INTRODUCTION Asthma is an important healthcare problem affecting millions in the United States. Additionally, a large proportion of patients with asthma suffer from obesity. These patients exhibit poor asthma control and reduced therapy response, increasing utilization of healthcare resources. Pulmonary symptoms improve after bariatric surgery (BS), and we hypothesized that asthma medication usage would decrease following BS. METHODS A retrospective data analysis was performed in adult patients from a single institution's database. Patients with obesity using at least one asthma medication pre-operatively who underwent BS were studied for up to 3-years post-operation. Poisson generalized linear mixed models for repeated measures were used to evaluate the effects of time and procedure type on the number of asthma medication. RESULTS Bariatric patients with at least one prescribed asthma medication (mean 1.4 0.6) were included (n = 751). The mean age at time of operation was 46.8 11.6 years, mean weight was 295.9 57 lbs, and mean body mass index (BMI) was 49 8.2 kg/m2; 87.7% were female, 33.4% had diabetes, 44.2% used gastroesophageal reflux disease (GERD) medication, and 64.4% used hypertension medication. The most common procedure was Roux-en-Y gastric bypass (79%), followed by sleeve gastrectomy (10.7%), adjustable gastric banding (8.1%), and duodenal switch (2.3%). The mean number of prescribed asthma medications among all procedures decreased by 27% at 30 days post-operation (p < 0.0001), 37% at 6 months (p < 0.0001), 44% at 1 year (p < 0.0001), and 46% at 3 years (p < 0.0001) after adjusting for risk factors. No significant differences in medication use over time between procedure types were observed. In the adjusted analysis, the mean number of asthma medications was 12% higher in patients using at least one GERD medication (p = 0.015) and 8% higher with 10-unit increase in pre-operative BMI (p = 0.006). CONCLUSION BS significantly decreases asthma medication use starting 30 days post-operation with a sustained reduction for up to 3 years.

Prompt and accurate detection of SARS-CoV-2, the virus that causes COVID-19, has been important during public health responses for containing the spread of COVID-19, including in hospital settings (1-3). In vitro diagnostic nucleic acid amplification tests (NAAT), such as real-time reverse transcription-polymerase chain reaction (RT-PCR) can be expensive, have relatively long turnaround times, and require experienced laboratory personnel.* Antigen detection tests can be rapidly and more easily performed and are less expensive. The performance? of antigen detection tests, compared with that of NAATs, is an area of interest for the rapid diagnosis of SARS-CoV-2 infection. The Quidel Sofia 2 SARS Antigen Fluorescent Immunoassay (FIA) (Quidel Corporation) received Food and Drug Administration Emergency Use Authorization for use in symptomatic patients within 5 days of symptom onset (4). The reported test positive percentage agreement between this test and an RT-PCR test result is 96.7% (95% confidence interval [CI] = 83.3%-99.4%), and the negative percentage agreement is 100.0% (95% CI = 97.9%-100.0%) in symptomatic patients.? However, performance in asymptomatic persons in a university setting has shown lower sensitivity (5); assessment of performance in a clinical setting is ongoing. Data collected during June 30-August 31, 2020, were analyzed to compare antigen test performance with that of RT-PCR in a hospital setting. Among 1,732 paired samples from asymptomatic patients, the antigen test sensitivity was 60.5%, and specificity was 99.5% when compared with RT-PCR. Among 307 symptomatic persons, sensitivity and specificity were 72.1% and 98.7%, respectively. Health care providers must remain aware of the lower sensitivity of this test among asymptomatic and symptomatic persons and consider confirmatory NAAT testing in high-prevalence settings because a false-negative result might lead to failures in infection control and prevention practices and cause delays in diagnosis, isolation, and treatment.

