COVID-19 vaccine uptake and vaccine hesitancy in Indian patients with cancer: A questionnaire-based survey

Background: Patients with cancer are at a higher risk of severe forms of coronavirus disease 2019 (COVID-19) and mortality. Therefore, widespread COVID-19 vaccination is required to attain herd immunity. Objective(s): We aimed to evaluate the uptake of the COVID-19 vaccine in Indian patients with cancer and to collect information regarding vaccine hesitancy and factors that contributed to vaccine hesitancy. Material(s) and Method(s): This was a questionnaire-based survey conducted between May 7, 2021 and June 10, 2021 in patients aged 45 years and over, with solid tumors. The primary end points of the study were the proportion of Indian patients with cancer aged 45 years and older who had not received the COVID-19 vaccine, and the reasons why these patients had not received the COVID-19 vaccine. Our secondary end points were the proportion of patients with a history of COVID-19 infection, and the proportion of the patients who had vaccine hesitancy. Additionally, we attempted to assess the factors that could impact vaccine hesitancy. Result(s): A total of 435 patients were included in the study. Of these, 348 (80%) patients had not received even a single dose of the COVID-19 vaccine;66 (15.2%) patients had received the first dose, and 21 (4.8%) had received both the doses. Approximately half (47.1%) of the patients reported that they took the COVID-19 vaccine based on the advice from a doctor. The reasons for not taking the COVID-19 vaccine could be considered as vaccine hesitancy in 259 (77%) patients. The two most common reasons were fear in 124 (38%) patients (fear of side-effects and of the impact of the vaccine on the cancer/therapy) and lack of information in 87 (26.7%) patients. On the multivariate analysis, the two factors found to be significantly associated with vaccine hesitancy were a lower educational level (OR, 1.78;95% CI, 1-3.17;P = 0.048) and a lack of prior advice regarding the COVID-19 vaccine (OR, 2.80;95% CI, 1.73-4.53;P < 0.001). Conclusion(s): Vaccine hesitancy is present in over half of our patients, and the most common reasons are a fear of the vaccine impacting the cancer therapy, fear of side-effects, and lack of information. Widespread vaccination can only be attained if systematic programs for education and dissemination of information regarding the safety and efficacy of the COVID-19 vaccine are given as much importance as fortification of the vaccination supply and distribution system.Copyright © 2021 Cancer Research, Statistics, and Treatment Published by Wolters Kluwer - Medknow.

Serum: differential pricing of the Covid-19 vaccine

Learning outcomes: The learning outcomes of this study are as follows: 1. the benefits of differential pricing over uniform pricing;2. the differences between second- and third-degree price discrimination;3. the rationale for charging different prices for segments having different willingness to pay;and 4. how different prices for the same product can lead to perceptions of unfairness and how companies might manage such an issue. Case overview/synopsis: This case outlines the decisions that Adar Poonawalla, the CEO of Serum Institute of India (Serum), had to make in late April 2021 concerning its pricing for the COVID-19 (Covid) vaccine. Serum was the world's largest manufacturer of vaccines, and its Covishield vaccine had received regulatory approval, but faced an unusual challenge and opportunity. In most countries, governments had procured Covid vaccines from manufacturers and then delivered the vaccines to consumers free of cost. But in India, there was a three-tier pricing system. While the Government of India had committed to free vaccines in government-run public hospitals, it also allowed vaccine makers to directly sell vaccines to state governments, as well as private hospitals, who were at liberty to charge consumers for the vaccines. This created an interesting pricing dilemma for Serum: as different customers had different willingness to pay, should Serum use differential pricing? Would such a tiered pricing system be considered fair? How many different price points should Serum maintain? By exploring these and related decisions that Poonawalla had to make, the case is intended to teach price discrimination. Complexity academic level: The case is intended for graduate-level courses in marketing, pricing and economics. This case illustrates the principles of differential pricing/price discrimination. More specifically, it highlights pricing strategies motivated by second- and third-degree price discrimination in an emerging market's health-care context. From the information in the case, the student can learn to apply the concepts of second- and third-degree price discrimination in marketing. After working through the case and assignment questions, instructors will be able to help students understand the following concepts: Teaching objective 1: the benefits of differential pricing over uniform pricing. Teaching objective 2: the differences between second- and third-degree price discrimination. Teaching objective 3: the rationale for charging different prices for segments having different willingness to pay. Teaching objective 4: how different prices for the same product can lead to perceptions of unfairness and how companies might manage such an issue. Supplementary material: Teaching notes are available for educators only. Subject code: CSS 8: Marketing. © 2023, Emerald Publishing Limited.

