Lived experiences of adolescents with major depressive disorder during the COVID pandemic: A qualitative study from a tertiary care center.

Objectives: Depression is a leading cause of global disease burden and morbidity among adolescents. Studies have reported higher rates of depression and anxiety secondary to the COVID pandemic and the psychosocial impact of social distancing measures. There is a paucity of literature on the subjective experiences of depressed adolescents in such pandemic circumstances. The objective of this study was to explore the lived experiences of adolescents with major depressive disorder (MDD) during the COVID pandemic, and the impact of the pandemic, and pandemic-related circumstances on adolescents' mental health and coping. Materials and Methods: In-depth interviews with eight adolescents diagnosed with MDD were analyzed using interpretative phenomenological analysis. Results: The analysis revealed three major themes; "The pandemic was arduous," "Negativity in family interactions," and "Effects on depression." Most adolescents coped using excessive screen time as a distraction, and their families perceived them as indolent. Conclusion: The study found that adolescents' experience of depression during the pandemic was extremely overwhelming because, on the one hand, they had to deal with immediate COVID infection-related worries and were not able to adjust to the new routine, not able to concentrate during online classes while also dealing with greater interpersonal discord with their parents and limited social resources for coping. The findings expand the clinical understanding of adolescents' experience of depression during pandemic circumstances and would aid in better management planning.

Perceptions of key stakeholders on peer led strength building program for suicide prevention among young adolescents: A qualitative study from Karnataka, India.

Context: Adolescent suicides are a significant public health concern in India and understanding the intersecting perspectives becomes imperative for the prevention of various mental health concerns. Aim: Assessing perceptions of various key stakeholders, that is, mental health experts, school and college teachers, and District Mental Health Program staff about peer-led strength building programs for suicide prevention. Settings and Design: A cross-sectional qualitative design using two Focus Group Discussions (FGDs) with mental health experts and teachers and one FGD with DMHP staff was conducted. The sample comprised 45 participants from Bengaluru urban district. Materials and Methods: The data were analyzed manually by the method of direct content analysis, and themes were determined using existing literature. Results: The teachers and the DMHP highlighted the need for an intensive training program/module that is necessary to be developed in order to train the peer leaders first. The mental health experts opined that creating a network will help in easy identification of the cases and appropriate treatment could be provided without delays. Conclusions: This study indicated that suicide is a preventable public health emergency and inaccessibility to existing as well as proper support systems was perceived as a major concern. Therefore, peer-led programs are beneficial in steering and improving help seeking behavior in suicidal adolescents.

Enhancing the Tribological Properties of Low-Density Polyethylene Using Hard Carbon Microfillers.

The application of low-density polyethylene (LDPE) has been confined to packaging applications due to its inadequate mechanical and tribological characteristics. We propose enhancing LDPE by integrating hard carbon spheres (CSs) to improve its strength, frictional characteristics, and wear resistance. LDPE/CS composites were created by blending LDPE with varying CS amounts (0.5-8 wt.%). Analysis using scanning electron microscopy and Raman spectroscopy confirmed CS presence in the LDPE matrix, with X-ray diffraction showing no microstructural changes post-blending. Thermal characterization exhibited notable improvements in thermal stability (~4%) and crystallinity (~7%). Mechanical properties such as hardness and Young's modulus were improved by up to 4% and 24%, respectively. Tribological studies on different composite samples with varying surface roughness under various load and speed conditions revealed the critical role of surface roughness in reducing friction by decreasing real contact area and adhesive interactions between asperities. Increased load and speed amplified shear stress on asperities, possibly leading to deformation and failure. Notably, integrating CSs into LDPE, starting at 1 wt.%, effectively reduced friction and wear. The composite with the highest loading (8 wt.%) displayed the most significant tribological enhancement, achieving a remarkable 75% friction reduction and a substantial 78% wear reduction.

Children's vulnerabilities and pathways to conflict with the law: Insights from Swatantra Clinic, a specialised mental health service at a tertiary care centre in India.

