Parity of esteem: A global COVID-19 vaccination approach for people with mental illnesses, based on facts from 34 countries; recommendations and solutions.

Background: The coronavirus disease (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has detrimental effects on physical and mental health. Patients with severe mental illness are at higher risk of contracting the virus due to social determinants of health. Vulnerable populations include the elderly, people with pre-existing conditions, and those exposed to SARS-CoV-2. Unfortunately, only a few countries have updated vaccination strategies to prioritize patients with mental illnesses. Therefore, we aimed to explore whether individuals with mental disorders are prioritized in vaccine allocation strategies in different world regions. They are often neglected in policymaking but are highly vulnerable to the threatening complications of COVID-19. Methods: A questionnaire was developed to record details regarding COVID-19 vaccination and prioritizations for groups of persons with non-communicable diseases (NCDs), mental disorders, and substance use disorders (SUDs). NCDs were defined according to the WHO as chronic diseases that are the result of a combination of genetic, physiological, environmental, and behavioral factors such as cardiovascular diseases, cancer, respiratory diseases, and diabetes. Results: Most countries surveyed (80%) reported healthcare delivery via a nationalized health service. It was found that 82% of the countries had set up advisory groups, but only 26% included a mental health professional. Most frequently, malignancy (68%) was prioritized followed by diabetes type 2 (62%) and type 1 (59%). Only nine countries (26%) prioritized mental health conditions. Conclusion: The spread of the coronavirus has exposed both the strengths and flaws of our healthcare systems. The most vulnerable groups suffered the most and were hit first and faced most challenges. These findings raise awareness that patients with mental illnesses have been overlooked in immunization campaigns. The range of their mortality, morbidity, and quality of life could have widened due to this delay.

Catalytic CO2 Fixation over a Robust Lactam-Functionalized Cu(II) Metal Organic Framework.

A porous, Cu(II)-metal organic framework (Cu-MOF) constituted of a rigid lactam functionalized ditopic ligand (H2L) was synthesized at room temperature under slow evaporation conditions {H2L = (5-(1-oxo-2,3-dihydro-1H-inden-2-yl)isophthalic acid)}. The single crystal X-ray structure revealed the formation of a 3D framework of Cu-MOF with one-dimensional (1D) channels decorated with lactam groups and exposed metal centers in the crystallographic c-axis. Interestingly, Cu(II) coordinated DMF molecules were eliminated from the Cu(II) metal center on activation of Cu-MOF at a temperature of 150 °C under high vacuum to generate a solvent free framework with pores lined with unsaturated Lewis acidic Cu(II) ions, i.e., Cu-MOF'. The lactam functionalized channels inclined toward the CO2, which interact with the Cu(II) metal sites lined in the channels of Cu-MOF' and exhibit fascinating solvent-free heterogeneous catalytic conversion of CO2 to cyclic carbonates at atmospheric pressure of CO2, under mild conditions. Furthermore, the Cu-MOF' catalyst was easily recycled and reused for several cycles without a significant loss in catalytic activity.

Dual Functionalized CuMOF-Based Composite for High-Performance Supercapacitors.

Herein, we utilized our previously reported highly porous CuMOF, {[Cu2(L)(H2O)2]·(5DMF)·(4H2O)}n, decorated with amine and trifluoromethyl functional groups for energy storage application. This robust framework in CuMOF enhances the chemical and thermal stabilities as well as improves the interfacial binding interactions. The poor conductivity of CuMOF usually restricts its practical utility in energy storage systems, due to which rGO was introduced along with CuMOF to form a CuMOF/rGO composite (1) through a facile ultrasonication technique. The synergistic effects between CuMOF and rGO induce a dramatic enhancement in specific capacitance (462 F g-1 at 0.8 A g-1) of 1 with a cycle life of 93.75% up to 1000 cycles. The results highlight 1 as an emerging contestant for next generation supercapacitors.

Functionalized Cu-MOF@CNT Hybrid: Synthesis, Crystal Structure and Applicability in Supercapacitors.

