Psychological impact of the COVID-19 pandemic in children with autism spectrum disorder - a literature review.

Objective: This review summarizes evidence pertaining to the impact of the COVID-19 pandemic on the psychological health of children and adolescents with autism spectrum disorder (ASD). Materials and Methods: An electronic search was conducted using four major databases: PubMed, ScienceDirect, Web of Science, and Google Scholar. Using an umbrella methodology, the reference lists of relevant papers were reviewed, and citation searches were conducted. The study included articles written in English between January 2020 and March 2021 that focused on the psychological health of autistic children and adolescents. Results: All eight studies included in the final review were cross-sectional. Three of the eight studies were conducted in Italy, two in Turkey, and one study each in Portugal, Spain, and the United Kingdom, with a total of 1,407 participants. All studies used a mixture of standardized and non-standardized questionnaires to collect data. The total number of patients were 1407 at a mean age of 9.53 (SD = 2.96) years. Seven studies report gender; male 74.7% (657/880) and female 25.3% (223/880). The finding showed that behavioral issues in children and adolescents with ASD have significantly increased; 521 (51.9 percent) of the 1004 individuals with ASD presented with behavioral changes, including conduct problems, emotional problems, aggression, and hyperactivity. Some studies also found increased anxiety and difficulties managing emotions. Only one study reported clinical stabilization in children with ASD during COVID-19. Finally, 82.7% of families and caregivers of children with ASD (544 out of 658) faced challenges during COVID-19. Conclusion: Although the studies in this review suggest a general worsening of ASD children's clinical status, it remains difficult to draw definitive conclusions at this moment, with newer COVID-19 variants on the rise worldwide. During this difficult pandemic period, caregivers, families, and healthcare professionals are recommended to pay more attention to the ASD patients' health and care needs.

Prognostic evaluation of quick sequential organ failure assessment score in ICU patients with sepsis across different income settings.

BACKGROUND: There is conflicting evidence on association between quick sequential organ failure assessment (qSOFA) and sepsis mortality in ICU patients. The primary aim of this study was to determine the association between qSOFA and 28-day mortality in ICU patients admitted for sepsis. Association of qSOFA with early (3-day), medium (28-day), late (90-day) mortality was assessed in low and lower middle income (LLMIC), upper middle income (UMIC) and high income (HIC) countries/regions. METHODS: This was a secondary analysis of the MOSAICS II study, an international prospective observational study on sepsis epidemiology in Asian ICUs. Associations between qSOFA at ICU admission and mortality were separately assessed in LLMIC, UMIC and HIC countries/regions. Modified Poisson regression was used to determine the adjusted relative risk (RR) of qSOFA score on mortality at 28 days with adjustments for confounders identified in the MOSAICS II study. RESULTS: Among the MOSAICS II study cohort of 4980 patients, 4826 patients from 343 ICUs and 22 countries were included in this secondary analysis. Higher qSOFA was associated with increasing 28-day mortality, but this was only observed in LLMIC (p < 0.001) and UMIC (p < 0.001) and not HIC (p = 0.220) countries/regions. Similarly, higher 90-day mortality was associated with increased qSOFA in LLMIC (p < 0.001) and UMIC (p < 0.001) only. In contrast, higher 3-day mortality with increasing qSOFA score was observed across all income countries/regions (p < 0.001). Multivariate analysis showed that qSOFA remained associated with 28-day mortality (adjusted RR 1.09 (1.00-1.18), p = 0.038) even after adjustments for covariates including APACHE II, SOFA, income country/region and administration of antibiotics within 3 h. CONCLUSIONS: qSOFA was independently associated with 28-day mortality in ICU patients admitted for sepsis. In LLMIC and UMIC countries/regions, qSOFA was associated with early to late mortality but only early mortality in HIC countries/regions.

Mechanical ventilation practices in Asian intensive care units: A multicenter cross-sectional study.