The enzyme cGAS functions as a sensor that recognizes the cytosolic DNA from foreign pathogen. The activation of the protein triggers the transcription of inflammatory genes, leading into the establishment of an antipathogen state. An interesting new discovery is that the detection of DNA by cGAS induced the formation of liquid-like droplets. However how cells regulate the formation of these droplets is still not fully understood. In order to unravel the molecular mechanism beneath the DNA-mediated phase separation of cGAS, we developed a polymer-based coarse-grained model which takes into accounts the basic structural organization in DNA and cGAS, as well as the binding properties between these biomolecules. This model was further integrated into a hybrid simulation algorithm. With this computational method, a multi-step kinetic process of aggregation between cGAS and DNA was observed. Moreover, we systematically tested the model under different concentrations and binding parameters. Our simulation results show that phase separation requires both cGAS dimerization and protein-DNA interactions, whereas polymers can be kinetically trapped in small aggregates under strong binding affinities. Additionally, we demonstrated that supramolecular assembly can be facilitated by increasing the number of functional modules in protein or DNA polymers, suggesting that multivalency and intrinsic disordered regions play positive roles in regulating phase separation. This is consistent to previous experimental evidences. Taken together, this is, to the best of our knowledge, the first computational model to study condensation of cGAS-DNA complexes. While the method can reach the timescale beyond the capability of atomic-level MD simulations, it still includes information about spatial arrangement of functional modules in biopolymers that is missing in the mean-field theory. Our work thereby adds a useful dimension to a suite of existing experimental and computational techniques to study the dynamics of phase separation in biological systems.

BACKGROUND AND PURPOSE Hemorrhagic transformation (HT) is a complication that may cause neurological deterioration in patients with acute ischemic stroke. Various radiological subtypes of HT can be distinguished. Their influence on functional outcome is currently unclear. The purpose of this study was to assess the associations between HT subtypes and functional outcome in acute ischemic stroke patients with proven large vessel occlusion included in the MR CLEAN trial (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic stroke in The Netherlands). METHODS All patients with follow-up imaging were included. HT was classified on follow-up CT scans according to the European Cooperative Acute Stroke Study II classification. Functional outcome was assessed using the modified Rankin Scale (mRS) 90 days after stroke onset. Ordinal logistic regression analysis with adjustment for potential confounders was used to determine the association of HT subtypes with functional outcome. RESULTS Of 478 patients, 222 had HT. Of these, 76 (16%) patients were classified as hemorrhagic infarction type 1, 71 (15%) as hemorrhagic infarction type 2, 36 (8%) as parenchymal hematoma type 1, and 39 (8%) as parenchymal hematoma type 2. Hemorrhagic infarction type 2 (adjusted common OR (acOR) 0.54, 95% CI: 0.32 to 0.89) and parenchymal hematoma type 2 (acOR 0.37, 95% CI 0.17 to 0.78) were significantly associated with a worse functional outcome. Hemorrhagic infarction type 1 and parenchymal hematoma type 1 were not significantly associated, although their point estimates pointed in the direction of worse outcome. CONCLUSION This study suggests that parenchymal hematoma type 2 is relevant for functional outcome after an acute ischemic stroke, and smaller HTs might also influence long term functional outcome. TRAIL REGISTRATION NUMBER ISRCTN10888758.

Automated contact tracing is a key solution to control the spread of airborne transmittable diseases: it traces contacts among individuals in order to alert people about their potential risk of being infected. The current SARS-CoV-2 pandemic put a heavy strain on the healthcare system of many countries. Governments chose different approaches to face the spread of the virus and the contact tracing apps were considered the most effective ones. In particular, by leveraging on the Bluetooth Low-Energy technology, mobile apps allow to achieve a privacy-preserving contact tracing of citizens. While researchers proposed several contact tracing approaches, each government developed its own national contact tracing app. In this paper, we demonstrate that many popular contact tracing apps (e.g., the ones promoted by the Italian, French, Swiss government) are vulnerable to relay attacks. Through such attacks people might get misleadingly diagnosed as positive to SARS-CoV-2, thus being enforced to quarantine and eventually leading to a breakdown of the healthcare system. To tackle this vulnerability, we propose a novel and lightweight solution that prevents relay attacks, while providing the same privacy-preserving features as the current approaches. To evaluate the feasibility of both the relay attack and our novel defence mechanism, we developed a proof of concept against the Italian contact tracing app (i.e., Immuni). The design of our defence allows it to be integrated into any contact tracing app.

