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In a series of three letters, Pavithra describes to their unborn child what it's like to be pregnant. The first conveys the terror of carrying a new being into a violently homophobic and racist world. The second and third letters recall the desire and beauty that the unborn child sparks in them. In the fourth letter, Pavithra writes to Noor Momo, now six years old, reflecting on the realities of parenting amidst ongoing violence and the uncertainties of the COVID-19 pandemic. In this final letter, Pavithra invokes Noor's aunts: her sister Raksha, and her dear friends Kriti, Batool, Mabel, and Marie. The words Chitthi, Masi, Khala and Chyama refer to "mother"s sister" in Tamil, Hindi, Urdu, and Nepali, respectively. [ABSTRACT FROM AUTHOR]

The increased load of plastic in waste streams after the COVID-19 pandemic outbreak has increased the possibility of microplastics (MPs) contamination channelling through the rivers and infiltrating the aquatic ecosystems. MPs in packaged water, community-stored water, groundwater, and surface water of Kaveri River (KR), Thamirabarani River (TR), Adyar River (AR), and Cooum River (CR) in Tamil Nadu were therefore investigated about 2 years after the COVID-19 pandemic outbreak. Using μFTIR and μRaman spectroscopy, polyamide, polypropylene, polyethylene, ethylene vinyl alcohol copolymer resin, and polyvinyl chloride were identified as the primary polymer types. The average number of MPs was 2.15 ± 1.9 MP/L, 1.1 ± 0.99 MP/L, 5.25 ± 1.15 MP/L, and 4 ± 2.65 MP/L in KR, TR, AR, and CR, respectively, and 1.75 ± 1.26 MP/L in groundwater, and 2.33 ± 1.52 MP/L in community stored water. Only LDPE was detected in recycled plastic-made drinking water bottles. More than 50% of MPs were found to be of size less than 1 mm, with fibrous MPs being the prevalent type, and a notable prevalence of blue-coloured microplastics in all the sample types. The Pollution Load Index (PLI) was >1 in all the rivers. Toxicity rating based on the polymer risk index (PORI) categorized AR and TR at medium risk (category II), compared to KR and CR at considerable risk (category III). Overall pollution risk index (PRI) followed a decreasing trend with CR > AR > KR > TR of considerable to low-risk category. Ecological risk assessment indicates a negligible risk to freshwater biota, except for four sites in the middle and lower stretches of Adyar River (AR - 2, AR - 4) and upper and lower stretches of Cooum River (CR - 1, CR - 3), located adjacent to direct sewer outlets, and one location in the lower stretch of Kaveri River (KR - 9), known for fishing and tourist activities. [Display omitted] • Open burning is a potential source of microplastics in the Adyar and Cooum Rivers. • Major MP types in rivers, groundwater, community stored water, and packaged water - PA, PP, PE, and PVC. • PLI value indicates that the four rivers were polluted with MPs. • The pollution risk index indicates a low risk in Tamrabarani and a high risk in Cooum Rivers. • Trained in Ecological Risk in rivers based on RQ – Adyar > Cooum > Cauvery > Thamirabarani. [ABSTRACT FROM AUTHOR]

