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1.
Sci Rep ; 14(1): 2787, 2024 02 02.
Artículo en Inglés | MEDLINE | ID: mdl-38307896

RESUMEN

India is the world's largest cotton producer and the only country that grows all four cultivated cotton species. There have been very few studies on the diversity and abundance of natural enemies of cotton insect pests in these cultivated cotton species. Therefore, the current study (2016-2018) was conducted to assess the diversity and abundance of natural enemies that cultivated cotton species harbour. Phule Dhanwantari, Suraj, Suvin, RCH-2, and DCH-32 were the five genotypes used in the study, each with a distinct genetic background. Using the adiv 2.0.1 and vegan R packages, we identified significant differences in natural enemies in terms of species diversity, richness, evenness, and abundance. Analysis of Similarity (ANOSIM) and Non-metric Multidimensional Scaling (NMDS) indicated substantial differences in the natural enemy community structure among the examined genotypes. A total of 17,279 natural enemies were collected and identified across genotypes from seven predatory families and five parasitoid families. The percentage share of these natural enemy families across genotypes and years, in descending order, is Coccinellidae (28.23%) < Tachinidae (19.23%) < Braconidae (12.68%) < Chrysopidae (11.65%) < Chalcididae (9.41%) < Aphelinidae (6.33%) < Pentatomidae (3.29%) < Ichneumonidae (2.37%) < Syrphidae (2.33%) < Vespidae (1.81%) < Asilidae (1.79%) < Geocoridae (0.89%). Coccinellidae, Tachinidae, Braconidae, Chrysopidae, Chalcididae, and Aphelinidae are the six major families that account for more than 85% of all recorded natural enemies. These six families have a higher percentage share in Phule Dhanwantary (90%) compared to the other genotypes. The conservation and better utilization of these natural enemies are crucial for the ecological and safe management of insect pests in the cotton ecosystem.


Asunto(s)
Escarabajos , Heterópteros , Himenópteros , Humanos , Animales , Ecosistema , Insectos , Gossypium/genética
2.
Nature ; 624(7990): 86-91, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38030721

RESUMEN

To close the gap between the rates of computational screening and experimental realization of novel materials1,2, we introduce the A-Lab, an autonomous laboratory for the solid-state synthesis of inorganic powders. This platform uses computations, historical data from the literature, machine learning (ML) and active learning to plan and interpret the outcomes of experiments performed using robotics. Over 17 days of continuous operation, the A-Lab realized 41 novel compounds from a set of 58 targets including a variety of oxides and phosphates that were identified using large-scale ab initio phase-stability data from the Materials Project and Google DeepMind. Synthesis recipes were proposed by natural-language models trained on the literature and optimized using an active-learning approach grounded in thermodynamics. Analysis of the failed syntheses provides direct and actionable suggestions to improve current techniques for materials screening and synthesis design. The high success rate demonstrates the effectiveness of artificial-intelligence-driven platforms for autonomous materials discovery and motivates further integration of computations, historical knowledge and robotics.

