed to fully understand the long-term safety and efficacy of these treatments as well as optimal dosing and monitoring strategies to ensure their safe and effective use in the paediatric population. [ABSTRACT FROM AUTHOR]

Psychiatric disorders in children and adolescents have a varied and heterogeneous presentation. Many risk factors play a role in the emergence of the disorder. Newer molecules have been tried for comorbidities in ASD and ADHD. Many have shown efficacy but need more robust evidence for clinical use. Oxytocin in ASD has shown efficacy however is not yet in clinical use. Viloxazine in ADHD has been FDA-approved and has shown efficacy in ADHD. Neuromodulation is tried in almost all disorders; however, studies are limited. Computer-based cognitive training has proven to be helpful in psychotic disorders. More trials are warranted to consolidate the evidence. Digital interventions and virtual reality can be a new way forward. Studies are limited. [ABSTRACT FROM AUTHOR]

Affective disorders in children and adolescents generally have a severe course of the illness, higher suicidal behavior, and adverse effect on overall development and life course. Presentation of pediatric depression and bipolar is usually different from adults, leading to longer delays in help-seeking and effective management. This narrative review highlights the magnitude, clinical presentation, comorbidity, differential diagnosis, and management approach of depression and bipolar in children and adolescents. Better awareness and expertise are essential for timely identification, comprehensive assessment, and holistic treatment. [ABSTRACT FROM AUTHOR]

Intellectual disability (ID) can be caused by various environmental and genetic factors and can lead to significant disability. There are numerous challenges in the field in terms of diagnosis and management. In this article, we have reviewed the literature in this field. A dependable estimate of the prevalence in India still remains to be made. Preventive measures and screening play an important role. The country could greatly benefit from a national newborn screening program, presence of more trained professionals, and public awareness measures. Drug treatments spanning beyond the usual drug classes have not yet found a breakthrough. Persons with ID face many challenges in the field of education, disability certification, access to government schemes, job placements, and living arrangements. We must take cognizance of these challenges at the earliest and work toward rectifying them. [ABSTRACT FROM AUTHOR]

Psychotherapies for the youth have resulted from the confluence of 3 major disciplines: adult psychology and psychiatry, developmental neurology and pediatrics, and developmental psychology and ethology. Since their humble origins in the psychoanalytically oriented play therapy and the related theories in the pre-War Germany, over more than a century, they have embraced diverse theoretical views that include but not limited to the integration of developmental issues, evolution of the child guidance movement, and the various influences of institutional and social policies. Such a rich journey has eventually resulted in evidence-based practices (EBPs)—powerful interventions for children and families for complex behavioral problems. In this chapter, we attempt to trace the blooming field of youth psychotherapies in their historical contexts, provide an account of the existing gaps of knowledge, briefly narrate the modern-day developments, mostly regarding the multimodal/eclectic treatment aspects and finally, given their rapid growth, we speculate about their (positive) future. Child and adolescent therapies have progressed considerably, as reflected in the number of controlled studies, their methodological quality, and identification of evidence-based treatments. Despite the methodological difficulties in outcome studies, the field has witnessed major advances regarding the efficacy of selected treatments in child and adolescent psychotherapy and good quality meta-analyses do suggest that 75% of children and young people who attend therapy benefit from it. However, despite the comforting data related to efficacy, major challenges still remain, especially in regard to patient engagement and dropout rates, gap in knowledge about what works and why it works, cultural sensitivity, and data of cost- effectiveness—just to quote a few. Several key areas have been neglected in research, such as the mechanisms of change, the moderators of treatment outcome, and the generalizability of the research findings to the clinical practice arena—this has greatly limited what we know about treatment and partly explains the relative lack of personalized psychotherapies and scarcity in their dissemination/generalization despite the documented evidence on their efficacy. Tailoring treatment more specifically to each patient may be necessary to reduce this nonresponsiveness and dropping outs, as one treatment does not fit all. This necessitates the need for eclecticism—to combine youth psychotherapies with other modes of treatments, such as medications, neuromodulation interventions, and Yoga and mindfulness-based cognitive therapy. Future practice for treatment of mental health conditions in the youth will likely adapt to this huge need for development of eclectic modalities and also reflect cost effectiveness and cultural sensitivity to an increasingly diverse population. [ABSTRACT FROM AUTHOR]

Age-old societal beliefs are being challenged and constantly changing with urbanization, industrialization, and modernization, which have blurred the typical family gender roles and structure. The studies conducted 2 to 3 decades back showed that family instability can negatively affect children's development. The absence or loss of one parent and conflicts between separated and divorced parents affect not only the child's mental health but also the child's physical health, overall growth, and future relationships. Single parents are often overburdened with the responsibilities of 2 parents, face social stigma, and lack social support, as a result they have difficulty spending time with their children. Hence children of single parents have poor academic performance, decreased social interactions, emotional and behavioral problems. Newer research has focused on the positive outcomes and protective factors that can steer the child towards better outcome. We need to focus on such protective and resilience-building factors to help the child adjust in the short and long run. [ABSTRACT FROM AUTHOR]