PURPOSE: This study investigated current practices of mechanical ventilation in Asian intensive care units, focusing on tidal volume, plateau pressure, and positive end-expiratory pressure (PEEP). MATERIALS AND METHODS: In this multicenter cross-sectional study, data on mechanical ventilation and clinical outcomes were collected. Predictors of mortality were analyzed by univariate and multivariable logistic regression. A scoring system was generated to predict 28-day mortality. RESULTS: A total of 1408 patients were enrolled. In 138 patients with acute respiratory distress syndrome (ARDS), 65.9% were on a tidal volume ≤ 8 ml/kg predicted body weight (PBW), and 71.3% were on sufficient PEEP. In 1270 patients without ARDS, 88.8% were on a tidal volume ≤ 10 ml/kg PBW. A plateau pressure < 30 cmH2O was measured in 92.2% of patients. Mortality rates increased from 13% to 74% as the generated predictive score increased from 5 to ≥8.5. Income classification, age, SOFA score, PaO2/FiO2 ratio, plateau pressure, number of vasopressors, and steroid use were associated with mortality. CONCLUSIONS: In Asia, low tidal volume ventilation and sufficient PEEP were underused in patients with ARDS. The majority of patients without ARDS were on intermediate tidal volumes. Country income, age, and severity of illness were associated with mortality.

Comparative photocatalytic study of visible light driven BiVO4, Cu2O, and Cu2O/BiVO4 nanocomposite for degradation of antibiotic for wastewater treatment.

Semiconductor-based photocatalysts have become increasingly used in the removal of pollutants from wastewater, especially antibiotics. A series of composite-based cuprous oxide and bismuth vanadate (Cu2O/BiVO4) composite-based photocatalysts were synthesized by using the chemical method. The structure of the Cu2O/BiVO4 composite was verified by using x-ray diffraction, scanning electron microscopy, photoluminescence, Fourier transform infrared spectroscopy, and UV-visible spectra. The degradation of methylene blue (MB) and tetracycline (TC) was investigated to check the photocatalytic activity of the Cu2O/BiVO4 composite series. The quantity of Cu2O was varied from 1% to 7% by weight to prepare the series of Cu2O/BiVO4 composites. The analysis of results verified that 5% Cu2O/BiVO4 exhibits an outstanding photocatalytic activity as compared to 1%, 3%, and 7% Cu2O/BiVO4, pure Cu2O, and pure BiVO4 under visible light irradiation. The optimum value of photocatalytic degradation achieved with 5% Cu2O/BiVO4 was 97% for MB dye and 95% for TC in 120 min, which is greater than the photocatalytic degradation of pure BiVO4 (MB 45% and TC 72%), pure Cu2O (MB 57% and TC 80%), 1% Cu2O/BiVO4 (MB 72% and TC 85%), 3% Cu2O/BiVO4 (MB 83% and TC 88%), and 7% Cu2O/BiVO4 (MB 87% and TC 91%). The stability and reusability of Cu2O/BiVO4 were also investigated. To check the major role of trapping in degradation, a trapping experiment was also performed by using three trapping agents: BQ, EDTA, and tBuOH. The results showed that Cu2O/BiVO4 exhibits an improved photocatalytic activity in the degradation of antibiotics in polluted water because the recombination rate of the electron-hole pair decreased and the surface area increased, which increased the active sites for redox reactions. Such a photocatalytic composite with high efficiency has various applications, such as energy production, environmental remediation, and water remediation.

Screening of a High-Affinity Aptamer for Aflatoxin M1 and Development of Its Colorimetric Aptasensor.

Aflatoxin M1 (AFM1), a secondary metabolite of Aspergillus spp., is highly toxic and widely present in food matrices. Therefore, the detection of AFM1 is of great importance for the protection of food safety. In this study, a five-segment sequence was designed as the initial library. Graphene oxide-SELEX (GO-SELEX) was applied to screen AFM1. After seven rounds of repeated screening, affinity and specificity assays showed that aptamer 9 was the best candidate for AFM1. The dissociation constant (Kd) of aptamer 9 was 109.10 ± 6.02 nM. To verify the efficiency and sensitivity aptamer for the detection of AFM1, a colorimetric sensor based on the aptamer was constructed. The biosensor showed good linearity in the range of AFM1 concentration of 0.5-500.0 ng/mL with a detection limit of 0.50 ng/mL. This colorimetric method was successfully used for the detection of AFM1 in milk powder samples. Its detection recovery was 92.8-105.2%. This study was conducted to provide a reference for the detection of AFM1 in food.