3.
Front Immunol ; 14: 1199092, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37795082

RESUMEN

Tuberculosis (TB) in the bovine is one of the most predominant chronic debilitating infectious diseases primarily caused by Mycobacterium bovis. Besides, the incidence of TB in humans due to M. bovis, and that in bovines (bovine TB, bTB) due to M. tuberculosis- indicates cattle as a major reservoir of zoonotic TB. While India accounts for the highest global burden of both TB and multidrug-resistant TB in humans, systematic evaluation of bTB prevalence in India is largely lacking. Recent reports emphasized markedly greater bTB prevalence in exotic and crossbred cattle compared to indigenous cattle breeds that represent more than one-third of the total cattle population in India, which is the largest globally. This study aimed at elucidating the immune responses underlying the differential bTB incidence in prominent indigenous (Sahiwal), and crossbred (Sahiwal x Holstein Friesian) cattle reared in India. Employing the standard Single Intradermal Tuberculin Test (SITT), and mycobacterial gene-targeting single as well as multiplex-PCR-based screening revealed higher incidences of bovine tuberculin reactors as well as Mycobacterium tuberculosis Complex specific PCR positivity amongst the crossbred cattle. Further, ex vivo mycobacterial infection in cultures of bovine peripheral blood mononuclear cells (PBMC) from SITT, and myco-PCR negative healthy cattle exhibited significantly higher intracellular growth of M. bovis BCG, and M. tuberculosis H37Ra in the crossbred cattle PBMCs compared to native cattle. In addition, native cattle PBMCs induced higher pro-inflammatory cytokines and signaling pathways, such as interferon-gamma (IFN-γ), interleukin-17 (IL-17), tank binding kinase-1 (TBK-1), and nitric oxide (NO) upon exposure to live mycobacterial infection in comparison to PBMCs from crossbred cattle that exhibited higher expression of IL-1ß transcripts. Together, these findings highlight that differences in the innate immune responses of these cattle breeds might be contributing to the differential susceptibility to bTB infection, and the resultant disparity in bTB incidence amongst indigenous, and crossbred cattle.


Asunto(s)
Mycobacterium bovis , Mycobacterium tuberculosis , Tuberculosis Bovina , Tuberculosis , Humanos , Animales , Bovinos , Leucocitos Mononucleares , Tuberculosis/genética , Tuberculosis/veterinaria , Tuberculosis/diagnóstico , Tuberculosis Bovina/prevención & control , Tuberculina , Inmunidad Innata
4.
Gen Psychiatr ; 36(2): e100756, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36937093

RESUMEN

Nicotine use is more prevalent in patients with psychiatric disorders, especially those diagnosed with psychotic illnesses. Previously, this higher prevalence has been partially attributed to the potential ameliorative effects of nicotine on symptom severity and cognitive impairment. Some healthcare professionals and patients perceive there is a beneficial effect of nicotine on mental health. Emerging data show that the harm associated with nicotine in the population of patients with mental health conditions outweighs any potential benefit. This paper will review the evidence surrounding the nicotinic system and schizophrenia, with a focus on any causality between nicotine and psychosis.

5.
Chemosphere ; 312(Pt 1): 137186, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-36368534

RESUMEN

Pharmaceutical pollution that imposes a health threat worldwide is making accurate and rapid detection crucial to prevent adverse effects. Herein, binder-free zinc oxide nanograins on carbon cloth (ZnO NGs@CC) have been synthesized hydrothermally and employed to fabricate a flexible electrochemical sensor for the quantification of hydroxychloroquine (HCQ) that is typical pharmaceutical pollution. The characteristics of ZnO NGs@CC were investigated by various in-depth electron microscopic, spectroscopic and electroanalytical approaches. Compared with the pristine CC platform, the ZnO NGs@CC platform exhibits superior electrochemical performance in detecting HCQ with a large oxidation current at a low over-potential of +0.92 V with respect to the Ag/AgCl (Sat. KCl) reference electrode. With the support of desirable characteristics, the fabricated ZnO NGs@CC-based electrochemical sensor for HCQ detection displays good performances in terms of wide sensing range (0.5-116 µM), low detection limit (0.09 µM), high sensitivity (0.279 µA µM-1 cm-2), and strong selectivity. By the resulting 3D hierarchical nanoarchitecture, ZnO NGs@CC has progressive structural advantages that led to its excellent electrochemical performance in sensing applications. Furthermore, the electrochemical sensor is employed to detect HCQ in biological and environmental samples and also achieves good recovery rates. Thus, the designed ZnO NGs@CC demonstrates admirable electrochemical activity toward HCQ real-time monitoring and would be an excellent electrochemical platform for HCQ sensing.