The synthesis of a metal-organic framework (MOF) named IITI-1 is reported by employing an H2 L linker with Cu(NO3 )2 ⋅3 H2 O in a mixed solvent system of N,N-dimethyl formamide (DMF) and H2 O. Further, in order to explore the energy storage application of IITI-1, a IITI-1/CNT hybrid was prepared by a simple ultrasonication technique. Incorporation of a carbon nanotube (CNT) in the layered IITI-1 MOF gave rise to enhanced electrolyte accessibility along with improved electrochemical storage capacity. The electrochemical investigations reveal a high specific capacitance (380 F g-1 at 1.6 A g-1 ) with a good rate performance for IITI-1/CNT. The IITI-1 MOF and the IITI-1/CNT composite were characterized by PXRD, BET, SEM, and TEM techniques. Moreover, IITI-1 MOF was also confirmed by single-crystal XRD analysis.

Mixed-Ligand-Architected 2D Co(II)-MOF Expressing a Novel Topology for an Efficient Photoanode for Water Oxidation Using Visible Light.

The structural diversity of Co(II) metal centers is known to influence their physicochemical properties. A novel two-dimensional (2D) Co(II)-MOF {[Co5(HL)4(dpp)2(H2O)2(µ-OH)2]·21H2O} n has been designed and synthesized by adopting a mixed-ligand strategy, using 1,3-di(4-pyridyl)propane (dpp) colinker with a flexible spacer H3L (H3L: 5-(2 carboxybenzyloxy)isophthalic acid). Co(II)-MOF features a 2D network, which is further interpenetrated among the equivalent sets and therefore results in a 3D supramolecular network. Topologically, the entire network can be viewed as a (3,4,8)-connected three-nodal net with the extended point symbol of {4.5.7}4{412.52.710.94}{52.8.92.10}2, duly assigned to the novel topological type smm2. The functional utility of Co(II)-MOF is demonstrated by employing it toward oxygen evolution reaction (OER) in a photoelectrochemical cell, exhibiting appreciable photocurrents of up to 5.89 mA/cm2 when used as an anode in a photoelectrochemical cell, while also displaying encouraging electrocatalytic currents of 9.32 mA/cm2 (at 2.01 V vs RHE) for the OER. Moreover, detailed electrochemical impedance spectroscopy studies confirm enhanced charge-transfer kinetics and improved conductivity under illumination with minimal effect of interfacial phenomena. This work provides a reference for the expanding field of research into applications of MOF materials and establishes MOF materials as favorable candidates for sustainable and efficient design of electrodes for water splitting.

A Cu(ii) metal-organic framework with significant H2 and CO2 storage capacity and heterogeneous catalysis for the aerobic oxidative amination of C(sp3)-H bonds and Biginelli reactions.

A Cu(ii) metal-organic framework, {[Cu2(L)(H2O)2]·(5DMF)(4H2O)}n (1), has been synthesized using an angular tetracarboxylic acid ligand (H4L) incorporating both trifluoromethyl (-CF3) and amine (-NH2) groups. Notably, the framework possesses high water and thermal stability. At atmospheric pressure, the activated framework 1' exhibits substantially high amounts of CO2 (35.5 and 20.8 wt% at 273 and 298 K respectively) and H2 (1.72 wt% at 77 K) adsorption. Also, 1' exhibits excellent catalytic activity for the condensation-cyclization reaction between 2-benzoyl pyridine and different benzylamines via oxidative amination of the C(sp3)-H bond to form 1,3-diarylated imidazo[1,5-a]pyridines under mild aerobic conditions. In addition to this, 1' shows excellent heterogeneous catalytic activity in Biginelli reactions. The solid catalyst could be recycled several times without significant loss in the catalytic activities.

A NbO type Cu(ii) metal-organic framework showing efficient catalytic activity in the Friedländer and Henry reactions.

A three-dimensional NbO type porous metal-organic framework 1 containing both tertiary amine groups and paddle wheel dinuclear Cu2(COO)4 secondary building units as the active centre was synthesized at room temperature. The activated framework 1' can be used as an efficient heterogeneous catalyst for the synthesis of quinoline derivatives by the Friedländer reaction and for the synthesis of ß-nitroalcohols by the Henry (nitroaldol) reaction. This MOF-based heterogeneous catalyst is easily recycled and reused further without losing its structural integrity and catalytic activity.

Synthesis of a NbO Type Homochiral Cu(II) Metal-Organic Framework: Ferroelectric Behavior and Heterogeneous Catalysis of Three-Component Coupling and Pechmann Reactions.

