Food consumption behavior and lifestyle changes among rural older adults before and during the Covid-19 pandemic in Northern India: A cross-sectional study (preprint)

Background: Due to Covid-19, the lockdown was imposed throughout the nation on 24 march 2020 and Covid-19 is not over yet, cases are still coming. Food insecurity was already a problem but it became even more challenging during the pandemic. Especially rural older adult people have had to deal with the problem of food and health-related issues due to the pandemic. Objective: This study aimed to assess food consumption behavior and lifestyle changes among rural older adults before and during the Covid-19 pandemic. Material and Methods: A retrospective cross-sectional study has been done; a multistage random sampling technique was used to select the participants. 450 participants were taken aged 60 and above for final analysis. The survey was conducted in the rural areas of the Varanasi District, Uttar Pradesh through personal interviews. The McNemar and Wilcoxon sign rank tests were used to examine differences before and during the Covid-19 pandemic, adopting the statistical significance of p< 0·05. Results: Mean age of participants were found 66.72 years. 66.0% of people faced a shortage of food. 40.9% of people reported that they had reduced their food intake and 39.6% reported that the reduction in food intake was due to the rise in the price of edible items. 27.6% of participants reported a reduction in body weight. There was a significant percentage decrease in consumption of milk products, pulse, and green vegetables(p<0.001), a percentage decrease in initiating and maintaining sleep (p<0.001), and worse health conditions (p<0.001). Conclusions: Food consumption behavior and lifestyles have changed significantly during the Covid-19 pandemic among rural older adults. Although some lifestyles haven’t changed significantly, the quantity of food and health conditions were compromised.

Impact of Covid-19 Pandemic on the Investment Behavior of DIIs and FIIs on Indian Debt and Equity Markets

This paper aims to examine the impact of the Covid-19 pandemic on the investment behaviours of both Domestic Institutional Investors (DIIs) and Foreign Institutional Investors (FIIs) in the Indian debt and equity markets. The study is based on the daily time-series data from January 01,2015, to June 03, 2020. The study has constructed three Structural Vector Auto Regression dynamic models to compare the investment behaviors of FIIs and DIIs in both pre-and post-pandemic periods. The results indicate that the Institutional Investors' activities do not significantly impact the equity returns in the Indian markets, which has remained so in the wake of Covid-19. The debt purchases and sales for the DIIs are relatively more inelastic to market returns and reflect the risk-averse investment attitude of DIIs because of the negligible impact of Covid-19. There is a drop in the risk appetite of the FIIs due to a rise in the share of debt holdings in their portfolio in the wake of the Covid-19 pandemic.

Problems and solutions to conduct of thesis of postgraduate medical students during the COVID-19 pandemic: an insight into the students perspective.

PURPOSE: The coronavirus disease 2019 (COVID-19) pandemic has adversely impacted medical education worldwide. However, its impact on the postgraduate medical thesis and dissertation work is still not evaluated. Through this study, we planned to find out the problems brought by the pandemic and likely alternatives and possible solutions to thrust the academic competence of postgraduate students. METHODS: After obtaining institutional ethics committee approval, we sent a 13-item questionnaire to postgraduate medical students in India via various social media online platforms. Data on the impact of the COVID-19 pandemic on thesis work and alternatives/solutions to improve the research competence were collected on a Likert scale and analyzed. RESULTS: We received a total of 398 responses out of which 377 entries were included for final analysis. The majority of participants (88%) reportedly had an adverse impact on the thesis work and out of 25% of the participants who recently submitted their around 45% had to do so without achieving the estimated sample size. The 6-month departmental review for thesis progress was seen in merely 28% of participants. Possible alternatives suggested were the maintenance of log books, task-based assessment of research methodology, departmental audits, and systematic reviews. Solutions suggested for improving the research competence of students were a compulsory research methodology curriculum, a biostatistics department in each institution, permission to conduct thesis work beyond submission time, exclusive time for research work, and financial incentives. CONCLUSION: Modification in the research aspect of the current postgraduate medical education is the need of the hour and the pandemic has enlightened us regarding the current weaknesses.

Antimicrobial therapeutics isolated from algal source: retrospect and prospect.

