A Critical Analysis on the Concept of Pratidwanta Cikitsa at par with PFA

Our society is now continuously afflicted by various traumatic events of both natural as well as manmade in nature. The health care team involved in disaster management focuses both on the physical as well as the psychological aspects of the affected in such situations through physical and psychological first aid. In 2016 with initiatives of World federation for Mental health, the theme of Mental Health day was announced as “Dignity in Mental Health - Psychological and Mental First Aid for all”. This approach could be also understood in the light of various contexts in the texts of Ayurvedic literature. The management of Janapadaudwamsa (events affecting a community) explained by Caraka in Vimanasthana of Caraka Samhita has principles at par with the PFA approach. A critical analysis of this Ayurvedic concept has been done in this work which reflects it as guidelines on how psychosocial first aid care should be and a practical outline for the attitude of support providing society

Mechanisms of barrier layer formation and erosion from in situ observations in the Bay of Bengal

During the Bay of Bengal (BoB) Boundary Layer Experiment (BoBBLE) in the southern BoB, time series of microstructure measurements were obtained at 8N, 89E from 4-14 July, 2016. These observations captured events of barrier layer (BL) erosion and re-formation. Initially, a three-layer structure was observed: a fresh surface mixed layer (ML) of thickness 10-20 m; a BL below of 30-40 m thickness with similar temperature but higher salinity; a high salinity core layer, associated with Summer Monsoon Current. Each of these three layers was in relative motion to the others, leading to regions of high shear at the interfaces. However, haline stratification overcame the destabilising influence of the shear regions, and preserved the three-layer structure. A salinity budget using in situ observations suggested that during the BL erosioni, high salinity surface waters (34.5 PSU) with weak stratification were advected to the time series location and replaced the three-layer structure with a deep ML (~60 m). Weakened stratification at the time series location also allowed atmospheric wind forcing to penetrate deeper. Turbulent kinetic energy dissipation rate and eddy diffusivity showed elevated values above 10-7 W kg-1 and 10-4 m2 s-1, respectively, in the upper 60 m. Later, the surface salinity decreased again (33.8 PSU) through horizontal advection, stratification became stronger and elevated mixing rates were confined to the upper 20 m, and the BL reformed. A 1-D model analysis suggests that in the study region, advection of temperature-salinity characteristics is essential for the maintenance of the BL and to the extent to which mixing penetrates the water column

BoBBLE: ocean-atmosphere interaction and its impact on the South Asian monsoon

The Bay of Bengal (BoB) plays a fundamental role in controlling the weather systems that make up the South Asian summer monsoon system. In particular,the southern BoB has cooler sea surface temperature (SST) that influence ocean-atmosphere interaction and impact on the monsoon. Compared to the southeast, the southwestern BoB is cooler, more saline, receives much less rain, and is influenced by the Summer Monsoon Current(SMC). To examine the impact of these features on the monsoon, the BoB Boundary Layer Experiment (BoBBLE) was jointly undertaken by India and the UK during June–July 2016. Physical and bio-geochemical observations were made using a CTD, five ocean gliders, a uCTD, a VMP, two ADCPs, Argo floats, drifting buoys, meteorological sensors and upper air radiosonde balloons. The observations were made along a zonal section at 8◦N between 85.3◦E and 89◦E with a 10-day time series at 89◦E, 8◦N. This paper presents the new observed features of the southern BoB from the BoBBLE field program, supported by satellite data. Key results from the BoBBLE field campaign show the Sri Lanka Dome and the SMC in different stages of their seasonal evolution and two freshening events during which salinity decreased in the upper layer leading to the formation of thick barrier layers. BoBBLE observations were taken during a suppressed phase of the intraseasonal oscillation; they captured in detail the warming of the ocean mixed layer and preconditioning of the atmosphere to convection

Familial hypercholesterolaemia in children and adolescents from 48 countries: a cross-sectional study