Asunto(s)
Óxido de Zinc , Óxido de Zinc/química , Carbono/química , Hidroxicloroquina , Electrodos , Preparaciones Farmacéuticas , Técnicas Electroquímicas/métodos
6.
Virusdisease ; 33(4): 429-444, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36311173

RESUMEN

Background: Severe acute respiratory syndrome Coronavirus-2 invades the cells via ACE2 receptor and damages multiple organs of the human body. Understanding the pathological manifestation is mandatory to endure the rising post-infection sequel reported in patients with or without comorbidities. Materials and methods: Our descriptive review emphasises the direct, indirect and post-infection damages due to COVID-19. We have performed an electronic database search according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines with selective inclusion and exclusion criteria. Results: The included studies substantiated the extensive damages in the multiple organs due to direct and indirect consequences of COVID-19. After an apparent recovery, the prolonged presentation of the symptoms manifests as post-COVID that can be related with persisting viral antigens and dysregulated immune response. Conclusion: A few of the symptoms of respiratory, cardiovascular, and neuropsychiatric systems that persist or reappear as post-COVID manifestations. Vaccination and preventive programs will effectively reduce the prevalence but, the post-COVID, a multisystem manifestation, will be a significant tribulation to the medical profession. However, the issue can be managed by implementing public health programs, rehabilitation services, and telemedicine virtual supports to raise awareness and reduce panic.

7.
Neotrop Entomol ; 51(4): 600-612, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-35680781

RESUMEN

Entomopathogens (EPFs) are potential alternatives to chemical insecticides for managing Bemisia tabaci (Genn.), an invasive pest of the cotton crop. EPFs alone may not always provide enough insect pest control, but combining EPFs with pesticides, provided both components are compatible, can make an integrated pest management program considerably more effective. Hence, the bioefficacy of EPFs against whitefly, their compatibility with pesticides, and the factors responsible for determining compatibility were studied. The highest nymphal mortality was recorded with the Beauveria bassiana strains Bb-4511 (95.1%) and Bb-4565 (89.9%), and Metarhizium anisopliae Ma-1299 (86.7%) at 1 × 106 conidia ml-1. Lower LC50 values were observed for Cordyceps javanica Cj-089 and Bb-4511, 0.2 × 104 and 0.5 × 104 conidia ml-1, respectively. The toxicity index values in insecticide sensitivity assays ranged from 19.4 to 119.6% among all the EPFs. Comparatively, all the EPFs except Bb-4543 and Bb-4565 showed compatible to moderately toxic reactions to neonicotinoids and spinosyns. Organophosphates (ethion) and pyrethrins (bifenthrin) were toxic to very toxic to all the EPFs except Bb-4511, Fv-083, and Ma-1299. Cj-102 and Cj-089 were compatible with 50% of the average recommended dose of bifenthrin and ethion, and the average recommended dose for the field application of neonicotinoids and spinosyns. Principal component analysis showed that spore production and toxicity index values correlate with each other and are responsible for determining the EPF compatibility with insecticides. The EPF spore production and toxicity index are important factors for determining chemical compatibility. Compatible EPFs can be used individually or in combination as promising and compatible biological alternatives to insecticides in the management of whitefly in cotton.


Asunto(s)
Hemípteros , Insecticidas , Plaguicidas , Animales , Insecticidas/farmacología , Neonicotinoides , Ninfa , Control Biológico de Vectores , Plaguicidas/farmacología , Esporas Fúngicas
8.
J Psychiatr Pract ; 28(1): 78-83, 2022 01 06.
Artículo en Inglés | MEDLINE | ID: mdl-34989350

RESUMEN

Anti-N-methyl-D-aspartate (anti-NMDA) receptor encephalitis is a condition that was only identified relatively recently. It often presents in psychiatric settings, with clinical presentations that may overlap with those of other psychiatric disorders such as psychoses secondary to schizophrenia, substance use, or brief delusional disorder. It often presents in women of child bearing age and has a relatively high mortality rate. The treatment approach for anti-NMDA receptor encephalitis is considerably different from that used for other psychiatric and neurological conditions. Early recognition, correct diagnosis, and appropriate management of the condition are of vital importance to the prognosis, including reducing mortality rate, admissions to intensive care units, recurrence, complications of the disease and in some cases, irreversible hippocampal damage. We present a case that highlights the typical presentation of anti-NMDA receptor encephalitis in a young woman and discuss management and outcome.


