Internet addiction and sleep quality among medical students during the COVID-19 pandemic: A multinational cross-sectional survey

BACKGROUND

The emergence of the COVID-19 pandemic has affected the lives of many people, including medical students. The present study explored internet addiction and changes in sleep patterns among medical students during the pandemic and assessed the relationship between them.

METHODS

A cross-sectional study was carried out in seven countries, the Dominican Republic, Egypt, Guyana, India, Mexico, Pakistan, and Sudan, using a convenience sampling technique, an online survey comprising demographic details, information regarding COVID-19, the Pittsburgh Sleep Quality Index (PSQI), and the Internet Addiction Test (IAT).

RESULTS

In total, 2749 participants completed the questionnaire. Of the total, 67.6% scored above 30 in the IAT, suggesting the presence of an Internet addiction, and 73.5% scored equal and above 5 in the PSQI, suggesting poor sleep quality. Internet addiction was found to be significant predictors of poor sleep quality, causing 13.2% of the variance in poor sleep quality. Participants who reported COVID-19 related symptoms had disturbed sleep and higher internet addiction levels when compared with those who did not. Participants who reported a diagnosis of COVID-19 reported poor sleep quality. Those living with a COVID-19 diagnosed patient reported higher internet addiction and worse sleep quality compared with those who did not have any COVID-19 patients in their surroundings.

CONCLUSION

The results of this study suggest that internet addiction and poor sleep quality are two issues that require addressing amongst medical students. Medical training institutions should do their best to minimize their negative impact, particularly during the current COVID-19 pandemic.

Central Retinal Vein Occlusion in patients with COVID-19 infection: A systematic review

This systematic review summarizes the evidence on patients diagnosed with central retinal vein occlusion (CRVO) secondary to COVID-19. We searched PubMed and Google Scholar from its inception till June 2021. From an initial 55 publications, 10 studies provided specific information on COVID-19 patients with CRVO. Studies described 10 patients, 60% were male and the mean age was 39.3 ± 11.6 years. Blurred vision (40%) and decreased vision (50%) were the most common presenting complain. Symptom onset ranged from 5 days to 6 weeks after initial complaint of fever. Laboratory results showed elevated inflammatory markers and D-dimers in 60% of patients included in our review. Common treatment options were intravitreal anti-VEGF injections, steroids, and anticoagulants. Traditional co-morbidities like diabetes mellites, hypertension, and morbid obesity (hyperlipidemia) were observed in only 3/10 patients. The prognosis was excellent as all patients saw improvement in their condition. Our findings highlight the importance of identifying CRVO as an important complication of COVID-19 infection. Thus, physicians should not overlook the likelihood of CRVO in patients with COVID-19 infection and offer prompt treatment.

Mental health risk among children during COVID-19 lockdown

The COVID‐19 pandemic has created a hugely detrimental impact on the psychological health of people around the world. Children are extremely vulnerable; therefore, it is of utmost importance to discuss the prevalence of the symptoms, their associated risk factors, and the strategies to identify and understand their deteriorating mental health (MH) before it leads to disastrous outcomes. Hence, parents and schools should come together in devising modes to create an environment in which children can easily tackle the lockdown periods which have become the new reality. Negative effects on MH have long‐term consequences, therefore necessary interventions must take place.

Factors affecting Pakistani young adults' intentions to uptake COVID-19 vaccination: An extension of the theory of planned behavior

INTRODUCTION

Aside from personal beliefs, young adults' intention to uptake the COVID-19 vaccine can be influenced by their fear of COVID-19 and perceived infectability of COVID-19. The present study incorporated fear of COVID-19 and perceived infectability with the theory of planned behavior (TPB) to form an expanded TPB to analyze factors affecting Pakistani young adults' intentions to uptake the COVID-vaccine in Pakistan.

METHODS

A cross-sectional study was conducted and recruited participants from Pakistani social media users. The proposed extended TPB model was examined by using structural equation modeling.

RESULTS

A total of 1034 individuals replied to the survey. The three factors of the original theory of planned behavior and the fear of COVID-19 were positively related to their intention to uptake COVID-19 vaccination (r = 0.25-0.66). Moreover, the perceived infectability positively influenced the three theories of planned behavioral factors and the fear of COVID-19 (r = 0.27-0.60), also affecting the participants' intentions to uptake COVID-19 vaccination.

