The COVID-19 pandemic compelled many consumers to adapt their grocery shopping, food preferences, and consumption behaviors. Based on 18 in-depth interviews with adults in the United States, this study uses a liminality framework to explore how the pandemic altered these behaviors. It also seeks to assess whether individuals have reverted to pre-pandemic consumption behaviors. Results show the mode of grocery shopping shifted; the frequency of grocery shopping declined; and the quantity of food increased in the initial stages of the pandemic with more people remaining home. By summer 2022, more individuals had shifted to online grocery shopping from shopping in-person, a departure from their pre-pandemic behavior. Findings also indicate the frequency of shopping largely mirrors pre-pandemic levels, though the quantity of groceries purchased has declined. Finally, the decline in food purchases is accompanied by increased spending on groceries in all phases of the pandemic.

Background: In endemic regions of several countries, the prevalence of leprosy has not come down to the level of elimination. On the contrary, new cases are being detected in large numbers. Clinically, it is frequently noted that despite completion of multibacillary multidrug therapy for 12 months, the lesions remain active, especially in cases with high bacteriological indices.Aim: The present study focused on finding out the viable number of Mycobacterium leprae during the 12-month regimen of multibacillary multidrug therapy, at six and 12 months intervals and, attempting to determine their role in disease transmission.Methods: Seventy eight cases of multibacillary leprosy cases were recruited from leprosy patients registered at The Leprosy Mission hospitals at Shahdara (Delhi), Naini (Uttar Pradesh) and Champa (Chhattisgarh), respectively. Slit skin smears were collected from these patients which were transported to the laboratory for further processing. Ribonucleic acid was extracted by TRIzol method. Total Ribonucleic acid was used for real-time reverse transcription-polymerase chain reaction (two-step reactions). A standard sample with a known copy number was run along with unknown samples for a reverse transcription-polymerase chain reaction. Patients were further assessed for their clinical and molecular parameters during 6th month and 12th month of therapy.Results: All 78 new cases showed the presence of a viable load of bacilli at the time of recruitment, but we were able to follow up only on 36 of these patients for one year. Among these, using three different genes, 20/36 for esxA, 22/36 for hsp18 and 24/36 for 16S rRNA cases showed viability of M. leprae at the time of completion of 12 months of multidrug therapy treatment. All these positive patients were histopathologically active and had bacillary indexes ranging between 3+ and 4+. Patients with a high copy number of the Mycobacterium leprae gene, even after completion of treatment as per WHO recommended fixed-dose multidrug therapy, indicated the presence of live bacilli.Limitations: Follow up for one year was difficult, especially in Delhi because of the migratory nature of the population. Patients who defaulted for scheduled sampling were not included in the study.Conclusion: The presence of a viable load of bacilli even after completion of therapy may be one of the reasons for relapse and continued transmission of leprosy in the community.

Justification In India, there is a lack of uniformity of treatment strategies for aplastic anemia (AA), and many children are managed only with supportive care due to non-availability of hematopoietic stem cell transplantation (HSCT). Process Eminent national faculty members were invited to participate in the process of forming a consensus statement in Hyderabad in July, 2016. Draft guidelines were circulated to all members, and comments received in a online meeting in October, 2020 were incorporated into the final draft. These were approved by all experts. Objective To facilitate appropriate management of children with acquired aplastic anemia. Recommendations Key recommendations are: i) A bone marrow biopsy is must to make a diagnosis of AA; ii) Rule out inherited bone marrow failure syndromes (IBMFS), connective tissue disorders, viral infections, paroxysmal nocturnal hemoglobinuria (PNH), drug or heavy metal induced marrow suppression in all cases of AA; iii) Conservative approach to transfusions should be followed, with a target to keep hemoglobin >6 g/dL in children with no co-morbidities; iv) HLA-matched sibling donor HSCT is the preferred choice of treatment for newly diagnosed very severe/severe AA; v) In absence of HLA-matched family donor, a matched unrelated donor (MUD) transplant or immunosuppressive therapy (IST) should be considered as alternate choice based on physician expertise; vi) Fludarabine, cyclophosphamide and anti-thymocyte globulin (ATG) based conditioning with cyclosporine and methotrexate as graft versus host disease (GvHD) prophylaxis is the preferred regimen; vii) Horse ATG and cyclosporine are the recommended drugs for IST. One should wait for 3-6 months for the response assessment and consideration of next line therapy.