Bidding under uncertainty: Harsh Constructions

Learning outcomes: 1. Probabilistic calculations of cost, and profit/loss using standard probability functions 2. Decision tree to find the expected monetary value (EMV) of different options. 3. Monte Carlo simulation for risk analysis. 4. Risk analysis in project management. Learning objectives: Learners will be able to understand and apply the following: how to approach uncertainty in business decisions using probabilistic calculations of cost, and profit/loss using standard probability functions;how to address uncertainty in business decisions by looking forward and reasoning backward, using the decision tree technique and the EMV of different decisions;how to analyse the risk inherent in business decisions by incorporating probability distributions for all critical variables in the form of Monte Carlo simulation;and appreciation of strategic considerations in risk analysis as it applies to project management Case overview/synopsis: The case describes the challenge facing Vilas Birari, the owner and chief executive of Harsh Constructions, a construction company headquartered in Nasik, India. Birari had to decide on the bid for a construction project in September of 2021, during the COVID-19 (COVID) pandemic. Due to successive waves of the pandemic, the state and federal governments announced lockdowns intermittently, causing uncertainty in costs related to labor, material and project completion. The dilemma before Birari was how to set a bid price that was not so low as to incur a loss and not so high as to lose the bid to competitors. The uncertainty made Birari's decision-making complex. The case invites students to help Birari find an optimum bid price by using various quantitative techniques, such as Monte Carlo simulation and decision trees. Complexity academic level: This case is intended for students of management at a master's level, in an elective course on management science, which is often also known as decision science. This compact case can be positioned in the second half of the course, when exploring risk management using computer simulation as a tool. The case serves both as an introduction to using simulation to manage uncertainty as well a contrast with simpler methods that are covered earlier in the course. Supplementary material: Teaching notes are available for educators only. Subject code: CSS 7: Management Science. © 2023, Emerald Publishing Limited.

Spectrum, Outcomes, and Mortality Predictors of Acute Kidney Injury among Non-COVID-19 Patients during COVID-19 Pandemic: Data from Four Intensive Care Units.

Introduction: The data of acute kidney injury (AKI), that is, community-acquired AKI (CA-AKI) and hospital-acquired AKI (HA-AKI) among non-COVID patients from intensive care units (ICU) during the coronavirus disease-2019 (COVID-19) pandemic are scarce. We planned to study the change in the profile of such patients compared to the pre-pandemic era. Materials and methods: This prospective observational study was conducted at four ICUs dealing with non-COVID patients at a government hospital in North India, and was aimed at assessing outcomes, and mortality predictors of AKI among non-COVID patients during the COVID-19 pandemic. Renal and patient survival at ICU transfer-out and hospital discharge, ICU and hospital stay duration, mortality predictors, and dialysis requirement at discharge were evaluated. The current or previous COVID-19 infection, previous AKI or chronic kidney disease (CKD), organ donors, and organ transplant patients were excluded. Results: Among the 200 non-COVID-19 AKI patients, diabetes mellitus (DM), primary hypertension, and cardiovascular diseases were the predominant comorbidities in descending order. The commonest cause of AKI was severe sepsis, followed by systemic infections and post-surgery patients. Dialysis requirements at ICU admission during ICU stay and above 30 days were seen in 20.5, 47.5, and 6.5% of patients, respectively. Incidence of CA-AKI and HA-AKI was 1.24:1, whereas dialysis requirement above 30 days was 0.85:1, respectively. The 30-day mortality was 42%. Hepatic dysfunction [hazard ratio (HR): 3.471], septicemia (HR: 3.342), age above 60 years (HR: 4.000), higher sequential organ failure assessment (SOFA) score (HR: 1.107; p = 0.001), anemia (p = 0.003), and low serum iron (p = 0.001) were important mortality predictors in AKI. Conclusion: Compared to the pre-COVID era, CA-AKI was more common than HA-AKI due to restricted elective surgeries during the COVID-19 pandemic. Acute kidney injury with multiorgan involvement and hepatic dysfunction, elderly age with higher SOFA score and sepsis were predictors of adverse renal and patient outcomes. How to cite this article: Singh B, Dogra PM, Sood V, Singh V, Katyal A, Dhawan M, et al. Spectrum, Outcomes, and Mortality Predictors of Acute Kidney Injury among Non-COVID-19 Patients during COVID-19 Pandemic: Data from Four Intensive Care Units. Indian J Crit Care Med 2023;27(2):119-126.