Several cities in the developing world, of which the capital city of India, New Delhi, is an example, often experience air quality in which pollutant levels go way above the levels considered hazardous for human health. To bring down the air quality to within permissible limits quickly, the measures typically taken involve shutting down certain high-polluting activities for some time to enable the air quality to recover temporarily. This paper presents a first-ever model based on artificial neural networks to forecast the extent of reduction in air quality parameters that can be achieved and the time period within which a change can be experienced when the source of the emissions is cut off temporarily. The model is based on the extensive data on the extent of reduction in air quality parameters that occurred during the lockdown that was imposed during the COVID-19 pandemic. The non-linear autoregressive exogenous network-based model chosen for the purpose employs the hour since stopping of emissions, relative humidity, wind speed, wind direction, and ambient temperature as input parameters to predict the rate of change of PM 2.5 with respect to the concentration at the start of the stopping of the emissions. Air quality data from a key monitoring station in New Delhi was used to develop the model. The model predicted the rate of drop in PM 2.5 with an R and MSE of 0.0044 and 0.9736, respectively, while training and 0.0095 and 0.9583 while testing. The model was then tested with data from 19 other stations in New Delhi, and accuracy of the model was found to be exceptionally accurate, with the correlation between the measured and the predicted PM 2.5 levels ranging from 0.74 to 0.94 and the MSE ranging from 0.0110 to 1.0746. Thus, the model can be employed to determine the number of hours of temporary stoppage of emissions required for the PM 2.5 concentration to reach safe levels. The methodology of development of the model can be extrapolated to construct models tailored for use in other parts of the world as well. • A novel ANN -based model is reported to predict rate of drop of PM 2.5 • Model has been trained on extensive dataset from the covid lockdown in Delhi. • Duration and efficacy of emergency measures to reduce emissions can be estimated. • The model uses easy-to-measure meteorological parameters as inputs. • Model has been validated for 19 stations of various land-use types in Delhi. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease 2019 (COVID-19) pandemic has posed an unprecedented challenge to the healthcare systems worldwide. This uncharted territory has changed the practices in modern healthcare delivery; this is particularly true in the case of minimally invasive surgery (MIS) where various changes are being adopted. This survey was conducted to determine the impact of the pandemic and the changes being adopted in the field of MIS, from a resource-limited developing country, India. Materials and Methods: The survey was carried out from 27 July to 22 August 2020, amongst MIS surgeons in India using an online questionnaire generated on Google Forms. Results: The survey was completed by 251 MIS surgeons nationwide. There was a proportional reduction of overall elective surgeries and MIS. Approximately 30% of the surgeons continued to use MIS, as during the pre-pandemic era. Pre-operative tests for COVID-19 (96.1%) and personal protective equipment (PPE, 66%–86%), including respirators (95.2%), are used uniformly across the nation. Almost half (43.1%) of the MIS surgeons are using ≥6 recommended intraoperative modifications in MIS to mitigate the COVID-19 transmission. Conclusion: MIS surgeons in India have adapted within a short time to the challenge of the pandemic by embracing pre-operative testing, PPE and new techniques/technologies to continue patient care. Innovations and low-cost indigenous customisations are the need of the hour for a developing country like India. Further studies are required to establish the true risk of viral transmission involved in MIS and the efficacies of the techniques/devices to reduce the spread of the virus. [ABSTRACT FROM AUTHOR]

All socioeconomic classes are impacted by the COVID-19 epidemic, with stress being one of the biggest symptoms causing indigestion, breathlessness, heart disease, obesity, and many more. The most commonly used selective serotonin reuptake inhibitors (SSRIs) drugs include, escitalopram, sertraline, paroxetine, and fluoxetine are provided by doctors. If the medicines are not taken in the recommended dosage, at the correct intervals, which can occasionally be fatal because persons with depression are susceptible to mood fluctuations. There are no appropriate ways to monitor high dosages in clinical laboratories, the requirement for simple, novel material with cutting-edge technology to do so is essential. Herein, we report the application of a single fluorescent probe, Tyrosine-GQDs for the detection of SSRI drugs. Upon addition of SSRI drugs into the Tyrosine-GQDs, the fluorescence emission intensity of Tyrosine-GQDs decreased due to the complex formation through H-bonding which is evidenced by the rise of new peaks in fluorescence spectra and lifetime measurements. The calculated detection limit proves that the designed nanoprobe is highly sensitive and selective towards escitalopram, sertraline, paroxetine, and fluoxetine are 0.13 × 10−6 M, 0.15 × 10−6 M, 0.07 × 10−6 M, and 0.07 × 10−6 M, respectively. A paper-based fluorescent sensor is fabricated using the designed probe which is efficient in the detection of the dosage of SSRI drugs. [Display omitted] • Tyrosine-GQDs are employed for the spectrophotometric detection of SSRI drugs. • The limit of detection for the SSRI drugs is quantified in sub-micromolar concentration. • The effect of interference shows that the complex formed between the Tyrosine-GQDs and drugs is highly stable. • The H-bond formation between the drugs and Tyrosine-GQDs dominates the mechanism responsible for the fluorescence quenching. • The fluorescent paper sensor is effective in determining the SSRI drugs. [ABSTRACT FROM AUTHOR]

