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Irrigation is increasingly being called upon to help stabilize and grow food and water security in the face of multiple crises;these crises include climate change, but also recent global food and energy price crises, including the 2007/08 food and energy price crises, and the more recent crises triggered by the COVID-19 pandemic and the war on Ukraine. While irrigation development used to focus on public, large-scale, surface- and reservoir-fed systems, over the last several decades, private small-scale investments in groundwater irrigation have grown in importance and are expected to see rapid future growth, particularly in connection with solar-powered pumping systems. But is irrigation 'fit-for-purpose' to support population growth, economic development, and multiple food, energy and climate crises? This paper reviews how fit-for-purpose irrigation is with a focus on economies of scale of surface and groundwater systems, and a particular examination of systems in Sub-Saharan Africa where the need for expansion is largest. The review finds challenges for both larger surface and smaller groundwater systems in the face of growing demand for irrigated agriculture and dwindling and less reliable water supplies. To support resilience of the sector, we propose both a holistic design and management improvement agenda for larger surface systems, and a series of suggestions to improve sustainability concerns of groundwater systems.
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Background: The coronavirus disease 2019 (COVID-19) pandemic has placed unprecedented demands on local public health units in Ontario, Canada, one of which was the need for in-house epidemiological modelling capabilities. The objective of this study is to develop a native Windows desktop app for epidemiological modelling, to be used by public health unit epidemiologists to predict COVID-19 transmission in Durham Region. Methods: The developed app is an implementation of a multi-stratified compartmental epidemiological model that can accommodate multiple virus variants and levels of vaccination, as well as public health measures such as physical distancing, contact tracing followed by quarantine and testing followed by isolation. It was used to investigate the effects of different factors on COVID-19 transmission, including vaccination coverage, vaccine effectiveness, waning of vaccine-induced immunity and the advent of the Omicron variant. The simulation start date was November 22, 2021. Results: For the Delta variant, at least 90% of the population would need to be vaccinated to achieve herd immunity. A Delta-variant-only epidemiological curve would be flattened from the start in the absence of immunity waning and within six months in the presence of immunity waning. The percentage of infections caused by the Omicron variant was forecast to increase from 1% to 97% in the first month of the simulation. Total Omicron infections were forecasted to be reduced, respectively, by 26% or 41% if 3,000 or 5,000 booster doses were administered per day. Conclusion: For the Delta variant, both natural and vaccination-induced immunity are necessary to achieve herd immunity, and waning of vaccine-induced immunity lengthens the time necessary to reach herd immunity. In the absence of additional public health measures, a wave driven by the Omicron variant was predicted to pose significant public health challenges with infections predicted to peak in 2-3 months from the start of the simulation, depending on the rate of administration of booster doses.
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The Covid-19 pandemic has grown to be a highly hazardous threat to the survival of most of the human race. It has not only caused prolonged stay-at-home or lockdown policies in many countries but has also been eating away from the global economy. Staying at home for long durations has affected the lives of daily wage workers tremendously and has also had negative consequences on the mental health of many. This paper aims to reduce the risk of contracting the disease when people leave their homes for essential services and during the gradual lift of the lockdown restrictions. This is achieved through a wearable device (wristband) which constantly looks for other wristbands in the vicinity using a WiFi module. This WiFi module is inbuilt into a NodeMCU Amica board and the setup is used in addition to a buzzer which sounds an alarm when two wristbands are dangerously close. In addition to the warning feature using the buzzer, the device would also store the contact history and the duration of contact on a remote server which can then be used for contact tracing in case a person is found to test positive for Covid-19. The interface of the remote server would be such that it gives a detailed list of the other wristbands that came into contact with any particular wristband. This device would also have an edge over some of the contact tracing apps as many people fear that these apps are an invasion of privacy and drain their mobile batteries quickly. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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Ultraviolet (UV) sterilization technology is widely used to reduce microorganisms that may remain on the surfaces after a standard cleaning to the minimum number. In this chapter we have proposed a robot named for disinfection, which consists of the UV light and hence the robot is a disinfection robot. It can be deployed at a variety of locations, especially due to the COVID-19 pandemic. Our UV bot has six 15W of UV lamps mounted on top of the UV bot platform covering 360 degrees. Our UV bot employs an embedded system based on a Raspberry Pi to aid in navigation and obstacle avoidance. © 2022 Elsevier Inc. All rights reserved.
