Tourism in India: The reasons of tourist gathering after 2ndwave

In today's Era,various industries are settling up in India and tourism is one of them. Tourism being one of the leading industries in India has set up the benchmark within last few years. Talking about today's scenario, the tourism industry is facing a huge loss because of the deadly humanitarian disease "COVID-19"that came at the end of 2019. It had led to the LOCKDOWN nationwide, leading towards the downfall of the hotel and tourism industry. Global covid-19 pandemic has challenged this sensitive industry with unprecedented circumstances and repercussions. Although, after the second wave, the situation is becoming better day by day, the tourist visits at famous stations have increased rapidly that may be harmful for the country and virus may further spread to the country and there are several reasons for increase in the tourist visit at different parts of the globe. These reasons have been considered as criteria for the study. The main objective of this work is to find out the main reasons why people are getting attracted towards tourism. In this work an AHP approach been proposed to solve the above discussed problem. Total seven criteria's have been taken from expert opinions which have been considered for study. It has been found that the reason "Upcoming 3rd Wave"has the maximum impact than other reasons for increment of people at tourist places. © 2023 Author(s).

Assessment of Knowledge and Attitude of Interns in the Prevention and Control of COVID-19

Background:Coronavirus disease 2019 (COVID-19) is defined as an illness caused by a novel coronavirus, now called Severe Acute Respiratory Syndrome Coronavirus 2. The present study was conducted to assess knowledge and attitude of interns in the prevention and control of COVID-19. Materials & Methods:50 interns of both genders were included. A questionnaire assessed knowledge comprising of each item contained 3 options, namely, “true”, “false” and “don’t know”;1 point was given for a correct answer, and 0 points were awarded for an incorrect answer or a “don’t know” response. The total score of this section ranged from 0 to 13, and higher scores were correlated with more knowledge. The attitude section included items, and a Likert scale was used to assess the level of agreement with the statements;response options ranged from 1 (strongly disagree) to 5 (strongly agree). Results: Out of 50 subjects, males were 22 and females were 28. What causes COVID-19 replied correct by 94%, incubation period of COVID-19 by 95%, overall mortality of COVID-19 by 84%, what are laboratory test available by 98%, family gatherings may spread infection by 89%, washing hands frequently, wearing masks and other measures can effectively prevent infection by 99%, most have good prognosis by 82% and suspected and confirmed patients should be isolated and treated in designated hospitals by 94%. Attitude was strongly agree, agree, not sure, disagree and strongly disagree in response to I pay close attention to the development of the epidemic situation in 94%, 5%, 1% respectively, I think I am playing an important role in controlling the epidemic in 92%, 3%, 3%, 1% and 1% respectively. It is believed that the outbreak will soon be contained in 90%, 2%, 5%, 2% and 1% and I am willing to cooperate with the relevant departments to take prevention and control measures in 82%, 8%, 6%, 3% and 1% respectively. Conclusion: Interns had sufficient knowledge and attitude in the prevention and control of COVID-19.

Choices, choices: selecting, defining, and measuring outcomes for young people with depressive disorders

