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Aquatic plants are promising green energy feedstocks owing to their high rate of growth, photosynthesis, and CO2-fixing efficiency. They possess a paramount advantage of non-competitiveness with food crops over the first or second generation biofuel feedstocks. Specifically, low lignin content and higher concentrations of polysaccharides make these plants very attractive for biogas and liquid biofuel production. However, a regular supply of biomass is a limitation that can be overcome by employing harvesting techniques with sustainable measures, which ensure rapid regrowth of biomass for the next cycle. Harvesting of both aquatic macrophytes (weeds) as well as macroalgae is achieved by either manual or mechanical means. Following regular supply through effective harvesting, biofuel production can be further restricted due to their complex structural make-up. In order to improve the biofuel production, various pretreatment methods have been explored to disrupt the complex structure of aquatic weeds and macroalgae, thereby increasing the breakdown of biomass material more readily. This review examines traditional and modern techniques for biofuel production using aquatic weeds and macroalgae. It also discusses recent advancements in the harvesting and pretreatment techniques that improve overall efficiency. Choosing an effective pretreatment method can greatly influence biofuel recovery and production.

Ambient air pollution level not only causes respiratory diseases but also cardiovascular diseases, besides, increased visits to the emergency department for asthma, chronic obstructive pulmonary disease (COPD), bronchitis, allergic rhinitis, attention deficit hyperactivity disorder (ADHD) in children and premature deaths in infants. The occurrence of Coronavirus-19 (COVID-19) pandemic is both, a boon and bane. Despite the deplorable situation aroused by the pandemic, strict lockdown measures implemented to curb the drastic spread of the disease, also culminated into astonishing outcomes that were not prioritized. This article illustrates the effects of the ongoing pandemic on air pollution and provides recommendations aimed at limiting it.

Aim There are limited data on psychological outcomes in older people with epilepsy (PWE). This analysis, from a large pooled dataset of clinical studies from the Managing Epilepsy Well (MEW) Network, examined clinical variables including depressive symptom severity, quality of life and epilepsy self-management competency among older (age 55+) vs younger (

Objective: As the coronavirus disease (COVID-19) outbreak is the first pandemic to occur in the modern smartphone era, people universally rely on their electronic devices to stay current on the rapidly evolving circumstances. The objective of this study was to examine how daily screen time levels affect the mental health of health care workers attempting to stay up to date on the ever-changing COVID-19-related information available to them.Methods: Health care workers at an academic teaching hospital were asked to participate in a 12-question online-based survey between the dates of May 30, 2020, and June 3, 2020. The questions included their sex, age range, occupation, department, daily screen time, changes in screen time in the last 4 weeks, and mental health outcomes such as sleep, mood, anxiety, and difficulty controlling worry.Results: No association was found between age, sex, occupation, and screen time. There was a statistically significant association between the type of department and daily screen time hours (P = .012). A positive trend was noted between screen time and sleep disruption (P = .09). An increase in hours in the last 4 weeks was associated with age (P = .03). A positive trend was also noted for an increase in screen hours and sleep disruption (P = .11) and anxiety (P = .10).Conclusions: A possible explanation for our finding of screen time not being associated with mental health outcomes could be that the knowledge that information was readily available through technology provided comfort to people as the pandemic evolved and brought changes to their daily lives.

Abiotic stresses like drought, cold, salinity, heat, oxidative stress and the presence of excess levels of heavy metal in the agroecosystems lead to a decrease in the growth and productivity of major crops worldwide. The majority of stresses are connected with each other and results in elevated adverse impacts on the plants as well as other important components of the environment. The intensity of stresses and associated adverse impacts are increasing substantially in the era of climate change that again triggers to produce abnormalities in the crops. To overcome the effects of abiotic stresses, a number of strategies have been investigated, such as developing and cultivate stress-tolerant varieties, use of organic fertilizers, and the application of high yielding varieties. Application of biochar to mitigate the impacts of major abiotic stresses especially drought, salinity, and heavy metal has been found very effective. Amendment of biochar in stress affected agroecosystems improves the soil physicochemical and biological features and thereby enhances the productivity of crops. In this chapter, efforts have been made to discuss about three major stresses, i.e. drought, salinity, and heavy metals, their impacts on soil as well as plant productivity. Further, the efficiency and mechanism of biochar in reducing the impacts of stresses when using as a soil amendment have also been discussed thoroughly.