Background Approximately 450 000 children are born with familial hypercholesterolaemia worldwide every year, yet only 2·1% of adults with familial hypercholesterolaemia were diagnosed before age 18 years via current diagnostic approaches, which are derived from observations in adults. We aimed to characterise children and adolescents with heterozygous familial hypercholesterolaemia (HeFH) and understand current approaches to the identification and management of familial hypercholesterolaemia to inform future public health strategies. Methods For this cross-sectional study, we assessed children and adolescents younger than 18 years with a clinical or genetic diagnosis of HeFH at the time of entry into the Familial Hypercholesterolaemia Studies Collaboration (FHSC) registry between Oct 1, 2015, and Jan 31, 2021. Data in the registry were collected from 55 regional or national registries in 48 countries. Diagnoses relying on self-reported history of familial hypercholesterolaemia and suspected secondary hypercholesterolaemia were excluded from the registry; people with untreated LDL cholesterol (LDL-C) of at least 13·0 mmol/L were excluded from this study. Data were assessed overall and by WHO region, World Bank country income status, age, diagnostic criteria, and index-case status. The main outcome of this study was to assess current identification and management of children and adolescents with familial hypercholesterolaemia. Findings Of 63 093 individuals in the FHSC registry, 11 848 (18·8%) were children or adolescents younger than 18 years with HeFH and were included in this study; 5756 (50·2%) of 11 476 included individuals were female and 5720 (49·8%) were male. Sex data were missing for 372 (3·1%) of 11 848 individuals. Median age at registry entry was 9·6 years (IQR 5·8–13·2). 10 099 (89·9%) of 11 235 included individuals had a final genetically confirmed diagnosis of familial hypercholesterolaemia and 1136 (10·1%) had a clinical diagnosis. Genetically confirmed diagnosis data or clinical diagnosis data were missing for 613 (5·2%) of 11 848 individuals. Genetic diagnosis was more common in children and adolescents from high-income countries (9427 [92·4%] of 10 202) than in children and adolescents from non-high-income countries (199 [48·0%] of 415). 3414 (31·6%) of 10 804 children or adolescents were index cases. Familial-hypercholesterolaemia-related physical signs, cardiovascular risk factors, and cardiovascular disease were uncommon, but were more common in non-high-income countries. 7557 (72·4%) of 10 428 included children or adolescents were not taking lipid-lowering medication (LLM) and had a median LDL-C of 5·00 mmol/L (IQR 4·05–6·08). Compared with genetic diagnosis, the use of unadapted clinical criteria intended for use in adults and reliant on more extreme phenotypes could result in 50–75% of children and adolescents with familial hypercholesterolaemia not being identified. Interpretation Clinical characteristics observed in adults with familial hypercholesterolaemia are uncommon in children and adolescents with familial hypercholesterolaemia, hence detection in this age group relies on measurement of LDL-C and genetic confirmation. Where genetic testing is unavailable, increased availability and use of LDL-C measurements in the first few years of life could help reduce the current gap between prevalence and detection, enabling increased use of combination LLM to reach recommended LDL-C targets early in life. Funding Pfizer, Amgen, Merck Sharp & Dohme, Sanofi–Aventis, Daiichi Sankyo, and Regeneron

Familial hypercholesterolaemia in children and adolescents from 48 countries: a cross-sectional study

Background: Approximately 450 000 children are born with familial hypercholesterolaemia worldwide every year, yet only 2·1% of adults with familial hypercholesterolaemia were diagnosed before age 18 years via current diagnostic approaches, which are derived from observations in adults. We aimed to characterise children and adolescents with heterozygous familial hypercholesterolaemia (HeFH) and understand current approaches to the identification and management of familial hypercholesterolaemia to inform future public health strategies. Methods: For this cross-sectional study, we assessed children and adolescents younger than 18 years with a clinical or genetic diagnosis of HeFH at the time of entry into the Familial Hypercholesterolaemia Studies Collaboration (FHSC) registry between Oct 1, 2015, and Jan 31, 2021. Data in the registry were collected from 55 regional or national registries in 48 countries. Diagnoses relying on self-reported history of familial hypercholesterolaemia and suspected secondary hypercholesterolaemia were excluded from the registry; people with untreated LDL cholesterol (LDL-C) of at least 13·0 mmol/L were excluded from this study. Data were assessed overall and by WHO region, World Bank country income status, age, diagnostic criteria, and index-case status. The main outcome of this study was to assess current identification and management of children and adolescents with familial hypercholesterolaemia. Findings: Of 63 093 individuals in the FHSC registry, 11 848 (18·8%) were children or adolescents younger than 18 years with HeFH and were included in this study; 5756 (50·2%) of 11 476 included individuals were female and 5720 (49·8%) were male. Sex data were missing for 372 (3·1%) of 11 848 individuals. Median age at registry entry was 9·6 years (IQR 5·8-13·2). 10 099 (89·9%) of 11 235 included individuals had a final genetically confirmed diagnosis of familial hypercholesterolaemia and 1136 (10·1%) had a clinical diagnosis. Genetically confirmed diagnosis data or clinical diagnosis data were missing for 613 (5·2%) of 11 848 individuals. Genetic diagnosis was more common in children and adolescents from high-income countries (9427 [92·4%] of 10 202) than in children and adolescents from non-high-income countries (199 [48·0%] of 415). 3414 (31·6%) of 10 804 children or adolescents were index cases. Familial-hypercholesterolaemia-related physical signs, cardiovascular risk factors, and cardiovascular disease were uncommon, but were more common in non-high-income countries. 7557 (72·4%) of 10 428 included children or adolescents were not taking lipid-lowering medication (LLM) and had a median LDL-C of 5·00 mmol/L (IQR 4·05-6·08). Compared with genetic diagnosis, the use of unadapted clinical criteria intended for use in adults and reliant on more extreme phenotypes could result in 50-75% of children and adolescents with familial hypercholesterolaemia not being identified. Interpretation: Clinical characteristics observed in adults with familial hypercholesterolaemia are uncommon in children and adolescents with familial hypercholesterolaemia, hence detection in this age group relies on measurement of LDL-C and genetic confirmation. Where genetic testing is unavailable, increased availability and use of LDL-C measurements in the first few years of life could help reduce the current gap between prevalence and detection, enabling increased use of combination LLM to reach recommended LDL-C targets early in life