In the last few decades, attention on new natural antimicrobial compounds has arisen due to a change in consumer preferences and the increase in the number of resistant microorganisms. Algae are defined as photosynthetic organisms that demonstrate a wide range of adaptability to adverse environmental conditions like temperature extremes, photo-oxidation, high or low salinity, and osmotic stress. Algae are primarily known to produce large amounts of secondary metabolite against various kinds of pathogenic microbes. Among these algae, micro and microalgae of river, lake, and algae of oceanic origin have been reported to have antimicrobial activity against the bacteria and fungi of pathogenic nature. Various polar and non- polar extracts of micro- and macro algae have been used for the suppression of these pathogenic fungi. Apart from these, certain algal derivatives have also been isolated from these having antibacterial and antifungal potential. Among the bioactive molecules of algae, polysaccharides, sulphated polysaccharides, phyco-cyanobilins polyphenols, lectins, proteins lutein, vitamin E, B12 and K1, peptides, polyunsaturated fatty acids and pigments can be highlighted. In the present review, we will discuss the biological activity of these derived compounds as antifungal/ antibacterial agents and their most promising applications. A brief outline is also given for the prospects of these isolated phytochemicals and using algae as therapeutic in the dietary form. We have also tried to answer whether alga-derived metabolites can serve as potential therapeutics for the treatment of SARS-CoV-2 like viral infections too.

Emissions of black carbon and polycyclic aromatic hydrocarbons: Potential implications of cultural practices during the Covid-19 pandemic

Emissions of black carbon (BC) and polycyclic aromatic hydrocarbons (PAHs) from various anthropogenic activities are often reported, yet cultural practices such as the multi-day Diwali festival and its influences on the emissions of these compounds are often overlooked. Major activities during this festival include burning rows of oil-filled earthen lamps (diyas) and fireworks (bursting of crackers). A comprehensive field investigation was conducted to document the role of Diwali celebrations on the releases of BC and PAHs during the ongoing Covid pandemic. The results show that large-scale releases of BC and PAHs were observed on the first day of Diwali compared to the remaining four days. BC and PM2.5 mass concentrations throughout the monitoring period ranged from 3.24 to 27.64 µg m-3 and 83.33 to 288.13 µg m-3, respectively. The source apportionment was performed based on the calculated backward trajectories. The results show that the contribution of fossil fuel emission at Adityapur (ADP), Sakchi (SAK), and Gamharia (GMA) was approximately 36.1%, 34.4%, and 55.56%, while biomass burning contribution was approx. 56.9%, 59.9%, 41.67%, respectively. The result showed that fossil fuel emissions were lower compared to biomass combustion during Diwali. Simultaneously, PAHs diagnostic ratio showed that vehicular discharge and coal burning significantly contributed to PAHs at these study sites.

4 Dimensional XStrain speckle tracking echocardiography: comprehensive evaluation of left ventricular strain and twist parameters in healthy Indian adults during COVID-19 pandemic.

INTRODUCTION: 4D XStrain speckle tracking echocardiography (STE) is a feasible newer technology to evaluate the strain and rotational deformation of left ventricle (LV). We aimed to exhaustively present the normal value ranges of LV strain and twist parameter in healthy Indian adults during COVID-19 pandemic and furthermore to analyse their relationship with age and gender. METHOD: Study population consisted of 80 adults of 18-60 years (58 men, 22 women), which was arbitrarily divided into two groups: Group A <30 years and Group B >31 years. RESULTS: GLS was higher in females (P<0.01) and in Group A (P<0.01). On the contrary GCS and GRS were higher in men (P=NS) and in Group B (P<0.01), at the mitral valve level. At the papillary muscle level GCS and GRS values are more in men (P<0.01) and in <30 years of age (P<0.01 and P<0.05 respectively). Furthermore, the values of numerous other strain parameters-GLSR, GCSR, GRSR, LGV, TV, TS, TSR, Shear, Shear rate, ROV and RV, reflected heterogeneous variation across gender and various age groups. Twist was greater in men and increased with increasing age (P<0.01). CONCLUSION: We have demonstrated a comprehensive data obtained in the current study utilizing 4D XStrain STE in healthy subjects. The LV speckle tracking software simultaneously provided 4D volumetric, strain, rotation and twist data in great detail. However, this distinctive technology has not been widely adopted and its evaluation is still limited to research applications. Therefore, further clinical studies are needed to validate our findings.

