COVID-19 pandemic and the determinants of depressive symptoms among senior citizens of India: An empirical investigation

The COVID-19 pandemic inflicted multiple threats to individuals' physical, mental, and financial health conditions. The pandemic-related restrictive behaviors pose serious consequences for public health and increase the risk of mental illness among individuals, particularly among older citizens. The combination of their pre-existing illnesses, social isolation, COVID fear, and financial adversity frequently aggravates their condition and leads to depression and mental illness. Thus, the present study investigates the mental health status and the determinants of depressive symptoms among older adults of Bhubaneswar during the COVID pandemic context. The study used the Geriatric Depression Scale (GDS-15) to measure their depressive symptoms. The social isolation parameter is measured with the De Jong Gierveld Loneliness Scale. Financial self-efficacy, COVID-19-related psychological fear, and comorbidity health status are other determinants considered. A chi-square test and multinomial logistic regression (MLR) models are adopted to find the probable risk factors that may influence depressive symptoms among older people. The results indicate that comorbidity health conditions, a social isolation mindset, and financial efficacy issues are the significant determinants that drive an older person towards different depression categories. The improvement of these influential factors can lead senior citizens to avoid any health emergency like COVID pandemic. In the event of a public health emergency, such as COVID pandemic, the government could use the study's findings to devise methods for assisting the elderly. Society as a whole should be aware of these findings, which can lead to depressive symptoms, and offer support to the elderly. Future research may concentrate on identifying the causes of depressive symptoms in different age groups or in the presence of specific comorbidity health conditions. Future research may also investigate the factors influencing depressive symptoms in a specific occupation. © 2023 John Wiley & Sons Australia, Ltd.

Validation of a MALDI-TOF MS Method for SARS-CoV-2 Detection on the Bruker Biotyper and Nasopharyngeal Swabs: A Brazil-UK Collaborative Study.

We developed a MALDI-TOF mass spectrometry method for the detection of the SARS-CoV-2 virus in saliva-gargle samples using Shimadzu MALDI-TOF mass spectrometers in the UK. This was validated in the USA to CLIA-LDT standards for asymptomatic infection detection remotely via sharing protocols, shipping key reagents, video conferencing, and data exchange. In Brazil, more so than in the UK and USA, there is a need to develop non-PCR-dependent, rapid, and affordable SARS-CoV-2 infection screening tests that also identify variant SARS-CoV-2 and other virus infections. In addition, travel restrictions necessitated remote collaboration with validation on the available clinical MALDI-TOF-the Bruker Biotyper (microflex® LT/SH)-and on nasopharyngeal swab samples, as salivary gargle samples were not available. The Bruker Biotyper was shown to be almost log103 more sensitive at the detection of high molecular weight spike proteins. A protocol for saline swab soaks out was developed, and duplicate swab samples collected in Brazil were analyzed by MALDI-TOF MS. The swab collected sample spectra that varied from that of saliva-gargle in three additional mass peaks in the mass region expected for IgG heavy chains and human serum albumin. A subset of clinical samples with additional high mass, probably spike-related proteins, were also found. Further, spectral data comparisons and analysis, subjected to machine learning algorithms in order to resolve RT-qPCR positive from RT-qPCR negative swab samples, showed 56-62% sensitivity, 87-91% specificity, and a 78% agreement with RT-qPCR scoring for SARS-CoV-2 infection.

SARS-CoV-2 Spike Protein Binding of Glycated Serum Albumin-Its Potential Role in the Pathogenesis of the COVID-19 Clinical Syndromes and Bias towards Individuals with Pre-Diabetes/Type 2 Diabetes and Metabolic Diseases.

The immune response to SARS-CoV-2 infection requires antibody recognition of the spike protein. In a study designed to examine the molecular features of anti-spike and anti-nucleocapsid antibodies, patient plasma proteins binding to pre-fusion stabilised complete spike and nucleocapsid proteins were isolated and analysed by matrix-assisted laser desorption ionisation-time of flight (MALDI-ToF) mass spectrometry. Amongst the immunoglobulins, a high affinity for human serum albumin was evident in the anti-spike preparations. Careful mass comparison revealed the preferential capture of advanced glycation end product (AGE) forms of glycated human serum albumin by the pre-fusion spike protein. The ability of bacteria and viruses to surround themselves with serum proteins is a recognised immune evasion and pathogenic process. The preference of SARS-CoV-2 for AGE forms of glycated serum albumin may in part explain the severity and pathology of acute respiratory distress and the bias towards the elderly and those with (pre)diabetic and atherosclerotic/metabolic disease.