Asunto(s)
Encefalitis Antirreceptor N-Metil-D-Aspartato , Enfermedades del Sistema Nervioso , Trastornos Psicóticos , Esquizofrenia , Encefalitis Antirreceptor N-Metil-D-Aspartato/diagnóstico , Encefalitis Antirreceptor N-Metil-D-Aspartato/terapia , Femenino , Humanos , Trastornos Psicóticos/diagnóstico , Trastornos Psicóticos/etiología , Trastornos Psicóticos/terapia , Receptores de N-Metil-D-Aspartato , Esquizofrenia/diagnóstico
9.
Indian J Crit Care Med ; 26(Suppl 2): S51-S65, 2022 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-36896363

RESUMEN

Deep vein thrombosis (DVT) is a preventable complication of critical illness, and this guideline aims to convey a pragmatic approach to the problem. Guidelines have multiplied over the last decade, and their utility has become increasingly conflicted as the reader interprets all suggestions or recommendations as something that must be followed. The nuances of grade of recommendation vs level of evidence are often ignored, and the difference between a "we suggest" vs a "we recommend" is overlooked. There is a general unease among clinicians that failure to follow the guidelines translates to poor medical practice and legal culpability. We attempt to overcome these limitations by highlighting ambiguity when it occurs and refraining from dogmatic recommendations in the absence of robust evidence. Readers and practitioners may find the lack of specific recommendations unsatisfactory, but we believe that true ambiguity is better than inaccurate certainty. We have attempted to comply with the guidelines on how to create guidelines.1 And to overcome the poor compliance with these guidelines.2 Some observers have expressed concern that DVT prophylaxis guidelines may cause more harm than good.3 We have placed greater emphasis on large randomized controlled trials (RCTs) with clinical end point and de-emphasized RCTs with surrogate end points and also de-emphasized hypothesis generating studies (observational studies, small RCTs, and meta-analysis of these studies). We have de-emphasized RCTs in non-intensive care unit populations like postoperative patients or those with cancer and stroke. We have also considered resource limitation settings and have avoided recommending costly and poorly proven therapeutic options. How to cite this article: Jagiasi BG, Chhallani AA, Dixit SB, Kumar R, Pandit RA, Govil D, et al. Indian Society of Critical Care Medicine Consensus Statement for Prevention of Venous Thromboembolism in the Critical Care Unit. Indian J Crit Care Med 2022;26(S2):S51-S65.

10.
A A Pract ; 15(11): e01545, 2021 Nov 05.
Artículo en Inglés | MEDLINE | ID: mdl-34752439

RESUMEN

The increasing coincidence of obesity with heart failure may preclude eligibility for orthotopic heart transplantation, requiring continuous-flow left ventricular assist devices (LVADs) as destination therapy. This report describes intraoperative considerations for patients who underwent LVAD implantation with concurrent laparoscopic sleeve gastrectomy (LSG) to promote weight loss. In particular, right ventricular dysfunction associated with acute left ventricular unloading may be compounded by pneumoperitoneum for LSG due to the difficulty in ventilating patients with obesity, hypercarbia-mediated increase in pulmonary vascular resistance, and variable cardiac loading conditions. We identify specific anesthetic challenges and discuss methods of monitoring and management.


Asunto(s)
Corazón Auxiliar , Laparoscopía , Obesidad Mórbida , Gastrectomía , Humanos , Obesidad Mórbida/cirugía , Estudios Retrospectivos , Resultado del Tratamiento
12.
J Invertebr Pathol ; 183: 107618, 2021 07.
Artículo en Inglés | MEDLINE | ID: mdl-33992641