A sensitive fluorescent assay based on gold-nanoclusters coated on molecularly imprinted covalent organic frameworks and its application in malachite green detection.

Malachite green (MG), as a parasiticide, is widely used in aquaculture to increase the production of the fishery industry. It poses a great danger to both the food system and the human body. In this study, a one-pot reverse microemulsion polymerization was employed to combine the gold nanoclusters (AuNCs) with molecularly imprinted polymers (MIPs) and covalent organic frameworks (COFs) to synthesize an efficient fluorescent hybrid probe (AuNCs@COFs@MIPs) for selective detection of MG. The specific recognition of AuNCs@COFs@MIPs towards MG triggers the fluorescence quenching of AuNCs. The fluorescent response was linearly related to the concentration over the range of 10-150 nmol/L with a limit of detection of 2.78 nmol/L. In addition, the proposed probe was further applied to fish and water samples. A favorable recovery ranged from 97.34 to 101.51 % toward trace amounts of MG indicating its promising application for detecting residue of veterinary drugs.

Green synthesis of graphene-based metal nanocomposite for electro and photocatalytic activity; recent advancement and future prospective.

The presence of pollutants in waste water is a demanding problem for human health. Investigations have been allocated to study the adsorptive behavior of graphene-based materials to remove pollutants from wastewater. Graphene (GO) due to its hydrophilicity, high surface area, and oxygenated functional groups, is an effective adsorbent for the removal of dyes and heavy metals from water. The disclosure of green synthesis opened the gateway for the economic productive methods. This article reveals the fabrication of graphene-based composite from aloe vera extract using a green method. The proposed mechanism of GO reduction via plant extract has also been mentioned in this work. The mechanism associated with the removal of dyes and heavy metals by graphene-based adsorbents and absorptive capacities of heavy metals has been discussed in detail. The toxicity of heavy metals has also been mentioned here. The Polyaromatic resonating system of GO develops significant π-π interactions with dyes whose base form comprises principally oxygenated functional groups. This review article illustrates a literature survey by classifying graphene-based composite with a global market value from 2010 to 2025 and also depicts a comparative study between green and chemical reduction methods. It presents state of art for the fabrication of GO with novel adsorbents such as metal, polymer, metal oxide and elastomers-based nanocomposites for the removal of pollutants. The current progress in the applications of graphene-based composites in antimicrobial, anticancer, drug delivery, and removal of dyes with photocatalytic efficacy of 73% is explored in this work. It gives a coherent overview of the green synthesis of graphene-based composite, various prospective for the fabrication of graphene, and their biotoxicity.

Epidemiology, Management, and Outcomes of Sepsis in ICUs among Countries of Differing National Wealth across Asia.

Rationale: Directly comparative data on sepsis epidemiology and sepsis bundle implementation in countries of differing national wealth remain sparse. Objectives: To evaluate across countries/regions of differing income status in Asia 1) the prevalence, causes, and outcomes of sepsis as a reason for ICU admission and 2) sepsis bundle (antibiotic administration, blood culture, and lactate measurement) compliance and its association with hospital mortality. Methods: A prospective point prevalence study was conducted among 386 adult ICUs from 22 Asian countries/regions. Adult ICU participants admitted for sepsis on four separate days (representing the seasons of 2019) were recruited. Measurements and Main Results: The overall prevalence of sepsis in ICUs was 22.4% (20.9%, 24.5%, and 21.3% in low-income countries/regions [LICs]/lower middle-income countries/regions [LMICs], upper middle-income countries/regions, and high-income countries/regions [HICs], respectively; P < 0.001). Patients were younger and had lower severity of illness in LICs/LMICs. Hospital mortality was 32.6% and marginally significantly higher in LICs/LMICs than HICs on multivariable generalized mixed model analysis (adjusted odds ratio, 1.84; 95% confidence interval, 1.00-3.37; P = 0.049). Sepsis bundle compliance was 21.5% at 1 hour (26.0%, 22.1%, and 16.2% in LICs/LMICs, upper middle-income countries/regions, and HICs, respectively; P < 0.001) and 36.6% at 3 hours (39.3%, 32.8%, and 38.5%, respectively; P = 0.001). Delaying antibiotic administration beyond 3 hours was the only element independently associated with increased mortality (adjusted odds ratio, 2.53; 95% confidence interval, 2.07-3.08; P < 0.001). Conclusions: Sepsis is a common cause of admission to Asian ICUs. Mortality remains high and is higher in LICs/LMICs after controlling for confounders. Sepsis bundle compliance remains low. Delaying antibiotic administration beyond 3 hours from diagnosis is associated with increased mortality. Clinical trial registered with www.ctri.nic.in (CTRI/2019/01/016898).