Pico metallic reinforced molecular innovated hair gel against microbial and parasitic manifestation: Clinical investigation under COVID era

"The development of Pico-metallic molecular dust as hair gel is supposed to be an innovative shielding formulation without involving the drugs moiety. The extraction and calcination of herbal parts unto the level of ""Bhasma"", where the extraction leads to inert through a series of processing acts as neutralizing and elimination of microbes, parasites and its toxins from physical intrusion through the hairs. The formulation of hair gel consisting Ketoconazole 1%, Methyl Paraben 1%, Glycerin 3% w/w along with reinforcement of Extracted Au, Ag & Fe Pico molecules. Most innovated here is the recovery of the Pico metallic dust extraction process from the collected micro metallic particular layer. Clinical investigation of the formulation among desirable health care 7 groups volunteers was representing remarkable results in cohort case-control study between its application, linear regression equation of y = 0.26175X-0.38108 and without, linear regression equation of y = 0.93168X-2.217 to estimate the incidence-prevalence ratio assessment. Thus, it exerts the P-Value is.000502. The result is significant at p <.05 r = 0.9628 and P-Value is.000402. The result is significant at p <.05, r = 0.966 respectively. Thus, its proved its clinical efficiency to minimize incidence and prevalence of microbial manifestation. Copyright © 2022, Anka Publishers. All rights reserved."

Direct Detection of Glycated Human Serum Albumin and Hyperglycosylated IgG3 in Serum, by MALDI-ToF Mass Spectrometry, as a Predictor of COVID-19 Severity.

The prefusion spike protein of SARS-CoV-2 binds advanced glycation end product (AGE)-glycated human serum albumin (HSA) and a higher mass (hyperglycosylated/glycated) immunoglobulin (Ig) G3, as determined by matrix assisted laser desorption mass spectrometry (MALDI-ToF). We set out to investigate if the total blood plasma of patients who had recovered from acute respiratory distress syndrome (ARDS) as a result of COVID-19, contained more glycated HSA and higher mass (glycosylated/glycated) IgG3 than those with only clinically mild or asymptomatic infections. A direct serum dilution, and disulphide bond reduction, method was developed and applied to plasma samples from SARS-CoV-2 seronegative (n = 30) and seropositive (n = 31) healthcare workers (HCWs) and 38 convalescent plasma samples from patients who had been admitted with acute respiratory distress (ARDS) associated with COVID-19. Patients recovering from COVID-19 ARDS had significantly higher mass AGE-glycated HSA and higher mass IgG3 levels. This would indicate that increased levels and/or ratios of hyper-glycosylation (probably terminal sialic acid) IgG3 and AGE glycated HSA may be predisposition markers for the development of COVID-19 ARDS as a result of SARS-CoV2 infection. Furthermore, rapid direct analysis of serum/plasma samples by MALDI-ToF for such humoral immune correlates of COVID-19 presents a feasible screening technology for the most at risk; regardless of age or known health conditions.