CONCLUSIONS

Perceived infectability was positively related to the participants' intentions to uptake COVID-19 vaccination, and perceived behavioral control was the strongest mediator. More evidence-based information concerning treatments and COVID-19 vaccination are needed to encourage individuals to uptake the vaccine.

Exploring determinants of financial system and environmental quality in high-income developed countries of the world: the demonstration of robust penal data estimation techniques

The financial system development has got considerable attention due to its association with the environment of the country. To address the apprehension of the researchers about the effect of the determinants of the financial system on the environmental quality of high-income developed countries, we analyze the data of twenty developed countries with sound and strong financial systems for the period 2001 to 2018. We consider both banking development and stock market development as the main key determinants of the financial system. We employ numerous modern-day penal data estimation techniques, namely Dynamic Penal GMM in both linear and non-linear form, Common Correlated Effect Mean Group (CCEMG), and Dynamic Fixed Effect for capturing the issues of heterogeneity, endogeneity, and cross-sectional dependence. Our results show that banking development substantiates the environmental quality in high-income developed countries. The positive gesture of the banking development on environmental quality could be the reason for the established environmentally friendly policies in the developed part of the world. Hence, we conclude that banking development in high-income developed countries significantly reduces the emissions of dangerous gases, which resultantly enhances the environmental quality. The study reveals an insignificant and tenuous impact of the market development on the environmental quality that might be due to the adoption of cleaner technologies by firms in the developed world that are environmentally friendly. The results of our long-term estimations also predict the significant effect of banking development and an insignificant effect of the market development on environmental quality. In addition, our results also demonstrate an inverted U-shaped relationship of the determinants of the financial system and environmental quality. More institutional and legal initiatives must be made for a more robust banking and stock market development framework by the policy makers with a view to substantiating the quality of the environment to a more sustainable level in the developed world.

Cross-cultural prevalence of sleep quality and psychological distress in healthcare workers during COVID-19 pandemic

BACKGROUND

Poor quality sleep and emotional disturbances are expected in times of crisis. COVID-19 has severely impacted healthcare worldwide and with that comes the concern about its effects on healthcare workers. The purpose of the present study was to assess sleep quality and psychological distress in healthcare workers during the COVID-19 pandemic.

METHODS

The present work is a multi-centric cross-sectional study targeting healthcare workers from India, Pakistan, and Nepal. It used an online version of the Pittsburg Sleep Quality Index and the General Health Questionnaire, and data were analyzed using SPSS V.24.

RESULTS

A total of 1790 participants completed the questionnaire. Of the 1790 participants, 57% reported poor sleep quality, and 10% reported a high level of psychological distress. A cross-cultural comparison found some differences between the different groups of participants. The details of the differences were further explored in the article.

CONCLUSION

The present study highlights that a significant proportion of healthcare workers are affected by poor sleep quality and psychological distress during the COVID-19 pandemic. It also emphasizes the imperative to provide them with psychosocial support to avoid potential short- and long-term psychological consequences of these troubling times.

Norovirus outbreak amid COVID-19 in the United Kingdom; priorities for achieving control

Norovirus, an enteric virus primarily responsible for gastroenteritis outbreaks worldwide, is currently causing outbreaks around the United Kingdom during the COVID-19 pandemic. With an already exhausted health care system, the significant burden norovirus can have on the National Health Service, including economic and social burdens, is immense and cannot be tolerated. Primary challenges and priorities to be focused on due to the increase in norovirus outbreaks include a further depletion of health care services, increase cases in schools, nurseries, and care facilities, underreporting of the cases, and no effective vaccine being available. Therefore, it is essential to increase awareness about norovirus and its transmission in public, take necessary precautions, and increase reporting of cases. This article discusses the impact norovirus has during the COVID-19 pandemic, and the challenges, and recommendations to achieve control before it reaches epidemic levels.