Psychological assessment process involves administration, scoring, interpretation, and report writing. In addition to the human resource, time, and effort required for the training, the assessment process itself requires significant time and effort on the part of trained professionals. This automatically translates into the cost, which sometimes can be significant. Given the significantly limited number of trained psychologists who are in clinical practice in India compared to the extent of the population of the country, the amount of assessment work can take away precious time from the intervention services. On the other hand, a significant number of psychological assessment tests used in India are generally old with outdated norms, are poorly standardized, and are not keeping pace with the global development. Given these issues, mental health profession on the whole, as well as the clients/patients can question the validity of the psychological assessments or some specific assessments. This article tries to discuss some of the issues related to the validity of the psychological assessments in general and in specific domains, such as ability, achievement, and psychopathology. In addition to mentioned issues, the article also tries to suggest possible measures to overcome those limitations. [ABSTRACT FROM AUTHOR]

The effects of digital technology on early brain development have been hotly debated for a long time. The COVID-19 pandemic increased these worries to a greater scale as it led to an inevitable surge in the use of digital technology across age groups. The risks and benefits of screens or gadgets are often discussed at length on multiple platforms. Technology has become a part of everyday life for humans of all age groups. Exposure to screens often starts in the first few months of life. It therefore becomes imperative to study the various ways by which it may affect the development of the human brain. Emerging clinical studies show that it may have a positive as well as negative effects on multiple aspects of brain development. In spite of the available research, there is no conclusive evidence to link the effects of digital technology with developmental disorders. The purpose of this review is to summarize the current evidence and conceptual understanding in this area. [ABSTRACT FROM AUTHOR]

Somatic Symptoms or Medically Unexplained Symptoms are commonly found in children and adolescents. These symptoms generally reflect the underlying psychological distress and cause significant distress to the child. Presenting symptoms include abdominal pain, headaches, and musculoskeletal pain. The nature of illness prompts multiple visits to clinical setups, burdening the existing health resources. Risk factors include individual, family, and environmental factors. Most stressful factors are seen to arise from day-to-day problems in children like academic problems, bullying, familial disharmony, temperamental traits, abuse, financial constraints, and parenting issues. Psychiatric and physical comorbidities are prevalent. During the assessment, it is pertinent to rule in positive signs and keep in mind the common psychiatric/physical differentials. Management includes a multidisciplinary approach involving the child and family. An overall visualization of the biopsychosocial framework of the child is done to cater to specific needs. Psychoeducation remains a key strategy, while incorporating behavioral management. This includes promoting strengths and positive behavior in child, gradual reduction in secondary gains, promotion of general well-being, focus on a well-rounded schedule incorporating different activities, and relaxation training. Psychosocial factors are worked upon at length while enhancing coping skills. Familial factors are taken into consideration and home environment may be improved. Comorbidities if present can be managed with medications. The goal is functional recovery and rehabilitation, which can be time taking and requires patience from the treating team. [ABSTRACT FROM AUTHOR]

Attention deficit hyperactivity disorder (ADHD) is the most common neuro-behavioral disorder characterized by a classical triad of hyperactivity-impulsivity and inattention prevalent in 5% of school-going children, mostly in boys. It is a chronic disorder with persistent of symptoms in a significant proportion of children diagnosed in childhood and impairing in most domains of socio-occupational functioning. Challenges in diagnosis occur due to symptoms domains of ADHD representing extremes of developmental processes of hyperactivity and inattention. Temperament is another construct that is important while evaluating a child with ADHD to avoid misdiagnosis and/or overdiagnosis. There is literature to support that the presentation of ADHD is not just limited to the triad of symptoms described in DSM 5, but it manifests a plethora of symptoms which, in the majority of cases, often go unnoticed. These symptoms may be a result of executive function deficits, emotion dysregulation, the presence of comorbid disorders, and/or psychosocial issues. Impairments of ADHD continue into adolescence and adulthood. However, ADHD in adults is still an under-researched area. The article aims to provide a bird's eye view of the various hidden difficulties inherent in ADHD but which often is missed in clinical practice. [ABSTRACT FROM AUTHOR]

The philosophy of childhood which deals with issues related to conception about childhood, children's rights, and moral status, etc., is important for clarifying attitudes towards the children in care provision and ethical and legal conundrums related to child and adolescent mental health. This is highlighted through the implications of philosophy of childhood on the age of consent, in particular, in reference to medical and sexual consent. [ABSTRACT FROM AUTHOR]