A CASE SERIES OF RAPID PROGRESSIVE FIBROTIC LUNG DISEASE AS A SEQUELA OF COVID-19 PNEUMONIA

SESSION TITLE: Pulmonary Issues in Transplantation Case Report Posters SESSION TYPE: Case Report Posters PRESENTED ON: 10/19/2022 12:45 pm - 01:45 pm INTRODUCTION: Fibrotic interstitial lung disease (fILD) can be idiopathic or associated with several underlying conditions and in response to various types of injury. Post COVID-19 fILD is an increasingly recognized clinical entity with the potential for a large burden of morbidity and mortality.[1] We present a series of 6 patients with progressive pulmonary fibrosis as sequela of COVID-19 requiring lung transplantation. CASE PRESENTATION: Four of the 6 patients had known underlying chronic ILD prior to COVID-19 infection (2 with idiopathic pulmonary fibrosis [IPF] and 1 each with scleroderma and rheumatoid arthritis associated ILD). The other 2 patients had no prior history of lung disease and asymptomatic before infection. One of these had a strong family history of IPF. The presentations involved signs of progressive respiratory failure after the initial lung injury from COVID-19. 4 patients were hospitalized during their acute COVID-19 illness and had varying treatments including steroids, antibiotics, anti-virals, convalescent plasma, Tocilizumab, and non-invasive positive pressure ventilation. At the time of transplant evaluation, CT imaging showed prominent interstitial thickening, honeycombing consistent with fibrotic processes for all our patients;PFT revealed severe restrictive ventilatory defect with reduced diffusion capacity ranging 24%-53%;3 patients required venous-venous extracorporeal membrane oxygenation (ECMO) as a bridge to transplantation for 14 and 93 days. The remainder required 6-10 L of supplemental oxygenation at rest. Two patients underwent initial transplant evaluation while in respiratory failure.5 patients received bilateral lung transplantation and one single left lung transplantation.Duration of time between initial COVID-19 induced lung injury and transplantation ranged from 3-13 months, with a median 6-7 months.Lung explant pathology showed advanced usual interstitial pneumonia in all. Superimposed diffuse alveolar damage was noted in 3 cases. Post-transplant to discharge ranged 10-31 days and at 2 months follow-up, all patients were liberated of oxygen needs. All subjects remain alive at a median 11-12 months, with no evidence of allograft dysfunction. DISCUSSION: Since the emergence of SARS-COV2 in 2019, histopathological fibrotic anomalies have been found to be present in up to one-third of those who recover from ARDS due to COVID-19 [2] and their incidence increases as duration of ARDS increases [3]. Further work is required to understand the pathogenesis of the fibrotic process following acute COVID-19. CONCLUSIONS: We highlight this syndrome with our case series of 6 patients who showed progressive fibrotic disease after COVID-19. Patients with pre-exiting ILD appear to be particularly at risk but this entity may occur in those without pre-existing ILD. Lung transplantation offers a viable treatment option for selected patients with an otherwise poor prognosis. Reference #1: 1.Bharat, A., Querrey, M., Markov, N. S., Kim, S., Kurihara, C., Garza-Castillon, R., Manerikar, A., Shilatifard, A., Tomic, R., Politanska, Y., Abdala-Valencia, H., Yeldandi, A. V., Lomasney, J. W., Misharin, A. V., & Budinger, G. (2020). Lung transplantation for pulmonary fibrosis secondary to severe COVID-19. medRxiv : the preprint server for health sciences, 2020.10.26.20218636. https://doi.org/10.1101/2020.10.26.20218636 Reference #2: 2. Rai DK, Sharma P, Kumar R. Post covid 19 pulmonary fibrosis. Is it real threat?. Indian J Tuberc. 2021;68(3):330-333. doi:10.1016/j.ijtb.2020.11.003 Reference #3: 3. Williamson EJ, Walker AJ, Bhaskaran K, Bacon S, Bates C, Morton CE, Curtis HJ, Mehrkar A, Evans D, Inglesby P, Cockburn J, McDonald HI, MacKenna B, Tomlinson L, Douglas IJ, Rentsch CT, Mathur R, Wong AYS, Grieve R, Harrison D, Forbes H, Schultze A, Croker R, Parry J, Hester F, Harper S, Perera R, Evans SJW, Smeeth L, Goldacre B. Factors associated with C VID-19-related death using OpenSAFELY. Nature. 2020 Aug;584(7821):430-436. doi: 10.1038/s41586-020-2521-4. Epub 2020 Jul 8. PMID: 32640463;PMCID: PMC7611074. DISCLOSURES: no disclosure on file for Philip Camp;research relationship with United Therapeutics Please note: 2016- ongoing by Reda Girgis, value=Grant/Research research relationship with Pfizer Please note: 2014-2020 by Reda Girgis, value=Grant/Research Speaker/Speaker's Bureau relationship with Boehringher Ingelheim Please note: 2016-ongoing by Reda Girgis, value=Honoraria Speaker/Speaker's Bureau relationship with Genentech Please note: 2016-ongoing by Reda Girgis, value=Honoraria No relevant relationships by Ryan Hadley No relevant relationships by Sheila Krishnan No relevant relationships by Sheetal Maragiri No relevant relationships by Edward Murphy No relevant relationships by Jay Patel No relevant relationships by Keval Ray No relevant relationships by Gayathri Sathiyamoorthy No relevant relationships by Neel Shah No relevant relationships by Subhan Toor