Soil quality degradation is one of the major outcomes of environmental pollution that can be characterized by deficient nutrients and concurrent presence of toxic substances in the agroecosystems. To enhance crop productivity, farmers use uncontrolled synthetic fertilizers that further deteriorate the soil health. Several organic components have been developed to reduce the overload of chemical fertilizers. Application of biochar to the soil is one of the potential methods that not only enhance the crop productivity but at the same time improve soil quality parameters. The application of biochar has also been proved to reduce the greenhouse gaseous emission from the agroecosystems. In this chapter, the efforts have been made to explore the production, features, mode of application, and effects of biochar on crop productivity and soil health. Further, the impact of biochar in the mitigation of abiotic stresses has also been discussed.

Aim There are limited data on psychological outcomes in older people with epilepsy (PWE). This analysis, from a large pooled dataset of clinical studies from the Managing Epilepsy Well (MEW) Network, examined clinical variables including depressive symptom severity, quality of life and epilepsy self-management competency among older (age 55+) vs younger (

Background: Body dysmorphic disorder (BDD) is preoccupation with perceived body defects leading to distress and impairment in social functioning. Most of adolescent BDD literature has been done on patients within the outpatient setting with prior versions of DSM with dearth of information about BDD and comorbid psychiatric conditions among adolescents within the inpatient setting. Aims: This pilot study evaluated the prevalence rate, clinical characteristics in adolescent BDD compared to non-BDD adolescents in a psychiatric in patient setting in addition to their comorbid issues like anxiety, OCD, ADHD and substance abuse. Methods: Forty-five consecutively admitted adolescent patients participated with 17 meeting the DSM 5 criteria for BDD while 28 did not. Patients were asked four questions designed around the DSM-5 criteria for BDD after which they were asked to complete questionnaires like BDDQ child and adolescent version, BDDM, Multiaxial Anxiety Scale for Children, Children's Depression Inventory, Y-BOCS and Vanderbilt ADHD rating scales. Results: Seventeen participants had BDD. Mean age of BDD patients was 13.1 while non-BDD was 12.4. Male patients with BDD were seven (41%) while female BDD patients were 10 (58.8%). Anxiety, depression, OCD and substance use disorders were common comorbid diagnoses. Majority of patients in the BDD group classified their BDD as a severe problem with more BDD, patient's considering suicide because of their BDD. Discussion: BDD is present in adolescents admitted in inpatient psychiatric hospital with more female patients endorsing BDD versus their male counterparts. Patients with BDD are more likely to endorse more comorbid psychiatric issues such as anxiety, OCD, ADHD and substance abuse.

Objective To determine associations between the rate of physical restraint and demographic variables such as body mass index (BMI), ethnicity, sex, and age in the emergency department (ED) along with clinical variables such as various psychiatric diagnoses and medications. Methods This 6-month (October 1, 2016-March 30, 2017) retrospective chart review was conducted in the ED of a community hospital, which is also a teaching institution for medical students and residents but does not have access to psychiatry consultations via phone or in person. A total of 165 agitated patients were included in the study. Agitated patients who were restrained were compared to those who were not physically restrained. Results Of the patients, 112 (68%) were physically restrained, and those not physically restrained were included as controls (n = 53, 32%). Younger age (P = .03), lower BMI (P = .04), intoxication (P = .001), preexisting diagnosis of depression (P = .02), and antipsychotics as a home medication (P = .03) were associated with physical restraints. In the ED, administration of haloperidol and olanzapine was associated with physical restraints. Current benzodiazepine prescription (P = .001), ED administration of ketamine (P = .001), and ED administration of diazepam (P = .001) were more common in those not physically restrained. Conclusions Risk factors for physical restraints can be used to identify high-risk patients early, and other treatments along with behavioral and environmental modifications may then be utilized. Further research to develop protocols using nonpharmacologic and pharmacologic measures to minimize use of restraints is required.