Lockdown and stay-at-home orders related to COVID-19 have exacerbated pressure on families in a time of public health threat and economic insecurity. Public child welfare (PCW) workers, inundated with job demands even in normal times, face cases complicated by the added stressor of a pandemic. The lockdown and economic crisis heighten the risk of abuse and neglect for children in precarious situations and shared trauma for PCW workers dealing with increased work and personal stressors. Symptoms of shared trauma can impede PCW workers from fulfilling job demands and responsibilities, which leads to inadequate resources for children in need of permanency and can potentially harm service delivery outcomes. The risk of significant shared traumatic stress among PCW workers thus needs to be mitigated with protective factors. Staff-focused policies and practices need to be created, utilized, and upheld through multilevel leadership, for the good of individual workers, their clients, and the larger society.

Multiple sclerosis (MS) is an inflammatory, demyelinating, central nervous system disease mediated by myelin-specific T cells. Environmental triggers that cause a breakdown of myelin-specific T cell tolerance are unknown. We found that CD8(+) myelin basic protein (MBP)-specific T cell tolerance can be broken and autoimmunity induced by infection with a virus that does not express MBP cross-reactive epitopes and does not depend on bystander activation. Instead, the virus activated dual T cell receptor (TCR)-expressing T cells capable of recognizing both MBP and viral antigens. These results demonstrate the importance of dual TCR T cells in autoimmunity and suggest a mechanism by which a ubiquitous viral infection could trigger autoimmunity in a subset of infected individuals, as hypothesized in the etiology of MS.

The availability of three COVID-19 vaccines in the United States provides an unprecedented opportunity to examine how vaccine platforms and timing of vaccination in pregnancy impact maternal and neonatal immunity. Here, we characterized the antibody profile after Ad26.COV2.S, mRNA-1273 or BNT162b2 vaccination in 158 pregnant individuals, and evaluated transplacental antibody transfer by profiling maternal and umbilical cord blood in 175 maternal-neonatal dyads. These analyses revealed lower vaccine-induced functions and Fc-receptor binding after Ad26.COV2.S compared to mRNA vaccination, and subtle advantages in titer and function with mRNA-1273 versus BN162b2. mRNA vaccinees had higher titers and functions against SARS-CoV-2 variants of concern. First and third trimester vaccination resulted in enhanced maternal immune responses relative to second trimester. Higher cord:maternal transfer ratios following first and second trimester vaccination reflect placental compensation for waning maternal titers. These results support vaccination early in pregnancy to maximize maternal protection throughout gestation, without compromising neonatal antibody protection.

PROBLEM: In accordance with guidelines from the Association of American Medical Colleges, medical schools across the United States suspended clerkships and transitioned preclinical courses online in March 2020 because of the COVID-19 pandemic. Hospitals and health systems faced significant burdens during this time, particularly in New York City. APPROACH: Third- and fourth-year medical students at the Icahn School of Medicine at Mount Sinai formed the COVID-19 Student WorkForce to connect students to essential roles in the Mount Sinai Hospital System and support physicians, staff members, researchers, and hospital operations. With the administration's support, the WorkForce grew to include over 530 medical and graduate students. A methodology was developed for clinical students to receive elective credit for these volunteer activities. OUTCOMES: From March 15, 2020 to June 14, 2020, student volunteers recorded 29,602 hours (2,277 hours per week) in 7 different task forces which operated at 7 different hospitals throughout the health system. Volunteers included students from all years of medical school as well as PhD, master's, and nursing students. The autonomous structure of the COVID-19 Student WorkForce was unique and contributed to its ability to quickly mobilize students to necessary tasks. The group leaders collaborated with other medical schools in the New York City area, sharing best practices and resources and consulting on a variety of topics. EXT STEPS: Going forward, the COVID-19 Student WorkForce will continue to collaborate with student leaders of other institutions and prevent volunteer burnout; transition select initiatives into structured, precepted student roles for clinical education; and maintain a state of readiness in the event of a second surge of COVID-19 infections in the New York City area.

