Associations between SARS-CoV-2 Infection or COVID-19 Vaccination and Human Milk Composition: A Multi-Omics Approach (preprint)

The risk of contracting SARS-CoV-2 via human milk-feeding is virtually non-existent. Adverse effects of COVID-19 vaccination for lactating individuals are not different from the general population, and no evidence has been found that their infants exhibit adverse effects. Yet, there remains substantial hesitation among this population globally regarding the safety of these vaccines. Herein we aimed to determine if compositional changes in milk occur following infection or vaccination, including any evidence of vaccine components. Using an extensive multi-omics approach, we found that compared to unvaccinated individuals SARS-CoV-2 infection was associated with significant compositional differences in 67 proteins, 385 lipids, and 13 metabolites. In contrast, COVID-19 vaccination was not associated with any changes in lipids or metabolites, although it was associated with changes in 13 or fewer proteins. Compositional changes in milk differed by vaccine. Changes following vaccination were greatest after 1-6 hours for the mRNA-based Moderna vaccine (8 changed proteins), 3 days for the mRNA-based Pfizer (4 changed proteins), and adenovirus-based Johnson and Johnson (13 changed proteins) vaccines. Proteins that changed after both natural infection and Johnson and Johnson vaccine were associated mainly with systemic inflammatory responses. In addition, no vaccine components were detected in any milk sample. Together, our data provide evidence of only minimal changes in milk composition due to COVID-19 vaccination, with much greater changes after natural SARS-CoV-2 infection.

Avascular necrosis in pediatric mandibular distraction - Report of a rare complication with a review on the pathogenic mechanism and management strategies

Avascular osseo-necrosis is one of the rare complications that has never been reported in pediatric mandibular distraction. However extensive periosteal stripping, developing tooth buds and aberrations related to the inferior alveolar canal in malformed syndromic mandible may lead to compromised vascularity to the osteotomised segments leading to avascular necrosis after monofocal mandibular distraction. The aim of the current case report is to describe this rare complication after pediatric MMDO and discuss in detail the possible etio-pathologic mechanisms and provide an insight for the management strategies.Copyright © 2021 The Authors

Interpreting Kerala's COVID-19 numbers

Through a series of data visualisations, the authors attempt to describe Kerala's COVID-19 trajectory, the state's policy response and how to assess its pandemic performance. Using demographic, economic, social (particularly public health) data, the authors provide context on the vulnerability of the state to outbreaks, show how to use comparative indicators, and account for district-level variation and reporting errors. Finally, the authors examine what has changed in the consequent waves of the pandemic and discuss the enduring strengths of the "Kerala model".

A web survey to assess the perceived mental healthcare among Medical Imaging Professionals during COVID-19 pandemic (preprint)

Importance: Medical Imaging Professionals (MIP’s) providing imaging services exposed to coronavirus disease 2019 (COVID-19) could be psychologically stressed.Objective: To assess the magnitude of the perceived mental health outcomes among MIP’s providing imaging services to patients exposed to COVID-19. We examined the psychological stress, depression and anxiety, experienced by MIP’s in the midst of the outbreak. Background: During the first week of March,2020 the surge of coronavirus disease (COVID-19) cases reached all over the globe with more than 150,000 cases. Healthcare national and international authorities have already initiated awareness and lockdown activities. Design, Settings, and Participants: This cross-sectional, web survey-based study collected demographic data and mental health measurements from 250 MIP’s from April 29, 2020, to May 15, 2020. MIP’s working during the pandemic in hospitals for patients with COVID-19 were eligible. An online sample of MIPs was successfully recruited via the authors' networks in India using data collection tool – write google forms. A DASS21 online questionnaire was completed by the participants and then their mental health was assessed.Results: Of 400 invited MIP’s, 314 (78.5%) participated in the study; and 187 (59.5%)were included as per inclusion criteria. Hundred and three (55.08%) participants screened positive for depression, 105 (56.14%) for anxiety, and 80 (42.78%) for stress. However, 25 (13.36%), 18 (9.62%) and 16 (8.55%) screened positive for extremely severe for depression, anxiety and stress respectively.Conclusion and Relevance: In this web survey of MIP’s during COVID-19 pandemic, participants reported experiencing high rates of psychological depression, anxiety and stress, especially frontline MIP’s directly engaged in the imaging procedures for patients with COVID-19. 

Knowledge and understanding among medical imaging professionals in India during the rapid rise of the covid-19 pandemic.

During the first week of March,2020 the surge of coronavirus disease (COVID-19) cases reached all over the globe with more than 100,000 cases. Healthcare national and international authorities have already initiated awareness and lockdown activities. A poor understanding of the disease among medical imaging professionals (MIPs) may result in rapid spread of infection. This study aimed to investigate the knowledge and understanding of MIPs about COVID-19. A cross-sectional, web-based study was conducted among MIPs about COVID- 19 during the fourth week of March 2020. An online sample of MIPs was successfully recruited via the authors' networks in India using data collection tool - write google forms. A self-developed online KAP questionnaire was completed by the participants. The knowledge and understanding questionnaire consisted questions regarding the clinical characteristics and transmission routes of COVID-19. Assessment on practices towards COVID-19 included questions on techniques while imaging against COVID-19 suspected patients. Of 700 participants, a total of 550 MIPs completed the survey (response rate: 78.57%); 56.7% were males, 85.4.1% were aged 17-26 years, and most were undergraduates (77.6%) and postgraduates (17.1%). Regarding COVID-19, most of the participants answered correctly (95.5%) on symptoms, (84.4%) time interval for visible symptoms, (98.0%) transmission and (44%) airborne transmission respectively. A significant proportion of MIPs (36.4%) had poor knowledge about wearing multiple masks as an effective measure against coronavirus infection. Most of the respondents (48.5%) incorrectly considered X-ray as the reliable method of diagnosis for suspected COVID-19 patients. 44.6% of the respondents lacked knowledge about the steps involved in hand washing technique which is one of the most important safety practice methods in medical imaging to prevent spread of infection. Factors such as age and occupation were associated with inadequate knowledge and poor perception of COVID-19. As the current global threat of COVID-19 continues to emerge, it is crucial and critical to improve the knowledge and understanding of MIPs. Educational videos and live webinars are urgently needed to reach MIPs and further detailed studies are the need of the hour.