Magnitude and Determinants of Mortalities Related to COVID-19: Evidence from 94 Countries Using Regression Techniques

This study attempts to investigate the factors determining COVID-19 deaths during the pandemic across countries by employing a rich dataset sourced from 94 countries updated till 6 February, 2022. For empirical analysis, the study makes use of cross-sectional linear regression technique in the first part and after required diagnostic tests use 2SLS regression technique for correcting possible endogeneity bias in the second part. Findings from the study indicate that factors like total reported cases, population size, population over 70 years of age, extreme poverty, and human development index play significant role in determining COVID-19-related death. Further, to check the robustness of the findings the present study employed LASSO regression. Findings from the study highlight the possibility of government intervention to devise appropriate policies to control COVID-related incidence and death.

Antimicrobial therapeutics isolated from algal source: retrospect and prospect

In the last few decades, attention on new natural antimicrobial compounds has arisen due to a change in consumer preferences and the increase in the number of resistant microorganisms. Algae are defined as photosynthetic organisms that demonstrate a wide range of adaptability to adverse environmental conditions like temperature extremes, photo-oxidation, high or low salinity, and osmotic stress. Algae are primarily known to produce large amounts of secondary metabolite against various kinds of pathogenic microbes. Among these algae, micro and microalgae of river, lake, and algae of oceanic origin have been reported to have antimicrobial activity against the bacteria and fungi of pathogenic nature. Various polar and non- polar extracts of micro- and macro algae have been used for the suppression of these pathogenic fungi. Apart from these, certain algal derivatives have also been isolated from these having antibacterial and antifungal potential. Among the bioactive molecules of algae, polysaccharides, sulphated polysaccharides, phyco-cyanobilins polyphenols, lectins, proteins lutein, vitamin E, B12 and K1, peptides, polyunsaturated fatty acids and pigments can be highlighted. In the present review, we will discuss the biological activity of these derived compounds as antifungal/ antibacterial agents and their most promising applications. A brief outline is also given for the prospects of these isolated phytochemicals and using algae as therapeutic in the dietary form. We have also tried to answer whether alga-derived metabolites can serve as potential therapeutics for the treatment of SARS-CoV-2 like viral infections too.

Development of lab score system for predicting COVID-19 patient severity: A retrospective analysis.

AIM: To develop an accurate lab score based on in-hospital patients' potent clinical and biological parameters for predicting COVID-19 patient severity during hospital admission. METHODS: To conduct this retrospective analysis, a derivation cohort was constructed by including all the available biological and clinical parameters of 355 COVID positive patients (recovered = 285, deceased = 70), collected in November 2020-September 2021. For identifying potent biomarkers and clinical parameters to determine hospital admitted patient severity or mortality, the receiver operating characteristics (ROC) curve and Fischer's test analysis was performed. Relative risk regression was estimated to develop laboratory scores for each clinical and routine biological parameter. Lab score was further validated by ROC curve analysis of the validation cohort which was built with 50 COVID positive hospital patients, admitted during October 2021-January 2022. RESULTS: Sensitivity vs. 1-specificity ROC curve (>0.7 Area Under the Curve, 95% CI) and univariate analysis (p<0.0001) of the derivation cohort identified five routine biomarkers (neutrophil, lymphocytes, neutrophil: lymphocytes, WBC count, ferritin) and three clinical parameters (patient age, pre-existing comorbidities, admitted with pneumonia) for the novel lab score development. Depending on the relative risk (p values and 95% CI) these clinical parameters were scored and attributed to both the derivation cohort (n = 355) and the validation cohort (n = 50). ROC curve analysis estimated the Area Under the Curve (AUC) of the derivation and validation cohort which was 0.914 (0.883-0.945, 95% CI) and 0.873 (0.778-0.969, 95% CI) respectively. CONCLUSION: The development of proper lab scores, based on patients' clinical parameters and routine biomarkers, would help physicians to predict patient risk at the time of their hospital admission and may improve hospital-admitted COVID-19 patients' survivability.

CRISPR-Cas system: from diagnostic tool to potential antiviral treatment.

This mini review focuses on the diagnosis and treatment of virus diseases using Crisper-Cas technology. The present paper describes various strategies involved in diagnosing diseases using Crispr-Cas-based assays. Additionally, CRISPR-Cas systems offer great potential as new therapeutic tools for treating viral infections including HIV, Influenza, and SARS-CoV-2. There are several major challenges to be overcome before this technology can be applied routinely in clinical settings, such as finding a suitable delivery tool, toxicity, and immunogenicity, as well as off-target effects. This review also discusses ways to deal with the challenges associated with Crisper-Cas technology. KEY POINTS: • Crisper technology is being applied to diagnose infectious and non-infectious diseases. • A new generation of CRISPR-Cas-based assays has been developed which detect pathogens within minutes, providing rapid diagnosis of diseases. • Crispr-Cas tools can be used to combat viral infections, specifically HIV, influenza, and SARS-CoV-2.