Talk 1: Presenter: Dr Darren Courtney Title: ''Response,'' ''Remission,'' and ''Recovery'' in randomized clinical trials for the Treatment of Adolescent Depression. ''Response,'' ''Remission,'' and ''Recovery'' are often used as dichotomized outcomes to define clinically important change in randomized clinical trials for mental disorders. These dichotomizations can guide clinical decisions to continue, intensify, switch, or stop treatment. Through a rigorous scoping review of randomized clinical trials for the treatment of adolescent major depressive disorder (N = 98), we found high variability in how these terms were operationally defined;with 53 unique outcome definitions of ''response'' across 45 trials that assessed response, 47 unique definitions of ''remission'' in 29 trials that assessed remission, and 19 unique definitions of ''recovery'' across 11 trials that assessed recovery. Moreover, there was a dearth of rationale based on empirical findings. Finally, reports of input from youth with lived experience in establishing these definitions were minimal. In studying and implementing interventions to address mental disorders arising from the COVID-19 pandemic, a new and standardized approach to define clinically important change is needed. Talk 2: Presenter: Dr Nancy Butcher Title: Measurement Matters: Evaluating Methods of Assessing Depression in Adolescent Clinical Trials. Rates of major depressive disorder in youth are on the rise, creating urgency for well-designed trials using well-measured outcomes during the COVID-19 pandemic era. Timely conduct of psychiatric trials in youth, however, may require innovative and virtual methods for outcome measurement as an alternative design to in-person assessments. The Children's Depression Rating Scale-Revised is the most commonly used method of measuring depressive symptoms in clinical trials of adolescents with major depressive disorder. Originally developed for use in children, it is unknown whether the Children's Depression Rating Scale-Revised is fit-for-purpose for measuring depression in adolescents. This study aimed to identify all existing evidence of key measurement properties of the Children's Depression Rating Scale-Revised in adolescents with major depressive disorder through a systematic review, and to evaluate these properties using a well-established appraisal method developed by the COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) Initiative. We found that it is unclear whether the Children's Depression Rating Scale-Revised can appropriately measure depression symptom severity of adolescents with major depressive disorder, either in person or via virtual assessment. No study assessed content validity, cross-cultural validity/measurement invariance, or measurement error of the Children's Depression Rating Scale-Revised in adolescents with major depressive disorder. Low-quality evidence was found for sufficient construct validity (n = 4 studies) and responsiveness (n = 2 studies). Very low-quality evidence was found for sufficient inter-rater reliability (n = 2 studies). The results for structural validity (n = 3 studies) and internal consistency (n = 5 studies) were inconclusive. No study evaluated the validity of the Children's Depression Rating Scale-Revised using a virtual mode of administration. Implications and future directions for depression outcome research will be discussed including tools to guide outcome measurement instrument selection and reporting using innovative and virtual methods. Talk 3: Presenter: Dr. Karolin Krause Title: Are Symptoms All That Matters? Contrasting Outcome Measurement in Youth Depression Trials with Youth Perceptions and Priorities Depression is a common mental health problem in adolescence worldwide. The COVID-19 pandemic is putting additional strain on youth wellbeing and may lead to a rising demand for effective treatment in the coming years. Within a person-centered healthcare framework, treatment effectiveness should be judged with reference to individual patient needs. A recent systematic review suggests that most clinical trials for adolescent depression assess outcomes in the domain of symptom change, and half assess functional impairment, while other outcomes are rarely considered. We conducted a mixed-methods investigation of youth outcome perceptions and priorities, to understand the extent to which this focus reflects what matters to youth. In semi-structured interviews conducted with 34 youth following participation in a psychotherapy trial for depression, symptomatic change was the most frequently discussed outcome (by 65%) but change in coping skills was discussed just as often, followed by improved family functioning (47%) and social functioning (35%). These outcomes were assessed by less than 5% of recently published quantitative treatment studies. Subsequently, Q-methodology was used in a purposive sample of 28 youth with lived experience of depression, to investigate which outcomes they considered most important. Four distinct profiles were identified: ''symptom reduction and enhanced well-being'';''improved coping and self-management'';''better understanding past and present'';and ''less interference with daily life.'' Findings suggest that a narrow focus on symptom metrics fails to cover secondary outcomes that matter to youth. Trialist should draw on emerging guidance provided by Core Outcome Sets to consider a broader range of outcomes. Trialists should further consider including a personalized outcome measure to reflect varying individual priorities and understand whether treatments enable progress toward youth's individual treatment goals. Talk 4: Presenter: Dr Suneeta Monga Title: Engaging Youth in Defining What Outcomes Matter: Development of a Core Outcome Set for Adolescent Depression with Active Youth Participation Reviews of the literature document the wide heterogeneity in what, how, and when outcomes are measured in adolescent major depressive disorder. Such heterogeneity significantly limits the ability to draw conclusions around the best or most effective treatment as individual trial results cannot be pooled together in systematic reviews when outcomes differ across trials. A Core Outcome Set, as defined by the Core Outcome Measures in Effectiveness Trials Initiative, is an agreed, minimum, standardized set of outcomes that should be measured and reported in all clinical trials and audits in a specific area of health or healthcare. In other areas of medicine, development of a Core Outcome Set has increased consistency across trials, maximized the potential for a trial to contribute to systematic reviews of key outcomes, increased measurement of appropriate outcomes, and reduced selective outcome reporting. The development of a Core Outcome Set for adolescent major depressive disorder with a strong emphasis on youth and caregiver involvement to ensure that outcomes that really matter to youth and caregivers are incorporated into the final Core Outcome Set is currently underway. The use of innovative approaches that support engagement and participation of youth with lived experience, and caregivers, in all steps of the development of this Core Outcome Set will be a focus of this presentation. Important adaptations to manage the current impact of COVID-19 on the Core Outcome Set development will also be discussed as part of this presentation.