Understanding the mechanical response and failure of consolidated extra-terrestrial soils requires analyses of the interactions between propagating cracks and the material's inherent pore structure. In this work, we investigate the fracture behaviour of lunar soil simulant consolidated using microbially induced calcite precipitation (MICP). We develop a numerical lattice network model using local beam elements to simulate the nucleation, propagation, branching, and merging of multiple cracks within a space brick subject to uniaxial compression. Our simulations capture the effects of local pores on crack paths as well as provide a means to predict the behaviour of samples with varying global porosity and/or uncertainties in local material stiffness. We identify multiple statistical lattice parameters that encode signatures of single or multiple crack growth events. Our results reveal the complexities involved in the fracture process with porous brittle solids and may easily be adapted to understand failure mechanisms and micro/macro crack evolution in other consolidated structures. [ABSTRACT FROM AUTHOR]

Osteitis fibrosa cystica (OFC) is a skeletal disease related to long standing, end-stage hyperparathyroidism. However, nowadays hypercalcemia due to primary or secondary hyperparathyroidism can often be detected early by laboratory screening and imaging modalities; consequentially the frequency of osteitis fibrosa cystica has drastically declined. OFC, also termed as Brown tumor, can mimic primary bone tumors clinically, which often leads to misdiagnosis and inappropriate management. Moreover due to its rarity, it is usually not considered initially in the differential diagnosis of bony tumors. Case presentation: This is the case of a 19-year-old female, who presented with pain over the left ankle region for 3 months. The biochemical screening revealed a picture consistent with primary hyperparathyroidism and the radiologically proven to be left inferior parathyroid adenoma. She underwent excision of the primary parathyroid adenoma, and gradual regression of symptoms was noted postoperatively. Osteitis fibrosa cystica is a rare manifestation of hyperparathtyroidism, which has become a forgotten entity lately due to early identification of hypercalcaemia by modern techniques. A delay in the diagnosis of parathyroid adenoma results in manifestations that can be avoided. The diagnosis of OFC requires a high degree of clinical suspicion. When hypersecretion of PTH is corrected, spontaneous regression of the lesion is expected. [ABSTRACT FROM AUTHOR]

Xanthine and its derivatives are considered a pharmacologically potential moiety that manifests immense biological activities. Owing to this much diversity in the biological field, this scaffold has fascinated the attention of many researchers around the globe to scrutinize its basic structure chemically as well as biologically. In recent years, xanthine derivatives have been used therapeutically in different pathological conditions due to their presence in day-to-day life. Herein, we review the recent progress in the synthesis of xanthine and its derivatives. Some of the widely used synthetic strategies such as (a) Traube's synthesis, (b) one-pot synthesis, (c) xanthine-anneleated synthesis, and (d) miscellaneous synthesis were compiled in this review paper. The results obtained from this review paper highlight the significance of various xanthine derivatives as possible leads to the development of new drugs. The data compiled in this review paper could help the medicinal chemist in designing new active compounds from the modification of the already existing compounds in the search for novel drug leads. This report concludes that the various synthetic procedures exemplified in this review paper may serve as a support system for the designing of new molecules with a xanthine scaffold. Thus, we hope that this molecule may serve as the prototype in order to find out more active xanthine derivatives. [ABSTRACT FROM AUTHOR]

In addition to entropy, extropy - the complementary dual of entropy has also gained importance as a measure of information in many areas. Extropy of order statistics, record values and mixed systems, residual extropy properties of k record values, past extropy have been extensively studied in literature. In this paper, we propose length (size) biased shift dependent measures of uncertainty i.e., weighted extropy and weighted residual extropy and study their monotone properties, characterization results, and some other properties in the case of order statistics and k-record values. We also discuss these studies for the past extropy measure. [ABSTRACT FROM AUTHOR]