Effects of statins on outcomes in Hispanic patients with COVID-19.

The Hispanic population is regarded among those who are at greater risk of adverse prognoses due to higher rates of diabetes and obesity in the USA during the COVID-19 pandemic. Statin medications are speculated to help treat the infection by decreasing inflammation caused by COVID-19. In this retrospective, observational study, outcomes of statin use were assessed among Hispanic patients with COVID-19 by screening all patients hospitalized between March, 2020 and March, 2021 at a tertiary care hospital in El Paso, Texas, resulting in a total of 1039 patients. The patients were categorized into a group of either being on statins or not. The considered outcomes were mechanical ventilation, intensive care unit (ICU) hospitalization, oxygen supplementation at discharge, hospital length of stay, and mortality. Patients receiving statins were observed to be older with more comorbidities. In the propensity-scores adjusted analysis, no association was found between statin use and: mortality (adjusted risk ratio (aRR)=0.96, p=0.754), mechanical ventilation (aRR=0.91, p=0.503), ICU transfer (aRR=0.96, p=0.395), and O2 supplementation at discharge (aRR=1.03, p=0.729). These outcomes were also evaluated in patients who had myocardial infarction and stroke with COVID-19. Among these patients, association was found between statin use and: a reduced risk of mortality (aRR=0.61, p=0.005), mechanical ventilation (aRR=0.53, p=0.012) and ICU transfers (aRR=0.81, p=0.005). These results may not give us a reason to start patients on statins for the specific treatment of COVID-19, but it may be sufficient evidence to suggest statins should not be discontinued during hospitalization due to COVID-19.

Microvillus Inclusion Disease: A Rare Mutation of STX3 in Exon 9 Causing Fatal Congenital Diarrheal Disease.

Inherited diarrheal disorders cause serious morbidity resulting in dependence on intensive care and parenteral nutrition. Microvillus inclusion disease (MVID) has been classically described and results from mutations in the gene coding myosin Vb, which is responsible for enterocyte polarization. Newer reports of mutations resulting in truncated syntaxin 3 (STX3) and Munc18-2 (STXBP2) proteins have been elucidated as causative. To date, five cases of STX3 abnormalities resulting in MVID have been described. We report an infant who presented with congenital diarrhea and was determined to have a rare mutation of STX3. This new finding would be beneficial in future functional genotype-phenotype correlation studies.

Macroeconomic determinants of remittances to India

Migration and remittances have always been an exciting arena of research for economists around the globe. Remittance flows have evolved as a significant economic variable over the past decade. In several developing countries, remittances exceed the other capital inflows and value of total exports. Thus, it is widely recognised as a potential funding source for economic development in emerging economies. The inflow of remittances to India has increased tremendously in the recent past making the country the highest recipient of remittances across the globe. Remittances are an essential component that contributes to narrowing the Current Account Deficit and has always been a stable constituent of the Balance of Payment. This paper is an attempt to explore the vital macroeconomic variables which determine the remittance flows to India. Notably, we enquire into the dominant motives of remittances in the Indian context. We employ an ARDL approach to cointegration to identify the macroeconomic determinants of remittances and find those crucial variables such as exchange rate, oil price, and domestic GDP substantially impact the flow of remittances. The results also indicate that the migrants are more vulnerable to the oil price shocks in host countries. The overall findings of our study are that (1) remittances are not countercyclical in the Indian context (2) remittances are subject to weak investment motive as opposed to the altruistic motive.

Viral Inactivation and Biocompatibility Study of Electrically Activated Water Mist.

In addition to the ongoing global problem of healthcare-acquired infections, the COVID-19 pandemic continues to pose a serious threat to the health of the global population. This unprecedented pandemic situation has reinforced the need for the development of technologies that can curb the transmission of viruses among human beings and help to control the infection. Existing disinfection techniques using either ultraviolet light or harsh chemicals pose safety risks and are not suitable for use in the presence of humans. Thus, the need for a safe and effective disinfection technique that can be used in the presence of humans to control viral transmission is evident. A technique that can continuously disinfect air and surfaces in indoor environments, where the chances of viral transmission are high, can be an indispensable tool to fight such a pandemic. The Airlens Minus Corona (AMC) device provided by Persapien Innovations has been developed to achieve this goal. In this study, the antiviral functionality and biocompatibility of AMC were evaluated. Activated water mist (AWM) generated from this device was tested in vitro and in vivo for its toxicity to cell lines and in animal model. The AWM was found to be non-cytotoxic to L-929 cell lines and had no sign of clinical toxicity in an animal model (rabbit). This device was further used to inactivate animal viruses and bacteriophages. The AWM was found to be effective in the complete inactivation of influenza A H1N1 virus within 5 minutes of direct treatment. This device was also found to be effective in inactivating >90% of bacteriophage particles.