COVID-19-INDUCED IMMUNOSUPPRESSION LEADING TO SECONDARY INFECTION AS DISSEMINATED COCCIDIOIDOMYCOSIS

SESSION TITLE: Post-COVID-19 Infection Complications SESSION TYPE: Case Report Posters PRESENTED ON: 10/17/2022 12:15 pm - 01:15 pm INTRODUCTION: Coccidioidomycosis caused by the fungi C. immitis and C. Posadasii is well known to be endemic to the Southwest United States. Less than 1% of these infections will manifest as extrapulmonary symptoms and multiple sites causing dissemination fungemia [1]. Risk factors for disseminated infection include exogenous immunosuppression, immunodeficiency, pregnancy, and ethnic backgrounds of African and Filipino descent [2]. CASE PRESENTATION: A 39-year-old previously immunocompetent Congolese male with recent onset of recurrent skin abscess, and positive testing for COVID-19 three week prior (not treated with steroids). He presents with shortness of breath, back pain, fevers after recently migrating from the Southwest region to the Midwest. Upon admission imaging with Computed Tomography (CT) revealed extensive pulmonary infiltrates (Fig 1), intra-abdominal abscesses, and magnetic resonance imaging revealing (MRI) osteomyelitis of the thoracic (Fig 2) and lumbar spine (Fig 3). His work of breathing continued to worsen, requiring prompt intubation, and he was initiated on a broad-spectrum antimicrobial regimen, including fluconazole, voriconazole, cefepime and vancomycin. Immunoglobulins, HIV and oxidative burst testing was unremarkable. Cultures from image-guided aspiration of the psoas abscess, incision, and drainages of skin abscess and bronchoalveolar lavage fluid were all positive for coccidioidomycosis, transitioned to amphotericin B. Course complicated with the development of multidrug-resistance pseudomonas aerogenes VAP treated with inhaled tobramycin and meropenem. He developed progressive acute respiratory distress syndrome with refractory hypoxemia. After 3 weeks of antimicrobial and anti-fungal treatment, a decision was made to transfer the patient to a lung transplant center, however, due to ongoing fungemia, he was deemed to be not a candidate for extracorporeal membrane exchange and lung transplantation. About a month into his hospitalization, the family decided to withdraw care. DISCUSSION: Reactivation of latent coccidiomycosis has been largely studied in the immunosuppressed population that includes HIV, hematological malignancies, and diabetes mellitus, however little is known about this fungal infection in the immunosuppressed state in the setting of COVID-19. Thus far only two case reports have been reported of co-infection if COVID-19 and pulmonary coccidioidomycosis [3]. The days of the COVID-19 pandemic might contribute to further delays in diagnosing this fungal infection due to similarities of pulmonary manifestation. CONCLUSIONS: This case demonstrates a COVID-19 infection leading to an immunosuppressed status resulting in disseminated infection from reactivation of latent coccidiomycosis. As a result, physicians must maintain a high level of suspicion for superimposed fungal infections in those with even relative immunosuppression from a recent COVID infection. Reference #1: Odio CD, Marciano BE, Galgiani JN, Holland SM. Risk Factors for Disseminated Coccidioidomycosis, United States. Emerg Infect Dis. 2017;23(2):308-311. doi:10.3201/eid2302.160505 Reference #2: Hector RF, Laniado-Laborin R. Coccidioidomycosis–a fungal disease of the Americas. PLoS Med. 2005;2(1):e2. doi:10.1371/journal.pmed.0020002 Reference #3: Shah AS, Heidari A, Civelli VF, et al. The Coincidence of 2 Epidemics, Coccidioidomycosis and SARS-CoV-2: A Case Report. Journal of Investigative Medicine High Impact Case Reports. January 2020. doi:10.1177/2324709620930540 DISCLOSURES: No relevant relationships by Stephen Doyle No relevant relationships by Connor McCalmon No relevant relationships by John Parent No relevant relationships by Jay Patel No relevant relationships by Angela Peraino No relevant relationships by Keval Ray

Resource Aware Fog Based Remote Health Monitoring System

In today's world of medical science, remote patient monitoring devices are becoming more important and a future need particularly in the present COVID-19 situation as individuals are preferred to be kept isolated. Patients would be benefited from a suitable monitoring system that measures their important medical parameters such as pulse rate, oxygen saturation or SpO2, body temperature, blood pressure, and Galvanized Skin Response (GSR). This system can increase the medical staff efficiency by drastically decreasing their duties in hospitals and the need to attend to them individually. Patients in their home isolation may utilize the device as well, and their vital indicators may be checked by doctors remotely. In this work, we are prototyping a powerefficient, wearable medical kit and a resource-aware fog network set up to handle the Internet of Things (IoT) data traffic. The idea behind the design is to process the critical medical sensors' data in the fog nodes which are deployed at the edge of the network. The data thus received, is used for a machine learning-based solution for personal health anomalies and COVID-19 infection risk analysis. © 2022 IEEE.