'Swatantra-Clinic' at NIMHANS, India, provides mental healthcare to vulnerable children. This study describes the clinical profile, vulnerability and protective factors of 77 adolescents in conflict with the law (CICL). 90.9 % (n=70) reported Adverse Childhood Experiences (ACEs), 58.4 % (n=45) had school-related difficulties, 68.9 % (n=53) reported child labour experiences, 64.9 % (n=50) had deviant peer associations, and 40 % (n=31) experimented with substance use. Despite vulnerabilities, 72.7 %(n=56) had a positive future orientation, 45.5 % (n=35) had supportive caregivers and exhibited prosocial skills. only 12 % (n=9) followed up on recommendations, highlighting the need for collaborative and transdisciplinary care to promote CICL rehabilitation and community integration.

Antivesiculation and Complete Unbinding of Tail-Tethered Lipids.

We report the effect of tail-tethering on vesiculation and complete unbinding of bilayered membranes. Amphiphilic molecules of a bolalipid, resembling the tail-tethered molecular structure of archaeal lipids, with two identical zwitterionic phosphatidylcholine headgroups self-assemble into a large flat lamellar membrane, in contrast to the multilamellar vesicles (MLVs) observed in its counterpart, monopolar nontethered zwitterionic lipids. The antivesiculation is confirmed by small-angle X-ray scattering (SAXS) and cryogenic transmission electron microscopy (cyro-TEM). With the net charge of zero and higher bending rigidity of the membrane (confirmed by neutron spin echo (NSE) spectroscopy), the current membrane theory would predict that membranes should stack with each other (aka "bind") due to dominant van der Waals attraction, while the outcome of the nonstacking ("unbinding") membrane suggests that the theory needs to include entropic contribution for the nonvesicular structures. This report pioneers an understanding of how the tail-tethering of amphiphiles affects the structure, enabling better control over the final nanoscale morphology.

Design of Nanostraws in Amine-Functionalized MCM-41 for Improved Adsorption Capacity in Carbon Capture.

Polymeric amine encapsulation in high surface area MCM-41 particles for CO2 capture is well established but has the drawback of leaching out the water-soluble polymer upon exposure to aqueous environments. Alternatively, chemical (covalent) grafting amine functional groups from an alkoxysilane such as 3-aminopropyltriethoxysilane (APTES) on MCM-41 offer better stability against this drawback. However, the diffusional restriction exhibited by the narrow uniform MCM-41 pores (2-4 nm) may impede amine functionalization of the available silanol groups within the inner mesoporous core. This leads to incomplete amine functionalization and could reduce the CO2 adsorption capacity in such materials. Our concept to improve access to the MCM-41 interior is based on the incorporation of nanostraws with larger inner diameter (15-30 nm) to create a hierarchical porosity and enhance the molecular transport of APTES. Halloysite nanotubes (HNT) are used as tubular straws that are integrated into the MCM-41 matrix using an aerosol-assisted synthesis method. Characterization results show that the intrinsic structure of MCM-41 remains unaltered after the incorporation of the nanostraws and amine functionalization. At an optimal APTES loading of 0.5 g (X = 2.0), the amine-functionalized composite of MCM-41 with straws (APTES/M40H) has a 20% higher adsorption capacity than the amine-modified MCM-41 (APTES/MCM-41) adsorbent. Furthermore, the CO2 adsorption capacity APTES/M40H doubles that of APTES/MCM-41 when normalized based on the composition of MCM-41 in the composite particle with straws. The facile integration of nanostraws in MCM-41 leading to hierarchical porosities could be effective toward the mitigation of diffusional restriction in porous materials with potential for other catalytic and adsorption technologies.

Progressive Learning of a Multimodal Classifier Accounting for Different Modality Combinations.

