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The present study was conducted to compare the performance of patient self-collected oral swab (OS) with healthcare worker (HCW)-collected nasopharyngeal swab (NPS) for SARS-CoV-2 detection by reverse transcription polymerase chain reaction (RT-PCR) in real-world setting. Paired OS and NPS were collected from 485 consecutive individuals presenting with symptoms of coronavirus disease-19 (COVID-19) or asymptomatic contacts of COVID-19 cases. Both specimens were processed for RT-PCR and cycle threshold (Ct) value for each test was obtained. Positive percent agreement (PPA), negative percent agreement (NPA), overall percent agreement (OPA) and kappa were calculated for OS RT-PCR compared with NPS RT-PCR as reference. A total of 116/485 (23.9%) participants were positive by NPS RT-PCR. OS had PPA of 71.6%, NPA of 98.8%, OPA of 92.4% and kappa of 0.771. Almost all participants (483/485, 99.6%) reported OS as a convenient and comfortable sample for SARS-CoV-2 testing over NPS. All participants with Ct values25 and majority (90.8%) with Ct values30 were detected by OS. To conclude, OS self-sampling was preferred in comparison with NPS due the ease and comfort during collection. The performance of OS RT-PCR for SARS-CoV-2 detection, however, was sub-optimal in comparison with NPS RT-PCR.

Background The currently available various methods of estimation of total iron binding capacity (TIBC) show marked variation in reference range. Although serum transferrin (TF) level is a sensitive indicator of iron status, its measurement requires immunoassay equipment which may not be available in many routine biochemistry laboratories. So, this study was planned to find the most appropriate method to estimate TIBC. Objectives This study aimed to compare different methods of TIBC estimation and to corelate the TIBC values obtained by different methods with serum TF concentration. Material and Methods This analytical cross-sectional study was performed in the clinical chemistry laboratory of the Biochemistry Department of Medical College Baroda & SSG Hospital, Vadodara, Gujarat, on 250 leftover serum samples destined to be discarded. In all these samples, serum TIBC was estimated by direct method, indirect method, as well as calculated method (iron + unsaturated iron binding capacity [UIBC]) along with the measurement of serum TF level. Statistical Analysis Among the different methods, repeated analysis of variance (ANOVA) analysis and Bland–Altman plot were used to find out significance of difference. Correlation coefficients were found between different methods of TIBC estimation and serum TF levels. Results The means of TIBC by calculated, indirect, and direct methods were 344.51, 342.23, and 378.24 µg/dL, respectively. The mean of serum TF was 295.3 mg/dL. There was statistically significant difference between TIBC by direct and indirect methods and between direct and calculated methods. There was a strong positive correlation between TIBC by direct method and serum TF (r = 0.888, p Conclusion Among different methods of estimation of TIBC, direct method is more reliable in reference to serum TF levels.

Key Points HMB is associated with rare and common variants in genes related to anemias and bleeding disorders.These are the first exome-sequencing results from patients with HMB, as well as their comparison with control exomes., Visual Abstract, Adolescents with low von Willebrand factor (VWF) levels and heavy menstrual bleeding (HMB) experience significant morbidity. There is a need to better characterize these patients genetically and improve our understanding of the pathophysiology of bleeding. We performed whole-exome sequencing on 86 postmenarchal patients diagnosed with low VWF levels (30-50 IU/dL) and HMB and compared them with 660 in-house controls. We compared the number of rare stop-gain/stop-loss and rare ClinVar “pathogenic” variants between cases and controls, as well as performed gene burden and gene-set burden analyses. We found an enrichment in cases of rare stop-gain/stop-loss variants in genes involved in bleeding disorders and an enrichment of rare ClinVar “pathogenic” variants in genes involved in anemias. The 2 most significant genes in the gene burden analysis, CFB and DNASE2, are associated with atypical hemolytic uremia and severe anemia, respectively. VWF also surpassed exome-wide significance in the gene burden analysis (P = 7.31 × 10−6). Gene-set burden analysis revealed an enrichment of rare nonsynonymous variants in cases in several hematologically relevant pathways. Further, common variants in FERMT2, a gene involved in the regulation of hemostasis and angiogenesis, surpassed genome-wide significance. We demonstrate that adolescents with HMB and low VWF have an excess of rare nonsynonymous and pathogenic variants in genes involved in bleeding disorders and anemia. Variants of variable penetrance in these genes may contribute to the spectrum of phenotypes observed in patients with HMB and could partially explain the bleeding phenotype. By identifying patients with HMB who possess these variants, we may be able to improve risk stratification and patient outcomes.

