Parity of esteem: A global COVID-19 vaccination approach for people with mental illnesses, based on facts from 34 countries; recommendations and solutions.

Background: The coronavirus disease (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has detrimental effects on physical and mental health. Patients with severe mental illness are at higher risk of contracting the virus due to social determinants of health. Vulnerable populations include the elderly, people with pre-existing conditions, and those exposed to SARS-CoV-2. Unfortunately, only a few countries have updated vaccination strategies to prioritize patients with mental illnesses. Therefore, we aimed to explore whether individuals with mental disorders are prioritized in vaccine allocation strategies in different world regions. They are often neglected in policymaking but are highly vulnerable to the threatening complications of COVID-19. Methods: A questionnaire was developed to record details regarding COVID-19 vaccination and prioritizations for groups of persons with non-communicable diseases (NCDs), mental disorders, and substance use disorders (SUDs). NCDs were defined according to the WHO as chronic diseases that are the result of a combination of genetic, physiological, environmental, and behavioral factors such as cardiovascular diseases, cancer, respiratory diseases, and diabetes. Results: Most countries surveyed (80%) reported healthcare delivery via a nationalized health service. It was found that 82% of the countries had set up advisory groups, but only 26% included a mental health professional. Most frequently, malignancy (68%) was prioritized followed by diabetes type 2 (62%) and type 1 (59%). Only nine countries (26%) prioritized mental health conditions. Conclusion: The spread of the coronavirus has exposed both the strengths and flaws of our healthcare systems. The most vulnerable groups suffered the most and were hit first and faced most challenges. These findings raise awareness that patients with mental illnesses have been overlooked in immunization campaigns. The range of their mortality, morbidity, and quality of life could have widened due to this delay.

Low-Concentration Gelatin Methacryloyl Hydrogel with Tunable 3D Extrusion Printability and Cytocompatibility: Exploring Quantitative Process Science and Biophysical Properties.

Three-dimensional (3D) bioprinting of hydrogels with a wide spectrum of compositions has been widely investigated. Despite such efforts, a comprehensive understanding of the correlation among the process science, buildability, and biophysical properties of the hydrogels for a targeted clinical application has not been developed in the scientific community. In particular, the quantitative analysis across the entire developmental path for 3D extrusion bioprinting of such scaffolds is not widely reported. In the present work, we addressed this gap by using widely investigated biomaterials, such as gelatin methacryloyl (GelMA), as a model system. Using extensive experiments and quantitative analysis, we analyzed how the individual components of methacrylated carboxymethyl cellulose (mCMC), needle-shaped nanohydroxyapatite (nHAp), and poly(ethylene glycol)diacrylate (PEGDA) with GelMA as baseline matrix of the multifunctional bioink can influence the biophysical properties, printability, and cellular functionality. The complex interplay among the biomaterial ink formulations, viscoelastic properties, and printability toward the large structure buildability (structurally stable cube scaffolds with 15 mm edge) has been explored. Intriguingly, the incorporation of PEGDA into the GelMA/mCMC matrix offered improved compressive modulus (∼40-fold), reduced swelling ratio (∼2-fold), and degradation rates (∼30-fold) compared to pristine GelMA. The correlation among microstructural pore architecture, biophysical properties, and cytocompatibility is also established for the biomaterial inks. These photopolymerizable bio(material)inks served as the platform for the growth and development of bone and cartilage matrix when human mesenchymal stem cells (hMSCs) are either seeded on two-dimensional (2D) substrates or encapsulated on 3D scaffolds. Taken together, this present study unequivocally establishes a significant step forward in the development of a broad spectrum of shape-fidelity compliant bioink for the 3D bioprinting of multifunctional scaffolds and emphasizes the need for invoking more quantitative analysis in establishing process-microstructure-property correlation.

Comprehensive functional outcome analysis and importance of bone remodelling on personalized cranioplasty treatment using Poly(methyl methacrylate) bone flaps.

Cranioplasty involves the surgical reconstruction of cranial defects arising as a result of various factors, including decompressive craniectomy, cranial malformations, and brain injury due to road traffic accidents. Most of the modern decompressive craniectomies (DC) warrant a future cranioplasty surgery within 6-36 months. The conventional process of capturing the defect impression and polymethyl methacrylate (PMMA) flap fabrication results in a misfit or misalignment at the site of implantation. Equally, the intra-operative graft preparation is arduous and can result in a longer surgical time, which may compromise the functional and aesthetic outcomes. As part of a multicentric pilot clinical study, we recently conducted a cohort study on ten human subjects during 2019-2022, following the human ethics committee approvals from the participating institutes. In the current study, an important aspect of measuring the extent of bone remodelling during the time gap between decompressive craniectomy and cranioplasty was successfully evaluated. The sterilised PMMA bone flaps were implanted at the defect area during the cranioplasty surgery using titanium mini plates and screws. The mean surgery time was 90 ± 20 min, comparable to the other clinical studies on cranioplasty. No signs of intra-operative and post-operative complications, such as cerebrospinal fluid leakage, hematoma, or local and systemic infection, were clinically recorded. Importantly, aesthetic outcomes were excellent for all the patients, except in a few clinical cases, wherein the PMMA bone flap was to be carefully customized due to the remodelling of the native skull bone. The extent of physiological remodelling was evaluated by superimposing the pre-operative and post-operative CT scan data after converting the defect morphology into a 3D model. This study further establishes the safety and efficacy of a technologically better approach to fabricate patient-specific acrylic bone flaps with improved surgical outcomes. More importantly, the study outcome further demonstrates the strategy to address bone remodelling during the patient-specific implant design.