The story of critical care in Asia: a narrative review.

BACKGROUND: Asia has more critically ill people than any other part of our planet. The aim of this article is to review the development of critical care as a specialty, critical care societies and education and research, the epidemiology of critical illness as well as epidemics and pandemics, accessibility and cost and quality of critical care, culture and end-of-life care, and future directions for critical care in Asia. MAIN BODY: Although the first Asian intensive care units (ICUs) surfaced in the 1960s and the 1970s and specialisation started in the 1990s, multiple challenges still exist, including the lack of intensivists, critical care nurses, and respiratory therapists in many countries. This is aggravated by the brain drain of skilled ICU staff to high-income countries. Critical care societies have been integral to the development of the discipline and have increasingly contributed to critical care education, although critical care research is only just starting to take off through collaboration across groups. Sepsis, increasingly aggravated by multidrug resistance, contributes to a significant burden of critical illness, while epidemics and pandemics continue to haunt the continent intermittently. In particular, the coronavirus disease 2019 (COVID-19) has highlighted the central role of critical care in pandemic response. Accessibility to critical care is affected by lack of ICU beds and high costs, and quality of critical care is affected by limited capability for investigations and treatment in low- and middle-income countries. Meanwhile, there are clear cultural differences across countries, with considerable variations in end-of-life care. Demand for critical care will rise across the continent due to ageing populations and rising comorbidity burdens. Even as countries respond by increasing critical care capacity, the critical care community must continue to focus on training for ICU healthcare workers, processes anchored on evidence-based medicine, technology guided by feasibility and impact, research applicable to Asian and local settings, and rallying of governments for support for the specialty. CONCLUSIONS: Critical care in Asia has progressed through the years, but multiple challenges remain. These challenges should be addressed through a collaborative approach across disciplines, ICUs, hospitals, societies, governments, and countries.

Impact of Meteorological factors and population size on the transmission of Micro-size respiratory droplets based Coronavirus: A brief study of highly infected cities in Pakistan

Ongoing Coronavirus epidemic (COVID-19) identified first in Wuhan, China posed huge impact on public health and economy around the globe. Both cough and sneeze based droplets or aerosols encapsulated COVID-19 particles are responsible for air borne transmission of this virus and caused unexpected escalation and high mortality worldwide. Current study intends to investigate correlation of COVID-19 epidemic with meteorological parameters particularly, temperature, rainfall, humidity, and wind speed along with population size. Data set of COVID-19 for highly infected cities of Pakistan was collected from the official website of National Institute of health (NIH). Spearmans rank (rs) correlation coefficient test employed for data analysis revealed significant correlation between temperature minimum (TM), temperature average (TA), wind speed (WS) and population size (PS) with COVID-19 pandemic. Furthermore, receiver operating characteristics (ROC) curve was used to analyze the sensitivity of TA, WS, and PS on transmission rate of COVID-19 in selected cities of Pakistan. The results obtained for sensitivity and specificity analysis for all selected parameters signifies sensitivity and direct correlation of COVID-19 transmission with temperature variation, WS and PS. Positive correlation and strong association of PS parameter with COVID-19 pandemic suggested need of more strict actions and control measures for highly populated cities. These findings will be helpful for health regulatory authorities and policymakers to take specific measures to combat COVID-19 epidemic in Pakistan.

Critical Care Bed Capacity in Asian Countries and Regions.

