Individual and group level risk factors in preventive health and panic buying behaviors during COVID-19 pandemic in India.

The present research explored individual and group level risk factors in preventive health and panic buying behaviors during the COVID-19 pandemic in India. Perceived susceptibility, perceived severity, COVID-19 anxiety, and personal identity were considered individual-level risk factors. Group based identities such as family, religious groups, and identification with one's nation were considered as group level risk factors. Standardized scales have been used to measure all the constructs under study. Data were collected electronically from 305 Indian respondents. Hierarchical regression analysis in SPSS Version 22 was used to test the hypotheses. Results showed that personal identity and identification with the nation predicted preventive health behavior. Panic buying behavior was predicted by the location of the respondents (containment versus non-containment zones), perceived severity, and one's personal identity. The interplay of individual and social factors is reflective of both individual and collective agencies in the adoption of preventive health behaviors, while only individual-level factors led to panic buying behavior. The findings of this study have implications for curbing, managing, and reinforcing desirable and non-desirable behavior during the present pandemic as well as in the future as well.

Risk perception, social distancing, and distress during COVID-19 pandemic: Exploring the role of online counseling and perceived social support.

The study explored the relationship between social distancing and distress along with risk factors of social distancing. Further, online counseling/mental health services and perceived social support were tested as possible moderators between social distancing and distress. Valid and reliable measures were used to collect the data from 300 Indian respondents. Process use of social networking platforms was found to significantly explain social distancing. Online counseling/mental health services and perceived social support moderated the relationship between social distancing and distress. Only 16% of the respondents used online mental health services during the study period. Lack of awareness and acceptance of these services were major barriers.

Quality of Life in the COVID-19 Pandemic in India: Exploring the Role of Individual and Group Variables.

The role of individual variables (COVID-19 anxiety, perceived susceptibility, perceived severity, optimistic bias and personal identity) as predictors of quality of life (QoL) during the novel coronavirus or COVID-19 pandemic is explored. Impact of group related variables (identification to family, religious group and nation) on QoL is also examined. Sample comprised 305 male and female Indian respondents, aged 18 to 78 years. Standardized measures have been utilised to assess the constructs. Results revealed that QoL was significantly influenced by individual variables (COVID-19 anxiety and personal identity) and group variables (identification with family and nation). The effect of COVID-19 anxiety and personal identity as individual variables is over and above that of demographic variables on QoL. Group variables (family and national identification) significantly impacted QoL over and above the individual variables. Findings would indeed, aid in the rehabilitation and assistance of people to live in COVID-19 crisis, and thereafter.

Depression, Anxiety and Stress Among Indians in Times of Covid-19 Lockdown.

Covid-19 has caused significant distress around the globe. Apart from the evident physical symptoms in infected cases, it has caused serious damage to public mental health. India, like other countries, implemented a nationwide lockdown to contain and curb the transmission of the virus. The current research is an attempt to explore psychological distress among people residing in India during the lockdown. Four hundred and three participants were asked to complete a questionnaire with questions around symptoms of depression, anxiety, stress, and family affluence. The results indicated that people who do not have enough supplies to sustain the lockdown were most affected, and family affluence was found to be negatively correlated with stress, anxiety, and depression. Among different professions, students and healthcare professionals were found to experience stress, anxiety, and depression more than others. Despite the current situation, stress, anxiety, and depression were found to be in normal ranges for mental health professionals highlighting their capabilities to remain normal in times of distress. Policymakers and other authorities may take the assistance of mental health professionals to help overcome psychological issues related to Covid-19.

Validation of an Algorithm to Identify Infective Endocarditis in People Who Inject Drugs.