From Pandemicto Progression: Framework for Virtual Mental Healthcare for Children & Youth in Response toCOVID-19

COVID-19 has necessitated child/youth mental health providers virtually delivering services to patients' homes. In contrast, traditional telepsychiatry is delivered to patients in medically and technologically optimized environments such as primary-care centres or emergency departments. The shift to direct to patient virtual mental healthcare is occurring quickly with scant guidance available for clinicians on how to address unique considerations for the virtual care of children and youth as they rapidly shift their practices away from in-person care. Therefore, we bridge this gap by discussing a six-pillar framework for delivering child and youth virtual mental healthcare that was necessitated by the COVID-19 pandemic. We also offer a discussion of the advantages, disadvantages, and future implications of such services as they are likely to continue even following the cessation of the COVID-19 pandemic.

Highly efficient single-domain antibody neutralization of interleukin-6, the factor at the epicenter of cytokine storm in acutely ill COVID-19 patients

Background: COVID-19 is a worldwide medical emergency with a high mortality rate Cytokine storm (CS) has been attributed as the major cause of morbidity, multi-organ failure & mortality in COVID-19 patients In CS, the uncontrolled increase in pro-inflammatory cytokines especially IL6 results in an influx of immune cells leading to progressive tissue destruction Use of IL6 receptor (IL6R) inhibitors have shown only modest benefit in acutely ill COVID-19 cases due to need for high doses and associated side effects. More efficacious and safer agents to targets IL6 are thus urgently needed We report generation of a potent camelid single domain antibody (sdAb) that robustly neutralizes human IL6 (hIL6) Methods: Two alpacas were immunized with purified hIL6 & a sdAb display phage library was prepared The library was enriched by panning for sdAbs recognizing hIL6 One group of closely related sdAbs was identified, expressed as soluble proteins, that displayed sub-nM affinity for hIL6. These sdAbs were found to neutralize hIL6 with low pM potencies in cell-based assays The most potent sdAb was expressed in CHO cells as a homodimer separated by a short amino acid spacer The homodimer was also encoded in an alphavirus-based replicon RNA (repRNA) & formulated with a Lipid InOrganic Nanoparticle (LION) The homodimer protein & repRNA were tested in vitro & in vivo Results: HEK293 cells transfected with Stat3-luciferase were treated for 6h with 50ng of hIL6 alone or hIL6 co-incubated 1h with 100ng of sdAb A complete abrogation of reporter activity was observed in the sdAb group To mimic CS, adult mice were challenged intraperitoneally (IP) for 30 min with 1mg of hIL6 alone or with sdAb, ranging from 0 25-4mg hIL6-induced Y705-STAT3 induction in liver was completely abolished by sdAb dimer at concentration ≥0.5mg, an effect not seen even with 500mg of IL6R Ab. Mice were injected 5 days with an intramuscular injection of PBS or 40mg LION-formulated hIL6 sdAb dimer repRNA and then given 100ng of hIL6 IP for 30m LION-injected group showed complete absence of hepatic Y705-STAT3 in response to hIL6 Conclusion: The novel humanized IL6 sdAB efficiently inhibited hIL6-induced hepatic STAT3 activation and may have potential as a therapeutic for acutely ill COVID-19 patients exhibiting CS & other IL6-driven pathologies Additionally, using a similar pipeline, we are developing inhibitors of ACE2 and IL-1b, which can be combined for efficacious COVID-19 treatment.