Role strain and COVID-era burden among South Asian caregivers of individuals with brain health conditions and disabilities

Background: The COVID-19 pandemic has renewed attention to the conflicting demands placed on caregivers worldwide. Nowhere is this more evident than in South Asia, where cultural norms and a scarcity of long-term care facilities have made the home the locus of caregiving for individuals with brain health conditions and disabilities. A hidden cost of this informal arrangement is the burden experienced by the primary caregiver. This may be exacerbated when traditional caregiving expectations clash with personal aspirations outside the family. Method(s): The COVID-19 pandemic has renewed attention to the conflicting demands placed on caregivers worldwide. Nowhere is this more evident than in South Asia, where cultural norms and a scarcity of long-term care facilities have made the home the locus of caregiving for individuals with brain health conditions and disabilities. A hidden cost of this informal arrangement is the burden experienced by the primary caregiver. This may be exacerbated when traditional caregiving expectations clash with personal aspirations outside the family. Result(s): The COVID-19 pandemic has renewed attention to the conflicting demands placed on caregivers worldwide. Nowhere is this more evident than in South Asia, where cultural norms and a scarcity of long-term care facilities have made the home the locus of caregiving for individuals with brain health conditions and disabilities. A hidden cost of this informal arrangement is the burden experienced by the primary caregiver. This may be exacerbated when traditional caregiving expectations clash with personal aspirations outside the family. Conclusion(s): Role strain may be a significant driver of burden when the caretaker's educational and professional potential collide with traditional South Asian family obligations. The burden reported by our respondents suggests that role strain may elevate stress among young, educated caregivers. Our results, therefore, provide indirect evidence concerning the changing economic and socio-cultural context of caregiving in South Asian households. Copyright © 2022 the Alzheimer's Association.

CNN-ACO Technique for Diagnostics of Covid-19 Using Wireless LAN Radiography

WLAN-based direct digital radiography is useful for Picture Archiving & Common System (PACS). This is used for Covid-19 diagnostics forX-ray image classification using the CNN model. ACO is further helpful in improving the efficiency of the system. In comparison with standard methods, these techniques provide highly efficient mechanism diagnostics of Covid-19. Copyright © 2022, Anka Publishers. All rights reserved.

