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Background: The COVID-19 pandemic has created public health crisis and economic instability globally. However, the pandemic and the nationwide lockdown have a significant impact on the psychosocial status, emotional state, relationships of individuals, family, and community. Families were facing challenges due to lockdown and will do their best to develop adaptive behavior for attaining self-stability. The present study helps to understand the effect of lockdown on family well-being and the shift of intrafamilial relationships during the lockdown. Subjects and Methods: A cross-sectional study was done in an urban area of Kakinada from April to June 2020. A convenient sample of 300 families was selected by systematic random method. One parent and one adolescent child from each family, a total of 600 study participants were included under the study. Data were collected using a semi-structured questionnaire, entered in Microsoft Excel and analyzed using IBM SPSS. The mean, frequencies, proportion, and Chi-square test were used to analyze data. Results: Adaptability has increased during lockdown by sharing of household work, from 3% before to 91.7%. 97.3% were happy spending time with family members. Communication and satisfaction have increased by a decrease in conflicts, from 19.7% to 7% during the lockdown. Only 3.08% of adults were facing either physical or verbal abuse. Conclusions: During the lockdown period, the family members spent quality time together acquired new skills, and conflicts among them were reduced. Domestic violence is low in this particular study area and familial bonding is high.

Background: In older adults multimorbidity increases with age and this increases the consumption of medications and the risk of Polypharmacy (PP). Along with this, the use of Potentially Inappropriate Medications (PIMs) among the elderly patients is a very common public concern. Objectives: The primary objective is to assess the pattern of PP and estimate the proportion of PP and PIMs among the geriatric in-patients. The secondary objective is to find out the association between serum creatinine and PP. Methods: A cross-sectional observational study was conducted among the geriatric in-patients aged ≥65 years admitted in medical wards by reviewing the case sheets. PIMs use was identified using Beer's criteria. Descriptive statistics like mean, range, standard deviation and proportions were used for Polypharmacy and PIMS. Inferential statistics like Pearson's Chi-squared test was used to find out association between serum creatinine and PP. Results: A total of 84 geriatric in-patients were enrolled as study subjects. Mean number of drugs prescribed was 6.9 (±3.2) and range 2-18. Proportion of PP was 73.8% and that of PIMs was found in 33.3% in the patients. There was significant association between an increase in serum creatinine levels with an increase in consumption of drugs. (p = 0.009) Conclusion: The proportion of PP and PIM and was found to be high among the geriatric patients. There was an increase in serum creatinine levels with increased consumption of drugs.

Solid state transformer (SST) is a high frequency switched power electronic based transformer with high controllability that enables flexible connectivity between existing medium voltage power distribution network, low voltage AC residential system and envisioned DC residential system. The SST is not a direct replacement of a conventional low frequency transformer, but a multi-purpose device that offers improved functionalities. The demanded requirements of the future power systems such as integration of distributed generation, DC loads and storage have enabled the microgrid technology to evolve. This paper is focused on the SST as an intermediary tool for microgrids. An overview of existing and possible SST based microgrid designs and control architectures, their advantages, disadvantages and the identified selection criteria are presented. With a special focus on existing experimental setups, the paper is concluded highlighting the possible areas of research that would enhance the integration of the SSTs into microgrids in the future.

Abstract Epidermolysis bullosa acquisita (EBA) is a difficult-to-treat subepidermal autoimmune blistering skin disease (AIBD) with circulating and tissue-bound anti-type VII collagen antibodies. Different reports have indicated increased concentration of tumor necrosis factor α (TNF) in the serum and blister fluid of patients with subepidermal AIBD. Furthermore, successful anti-TNF treatment has been reported for individual patients with AIBD. Here we show that in mice, induction of experimental EBA by repeated injections of rabbit anti-mouse type VII collagen antibodies led to increased expression of TNF in skin, as determined by real-time polymerase chain reaction (PCR) and immunohistochemistry. To investigate whether the increased TNF expression is of functional relevance in experimental EBA, we inhibited TNF function using the soluble TNF receptor fusion protein etanercept (Enbrel) or a monoclonal antibody to murine TNF. Interestingly, mice that received either of these treatments showed significantly milder disease progression than controls. In addition, immunohistochemical staining demonstrated reduced numbers of macrophages in lesional skin in mice treated with TNF inhibitors compared with controls. Furthermore, etanercept treatment significantly reduced disease progression in immunization-induced EBA. In conclusion, increased expression of TNF in experimental EBA is of functional relevance, as both the prophylactic blockade of TNF and the therapeutic use of etanercept impaired induction and progression of experimental EBA. Thus, TNF is likely to serve as a new therapeutic target for EBA and AIBDs with a similar pathogenesis.