OBJECTIVE: To assess the number of adult critical care beds in Asian countries and regions in relation to population size. DESIGN: Cross-sectional observational study. SETTING: Twenty-three Asian countries and regions, covering 92.1% of the continent's population. PARTICIPANTS: Ten low-income and lower-middle-income economies, five upper-middle-income economies, and eight high-income economies according to the World Bank classification. INTERVENTIONS: Data closest to 2017 on critical care beds, including ICU and intermediate care unit beds, were obtained through multiple means, including government sources, national critical care societies, colleges, or registries, personal contacts, and extrapolation of data. MEASUREMENTS AND MAIN RESULTS: Cumulatively, there were 3.6 critical care beds per 100,000 population. The median number of critical care beds per 100,000 population per country and region was significantly lower in low- and lower-middle-income economies (2.3; interquartile range, 1.4-2.7) than in upper-middle-income economies (4.6; interquartile range, 3.5-15.9) and high-income economies (12.3; interquartile range, 8.1-20.8) (p = 0.001), with a large variation even across countries and regions of the same World Bank income classification. This number was independently predicted by the World Bank income classification on multivariable analysis, and significantly correlated with the number of acute hospital beds per 100,000 population (r = 0.19; p = 0.047), the universal health coverage service coverage index (r = 0.35; p = 0.003), and the Human Development Index (r = 0.40; p = 0.001) on univariable analysis. CONCLUSIONS: Critical care bed capacity varies widely across Asia and is significantly lower in low- and lower-middle-income than in upper-middle-income and high-income countries and regions.

Cinnamyl alcohol modified chitosan oligosaccharide for enhancing antimicrobial activity.

The present study aims at synthesizing and in vitro antibacterial activity evaluation of chitosan oligosaccharide (COS) modified by Cinnamyl alcohol (Cin) onto the OH position of COS. Three different degrees of substitution (DS) COS-O-Cin1-3 were synthesized by changing different molar ratios of COS to Cin. UV-visible spectroscopy (UV-vis), Fourier transform infrared (FT-IR), 1H nuclear magnetic resonance (1H NMR), thermogravimetric analysis (TGA), X-ray diffraction (XRD) and elemental analysis were conducted to characterize the successful synthesis of COS-O-Cin1-3. The results showed that they exhibited higher thermal stability, weaker crystallinity and better antibacterial properties than that of COS. These results aided in obtaining the important supports for exploring new functional antibacterial agents, which expand the scope of COS's application in the food industry.

Characterization of a novel d-arabinose isomerase from Thermanaeromonas toyohensis and its application for the production of d-ribulose and l-fuculose.

d-Ribulose and l-fuculose are potentially valuable rare sugars useful for anticancer and antiviral drugs in the agriculture and medicine industries. These rare sugars are usually produced by chemical methods, which are generally expensive, complicated and do not meet the increasing demands. Furthermore, the isomerization of d-arabinose and l-fucose byDd-arabinose and l-fucose by d-arabinose isomerase from bacterial sources for the production of d-ribulose and l-fuculose have not yet become industrial due to the shortage of biocatalysts, resulting in poor yield and high cost of production. In this study, a thermostable d-ribulose- and l-fuculose producing d-arabinose isomerase from the bacterium Thermanaeromonas toyohensis was characterized. The recombinant d-arabinose isomerase from T. toyohensis (Thto-DaIase) was purified with a single band at 66 kDa using His-trap affinity chromatography. The native enzyme existed as a homotetramer with a molecular weight of 310 kDa, and the specific activities for both d-arabinose and l-fucose were observed to be 98.08 and 85.52 U mg-1, respectively. The thermostable recombinant Thto-DaIase was activated when 1 mM Mn2+ was added to the reactions at an optimum pH of 9.0 at 75 °C and showed approximately 50% activity for both d-arabinose and l-fucose at 75 °C after 10 h. The Michaelis-Menten constant (Km), the turnover number (kcat) and catalytic efficiency (kcat/Km) for d-arabinose/l-fucose were 111/81.24 mM, 18,466/10,688 min-1, and 166/132 mM-1  min-1, respectively. When the reaction reached to equilibrium, the conversion rates of d-ribulose from d-arabinose and l-fuculose from l-fucose were almost 27% (21 g L-1) and 24.88% (19.92 g L-1) from 80 g L-1 of d-arabinose and l-fucose, respectively.

Genotoxic and hematological effects of chlorpyrifos exposure on freshwater fish Labeo rohita.

