Editorial Board

Source at http://dx.doi.org/10.1186/s12888-017-1345-8 Background: The duration of untreated psychosis is determined by both patient and service related factors. Few studies have considered the geographical accessibility of services in relation to treatment delay in early psychosis. To address this, we investigated whether treatment delay is co-determined by straight-line distance to hospital based specialist services in a mainly rural mental health context. Methods: A naturalistic cross-sectional study was conducted among a sample of recent onset psychosis patients in northern Norway (n = 62). Data on patient and service related determinants were analysed. Results: Half of the cohort had a treatment delay longer than 4.5 months. In a binary logistic regression model, straight-line distance was found to make an independent contribution to delay in which we controlled for other known risk factors. Conclusions: The determinants of treatment delay are complex. This study adds to previous studies on treatment delay by showing that the spatial location of services also makes an independent contribution. In addition, it may be that insidious onset is a more important factor in treatment delay in remote areas, as the logistical implications of specialist referral are much greater than for urban dwellers. The threshold for making a diagnosis in a remote location may therefore be higher. Strategies to reduce the duration of untreated psychosis in rural areas would benefit from improving appropriate referral by crisis services, and the detection of insidious onset of psychosis in community based specialist services

Soil conservation issues in India

Despite years of study and substantial investment in remediation and prevention, soil erosion continues to be a major environmental problem with regard to land use in India and elsewhere around the world. Furthermore, changing climate and/or weather patterns are exacerbating the problem. Our objective was to review past and current soil conservation programmes in India to better understand how production-, environmental-, social-, economic- and policy-related issues have affected soil and water conservation and the incentives needed to address the most critical problems. We found that to achieve success in soil and water conservation policies, institutions and operations must be co-ordinated using a holistic approach. Watershed programmes have been shown to be one of the most effective strategies for bringing socio-economic change to different parts of India. Within both dryland and rainfed areas, watershed management has quietly revolutionized agriculture by aligning various sectors through technological soil and water conservation interventions and land-use diversification. Significant results associated with various watershed-scale soil and water conservation programmes and interventions that were effective for reducing land degradation and improving productivity in different parts of the country are discussed

MicroRNAs:New players in IBD

MicroRNAs (miRNAs) are small non-coding RNAs, 18–23 nucleotides long, which act as post-transcriptional regulators of gene expression. miRNAs are strongly implicated in the pathogenesis of many common diseases, including IBDs. This review aims to outline the history, biogenesis and regulation of miRNAs. The role of miRNAs in the development and regulation of the innate and adaptive immune system is discussed, with a particular focus on mechanisms pertinent to IBD and the potential translational applications

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Adaptive noise suppression filter based integrated voltage and frequency controller for two-winding single-phase self-excited induction generator

In this study, an adaptive noise suppression filter based control algorithm is proposed for integrated voltage and frequency controller (IVFC) of a speed governor-free hydro turbine driven single-phase self-excited induction generator (SEIG). A voltage source converter (VSC) is employed to control the terminal voltage of SEIG with adjustable reactive power. It also mitigates the harmonics injected by non-linear loads in the SEIG system. A resistive dump load with a chopper is connected at dc-bus of VSC. The dump load is controlled to regulate the system frequency at varying loads and mechanical power input to the unregulated micro hydro turbine during seasonal changes. The frequency estimation and phase shifting technique is used for frequency estimation and for generation of quadrature signal of point of common coupling voltage. The proposed IVFC is designed, developed and implemented using a digital signal processor for a two-winding single-phase SEIG of 5 kW rating and test results are presented to demonstrate its performance under steady state and dynamic conditions

Modified electronic load controller for constant frequency operation with voltage regulation of Small hydro-driven single-phase SEIG

This paper is aimed at design and implementation of a modified electronic load controller (MELC) for constant frequency operation with voltage regulation of a two winding single-phase self-excited induction generator (SEIG) applicable for renewable energy applications specifically for off-grid power generation using a small-size hydro energy. The system frequency is maintained constant at a reference level for fixed as well as variable input mechanical power to the prime mover experienced in small hydro systems due to seasonal variations. The point of common coupling (PCC) voltage is also regulated by the controller at varying loads by controlling the power flow to the dump load. The proposed MELC is developed for the constant frequency generation and voltage regulation of single-phase SEIG with frequency as a feedback variable

Green controller for efficient diesel engine driven single-phase SEIG using maximum efficiency point operation

This paper presents a green controller for a governor-less diesel engine driven two-winding single phase standalone self-excited induction generator (SEIG) based on search-then-converge network algorithm. Diesel engines used for driving standalone electric generators are designed with a rated power output. Normally such engines exhibit maximum efficiency at about 80% of their maximum power rating. This point of operation is called as maximum efficiency point of operation. The proposed control operates the single-phase SEIG to generate a fixed electric power to achieve a maximum efficiency point of operation of the diesel engine irrespective of quantum and nature of load. The proposed controller diverts the surplus generated electric power to the battery energy storage system after satisfying the power demand of the load in order to conserve electrical energy and to improve the overall system efficiency. The operation of a diesel engine at maximum efficiency point of operation with constant mechanical loading irrespective of amount of electrical loading on the generator reduces the brake specific CO, smoke, and unwanted hydro carbon emission from the engine. Thus this scheme is named as a green controller