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Introduction: Corona virus disease has several dermatological symptoms. Telogen effluvium is one of them. The present study presents a case series of post COVID Telogen effluvium from Central India region. Material and Method: This retrospective observational study included 72 patients (61 females & 11males), aged 29 to 62 years (median 49 yrs). The patient’s demography, history of hair fall, signs and symptoms, co morbidities and the treatment received for COVID-19 infection, Psychological perceived stress score, triggering factors for Telogen effluvium, Vitamin B12, Vitamin D and Ferritin levels were recorded & analysed. Result: The included patients were suffering from at least one co morbidity. Thirty patients had severe COVID-19 infection and were hospitalized. Psychological perceived stress score was low (12) in two, moderate (16-24) in twenty and high (29-38) in fifty patients. Vitamin B12 was low in twelve and Ferritin in ten patients. Seventy patients (97.2%) had positive hair pull test and 69 (95.8 %) had diffuse loss of hair. Discussion: Post covid Telogen effluvium was seen generally in females, and in middle aged. Most, 70/72 had moderate to severe psychological stress, Psychological perceived stress score was more than 16. Patients reported 2.2 to 6 months (median 3.5 months) after COVID-19 infection. Most 69 (95.8%) had diffuse hair loss. Post Covid patients may have several triggering factors for Telogen effluvium like psychological stress, nutritional deficiency or the drugs (heparin). Conclusion: Post Covid Telogen effluvium could be triggered by psychological stress, nutritional deficiencies (Vitamin B12, Iron) or drugs (heparin). Such cases could be managed by identification of triggering factors, proper counselling, high protein diet with vitamin supplementation.
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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the 2019 novel coronavirus disease pandemic (COVID-19). Despite vast research about the adult population, there has been little data collected on acute kidney injury (AKI) epidemiology, associated risk factors, treatments, and mortality in pediatric COVID-19 patients admitted to the ICU. AKI is a severe complication of COVID-19 among children and adolescents. Therefore, understanding all aspects of the disease is crucial to further developing treatment and preventative care strategies to reduce morbidity and mortality. This study aims to assess AKI incidence among COVID-19 pediatric patients in the pediatric intensive care unit (ICU) within North America using the Virtual Pediatric Systems (VPS) database. Additionally, this study assesses AKI associated risk factors, treatments such as kidney replacement therapy (KRT) and associated mortality rates among COVID-19 pediatric patients within North America using VPS data. This is a retrospective study of COVID-19 pediatric patients (age < 24 years) in the pediatric ICU within North America using the VPS COVID-19 database between January 1, 2020 and June 30, 2020. Currently data regarding 1240 pediatric COVID-19 patients has been analyzed. 172 of these patients had renal/urinary system involvement. Of the 172 patients with renal involvement, there were 19 confirmed deaths. This means that 45% of all confirmed pediatric COVID-19 deaths were associated with renal involvement. 36 patients received KRT and there are 2 confirmed deaths in this group. Additionally, 264 (24.67%) patients were diagnosed with Multisystem Inflammatory Syndrome in Children (MIS-C). Although COVID-19 in the pediatric population tends to present more favorably, renal involvement among the pediatric COVID-19 patient population may be considered a negative prognostic factor with respect to patient outcomes.
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Introduction: A single tertiary care center has offered oral immunotherapy (OIT) as a clinical service since 2018 using commercial products and subsequently has offered FDA-approved Peanut (Arachis- hypogaea) Allergen Powder-dnfp (PNAP) since July 2020. Shared decision making regarding OIT was based on previous IgE testing, history, and family preference. Methods: A retrospective chart review was performed in REDCap database. Results: A total of 37 patients initiated OIT (21 commercial products and 16 PNAP). The mean age was 9.25 for commercial product and 7.25 for PNAP with more males than females participating. Co-morbid conditions included allergic rhinitis, asthma, and eczema. Mean peanut IgE prior to starting was 49.75 and Ara h2 was 32.73. Prior reactions to peanut included skin, GI and anaphylaxis. Three children failed an oral challenge prior to starting OIT. There were 5 children that had never ingested peanuts but completed OIT. Minor intermittent side effects including stomach upset and itchy mouth were reported during escalation of both products. Dose adjustment was required for 1 PNAP patient for complaint of dysphagia and pain. There were 4 patients who dropped out of OIT: refusal to eat (1), unrelated GI disease (1) and the COVID-19 pandemic (2). All patients upon reaching maintenance are daily dosing with peanuts or chocolate-covered peanut candy. Lifestyle changes reported since reaching maintenance include eating in restaurants previously avoided and ingesting foods with labels stating: “may contain peanuts,” and “foods processed in a facility with peanuts.” Conclusions: Peanut OIT is safe and well tolerated in our patient population.