In classification tasks, such as face recognition and emotion recognition, multimodal information is used for accurate classification. Once a multimodal classification model is trained with a set of modalities, it estimates the class label by using the entire modality set. A trained classifier is typically not formulated to perform classification for various subsets of modalities. Thus, the model would be useful and portable if it could be used for any subset of modalities. We refer to this problem as the multimodal portability problem. Moreover, in the multimodal model, classification accuracy is reduced when one or more modalities are missing. We term this problem the missing modality problem. This article proposes a novel deep learning model, termed KModNet, and a novel learning strategy, termed progressive learning, to simultaneously address missing modality and multimodal portability problems. KModNet, formulated with the transformer, contains multiple branches corresponding to different k-combinations of the modality set S. KModNet is trained using a multi-step progressive learning framework, where the k-th step uses a k-modal model to train different branches up to the k-th combination branch. To address the missing modality problem, the training multimodal data is randomly ablated. The proposed learning framework is formulated and validated using two multimodal classification problems: audio-video-thermal person classification and audio-video emotion classification. The two classification problems are validated using the Speaking Faces, RAVDESS, and SAVEE datasets. The results demonstrate that the progressive learning framework enhances the robustness of multimodal classification, even under the conditions of missing modalities, while being portable to different modality subsets.

Lubrication mechanisms of dispersed carbon microspheres in boundary through hydrodynamic lubrication regimes.

HYPOTHESIS: Carbon microspheres have been shown to reduce friction and surface wear at relatively low speeds and high applied loads (i.e., within the boundary lubrication regime). We hypothesize that in dilute colloidal lubricating systems there is an interplay between the size of the carbon microspheres and the lubrication gap size, which determines the dominant lubricating mechanism of the system. EXPERIMENTS: A 60 wt% aqueous glycerol solution was used as the base lubricant and compared to various carbon particle-based lubricant formulations ranging in particle concentrations from 0.05 to 0.30 vol%. The tribological properties of the various lubricant formulations were tested on a pin-on-disk tribometer. A simplified Stribeck plot was produced to understand the changing mechanism of lubrication over a wide range of conditions. FINDINGS: The Stribeck curves show that the carbon microspheres assist lubrication by a rolling mechanism primarily in the boundary lubrication regime. A 0.20 vol% carbon-based lubricant formulation showed the best friction reduction compared to the base lubricant. Increasing speed increases the lubricating gap between the friction pair beyond the size of the particles, thereby nullifying the rolling mechanism of the particles. We introduce a modified specific film thickness parameter to determine the lubrication regime in a particle-lubricant system.

Musical preferences of Indian children with autism spectrum disorder and acceptability of music therapy by their families: An exploratory study.

Background: Music therapy has been in use for children with autism spectrum disorder (ASD) since the 1940s. However, there is limited scientific evidence on its use in the Indian context. Aim: The present study aims to explore musical preferences of children with ASD and their caregivers' acceptability of music as a form of intervention. Materials and Methods: It is a cross-sectional study of 120 subjects diagnosed with ASD as per the Diagnostic and Statistical Manual of Mental Disorders-5 identified by convenience sampling. A semi-structured interview schedule consisting of 25 objective response questions with multiple choices and 11 open-ended questions (pertaining to music and the use of music) was used to explore caregivers'/parents' thoughts and beliefs. The responses to open-ended questions were collected in narrative mode. A descriptive approach of content analysis was adopted to analyse the data. The data are presented using descriptive statistics. Institutional Ethics Committee's approval was obtained for conducting the study. Results: Most of the children liked (89.2%, n = 107) music and responded (88.3%, n = 106) actively (listen intently/hum or sing or dance along) to music. Most subjects preferred rhythm (65%, n = 78) over melody (15%, n = 18). While 98.3% (n = 118) of the parents were willing to try music therapy for their child, 61% of them (n = 72) asked follow-up questions like - "Is there available data on it?" (n = 12; 10.2%) and "Will it be worth investing our time and efforts on it?" (n = 60; 50.8%). Conclusion: Most of the children including those with auditory sensitivity like music and prefer rhythm over melody. Caregivers possess a positive attitude toward the use of music therapy. However, most of them wish to clarify the scientific basis of the same.

Predicting and Visualizing Citrus Color Transformation Using a Deep Mask-Guided Generative Network.