This research examines the perception of work stress among primary school teachers in the Wellington region. Specifically, it focuses on the way teachers perceive work stress, the contributing factors and the coping strategies employed. Interpretative phenomenological analysis is the qualitative approach and methodology chosen to examine the way teachers make sense of their stress experiences. The educational sector in New Zealand has undergone enormous legislative and organisational change and in the recent past there have been nationwide primary school teacher strikes. While research on teacher stress in New Zealand in relation to the 1989 major reforms has been published, there has been little recent qualitative research on work stress in primary school teachers. This study shows that these teachers experience moderate to high levels of stress because of work overload, the multiplicity of sources of stress, the emotional demands of the role and the frustration and constraints they face in role performance. Even so, these teachers derive satisfaction from the core job of teaching and utilise positive coping strategies to manage their stress and work demands, with most of them intending to stay in the role. However, the sustainability of the role of teaching is a concern, as societal misperceptions about teaching and lack of respect for them pose challenges for those continuing in the profession long term. This study contributes to the base literature on teacher stress in the New Zealand context and offers recommendations for supporting the well-being of primary school teachers.

Screen viewing time is the total time spent by a child on any digital/electronic device. The objective of the present study was to determine the incidence and predictors of excessive screen viewing time in children in Ujjain, India. This cross-sectional, community-based study was conducted through house-to-house survey by using the three-stage cluster sampling method in 36 urban wards and 36 villages of Ujjain district, India. Excessive screen viewing time was defined as screen viewing for > 2 h/day. The prevalence of excessive screen viewing time was 17.83%. Risk factors identified using the multivariate logistic regression model were: age (OR: 1.5, P < 0.001); mobile phone use before bedtime (OR: 3.17, P = 0.008); parents’ perception about the child habituated to screen (OR: 14.03, P < 0.001); television in bedroom (OR: 48.69, P < 0.001); morning mobile screen viewing time (OR: 9.27, P < 0.001); not reading books other than textbooks (OR: 9.71, P < 0.001); and lack of outdoor play for >2 h (OR: 4.20, P < 0.001). Presence of eye pain was a protective factor for excessive screen viewing time (OR: 0.12, P = 0.011). The study identified multiple modifiable risk factors for excessive screen viewing time.

Screen viewing time is the total time spent by a child on any digital/electronic device. The objective of the present study was to determine the prevalence and predictors of excessive screen viewing time in children in Ujjain, India. This cross-sectional, community-based study was conducted through a house-to-house survey using the three-stage cluster sampling method in 36 urban wards and 36 villages of Ujjain District, India. Excessive screen viewing time was defined as screen viewing for >2 h/day. The prevalence of excessive screen viewing time was 18%. Risk factors identified using the multivariate logistic regression model were age (OR: 1.63, p < 0.001); mobile phone use before bedtime (OR: 3.35, p = 0.004); parents’ perception about the child’s habituation to screen time (OR: 8.46, p < 0.001); television in the bedroom (OR: 35.91, p < 0.001); morning mobile screen viewing time (OR: 6.40, p < 0.001); not reading books other than textbooks (OR: 6.45, p < 0.001); and lack of outdoor play for >2 h (OR: 5.17, p < 0.001). The presence of eye pain was a protective factor for excessive screen viewing time (OR: 0.13, p = 0.012). This study identified multiple modifiable risk factors for excessive screen viewing time.