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A COVID-19 pandemic has caused public health crisis across the globe. People are under insurmountable psychological pressure which may lead to various psychological problems, such as anxiety, fear, depression, and insomnia. The aim of this study was to survey the general public in India to better understand their psychological distress, associated risk factors after one month of nationwide lock-down during the COVID-19 outbreak. Methods: A cross-sectional, observational study was carried out in India. We used snowball sampling technique and the data was collected using an online self-designed semi-structured questionnaire developed by using google forms. Results: Findings revealed significant rise in perceived susceptibility to COVID-19. Around 62% were dreaded of COVID-19 infection and perceived to be at risk of the same. A significant association was found between perceived susceptibility to COVID-19 infection and psychological distress (p value = 0.007) as well as between psychological distress with not having family around during lockdown (p value = 0.012). Discussion: As disease progresses, the psychological distress levels were also influenced by rising cases, media exposure, lock-down, and prevention and control measures taken against the epidemic situation. The Health Belief Model advocates that only those individuals who perceive themselves at risk of developing a disease will engage in behaviours to reduce their risk of developing the disease. Considering high perceived susceptibility for COVID-19, stimulus should be provided to the population for eliciting health promotion behaviours among them. The health promotion messages should be delivered using a mix of various effective communication strategies.
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We aim to study the relationship between vitamin D level, risk and severity of Coronavirus disease of 2019 (COVID-19) infection in pediatric population through systematic review. We searched PubMed, CINAHL, EMBASE, Cochrane Library and Google Scholar from December 2019 to June 2021 for retrieving articles studying association between vitamin D deficiencies with COVID-19. Qualitative details were synthesized in evidence table and quantitative data was used for deriving pooled estimate through meta-analysis. After initial search of 2261 articles, eight eligible studies (two reviews) were included in the systematic review. Meta-analysis of the quantitative data (six studies) showed pooled prevalence of vitamin D deficiency as 45.91% (95% CI: 25.148-67.450). In infected pediatric patients, low levels of vitamin D increased the risk of severe disease (odds ratio-5.5; 95% CI: 1.560-19.515; P = 0.008). It was also found that children and adolescents having vitamin D deficiency had greater risk of COVID infection as compared to patients with normal vitamin D levels. Improvement in disease severity with vitamin D supplementation was also noted. The systematic review showed that almost half of the pediatric COVID patients suffer from vitamin D deficiency. It is also clear that the low level of vitamin D is associated with greater risk of infection and poorer outcome in pediatrics.
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COVID-19 , Pediatrics , Vitamin D Deficiency , Adolescent , Child , Humans , Prognosis , SARS-CoV-2 , Vitamin D , Vitamin D Deficiency/epidemiologyABSTRACT
TOPIC: Lung Pathology TYPE: Medical Student/Resident Case Reports INTRODUCTION: The versatility of emerging cancer therapies is due to the advancements in gene focused strategies whereby the identification of key driver mutations has led to the development of selectively targeted drugs. Crizotinib is one such drug used for non-small cell lung cancer (NSCLC). A rare but serious adverse effect (AE) of interstitial lung disease (ILD) has been reported in about 2% of patients on Crizotinib. CASE PRESENTATION: A 63 year-old man with metastatic squamous cell carcinoma of head and neck, history of Hodgkin's lymphoma post radiation, tobacco use presented with dyspnea, cough, and fever. Physical exam revealed respiratory distress, SpO2 89% on room air and diffuse rhonchi bilaterally. He was placed on 6 liters of nasal cannula with improvement in hypoxia. White blood cell was 11000/uL, c-reactive protein (CRP) 14.23 mg/d, procalcitonin 4.72ng/ml and brain natriuretic peptide 309 pg/ml. Sputum culture, COVID real time polymerase chain reaction (PCR), respiratory viral panel and a methicillin resistant Staphylococcus aureus nasal PCR swab were all negative. Chest radiograph showed bilateral consolidations, concerning for multifocal community acquired pneumonia for which he received broad spectrum antibiotics. However, the patient's respiratory status worsened on day 2. He was requiring 40L and FiO2 60% on high-flow nasal cannula (HFNC) to keep SpO2 > 92%. The patient then reported starting Crizotinib 250 mg oral twice/day 9 days ago and developed dyspnea and cough shortly thereafter. A computer tomography (CT) scan of the chest showed a right lower lobe segmental pulmonary embolism (PE) and severe bilateral airspace disease, with diffuse consolidation and ground glass opacities. He received anticoagulation for the PE and methylprednisolone 500mg IV twice/day due to concern for Crizotinib induced ILD. There was marked improvement in his respiratory status with decreasing oxygen