Skewed normatives in India’s judicial discourse on rape

India has relatively strong legal frameworks in place to promote gender equality. However, the achievement of justice and equality for women in their everyday lives remains an elusive goal. Medha Garg analyses some judicial pronouncements from cases involving rape to argue that the judiciary itself often displays patriarchal attitudes that indirectly reinforce sexist and misogynistic norms

Existence of Picard operator and iterated function system

[EN] In this paper, we define weak θm− contraction mappings and give a new class of Picard operators for such class of mappings on a complete metric space. Also, we obtain some new results on the existence and uniqueness of attractor for a weak θm− iterated multifunction system. Moreover, we introduce (α, β, θm)− contractions using cyclic (α, β)− admissible mappings and obtain some results for such class of mappings without the continuity of the operator. We also provide an illustrative example to support the concepts and results proved herein.The authors are thankful to the learned referee for valuable suggestions. The second author is also thankful to AISTDF, DST for the research grant vide project No. CRD/2018/000017.Garg, M.; Chandok, S. (2020). Existence of Picard operator and iterated function system. Applied General Topology. 21(1):57-70. https://doi.org/10.4995/agt.2020.11992OJS5770211S. Alizadeh, F. Moradlou and P. Salimi, Some fixed point results for (α, β) − (ψ, φ)- contractive mappings, Filomat 28 (2014), 635-647. https://doi.org/10.2298/FIL1403635AM. F. Barnsley, Fractals Everywhere, Revised with the Assistance of and with a Foreword by Hawley Rising, III. Academic Press Professional, Boston (1993).R. M. T. Bianchini, Su un problema di S. Reich riguardante la teoria dei punti fissi, Boll. Un. Mat. Ital. 5 (1972), 103-108.E. L. Fuster, A. Petrusel and J. C. Yao, Iterated function system and well-posedness, Chaos Sol. Fract. 41 (2009), 1561-1568. https://doi.org/10.1016/j.chaos.2008.06.019R. H. Haghi, Sh. Rezapour and N. Shahzad, Some fixed point generalizations are not real generalizations, Nonlinear Anal. 74 (2011), 1799-1803. https://doi.org/10.1016/j.na.2010.10.052N. Hussain, V. Parvaneh, B. Samet and C. Vetro, Some fixed point theorems for generalized contractive mappings in complete metric spaces, Fixed Point Theory Appl. 2015, 185 (2015). https://doi.org/10.1186/s13663-015-0433-zJ. E. Hutchinson, Fractals and self similarity, Indiana Univ. Math. J. 30, no. 5 (1981), 713-747. https://doi.org/10.1512/iumj.1981.30.30055M. Imdad, W. M. Alfaqih and I. A. Khan, Weak θ−contractions and some fixed point results with applications to fractal theory, Adv. Diff. Eq. 439 (2018). https://doi.org/10.1186/s13662-018-1900-8M. Jleli and B. Samet, A new generalization of the Banach contraction principle, J. Inequal. Appl. 38 (2014). https://doi.org/10.1186/1029-242X-2014-38M. Radenovic and S. Chandok, Simulation type functions and coincidence points, Filomat, 32, no. 1 (2018), 141-147. https://doi.org/10.2298/FIL1801141RB. E. Rhoades, A comparison of various definitions of contractive mappings, Trans. American Math. Soc. 226 (1977), 257-290. https://doi.org/10.1090/S0002-9947-1977-0433430-4I. A. Rus, Picard operators and applications, Sci. Math. Jpn. 58, no. 1 (2003), 191-219.I. A. Rus, A. Petrusel and G. Petrusel, Fixed Point Theory, Cluj University Press, Cluj-Napoca, 2008.N. A. Secelean, Countable Iterated Function Systems, LAP LAMBERT Academic Publishing (2013). https://doi.org/10.1186/1687-1812-2013-277N. A. Secelean, Iterated function systems consisting of F-contractions, Fixed Point Theory Appl. 2013, 277 (2013). https://doi.org/10.1186/1687-1812-2013-277V. M. Sehgal, On fixed and periodic points for a class of mappings, J. London Math. Soc. 5 (1972), 571-576. https://doi.org/10.1112/jlms/s2-5.3.571S.-A. Urziceanu, Alternative charaterizations of AGIFSs having attactors, Fixed Point Theory 20 (2019), 729-740. https://doi.org/10.24193/fpt-ro.2019.2.4

Risk Factors Associated With Severe Hypoglycemia in Older Adults With Type 1 Diabetes

OBJECTIVE Severe hypoglycemia is common in older adults with long-standing type 1 diabetes, but little is known about factors associated with its occurrence

