Racial Disparities and Common Respiratory Infectious Diseases in Children of the United States: A Systematic Review and Meta-Analysis.

Due to the lack of sufficient data on the relationship between racial disparities and the occurrence of infectious respiratory diseases in children, the aim of this systematic review and meta-analysis is to evaluate the presence of racial gaps in the occurrence of respiratory infectious diseases in children. This study follows the PRISMA flow guidelines for systematic reviews and the standards of meta-analysis for 20 quantitative studies conducted from 2016 to 2022 including 2,184,407 participants. As evidenced from the review, in the U.S., racial disparities are present among children, with Hispanic and Black children carrying the burden of infectious respiratory disease occurrence. Several factors are contributory to these outcomes among Hispanic and Black children, including higher rates of poverty; higher rates of chronic conditions, such as asthma and obesity; and seeking care outside of the home. However, vaccinations can be used to reduce the risk of infection among Black and Hispanic children. Whether a child is very young or a teen, racial disparities are present in occurrence rates of infectious respiratory diseases, with the burden resting among minorities. Therefore, it is important for parents to be aware of the risk of infectious diseases and to be aware of resources, such as vaccines.

Polyethylene glycol (PEG): The nature, immunogenicity, and role in the hypersensitivity of PEGylated products.

Polyethylene glycol (PEG) is a versatile polymer that is widely used as an additive in foods and cosmetics, and as a carrier in PEGylated therapeutics. Even though PEG is thought to be less immunogenic, or perhaps even non-immunogenic, with a variety of physicochemical properties, there is mounting evidence that PEG causes immunogenic responses when conjugated with other materials such as proteins and nanocarriers. Under these conditions, PEG with other materials can result in the production of anti-PEG antibodies after administration. The antibodies that are induced seem to have a deleterious impact on the therapeutic efficacy of subsequently administered PEGylated formulations. In addition, hypersensitivity to PEGylated formulations could be a significant barrier to the utility of PEGylated products. Several reports have linked the presence of anti-PEG antibodies to incidences of complement activation-related pseudoallergy (CARPA) following the administration of PEGylated formulations. The use of COVID-19 mRNA vaccines, which are composed mainly of PEGylated lipid nanoparticles (LNPs), has recently gained wide acceptance, although many cases of post-vaccination hypersensitivity have been documented. Therefore, our review focuses not only on the importance of PEGs and its great role in improving the therapeutic efficacy of various medications, but also on the hypersensitivity reactions attributed to the use of PEGylated products that include PEG-based mRNA COVID-19 vaccines.

Impact of Covid-19 on gastrointestinal cancer surgery: A National Survey.

PURPOSE: To understand the actual impact of the Covid-19 pandemic and frame the future strategies, we conducted a pan India survey to study the impact on the surgical management of gastrointestinal cancers. METHODS: A national multicentre survey in the form of a questionnaire from 16 tertiary care gastrointestinal oncology centres across India was conducted from January 2019 to June 2021 that was divided into a 15-month pre-Covid era and a similar period of active Covid pandemic era. RESULTS: There was significant disruption of services; 13 (81%) centres worked as dedicated Covid care centres and 43% reported suspension of essential care for more than 6 months. In active Covid phase, there was a 14.5% decrease in registrations and proportion of decrease was highest in the centres from South zone (22%). There was decrease in resections across all organ systems; maximum reduction was noted in hepatic resections (33%) followed by oesophageal and gastric resections (31 and 25% respectively). There was minimal decrease in colorectal resections (5%). A total of 584 (7.1%) patients had either active Covid-19 infection or developed infection in the post-operative period or had recovered from Covid-19 infection. Only 3 (18%) centres reported higher morbidity, while the rest of the centres reported similar or lower morbidity rates when compared to pre-Covid phase; however, 6 (37%) centres reported slightly higher mortality in the active Covid phase. CONCLUSION: Covid-19 pandemic resulted in significant reduction in new cancer registrations and elective gastrointestinal cancer surgeries. Perioperative morbidity remained similar despite 7.1% perioperative Covid 19 exposure.

