Utility of illness symptoms for predicting COVID-19 infections in children.

BACKGROUND: The Centers for Disease Control and Prevention and the American Academy of Pediatrics recommend that symptomatic children remain home and get tested to identify potential coronavirus disease 2019 (COVID-19) cases. As the pandemic moves into a new phase, approaches to differentiate symptoms of COVID-19 versus other childhood infections can inform exclusion policies and potentially prevent future unnecessary missed school days. METHODS: Retrospective analysis of standardized symptom and exposure screens in symptomatic children 0-18 years tested for SARS-CoV-2 at three outpatient sites April to November 2020. Likelihood ratios (LR), number needed to screen to identify one COVID-19 case, and estimated missed school days were calculated. RESULTS: Of children studied (N = 2,167), 88.9% tested negative. Self-reported exposure to COVID-19 was the only factor that statistically significantly increased the likelihood of a positive test for all ages (Positive LR, 5-18 year olds: 5.26, 95% confidence interval (CI): 4.37-6.33; 0-4 year olds: 5.87, 95% CI: 4.67-7.38). Across ages 0-18, nasal congestion/rhinorrhea, sore throat, abdominal pain, and nausea/vomiting/diarrhea were commonly reported, and were either not associated or had decreased association with testing positive for COVID-19. The number of school days missed to identify one case of COVID-19 ranged from 19 to 48 across those common symptoms. CONCLUSIONS: We present an approach for identifying symptoms that are non-specific to COVID-19, for which exclusion would likely lead to limited impact on school safety but contribute to school-days missed. As variants and symptoms evolve, students and schools could benefit from reconsideration of exclusion and testing policies for non-specific symptoms, while maintaining testing for those who were exposed.

EphrinA1-EphA2 interaction-mediated apoptosis and FMS-like tyrosine kinase 3 receptor ligand-induced immunotherapy inhibit tumor growth in a breast cancer mouse model.

BACKGROUND: The receptor tyrosine kinase EphA2 is overexpressed in several types of cancers and is currently being pursued as a target for breast cancer therapeutics. The EphA2 ligand EphrinA1 induces EphA2 phosphorylation and intracellular internalization and degradation, thus inhibiting tumor progression. The hematopoietic growth factor, FMS-like tyrosine kinase 3 receptor ligand (Flt3L), promotes expansion and mobilization of functional dendritic cells. METHODS: We tested the EphrinA1-EphA2 interaction in MDA-MB-231 breast cancer cells focusing on the receptor-ligand-mediated apoptosis of breast cancer cells. To determine whether EphrinA1-EphA2 interaction-associated apoptosis and Flt3L-mediated immunotherapy would have an additive effect in inhibiting tumor growth, we used an immunocompetent mouse model of breast cancer to evaluate intratumoral (i.t.) inoculation strategies with human adenovirus (HAd) vectors expressing either EphrinA1 (HAd-EphrinA1-Fc), Flt3L (HAd-Flt3L) or a combination of EphrinA1-Fc + Flt3L (HAd-EphrinA1-Fc + HAd-Flt3L). RESULTS: In vitro analysis demonstrated that an EphrinA1-EphA2 interaction led to apoptosis-related changes in breast cancer cells. In vivo, three i.t. inoculations of HAd-EphrinA1-Fc showed potent inhibition of tumor growth. Furthermore, increased inhibition in tumor growth was observed with the combination of HAd-EphrinA1-Fc and HAd-Flt3L accompanied by the generation of an anti-tumor adaptive immune response. CONCLUSIONS: The results obtained in the present study, indicating the induction of apoptosis and inhibition of mammary tumor growth, show the potential therapeutic benefits of HAd-EphrinA1-Fc. In combination with HAd-Flt3L, this represents a promising strategy for effectively inducing mammary tumor regression by HAd vector-based therapy.

Role of Psychological Makeup in Psychological Rehabilitation of Acid Attack Victims.

From eve-teasing to more aggressive forms of sexual violence, subjection of women to sexual violence has been on the rise. One heinous form of sexual violence is the acid attack. Acid attack refers to the intentional act of throwing acid on an individual with the intent of harming, torturing, disfiguring, injuring, or killing them. Despite an increase in the number of reported cases of acid attacks, the initial nonavailability of strict legislatures and underreporting of the crime have led to gross underrepresentation of the acid attack victims in the scientific literature. Moreover, most researches focus on the impact of acid attack and not on the process of recovery for these victims. Hence, this paper attempts to explore the role of psychological makeup in the psychological rehabilitation of acid attack victims. This study adopted the homogeneous purposive sampling method. The sample consisted of 30 female victims of acid attack between the age group of 18 to 25 years. The narratives of these victims focusing on their experiences before and after the incidence were collected. Findings of this study indicate that psychological makeup is an important variable that is responsible for the successful recovery from trauma. Nearly all of the victims have shown symptoms of maladaptive psychological makeup after facing a violent event. However, after participation in the rehabilitation program, the victims moved from having maladaptive psychological makeup toward having adaptive psychological makeup. The emergent subthemes comprising maladaptive psychological makeup consists of cognitive distortions, hopelessness, shame, and suicidal ideation; and for adaptive psychological makeup, these are positive life orientation, belief in the just world, and self-efficacy. The insights of the study will contribute to an improved understanding of the recovery process of the acid attack victims and help in planning intervention protocols for them.