Online retailing is a global trend which is rapidly gaining momentum in India. The study aims to estimate the challenges and opportunities of online retail business in the Indian market. A SWOT analysis has been performed from the assessment of literature review. The growing number of internet users in India provides a great opportunity foronline retail market. With advent of various payment methods like net banking, mobile apps, wallet payments systems, the transaction procedures have easen up which lead to increase use of online buying channels. Cash on delivery has also entrusted customers. The key challenges are to maintain the privacy of customer personal and financial data, to have smooth logistics network, to improve reach of online market to rural customers, handling fake websites etc. Recommendations are made at the end suggesting that it is paramount for a large consumer market like India to put an effective framework which can help in leveraging the opportunities generated from online retail market space. Keywords: Online retail industry, Challenges, Opportunities, SWOT, Online retail market.

Introduction Poly(methyl methacrylate) is widely used as denture base material due its better physical properties, ease to fabricate, and repair. Despite being the material of choice for the denture fabrication, dentures made from poly(methyl methacrylate) may exhibit dimensional changes due to volumetric shrinkage. This further affects the retention of the denture. Various methods have been used to overcome this problem. One such method is the use of injection molding technique. So, a study was planned to evaluate the efficacy of dentures processed by injection molding technique in reducing the volumetric shrinkage. Objective To evaluate and compare the dimensional accuracy of poly(methyl methacrylate) resin processed by conventional and injection molding technique. Materials and Methods A total of 90 samples were made. Half of the samples (45) were fabricated by compression molding and half (45) by injection molding technique. Dimensional change was studied at three equidistant points in posterior region with the help of digitized travelling microscope. Statistical analysis was done using student’s t-test. Result Dimensional accuracy of injection molded poly(methyl methacrylate) resin was greater than that of compression molded poly(methyl methacrylate).

Gallbladder specimens are ditzel in surgical pathology and opportunistic diseases like cryptosporidiosis where they are easy to miss. We describe three cases of gallbladders with mucosal papillary hyperplasia with acute and chronic inflammation, all of which revealed cryptosporidiosis on complete histological evaluation. The patients were found to be HIV positive on further chart review. In the absence of clinical history, which is often the case with gallbladder specimens, the finding of mucosal papillary hyperplasia can be a reactive response to an infectious cause and can serve as a helpful clue to look for organisms with patience at higher magnification.

Increased awareness of von Willebrand Disease (VWD) has led to more frequent diagnostic laboratory testing, which insurers often dictate be performed at a facility with off-site laboratory processing, instead of a coagulation facility with onsite processing. Off-site processing is more prone to preanalytical variables causing falsely low levels of von Willebrand Factor (VWF) due to the additional transport required. Our aim was to determine the percentage of discordance between off-site and onsite specimen processing for VWD in this multicenter, retrospective study. We enrolled females aged 12 to 50 years who had off-site specimen processing for VWF assays, and repeat testing performed at a consulting institution with onsite coagulation phlebotomy and processing. A total of 263 females from 17 institutions were included in the analysis. There were 251 subjects with both off-site and onsite VWF antigen (VWF:Ag) processing with 96 (38IU/dL) being low off-site and 56 (22IU/dL) low onsite; 223 subjects had VWF ristocetin co-factor (VWF:RCo), 122 (55IU/dL) were low off-site and 71 (32IU/dL) were low onsite. Similarly, 229 subjects had a Factor VIII (FVIII) assay, and 67 (29IU/dL) were low off-site with less than half, 29 (13IU/dL) confirmed low with onsite processing. Higher proportions of patients demonstrated low VWF:Ag, VWF:RCo, and/or FVIII with off-site processing compared to onsite (McNemar's test P-value

Introduction: The synthesis of copper soap (laurate), and its complex with 2-amino 6- methylbenzothiazole and their elemental and spectral analysis have been done for comparative studies using IR, NMR, Mass and ESR spectra. Methods: The fungicidal activities, with reference to Alternaria alternata and Aspergillus niger at different concentrations by P.D.A. technique were also studied. Results and Conclusion: The present research work comprises detailed thermal analysis using TGA technique to determine their kinetic and thermodynamic parameters by applying various equations like Freeman Carroll, Coats-Redfern equation, Horowitz-Metzger equation, Broido equation, Piloyan–Novikova equation.