OBJECTIVE: To study impact of COVID-19 pandemic on frequency, clinical/electrophysiological profile and treatment outcomes in pediatric Guillain-Barr syndrome (GBS). BACKGROUND: GBS is the most frequent cause of pediatric acute flaccid paralysis. The effect of the COVID-19 pandemic on pediatric GBS is unclear in the literature. METHODS: We conducted an ambispective, multicentric, cohort study involving 12 of 27 centres in GBS Consortium, during two periods: pre-COVID-19 (March-August 2019) and during COVID-19 (March-August 2020). Children 12 years who satisfied National Institute of Neurological Diseases and Stroke criteria for GBS/variants were enrolled. Details pertaining to clinical/laboratory parameters, treatment and outcomes (modified Rankin Scale (mRS) at discharge, GBS Disability score at discharge and 3 months) were analysed. RESULTS: We enrolled 33 children in 2019 and 10 in 2020. Children in 2020 were older (median 10.4 [interquartile range 6.75C11.25] years versus 5 (2.5C8.4) years; P = 0.022) and had more sensory symptoms (50% versus 18.2%; P = 0.043). The 2020 group had relatively favourable mRS at discharge (median 1 (1C3.5) versus 3 (2C4); P = 0.042) and GBS disability score at 3 months (median 0 (0C0.75) versus 2 (0C3); P = 0.009) compared to 2019. Multivariate analysis revealed bowel involvement (P = 0.000) and ventilatory support (P = 0.001) as independent predictors of disability. No child in 2020 had preceding/concurrent SARS-CoV2 infection. CONCLUSIONS: The COVID-19 pandemic led to a marked decline in pediatric GBS presenting to hospitals. Antecedent illnesses, clinical and electrophysiological profile of GBS remained largely unchanged from the pre-pandemic era.

BACKGROUND: To date, specific cytokines associated with development of acute respiratory distress syndrome (ARDS) and extrapulmonary multiple organ dysfunction (MOD) in COVID-19 patients have not been systematically described. We determined the levels of inflammatory cytokines in patients with COVID-19 and their relationships with ARDS and extrapulmonary MOD. METHODS: The clinical and laboratory data of 94 COVID-19 patients with and without ARDS were analyzed. The levels of inflammatory cytokines (interleukin 6 [IL-6], IL-8, IL-10, and tumor necrosis factor &#945; [TNF-&#945;]) were measured on days 1, 3, and 5 following admission. Seventeen healthy volunteers were recruited as controls. Correlations in the levels of inflammatory cytokines with clinical and laboratory variables were analyzed, furthermore, we also explored the relationships of different cytokines with ARDS and extrapulmonary MOD. RESULTS: The ARDS group had higher serum levels of all 4 inflammatory cytokines than the controls, and these levels steadily increased after admission. The ARDS group also had higher levels of IL-6, IL-8, and IL-10 than the non-ARDS group, and the levels of these cytokines correlated significantly with coagulation parameters and disseminated intravascular coagulation (DIC). The levels of IL-6 and TNF-&#945; correlated with the levels of creatinine and urea nitrogen, and were also higher in ARDS patients with acute kidney injury (AKI). All 4 inflammatory cytokines had negative correlations with PaO2/FiO2. IL-6, IL-8, and TNF-&#945; had positive correlations with the APACHE-II score. Relative to survivors, non-survivors had higher levels of IL-6 and IL-10 at admission, and increasing levels over time. CONCLUSIONS: The cytokine storm apparently contributed to the development of ARDS and extrapulmonary MOD in COVID-19 patients. The levels of IL-6, IL-8, and IL-10 correlated with DIC, and the levels of IL-6 and TNF-&#945; were associated with AKI. Relative to survivors, patients who died within 28 days had increased levels of IL-6 and IL-10.