Chlorpyrifos is a commonly used organophosphate insecticide that causes toxicological effects in aquatic organisms especially in fish. This study determined the effects of chlorpyrifos on the genotoxic and hematological parameters of freshwater fish, Labeo rohita. The genotoxic effects of different sublethal concentrations of chlorpyrifos were investigated in the erythrocytes of Labeo rohita (commonly known as Rohu) using the Micronucleus test. Effects of chlorpyrifos on the hematological parameters of the fish were also observed. Fish specimens were exposed to three sublethal concentrations of chlorpyrifos viz., sublethal I (SL-I, 1/6th of LC50 = ∼73.8 µg/L), sublethal II (SL-II, 1/4th of LC50 = ∼110.7 µg/L) and sublethal III (SL-III, 1/2nd of LC50 = ∼221.4 µg/L) for 96 h. Blood samples were collected at every 24 h and were subjected to the Micronucleus assay. The observed micronucleus frequencies were concentration and time-dependent. The MN induction was significantly highest (p < 0.01) at all the concentrations on 96-h exposure. During the experimental period, hematological parameters like total erythrocytes count (TEC), hemoglobin (Hb) and packed cell volume (PCV) decreased, whereas total leukocytes count (TLC) increased. This study indicated that the Micronucleus assay is a useful tool to detect genotoxic potential of chlorpyrifos in fish.

Laparoscopic Appendectomy in Pregnancy With Acute Appendicitis: Single Center Experience With World Review.

OBJECTIVES: This clinical study is aiming to discuss the therapeutic benefit of laparoscopic appendectomy (LA) by comparing with conventional open appendectomy (OA) in pregnancy. MATERIALS AND METHODS: The clinical data of 26 pregnant women who underwent appendectomy from 2012 to 2016 was retrospectively analyzed. The variables analyzed included baseline information, operation characteristics, maternal complications, and infant health outcomes. The patients were divided in 2 LA and OA groups according to the surgical approach and their clinical characteristics were compared. RESULTS: Of reported 26 patients, 7 underwent LA whereas the remaining 19 patients underwent OA. The median age of the patients was 28 years (range, 19 to 39 y). The median gestational period was 21.5 weeks (range, 5 to 33 wk). The postoperative pathology showed complicated appendicitis 7 cases. The result showed significantly shorter operation time (42.14±8.63 vs. 65.21±26.58 min, P=0.003), hospital stay (4.14±1.77 vs. 6.47±2.72 d, P=0.021), and earlier recovery of gastrointestinal function in the LA group compared with OA group. There were no maternal and fetal deaths occurred in perioperative period in both groups. CONCLUSIONS: LA has not increased morbidity and mortality but displayed shorter hospital stay, operation time and recovery of gastrointestinal function to OA as well as good cosmetic results. Therefore, LA in patients with pregnancy can be considered as preferred approach in sophisticated hands without increased risks.

Biological removal of phyto-sterols in pulp mill effluents.

Phyto-sterols and extractives found in pulp mill effluents are suspected to cause endocrine abnormalities in receiving water fish. The control of sterols in pulp mill effluents through biological secondary wastewater treatment was studied using two lab-scale bioreactor systems. After achieving a stable performance, both bioreactor systems successfully removed (>90%) sterols and the estimated biodegradation was up to 80%. Reactor 1 system operating at 6.7 ± 0.2 pH effectively treated pulp mill effluent sterols spiked up to 4500 µg/L in 11 h HRT and 11 day SRT. However, Reactor 2 system operating at 7.6 ± 0.2 pH performed relatively poorly. Retention time reductions beyond critical values deteriorated the performance of treatment systems and quickly reduced the sterols biodegradation. The biodegradation loss was indicated by mixed liquor sterols content that started increasing. This biodegradation loss was compensated by the increased role of bio-adsorption and the overall sterols removal remained relatively high. Hence, a relatively small (20-30%) loss in the overall sterols removal efficiency did not fully reflect the associated major (60-70%) loss in the sterols biodegradation because the amount of sterols accumulated in the sludge due to adsorption increased so the estimate of sterols removal through adsorption increased from 30-40% to 70-80% keeping the overall sterols removal still high.