INTRODUCTION: Infective endocarditis is associated with high morbidity and mortality. Currently, there is concern that the incidence of infective endocarditis associated with people who inject drugs (PWID) is increasing. However, it is difficult to monitor population-wide trends in PWID-associated infective endocarditis, as there is no International Statistical Classification of Diseases, 10th Revision (ICD-10) code for injection drug use. To address this barrier, we sought to develop a validated algorithm using ICD-10 discharge diagnosis codes. MATERIALS AND METHODS: We constructed a cohort of patients whose hospital discharge diagnosis included infective endocarditis. We reviewed 100 patients with incident infective endocarditis from 2014 to 2016 for their infective endocarditis and injection drug use status. We calculated the operating characteristics for algorithms constructed using permutations of ICD-10 codes associated with injection drug use. We repeated this analysis in a cohort of 100 patients with incident infective endocarditis from 2009 to 2011 to examine the temporal stability of the operating characteristics of each algorithm. RESULTS: We found that a combination of hepatitis C virus, drug use, and mental/behavioral disorder codes yielded the highest sensitivity (93%) and positive predictive value (83%) of the algorithms analyzed. DISCUSSION: We have described the first algorithm, validated against chart review data, for identifying PWID-associated infective endocarditis cases using ICD-10 codes. The high sensitivity and positive predictive value indicate that this algorithm can be used for surveillance and research with confidence. CONCLUSIONS: This algorithm will enable researchers to examine epidemiological trends in PWID-associated infective endocarditis.

Inhospital death is a biased measure of fatal outcome from bloodstream infection.

PURPOSE: Inhospital death is commonly used as an outcome measure. However, it may be a biased measure of overall fatal outcome. The objective of this study was to evaluate inhospital death as a measure of all-cause 30-day case fatality in patients with bloodstream infection (BSI). PATIENTS AND METHODS: A population-based surveillance cohort study was conducted, and patients who died in hospital within 30 days (30-day inhospital death) were compared with those who died in any location by day 30 post BSI diagnosis (30-day all-cause case fatality). RESULTS: A total of 1,773 residents had first incident episodes of BSI. Overall, 299 patients died for a 30-day all-cause case fatality rate of 16.9%. Most (1,587; 89.5%) of the patients were admitted to hospital, and ten (5.4%) of the 186 patients not admitted to hospital died. Of the 1,587 admitted patients, 242 died for a 30-day inhospital death rate of 15.2%. A further 47 patients admitted to hospital died after discharge but within 30 days of BSI diagnosis for a 30-day case fatality rate among admitted patients of 18.2%. Patients who died following discharge within 30 days were older and more likely to have dementia. CONCLUSION: The use of inhospital death is a biased measure of true case fatality.

Heating Injection Drug Preparation Equipment Used for Opioid Injection May Reduce HIV Transmission Associated With Sharing Equipment.

BACKGROUND: London, Canada, experienced an HIV outbreak among persons who inject drugs despite widespread distribution of harm reduction equipment. Hydromorphone controlled-release (HMC) is the local opioid of choice. Injection drug preparation equipment (IDPE; ie, cookers and filters) is often shared and reused because of the perception that there is residual HMC in the IDPE after use. The purpose of this study was to investigate the mechanisms of HIV transmission in this context. METHODS: Residual hydromorphone, (controlled-release or immediate-release), remaining in the IDPE, was measured with liquid chromatography-tandem mass spectrometry, in conditions replicating persons who inject drug use. HIV was added to IDPE in the presence HMC, hydromorphone immediate-release, or microcrystalline cellulose (an HMC drug excipient). HIV viral persistence was measured by reverse transcriptase activity and infectivity of indicator Tzm-bl cells. RESULTS: Forty-five percent of HMC remained in the IDPE after the first aspiration of solution, with no change after heating. HIV persistence and infectivity were preserved in the presence of HMC, and less so with microcrystalline cellulose. Heating the IDPE rapidly inactivated HIV. CONCLUSIONS: Sharing of IDPE is a potential means of HIV transmission. HMC encourages IDPE sharing because of the residual drug in the IDPE, and the HMC excipients preserve HIV viability. Heating IDPE before aspiration of the opioid may be a harm reduction strategy.

A review of the role of CpG oligodeoxynucleotides as toll-like receptor 9 agonists in prophylactic and therapeutic vaccine development in infectious diseases.