A chiral tetracarboxylic acid ligand, H4L, incorporating the (S)-(+)-2-methylpiperazine moiety in its middle, solvothermally forms a homochiral Cu(II) framework, {[Cu2(L)(H2O)2]·(4DMF)(4H2O)}n (LCu). It forms a non-interpenetrated structure consisting of [Cu2(COO)4] paddle-wheel secondary bonding units (SBUs) with NbO topology. Interestingly, the framework LCu exhibits excellent ferroelectric properties. It shows a remnant polarization (Pr) of ∼3.5 µC cm-2 and a coercive field (Ec) of ∼12 kV cm-1 with a distinct electric hysteresis loop. Dielectric studies of LCu reveal almost frequency-independent behavior with a dielectric constant (εr) of ∼42 and a low dielectric loss (tan δ) of ∼0.04 up to 106 Hz, for potential use in high-frequency applications. In addition, activated framework LCu' having uncoordinated metal sites acts as an efficient heterogeneous catalyst in the three-component coupling of amines, aldehydes, and alkynes, as well as in Pechmann reactions of phenols with ß-ketoesters.

Narcolepsy in Adolescence-A Missed Diagnosis: A Case Report.

Narcolepsy is an uncommon sleep cycle disorder with a usual onset in adolescence, but it is often misdiagnosed and underdiagnosed. Rarely is the tetrad of excessive daytime sleepiness, cataplexy, hypnagogic hallucinations, and sleep paralysis seen in patients. The clinical characteristics of narcolepsy are often confused with many psychiatric and neurologic disorders. Lack of clinical awareness about narcolepsy leads to frequent prescriptions of antiepileptics and psychotropics, which can adversely affect the quality of life of children and adolescents. We report a case of an adolescent male who presented with all four cardinal symptoms of narcolepsy and had been misdiagnosed with epilepsy, psychosis, and depression. We discuss various issues regarding narcolepsy in children and adolescents.

Primary liposarcoma of the orbit.

Liposarcoma is the most common sarcoma in adults, but is an extremely rare tumor of the orbit. We report 4 cases of primary orbital liposarcoma treated at our center. All cases had tumor localized to the orbit and underwent exenteration followed by radiotherapy in one patient. None of the patients had a recurrence until a follow-up of 1-5 years (mean: 4 years).

Anatomical and functional graft survival, 10 years after epikeratoplasty in keratoconus.

PURPOSE: To report outcomes of epikeratoplasty in keratoconus (KC), utilizing manually-prepared plano donor lenticules in terms of flattening of the cone, reduction in astigmatism and improvement in the visual acuity. MATERIALS AND METHODS: Patients with KC, having visual acuity <20/200, astigmatism >12 diopters (D) but without corneal opacity underwent epikeratoplasty, using manually prepared plano donor lenticules from fresh or M.K preserved corneas, between 1990 - 2000 and followed for 10 years, were included in this report. Visual acuity slit-lamp-biomicroscopy, keratometry, and refraction were performed at 8 weeks, 12 weeks, and 6 months for all 59 patients. The same were carried out at 1 year, 5 years, and 10 years depending upon the availability of the patient for that period. RESULTS: Of the 59 patients, only 26 were available for follow-up after 10 years. At 3 months, 1 year and 5 years, best corrected visual acuity of (BCVA) ≥20/60 were achieved in 84.7%, 84.4% and 80.3% of eyes, respectively. BCVA was 73% at 10-year follow- up, which was due to the presence of posterior subcapsular cataract (PSC). The average keratometric astigmatism and average flattening in diopters stabilized at the end of 3 months, which remained constant at 1, 5, and 10-year follow-up. The average diopter of myopia was stabilized by 1 year, which was almost same at 10 year. Graft was clear in all but 1 eye at 10 year follow-up. CONCLUSION: Epikeratoplasty is a useful technique for keratoconic eyes without apical scarring who fail or unable to use contact lenses.

Atriofascicular pathways: Where to ablate?