Drug formulations such as spray drying are often required to improve the physicochemical properties and bioavailability of hydrophobic drugs. However, excipients often carry contaminants/ impurities and may also increase moisture levels in solid formulations, which can have detrimental effects on the drugs, including drug degradation and stability. Hence, achieving adequate shelf life of drug products has been among the most challenging issues for pharmaceuticals. Here we report a case study where we systematically studied the oxidative degradation of a pharmaceutical compound GENE-A, spray-dried and dispersed in hydroxypropyl methylcellulose-acetate succinate polymer matrix. Three different oxidative degradation products were observed, and their mechanisms of formation were investigated via forced degradation studies. Finally, we used several antioxidants based on their mechanisms of action to reduce/ prevent the drug degradation process. Propyl gallate alone and in combination with Ethylenediaminetetraacetic acid completely prevented the formation of two degradation products, whereas there was no significant impact observed on the third one. The results showed that both metal chelators and free radical terminators most effectively prevented drug degradation. This study may address some of the key issues that pharmaceutical companies encounter and offer appropriate solutions to counter the oxidative degradation process of pharmaceuticals.

Organic solvents and water are routinely used during the synthetic pathway of an active pharmaceutical ingredient (API) and extraction work up, respectively. Residual amounts of solvents and water tend to be strictly controlled at each step of a process as carryover can often negatively affect crystallization or the reactivity of catalysts and/or activating agents. A rapid, accurate, and precise measurement of these attributes is an important part of this overall control strategy. Here, we have developed a loss on drying (LOD) method for measuring total volatile matter for in-process control liquid and solid samples during a small molecule API manufacturing process, which relies on a halogen moisture analyzer with an integrated mass balance. Mixtures of lactose and microcrystalline cellulose with varying water content were prepared and used for evaluating the precision of the LOD technique with varying sample sizes. We have successfully demonstrated here that not only are the moisture measurements using this LOD method comparable to the traditional methods like Karl Fischer (KF) titration and/or gas chromatography (GC) for volatile solvents but also the LOD measurement process is much faster and requires little to no sample preparation. Further, we present a case study of using LOD and KF together to obtain the ratio of water and DMA (a high boiling point solvent), enabling a more efficient manufacturing process as it obviates the need for specialized HPLC or GC methods needed for measuring high boiling solvents such as DMA.

Background Workers critical to emergency response and continuity of essential services during the COVID-19 pandemic are at a disproportionally high risk of SARS-CoV-2 infection. Prospective cohort studies are needed for enhancing the understanding of the incidence of symptomatic and asymptomatic SARS-CoV-2 infections, identifying risk factors, assessing clinical outcomes, and determining the effectiveness of vaccination. Objective The Research on the Epidemiology of SARS-CoV-2 in Essential Response Personnel (RECOVER) prospective cohort study was designed to estimate the incidence of symptomatic and asymptomatic SARS-CoV-2 infections, examine the risk factors for infection and clinical spectrum of illness, and assess the effectiveness of vaccination among essential workers. Methods The RECOVER multisite network was initiated in August 2020 and aims to enroll 3000 health care personnel (HCP), first responders, and other essential and frontline workers (EFWs) at 6 US locations. Data on participant demographics, medical history, and vaccination history are collected at baseline and throughout the study. Active surveillance for the symptoms of COVID-19–like illness (CLI), access of medical care, and symptom duration is performed by text messages, emails, and direct participant or medical record reports. Participants self-collect a mid-turbinate nasal swab weekly, regardless of symptoms, and 2 additional respiratory specimens at the onset of CLI. Blood is collected upon enrollment, every 3 months, approximately 28 days after a reverse transcription polymerase chain reaction (RT-PCR)–confirmed SARS-CoV-2 infection, and 14 to 28 days after a dose of any COVID-19 vaccine. From February 2021, household members of RT-PCR–confirmed participants are self-collecting mid-turbinate nasal swabs daily for 10 days. Results The study observation period began in August 2020 and is expected to continue through spring 2022. There are 2623 actively enrolled RECOVER participants, including 280 participants who have been found to be positive for SARS-CoV-2 by RT-PCR. Enrollment is ongoing at 3 of the 6 study sites. Conclusions Data collected through the cohort are expected to provide important public health information for essential workers at high risk for occupational exposure to SARS-CoV-2 and allow early evaluation of COVID-19 vaccine effectiveness. International Registered Report Identifier (IRRID) DERR1-10.2196/31574