This article reviews the biology of Toll-like receptors, the current understanding of the mechanism by which CpG oligodeoxynucleotides (ODNs) perturb immune function and the published literature describing their evaluation in the development of vaccines in humans. The role of these molecules as immune modulators in HCV treatment is also considered. There has been considerable research evaluating the role of CpG ODNs as an adjuvant and immune modulator in hepatitis B, hepatitis C and influenza. The safety and immunogenicity of the 1018 ISS compound in combination with Engerix-B was assessed in 99 healthy, adult seronegative volunteers. One month following the first immunization dose, 78.7% in the rHBsAg plus 1018 ISS group versus 11.8% in the Engerix-B group achieved protective titres. One hundred percent of rHBsAg plus 1018 ISS and 18.0% of hepatitis B vaccine-alone recipients were seroprotected 1 week following the second dose of study vaccine. After all doses of vaccine had been administered, seroprotection rates were 100% and 64%, respectively (p < 0.001). CPG 7909 was co-administered with Engerix-B in 56 healthy adults. After the second injection (week 6 time point), seroprotection was achieved in 100% of CPG 7909 recipients (0.5 mg 13/13; 1.0 mg 12/12; 0.125 mg 12/12) compared with 55% (6/11) of control participants (p = 0.0003). Twelve months post prime, all subjects who had received the full course of vaccination maintained seroprotective anti-HBs titres. The safety and immunogenicity of Engerix B plus CPG 7909 was assessed in HIV seropositive patients. All CPG 7909 recipients (n = 19) and 17/19 (89%) control subjects achieved seroprotection by 2 weeks after the third and final injection (10 weeks). Seroprotective titres remained in all CPG 7909 recipients at 48 weeks (100%) versus 12/19 (63%) for controls (p = 0.008). This cohort of HIV-infected patients was followed at 6-month intervals for up to 60 months after enrolment. The difference in seroprotection (> or =10 mIU/L) and GMT between study arms remained significant (p < 0.05) at all time points from month 24 to month 60. There is great potential for CpG ODN as vaccine adjuvants and as therapeutic immune modulators. The use of these molecules as a hepatitis B vaccine adjuvant is most promising.

Exploring Factors Behind Offline and Online Selfie Popularity Among Youth in India.

"The Selfie Culture," practiced globally, is gaining popularity with each passing day. Owing to its ubiquitous fame across the globe, it becomes essential to inquire the grounds for such worldwide recognition. In few years, it also became the center of attraction among researchers and previous studies had recognized two important aspects of selfie: first, why is selfie posting on social media is increasing day by day and second, who choose to involve more frequently in selfie posting behavior on social media? However, these studies focused only on its online popularity on various social media platforms but did not pay much attention on its offline popularity among selfie takers. In addition to this, the multifaceted sides of selfie which may make it different from other pictures and might also play an important role in its popularity in both offline and online platforms remained unexplored. The present study addressed this gap and explored two important aspects of selfie related behavior, First, it emphasized the significance of understanding the user's conception of selfie and second, it explored the determining factors behind both offline (taking) and online (posting) modes of the practice. 60 college going students (44 females and 16 males) living in Delhi, India participated in the study. Semi-structured interviews were conducted and qualitative thematic analysis was used to cull out the themes. The results showed five factors (looks good, keeping memories, mood driven, mirroring the self and posting on social media) behind selfie offline (taking) involvement. Further, the online (posting) selfie popularity had been driven by three factors (social approval, being the best among the rest, to maintain online presence). Participants' popularity of selfie usage in both offline and online modes advocates the need to explore the offline selfie involvement of selfie takers in future research. The study also extended the existing conceptualization of selfie phenomenon which could help to unravel its wide popularity among its users.

Clinical Characteristics and Factors Associated With Mortality in First-Episode Infective Endocarditis Among Persons Who Inject Drugs.