The United States and Mexico have engaged in hydrodiplomacya practice of transboundary water management that blends water diplomacy and science diplomacy--for more than 75 years, since the adoption of the Treaty of 1944 and the creation of the International Boundary and Water Commission We examine six major turning points in U S -Mexico hydrodiplomacy to ascertain the key factors in the regions history of resolving transboundary water issues We find that recognized adaptive governance indicatorssuch as social learning, sustained relationships, flexible governance mechanisms, and state and non-state networks are essential elements of hydrodiplomacy Our research suggests that robust and foundational institutions comprise another key indicator of adaptive governance specifically in transboundary contexts A commitment to both science and diplomacy have been important components underlying the effectiveness of hydrodiplomacy in the border region Binational networks involving diverse state and non-state actors at multiple scales have increasingly played a pivotal role in shaping desirable hydrodiplomatic outcomes in the region

BACKGROUND: Haloperidol, a widely used antipsychotic, has been suggested as potentially useful for patients with COVID-19 on the grounds of its in-vitro antiviral effects against SARS-CoV-2, possibly through sigma-1 receptor antagonist effect. METHODS: We examined the associations of haloperidol use with intubation or death and time to discharge home among adult patients hospitalized for COVID-19 at Assistance Publique-H?pitaux de Paris (AP-HP) Greater Paris University hospitals. Study baseline was defined as the date of hospital admission. The primary endpoint was a composite of intubation or death and the secondary endpoint was discharge home among survivors in time-to-event analyses. In the primary analyses, we compared these two outcomes between patients receiving and not receiving haloperidol using univariate Cox regression models in matched analytic samples based on patient characteristics and other psychotropic medications. Sensitivity analyses included propensity score analyses with inverse probability weighting and multivariable Cox regression models. RESULTS: Of 15,121 adult inpatients with a positive COVID-19 PT-PCR test, 39 patients (0.03%) received haloperidol within the first 48 hours of admission. Over a mean follow-up of 13.8 days (SD = 17.9), 2,024 patients (13.4%) had a primary end-point event and 10,179 patients (77.6%) were discharged home at the time of study end on May 1(st). The primary endpoint occurred in 9 patients (23.1%) who received haloperidol and 2,015 patients (13.4%) who did not. The secondary endpoint of discharge home occurred in 16 patients (61.5%) who received haloperidol and 9,907 patients (85.8%) who did not. There were no significant associations between haloperidol use and the primary (HR, 0.80; 95% CI, 0.39 to 1.62, p = 0.531) and secondary (HR, 1.30; 95% CI, 0.74 to 2.28, p = 0.355) endpoints. Results were similar in multiple sensitivity analyses. CONCLUSION: Findings from this multicenter observational study suggest that haloperidol use prescribed at a mean dose of 4.5 mg per day (SD = 5.2) for a mean duration of 8.4 days (SD = 7.2) may not be associated with risk of intubation or death, or with time to discharge home, among adult patients hospitalized for COVID-19.

We present a case of haemorrhagic enterocolitis in a patient with SARS-CoV-2 who recovered from respiratory failure after support with venovenous extracorporeal membrane oxygenation. We describe clinicopathological features consistent with the systemic coinfection/reactivation of cytomegalovirus (CMV) concurrent with COVID-19 infection and the protracted clinical course of resolution of gastrointestinal inflammation after the treatment of CMV infection. Stool PCR, abdominal CT perfusion scan and histological examination of ileal and colonic tissues excluded enterocolitis secondary to other causes of infection (common viral, bacterial and protozoal gastrointestinal pathogens), macrovascularand microvascular ischaemia and classic inflammatory bowel disease, respectively. We propose possible synergistic pathophysiologic mechanisms for enterocolitis complicating severe COVID-19 infection: (1) T lymphocyte depletion and immune response dysregulation, (2) use of immunomodulators in the management of severe COVID-19 infection and (3) high concentration of ACE-2 receptors for COVID-19 virus in the gastrointestinal tract.