Epidemiology of the US coronavirus disease 2019 (COVID-19) outbreak focuses on individuals' biology and behaviors, despite centrality of occupational environments in the viral spread. This demonstrates collusion between epidemiology and racial capitalism because it obscures structural influences, absolving industries of responsibility for worker safety. In an empirical example, we analyzed economic implications of race-based metrics widely used in occupational epidemiology. In the United States, White adults have better average lung function and worse hearing than Black adults. Impaired lung function and impaired hearing are both criteria for workers' compensation claims, which are ultimately paid by industry. Compensation for respiratory injury is determined using a race-specific algorithm. For hearing, there is no race adjustment. Selective use of race-specific algorithms for workers' compensation reduces industries' liability for worker health, illustrating racial capitalism operating within public health. Widespread and unexamined belief in inherent physiological inferiority of Black Americans perpetuates systems that limit industry payouts for workplace injuries. We see a parallel in the epidemiology of COVID-19 disparities. We tell stories of industries implicated in the outbreak and review how they exemplify racial capitalism. We call on public health professionals to critically evaluate who is served and neglected by data analysis and to center structural determinants of health in etiological evaluation. [ABSTRACT FROM AUTHOR]

The main aim of this study is to assist in the diagnosis of viral infection using RT-PCR, which helps in easy detection and rapid result of infection. RT-PCR is more sensitive and precise to the identification of viral infection than the traditional process. It is a gold standard technique that helps to diagnose viral infection in the laboratory. Using different labeled samples ensures simple identification when used in multiple formats. RTPCR viral nucleic acid testing was one of the fastest established methods of laboratory diagnosis. In a novel viral pandemic as COVID viral infection is an epidemic in the current situation. RT-PCR is helpful in the development dimension and the analysis aims to educate the scientist on the current state of viral infection. We explain both the benefits of using PCR and limitations. The PCR has provided major methodological advantages and improved patient outcomes. This might help in the detection of viral infection at a faster rate. [ABSTRACT FROM AUTHOR]

COVID-19, an epidemic viral disease which originated in Wuhan, China, has caused a major halt in the normal routine of people worldwide. It was declared as a public health emergency of international concern by the World Health Organisation. The novel corona virus has caused major challenges to the health professionals owing to its different speed of reaction and types of response around the world. Due to the characteristics of dental setting and treatment modalities, the dental professionals and the patients are at major risk of cross infection. Periodontists can be at high risk while performing aerosol generating procedures to asymptomatic patients, as saliva has been identified in saliva of infected patients. This review article aims to discuss the effect of COVID-19 on periodontal practise and future changes to be done in the COVID-19 era. [ABSTRACT FROM AUTHOR]

We sequenced ≈50% of coronavirus disease cases imported to Hong Kong during March-July 2021 and identified 70 cases caused by Delta variants of severe acute respiratory syndrome coronavirus 2. The genomic diversity detected in Hong Kong was similar to global diversity, suggesting travel hubs can play a substantial role in surveillance. [ABSTRACT FROM AUTHOR]

After its identification as a human pathogen in 2019, the novel coronavirus, SARS-CoV-2, has spread rapidly around the world. Health care workers worldwide have had the task of preparing and responding to the pandemic with little evolving data or guidelines. Regarding the protocols for our labor and delivery unit, we focused on applying the four pillars of biomedical ethics--beneficence, nonmaleficence, autonomy, and justice--while considering the women, their fetuses, their significant others and support persons, health care professionals and auxiliary staff, and society as a whole. We also considered the downstream effect of our decisions in labor and delivery on other disciplines of medicine, including pediatrics, anesthesiology, and critical care. This article focuses on how these prima facie principles helped guide our recommendations in this unprecedented time. [ABSTRACT FROM AUTHOR]