Introduction Pancytopenia is a clinical entity encountered in pediatric practice as a feature of various benign and malignant disorders. It describes the simultaneous presence of anemia, leucopenia and thrombocytopenia. Attempts to identify the correct etiology and gauging the severity of pancytopenia will help to determine the management and prognosis of the patients. Objectives To study etio-hematological profile, clinical correlates and outcome of pancytopenia in Indian children Methods This prospective observational study of children with pancytopenia was conducted at a tertiary care center from August 2015 to July 2016. Clinical, hematological and bone marrow studies were performed and patients were followed for one year. The collected data were statistically analyzed. Results Out of 84 cases, the mean age at diagnosis was 70 (70.77±4.8) months. Bone marrows showed aplastic changes in 37% and hyperplasia in 14% of patients. In our study, most common causes were aplastic anemia, acute leukemia and nutritional anemia. During the first year of follow-up, 67% pancytopenics survived and 12% succumbed (rest discontinued treatment) with ~26% of aplastic anemia (7/27 cases) and 9% of acute leukemia (2/22 cases) not surviving. Anthropometric status of patients and severity in aplastic anemia were significantly associated (p < 0.05) with outcome. Conclusion The data gathered support a complex picture for pancytopenia in our study population since both benign nutritional deficiencies and malignant hematological neoplasms were common. Bone marrow studies seem to be of salient use in delineating etiology. As the outcome is multifactorial, factors like anthropometry, hematological parameters have a bearing on prognosis.

Background: Workers critical to emergency response and continuity of essential services during the COVID-19 pandemic are at a disproportionally high risk of SARS-CoV-2 infection. Prospective cohort studies are needed for enhancing the understanding of the incidence of symptomatic and asymptomatic SARS-CoV-2 infections, identifying risk factors, assessing clinical outcomes, and determining the effectiveness of vaccination. Objective: The Research on the Epidemiology of SARS-CoV-2 in Essential Response Personnel (RECOVER) prospective cohort study was designed to estimate the incidence of symptomatic and asymptomatic SARS-CoV-2 infections, examine the risk factors for infection and clinical spectrum of illness, and assess the effectiveness of vaccination among essential workers. Methods: The RECOVER multisite network was initiated in August 2020 and aims to enroll 3000 health care personnel (HCP), first responders, and other essential and frontline workers (EFWs) at 6 US locations. Data on participant demographics, medical JMIR Res Protoc 2021 | vol. 10 | iss. 12 | e31574 | p. 1 https://www.researchprotocols.org/2021/12/e31574 (page number not for citation purposes) Edwards et al JMIR RESEARCH PROTOCOLS