Ocean acidification is a result of the uptake of anthropogenic CO2 from the atmosphere into the ocean and has been identified as a major environmental and economic threat. The release of several thousands of petagrams of carbon over a few hundred years will have an overwhelming effect on surface ocean carbon reservoirs. The recorded and anticipated changes in seawater carbonate chemistry will presumably affect global oceanic carbonate production. Coccolithophores as the primary calcifying phytoplankton group, and especially Emiliania huxleyi as the most abundant species have shown a reduction of calcification at increased CO2 concentrations for the majority of strains tested in culture experiments. A reduction of calcification is associated with a decrease in coccolith weight. However, the effect in monoclonal cultures is relatively small compared to the strong variability displayed in natural E. huxleyi communities, as these are a mix of genetically and sometimes morphologically distinct types. Average coccolith weight is likely influenced by the variability in seawater carbonate chemistry in different parts of the world's oceans and on glacial/interglacial time scales due to both physiological effects and morphotype selectivity. An effect of the ongoing ocean acidification on E. huxleyi calcification has so far not been documented in situ. Here, we analyze E. huxleyi coccolith weight from the NW Mediterranean Sea in a 12-year sediment trap series, and surface sediment and sediment core samples using an automated recognition and analyzing software. Our findings clearly show (1) a continuous decrease in the average coccolith weight of E. huxleyi from 1993 to 2005, reaching levels below pre-industrial (Holocene) and industrial (20th century) values recorded in the sedimentary record and (2) seasonal variability in coccolith weight that is linked to the coccolithophore productivity. The observed long-term decrease in coccolith weight is most likely a result of the changes in the surface ocean carbonate system. Our results provide the first indications of an in situ impact of ocean acidification on coccolithophore weight in a natural E. huxleyi population, even in the highly alkaline Mediterranean Sea.

The response of coccolithophore calcification to ocean acidification has been studied in culture experiments as well as in present and past oceans. The response, however, is different between species and strains, and for the relatively small carbonate chemistry changes observed in natural environments, a uniform response of the entire coccolithophore community has not been documented so far. Moreover, previous palaeo-studies basically focus on changes in coccolith weight due to increasing CO2 and the resulting changes in the carbonate system, and only few studies focus on the influence of other environmental factors. In order to untangle changes in coccolithophore calcification due to environmental factors such as temperature and/or productivity from changes caused by increasing pCO2 and decreasing carbonate ion concentration, we here present a study on coccolith calcification from the Holocene North Atlantic Ocean. The pre-industrial Holocene, with its predominantly stable atmospheric CO2, provides the conditions for such a comprehensive analysis. For an analysis on changes in major components of Holocene coccolithophores under natural conditions, the family Noelaerhabdaceae was selected, which constitutes the main part of the assemblage in the North Atlantic. Records of average coccolith weights from three Holocene sediment cores along a north–south transect in the North Atlantic were analysed. During the Holocene, mean weight (and therefore calcification) of Noelaerhabdaceae (Emiliania huxleyi and Gephyrocapsa) coccoliths decreased at the Azores (Geofar KF 16) from around 7 to 6 pg, but increased at the Rockall Plateau (ODP site 980) from around 6 to 8 pg, and at the Vøring Plateau (MD08-3192) from 7 to 10 pg. The amplitude of average weight variability is within the range of glacial–interglacial changes that were interpreted to be an effect of decreasing carbonate ion concentration. By comparison with SEM assemblage counts, we show that weight changes are not only partly due to variations in the coccolithophore assemblage but also an effect of a change in calcification and/or morphotype variability within single species. Our results indicate that there is no single key factor responsible for the observed changes in coccolith weight. A major increase in coccolith weight occurs during a slight decrease in carbonate ion concentration in the late Holocene at the Rockall Plateau and Vøring Plateau. Here, more favourable productivity conditions apparently lead to an increase in coccolith weight, either due to the capability of coccolithophore species, especially E. huxleyi, to adapt to decreasing carbonate ion concentration or due to a shift towards heavier calcifying morphotypes.