Citrus rind color is a good indicator of fruit development, and methods to monitor and predict color transformation therefore help the decisions of crop management practices and harvest schedules. This work presents the complete workflow to predict and visualize citrus color transformation in the orchard featuring high accuracy and fidelity. A total of 107 sample Navel oranges were observed during the color transformation period, resulting in a dataset containing 7,535 citrus images. A framework is proposed that integrates visual saliency into deep learning, and it consists of a segmentation network, a deep mask-guided generative network, and a loss network with manually designed loss functions. Moreover, the fusion of image features and temporal information enables one single model to predict the rind color at different time intervals, thus effectively shrinking the number of model parameters. The semantic segmentation network of the framework achieves the mean intersection over a union score of 0.9694, and the generative network obtains a peak signal-to-noise ratio of 30.01 and a mean local style loss score of 2.710, which indicate both high quality and similarity of the generated images and are also consistent with human perception. To ease the applications in the real world, the model is ported to an Android-based application for mobile devices. The methods can be readily expanded to other fruit crops with a color transformation period. The dataset and the source code are publicly available at GitHub.

Gaming among female adolescents: profiling and psychopathological characteristics in the Indian context.

Objectives: Gaming is a predominant leisure time activity among adolescents, and the literature suggests that unrestrained gaming behavior might lead to gaming disorder. ICD-11 and DSM-5 have recognized gaming disorder as a psychiatric condition and grouped it under the behavioral addiction category. Research on gaming behavior and addiction is largely based on data from the male population, and problematic gaming has largely been understood from the male perspective. In this study, we are attempting to bridge the existing lacuna in the literature by exploring gaming behavior, gaming disorder, and its related psychopathological characteristics among female adolescents in India. Methods: The study was conducted on a sample of 707 female adolescent participants who were contacted through schools and academic institutes in a city in Southern India. The study adopted a cross-sectional survey design, and data were administered using the mixed modality of online and offline data collection. The participants filled out the following set of questionnaires: socio-demographic sheet, Internet Gaming Disorder Scale-Short-Form (IGDS9-SF), Strength and Difficulties Questionnaire (SDQ), Rosenberg self-esteem scale, and Brief sensation-seeking scale (BSSS-8). The data gathered from the participants were then statistically analyzed using SPSS software version 26. Results: The descriptive statistics revealed that 0.8% of the sample (i.e., five participants out of 707) obtained scores meeting gaming addiction criteria. Correlation analysis demonstrated a significant relationship between all the psychological variables with total IGD scale scores (p < 0.05). Total SDQ, total BSSS-8, and domain scores of SDQ, such as emotional symptoms, conduct, hyperactivity, and peer problems, were positively correlated, whereas total Rosenberg scores and domain scores of prosocial behaviors of SDQ were negatively correlated. The Mann-Whitney U-test was employed to compare "with gaming disorder" and "without gaming disorder" categories of female participants. Comparing these two groups revealed significant differences in emotional symptoms, conduct, hyperactivity/inattention, peer problem, and self-esteem scale scores. Furthermore, quantile regression was computed, showing that conduct, peer problem, and self-esteem displayed trend-level prediction for gaming disorder. Conclusion: Female adolescents prone to gaming addiction can be identified through psychopathological characteristics of conduct, peer problem, and low self-esteem. This understanding can be useful in developing a theoretical model focusing on early screening and preventive strategies for at-risk female adolescents.

Altered cerebellar lobular volumes correlate with clinical deficits in siblings and children with ASD: evidence from toddlers.