Highlights of Library Automation related documents in the INSPEC

The paper has attempted to analyse the Library Automation related records in the INSPEC (1969 to July 2004). The growth of Library Automation related literature, country of input, scattering of literature in different publication types, core journals publishing Library Automation related publications, language-wise proportion of the literature, content analysis through keywords/descriptors, availability of URLs (Universal Resource Locator) for full text articles as alternative locations were the main focus of the study. After the year 1984, the literature grows approximately linearly with a growth rate of about 600 items per year. The USA is the predominant publishing country of Library Automation related literature. Journals are the most preferred publication media, followed by Conference/Proceedings-Papers, Book-Chapters, and Reports publications. Most productive journals are: Library Hi Tech, followed by Computers in Libraries, VINE, Information Technology and Libraries, and Program. English articles constitute 91.83% of the total literature. That means the non-English articles constitute only 8.17%. The keyword analysis indicates that the key areas of Library Automation were cataloguing; academic-libraries; information-retrieval; Internet; and information-services. The most occurred URL was http://www.dlib.org/ as alternative locations in the availability notes of Library Automation related records

Impact of diurnal forcing on intraseasonal sea surface temperature oscillations in the Bay of Bengal

The diurnal cycle is an important mode of sea surface temperature (SST) variability in tropical oceans, influencing air-sea interaction and climate variability. Upper ocean mixing mechanisms are significant at diurnal time scales controlling the intraseasonal variability (ISV) of SST. Sensitivity experiments using an Ocean General Circulation Model (OGCM) for the summer monsoon of the year 2007 show that incorporation of diurnal cycle in the model atmospheric forcings improves the SST simulation at both intraseasonal and shorter time scales in the Bay of Bengal (BoB). The increase in SST-ISV amplitudes with diurnal forcing is approximate to 0.05 degrees C in the southern bay while it is approximate to 0.02 degrees C in the northern bay. Increased intraseasonal warming with diurnal forcing results from the increase in mixed layer heat gain from insolation, due to shoaling of the daytime mixed layer. Amplified intraseasonal cooling is dominantly controlled by the strengthening of subsurface processes owing to the nocturnal deepening of mixed layer. In the southern bay, intraseasonal variability is mainly determined by the diurnal cycle in insolation, while in the northern bay, diurnal cycle in insolation and winds have comparable contributions. Temperature inversions (TI) develop in the northern bay in the absence of diurnal variability in wind stress. In the northern bay, SST-ISV amplification is not as large as that in the southern bay due to the weaker diurnal variability of mixed layer depth (MLD) limited by salinity stratification. Diurnal variability of model MLD is not sufficient to create large modifications in mixed layer heat budget and SST-ISV in the northern bay

Formation of summer phytoplankton bloom in the northwestern Bay of Bengal in a coupled physical-ecosystem model

The Bay of Bengal (BoB) is considered to be a region of low biological productivity, owing to nutrient limitation, caused by strong salinity stratification induced by the freshwater influx from rivers and precipitation. Satellite and in situ observations, however, reveal the presence of prominent regional blooms in the bay in response to monsoonal forcings. Bloom dynamics of the BoB are presumably determined by freshwater as well as the local and remote effect of winds and remain to be explored in detail. Using a coupled physical-ecosystem model, we have examined the oceanic processes controlling productivity in the northwestern BoB during the summer monsoon. The region exhibits a prominent bloom lasting for a period of about 2 months, supporting major fishing zones along the northeast coast of India. The ecosystem model simulates the spatial and temporal evolution of the surface bloom in good agreement with Sea-Viewing Wide Field-of-View Sensor (SeaWiFS) observations. Vertical distribution of upper ocean physical and biological tracers and a nitrate budget analysis reveal the dominant role of coastal upwelling induced by alongshore winds in triggering the bloom. Horizontal advection plays a secondary role by supplying nutrients from coastal to offshore regions. The bloom decays with the weakening of winds and upwelling by the end of summer monsoon. The simulated bloom in the northwestern bay remains largely unaffected by the freshwater effects, since the peak bloom occurs before the arrival of river plumes