In spite of numerous recent outcome studies of extremely low birth weight (ELBW) infants, no data exist on their development prior to term. In this study we traced and compared the neurobehavioral development of 251 ELBW (less than 1,000 g) and 240 low birth weight (LBW; 1,000 g-2,500 g) preterms born between 1995 and 2004 from 32 to 37 weeks postconceptional age (PCA), using the Neurobehavioral Assessment of the Preterm Infant (NAPI; Korner & Thom, 1990). Compared to the original NAPI cohort of 521 infants (born 1983-1989), the ELBW and LBW infants were at higher medical risk, displayed weaker motor development, a tighter scarf sign and popliteal angle at all or most PCAs, and a weaker cry at older PCAs; they did not differ in irritability and percent asleep ratings. Few differences were noted between the ELBW and LBW groups. Research is now needed to determine whether the 1995 to 2004 NAPI values of ELBW and LBW infants at 32 to 37 weeks PCA are predictive of later outcome of high-risk preterms. (Contains 3 tables and 7 figures.)

Background: Sleep disturbances are important symptoms to monitor in people with bipolar disorder (BD) but the precise longitudinal relationships between sleep and mood remain unclear. We aimed to examine associations between stable and dynamic aspects of sleep and mood in people with BD, and assess individual differences in the strength of these associations. Methods: Participants (N = 649) with BD-I (N = 400) and BD-II (N = 249) provided weekly self-reports of insomnia, depression and (hypo)mania symptoms using the True Colours online monitoring tool for 21 months. Dynamic structural equation models were used to examine the interplay between weekly reports of insomnia and mood. The effects of clinical and demographic characteristics on associations were also assessed. Results: Increased variability in insomnia symptoms was associated with increased mood variability. In the sample as a whole, we found strong evidence of bidirectional relationships between insomnia and depressive symptoms but only weak support for bidirectional relationships between insomnia and (hypo)manic symptoms. We found substantial variability between participants in the strength of prospective associations between insomnia and mood, which depended on age, gender, bipolar subtype, and a history of rapid cycling. Conclusions: Our results highlight the importance of monitoring sleep in people with BD. However, researchers and clinicians investigating the association between sleep and mood should consider subgroup differences in this relationship. Advances in digital technology mean that intensive longitudinal data on sleep and mood are becoming increasingly available. Novel methods to analyse these data present an exciting opportunity for furthering our understanding of BD. [ABSTRACT FROM AUTHOR]

The coccolithophore Emiliania huxleyi is a marine phytoplankton species capable of forming small calcium carbonate scales (coccoliths) which cover the organic part of the cell. Calcification rates of E. huxleyi are known to be sensitive to changes in seawater carbonate chemistry. It has, however, not yet been clearly determined how these changes are reflected in size and weight of individual coccoliths and which specific parameter(s) of the carbonate system drive morphological modifications. Here, we compare data on coccolith size, weight, and malformation from a set of five experiments with a large diversity of carbonate chemistry conditions. This diversity allows distinguishing the influence of individual carbonate chemistry parameters such as carbon dioxide (CO2), bicarbonate (HCO3−), carbonate ion (CO32−), and protons (H+) on the measured parameters. Measurements of fine-scale morphological structures reveal an increase of coccolith malformation with decreasing pH suggesting that H+ is the major factor causing malformations. Coccolith distal shield area varies from about 5 to 11 μm2. Changes in size seem to be mainly induced by varying [HCO3−] and [H+] although influence of [CO32−] cannot be entirely ruled out. Changes in coccolith weight were proportional to changes in size. Increasing CaCO3 production rates are reflected in an increase in coccolith weight and an increase of the number of coccoliths formed per unit time. The combined investigation of morphological features and coccolith production rates presented in this study may help to interpret data derived from sediment cores, where coccolith morphology is used to reconstruct calcification rates in the water column.