Complex neuropsychiatric presentation of 17q12 duplication syndrome: A case report.

The chromosomal band 17q12 is characterized by a high density of genes and is bordered by segmental duplications, the structural arrangement of which increases the susceptibility of the region to deletions and duplications. Duplication of 17q12 is a rare genetic condition associated with variable characteristics from clinically asymptomatic to intellectual disabilities, seizures, and behavioral problems. The variability in phenotype is primarily due to variable expressivity and incomplete penetrance. Diagnosis is mostly established by chromosomal microarray. Treatment involves a multidisciplinary approach. We present a case of a 43-year-old female who initially presented with hyperphagia and was eventually diagnosed with bulimia nervosa, anxiety, mood disorder, and personality disorder. Additional research is required to better understand the impact of 17q12 duplication syndrome on the development of bulimia nervosa since its pathogenesis has not been adequately described in the current literature.

Deficiency of phyto-available sulphur, zinc, boron, iron, copper and manganese in soils of India.

Nutrient deficiencies in soil-crop contexts and inappropriate managements are the important reasons for low crop productivity, reduced nutritional quality of agricultural produce and animal/human malnutrition, across the world. The present investigation was carried out to evaluate nutrient deficiencies of sulphur (S) and micronutrients [zinc (Zn), boron (B), iron (Fe), copper (Cu) and manganese (Mn)] in agricultural soils of India for devising effective management strategies to achieve sustainable crop production, improved nutritional quality in crops and better animal/human health. A total of 2,42,827 surface (0-15 cm depth) soil samples were collected from agriculture fields of 615 districts lying in 28 states of India and were analysed for available S and micronutrients concentration. The study was carried out under the aegis of All India Coordinated Research Project on Micro- and Secondary-Nutrients and Pollutant Elements in Soils and Plants. The mean concentrations were 27.0 ± 29.9 mg kg-1 for available S, 1.40 ± 1.60 mg kg-1 for available Zn and 1.40 ± 4.70 mg kg-1 for available B, 31.0 ± 52.2 mg kg-1 for available Fe, 2.30 ± 3.50 mg kg-1 for available Cu and 17.5 ± 21.4 mg kg-1 for available Mn. There were variable and widespread deficiencies of S and micronutrients in different states. The deficiencies (acute deficient + deficient + latent deficiency) of S (58.6% of soils), Zn (51.2% of soils) and B (44.7% of soils) were higher compared to the deficiencies of Fe (19.2% of soils), Cu (11.4% of soils) and Mn (17.4% of soils). Out of 615 districts, > 50% of soils in 101, 131 and 86 districts were deficient in available S, available Zn and available B, respectively. Whereas, > 25% of soils in 83, 5 and 41 districts had deficiencies of available Fe, available Cu and available Mn, respectively. There were occurrences of 2-nutrients deficiencies such S + Zn (9.30% of soils), Zn + B (8.70% of soils), S + B (7.00% of soils) and Zn + Fe (5.80% of soils) to a greater extent compared to the deficiencies of Zn + Mn (3.40% of soils), S + Fe (3.30% of soils), Zn + Cu (2.80% of soils) and Fe + B (2.70% of soils). Relatively lower % of soils were deficient in 3-nutrients (namely S + Zn + B, S + Zn + B and Zn + Fe + B), 4-nutrients (namely Zn + Fe + Cu + Mn) and 5-nutrients (namely Zn + Fe + Cu + Mn + B) simultaneously. The information regarding the distribution of deficiencies of S and micronutrients (both single and multi-nutrients) could be used by various stakeholders for production, supply and application of right kind of fertilizers in different districts, states and agro-ecological regions of India for better crop production, crop nutritional quality, nutrient use efficiency, soil health and for tackling human and animal malnutrition.

Evaluation of implant properties, safety profile and clinical efficacy of patient-specific acrylic prosthesis in cranioplasty using 3D binderjet printed cranium model: A pilot study.