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

Preoperative Clonidine with Perioperative Dexmedetomidine for Attenuating Haemodynamic Responses and Blood Loss in Patients Undergoing Elective Transnasal Transsphenoidal Resection of Pituitary Tumours: A Randomised Clinical Study

Introduction: Transsphenoidal resection of pituitary tumours presents challenges for an anaesthesiologist due to haemodynamic fluctuations caused by intense nociceptive stimuli during different surgical stages. This relatively short procedure requires a smooth and rapid emergence for spontaneous airway control and assessment of surgical outcomes. Therefore, the chosen anaesthetic agent should provide effective haemodynamic control and facilitate rapid recovery. Alpha-2 agonists such as dexmedetomidine and clonidine are known to centrally decrease noradrenaline release, thus reducing sympathetic outflow. This could be particularly beneficial in minimising haemodynamic fluctuations during such surgeries. Aim: To compare the effects of preoperative clonidine and perioperative dexmedetomidine in attenuating haemodynamic responses and blood loss in patients undergoing elective Transnasal Transsphenoidal resection (TNTS) of pituitary tumours. Materials and Methods: A randomised, double-blinded study was conducted in the Department of Neuroanesthesiology at Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India, over a period of one year, from February 2022 to January 2023. Sixty patients of either sex, aged 18-65 years with ASA I or II, scheduled for elective TNTS pituitary surgery, were enrolled and divided into group A and group B. Group A received clonidine tablets (3 mcg/kg) 180 minutes prior to surgery, while group B received intravenous (i.v.) infusion of dexmedetomidine (1 mcg/kg/min) over 10 minutes before induction, followed by 0.5-0.7 mcg/kg/hr. Group A received a placebo of 0.9% Normal Saline (NS) (50 mL). Heart Rate (HR), Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), and Mean Arterial Pressure (MAP) were recorded at baseline, intubation, nasal pack insertion, endoscope insertion, and at various time intervals. Data obtained were analysed using unpaired sample t-test for independent groups, and Chi-square test was used for categorical data. A probability value of 0.05 was considered significant for both statistical tests. Results: The mean age of participants was 42±11 years for group A and 43±12 years for group B, with a male: female ratio of 66.6% to 33.3% in group A and 70% to 30% in group B, respectively. The mean Body Mass Index (BMI) was 26.4±3.2 in group A and 25.2±1.7 in group B. HR, SBP, and MAP decreased at various stages in group B compared to group A, and these differences were statistically significant (p-value <0.05). The study also found that the total consumption of propofol was significantly less in group B (220±38) compared to group A (282±140). Similarly, total fentanyl consumption was significantly lower in group B (5.83±1.60) than in group A (16.6±23.9). Although not statistically significant, total blood loss was also lower in group B (115±63) compared to group A (156±108). Conclusion: Intraoperative infusion of i.v. dexmedetomidine provides a reasonable choice compared to orally administered clonidine for transsphenoidal pituitary tumour resection, considering its favorable effects on haemodynamic stability and anaesthetic requirements

Effectiveness of artificial intelligence-assisted colonoscopy in early diagnosis of colorectal cancer: a systematic review

Introduction: As artificial intelligence (AI)-assisted diagnosis gained immense popularity, it is imperative to consider its utility and efficiency in the early diagnosis of colorectal cancer (CRC), responsible for over 1.8 million cases and 881 000 deaths globally, as reported in 2018. Improved adenoma detection rate, as well as better characterizations of polyps, are significant advantages of AI-assisted colonoscopy (AIC). This systematic review (SR) investigates the effectiveness of AIC in the early diagnosis of CRC as compared to conventional colonoscopy. Materials and methods: Electronic databases such as PubMed/Medline, SCOPUS, and Web of Science were reviewed for original studies (randomized controlled trials, observational studies), SRs, and meta-analysis between 2017 and 2022 utilizing Medical Subject Headings terminology in a broad search strategy. All searches were performed and analyzed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis methodology and were conducted from November 2022. A data extraction form based on the Cochrane Consumers and Communication Review group's extraction template for quality assessment and evidence synthesis was used for data extraction. All included studies considered for bias and ethical criteria and provided valuable evidence to answer the research question. Results: The database search identified 218 studies, including 87 from PubMed, 60 from SCOPUS, and 71 from Web of Science databases. The retrieved studies from the databases were imported to Rayyan software and a duplicate article check was performed, all duplicate articles were removed after careful evaluation of the data. The abstract and full-text screening was performed in accordance with the following eligibility criteria: Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) for observational studies; Preferred Reporting Items for Systematic Reviews and Meta-Analysis for review articles, ENTREQ for narrative studies; and modified JADAD for randomized controlled trials. This yielded 15 studies that met the requirements for this SR and were finally included in the review. Conclusion: AIC is a safe, highly effective screening tool that can increase the detection rate of adenomas, and polyps resulting in an early diagnosis of CRC in adults when compared to conventional colonoscopy. The results of this SR prompt further large-scale research to investigate the effectiveness in accordance with sex, race, and socioeconomic status, as well as its influence on prognosis and survival rate.</p