BACKGROUND: Atriofascicular accessory pathway (AP), often referred to as Mahaim pathway, is an uncommon form of preexcitation. The usual target for ablation is at the site of a high-frequency potential along the tricuspid annulus (TA). We present our observations in mapping and ablation of 29 patients with atriofascicular APs. METHODS AND RESULTS: Twenty-nine consecutive patients who underwent radiofrequency ablation (RFA) for atriofascicular pathways comprised the series. Demographic factors, clinical features of the tachycardia, ablation site, and results were analyzed. The mean age was 19 +/- 8 years; 15 were men. Three patients had Ebstein's anomaly of the tricuspid valve. Four patients had an additional AP and two patients had concomitant typical atrioventricular nodal reentrant tachycardia. RFA was successful in 28 patients (97%); repeat ablation was required in two patients. The site of successful ablation was on the TA at the site of a sharp, high frequency potential in 15 patients (52%). In the remaining 14 patients, a potential was not found along the TA, and ablation was targeted at the ventricular insertion of the AP into the distal right bundle. At the successful ventricular ablation site, local ventricular activation preceded the surface electrocardiogram by 20 +/- 6 ms. Eight of the 14 patients (57%) undergoing ablation in the ventricle, developed right bundle branch block (RBBB). One patient who underwent successful ablation along the TA also manifested RBBB after ablation; however, this patient had Ebstein's anomaly and preexcitation had completely masked the RBBB. The mean procedure and fluoroscopy time was 150 +/- 32 and 35 +/- 12 minutes, respectively. CONCLUSIONS: In atriofascicular pathways, an AP potential was found along the TA in only 52% of patients. Ablation at the ventricular insertion site often resulted in RBBB (57%), but the AP was also successfully ablated.

Does device-based testing save time during automatic implantable cardioverter-defibrillator implantation?

BACKGROUND: Defibrillation testing can be done either via an external cardiac defibrillator or directly via the implanted defibrillator during implantation (device-based testing). The advantage of one testing methodology over the other has not been adequately studied. METHODS AND RESULTS: Seventy-four patients (72% men) were randomized into two groups depending on the defibrillation testing methodology used--external cardiac defibrillation and device-based testing groups. R-wave, pacing threshold, pacing impedance, defibrillation threshold, defibrillation pathway impedance and total procedure time were not significantly different between the two groups. CONCLUSIONS: Device-based testing did not significantly reduce the procedure time. Lead and defibrillation parameters were similar in both the groups; lead repositioning and replacement were required in three patients in the external cardiac defibrillation group.

Idiopathic fascicular ventricular tachycardia.

Idiopathic fascicular ventricular tachycardia is an important cardiac arrhythmia with specific electrocardiographic features and therapeutic options. It is characterized by relatively narrow QRS complex and right bundle branch block pattern. The QRS axis depends on which fascicle is involved in the re-entry. Left axis deviation is noted with left posterior fascicular tachycardia and right axis deviation with left anterior fascicular tachycardia. A left septal fascicular tachycardia with normal axis has also been described. Fascicular tachycardia is usually seen in individuals without structural heart disease. Response to verapamil is an important feature of fascicular tachycardia. Rare instances of termination with intravenous adenosine have also been noted. A presystolic or diastolic potential preceding the QRS, presumed to originate from the Purkinje fibers can be recorded during sinus rhythm and ventricular tachycardia in many patients with fascicular tachycardia. This potential (P potential) has been used as a guide to catheter ablation. Prompt recognition of fascicular tachycardia especially in the emergency department is very important. It is one of the eminently ablatable ventricular tachycardias. Primary ablation has been reported to have a higher success, lesser procedure time and fluoroscopy time.

Successful exclusion of descending thoracic aortic pseudoaneurysm by endovascular stent-graft placement.

Endograft Stenting for contained rupture in descending thoracic aorta has not been reported in the past. We successfully deployed a 28 mm long AneuRx cuff, percutaneously to exclude the descending thoracic aortic pseudoaneurysm in a 62-year-old patient with inoperable retroperitoneal malignant fibrous histiocytoma.

Catheter ablation of atrial tachycardia using a real-time position management mapping system.

Catheter ablation for atrial tachycardia is limited by its low success rate and prolonged procedure time because of difficulties in mapping the site of the tachycardia. A new three-dimensional mapping system, the Cardiac Pathways mapping system, using an ultrasound transducer, has recently become available. We report a case of focal atrial tachycardia ablation with this system.

Radiofrequency ablation of incessant atrial tachycardia in an infant.

Ectopic automatic atrial tachycardia, an uncommon type of supraventricular tachycardia in children and adults, has been reported to be resistant to medical therapy unlike reentrant supraventricular tachycardia. We report a case of incessant atrial tachycardia in an infant, which was successfully treated with radiofrequency catheter ablation.

Stenting through a portacath for totally occluded superior vena cava in a case of non-Hodgkin s lymphoma.

Superior vena cava (SVC) syndrome often presents with slowly progressive symptoms worsening over weeks or may cause abrupt symptoms and constitute a true medical emergency. Percutaneous intervention is the treatment of choice. We report a case of SVC stenting in a middle-aged woman with SVC obstruction secondary to portacath insertion for chemotherapy.