A review on 2D-ZnO nanostructure based biosensors: from materials to devices

During the COVID'19 outbreak, biosensing devices won increasing relevance, demonstrating their potential in the medical diagnostic field. Hence, the present review reports on the main advances in 2D-ZnO nanostructure-based biosensors. So far, bulk ZnO has shown potential for biosensing, optical, and power electronic applications, mainly based on its wide band gap. In the post graphene era, its 2-D allotropes like ZnO sheets and ZnO nanoribbons have outperformed the bulk ZnO structures for specific applications. ZnO demonstrates various stable and feasible morphologies: nanotubes, nanowires, nanorods, nanosheets, nanoparticles, and nanobelts. As a matrix layer in biosensing applications, ZnO strongly binds to biomolecules due to its high isoelectric point (IEP) and shows a strong sensitivity due to the high surface-to-volume ratio. Further, ZnO nanostructures used as a matrix layer play an important role in inhibiting specific biological interactions and hence improve the sensitivity of sensing devices. Further, bioselective layers are typically immobilized onto ZnO either by direct adsorption or by covalent binding. ZnO based biosensors are categorized into optical, piezoelectric, and electrochemical biosensors, among others, based on their biosensing mechanism. In particular, electrochemical sensors produce signals via an electrical pathway for detecting and monitoring the target molecules. Optical sensors produce signals based on luminescence or reflectance, among others. Piezoelectric biosensors produce signals by mass loading of the piezoelectric material. ZnO-based FET biosensors are also reported, showing sensing application by the change in the channel's conductance. Further, recent literature on the detection of COVID-19 using ZnO nanostructures is presented.

Morning Star BrandCom: combating Covid-19 vaccine hesitancy

Learning outcomes: This case is intended to help students of business communication and public relations to trace the effects of communication by public figures and understand essential elements of designing effective communication. After working through the case and assignment questions, the students will be able to:understand the drivers of vaccine hesitancy;analyze the effects of mass communication on public sentiment, in a fast-changing public health situation;anddesign interventions to influence public awareness and action, using a simple model (5W) for mass communication. Case overview/synopsis: As the vaccines first arrived after the devastating first wave of the Covid-19 pandemic, Indians hesitated to take the shot. Vaccine hesitancy, a worldwide phenomenon, hampered the uptake of the first Covid vaccines despite the dark clouds of the lethal disease. The case looks at the massive problem of vaccine hesitancy and how an integrated communication strategy could overcome and mitigate the challenge. The case protagonist, the leader of a communications agency, looks at the messaging, medium and platforms needed for strategic communication pitch to combat this vaccine hesitancy. Complexity academic level: The case was designed for use in a graduate-level course in business communication. This case may be positioned toward the middle or end of the course to illustrate mass communication strategy for pressing and sensitive challenges. The case may also be used in a course on public relations, both at graduate and undergraduate levels. Supplementary materials: Teaching notes are available for educators only. Subject code: CSS 8: Marketing. © 2022, Emerald Publishing Limited.

Moderna’s Spikevax: a prickly pricing decision

Research methodology: The case was compiled using secondary research, including the following sources, all of which are cited in the References List section of the case: Company annual reports, press releases and company websites and news media, podcasts, video recordings, websites of trade associations and other public domain sources. Case overview/synopsis: This case highlights the decisions facing Moderna, Inc. (Moderna) related to pricing of its COVID-19 vaccine in the European Union (EU) in July of 2021. The CEO, Stéphane Bancel, must balance the need for improving shareholder returns with the call to act responsibly during a global pandemic. Should Moderna raise prices or hold prices constant? What other options might be available to the CEO? Complexity academic level: At the authors’ institute, instructors use this case in a second-year marketing elective in pricing at the MBA level. Within the elective, the case enables a discussion on concepts of value realization through pricing and leadership decision strategies. The case may also be used in at the Executive MBA level, in a course of strategic leadership. © 2022, Emerald Publishing Limited.