Importance: Persons who inject drugs (PWID) represent a distinct demographic of patients with infective endocarditis. Many centers do not perform valvular surgery on these patients owing to concerns about poor outcomes. Addiction services are underused in hospitals. Objectives: To compare clinical characteristics in first-episode infective endocarditis in PWID who are surgically vs medically managed and to identify variables associated with mortality. Design, Setting, and Participants: This case series studied PWID treated for a first episode of infective endocarditis between April 1, 2007, and March 30, 2016. Participants were adult patients (aged ≥18 years) admitted to any of 3 hospitals in London, Ontario, Canada. Analysis occurred between July 2016 and November 2017. Main Outcomes and Measures: Survival among PWID; the causative organisms, site of infection, and cardiac as well as noncardiac complications; referral to addiction services; and surgical vs medical management. Results: Of 370 total first-episode cases of infective endocarditis, 202 (54.6%) were in PWID. Among PWID, 105 (52%) were male, the median (interquartile range) age was 34 (28-42) years, and patients were predominantly positive for the hepatitis C virus (69.8% [141 of 202]). Right-sided infection was more common (61.4% [124 of 202]), and most infections were caused by Staphylococcus aureus (77.2% [156 of 202]). Surgery occurred in 19.3% of patients (39 of 202). The all-cause mortality rate was 33.7% (68 of 202). Adjusting for age and sex, survival analysis demonstrated that surgery was associated with lower mortality (hazard ratio [HR], 0.44; 95% CI, 0.23-0.84; P = .01), as was referral to addiction treatment (HR, 0.29; 95% CI, 0.12-0.73; P = .008). Higher mortality was associated with left-sided infection (HR, 3.26; 95% CI, 1.82-5.84; P < .001) and bilateral involvement (HR, 4.51; 95% CI, 2.01-10.1; P < .001). Conclusions and Relevance: This study presents the demographic characteristics of first-episode infective endocarditis in PWID. Results highlight the potentially important role of addictions treatment in this population. Further study to optimize selection criteria for surgery in PWID is warranted.

Biodiesel synthesis from Calophyllum inophyllum oil with different supercritical fluids.

Biodiesel or fatty acid methyl esters (FAMEs) is primarily synthesized using edible vegetable oils and methanol with a catalyst. However, in the present study, FAMEs were synthesized from a non-edible oil (Calophyllum inophyllum also called as sura honne, Punnagam, Alexandrian Laurel) in different supercritical fluids: methanol (MeOH), methyl tert-butyl ether (MTBE), methyl acetate (MeOAc) and dimethyl carbonate (DMC) non-catalytically. Reactions were performed from 523K to 673K at 30MPa with a molar ratio of 40:1 with times varying from 3min to 3h. Conversions higher than 80% were obtained within 30min for oil reaction with MeOH and DMC at 623K and conversions of 60% and 70% were obtained at 673K with MeOAc and MTBE, respectively. Pseudo first order kinetics was used to obtain the rate constants and the activation energies followed the order: EMeOH

Infectious diseases specialist management improves outcomes for outpatients diagnosed with cellulitis in the emergency department: a double cohort study.

Three hospital emergency rooms (ERs) routinely referred all cases of cellulitis requiring outpatient intravenous antibiotics, to a central ER-staffed cellulitis clinic. We performed a retrospective cohort study of all patients seen by the ER clinic in the last 4months preceding a policy change (ER management cohort [ERMC]) (n=149) and all those seen in the first 3months of a new policy of automatic referral to an infectious disease (ID) specialist-supervised cellulitis clinic (ID management cohort [IDMC]) (n=136). Fifty-four (40%) of 136 patients in the IDMC were given an alternative diagnosis (noncellulitis), compared to 16 (11%) of 149 in the ERMC (P<0.0001). Logistic regression-demonstrated rates of disease recurrence were lower in the IDMC than the ERMC (hazard ratio [HR], 0.06; P=0.003), as were rates of hospitalization (HR, 0.11; P=0.01). There was no significant difference in mortality. Automatic ID consultation for cellulitis was beneficial in differentiating mimickers from true cellulitis, reducing recurrence, and preventing hospital admissions.