Gender-Based Violence During COVID-19 Pandemic: A Mini-Review.

Purpose: Quarantine is necessary to reduce the community spread of the Coronavirus disease, but it also has serious psychological and socially disruptive consequences. This is known as the quarantine paradox that also includes a surge in the cases of gender-based violence. However, there exists a clear gap of rigorous literature exploring the issue. Hence, the current paper attempts to understand gender-based violence as an aspect of the COVID-19 lockdown. It reviews the pattern of rise in gender violence cases and the resultant psychological and social issues and attempts to create awareness by initiating a discourse urging for change in the response towards the victims of gender-based violence. The paper further attempts to suggest measures to mitigate the issues arising out of gender violence during quarantine. Method: The current paper reviews the literature on the rise of gender-based violence in the times of current and past pandemics. The paper also reviews the published reports in scientific as well as mass media literatures focusing on the rise of gender-based violence during the imposed lockdown, its consequences, and the measures taken by the governments to tackle the issue. Results: The present review reveals that similar to the previous pandemics and epidemics, there has been an alarming rise in the incidents of gender-based violence during the COVID-19 pandemic. The present review further reveals various other risk factors that have been found attributive to the surge of gender-based violence such as economic insecurity and alcohol consumption. The results of the review indicate that despite its global prevalence, gender-based violence has been one of the most neglected outcomes of pandemics. Moreover, the legislatures and services available for such victims are often inadequate and, thus, worsening their situation. Conclusion: Pandemic situations have been found to be associated with advancements in the medical field. However, a part and parcel of this situation is the age-old practice of quarantine that has several negative outcomes. This also includes a surge in gender-based violence that raises serious concerns about the safety of women. As the legislatures provided and measures taken by the governments are falling short in dealing with the issue, a number of non-government organizations are stepping up to provide necessary services to these victims.

Physical Fitness and Exercise During the COVID-19 Pandemic: A Qualitative Enquiry.

The COVID-19 pandemic has brought this fast-moving world to a standstill. The impact of this pandemic is massive, and the only strategy to curb the rapid spread of the disease is to follow social distancing. The imposed lockdown, resulting in the closure of business activities, public places, fitness and activity centers, and overall social life, has hampered many aspects of the lives of people including routine fitness activities of fitness freaks, which has resulted in various psychological issues and serious fitness and health concerns. In the present paper, the authors aimed at understanding the unique experiences of fitness freaks during the period of lockdown due to COVID-19. The paper also intended to explore the ways in which alternate exercises and fitness activities at home helped them deal with psychological issues and physical health consequences. Semi-structured telephone interviews were conducted with 22 adults who were regularly working out in the gym before the COVID-19 pandemic but stayed at home during the nationwide lockdown. The analysis revealed that during the initial phase of lockdown, the participants had a negative situational perception and a lack of motivation for fitness exercise. They also showed psychological health concerns and overdependence on social media in spending their free time. However, there was a gradual increase in positive self-perception and motivation to overcome their dependence on gym and fitness equipment and to continue fitness exercises at home. Participants also tended to play music as a tool while working out. The regular fitness workout at home during the lockdown greatly helped them to overcome psychological issues and fitness concerns.

Onset and pattern of tear secretions in full-term neonates.

PURPOSE: Serial evaluations of total, basal and emotional tear secretion in full-term normal neonates to determine the time after birth when these parameters attain normal adult values. METHOD: Both eyes of 102 full-term normal neonates were prospectively evaluated for tear secretions in the Department of Ophthalmology, over a period of one year. Serial recording of the Schirmer I test (total tear secretions), Basal Secretion Test, and Schirmer II test (emotional tears) was done, the first one being within 6 hours of birth. All the tests were repeated in each infant until normal adult values for each test were obtained. RESULTS: The average values of the Schirmer I test, Basal Secretion Test and Schirmer II test at birth were 23.2 (+/- 3.96) mm, 6.2 (+/- 2.15) mm and 19.2 (+/- 4.94) mm, respectively. A statistically significant correlation of birth weight but not of gestational age was found with basal secretions (p = 0.004) as well as with emotional tears (Schirmer II test, p = 0.010). At birth, 98% of infants had total tear secretion, 3.9% had basal tear secretion and 2.9% had emotional tear secretion comparable to normal adult values. All the parameters of tear secretions increased with time, so that 100% of infants had total tear secretion comparable to normal adult values within 12 hours of birth. The basal secretions took three weeks and emotional tears took four weeks to attain normal adult values in all the neonates. CONCLUSION: Total tear secretions were the earliest to reach normal adult values, followed by basal secretions and, lastly, emotional tears. Reduced basal tears at birth may predispose neonates to corneal drying during prolonged ocular examinations such as indirect ophthalmoscopy and procedures under general anesthesia.