Pre-hospitalization proton pump inhibitor use and clinical outcomes in COVID-19.

INTRODUCTION: Severe acute respiratory syndrome coronavirus-2 may escape the inactivation by gastric acid because of hypochlorhydria caused by proton pump inhibitors (PPIs), which could predispose the patients to severe COVID-19. METHODS: We studied the association between prehospitalization PPI exposure and clinical outcomes among hospitalized COVID-19 patients. RESULTS: A total of 295 hospitalized COVID-19 patients were included in the study. 15.6% of hospitalized COVID-19 patients were on PPIs at home. Mortality among PPI-users was 2.3 times higher than non-users, along with 2.3 times higher risk of acute respiratory distress syndrome after adjusting for confounding variables. CONCLUSION: We found that prehospitalization PPI-exposure is independently associated with worse clinical outcomes, including mortality in COVID-19 patients, regardless of the presence of cardiovascular comorbidities.

Frontier review on the propensity and repercussion of SARS-CoV-2 migration to aquatic environment.

Increased concern has recently emerged pertaining to the occurrence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in aquatic environment during the current coronavirus disease 2019 (COVID-19) pandemic. While infectious SARS-CoV-2 has yet to be identified in the aquatic environment, the virus potentially enters the wastewater stream from patient excretions and a precautionary approach dictates evaluating transmission pathways to ensure public health and safety. Although enveloped viruses have presumed low persistence in water and are generally susceptible to inactivation by environmental stressors, previously identified enveloped viruses persist in the aqueous environment from days to several weeks. Our analysis suggests that not only the surface water, but also groundwater, represent SARS-CoV-2 control points through possible leaching and infiltrations of effluents from health care facilities, sewage, and drainage water. Most fecally transmitted viruses are highly persistent in the aquatic environment, and therefore, the persistence of SARS-CoV-2 in water is essential to inform its fate in water, wastewater and groundwater and subsequent human exposure.

Cohort profile: Indian Network of Population-Based Surveillance Platforms for Influenza and Other Respiratory Viruses among the Elderly (INSPIRE).

PURPOSE: We describe here a multicentric community-dwelling cohort of older adults (>60 years of age) established to estimate incidence, study risk factors, healthcare utilisation and economic burden associated with influenza and respiratory syncytial virus (RSV) in India. PARTICIPANTS: The four sites of this cohort are in northern (Ballabgarh), southern (Chennai), eastern (Kolkata) and western (Pune) parts of India. We enrolled 5336 participants across 4220 households and began surveillance in July 2018 for viral respiratory infections with additional participants enrolled annually. Trained field workers collected data about individual-level and household-level risk factors at enrolment and quarterly assessed frailty and grip strength. Trained nurses surveilled weekly to identify acute respiratory infections (ARI) and clinically assessed individuals to diagnose acute lower respiratory infection (ALRI) as per protocol. Nasal and oropharyngeal swabs are collected from all ALRI cases and one-fifth of the other ARI cases for laboratory testing. Cost data of the episode are collected using the WHO approach for estimating the economic burden of seasonal influenza. Handheld tablets with Open Data Kit platform were used for data collection. FINDINGS TO DATE: The attrition of 352 participants due to migration and deaths was offset by enrolling 680 new entrants in the second year. All four sites reported negligible influenza vaccination uptake (0.1%-0.4%), low health insurance coverage (0.4%-22%) and high tobacco use (19%-52%). Ballabgarh had the highest proportion (54.4%) of households in the richest wealth quintile, but reported high solid fuel use (92%). Frailty levels were highest in Kolkata (11.3%) and lowest in Pune (6.8%). The Chennai cohort had highest self-reported morbidity (90.1%). FUTURE PLANS: The findings of this cohort will be used to inform prioritisation of strategies for influenza and RSV control for older adults in India. We also plan to conduct epidemiological studies of SARS-CoV-2 using this platform.