COVID-19 has impacted the healthcare system across the globe. The study will span three pandemic waves in 2020, 2021, and 2022. The goal is to learn how the pandemic affects antenatal care (ANC) and emergency delivery care for pregnant women in Tamil Nadu, India, and how medical services respond. The study employs counterfactual analysis to evaluate the causal impact of the pandemic. A feedforward in combination with a simple auto-regressive neural network (AR-Net) is used to predict the daily number of calls for ambulance services (CAS). Three categories of the daily CAS count between January 2016 and December 2022 are utilised. The total CAS includes all types of medical emergencies; the second group pertains to planned ANC for high-risk pregnant women and the third group comprises CAS from pregnant women for medical emergencies. The second wave's infection and mortality rates were up to six times higher than the first. The phases in wave-II, post-wave-II, wave-III, and post-wave-III experienced a significant increase in both total IFT (inter-facility transfer) and total non-IFT calls covering all emergencies relative to the counterfactual, as evidenced by reported effect sizes of 1 and a range of 0.65 to 0.85, respectively. This highlights overwhelmed health services. In Tamil Nadu, neither emergency prenatal care nor planned prenatal care was affected by the pandemic. In contrast, the increase in actual emergency-related IFT calls during wave-II, post-wave-II, wave-III, and post-wave-III was 62%, 160%, 141%, and 165%, respectively, relative to the counterfactual. During the same time periods, the mean daily CAS related to prenatal care increased by 47%, 51%, 38%, and 38%, respectively, compared to pre-pandemic levels. The expansion of ambulance services and increased awareness of these services during wave II and the ensuing phases of Covid-19 pandemic have enhanced emergency care delivery for all, including obstetric and neonatal cohorts. [ABSTRACT FROM AUTHOR]

Background: In the era of COVID-19, travel restrictions and social distancing measures have changed the landscape for device interrogations of pacemakers and defibrillators for rural Victorians. Previously, device checks were performed infrequently in large volume, face-to-face rural clinics by visiting cardiologists and technicians. Access to remote areas and social distancing restrictions have made these clinics unfeasible to operate. The Cardiac Society of Australia and New Zealand (CSANZ) and Heart Rhythm Society (HRS) COVID-19 consensus statements have suggested the utilisation of remote monitoring to minimise the potential spread of COVID-19 infections between clinicians and high-risk patients. A novel solution to this challenge was the implementation of a remote device interrogation (RI) service located in two kiosks at two rural pharmacies. This service was termed Remote Device Interrogation Kiosks (ReDInK).Aim: This cross-sectional observational study aimed to describe the set-up process, safety and efficacy of RI and customer satisfaction of the ReDInK program.Methods: Two-hundred-and-ninety-two (292) rurally located patients with implantable cardiac devices were identified via the cardiology department database. Of these, 101 (44%) were enrolled into the ReDInK program across two rurally located pharmacies between April and July 2020. RI was performed and download outcomes were reviewed. A customer satisfaction survey assessed attitudes towards the program and explored options of ongoing service application.Results: Of 101 patients enrolled into ReDInK, 96 (95%) resulted in satisfactory device checks. Four (4) individuals failed-to-attend and one individual experienced technical download issues. Of the 96 satisfactory device checks, three required in-person follow-up for reasons including battery replacement, lead repositioning and in-person programming. No adverse events were reported. A satisfaction telephone survey was conducted with 81 (83%) participants enrolled in ReDInK. Seventy-one (71) individuals (88%) of those surveyed expressed satisfaction and 73 (90%) labelled the process as efficiently conducted. Sixty-nine (69) (85%) participants felt reassured that this service was established during the pandemic. However 47 (58%) participants reported they would still feel comfortable to undergo in-person reviews despite social distancing recommendations.Conclusions: With the COVID-19 pandemic posing restrictions to social distancing and reducing unnecessary in-person interaction, the ReDInK program emerges as an efficacious and safe solution for patients in rural Victoria. The program's widely positive reception and successful conduction in rural Victoria invites further opportunity for a wider application of similar programs, expanding its role to metropolitan areas. [ABSTRACT FROM AUTHOR]

We describe an introduction of clade GH severe acute respiratory syndrome coronavirus 2 causing a fourth wave of coronavirus disease in Hong Kong. The virus has an ORF3a-Q57H mutation, causing truncation of ORF3b. This virus evades induction of cytokine, chemokine, and interferon-stimulated gene expression in primary human respiratory cells. [ABSTRACT FROM AUTHOR]