requirements after steroid initiation. DISCUSSION: Crizotinib is a tyrosine kinase inhibitor (TKI) that suppresses anaplastic lymphoma kinase (ALK) gene activity. ILD due to Crizotinib is thought to be related to direct cytotoxicity to the pneumocytes. Risk factors include male sex, smoking, history of pulmonary fibrosis, history of radiation and combination therapy with immunotherapy. Our patient had several risk factors, except history of pulmonary fibrosis. There is no established therapy for TKI induced ILD, but some case reports recommend using systemic corticosteroids. Other case reports have demonstrated that continuing therapy with another ALK inhibitor, such as Alectinib, did not result in recurrence of ILD. CONCLUSIONS: TKIs are generally well tolerated but can rarely cause severe ILD. It is important to consider risk factors for TKI induced ILD prior to their administration. Prompt discontinuation of the drug and treatment with corticosteroids can cause symptomatic resolution of TKI induced ILD. REFERENCE #1: Fujiuchi S, Fujita Y, Sasaki T, Ohsaki Y. Successful alectinib treatment after crizotinib-induced interstitial lung disease. Respirol Case Rep. 2016 Apr 7;4(3):e00156. REFERENCE #2: Suh CH, Kim KW, Pyo J, Hatabu H, Nishino M. The incidence of ALK inhibitor-related pneumonitis in advanced non-small-cell lung cancer patients: A systematic review and meta-analysis. Lung Cancer. 2019;132:79-86. REFERENCE #3: He Y, Zhou C. Tyrosine kinase inhibitors interstitial pneumonitis: diagnosis and management. Transl Lung Cancer Res. 2019;8(Suppl 3):S318-S320. DISCLOSURES: No relevant relationships by Stephanie Ibrahim, source=Web Response No relevant relationships by Mahnoor Mir, source=Web Response No relevant relationships by Abhishek Pandya, source=Web Response No relevant relationships by Marcos Restrepo, source=Web Response
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The usage of laptops and cell phones has drastically increased recently, specifically because of the Covid-19 pandemic. The pandemic and resulting shut downs have necessitated online studies, work from home, online meetings, video conferencing etc. Availability of either a laptop or cell phone has become basic requirement for attending online classes or virtual meetings. Hence, the usage of entry-level laptops (for example Intel Core-i3) and mid-range laptops (for example AMD Ryzen 5) has recently gained popularity. This particular research study aims to determine the power consumption and changes in temperature of the microprocessor, physical memory, and integrated graphics card when different benchmark software (Cinebench R23, Unigine Superposition 1.1), stress test, and video game (CS-GO) executing instructions individually and simultaneously with each other. Three different types of system configurations (Intel Core-i3, AMD Ryzen 5 low power, and AMD Ryzen 5 High-performance) were used to determine the performance and benchmarking of the processor with different physical memory, and different integrated graphics processing units. These processors have been tested under multiple benchmark software, stress tests, and video games. Cinebench R23, Unigine Superposition, Counter-Strike: Global Offensive software/game were used to analyze the performance. Mainly, power consumption, temperature changes with the different load on the processor, physical memory, and load on integrated GPU were analyzed when application was running. © 2021 ACM.
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BACKGROUND: Given the limited and diverse nature of published literature related to COVID-19 in pediatrics, it is imperative to provide evidence-based summary of disease characteristics for guiding policy decisions. We aim to provide comprehensive overview of epidemiological, clinical and biomarker profile of COVID-19 infection in pediatric population. METHODS: For this umbrella review, published systematic reviews from PubMed and pre-print databases were screened. Literature search was conducted from December 2019 to April 2021. Details of clinical, radiological and laboratory features were collected from each review. Qualitative observations were synthesized and pooled prevalence of mortality and asymptomatic cases were assessed using meta-analysis. RESULTS: Evidence synthesis of 38 systematic reviews included total 1145 studies and 334 398 children and adolescents. Review revealed that COVID-19 is relatively milder with better prognosis in pediatrics. However, patients with comorbidity are at higher risk. Meta-analysis of reviews showed that 21.17% (95% CI: 17.818-24.729) of the patients were asymptomatic and mortality rate was 0.12% (95% CI: 0.0356-0.246). Though there was no publication bias, significant heterogeneity was observed. Fever (48-64%) and cough (35-55.9%) were common symptoms, affecting almost every alternate patient. Ground-glass opacities (prevalence range: 27.4-61.5%) was most frequent radiographic observation. Rise in C-reactive protein, lactate dehydrogenase and D-dimer ranged from 14% to 54%, 12.2-50% and 0.3-67%, respectively. Some of the included reviews (44.7%-AMSTAR; 13.2%-GRADE) were of lower quality. CONCLUSION: Current umbrella review provides most updated information regarding characteristics of COVID-19 infection in pediatrics and can be used to guide policy decision regarding vaccination prioritization, early screening and identification of at-risk population.