BACKGROUND: The COVID-19 pandemic has inundated the capacity of hospitals across the globe, exhausting resources, and placing extreme burden on health care workers (HCWs). Hospital preparedness during infectious disease outbreak involves development and implementation of appropriate strategies, procedures, and adequate training for HCWs. Reliable and valid tools to evaluate the perception of HCWs on the effectiveness of hospital preparedness strategies are imperative and literature is yet to fill that gap. METHODS: Items for The Staff Questionnaire for Infectious Disease Outbreak Readiness and Preparedness (SQIDORP) were selected from literature that addressed hospital preparedness during novel pandemic outbreaks. The SQIDORP was distributed within a regional hospital in Victoria, Australia. Psychometric evaluation included estimates of reliability and factor analysis while factors associated with the questionnaire were explored using regression analysis. RESULTS: Omega coefficient of 0.89, Cronbachs alpha coefficient of 0.88 and item-total correlations (> 0.3) indicated adequate reliability of the SQIDORP. Factor Analysis yielded three meaningful latent factors that are effectiveness of training (Factor 1), self-confidence (Factor 2) and risk to self and stress (Factor 3). Demographic factors did not influence the correlation with SQIDORP. However, rating the current plan for management of COVID-19 in your ward and personal knowledge/skills in caring for patients with COVID-19 had significant positive correlation and accounted for 33% of the variance in readiness and preparedness using SQIDORP (R2 = 0.33, F = 10.227, P < 0.001). CONCLUSION: Most of the items of SQIDORP questionnaire achieved adequate internal consistence reliability. This is a valuable tool that can be utilized by hospitals to explore aspects of preparedness and give insights to the knowledge, skills, and mental health of HCWs, as perceived by the HCW themselves.

The COVID-19 pandemic is one of the most devastating public health emergencies in history. In late 2020 and after almost a year from the initial outbreak of the novel coronavirus (SARS-CoV-2), several vaccines were approved and administered in most countries. Saudi Arabia has established COVID-19 vaccination centers in all regions. Various facilities were selected to set up these vaccination centers, including conference and exhibition centers, old airport terminals, pre-existing medical facilities, and primary healthcare centers. Deciding the number and locations of these facilities is a fundamental objective for successful epidemic responses to ensure the delivery of vaccines and other health services to the entire population. This study analyzed the spatial distribution of COVID-19 vaccination centers in Jeddah, a major city in Saudi Arabia, by using GIS tools and methods to provide insight on the effectiveness of the selection and distribution of the COVID-19 vaccination centers in terms of accessibility and coverage. Based on a spatial analysis of vaccine centers coverage in 2020 and 2021 in Jeddah presented in this study, coverage deficiency would have been addressed earlier if the applied GIS analysis methods had been used by authorities while gradually increasing the number of vaccination centers. This study recommends that the Ministry of Health in Saudi Arabia evaluated the assigned vaccination centers to include the less-populated regions and to ensure equity and fairness in vaccine distribution. Adding more vaccine centers or reallocating some existing centers in the denser districts to increase the coverage in the uncovered sparse regions in Jeddah is also recommended. The methods applied in this study could be part of a strategic vaccination administration program for future public health emergencies and other vaccination campaigns.