Symptoms and risk factors for long COVID in non-hospitalized adults.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is associated with a range of persistent symptoms impacting everyday functioning, known as post-COVID-19 condition or long COVID. We undertook a retrospective matched cohort study using a UK-based primary care database, Clinical Practice Research Datalink Aurum, to determine symptoms that are associated with confirmed SARS-CoV-2 infection beyond 12 weeks in non-hospitalized adults and the risk factors associated with developing persistent symptoms. We selected 486,149 adults with confirmed SARS-CoV-2 infection and 1,944,580 propensity score-matched adults with no recorded evidence of SARS-CoV-2 infection. Outcomes included 115 individual symptoms, as well as long COVID, defined as a composite outcome of 33 symptoms by the World Health Organization clinical case definition. Cox proportional hazards models were used to estimate adjusted hazard ratios (aHRs) for the outcomes. A total of 62 symptoms were significantly associated with SARS-CoV-2 infection after 12 weeks. The largest aHRs were for anosmia (aHR 6.49, 95% CI 5.02-8.39), hair loss (3.99, 3.63-4.39), sneezing (2.77, 1.40-5.50), ejaculation difficulty (2.63, 1.61-4.28) and reduced libido (2.36, 1.61-3.47). Among the cohort of patients infected with SARS-CoV-2, risk factors for long COVID included female sex, belonging to an ethnic minority, socioeconomic deprivation, smoking, obesity and a wide range of comorbidities. The risk of developing long COVID was also found to be increased along a gradient of decreasing age. SARS-CoV-2 infection is associated with a plethora of symptoms that are associated with a range of sociodemographic and clinical risk factors.

Covid-19 Interior Security Tracking System Based on the Artificial Intelligence

This article presents an inexpensive artificial intelligence solution aimed at increasing indoor safety of COVID-19, including a number of important aspects: (1) breakdown of the process (2) Method for mask identification (3). Assessment methodology of social distancing The Arduino Uno sensor system uses an infrasound sensor or heat camera, whereas the Raspberry Pi is equipped with computer vision technologies for mask detection and social distance checks. Indoor measures are the most prevalent—people with a high body heat should stay at home, masks should be worn, and their distance should be at least 1.5–2 m. In the first case, the Arduino Uno temperature sensor board is utilized, while we utilize a single-board Pi Raspberry computer coupled with camera for two additional situations, using computer vision techniques. Due to their compact size and cost, we chose to utilize these devices. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Biophysical Fitness Landscape of the SARS-CoV-2 Delta Variant Receptor Binding Domain.

Among the five known SARS-CoV-2 variants of concern, Delta is the most virulent leading to severe symptoms and increased mortality among infected people. Our study seeks to examine how the biophysical parameters of the Delta variant correlate to the clinical observations. Receptor binding domain (RBD) is the first point of contact with the human host cells and is the immunodominant form of the spike protein. Delta variant RBD contains two novel mutations L452R and T478K. We examined the effect of single as well as the double mutations on RBD expression in human Expi293 cells, RBD stability using urea and thermal denaturation, and RBD binding to angiotensin converting enzyme 2 (ACE2) receptor and to neutralizing antibodies using isothermal titration calorimetry. Delta variant RBD showed significantly higher expression compared to the wild-type RBD, and the increased expression is due to L452R mutation. Despite their non-conservative nature, none of the mutations significantly affected RBD structure and stability. All mutants showed similar binding affinity to ACE2 and to Class 1 antibodies (CC12.1 and LY-CoV016) as that of the wild-type. Delta double mutant L452R/T478K showed no binding to Class 2 antibodies (P2B-2F6 and LY-CoV555) and a hundred-fold weaker binding to a Class 3 antibody (REGN10987), and the decreased antibody binding is determined by the L452R mutation. These results indicate that the immune escape from neutralizing antibodies, rather than increased receptor binding, is the main biophysical parameter that determined the fitness landscape of the Delta variant RBD.

A Comprehensive Study of Internet of Things and Digital Business on the Economic Growth and its Impact on Human Resource Management

The research paper aims to examine the impact of digitalization and IoT technologies on the business world and the ways in which it also impacts the global economy. The paper examines that digital Human Resource Management can increase the productivity and the efficiency of both the HR professionals and the employees of the organisation. The findings of the research also reveals that through digitalisation the HR managers can build better relationships between the employee and the company, can think about the wellbeing of the employees better, and make them feel more valued and appreciated. It can also help in creating a competitive atmosphere in the workplace which can motivate the employees. The research further reveals that the active IoT technologies are increasing in the business world. The articles also analyses the advantages and disadvantages of implementing digitalisation and IoT in the workplace and there exists some requirements that need to be met for the successful implementation of the IoT technology. The research also estimates that in future companies can develop their business by adopting digitalisation. In the paper it is also mentioned that during the pandemic the global economy has decreased and to balance the condition it is important to implement digitalisation in the business world. © 2021 IEEE.