RESUMEN

The whitefly, Bemisia tabaci Gennadius (Hemiptera: Aleyrodidae), is becoming a serious problem on Bt cotton. It causes enormous crop loss through its direct feeding and as a vector of cotton leaf curl virus. Chemical-dependent management is harming the environment and increased insecticide resistance is often observed in the fields. Identification of most virulent strains of entomopathogenic fungi (EPF) is essential to serve as an important component of an IPM program for management of B. tabaci. Compared to B. tabaci adults, the nymphal stage is reported to be more susceptible to entomopathogens, and targeting nymphs also helps vector management. We evaluated the bioefficacy of EPF and chemical pesticides against nymphs of B. tabaci on Bt cotton under polyhouse and field conditions. The bioefficacy index (BI) was considered as a mechanism to select the most effective EPF strains for field evaluation. The highest nymphal mortality under polyhouse conditions was recorded for Metarhizium anisopliae NA-01299 (86.7%), Beauveria bassiana MT-4511 (85.1%), Cordyceps javanica IT-10498 (81.1%), IT-10499 (81%), and B. bassiana NA-0409 (78.2%) relative to other EPF strains, spiromesifen (69.6%), buprofezin (62.2%) and pyriproxyfen (52.7%) at 7-days-post-spray treatment (DAS). However, among all the EPF, the highest BI was recorded in C. javanica IT-10499 (77%), IT-10495 (75.4%), Fusarium verticillioides IT-10493 (74.6%), and B. bassiana MT-4511 (73.1%). The pooled data of two-year field trials (2017-18 & 2018-19) revealed that the highest nymphal mortality was recorded for MT-4511 (85%), IT-10499 (83.2%), and pyriproxyfen 10% EC (78.6%) at 7-DAS. The BI-based selection of EPF proved to be a useful predictor of field efficacy. A sequential spray of the selected EPF would be a vital approach for resilient and sustainable integrated management of the B. tabaci nymphal population under field conditions.


Asunto(s)
Agentes de Control Biológico/farmacología , Hemípteros/microbiología , Control de Insectos , Control Biológico de Vectores , Animales , Beauveria/fisiología , Cordyceps/fisiología , Fusarium/fisiología , Hemípteros/crecimiento & desarrollo , Metarhizium/fisiología , Ninfa/crecimiento & desarrollo , Ninfa/microbiología
13.
Phys Chem Chem Phys ; 23(17): 10357-10364, 2021 May 05.
Artículo en Inglés | MEDLINE | ID: mdl-33884398

RESUMEN

An outstanding issue in the longevity of photovoltaic (PV) modules is the accelerated degradation caused by the presence of moisture. Moisture leads to interfacial instability, de-adhesion, encapsulant decomposition, and contact corrosion. However, experimental characterization of moisture in PV modules is not trivial and its impacts can take years or decades to establish in the field, presenting a major obstacle to designing high-reliability modules. First principles calculations provide an alternative way to study the ingress of water and its detrimental effect on the structure and decomposition of the polymer encapsulant and interfaces between the encapsulant and the semiconductor, the metal contacts, or the dielectric layer. In this work, we use density functional theory (DFT) computations to model single chain, crystalline and cross-linked structures, infrared (IR) signatures, and degradation mechanisms of ethylene vinyl acetate (EVA), the most common polymer encapsulant used in Si PV modules. IR-active modes computed for low energy EVA structures and possible decomposition products match well with reported experiments. The EVA decomposition energy barriers computed using the Nudged Elastic Band (NEB) method show a preference for acetic acid formation as compared to acetaldehyde, are lowered in the presence of a water solvent or hydroxyl ion catalyst, and match well with reported experimental activation energies. This systematic study leads to a clear picture of the hydrolysis-driven decomposition of EVA in terms of energetically favorable mechanisms, possible intermediate structures, and IR signatures of reactants and products.

14.
RSC Adv ; 11(34): 20752-20759, 2021 Jun 09.
Artículo en Inglés | MEDLINE | ID: mdl-35479356

RESUMEN

In this work, the effects of gamma-ray irradiation (up to 3 kGy) on the structural and electronic properties of poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate) (PEDOT:PSS), irradiated in air and vacuum environments are systematically investigated. Raman spectroscopy indicates that there is no significant change in structural conformation of PEDOT:PSS film after gamma-ray irradiation. However, the conductivity of the film decreases as a function of dose in both air and vacuum environments, which can be deduced as a result of defects created in the structure. Hall effect measurements showed higher carrier concentration when the samples are irradiated under vacuum in comparison to the air environment, whereas mobility decreases as a function of dose irrespective of the environment. Furthermore, the electron spin resonance spectra provided evidence of the evolution of polaron population after gamma-ray exposure of 3 kGy, due to the decrease in charge delocalization and molecular ordering of the molecules. This decrease in conductivity and mobility of the PEDOT:PSS films irradiated in air and vacuum environments can be mainly ascribed to the defects and radical formation after gamma-ray exposure, favoring chain scission or cross-linking of the polymers.