BACKGROUND: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by impaired social and communication skills, narrow interests, and repetitive behavior. It is known that the cerebellum plays a vital role in controlling movement and gait posture. However, recently, researchers have reported that the cerebellum may also be responsible for other functions, such as social cognition, reward, anxiety, language, and executive functions. METHODS: In this study, we ascertained volumetric differences from cerebellar lobular analysis from children with ASD, ASD siblings, and typically developing healthy controls. In this cross-sectional study, a total of 30 children were recruited, including children with ASD (N = 15; mean age = 27.67 ± 5.1 months), ASD siblings (N = 6; mean age = 17.5 ± 3.79 months), and typically developing children (N = 9; mean age = 17.67 ± 3.21 months). All the MRI data was acquired under natural sleep without using any sedative medication. We performed a correlation analysis with volumetric data and developmental and behavioral measures obtained from these children. Two-way ANOVA and Pearson correlation was performed for statistical data analysis. RESULTS: We observed intriguing findings from this study, including significantly increased gray matter lobular volumes in multiple cerebellar regions including; vermis, left and right lobule I-V, right CrusII, and right VIIb and VIIIb, respectively, in children with ASD, compared to typically developing healthy controls and ASD siblings. Multiple cerebellar lobular volumes were also significantly correlated with social quotient, cognition, language, and motor scores with children with ASD, ASD siblings, and healthy controls, respectively. CONCLUSIONS: This research finding helps us understand the neurobiology of ASD and ASD-siblings, and critically advances current knowledge about the cerebellar role in ASD. However, results need to be replicated for a larger cohort from longitudinal research study in future.

Uncovering the Optimal Molecular Characteristics of Hydrophobe-Containing Polypeptoids to Induce Liposome or Cell Membrane Fragmentation.

Cellular functions of membrane proteins are strongly coupled to their structures and aggregation states in the cellular membrane. Molecular agents that can induce the fragmentation of lipid membranes are highly sought after as they are potentially useful for extracting membrane proteins in their native lipid environment. Toward this goal, we investigated the fragmentation of synthetic liposome using hydrophobe-containing polypeptoids (HCPs), a class of facially amphiphilic pseudo-peptidic polymers. A series of HCPs with varying chain lengths and hydrophobicities have been designed and synthesized. The effects of polymer molecular characteristics on liposome fragmentation are systemically investigated by a combination of light scattering (SLS/DLS) and transmission electron microscopy (cryo-TEM and negative stained TEM) methods. We demonstrate that HCPs with a sufficient chain length (DPn ≈ 100) and intermediate hydrophobicity (PNDG mol % = 27%) can most effectively induce the fragmentation of liposomes into colloidally stable nanoscale HCP-lipid complexes owing to the high density of local hydrophobic contact between the HCP polymers and lipid membranes. The HCPs can also effectively induce the fragmentation of bacterial lipid-derived liposomes and erythrocyte ghost cells (i.e., empty erythrocytes) to form nanostructures, highlighting the potential of HCPs as novel macromolecular surfactants toward the application of membrane protein extraction.

Personal meaning of recovery among persons with schizophrenia.

BACKGROUND: Recovery in mental illness is not synonymous with cure. Personal recovery approach consider recovery as a process and not as an outcome. This approach takes into account the subjective meaning of recovery by assessing how a person has learned to accommodate and live with an illness. AIM: To study the personal meaning of recovery among persons with schizophrenia. METHOD: This article presents the findings of a qualitative study about what 'recovery' means to persons with schizophrenia. A semi structured interview schedule was prepared based on literature review and expert opinion. Twenty participants who met the inclusion criteria and personally consider themselves recovering/recovered from schizophrenia were selected for the in-depth qualitative interviews. Data was analyzed using Interpretative Phenomenological Analysis (IPA). Meaning of recovery from each participant's perspective was recorded. FINDINGS: The results indicate factors that patients deem important for their recovery are, absence of symptoms, regaining functioning, being able to work, having adequate emotional stability and not being on medicines. The findings are examined in the background of the previous studies and suggestions for clinical practice and research is also discussed. CONCLUSION: Recovery is far more than remission of symptoms. Persons with mental illness has their own criteria of recovery, which could be very distinct from the clinical definition. Current study findings can help in identifying meaning of recovery through the perspectives of persons with mental illness and in developing and implementing recovery-oriented services.

Development of a scale to assess the determinants of positive coping in parents of children with intellectual disability.

Identifying the determinants of positive coping is a critical step in empowering the parents of children with intellectual disability. In this context, this study aims to develop a scale to assess the determinants of positive coping. Accordingly, culturally relevant items were pooled, got validated by experts and refined. The scale was administered to 150 parents of children with intellectual disability. Factor analysis done through polychoric correlation helped reduce the items. Cronbach's alpha coefficients were established for reliability testing. The validity of the new scale was examined with the subjective wellbeing on a visual analogue scale and Family Interview for Stress and Coping in Mental Retardation. The new scale has a Cronbach's alpha of 0.71 and an intraclass correlation of 0.64. After factor analysis, 12 items were retained in the final version. This study also identified specific factors associated with positive coping. The new scale can be used with parents of children with intellectual disabilities to identify the determinants of positive coping.