Heavy menstrual bleeding is common in adolescents. The frequency and predictors of bleeding disorders in adolescents, especially with anovulatory bleeding, are unknown. Adolescents referred for heavy menstrual bleeding underwent an evaluation of menstrual bleeding patterns, and bleeding disorders determined a priori. The primary outcome was the diagnosis of a bleeding disorder. Two groups were compared: anovulatory and ovulatory bleeding. Multivariable logistic regression analysis of baseline characteristics and predictors was performed. Kaplan Meier curves were constructed for the time from the first bleed to bleeding disorder diagnosis. In 200 adolescents, a bleeding disorder was diagnosed in 33% (n=67): low von Willebrand factor levels in 16%, von Willebrand disease in 11%, and qualitative platelet dysfunction in 4.5%. The prevalence of bleeding disorder was similar between ovulatory and anovulatory groups (31% vs. 36%; P=0.45). Predictors of bleeding disorder included: younger age at first bleed (OR: 0.83; 95%CI: 0.73, 0.96), Hispanic ethnicity (OR: 2.48; 95%CI: 1.13, 5.05), non-presentation to emergency department for heavy bleeding (OR: 0.14; 95%CI: 0.05, 0.38), and International Society on Thrombosis and Haemostasis (ISTH) Bleeding Assessment Tool score ≥4 (OR: 8.27; 95%CI: 2.60, 26.44). Time from onset of the first bleed to diagnosis was two years in the anovulatory, and six years in the ovulatory cohort (log-rank test, P

We evaluated the performance of oral swab specimen both health-care worker (HCW) collected and self-collected for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) detection with rapid antigen test (RAT) as compared to reverse transcriptase polymerase chain reaction (RT-PCR). Of the 529 participants enrolled, 121 (22.8%) were RT-PCR positive. Among the RT-PCR positives, 62 (51.2%) were RAT positive using oral swab. When compared with RT-PCR, RAT with oral swab had sensitivity and specificity of 63.3 and 96.8% respectively among symptomatic individuals. No statistically significant difference was observed in RAT positivity with HCW collection and self-collection, p = 0.606. Ct values were significantly lower in RT-PCR and RAT positive samples (ORF gene: 18.85 ± 4.36; E gene: 18.72 ± 4.84) as compared to RT-PCR positive and RAT negative samples (ORF gene: 26.98 ± 7.09; E gene: 26.97 ± 7.07), p

Different forms of face coverings used by the public, like masks, gamchas, shields etc., are now widely recommended as source control during the COVID-19 pandemic. Significant debates about the general community use of face masks for guard against coronavirus disease 2019 (COVID-19) stemmed from differing views expressed by health authorities. We believe that the stigmatization and misconceptions about the use of face masks may delay the containment of the COVID-19 pandemic. The leading narrative driving policy, has observed face coverings as a medical intervention and evaluated its efficiency from an infection control perspective. We recommend that public officials and governments strongly encourage extensive use of face masks in public including the use of appropriate regulation. Face masks should not only measure as medical tools but as a community practice to reduce transmission of respiratory infections such as COVID-19.