Introduction Epilepsy has been reported by the CDC to have a prevalence of 1.2% in the United States, which accounts for roughly 3.4 million adults in 2015. Nearly 1 million of those adults are aged 55 or older.1 Epilepsy is more likely to develop in older adults because risk factors for epilepsy are more common as people age including stroke/cardiovascular disease, neurodegenerative disorders, brain tumor and long-term sequelae of alcohol abuse.2 As our population ages, there will be even more older people with epilepsy. A common comorbidity in epilepsy is depression. While the prevalence of depression in patients with epilepsy varies in literature, it is estimated to be between 15% and 37%.3 The significance of depressive symptoms on quality of life has been shown to be greater than that of short-term seizure control.4 For older people, balancing epilepsy treatment in conjunction with other health problems can present with great difficulty. Many antiepileptic's also have side effects such as bone loss, dizziness and greater risk for falls, which can make someone more likely to fall and become injured.5 This analysis, from a large pooled dataset of multiple epilepsy treatment studies, examined presence and symptom severity of depression in older adults (age > 55) with epilepsy in comparison to younger adults (age Methods Analysis was completed using baseline data and clinical variables from 9 studies of the Managing Epilepsy Well (MEW) Network integrated research database (MEW DB). Patients were divided into two groups; age 18-55 and age greater than or equal to 55. A total of 935 adults participated, out of which 161 (17.2 %) were of age 55 or greater and 774 adults younger than 55 (82.8 %). Other demographics included were gender, race, marital status, highest education level and annual income. Standardized rating scales included Quality of Life in Epilepsy (QOLIE-10) and Patient Health Questionnaire (PHQ-9) for depressive symptoms. The QOLIE-10 scoring was harmonized to accommodate slightly different versions of this scale within the integrated dataset. Results The mean age for older patients was 61.5 vs. 34.4 for younger patients. Approximately 60% of patients in both groups were females. Among older patients 109 (76.2%) were white, 24 (16.8%) African Americans, and 4 (3.1%) Hispanic. Majority of these patients (78.6%) had a college education and 53.4% were either married or co-habiting. Demographics of the under 55 group were largely similar. Mean PHQ-9 score was 8.5 in older patients vs. 9.5 in younger patients (p= 0.07). Amongst older patients, those with moderate-severe depression defined as PHQ-9 > 10 had an average of 7 seizures in 30 days, compared to those with scores 10) in both younger and older groups was associated with worse QOL (p= Conclusions Depression is common in people with epilepsy across the lifespan. Depression is more common in those with poorly controlled epilepsy, and more severe depressive symptoms are associated with poorer quality of life. However, we did not find that these findings were different in older vs. younger patients. Methodological limitations such as the clinical trials’ data source and relatively young age of the sample overall could have biased findings. Future analyses need to sample more elderly people with epilepsy including the “old-old” and those with more extensive medical comorbidity. This research was funded by: This study was supported in part by CDC grants U48DP001930 (CWRU), U48DP005030 (CWRU) U48DP005008 (NYU), 148DP005013 (WA), and 1U48DP005018 (Geisel School of Medicine at Dartmouth) under the Health Promotion and Disease Prevention Research Centers Program.

Factitious disorder can present in multiple health care settings, with patients intentionally producing symptoms to assume the sick role. This assumption of the sick role can result in multiple hospitalizations with unnecessary diagnostic workup, as well as invasive diagnostic procedures that can lead to worrisome side effects. Differential diagnoses that should be ruled out include malingering, somatic symptom disorder, and anxiety disorders. For many providers, patients with factitious disorder can be a challenge to treat because the etiology of the disorder remains unclear. There are multiple psychological theories that attempt to explain the motivation and thought process behind the voluntary production of symptoms. Some of these theories have addressed disruptive attachments during childhood, possible intergenerational transfer of the disorder, personal identity conflicts, somatic illness as a form of masochistic activity toward oneself, and intrapsychic conflicts. Confrontation and psychotherapy with a multidisciplinary team has been proposed as a form of treatment. An understanding of the psychological factors associated with factitious disorder can help providers understand the rationale behind the patient's presentation and aid in the formulation of a treatment plan.

Factitious disorder can present in multiple health care settings, with patients intentionally producing symptoms to assume the sick role. This assumption of the sick role can result in multiple hospitalizations with unnecessary diagnostic workup, as well as invasive diagnostic procedures that can lead to worrisome side effects. Differential diagnoses that should be ruled out include malingering, somatic symptom disorder, and anxiety disorders. For many providers, patients with factitious disorder can be a challenge to treat because the etiology of the disorder remains unclear. There are multiple psychological theories that attempt to explain the motivation and thought process behind the voluntary production of symptoms. Some of these theories have addressed disruptive attachments during childhood, possible intergenerational transfer of the disorder, personal identity conflicts, somatic illness as a form of masochistic activity toward oneself, and intrapsychic conflicts. Confrontation and psychotherapy with a multidisciplinary team has been proposed as a form of treatment. An understanding of the psychological factors associated with factitious disorder can help providers understand the rationale behind the patient's presentation and aid in the formulation of a treatment plan.