“Oh my God! How did I miss this?” - Barriers to Discussing Pronouns and Gender Identity in Pediatric Primary Care

Purpose: Pediatric gender centers have seen a notable increase in demand for gender-affirming care services during the COVID-19 pandemic. This increased need has contributed to delays in youth accessing this time-sensitive care and amplified the importance of primary care providers (PCPs) playing an active role supporting gender diverse youth in the post-pandemic world. To guide interventions to support PCPs in gender-affirming care, we sought to understand how often PCP’s see gender diverse youth in primary care and assess PCP comfort facilitating conversations about gender identity in this setting. The objectives of this study were to (1) understand whether PCPs are routinely discussing pronouns and gender identity with adolescents and (2) explore barriers to and the impact of having such discussions in primary care. Methods: This project integrated data from a needs assessment survey and from semi-structured, qualitative interviews with pediatric PCPs. The 15-item survey was administered to PCPs in a large, hospital-affiliated, pediatric primary care network in the northeastern US to better understand PCPs experiences providing adolescent healthcare. Hour long, semi-structured interviews were conducted with pediatric PCPs in the pacific northwest using an interview guide developed in partnership with two PCP stakeholders. Survey responses were analyzed descriptively. Interviews were transcribed and analyzed by two authors in Dedoose qualitative analysis software via inductive thematic analysis using an iteratively designed codebook that was adjudicated to consensus. Results: Of the pediatric PCPs surveyed (n=85), the majority were pediatricians (67%) and most had been in practice for more than 5 years (75%). Almost all (92%) PCPs reported caring for at least one gender diverse youth in their practice in the last year. However, PCPs reported discussing pronouns (15%) and gender identity (29%) during annual well visits with adolescent patients much less frequently than discussing mood (98%), motor vehicle safety (77%) and sexuality (61%). Relatedly, gender-affirming care (60%) was the topic most frequently selected by PCPs for additional education. In separate PCP interviews, participants (n=15) indicated that while they felt discussions about pronouns and gender identity were important, they experienced specific structural and interpersonal barriers that prevented these conversations from occurring. These barriers included poor health system infrastructure (like forms and electronic health records), staff concerns, uncertainty around language, lack of awareness and fear. PCPs also discussed that when they asked about pronouns and gender identity, it normalized conversations about gender, helped facilitate family support, created welcoming environments in the health system and allowed for earlier identification of youth in need of support. Conclusions: Pediatric PCPs recognize the critical role they play in supporting gender-diverse youth and their families, particularly around normalizing conversations about gender identity. However, multiple individual and clinic-level barriers to asking about pronouns and gender identity remain. These results highlight the continued need to provide resources, education and support to PCPs in discussing these topics in the primary care setting to facilitate access to time-sensitive gender-affirming care. Sources of Support: This project was supported by the Seattle Children's Research Institute Career Development and AHRQ K12HS026393-03 (PI: Sequeira).

The use of music at home reduces symptoms of dementia and caregiver distress

BACKGROUND: As Alzheimer's disease progresses, neuropsychiatric symptoms, particularly those common in the middle stages of the disease can be increasingly stressful for family caregivers. Music-based interventions, when personalized and added to daily caregiving routines, have been shown to reduce occurrences or severity of these undesirable symptoms. In this study, family caregivers learned to implement music interventions to mitigate the impact of challenging behaviors. METHOD: We present the results of interim analyses of the results for the first group of participants in a study of a psychoeducational, music-based intervention for family caregivers. Eighteen NYC-based family caregivers participated in a 6-week program either in person (pre-COVID) or online with a music therapist. Following each weekly one-hour workshop, caregivers were asked to utilize music interventions such as singing during care, listening to personalized playlists on Spotify, or facilitating music and movement with their care recipient. The Neuropsychiatric Inventory-Questionnaire was used to measure twelve neuropsychiatric domains and measure caregiver distress before and after the 6-week intervention. Paired sample t-tests were used to measure change in these outcomes for caregiver and care recipient. A Pearson correlation coefficient was used to estimate the relationship between symptoms of dementia and caregiver distress. RESULTS: There was a significant improvement in both neuropsychiatric domains in care recipients from before (M= 12.23 ± 6.26) the six-week program to after (7.83 ± 3.51), p =.028, and in caregiver distress prior (M=14.88 ± 9.36) to after (8.68 ± 5.95), p =.03. The symptoms most reported to contribute to caregiver distress were irritability (n=12), night-time behaviors (n=12), and agitation (n=11). Neuropsychiatric symptoms and caregiver distress were found to be strongly correlated, r (16) =.64, p=.004. CONCLUSION: Preliminary results of this ongoing study indicate that caregivers who implement music-based interventions can both reduce undesirable symptoms of dementia and thereby their own distress. © 2021 the Alzheimer's Association.