BackgroundCOVID-19 has spread worldwide since late 2019, with an unprecedented case count and death toll globally. Health care personnel (HCP), first responders, and other essential and frontline workers (OEWs) are at increased risk of SARS-CoV-2 infection because of frequent close contact with others. ObjectiveThe Arizona Healthcare, Emergency Response, and Other Essential Workers Study (AZ HEROES) aims to examine the epidemiology of SARS-CoV-2 infection and COVID-19 illness among adults with high occupational exposure risk. Study objectives include estimating the incidence of SARS-CoV-2 infection in essential workers by symptom presentation and demographic factors, determining independent effects of occupational and community exposures on incidence of SARS-CoV-2 infection, establishing molecular and immunologic characteristics of SARS-CoV-2 infection in essential workers, describing the duration and patterns of real-time reverse transcription–polymerase chain reaction (rRT-PCR) positivity, and examining postvaccine immunologic response. MethodsEligible participants include Arizona residents aged 18 to 85 years who work at least 20 hours per week in an occupation involving regular direct contact (ie, within 3 feet) with others. Recruitment goals are stratified by demographic characteristics (50% aged 40 years or older, 50% women, and 50% Hispanic or American Indian), by occupation (40% HCP, 30% first responders, and 30% OEWs), and by prior SARS-CoV-2 infection (with up to 50% seropositive at baseline). Information on sociodemographics, health and medical history, vaccination status, exposures to individuals with suspected or confirmed SARS-CoV-2 infection, use of personal protective equipment, and perceived risks are collected at enrollment and updated through quarterly surveys. Every week, participants complete active surveillance for COVID-like illness (CLI) and self-collect nasal swabs. Additional self-collected nasal swab and saliva specimens are collected in the event of CLI onset. Respiratory specimens are sent to Marshfield Laboratories and tested for SARS-CoV-2 by rRT-PCR assay. CLI symptoms and impact on work and productivity are followed through illness resolution. Serum specimens are collected every 3 months and additional sera are collected following incident rRT-PCR positivity and after each COVID-19 vaccine dose. Incidence of SARS-CoV-2 infections will be calculated by person-weeks at risk and compared by occupation and demographic characteristics as well as by seropositivity status and infection and vaccination history. ResultsThe AZ HEROES study was funded by the US Centers for Disease Control and Prevention. Enrollment began on July 27, 2020; as of May 1, 2021, a total of 3165 participants have been enrolled in the study. Enrollment is expected to continue through December 1, 2021, with data collection continuing through at least April 2022, contingent upon funding. ConclusionsAZ HEROES is unique in aiming to recruit a diverse sample of essential workers and to prospectively follow strata of SARS-CoV-2 seronegative and seropositive adults. Survey results combined with active surveillance data on exposure, CLI, weekly molecular diagnostic testing, and periodic serology will be used to estimate the incidence of symptomatic and asymptomatic SARS-CoV-2 infection, assess the intensity and durability of immune responses to natural infection and COVID-19 vaccination, and contribute to the evaluation of COVID-19 vaccine effectiveness. International Registered Report Identifier (IRRID)DERR1-10.2196/28925

BACKGROUND:The Arizona Healthcare, Emergency Response, and Other Essential workers Study (AZ HEROES) aims to examine the epidemiology of SARS-CoV-2 infection and COVID-19 illness among adults with high occupational exposure risk. OBJECTIVE:Study objectives include estimating incidence of SARS-CoV-2 infection in essential workers by symptom presentation and demographic factors, determining independent effects of occupational and community exposures on incidence of SARS-CoV-2 infection, establishing molecular and immunologic characteristics of SARS-CoV-2 infection in essential workers, describing the duration and patterns of rRT-PCR-positivity, and examining post-vaccine immunologic response. METHODS:Eligible participants include Arizona residents aged 18-85 years who work at least 20 hours per week in an occupation involving regular direct contact (within three feet) with others. Recruitment goals are stratified by demographic characteristics (50% aged 40 or older, 50% women, and 50% Hispanic or American Indian), by occupation (40% healthcare personnel, 30% first responders, and 30% other essential workers), and by prior SARS-CoV-2 infection (with up to 50% seropositive at baseline). Information on sociodemographics, health and medical history, vaccination status, exposures to individuals with suspected or confirmed SARS-CoV-2 infection, use of personal protective equipment, and perceived risks are collected at enrollment and updated through quarterly surveys. Every week, participants complete active surveillance for COVID-19-like illness (CLI) and self-collect nasal swabs. Additional self-collected nasal swab and saliva specimens are collected in the event of CLI onset. Respiratory specimens are sent to Marshfield Laboratories and tested for SARS-CoV-2 by real-time reverse transcription polymerase chain reaction (rRT-PCR) assay. CLI symptoms and impact on work and productivity are followed through illness resolution. Serum specimens are collected every 3 months and additional sera are collected following incident rRT-PCR positivity and after each COVID-19 vaccine dose. Incidence of SARS-CoV-2 infections will be calculated by person-weeks at risk and compared by occupation and demographic characteristics and by seropositivity status and infection and vaccination history. RESULTS:The AZ HEROES study was funded by the Centers for Disease Control and Prevention. Enrollment began July 27, 2020 and as of May 1, 2021 a total of 3,165 participants have been enrolled in the study. CONCLUSIONS:AZ HEROES is unique in aiming to recruit a diverse sample of essential workers and prospectively following strata of SARS-CoV-2 seronegative and seropositive adults. Survey results combined with active surveillance data on exposure, CLI, weekly molecular diagnostic testing, and periodic serology will be used to estimate the incidence of symptomatic and asymptomatic SARS-CoV-2 infection, assess the intensity and durability of immune responses to natural infection and COVID-19 vaccination, and contribute to the evaluation of COVID-19 vaccine effectiveness. CLINICALTRIAL: INTERNATIONAL REGISTERED REPORT:DERR1-10.2196/28925.