Knowledge, attitude and practice about airborne infection control guidelines among medical residents of tertiary care hospital in Jabalpur

Background: Adherence to National Airborne Infection Control Guidelines by health Care professioinals is an effective way of reducing the risk of air-borne infections such as H1N1, COVID19 and TB. This study aims to assess the knowledge, attitude and implementation of national airborne infection control guidelines by resident doctors in a tertiary medical college hospital at Jabalpur. Methods: A cross-sectional study was conducted from December 2019- February 2021. Total 301 Interns, postgraduates and senior residents in surgery and medicine aligned clinical departments were included by convenient sampling method. Pre- designed questionnaire was used to assess Knowledge, Attitude and Practice on National Air-borne infection control guidelines. Data was analysis by using SPSS and presented in Percentages, Mean (Standard Deviation). Chi-Square test was used to find the association and t - test was used to find the mean difference between KAP and Resource scores. p-value of less than 0.05 was considered as statistically significant. Results: Almost 95%,77% and 74% of study participants were having adequate knowledge, attitude and practice on National Airborne Infection Control Guidelines respectively. Statistically significant association was observed between participants age, designation with their KAP score (p value<0.05). Conclusions: The overall knowledge, attitude and practice were adequate but there was significant gap persist between KAP and satisfaction on available resources. The study findings were useful for healthcare professional in designing interventions to improve the adherence towards the NAIC guidelines and also to benchmark evaluation of interventions.

Antibody-Dependent Complement Responses toward SARS-CoV-2 Receptor-Binding Domain Immobilized on "Pseudovirus-like" Nanoparticles.

Many aspects of innate immune responses to SARS viruses remain unclear. Of particular interest is the role of emerging neutralizing antibodies against the receptor-binding domain (RBD) of SARS-CoV-2 in complement activation and opsonization. To overcome challenges with purified virions, here we introduce "pseudovirus-like" nanoparticles with ∼70 copies of functional recombinant RBD to map complement responses. Nanoparticles fix complement in an RBD-dependent manner in sera of all vaccinated, convalescent, and naïve donors, but vaccinated and convalescent donors with the highest levels of anti-RBD antibodies show significantly higher IgG binding and higher deposition of the third complement protein (C3). The opsonization via anti-RBD antibodies is not an efficient process: on average, each bound antibody promotes binding of less than one C3 molecule. C3 deposition is exclusively through the alternative pathway. C3 molecules bind to protein deposits, but not IgG, on the nanoparticle surface. Lastly, "pseudovirus-like" nanoparticles promote complement-dependent uptake by granulocytes and monocytes in the blood of vaccinated donors with high anti-RBD titers. Using nanoparticles displaying SARS-CoV-2 proteins, we demonstrate subject-dependent differences in complement opsonization and immune recognition.

Convergent Evolution of Multiple Mutations Improves the Viral Fitness of SARS-CoV-2 Variants by Balancing Positive and Negative Selection.

Multiple mutations have been seen to undergo convergent evolution in SARS-CoV-2 variants of concern. One such evolution occurs in Beta, Gamma, and Omicron variants at three amino acid positions K417, E484, and N501 in the receptor binding domain of the spike protein. We examined the physical mechanisms underlying the convergent evolution of three mutations K417T/E484K/N501Y by delineating the individual and collective effects of mutations on binding to angiotensin converting enzyme 2 receptor, immune escape from neutralizing antibodies, protein stability, and expression. Our results show that each mutation serves a distinct function that improves virus fitness supporting its positive selection, even though individual mutations have deleterious effects that make them prone to negative selection. Compared to the wild-type, K417T escapes Class 1 antibodies and has increased stability and expression; however, it has decreased receptor binding. E484K escapes Class 2 antibodies; however, it has decreased receptor binding, stability, and expression. N501Y increases receptor binding; however, it has decreased stability and expression. When these mutations come together, the deleterious effects are mitigated due to the presence of compensatory effects. Triple mutant K417T/E484K/N501Y has increased receptor binding, escapes both Class 1 and Class 2 antibodies, and has similar stability and expression as that of the wild-type. These results show that the convergent evolution of multiple mutations enhances viral fitness on different fronts by balancing both positive and negative selection and improves the chances of selection of mutations together.