The Citizenship Amendment Act 2019 and the National Register of Citizens in India are perceived as reflective of a religious classification in grant and continuance of Indian citizenship. The study aimed to discuss the future effects of the amended Citizenship Act 2019 and suggest alternatives to accommodate India's constitutional ethos. A considerable fraction of the Indian citizenry was discorded with this Act because Article 14 of the Indian Constitution prohibits discrimination based on religion, among other grounds. On the other hand, the state's stance asserted that the law aims to protect the persecuted religious minorities from other states. This study dealt with the nuances and intricacies of the problem to explicate viable solutions by an in-depth analysis of the issue in an unprejudiced manner where it used a combined doctrinal and empirical research to assess the perspectives on the policy in the Global South from the Indian experience. The findings reflected that while a majority of the provisions in the Act can be justified based on constitutional parameters, its few provisions are unconstitutional. In summary, even after juxtaposing all the justifications of the Act against the allegations, a considerable portion of the Act remains unconstitutional, and it needs to be revisited based on constitutional parameters.

Cold storage of blood for 5 to 6 weeks has been shown to impair endothelial function after transfusion and has been associated with measures of end-organ dysfunction. Although the products of hemolysis, such as cell-free plasma hemoglobin, arginase, heme, and iron, in part mediate these effects, a complete analysis of transfused metabolites that may affect organ function has not been evaluated to date. Blood stored for either 5 or 42 days was collected from 18 healthy autologous volunteers, prior to and after autologous transfusion into the forearm circulation, followed by metabolomics analyses. Significant metabolic changes were observed in the plasma levels of hemolytic markers, oxidized purines, plasticizers, and oxidized lipids in recipients of blood stored for 42 days, compared with 5 days. Notably, transfusion of day 42 red blood cells (RBCs) increased circulating levels of plasticizers (diethylhexyl phthalate and derivatives) by up to 18-fold. Similarly, transfusion of day 42 blood significantly increased circulating levels of proinflammatory oxylipins, including prostaglandins, hydroxyeicosatrienoic acids (HETEs), and dihydroxyoctadecenoic acids. Oxylipins were the most significantly increasing metabolites (for 9-HETE: up to ∼41-fold, P = 3.7e-06) in day 42 supernatants. Measurements of arginine metabolism confirmed an increase in arginase activity at the expense of nitric oxide synthesis capacity in the bloodstream of recipients of day 42 blood, which correlated with measurements of hemodynamics. Metabolic changes in stored RBC supernatants impact the plasma metabolome of healthy transfusion recipients, with observed increases in plasticizers, as well as vasoactive, pro-oxidative, proinflammatory, and immunomodulatory metabolites after 42 days of storage.

Background One of the most common rare inherited bleeding disorders, congenital factor VII (FVII) deficiency typically has a milder bleeding phenotype than other rare bleeding disorders. Categorizing severity in terms of factor activity associated with hemophilia (severe

Isolated brain metastasis (IBM) as a recurrence of primary esophageal adenocarcinoma (AC) has rarely been reported in the literature and typically manifests within a short period of time after diagnosing the primary lesion. We present here an unusual case of an IBM presenting nearly 5 years after neoadjuvant chemoradiation therapy and surgical resection of a primary distal esophageal tumor with no interval evidence of recurrence. A 53-year-old man presented to our gastroenterology clinic with progressive dysphagia and weight loss. On upper endoscopy, the patient was found to have a large obstructing distal esophageal mass with biopsies reported as moderately differentiated AC. Subsequent computed tomography (CT) chest/abdomen/pelvis (C/A/P) and magnetic resource imaging (MRI) brain were negative for any distant metastases. The patient received preoperative chemotherapy and radiation therapy, followed by distal esophagectomy with findings of stage IIIB disease. He did well after surgery and was monitored closely by his oncologist with no evidence of recurrence on interval imaging or follow-up endoscopy. Several years after his diagnosis, however, the patient developed new neurologic symptoms, and an MRI brain revealed a solitary cerebellar lesion with surrounding edema concerning for metastatic disease. Positron emission tomography and CT C/A/P were negative for any other new lesions. The tumor was resected, and pathology was confirmed as metastatic AC of esophageal origin. To our knowledge, this is the first case of recurrent esophageal AC presenting as an isolated cerebellar lesion 5 years after treatment of the primary tumor.