Epstein Barr virus (EBV) associated Hodgkin lymphoma (HL) has been defined as cases with clonal EBV infection, EBV genome and gene products in the Reed Sternberg cells. We evaluated the prevalence and clinico-pathological association of EBV in North Indian HL patients. Eighty-eight cases of histologically confirmed classic HL were evaluated for EBV by both IHC expression of LMP1 and real time PCR on formalin fixed lymph node tissue. The expression pattern was analyzed for any association with clinical and histomorphological parameters. Nodular sclerosis subtype was seen in 79.5% patients and mixed cellularity was seen in the remaining patients. Ninety percent of the cases were positive for EBV. The detection rate of EBV by IHC was higher. The EBV positive cases presented with higher disease stage (p < 0.05). The presence of histomorphological features like granuloma formation (5/5), atypical lymphocytes (8/8), histiocyte clusters (26/28), large area of necrosis (11/12), less prominent inflammatory response (25/27) was associated with EBV positivity (p > 0.05). In our study population a high proportion of HL cases showed positivity for EBV indicating a pathogenic role. The positivity was independent of age, gender and histological subtype. Further evaluation of EBV positivity in modulation of tumor immunity may provide insights into variable treatment outcome in EBV positive cases.

Disability, CBR and Inclusive Development aims to enhance knowledge in the field of disability and inclusive development, addressing the needs of practitioners, policy makers, DPOs and the scientific community.

Objective: The study aimed to screen household contacts of persons diagnosed with leprosy having a high bacterial index, at a tertiary referral centre. Methods: This hospital based study involved 334 persons who were newly diagnosed as leprosy with a high bacterial index, attending a tertiary referral hospital, Champa, Chhattisgarh, India. We enumerated all the household contacts of registered cases and invited them to be screened for leprosy. Results: Of 334 high BI cases, 252 (75%) were male and 82 (25%) were female, with ages ranging from 12 to 75 years. Sixty two (18%) had Grade 2 disability and 32% had a bacterial index of above 5+ at the time of diagnosis. A total of 1,397 household members were enrolled for screening and 678 (49%) were examined for leprosy. One hundred and sixteen household members were found to have signs of leprosy, and among these, 57 (49%) were identified as new cases, 11 (10%) were known cases on treatment and 48 (41%) had been previously treated for leprosy. Conclusion: This study showed that screening of household contacts of high BI cases is an effective method of leprosy case detection and emphasizes the continuing need to screen and follow up. Continued health education and motivation of household contacts will enhance voluntary reporting for periodical screening.

This study uses infrared (IR) spectroscopy to achieve process understanding during the synthesis of a tetrasubstituted acyclic olefin via ketone enolization and tosylation. ReactIR, an inline Fourier transform IR immersion probe, was used to monitor ketone enolate formation and tosylation in a two-step, one-pot reaction. A quantitative univariate model was constructed from the ketone carbonyl IR peak height of the starting material. This model was used to determine the rate of consumption of the starting material and to establish end points for various reaction conditions. For the second step of the reaction, the vinyl sulfonate formation, the entire IR spectrum was analyzed and offline HPLC data were collected to measure the ratio of E versus Z tetrasubstituted vinyl tosylate products. Principal component analysis and partial least-squares regression were employed to build a multivariate model that was then used to quantify and predict the relative amount of E and Z stereoisomers in situ. Sensitivity and applicability of the models were then validated using reaction data acquired across a variety of experimental conditions.

The direct application of Knochel-Hauser derivative arylmagnesium halides in Kumada-Corriu couplings is described. By utilizing the in situ-generated Grignard reagents, the transmetalation with stoichiometric zinc salts to known Negishi coupling conditions is avoided, thereby streamlining the transformation. Several aromatic hetereocycles participate in the deprotonation and couple with a variety of phenyl iodides and bromides in isolated yields up to 81%. The parent system is demonstrated on 6 g scale with 79% yield, and monitored via ReactIR to show the stability of the Grignard and progression of the deprotonation/C-C coupling reaction. (C) 2018 Elsevier Ltd. All rights reserved.