16.
Health Care Women Int ; 42(4-6): 611-635, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-32779972

RESUMEN

From 2005-06 to 2015-16, proportion of cesarean deliveries in total deliveries has almost doubled in India. In this paper, we study changes in prevalence of cesarean deliveries across different social-economic groups and study factors affecting odds of undergoing cesarean delivery. The present paper was based on National Family Health Surveys and employs logistic regression. We find that rise in cesarean deliveries has been across social groups, religions, urban/rural India, wealth groups, though increase has not been uniform. Further, many economically affluent states have high proportion of cesarean deliveries. We find that women delivering at private hospitals had significantly higher odds of opting for cesarean delivery. Further, women belonging to rich households were more likely to go through surgery for birth. In case of earlier terminated pregnancies, odds were higher too. The higher odds of cesarean sections in the relatively affluent geographic regions, richer households and private institutions indicate that these procedures may be driven by non-medical reasons in many cases, pointing toward the use of surgical procedures for the convenience.


Asunto(s)
Cesárea , Hospitales Privados , Femenino , Humanos , India/epidemiología , Parto , Embarazo , Población Rural
17.
J Cardiothorac Vasc Anesth ; 35(3): 888-895, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32718887

RESUMEN

OBJECTIVES: To determine in-hospital outcomes and assess high-risk groups among chronic heart failure (CHF) patients with aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR). DESIGN: A retrospective analysis of the Nationwide Inpatient Sample database from January 2012 to September 2015 was performed. SETTING: Hospitals across the United States that offer TAVRs or SAVRs. PARTICIPANTS: Adults with a diagnosis of CHF and AS. INTERVENTIONS: The patients underwent either TAVR or SAVR. MEASUREMENTS AND MAIN RESULTS: Totals of 5,871 and 4,008 CHF patients underwent TAVR and SAVR, respectively. TAVR patients were significantly older, more were female, and had a higher comorbidity burden. No significant differences in in-hospital mortality were noted between TAVR and SAVR. However, mean length of stay was significantly longer by 3.5 days in the SAVR group, as was the mean total cost. With the exception of complete heart block, permanent pacemaker implantation, and vascular complications, the majority of postoperative events were higher among the SAVR group. Multivariate regression analysis identified postoperative cardiac, respiratory and renal complications as significant predictors of in-hospital mortality for both groups. Additionally, age ≥75 years and vascular complications were significant predictors of mortality for patients undergoing TAVR. CONCLUSIONS: Among CHF patients with symptomatic AS, TAVR had similar in-hospital mortality rate compared with SAVR despite higher comorbidity burden. TAVR patients are at a lower risk of cardiovascular, respiratory, and renal complications and might lead to reduced length of hospital stay and cost. Hence, TAVR may be a safer option in this population.


Asunto(s)
Estenosis de la Válvula Aórtica , Insuficiencia Cardíaca , Implantación de Prótesis de Válvulas Cardíacas , Reemplazo de la Válvula Aórtica Transcatéter , Adulto , Anciano , Válvula Aórtica/cirugía , Estenosis de la Válvula Aórtica/cirugía , Femenino , Mortalidad Hospitalaria , Humanos , Masculino , Complicaciones Posoperatorias/epidemiología , Estudios Retrospectivos , Factores de Riesgo , Reemplazo de la Válvula Aórtica Transcatéter/efectos adversos , Resultado del Tratamiento , Estados Unidos/epidemiología
18.
J Trop Pediatr ; 67(1)2021 01 29.
Artículo en Inglés | MEDLINE | ID: mdl-33367907