Sleep among youth during the COVID-19 pandemic: Differences between summer and school-year

Introduction: Insufficient sleep is highly prevalent among school-age youth and adolescents, which has been exacerbated by the COVID- 19 pandemic. However, it is unclear whether sleep during COVID-19 varies based on whether school is in session. We examined the sleep of school-age youth and adolescents during COVID-19 and described changes in rates of insufficient sleep from summer (Time 1) to school year (Time 2). We further examined whether insufficient sleep is associated with mental health service utilization. Methods: Adults in Southwestern Pennsylvania with children under 18 years old in their household completed a repeated cross-sectional electronic survey. The survey was designed to assess usage of, and unmet need for, health and social service resources, among other health behaviors. As responses were anonymous with no longitudinal linking, we used descriptive statistics and Chi-Square tests to examine our aims at each time point. Insufficient sleep was operationalized as <9 hours (school-age youth) and <8 hours (adolescents) of sleep duration, per National Sleep Foundation standards. Results: Data were analyzed from n=97 school-age youth and n=83 adolescents at Time 1, and n=77 school-age youth and n=82 adolescents at Time 2. Most school-age youth (76.3%) obtained sufficient sleep at Time 1, which was maintained at Time 2. However, while 75.6% of adolescents obtained sufficient sleep at Time 1, that number fell to 63.3% at Time 2. Youth with insufficient sleep were more likely to utilize mental health services than those obtaining sufficient sleep at a borderline level of statistical significance (p-value = 0.097), after controlling for age group. Conclusion: The rate of insufficient sleep among adolescents during COVID-19 is meaningfully higher than non-COVID, school-year rates recently reported among adolescents. Youth with insufficient sleep are more likely to utilize mental health services, though the direction of causality in that association is unknown. Future work should focus on strategies for increasing access to sleep promotion programs that support sleep health and mental health during a time of great stress.

Two cases of atypical diverticular abscesses from sigmoid colon resulting from COViD-19 crisis-induced management delay

as the world is facing the biggest crisis of this century, sick patients become sicker without timely intervention. abscess arising from Sigmoid diverticulitis can have increased morbidity and mortality if not treated urgently. Timely intervention supported by care in the intensive Therapy Unit (ITU) reduces both mortality and morbidity significantly in an advanced situation. Two cases with Diverticular abscess are discussed in this article who had uncommon presentation resulting from undue delay related to COViD-19 crisis-induced lockdown. Their surgical intervention got delayed due to multifactorial crises including ITU bed-shortage resulting in increased mortality and morbidity. The multifactorial influences of lockdown on the unwanted delay in referral, aggravated presentation, and the complicated outcome of a common emergency condition demand more awareness for reducing risk.

What is the association between income loss during the COVID-19 pandemic and children's dental care?

BACKGROUND: The degree to which children experience unmet need for dental care during the COVID-19 pandemic and its association with pandemic-related household job or income loss are unknown. METHODS: The authors performed a cross-sectional household survey of 348 families in Pittsburgh, Pennsylvania, from June 25 through July 2, 2020. Unmet need for child dental care and pandemic-related household job or income loss were assessed using caregiver self-report. RESULTS: Caregivers reported that the greatest unmet child health care need during the COVID-19 pandemic was dental care (16%), followed by medical care for a well visit or vaccination (5%). Approximately 40% of caregivers reported job loss or a decrease in household income due to the COVID-19 pandemic. The authors found a significant association between the probability of unmet child dental care and pandemic-related household job or income loss (P = .022). Losing a job or experiencing a decrease in income due to the COVID-19 pandemic was associated with unmet child dental care (relative risk, 1.77;95% confidence interval, 1.08 to 2.88). CONCLUSIONS: In this sample, 3 times as many households reported unmet dental care for a child compared with unmet medical care. Unmet child dental care was more common in households where pandemic-related job or income loss occurred. PRACTICAL IMPLICATIONS: If unmet dental care continues as a result of the COVID-19 pandemic, nontraditional strategies for delivering dental care can be considered to improve access to dental care for children, such as teledentistry and oral health prevention services in primary care settings.