Increased high-temperature extremes and associated population exposure in Africa by the mid-21st century

Previous studies warned that heat extremes are likely to intensify and frequently occur in the future due to climate change. Apart from changing climate, the population's size and distribution contribute to the total changes in the population exposed to heat extremes. The present study uses the ensemble mean of global climate models from the Coupled Model Inter-comparison Project Phase six (CMIP6) and population projection to assess the future changes in high-temperature extremes and exposure to the population by the middle of this century (2041-2060) in Africa compared to the recent climate taken from 1991 to 2010. Two Shared Socioeconomic Pathways (SSPs), namely SSP2-4.5 and SSP5-8.5, are used. Changes in population exposure and its contributors are quantified at continental and for various sub-regions. The intensity of high-temperature extremes is anticipated to escalate between 0.25 to 1.8 °C and 0.6 to 4 °C under SSP2-4.5 and SSP5-8.5, respectively, with Sahara and West Southern Africa projected to warm faster than the rest of the regions. On average, warm days' frequency is also expected to upsurge under SSP2-4.5 (26-59%) and SSP5-8.5 (30-69%) relative to the recent climate. By the mid-21st century, continental population exposure is expected to upsurge by ~25% (28%) of the reference period under SSP2-4.5|SSP2 (SSP5-8.5|SSP5). The highest increase in exposure is expected in most parts of West Africa (WAF), followed by East Africa. The projected changes in continental exposure (~353.6 million person-days under SSP2-4.5|SSP2 and ~401.4 million person-days under SSP5-8.5|SSP5) are mainly due to the interaction effect. However, the climate's influence is more than the population, especially for WAF, South-East Africa and East Southern Africa. The study findings are vital for climate change adaptation.

Diversity of the Anisoptera & Zygoptera (Odonata: Insecta) of Swat, Pakistan

Odonates are important biological control agents for the control of insect pests and insect disease vectors of medical and veterinary importance. The present study was conducted to evaluate the odonate fauna of Swat, Pakistan from March to October 2019. A total of 200 specimens of odonates were collected from diverse habitats. The collected specimens of the order Odonata belonged to 5 families, three families of suborder Anisoptera namely Libellulidae, Gomphidae and Aeshnidae while two families of suborder Zygoptera (Chlorocyphidae and Coenagrionidae). The specimens were categorized into 12 genera and 22 species. Libellulidae was the dominant family (n = 138) accounting for 69% of the odonate fauna. Orthetrum was the dominant genus (n = 73) of suborder Anisoptera accounting for 36.5% of the odonate fauna. The least dominant genera were Anax, Paragomphus and Rhyothemis (n = 5 each) accounting each for 2.5% of the odonate fauna. In Zygoptera, the dominant genus was Ceriagrion (12.5%) and the least dominant genus was Ischnura (6%). Pantala flavescens (Fabricius, 1798) was the most abundant odonate species in the study area recorded from all surveyed habitats. Shannon Diversity Index (H) was 2.988 and Simpson Diversity Index (D) was 0.95 for the collected odonate fauna. The highest abundance of Odonata was recorded in August, September and May while no odonate species were recorded in January, February, November and December. Lotic water bodies were the most suitable habitats with abundant odonate fauna. Anax immaculifrons (Rambur, 1842) was the largest sized odonate species having a wingspan of 53.2±1.63 mm and body length of 56.3 ± 0.4 mm. The present study shows the status of odonate fauna of Swat, Pakistan in diverse habitats and seasonsonal variation throughout the year. Further work is recommended to bridge the gaps in the existing literature.

COVID-19 suicide and its causative factors among the healthcare professionals: Case study evidence from press reports

PURPOSE

Recent research has demonstrated the psychological impact of the coronavirus disease 2019 (COVID-19) pandemic among the general population. However, COVID-19-related suicides among healthcare professionals (HCPs) have yet to be investigated.

FINDINGS

The present study utilized retrospective press media suicide reports and identified a total of 26 worldwide HCP COVID-19-related suicide cases (aged 22-60 years; 14 females; most of the cases from India). The cases comprised doctors (n = 11), nurses (n = 9), paramedics (n = 5), and one medical student. Being infected with the COVID-19 was the most common suicide reason, followed by work-related stress, and fear related to COVID-19 infection/transmission. Among the eight cases diagnosed with COVID-19, most were female (n = 6), and either doctors (n = 4) or nurses (n = 4).

PRACTICE IMPLICATIONS

The present findings will be helpful for human resources departments in healthcare workplaces in ensuring HCP's mental wellbeing.

Population preferences and attitudes towards COVID-19 vaccination: a cross-sectional study from Pakistan

Background

While vaccine development is itself a challenge; ensuring optimal vaccine uptake at population level can present an even more significant challenge. Therefore, this study aimed to assess the Pakistani population’s attitude and preferences towards the Coronavirus disease 2019 (COVID-19) vaccine.