Impact of Covid-19 on Gastrointestinal Cancer Surgery: A National Survey (preprint)

Purpose: To understand the actual impact of the Covid-19 pandemic and frame the future strategies, we conducted a pan India survey to study the impact on the surgical management of gastrointestinal cancers.Methods: A national multicentre survey in the form of a questionnaire from 16 tertiary care gastrointestinal oncology centres across India was conducted from January 2019 to June 2021 that was divided into a 15-month pre-Covid era and a similar period of active Covid pandemic era.Results: There was significant disruption of services; 13 (81%) centres worked as dedicated Covid care centres and 43% reported suspension of essential care for more than 6 months. In active Covid phase there was a 14.5% decrease in registrations and proportion of decrease was highest in the centres from South zone (22%). There was decrease in resections across all organ systems; maximum reduction was noted in hepatic resections (33%) followed by esophageal and gastric resections (31 and 25% respectively). There was minimal decrease in colorectal resections (5%). A total of 584 (7.1%) patients had either active Covid-19 infection or developed infection in the post-operative period or had recovered from Covid-19 infection. Only 3(18%) centres reported higher morbidity, while rest of the centres reported similar or lower morbidity rates when compared to pre-Covid phase; however 6 (37%) centres reported slightly higher mortality in the active Covid phase.Conclusion: Covid -19 pandemic resulted in significant reduction is new cancer registrations and elective gastrointestinal cancer surgeries. Perioperative morbidity remained similar despite 7.1% perioperative Covid -19 exposure. 

A qualitative insight into the perceptions and COVID-19 vaccine hesitancy among Pakistani pharmacists.

A qualitative exploration of pharmacists' perceptions regarding COVID-19 conspiracies and their willingness to get vaccinated. A semi-structured questionnaire guide was developed using ground theory to conduct in-depth interviews. A total of 36 participants gave consent for an audio-recorded interview. Results have shown that most of the respondents believed that SARS-CoV-2 is a natural virus, not man-made, that causes a disease just like other viruses and it is absurd to believe that the vaccine is being used by foreign powers for the implantation of microchips just to control humans. A general opinion thatwhich reflected from the in-depth interview is that the pharmaceutical companies may be hiding some important information on COVID-19 to promote the sale of their product. Some doubts on the reliability and trustworthiness on the COVID-19 vaccine safety and efficacy data were noticed among the respondents. Factors leading to COVID-19 vaccine hesitancy were adverse reaction, cost of COVID-19 vaccine, and limited data on safety and efficacy profile of COVID-19 vaccine. COVID-19 vaccine hesitancy among health professionals is a major hindrance to our current fight against COVID-19 pandemic. Findings of this study are alarming, and the stakeholders must consider this ongoing vaccination campaign as an opportunity to formulate a mechanism to ensure high vaccination rate among general public and healthcare providers in Pakistan.KEY POINTSWhat was already known?According to World Health Organization (WHO), vaccine hesitancy is one of the ten major threats to global healthcare system and it is a major barrier to achieve herd immunity around the globe.Pakistan has begun vaccinating its people in a systematic phase-wise manner under which the healthcare workers and elderly people are prioritized for vaccination.Previous experience tells us that vaccine hesitancy is a major problem in Pakistan and it is better to understand perceptions of pharmacists about COVID-19 vaccine who are the primary source of information for most of general population.What this study adds:This study is first of its kind to explore vaccine hesitancy among Pakistani pharmacists and the results of this study show that majority of the participants were willing to get COVID-19 vaccine and few of them have even got themselves vaccinated at the start of vaccination campaign.Many among the willing participants considered cost of vaccine, adverse reactions, limited data, safety, and efficacy as major hindrance to their decision to get vaccine.Few participants were found highly vaccine-hesitant because of their staunch belief in the prevalent myths and rumors about COVID-19 vaccine.

An Efficient Deep Learning Model to Detect COVID-19 Using Chest X-ray Images.