Lived experiences of children and adolescents with obsessive-compulsive disorder: interpretative phenomenological analysis.

BACKGROUND: Childhood obsessive-compulsive disorder (OCD) is distinct from OCD in adults. It can be severely disabling and there is little qualitative research on OCD in children. The present study aims to explore the subjective experiences of diagnosis, treatment processes and meaning of recovery in children and adolescents suffering from OCD and provide a conceptual model of the illness. METHODS: It is a qualitative study of ten children and adolescents selected by purposive sampling. MINI KID 6.0, Children's Yale-Brown Obsessive-Compulsive Scale and Clinical Global Impression-Severity Scale were administered at the time of recruitment of subjects into the study. Interviews were conducted using an in-depth semi-structured interview guide and audio-recorded. The transcribed interviews were analyzed using Interpretative Phenomenological Analysis (IPA). The study sought to explore participants' sense-making of their world, their thoughts, feelings and perceptions through interpretative enquiry. The findings were confirmed by a process called investigator triangulation, member check and peer validation. RESULTS: IPA yielded five major themes-'illness perception changes over time', 'disclosure on a spectrum', 'cascading effects of OCD', 'treatment infuses hope and helps', and 'navigating through OCD'. A summary of these themes and their subthemes is presented as a conceptual model. The essence of this model is to show the inter-relationship between themes and provide a comprehensive understanding of the phenomenon of OCD. CONCLUSIONS: To the best of our knowledge, this is the first study to explore lived experiences of children and adolescents with OCD using interpretative phenomenological analysis (IPA). It was noted that perception of illness and treatment processes evolves over time, and recovery is viewed as a process. Future qualitative research can be carried out with a focus on 'therapist-related barriers' or 'student-teacher dyads' that can inform clinical practice and school policies respectively. Trial registration NIMH/DO/IEC (BEH. Sc. DIV)/2018, l1 April 2018.

Intervention-based mental health training for community level workers in India -A systematic review.

Community-level workers (CLWs) are frontline workers who function as mediators between the government and the community. They effectively and efficiently distribute government policies and welfare schemes directly to the public, especially health aspects. They play a vital role in primary care access and quality. Many recent studies demonstrate that physical health training of CLWs is indeed effective and increases access to services. However, there are no recent reviews that systematically understand the training of CLWs concerning mental health interventions, and reviews on CLW's understanding about mental health issues and implementation at the community level is inadequate. CLWs are underutilized in aspects of mental health interventions despite having more potential for the same. They are the ones who need to know much about mental health issues and treatment availabilities. To understand this gap, a systematic review on training on mental health interventions to the CLWs in India, the method and content of mental health training in such studies was done. Our systematic search following the PRISMA guidelines included eight studies that met the eligibility criteria. The review of the studies that satisfied inclusion criteria suggests that training on mental health interventions with CLWs sounds effective. The researcher also provides recommendations to strengthen the CLWs mental health knowledge and discusses implications of mental health interventions through trained CLWs for the community. Based on the review findings, the researcher recommends ideas about how CLWs can be utilized accordingly in mental health aspects during the current pandemic.

Hydrophobically modified chitosan biopolymer connects halloysite nanotubes at the oil-water interface as complementary pair for stabilizing oil droplets.

