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The COVID-19 pandemic has hit the electroconvulsive therapy (ECT) services hard worldwide as it is considered an elective procedure and hence has been given less importance. Other reasons include the risk of transmission of infections, lack of resources, and the scarcity of anesthesiologists due to their diversion to intensive care units to manage COVID-19 patients. However, ECT is an urgent and life-saving measure for patients diagnosed with depression and other severe mental illnesses who have suicidality, catatonia, or require a rapid therapeutic response. COVID-19 pandemic is a significant source of stress for individuals due to its impact on health, employment, and social support resulting in new-onset psychiatric illnesses and the worsening of a pre-existing disorder. Hence, a continuation of the ECT services during the COVID-19 pandemic is of paramount importance. In this narrative review, the authors from India have compiled the literature on the ECT practice during the COVID-19 pandemic related to the screening and testing protocol, necessity of personal protective equipment, modification in ECT Suite, electrical stmulus settings, and anesthesia technique modification. The authors have also shared their experiences with the ECT services provided at their institute during this pandemic. This description will help other institutes to manage the ECT services uninterruptedly and make ECT a safe procedure during the current pandemic.The marginalized and vulnerable population like those with mental illnesses and other disabilities, senior citizens, disaster victims and women are at risk of facing violation of their rights. To preserve the rights of the above-mentioned vulnerable groups, Government of India has passed a legislation named Legal Services Authority Act, 1987. AUZ454 In this article authors discuss the interconnection between mental illness and rights violation, how Legal Services Authority Act, 1987 is relevant in preserving rights of persons with mental illness and other vulnerable groups, different programs under the above legislation, the provisions under those programs and how to obtain them.
Violent behaviour is an alarming problem among schizophrenia patients. The effects of historical, clinical, and pathological risk factors for violence have been investigated by multiple studies, but consensus has not been achieved. As psychotic symptoms are more direct and intuitive indicators for violence, identifying robustly associated symptoms is a crucial part of the future prediction and precise management of violent patients in clinics. This study aims to identify the psychotic symptoms correlated with violence among schizophrenia patients in a Chinese population.

In this cross-sectional study, the medical records of 7711 schizophrenia patients (4711 in the discovery set and 3000 in the validation set) were collected from 1998 to 2010. Their psychotic symptoms were extracted, and the patients were divided into violent and non-violent groups. Multivariate logistic analysis was applied to identify symptoms associated with violence in the discovery set.

Eight psychotic symptoms were found to be significantly correlated with violence in schizophrenia. "Destruction of property", "verbal aggression" and "insomnia" increased the risk of violence, while "flat affect", "delusion of persecution", "auditory hallucination", "vagueness of thought" and "poverty of thought" decreased the risk of violence. The regression model was evaluated by receiver operating characteristic (ROC) analysis for its discriminatory performance, achieving area under curve (AUC) values of 0.887 in the discovery sample set and 0.824 in the validation sample set.

The correlated symptoms identified by this study can serve as future candidate predictors for violence in schizophrenia, paving the way for precise management of schizophrenia patients in clinics.
The correlated symptoms identified by this study can serve as future candidate predictors for violence in schizophrenia, paving the way for precise management of schizophrenia patients in clinics.This in vitro study used the same frequency and duration of acid contact as a previous in situ/in vivo study to evaluate the effect of erosion on CAD/CAM restorative materials and human enamel and to compare the effects of in vitro and in situ/in vivo acid challenges on CAD/CAM restorative materials and human enamel. The CAD/CAM restorative materials (IPS e.max CAD, Lava Ultimate, and PMMA block) and human enamel were eroded by immersion in 150 ml of cola drink for 14 days (4 × 5 min/day). The surface microhardness and surface roughness of the specimens were measured at baseline (T1), day 7 (T2), and day 14 (T3). The substance losses were measured at T2 and T3. The data were statistically analyzed using repeated measures ANOVA and Bonferroni's test (α = 0.05). Erosion significantly decreased the surface microhardness of the CAD/CAM restorative materials and human enamel (all P less then 0.001). The overall percentage of surface microhardness loss (%SMHl) of the PMMA block and enamel due to in vitro erosion s, no significant difference was found between in vitro and in situ/in vivo erosion.
Evaluation of the effect of three different dynamic fatigue protocols on the fracture resistance of two monolithic strength-gradient zirconia materials.

A total of 240 specimens (3×4×45mm) was milled from two different layers (incisal and middle) of two types of strength-gradient zirconia blanks (IPS e. max ZirCAD MT Multi A2 vs. IPS e. max ZirCAD Prime A2), resulting in 60 specimens per material and layer group (IPS e. max ZirCAD MT Multi A2 incisal (MI), middle (MM); IPS e. max ZirCAD Prime A2 incisal (PI), middle (PM)). Each group was divided into one static (n=15) and three dynamic fatigue protocols (N=45, n=15) i. 50 N increase every 5000 cycles ii. Increase by 5% of static fracture load every 5000 cycles iii. 10 N increase every 1000 cycles until facture. All specimens were loaded until facture in CeraTest 2k. Kaplan-Meier, Log-Rank and Chi-squared-test as well as Weibull statistics were performed. A fractographic analysis was performed. The specimens were classified according to the number of crack origins and evaluated using the Ciba-Geigy table.
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