Method

A cross-sectional study was carried out through an online self-administered questionnaire from 27 September 2020 to 11 October 2020. A total of 883 people responded to the survey. The questionnaire included the participants’ socio-demographic variables, attitudes, beliefs towards the COVID-19 vaccine and acceptance and rejection of vaccination, and reasons for them. Logistic regression analysis was used to analyze the predictors for vaccine acceptance and willingness to pay for the vaccine.

Results

A majority (70.8%) of respondents will accept the COVID-19vaccine if available, and 66.8% showed a positive attitude towards vaccination. Monthly family income, education level, self-diagnosis of COVID-19 or a friend, family member, or colleague are significant factors influencing the acceptance of COVID-19 vaccination. The dogma of being naturally immune to COVID-19 was a key reason for the refusal of the vaccine. Less than half (48%) of those who refuse will vaccinate themselves if government officials have made it compulsory. A third (33.9%) of participants were willing to pay up to (7 USD) 1000 Pkr (Pakistani Rupees) for the vaccine.

Conclusion

The population’s positive attitude should be improved by increasing awareness and eradicating false myths about vaccines through large-scale campaigns.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-11814-5.

Roles of N6-Methyladenosine Demethylase FTO in Malignant Tumors Progression

In 2007, the fat mass and obesity-associated (FTO) gene was discovered initially to regulate body mass index and obesity and was subsequently found to be the first mRNA N6-methyladenosine (m6A) demethylation enzyme, which can demethylate m6A. A growing body of evidence shows that m6A modification is involved in a variety of cell biological processes, including cell proliferation, apoptosis, and self-renewal through different regulatory mechanisms. In recent years, a large number of studies have found that m6A modification play key role in the occurrence and development of tumors, such as acute myeloid leukemia, breast cancer, lung cancer, etc. As a function of m6A demethylase, FTO has attracted more and more attention in cancer. There is evidence that specific FTO single nucleotide polymorphisms (SNPs) may be significantly associated with overweight and cancer susceptibility by regulating the expression of related genes. Besides, when the expression level of FTO is altered or dysfunctional, it may be involved in the occurrence and progression of a variety of tumors as a tumor suppressor gene or oncogene, usually in an m6A-dependent manner. Further research found that FTO is involved in the development of different kinds of malignant tumors, but the mechanism is unknown. According to this review, The FTO gene's research progress in tumors is reviewed, aiming to find new targets for molecular pathological diagnosis and molecular targeted therapy of tumors.

Honey as a bioindicator of environmental organochlorine insecticides contamination

Honey is a suitable matrix for the evaluation of environmental contaminants including organochlorine insecticides. The present study was conducted to evaluate residues of fifteen organochlorine insecticides in honey samples of unifloral and multifloral origins from Dir, Pakistan. Honey samples (5 g each) were extracted with GC grade organic solvents and then subjected to Rotary Evaporator till dryness. The extracts were then mixed with n-Hexane (5 ml) and purified through Column Chromatography. Purified extracts (1μl each) were processed through Gas Chromatograph coupled with Electron Capture Detector (GC-ECD) for identification and quantification of the insecticides. Of the 15 insecticides tested, 46.7% were detected while 53.3% were not detected in the honey samples. Heptachlor was the most prevalent insecticide with a mean level of 0.0018 mg/kg detected in 80% of the samples followed by β-HCH with a mean level of 0.0016 mg/kg detected in 71.4% of the honey samples. Honey samples from Acacia modesta Wall. were 100% positive for Heptachlor with a mean level of 0.0048 mg/kg followed by β-HCH with a mean level of 0.003 mg/kg and frequency of 83.3%. Minimum levels of the tested insecticides were detected in the unifloral honey from Ziziphus jujuba Mill. Methoxychlor, Endosulfan, Endrin and metabolites of DDT were not detected in the studied honey samples. Some of the tested insecticides are banned in Pakistan but are still detected in honey samples indicating their use in the study area. The detected levels of all insecticides were below the Maximum Residue Levels (MRLs) and safe for consumers. However, the levels detected can cause mortality in insect fauna. The use of banned insecticides is one of the main factors responsible for the declining populations of important insect pollinators including honeybees.