Key points In a multicenter point-prevalence study, we found that the rate of supportive care was high; among those receiving COVID-19 drug therapies, adverse reactions occurred in 12% of patients. Purpose There are currently no FDA-approved medications for the treatment of coronavirus disease 2019 (COVID-19). At the onset of the pandemic, off-label medication use was supported by limited or no clinical data. We sought to characterize experimental COVID-19 therapies and identify safety signals during this period. Methods We conducted a noninterventional, multicenter, point prevalence study of patients hospitalized with suspected/confirmed COVID-19. Clinical and treatment characteristics within a 24-hour window were evaluated in a random sample of up to 30 patients per site. The primary objective was to describe COVID-19–targeted therapies. The secondary objective was to describe adverse drug reactions (ADRs). Results A total of 352 patients treated for COVID-19 at 15 US hospitals From April 18 to May 8, 2020, were included in the study. Most patients were treated at academic medical centers (53.4%) or community hospitals (42.6%). Sixty-seven patients (19%) were receiving drug therapy in addition to supportive care. Drug therapies used included hydroxychloroquine (69%), remdesivir (10%), and interleukin-6 antagonists (9%). Five patients (7.5%) were receiving combination therapy. The rate of use of COVID-19–directed drug therapy was higher in patients with vs patients without a history of asthma (14.9% vs 7%, P = 0.037) and in patients enrolled in clinical trials (26.9% vs 3.2%, P < 0.001). Among those receiving drug therapy, 8 patients (12%) experienced an ADR, and ADRs were recognized at a higher rate in patients enrolled in clinical trials (62.5% vs 22%; odds ratio, 5.9; P = 0.028). Conclusion While we observed high rates of supportive care for patients with COVID-19, we also found that ADRs were common among patients receiving drug therapy, including those enrolled in clinical trials. Comprehensive systems are needed to identify and mitigate ADRs associated with experimental COVID-19 treatments. [ABSTRACT FROM AUTHOR]

The article reports that rapid and accurate diagnostic tests are essential for controlling the ongoing Covid-19 pandemic. Topics include examines that the current standard involves testing of nasopharyngeal swab specimens by quantitative reverse-transcriptase polymerase chain reaction to detect SARS-CoV-2; and examines that rigorous evaluation is needed to determine how saliva specimens compare with nasopharyngeal swab specimens with respect to sensitivity in detection of SARSCoV-2.

Newly emerging severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing coronavirus disease 2019 (COVID-19) pandemic has now spread across the globe in past few months while affecting 26 million people and leading to more than 0.85 million deaths as on 2nd September, 2020. Severity of SARS-CoV-2 infection increases in COVID-19 patients due to pre-existing health co-morbidities. This mini-review has focused on the three significant co-morbidities viz., heart disease, hypertension, and diabetes, which are posing high health concerns and increased mortality during this ongoing pandemic. The observed co-morbidities have been found to be associated with the increasing risk factors for SARS-CoV-2 infection and COVID-19 critical illness as well as to be associated positively with the worsening of the health condition of COVID-19 suffering individuals resulting in the high risk for mortality. SARS-CoV-2 enters host cell via angiotensin-converting enzyme 2 receptors. Regulation of crucial cardiovascular functions and metabolisms like blood pressure and sugar levels are being carried out by ACE2. This might be one of the reasons that contribute to the higher mortality in COVID-19 patients having co-morbidities. Clinical investigations have identified higher levels of creatinine, cardiac troponin I, alanine aminotransferase, NT-pro BNP, creatine kinase, D-dimer, aspartate aminotransferase and lactate dehydrogenase in patients who have succumbed to death from COVID-19 as compared to recovered individuals. More investigations are required to identify the modes behind increased mortality in COVID-19 patients having co-morbidities of heart disease, hypertension, and diabetes. This will enable us to design and develop suitable therapeutic strategies for reducing the mortality. More attention and critical care need to be paid to such high risk patients suffering from co-morbidities during COVID-19 pandemic. [ABSTRACT FROM AUTHOR]