BACKGROUND Not long after the widespread surge in the corona virus disease 2019 (Covid-19) cases globally, dentistry was identified as one of the riskiest profession during this pandemic. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), similar to many other microorganisms, was found to be prevalent in the mucous and salivary secretions of the infected patients. The proximity of dentists to these bodily fluids demands appropriate enhancement of the safety precautions followed to avoid the spread of infection. During the initial phase of the pandemic lockdowns globally, most dental practices were closed, except for emergency procedures. The fear of the virus was largely prevalent. However, prolonged closures of dental practices with the subsequent halt of all routine and elective dental procedures led to the additional fear of financial losses. This questionnaire study intends to gauge the awareness of Covid-19 risks among dentists and evaluate the modifications done in their practices to enhance safety and avoid the spread of infection. METHODS 311 dentists participated in an online questionnaire study conducted via google survey. Answers were recorded and statistically analysed using statistical package for social sciences (SPSS). RESULTS 97.4 % of the dentists were aware of Covid-19 while 95.2 % had made at least one or more modifications in their clinical practice to prevent risk of spread of covid-19 viral infection. CONCLUSIONS On the whole, this study implies that majority of the dentists are aware of Covid-19 and have taken some safety precautions to curb the viral spread. In order to ensure that the left out people have sufficient knowledge, help or support, recommendations have been given whenever possible.

IMPORTANCE: Vaccine breakthrough by an emergent SARS-CoV-2 variant poses a great risk to global public health. OBJECTIVE: To determine the SARS-CoV-2 variant responsible for 6 cases of vaccine breakthrough. DESIGN: Nasopharyngeal swabs from suspected vaccine breakthrough cases were tested for SARS-CoV-2 by qPCR for Wuhan-Hu1 and Alpha variant. Positive samples were then sequenced by Swift Normalase Amplicon Panels to determine the causal variant. SETTING: Transmission event occurred at events surrounding a wedding outside of Houston, TX. Two patients from India, likely transmitted the Delta variant to other guests. PARTICIPANTS: Following a positive SARS-CoV-2 qPCR test at a third-party site, six fully vaccinated patients were investigated. Three males and three females ranged from 53 to 69 years old. One patient suffered from diabetes while three others were classified as overweight. No significant other comorbidities were identified. None of the patients had a history of failed vaccination.

Periodontitis is a complex immune-inflammatory condition characterized by the disruption of the periodontal ligament and subsequent formation of periodontal pockets, and by alveolar bone loss, often resulting in tooth loss. A myriad of factors, namely, genetic, metabolic, immunological, and inflammatory, is associated with progression of periodontitis. Periodontitis is also associated with systemic conditions such as neoplastic disorders, obesity, and diabetes. The current diagnosis of this disease relies on clinical measurements such as clinical attachment loss and probing depth, which have poor precision due to patient, operator and probe-related factors. Thus, there is a need to develop reliable, objective, and reproducible biomarkers for early diagnosis of periodontitis. In this regard, saliva, with contributions from the gingival crevicular fluid, holds great potential. However, most of the information on biomarkers of periodontium-related salivary proteins has come from studies on the molecular pathogenesis of periodontitis. In periodontitis, a more holistic approach, such as the use of -omics technologies, for biomarker discovery, is needed. Herein, we review the biomarkers proposed to date for the assessment of periodontitis, with emphasis on the role of salivary peptides in periodontitis and their assessment by high-throughput saliva proteomics. We also discuss the challenges pertaining to the identification of new periodontitis biomarkers in saliva.

During COVID-19 lockdown, individuals were asked to leave their home only to meet the most urgent needs, such as grocery purchases and medical emergencies This study aimed to know the consumers' health safety practices and their concerns toward grocery shopping and to know their adoption of healthier food as a result of the outbreak An online survey was conducted during the second month of the COVID-19 lockdown This study includes 212 respondents Appropriate statistical tools were used to analyze the data The findings of the study revealed that females were ahead compared to males in pursuing health safety practices during grocery shopping, but the frequency of following physical distancing for both males and females was not up to the mark The most important concern about grocery shopping was fear of unavailability of stocks and fear of getting infected from grocery storekeepers It was also found that, compared to earlier, people had reduced their frequency of grocery shopping and tried to shop quickly and efficiently People bought more packaged foods and also made purchases from brands that were new to them As a result of the COVID-19 pandemic, the adoption of healthier food habits varied significantly with gender, age, and household income of the respondents This study indicates that there is a need to raise awareness among people on how to shop safely in grocery stores and that good hygiene practice should be followed in grocery stores to mitigate the risk of infection to consumers