Aim: To determine the utility of the HACOR score in predicting weaning failure in resource-limited settings. Objectives: The primary objective was to determine a cut-off value of the HACOR score, sensitivity, and specificity to predict failed weaning. The secondary objective was to determine which out of five components of the score was significantly different between the successful weaning and the failed weaning groups. Introduction: Most weaning indices are either inaccurate or are dependent on complex ventilatory parameters, which are difficult to measure in resource-limited settings. This study aimed to determine the utility of the HACOR score consisting of heart rate, acidosis, consciousness level, oxygenation, and respiratory rate as a predictor of weaning in the intensive care unit. Materials and methods: It was a prospective observational study on 120 patients between 18 and 90 years. The HACOR score was evaluated at 30 minutes of spontaneous breathing trial (SBT). The total duration of SBT was 120 minutes. Results: Out of 120 patients, 83 (69.2%) had successful weaning, whereas 37 (30.8%) had weaning failure. The median and interquartile range (IQR) of the HACOR score in the successful weaning group was 2 (0-3) and 6 (5-8) in the failed weaning group (p-value <0.001). There was a significant difference in each of the five components of the HACOR score between the successful and failed weaning groups (p <0.05). HACOR score ≥5 predicted failed weaning, sensitivity 83.8%, specificity 96.4%, area under the curve (AUC) 0.950, and 95% confidence interval (CI) [0.907-0.993], p <0.001. Multivariable logistic regression analysis showed that HACOR score ≥5 is an independent predictor of weaning failure [p <0.001, 95% CI (1.9-4.2), adjusted odds ratio 2.82]. Conclusion: A HACOR score ≥5 is an excellent predictor of weaning failure. This score may be useful as a weaning strategy in the intensive care unit. [ABSTRACT FROM AUTHOR]

Summary: Cloud computing is the provision of on‐demand computing resources over the internet and on a pay‐as‐you‐go basis, ranging from software to computation power. Task scheduling and its execution is a fundamental requirement of cloud environment. However, dynamic scheduling of tasks on basis of priority is a challenging area such that the tasks finish before their deadline. Earliest Deadline First (EDF) has been considered in literature for task scheduling to meet the deadlines. However, basic EDF (i.e., which schedules tasks on basis of deadline only)is not suitable for cloud environment. Therefore, this work proposes modified Preemptive EDF (p‐EDF) and Non‐Preemptive EDF (np‐EDF) algorithms considering task priority and cloud provider cost. As both algorithms have their own merits and de‐merits, a hybrid EDF is further proposed which makes decision dynamically whether to cause preemption or not, using a Determiner function. The objective of the work is to avoid unnecessary wastage of CPU power and time due to unnecessary preemptions, along with avoiding unnecessary deadline misses such that the high priority task does not wait for the low priority task to end. Simulation results show that the proposed algorithm outperforms other considered benchmark scheme for different performance parameters such as Deadline Miss Count, Preemption Count and average waiting time. [ABSTRACT FROM AUTHOR]

Introduction: The objective of the study was to evaluate the clinical profile and outcome of patients with secondary hemophagocytic lymphohistiocytosis (HLH) in critically ill patients. Materials and methods: A prospective observational study was conducted where critically ill adult patients presenting with fever and bicytopenia were evaluated according to the HLH-2004 diagnostic criteria for the presence of secondary HLH. The underlying trigger, clinical profile, treatment, and outcome of patients with HLH were analyzed. Results: Of the 76 critically ill patients with fever and bicytopenia, 33 (43%) patients were diagnosed with HLH. The following triggers for HLH were identified: bacterial infections (23%), fungal infections (10%), viral infections (10%), parasitic infections (10%), autoimmune diseases (13%), and malignancy (8%). A total of 78% of the HLH cases received steroids, but the use of steroids was not associated with improvement in mortality. Conclusion: There is a high prevalence of HLH in patients presenting with fever and bicytopenia in critically ill adult patients. Infections were identified as the most common trigger of HLH. [ABSTRACT FROM AUTHOR]

Wireless sensor networks (WSNs) have been imperative means for the collection of information in various fields. Integration of WSN with the latest technology like unmanned aerial vehicles (UAVs) can increase the overall performance of the WSN by increasing the sensor coverage or reducing the latency. However, for full coverage of the sensors to avoid data loss, to reduce the time required to deliver the data to sink and to minimize the calculation of the total path length, overall trajectory optimization is required. In order to solve these challenges, in this work, trajectory of the UAV is considered as a hamiltonian path that covers all the cluster heads in the WSN. The proposed scheme is able to calculate path in polynomial time which is otherwise considered to be NP-Hard. Moreover, data of sensor nodes is sent directly to the UAV thereby eliminating the need of any routing protocol. Simulation results show that the coverage of nodes is improved along with minimized data loss in comparison with single-hop and multi-hop routing protocols of WSN. [ABSTRACT FROM AUTHOR]

Addition of preschool education/care (3-8 years of age) or what has been rightly addressed in the policy as I early childcare and education i is a path breaking step towards better human development index and literacy rates in India. Inclusion of Early Childhood Care and Education A major change that has been brought in the NEP is the structural change in the school education from 10+2 structure to 5+3+3+4 structure. The Ministry of Education recently announced that the new format of twice a year board examination will be started from 2024; students can appear for exams for the syllabus that they feel prepared and ready for in the first exam and give the remainder in the next exam ( I India i , n.d.; The Times of India, 2023). Limitations and Challenges One of the limitations of the NEP is its major and predominant focus on school-based education. [Extracted from the article]