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COVID-19 , Pediatrics , Adolescent , Biomarkers , Child , Cough , Humans , SARS-CoV-2ABSTRACT
Introduction: The “obesity paradox” has been reported in critically ill patients with acute respiratory distress syndrome (ARDS). Obese patients with ARDS were shown to have more ventilator free days and lower mortality compared to non-obese patients. One proposed explanation was increased levels of pro-inflammatory cytokines creating a protective environment from acute inflammation. In COVID-19, BMI ≥ 30 increases risk of illness severity, need for critical care, respiratory failure requiring use of invasive mechanical ventilation (IMV), and mortality. It is unknown if the “obesity paradox” applies to patients with SARS-CoV2 who require IMV. We examined a cohort of patients with respiratory failure due to COVID-19 who required IMV and compared outcomes between obese and non-obese patients. Methods: Data was collected from patients treated in the COVID Intensive Care Unit (ICU) from March to June 2020. A total of 85 patients were identified. All patients were COVID nasopharyngeal swab positive. Results: There were 38 (44.7%) patients with BMI < 30, and 47 (55.3%) with BMI ≥ 30. The median BMI was 25.5 in the BMI < 30 group, and 37.5 in the BMI ≥ 30 group. In the BMI < 30 group, median age was 67 years, majority male (65.8%) and African American (50%). The BMI ≥ 30 group had a median age of 63.5, majority male (53.2%) and African American (63.8%). Median Sequential Organ Failure Assessment score on admission was higher in the BMI ≥ 30 group at 3 (1.5-4.5) vs. 2 (1.0-4.0). There was elevated creatinine on admission with higher percentage of diabetes, heart failure, and renal disease in the BMI ≥ 30 group. Inflammatory markers, such as CRP and IL-6 were lower in the higher BMI group at presentation. There was higher in-hospital mortality in the BMI ≥ 30 group at 57.5%, with longer ICU length of stay (12.35 vs. 7.6 days), longer days on ventilator (10.2 vs. 4 days), and lower PaO2/FiO2 ratio after intubation (146 vs 348). The higher BMI group had higher rates of prone ventilation, paralytic use, and extracorporeal membrane oxygenation support. Discussion: From our data, obesity did not appear to have better outcomes in ARDS due to COVID-19 infection. Higher BMI was associated with higher disease severity, severe respiratory failure, longer ventilator days, longer ICU length of stay, and higher mortality. Interestingly, inflammatory markers were initially lower in obese patients, suggesting a possible adaptive physiologic response to inflammation, but without effect on overall outcomes.
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The world is concerned about managing COVID-19 pandemic and its consequences. The COVID-19 has not only affected physical health and the economy but impacted the mental health of people globally. It has created a parallel epidemic of psychological distress. Experts envision a gigantic influx of patients needing mental health care, with needs far greater than the nation's existing public health systems can deal with. This paper discusses Indian scenario of mental health issues fueled by COVID-19 pandemic and strategies to address mental health emergency by adopting unconventional sustainable measures and formally integrating mental health into public health preparedness and emergency response plans of the country.
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With the growing understanding of coronavirus disease-2019 (COVID-19) pathogenesis, different therapeutic targets are being considered for the management of COVID-19. The development of new drugs is a time-consuming process;hence, many drugs acting on similar therapeutic targets/sites in the COVID-19 treatment are repurposed in COVID-19. In this article, an expert panel deliberated on the existing evidence on the immunopathogenesis, therapeutic targets under consideration for treatment of COVID-19, and the place of mefenamic acid in the therapy landscape of COVID-19. The expert panel has also provided recommendations regarding the dose and regimen of mefenamic acid in different phases of the COVID-19 disease.