A cross-sectional and histological analysis to understand the cytological effects of cell phone radiation on buccal mucosa of children.

Context: The ongoing pandemic has affected all the spheres of life and one of the severely affected avenues is the education of a child. The online education has seen an upward curve since the start of COVID-19 pandemic. Schools globally have adopted online class tutorials as the main method to impart education and directly increasing the screen time for a child. Aim: The aim of the present study was to evaluate the cytological effects of prolonged mobile phone usage on the buccal mucosa of children. Settings and Design: Stratified sampling was used for the selection of subjects for the study. After a questionnaire regarding the usage of a mobile phone was distributed among the parents of children. Among them, 90 children were selected on the basis of pattern and frequency of mobile phone usage in the child. Materials and Methodology: The children were divided into three groups based on the per day hours of viewing of mobile phone, i.e., Group 1: Usage of 1-2 h a day, Group 2: Usage of 3-6 h a day, and Group 3: Usage of >6 h a day. The time frame taken into consideration was 1 year after the pandemic started. This was specifically to understand the impact of the online education. Swab was obtained by using the conventional ice-cream stick method from the buccal mucosa. Statistical Analysis: The samples were subjected to histological and microscopical analysis to observe for cytological changes. One-way ANOVA was used to determine the statistical significance if any. Results: The results obtained clearly showed that Group 3 (>6 h usage per day) showed the highest number of cellular and chromosomal aberrations which was significant. Conclusion: The results indicated that impact due to the prolonged screen time on the buccal mucosa is significant. A direct proportionality was seen between the apoptotic changes and chromosomal aberrations and the number of daily hour usage.

The effect of COVID-19 pandemic on economic growth and public debt: an analysis of India and the global economy

Purpose The study attempts to examine the effect of the COVID-19 pandemic on the economic growth and public debt of the Indian economy. The authors also attempt to make quarterly projections of economic growth and external debt (ED) for the next five years. The objective is to understand how much time the economy takes to recover and at what pace. Consequently, this study elucidates the composition of debt after the crisis in the next five years. Design/methodology/approach To predict India's gross domestic product (GDP) and ED for the next five years, the authors used an auto-regressive integrated moving average (ARIMA) model. This model was built under a Box-Jenkins methodology (Box and Jenkins, 1976) and was subjected to an augmented Dickey-Fuller (ADF) test to check the stationarity of the data. The methodology includes three main steps to estimate and forecast the model: identification, estimation, and diagnostic and forecasting. Findings The study finds that the outbreak of the COVID-19 pandemic has significant implications for economic growth and public debt. The economy faced contraction in the first quarter of the year 2020 due to the suspension of economic activities and still struggling with the negative values of GDP. The forecasting results reveal that ED will continue to grow to meet the increasing health expenditure needs, and GDP will also bounce back slowly after the end of the year 2021. It has been noticed that the recurrent crisis derails the developing economies from the path of sustainable development to a prolonged economic slump with mounting public debt. Originality/value The study examines the impact of the COVID-19 pandemic on economic growth and public debt with particular reference to India. To the best of the authors' knowledge, this is the first time the quarterly projections for GDP and ED have been made after the COVID-19 crisis.

Pediatric Acute Respiratory Distress Syndrome in COVID-19 Pandemic: Is it the Puzzle of the Century?

Bhowmick R, Gulla KM. Pediatric Acute Respiratory Distress Syndrome in COVID-19 Pandemic: Is it the Puzzle of the Century? Indian J Crit Care Med 2022;26(3):264-265.