Celery root belongs to a group of plants classified as the umbelliferous family, which contains phytoestrogens. Phytoestrogens are structurally similar to estrogen as they share a pair of hydroxyl groups and phenolic ring, which enables them to bind to estrogen receptors directly, making them a herbal remedy for low estrogen states such as menopause. We present a case of a female patient with depression who was stabilized on venlafaxine and St John's Wort, and who developed a manic episode due to elevated serum venlafaxine levels after she started taking celery extracts for menopausal related issues. We proffer a hypothesis for this unusual occurrence.

To the Editor: Although trimethoprim-sulfamethoxazole (TMP-SMX) seldom causes psychosis, the side effect of visual and auditory hallucinations has been described previously, principally among immunocompromised persons and elderly patients.1 We are aware of only a single case report of psychosis in an immunologically competent teen2 and of no suicides or attempts attributed to TMP-SMX. Here, we report a case of catastrophic self-injury resulting from TMP-SMX–induced psychosis. Case report. An 18-year-old white, male, high-school senior was admitted to the hospital in January 2015 for a self-inflicted gunshot to the face. Seven days before admission, the patient initiated a course of TMP-SMX for an infected toenail. He began to feel depressed and moody and withdrew to his room. His family said he appeared agitated and was uncharacteristically rude. On the day of admission, the patient “saw” his deceased paternal uncle, himself a victim of suicide. The vision audibly reassured him, “It is okay to shoot yourself.” Shortly afterward, the patient did so, leaving a photograph of his uncle on the floor nearby. He denied past psychiatric treatment but recalled experiencing mood changes and hallucinations when treated with TMP-SMX 8 months earlier. To minimize psychiatric symptoms, he had taken the medication every other day rather than as prescribed. Medical and substance use history was insignificant. Family history was noteworthy for suicide in a paternal uncle and possible depression in the father. At admission, the patient displayed extensive facial injuries. His mandible was missing and a gaping cavity assuming the dimensions of a large pear or small gourd replaced his nose, mouth, and much of the maxilla. The narrow part of the wound created a wide chasm separating the laterally displaced though still functional eyes. He was conscious and had limited capacity to communicate. Results from the urine toxicology screen were negative, and electrolytes were within normal limits. The computerized tomography scan showed extensive facial fractures, a small anterior subdural bleed to the left of the falx cerebri, a left inferior frontal gyrus contusion, and punctate air pockets in the left inferior frontal fossa. TMP-SMX was discontinued while critical care and surgical teams stabilized the patient. The brain lesions did not require neurosurgical intervention. On the 10th hospital day, the patient could be interviewed; he denied, through nods and hand signals, that he had experienced any symptoms of depression or psychosis since coming to the hospital. He was lucid and as cheerful as one could hope under the circumstances. The diagnosis of TMP-SMX–induced psychotic disorder (DSM-5) was made on the basis of hallucinations, which developed during both of 2 courses of treatment with TMP-SMX, a drug that can cause these symptoms. The condition is not explained by the presence of another psychotic disorder, reveals no evidence of delirium, and caused extreme distress and impairment. The patient and his family were referred for counseling to aid their adjustment to the new circumstances. The mechanism for TMP-SMX psychosis is unknown. Both component drugs inhibit metabolism of folic acid, deficiencies of which have long been associated with neuropsychiatric symptoms. Trimethoprim irreversibly inhibits dihydrofolate reductase (DHFR), thereby limiting the conversion of dihydrofolate to tetrahydrofolate, the active form of folic acid. DHFR is also critical for reducing dihydrobiopterin to tetrahydrobiopterin (BH4) in a BH4 salvage pathway. Deficiency of BH4, a cofactor in the biosynthesis of the biogenic amines,3 has been linked to schizophrenia.4 This case highlights the importance of alerting patients about a rare TMP-SMX side effect. Although the mechanism of toxicity is unknown, putative impairments in folate- and biopterin-synthetic pathways warrant further research.