There exists a significant demand to develop patient-specific prosthesis in reconstruction of cranial vaults after decompressive craniectomy. we report here, the outcomes of an unicentric pilot study on acrylic cranial prosthesis fabricated using a 3D printed cranium model with its clinically relevant mechanical properties. METHODS: The semi-crystalline polymethyl methacrylate (PMMA) implants, shaped to the cranial defects of 3D printed cranium model, were implanted in 10 patients (mean age, 40.8 ± 14.8 years). A binderjet 3D printer was used to create patient-specific mould and PMMA was casted to fabricate prosthesis which was analyzed for microstructure and properties. Patients were followed up for allergy, infection and cosmesis for a period of 6 months. RESULTS: As-cast PMMA flap exhibited hardness of 15.8 ± 0.24Hv, tensile strength of 30.7 ± 3.9 MPa and elastic modulus of 1.5 ± 0.1 GPa. 3D microstructure of the semi-crystalline acrylic implant revealed 2.5-15 µm spherical isolated pores. The mean area of the calvarial defect in craniectomy patients was 94.7 ± 17.4 cm2. We achieved a cranial index of symmetry (CIS -%) of 94.5 ± 3.9, while the average post-operative Glasgow outcome scale (GOS) score recorded was 4.2 ± 0.9. CONCLUSIONS: 3D printing based patient-specific design and fabrication of acrylic cranioplasty implant is safe and achieves acceptable cosmetic and clinical outcomes in patients with decompressive craniectomy. Our study ensured clinically acceptable structural and mechanical properties of implanted PMMA, suggesting that a low cost 3D printer based PMMA flap is an affordable option for cranioplasty in resource constrained settings.

Psychosis as an indicator of recurrent non-Hodgkin's lymphoma: a rare presentation.

Psychotic manifestations of brain tumours are rare but described in the literature mostly along with other neurological deficits. Memory loss, difficulty in attention and concentration, depression, anxiety, and mood symptoms are commonly described in brain tumours. A schizophrenia-like picture without a deficit in motor or sensory function may land the clinician into a diagnostic dilemma. Primary central nervous system lymphoma (PCNSL) is a highly malignant disease with high mortality and needs immediate attention. Our case which had a unique recurrence in the postoperative period with psychotic symptoms can be an eye-opener to be more vigilant about underlying clinical extension.

A case of craniopharyngioma presenting as rapidly progressive dementia.

Rapidly progressive dementia (RPD) is generally obvious to family member but often difficult for physicians to pinpoint the underlying pathology. Some common causes, such as prion's disease, Alzheimer's disease, central nervous system vasculitis, or infection, might present with disease-specific signs or symptoms where many etiologies do not produce such warning signs. Here, we are presenting a case who attended the psychiatric clinic for decreased motivation to do work, easy fatigability, infrequent falls, recent memory impairment, increased appetite, polydipsia and polyuria, and provisionally diagnosed with RPD. Magnetic resonance imaging revealed solid cystic lesion in suprasellar location involving hypothalamus, optic chiasma, and optic tracts, compressing the floor of the third ventricle suggestive of craniopharyngioma which is one of the very few reports in literature.

Arachnoid Cyst and Psychosis: The Troublemaker or Innocent Bystander.

Organic underpinning of a psychotic disturbance is often missed. Arachnoid cysts are considered a rare neurological tumor, few of which exhibit any symptomatology. In most cases, they are diagnosed by accident. Literature regarding the coexistence of arachnoid cysts with psychiatric disorders is sparse. Here, we present a case who presented with a typical presentation of psychosis which was not enough for suspecting for an organic etiology.

An Unusual Case of Baclofen Abuse.

Baclofen was initially used for the treatment of spastic conditions. Last decade has seen its emergence as a treatment of profound interest in alcohol dependence, opiates and cocaine abuse, and tobacco addiction. However, the published literature on baclofen abuse is sparse. Here, we report a patient with baclofen abuse.

Effect of cluster expansion on photoionization of iron pentacarbonyl doped inert gas clusters under gigawatt intensity laser irradiation.

RATIONALE: The aim of the investigation was to understand the variation in ionization dynamics of inert gas clusters upon doping with species with lower ionization energy than the inert gas constituent. It was postulated that the use of dopant species having lower ionization energy would lead to facile ionization of doped inert gas clusters, resulting in enhancement of the charge state of atomic ions compared with those obtained for pure inert gas clusters. METHODS: Inert gas clusters (Ar(n), Kr(n) or Xe(n)) doped with iron pentacarbonyl were generated by supersonic expansion and subjected to gigawatt intensity laser pulses (266, 355, 532 and 1064 nm wavelengths) obtained from a nanosecond Nd:YAG laser. The ions generated upon laser-cluster interaction were characterized using a time-of-flight mass spectrometer. RESULTS: Upon interaction of the laser with the doped inert gas clusters, the charge states of the atomic ions were found to increase with the laser wavelength. However, the highest observed charge states were found to be lower for doped inert gas clusters than for pure inert gas clusters, at all laser wavelengths. CONCLUSIONS: Wavelength-dependent generation of multiply charged atomic ions has been explained based on the three stage model, i.e. multiphoton ionization ignited-inverse bremsstrahlung heating, and electron ionization. This model explains enhancement in the charge state of atomic ions with increasing wavelength based on inverse bremsstrahlung heating of the inner ionized electron, which is a more efficient process at longer wavelengths. Inefficient coupling of laser energy in the case of doped inert gas clusters compared with pure inert gas clusters has been rationalized on the basis of accelerated disintegration of the cluster due to facile initial ionization of dopant molecules having low ionization energy. The results suggest that a longer laser wavelength and a slower rate of cluster expansion facilitate the efficient transfer of optical energy into cluster systems.