RESUMEN

BACKGROUND: During the current ongoing COVID-19 pandemic, psychological problems like anxiety, depression, irritability, mood swings, inattention and sleep disturbance are fairly common among quarantined children in several studies. A systematic review of these publications to provide an accurate burden of these psychiatric/behavioral problems is needed for planning mitigating measures by the health authorities. METHODS: Different electronic databases (MEDLINE, EMBASE, Web of Science, CENTRAL, medRxiv and bioRxiv) were searched for articles describing psychological/behavioral complications in children/adolescents with/without pre-existing behavioral abnormalities and their caregivers related to the COVID-19 pandemic. Only original articles with/without comparator arms and a minimum sample size of 50 were included in the analysis. The pooled estimate of various psychological/behavioral problems was calculated using a random-effect meta-analysis. RESULTS: Fifteen studies describing 22 996 children/adolescents fulfilled the eligibility criteria from a total of 219 records. Overall, 34.5%, 41.7%, 42.3% and 30.8% of children were found to be suffering from anxiety, depression, irritability and inattention. Although the behavior/psychological state of a total of 79.4% of children was affected negatively by the pandemic and quarantine, at least 22.5% of children had a significant fear of COVID-19, and 35.2% and 21.3% of children had boredom and sleep disturbance. Similarly, 52.3% and 27.4% of caregivers developed anxiety and depression, respectively, while being in isolation with children. CONCLUSION: Anxiety, depression, irritability, boredom, inattention and fear of COVID-19 are predominant new-onset psychological problems in children during the COVID-19 pandemic. Children with pre-existing behavioral problems like autism and attention deficit hyperactivity disorder have a high probability of worsening of their behavioral symptoms.


Asunto(s)
COVID-19/psicología , Cuidadores/psicología , Pandemias , Cuarentena/psicología , Adolescente , Ansiedad/epidemiología , Niño , Estudios Transversales , Depresión/epidemiología , Humanos , Salud Mental , Problema de Conducta
19.
Postgrad Med J ; 97(1147): 275-279, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-32900824

RESUMEN

Medical migration has become a global phenomenon, partly led by easier air travel, economic factors and the expansion of medical technology. New Zealand has gradually evolved from being 'bicultural' to a multicultural, multitextured society. The movement of the Indian people, particularly Indian physicians, will be the focus of this paper. In the last three decades, migration eligibility in New Zealand has changed from countries of origin or ability to speak English, to profession and skills. Despite struggling with its own issues, New Zealand has proven to be a preferred destination for Indian medical graduates (IMGs). India is widely recognised as the largest 'donor country' for doctors, many of whom go on to establish themselves as leaders and prominent figures in their field. This migration involves three parties: India as a donor country, New Zealand as a recipient country and IMGs as the drivers of this process. Factors behind this growing phenomenon are examined and recommendations are made so that all three parties can benefit from it.


Asunto(s)
Diversidad Cultural , Emigración e Inmigración/tendencias , Médicos Graduados Extranjeros , Competencia Clínica , Médicos Graduados Extranjeros/educación , Médicos Graduados Extranjeros/normas , Humanos , India/etnología , Nueva Zelanda , Profesionalismo
20.
A A Pract ; 14(14): e01355, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33278087

RESUMEN

Symptomatic carotid artery disease stenosis warrants open surgical carotid endarterectomy (CEA). However, patients with continuous-flow left ventricular assist devices (CF-LVADs) present unique challenges when vasopressors and volume are used to maintain cerebral perfusion pressure after carotid cross-clamping. This report describes patients with CF-LVADs who underwent CEA. We identify how preload, contractility, afterload, pump speed, mean arterial pressure, and anticoagulation should be addressed to maintain CF-LVAD outflow and cerebral perfusion during the procedure. Anesthesiologists can combine an understanding of continuous-flow physiology with invasive monitors to optimize cardiac output and cerebral blood flow during CEA procedures.


Asunto(s)
Estenosis Carotídea , Endarterectomía Carotidea , Corazón Auxiliar , Estenosis Carotídea/cirugía , Circulación Cerebrovascular , Humanos , Vasoconstrictores
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