Physiologic and biochemical rationale for treating COVID-19 patients with hyperbaric oxygen

The SARS-Cov-2 (COVID-19) pandemic remains a major worldwide public health issue. Initially, improved supportive and anti-inflammatory intervention, often employing known drugs or technologies, provided measurable improvement in management. We have recently seen advances in specific therapeutic interventions and in vaccines. Nevertheless, it will be months before most of the world's population can be vaccinated to achieve herd immunity. In the interim, hyperbaric oxygen (HBO2) treatment offers several potentially beneficial therapeutic effects. Three small published series, one with a propensity-score-matched control group, have demonstrated safety and initial efficacy. Additional anecdotal reports are consistent with these publications. HBO2 delivers oxygen in extreme conditions of hypoxemia and tissue hypoxia, even in the presence of lung pathology. It provides anti-inflammatory and anti-pro inflammatory effects likely to ameliorate the overexuberant immune response common to COVID-19. Unlike steroids, it exerts these effects without immune suppression. One study suggests HBO(2 )may reduce the hypercoagulability seen in COVID patients. Also, hyperbaric oxygen offers a likely successful intervention to address the oxygen debt expected to arise from a prolonged period of hypoxemia and tissue hypoxia. To date, 11 studies designed to investigate the impact of HBO2 on patients infected with SARS-Cov-2 have been posted on clinicaltrials.gov . This paper describes the promising physiologic and biochemical effects of hyperbaric oxygen in COVID-19 and potentially in other disorders with similar pathologic mechanisms.

Mobilizing the streets: the role of food vendors in urban life

This paper introduces a special issue on food vending in the city. It contextualizes a collection of papers on street food and markets across time and global space that authors submitted before the 2020 pandemic. Focusing specifically on the mobilization of urban space for food provisioning and microenterprise, we theorize markets beyond the singular narrative of capital accumulation. Given the particular moment of its publication–which comes almost one year after the World Health Organization declared the novel coronavirus to be a pandemic in March 2020–our introduction probes the impact of COVID-19 on food vendors as well as on the cities that sustain them. Drawing on examples from cities such as New Delhi, New York City, Los Angeles and beyond, we comment on how the pandemic has unleashed threats to livelihoods and liveliness, and we also draw attention to the possibility of new social and economic opportunities in this moment of crisis, including innovative uses of urban space. © 2021 Association for the Study of Food and Society.

EVDHM-ARIMA-Based Time Series Forecasting Model and Its Application for COVID-19 Cases

The time-series forecasting makes a substantial contribution in timely decision-making. In this article, a recently developed eigenvalue decomposition of Hankel matrix (EVDHM) along with the autoregressive integrated moving average (ARIMA) is applied to develop a forecasting model for nonstationary time series. The Phillips-Perron test (PPT) is used to define the nonstationarity of time series. EVDHM is applied over a time series to decompose it into respective subcomponents and reduce the nonstationarity. ARIMA-based model is designed to forecast the future values for each subcomponent. The forecast values of each subcomponent are added to get the final output values. The optimized value of ARIMA parameters for each subcomponent is obtained using a genetic algorithm (GA) for minimum values of Akaike information criterion (AIC). Model performance is evaluated by estimating the future values of daily new cases of the recent pandemic disease COVID-19 for India, USA, and Brazil. The high efficacy of the proposed method is convinced with the results.

Integrating Metamaterial Antenna Node and LiFi for Privacy Preserving Intelligent COVID-19 Hospital Patient Management.

Light fidelity (LiFi) and wireless fidelity (WiFi) can be applied with the same network under the different constraints, which is suitable for COVID-19 surveillance in hospitals. The LiFi network is a high-capacity and security platform. A COVID-19 surveillance system using LiFi is proposed, which consists of two switching modes: communication and surveillance. Firstly, the communication targets are to accommodate the electromagnetic interference (EMI) immunity and high-capacity and security data transmission, where secondly the COVID-19 surveillance can be applied. In operation, the up and downlink system uses a metamaterial antenna embedded by Mach Zehnder interferometer (MZI). An antenna consists of silver bars embedded at the microring center with two-phase modulators at its sides. The entangled source namely a dark soliton is applied to form the transmission, where the information security based on quantum cryptography can be managed. By using the suitable parameters, the whispering gallery modes (WGMs) are generated and the up and downlink nodes are formed. The input information is multiplexed with time to form the multiplexed signals, where the big data transmission (40 Pbit  s - 1 ) can be employed. By using the surveillance mode, the plasmonic antenna can be applied for temperature and electric force sensors, which can offer the disinfectant spray and temperature sensor for COVID-19 applications. The optimum plasma force sensitivity is 0.16 N kg-1 mW-1. The center frequencies of 191.48 THz and 199.41 THz are obtained for uplink and downlink antennas, respectively. The optimum temperature sensitivity is 0.05 rads-1 °C-1. In conclusion, the novelty of proposed work is that the integrated sensor circuits are employed for COVID-19 surveillance in the hospital. The fuzzy-based system is designed for critical patient monitoring alert using this surveillance and management inside the hospital for COVID-19 patients.