The tragic pandemic of COVID-19, due to the Severe Acute Respiratory Syndrome coronavirus-2 or SARS-CoV-2, has shaken the entire world, and has significantly disrupted healthcare systems in many countries. Because of the existing challenges and controversies to testing for COVID-19, improved and cost-effective methods are needed to detect the disease. For this purpose, machine learning (ML) has emerged as a strong forecasting method for detecting COVID-19 from chest X-ray images. In this paper, we used a Deep Learning Method (DLM) to detect COVID-19 using chest X-ray (CXR) images. Radiographic images are readily available and can be used effectively for COVID-19 detection compared to other expensive and time-consuming pathological tests. We used a dataset of 10,040 samples, of which 2143 had COVID-19, 3674 had pneumonia (but not COVID-19), and 4223 were normal (not COVID-19 or pneumonia). Our model had a detection accuracy of 96.43% and a sensitivity of 93.68%. The area under the ROC curve was 99% for COVID-19, 97% for pneumonia (but not COVID-19 positive), and 98% for normal cases. In conclusion, ML approaches may be used for rapid analysis of CXR images and thus enable radiologists to filter potential candidates in a time-effective manner to detect COVID-19.

Variability in air-pollutants, aerosols, and associated meteorology over peninsular India and neighboring ocean regions during COVID-19 lockdown to unlock phases

The study focuses on the variability in aerosols, air-pollutants, and associated meteorological characteristics over peninsular India and neighboring ocean regions during both lockdown (25 March-31 May) and unlock (June–September) periods in 2020. During first lockdown phase, 40–60% reduction in aerosol loading observed over most parts except central-west India and the southern BOB. HYSPLIT model-based ‘back trajectory’ suggests the increase in anthropogenic aerosols over BOB due to long-range transport from an elevated layer. During second lockdown phase, an increase in AOD found over the eastern parts of India might come from the continuous operation of coal-fired thermal power plants and coal mines, besides domestic emissions. A surge in sea salt aerosols over BOB during the last two lockdown phases could be due to the Amphan super cyclone. During unlock phases, only natural aerosols show significant variation over the coastal and neighboring ocean regions with the simultaneous presence of intense summer monsoon. However, anthropogenic aerosols increased over the inland areas, which is most prominent in second and fourth unlock phases and could be attributed to the long-range transport. Temporal analysis of particulate matters and gaseous pollutants over coastal cities suggests Ahmedabad to be the most polluted one. The highest fall in NO2 was observed over Mumbai, whereas O3 concentration was appreciably enhanced over Ahmedabad, Visakhapatnam, and Chennai. Besides low anthropogenic emissions, long-range transport and prevailing meteorological conditions also played a significant role in governing the observed changes in aerosol loading and air pollutant concentration. © 2021 Turkish National Committee for Air Pollution Research and Control

Impact of COVID-19 on Mental Health in Adolescents: A Systematic Review.

Due to lack of sufficient data on the psychological toll of the COVID-19 pandemic on adolescent mental health, this systematic analysis aims to evaluate the impact of the pandemic on adolescent mental health. This study follows the PRISMA guidelines for systematic reviews of 16 quantitative studies conducted in 2019-2021 with 40,076 participants. Globally, adolescents of varying backgrounds experience higher rates of anxiety, depression, and stress due to the pandemic. Secondly, adolescents also have a higher frequency of using alcohol and cannabis during the COVID-19 pandemic. However, social support, positive coping skills, home quarantining, and parent-child discussions seem to positively impact adolescent mental health during this period of crisis. Whether in the United States or abroad, the COVID-19 pandemic has impacted adolescent mental health. Therefore, it is important to seek and to use all of the available resources and therapies to help adolescents mediate the adjustments caused by the pandemic.

Potential Years of Life Lost Due to COVID-19 in the United States, Italy, and Germany: An Old Formula with Newer Ideas.

Today, the world is facing the challenge of a major pandemic due to COVID-19, which has caused more than 6.1 million cases of infection and nearly 370,000 deaths so far. Most of the deaths from the disease are clustered in the older population, but the young and children are not spared. In this context, there is a critical need to revisit the formula for calculating potential years of life lost (PYLL). Data on age-specific deaths due to COVID-19 in three countries, including the United States (US), Italy, and Germany, were evaluated. New York State, as a significant outlier within the US, was also included. PYLLs in the US were five times as high as those of Italy. Compared with Germany, PYLLs in Italy were 4 times higher, and the rates in the US were 23, 25, and 18 times higher when using upper age limits of 70, 75, and 80, respectively. Standardized PYLLs in New York were 2 times as high as the rates in Italy, and 7 to 9 times as high as PYLLs in Germany. The revised formula of PYLL, using an upper limit of age 80, is recommended to accurately measure premature deaths due to a major disastrous disease such as COVID-19.