Risk Factors Associated With Severe Hypoglycemia in Older Adults With Type 1 Diabetes

Severe hypoglycemia is common in older adults with long-standing type 1 diabetes, but little is known about factors associated with its occurrence. A case-control study was conducted at 18 diabetes centers in the T1D Exchange Clinic Network. Participants were ≥60 years old with type 1 diabetes for ≥20 years. Case subjects (n = 101) had at least one severe hypoglycemic event in the prior 12 months. Control subjects (n = 100), frequency-matched to case subjects by age, had no severe hypoglycemia in the prior 3 years. Data were analyzed for cognitive and functional abilities, social support, depression, hypoglycemia unawareness, various aspects of diabetes management, C-peptide level, glycated hemoglobin level, and blinded continuous glucose monitoring (CGM) metrics. Glycated hemoglobin (mean 7.8% vs. 7.7%) and CGM-measured mean glucose (175 vs. 175 mg/dL) were similar between case and control subjects. More case than control subjects had hypoglycemia unawareness: only 11% of case subjects compared with 43% of control subjects reported always having symptoms associated with low blood glucose levels (P < 0.001). Case subjects had greater glucose variability than control subjects (P = 0.008) and experienced CGM glucose levels <60 mg/dL for ≥20 min on 46% of days compared with 33% of days in control subjects (P = 0.10). On certain cognitive tests, case subjects scored worse than control subjects. In older adults with long-standing type 1 diabetes, greater hypoglycemia unawareness and glucose variability are associated with an increased risk of severe hypoglycemia. A study to assess interventions to prevent severe hypoglycemia in high-risk individuals is needed

Abstracts of Scientifica 2022

This book contains the abstracts of the papers presented at Scientifica 2022, Organized by the Sancheti Institute College of Physiotherapy, Pune, Maharashtra, India, held on 12–13 March 2022. This conference helps bring researchers together across the globe on one platform to help benefit the young researchers. There were six invited talks from different fields of Physiotherapy and seven panel discussions including over thirty speakers across the globe which made the conference interesting due to the diversity of topics covered during the conference. Conference Title:  Scientifica 2022Conference Date: 12–13 March 2022Conference Location: Sancheti Institute College of PhysiotherapyConference Organizer: Sancheti Institute College of Physiotherapy, Pune, Maharashtra, Indi

Career intentions of medical students in the UK: a national, cross-sectional study (AIMS study)

Objective To determine current UK medical students’ career intentions after graduation and on completing the Foundation Programme (FP), and to ascertain the motivations behind these intentions.Design Cross-sectional, mixed-methods survey of UK medical students, using a non-random sampling method.Setting All 44 UK medical schools recognised by the General Medical Council.Participants All UK medical students were eligible to participate. The study sample consisted of 10 486 participants, approximately 25.50% of the medical student population.Outcome measures Career intentions of medical students postgraduation and post-FP, motivations behind these career intentions, characterising the medical student population and correlating demographic factors and propensity to leave the National Health Service (NHS).Results The majority of participating students (8806/10 486, 83.98%) planned to complete both years of the FP after graduation, with under half of these students (4294/8806, 48.76%) intending to pursue specialty training thereafter. A subanalysis of career intentions after the FP by year of study revealed a significant decrease in students’ intentions to enter specialty training as they advanced through medical school. Approximately a third of surveyed students (3392/10 486, 32.35%) intended to emigrate to practise medicine, with 42.57% (n=1444) of those students not planning to return. In total, 2.89% of students intended to leave medicine altogether (n=303). Remuneration, work-life balance and working conditions were identified as important factors in decision-making regarding emigration and leaving the profession. Subgroup analyses based on gender, type of schooling, fee type and educational background were performed. Only 17.26% of surveyed students were satisfied or very satisfied with the overall prospect of working in the NHS.Conclusions The Ascertaining the career Intentions of UK Medical Students study highlights UK students’ views and career intentions, revealing a concerning proportion of those surveyed considering alternative careers or emigration. Addressing factors such as remuneration, work-life balance and working conditions may increase retention of doctors and improve workforce planning efforts