Biomarker profile in pediatric inflammatory multisystem syndrome temporarily associated with SARS-CoV-2 (PIMS-TS)/multisystem inflammatory syndrome in children (MIS-C)

Pediatric Inflammatory Multisystem Syndrome temporarily associated with SARS-CoV-2 (P1MS-TS) or Multisystem Inflammatory Syndrome in Children (MIS-C) is a post COVID-19 multisystem inflammatory syndrome in children and adolescents <21 years of age. It is slowly emerging in India with clinical features overlapping with Kawasaki Disease (KD) and Toxic Shock Syndrome (TSS). Ten P1MS-TS cases admitted in a pediatric hospital between July and Sept 2020 were compared with 19 Kawasaki Disease (KD) patients' data. The median age of PIMS-TS was 6 years (older to KD), 80% were males. PMS-TS cases had high inflammatory markers: CRP, ferritin, interleukin (IL)-6. Other distinct features were lymphopenia, hypoalbuminemia, and hyponatremia. Serial measurements of CRP showed high baseline values with subsequent decrease. NT-Pro BNP level was extremely elevated;suggestive of cardiac injury. All patients recovered. Laboratory features of P1MS-TS present a unique pattern of intense inflammation, and cardiac involvement that is different from features of pre COVID-19 KD. CRP remains a useful, inexpensive marker for P1MS-TS diagnosis and clinical progression.

Faculties perception on anatomy teaching and assessment in lockdown and post-lockdown new normal phase

Introduction: For last five-six months in the Corona Virus Disease (COVID-19) lockdown period the Phase 1 MBBS students were being taught Anatomy theory as well as demonstration topics in online mode. Faculties were new to the mode initially, but gradually they coped up for online teaching. Now, in coming near future, institutes will resume with physical class activities and examinations will be held in departments;in the 'new normal period' even when the COVID cases are increasing day-by-day. Aim: This study was an endeavour to explore faculties' perception in Anatomy teaching and assessment in online teaching and side by side their opinion for planning to resume class and assessment in new normal phase. Materials and Methods: For this amongst the faculties of Anatomy of West Bengal, posted in 17 different medical teaching institutes;included in the Whatsapp group of Anatomical Society of India West Bengal (WB) Chapter;this cross-sectional study was carried on by an online survey using a pretested predesigned structured questionnaire upon 14 questions regarding their perception of online class-cum-assessments as practiced as well as their perception for future post-unlock class sessions and assessment methods;assuring anonymity;with encouragement and support from Anatomical Society of India WB chapter. Out of total 199 faculties 163 responded in time and their responses was tabulated. Results: From the response of 163 faculties, it came out that all faculties taught 'abdomen', 'head neck', 'neuroanatomy' parts as well as some parts of histology and embryology. Google classroom was most favoured teaching platform followed by Zoom meeting application. Majority (84.6%) of the faculties used to take lecture classes by sharing Power Point Presentation (PPT) during class hours;and 46% used to share the prerecorded demonstration video of the parts. Only 5% of them felt that by this mode full competency could be achieved for the students. Question sharing followed by answer writing-scan-mail was the most favoured (88.9%) mode of theory assessments;although 57% faculties used Multiple Choice Questions (MCQs) for assessment. In the 'new-normal phase' when the college and class will resume, faculties like to have demonstration classes with 'mini-group' and lecture topics to be covered solely in online mode. For theory assessment MCQs was mostly opted (63.8%) supplemented by camera-observed Objective Structured Practical Examination (OSPE) in the practical portion (50.3%). Conclusion: This study not only provides the experience shared by faculties in conducting the online teaching of Anatomy in the lockdown phases, but also provides insight in planning of the classes and examinations in the post-lockdown COVID-19 times which can be presented as recommendation to the university, which is yet to plan out the examination in 'new normal' era.