The integration of cationic and hydrophobic functionalities into hydrophobically modified chitosan (HMC) biopolymer facilitates complementary emulsion stabilization with negatively charged halloysite clay nanotubes (HNT). Oil-in-water emulsions with smaller droplet sizes and significantly improved interfacial resistance to droplet coalescence are obtained on complementary emulsion stabilization by HNT and HMC compared to the individual emulsifiers alone. Contact angle measurements shows that the adsorption of the cationic HMC onto the negatively charged HNT modifies the surface wettability of the nanotubes, facilitating the attachment of the nanotubes to the oil-water interface. High resolution cryo-SEM imaging reveals that free HMC chains locks the nanotubes together at the oil-water interface, creating a high barrier to droplet coalescence. The emulsion stability is an order of magnitude higher for conditions in which the aqueous HNT dispersion is stabilized by the HMC compared to conditions where the negatively charged HNT is strongly flocculated by the cationic HMC. The hydrophobic interaction between HMC chains, insertion of HMC hydrophobes into the oil phase and electrostatic interactions between HMC and HNT are proposed as key mechanisms driving the increased emulsion stability. For potential application as a dispersant system for crude oil spill treatment, the nanotubular morphology of HNT was further exploited for the encapsulation of the water-insoluble surfactant, sorbitan monooleate (Span 80). The HMC and HNT sterically strengthens the oil-water interfacial layer while release of the Span 80 surfactant from the HNT lumen lowers the oil-water interfacial tension. The concepts advanced here are relevant in the development of environmentally-benign dispersants for oil spill remediation.

Transformation of Lipid Vesicles into Micelles by Adding Nonionic Surfactants: Elucidating the Structural Pathway and the Intermediate Structures.

The phospholipid lecithin (L) and the nonionic surfactant Tween 80 (T) are used together in various contexts, including in drug delivery and oil spill remediation. There is hence a need to elucidate the nanostructures in LT mixtures, which is the focus of this paper. We study these mixtures using cryogenic transmission electron microscopy (cryo-TEM), coupled with dynamic light scattering and small-angle neutron scattering. As the concentration of Tween 80 is increased, the vesicles formed by lecithin are transformed into spherical micelles. We identify bicelles (i.e., disc-like micelles) as well as cylindrical micelles as the key stable nanostructures formed at intermediate L/T ratios. The bicelles have diameters ∼13-26 nm, and the bicelle size decreases as the Tween 80 content increases. We propose that the lecithin lipids form the body of the discs, while the Tween 80 surfactants occupy the rims. This hypothesis is consistent with geometric arguments because lecithin is double-tailed and favors minimal curvature, whereas the single-tailed Tween 80 molecules prefer curved interfaces. In the case of cylindrical micelles, cryo-TEM reveals that the micelles are short (length < 22 nm) and flexible. We are able to directly visualize the microstructure of the aggregates formed by lecithin-Tween 80 mixtures, thereby enhancing the understanding of morphological changes in the lecithin-Tween 80 system.

Clinical profile of children and adolescents diagnosed with anorexia nervosa in Indian context.

OBJECTIVE: This study was conducted to assess the trends observed in the prevalence pattern, clinical presentation, psychosocial profile and treatment profile of anorexia nervosa in children and adolescents who presented to a tertiary care child and adolescent psychiatry centre over a period of ten years. METHODS: Case records of children and adolescents diagnosed with anorexia nervosa at the department of child and adolescent psychiatry from 1st April 2009-31 st March 2019 were obtained from the medical records department of the National Institute of Mental Health and Neurosciences (NIMHANS). Standardized data abstraction forms were developed and used for the purpose of this study. Pseudo-anonymization was done to ensure confidentiality and clinical characteristics of the sample were studied using frequency analysis and central tendencies. RESULTS: Prevalence of anorexia nervosa in a clinic-based population is estimated to be 0.07% over the 10-year period. The mean age at presentation was 13.96 years (SD-2.3) and the male to female ratio was 1:12. The majority (80.8%) were admitted and only one patient (3.8%) received treatment on an outpatient basis. Two or more psychosocial stressors were associated with the onset of illness in 88.5% (n = 23) of the patients and dysfunctional family dynamics was noted to be a significant issue in the majority of cases. All the patients received pharmacotherapy and CBT-based individual therapy. The overall outcome was favourable based on the CGI-I scores. CONCLUSIONS: Prevalence of anorexia nervosa in the clinic-based setting is rising in the Indian context. Sample characteristics are similar to those seen in the west. There is a huge demand-supply gap that calls for creating a service provider network to ensure community-based care.