Psychological distress and related factors regarding COVID-19 among the ancillary hospital staff: A cross-sectional study.

Background: Healthcare workers (HCWs) are at the front line of the Coronavirus disease (COVID-19) outbreak response. They have faced great risks to both physical and mental health. We aimed to assess the psychological effect of COVID-19 among ancillary hospital staff. Methods: A cross-sectional study was conducted among 267 on-duty ancillary hospital staff using a semi-structured questionnaire to assess their psychological status and risk perception. In addition, their knowledge, attitude, and practices (KAP) and risk perception were also assessed. The General Health Questionnaire (GHQ-12) was used to screen for psychological distress. Results: Among 267 participants, the mean (±SD) age was 33.5 (7.6) years. The majority knew about the symptoms of COVID-19 (88.4%), droplet spread (99.3%), and the importance of isolation (99.3%). About 35.2% were worried about infecting family members, while 26.2% were worried about colleagues at the frontline. Only 38.9% of them had a good knowledge score. Participants with high school and above education level had significantly good knowledge about COVID-19 (OR = 1.99; 95% CI = 1.17- 3.39) than those with primary school or below. Being female (OR 1.99; 95% CI 1.17-3.39) and working with COVID-19 patients (OR 3.88, 95% CI 1.77-8.47, P = 0.001) was associated with psychological distress. Conclusion: The ancillary hospital staff had insufficient knowledge regarding the risk factors of COVID-19 but possessed positive attitudes and practices. Continued health education and appropriate psychological interventions may improve understanding and reduce psychological distress.

Ensemble Deep Learning Derived from Transfer Learning for Classification of COVID-19 Patients on Hybrid Deep-Learning-Based Lung Segmentation: A Data Augmentation and Balancing Framework.

BACKGROUND AND MOTIVATION: Lung computed tomography (CT) techniques are high-resolution and are well adopted in the intensive care unit (ICU) for COVID-19 disease control classification. Most artificial intelligence (AI) systems do not undergo generalization and are typically overfitted. Such trained AI systems are not practical for clinical settings and therefore do not give accurate results when executed on unseen data sets. We hypothesize that ensemble deep learning (EDL) is superior to deep transfer learning (TL) in both non-augmented and augmented frameworks. METHODOLOGY: The system consists of a cascade of quality control, ResNet-UNet-based hybrid deep learning for lung segmentation, and seven models using TL-based classification followed by five types of EDL's. To prove our hypothesis, five different kinds of data combinations (DC) were designed using a combination of two multicenter cohorts-Croatia (80 COVID) and Italy (72 COVID and 30 controls)-leading to 12,000 CT slices. As part of generalization, the system was tested on unseen data and statistically tested for reliability/stability. RESULTS: Using the K5 (80:20) cross-validation protocol on the balanced and augmented dataset, the five DC datasets improved TL mean accuracy by 3.32%, 6.56%, 12.96%, 47.1%, and 2.78%, respectively. The five EDL systems showed improvements in accuracy of 2.12%, 5.78%, 6.72%, 32.05%, and 2.40%, thus validating our hypothesis. All statistical tests proved positive for reliability and stability. CONCLUSION: EDL showed superior performance to TL systems for both (a) unbalanced and unaugmented and (b) balanced and augmented datasets for both (i) seen and (ii) unseen paradigms, validating both our hypotheses.

Association of Psychosocial Risk Factors and Outcomes in Heart Failure: Does COVID-19 Affect Outcomes?

Psychosocial risk factors (PSRFs) have emerged as crucial nontraditional risk factors affecting outcomes in patients with heart failure (HF). There is a paucity of data studying these risk factors in HF nationally. Additionally, whether the COVID-19 pandemic impacted outcomes remains unexplored, given the increased psychosocial risk during these times. Our objective is to assess the impact of PSRFs on the outcomes of HF and their comparison across non-COVID-19 and COVID-19 eras. Patients with a diagnosis of HF were selected using the 2019-2020 Nationwide Readmissions Database. Two cohorts were created based on the presence or absence of PSRFs and compared across non-COVID-19 and COVID-19 eras. We examined the association using hierarchical multivariable logistic regression models. A total of 305,955 patients were included, of which 175,348 (57%) had PSRFs. Patients with PSRFs were younger, less likely to be female, and had a higher prevalence of cardiovascular risk factors. All-cause readmissions were higher in patients with PSRFs in both the eras. All-cause mortality [odds ratio, OR 1.15 (1.04-1.27), P = 0.005] and composite of MACE [OR 1.11 (1.06-1.16), P < 0.001] were higher in patients in the non-COVID-19 era. Compared to 2019, patients with PSRFs and HF in 2020 had significantly higher all-cause mortality [OR 1.13 (1.03-1.24), P = 0.009]; however, the composite of MACE was comparable [OR 1.04 (1.00-1.09), P = 0.03]. In conclusion, the presence of PSRFs in patients with HF is associated with a significant increase in all-cause readmissions in COVID-19 and non-COVID-19 eras. The worse outcomes evident in the COVID-19 era highlights the importance of multidisciplinary care in this vulnerable population.

Reaction of Epichlorohydrin with 2-aryl-4,5-dimethyl-1-hydroxy imidazole: A Combined DFT and Experimental Study (preprint)

This pandemic situation has made us to understand that we need to have look for more potential anti-viral agents in order to combat the SARS virus. During this period many existing anti-viral agents are directly being used to find their efficacy or being modified to increase their efficacy. In an ongoing effort to discover a noble series of imidazole-based epoxides, which can act as synthon for the synthesis of β-Amino alcohols, were designed and synthesized using a mild, efficient, and metal free approach starting from N1-hydroxy-2,4,5-trisubstituted-imidazoles and epichlorohydrin as precursor compound which may have higher potential to show biological activity. To support the experimental finding, we have performed Density Functional Theory (DFT) calculation. On the basis of the experimental findings and theoretical calculation we have drawn the reaction pathway that led to the product formation.

Non-cancer risk evaluation using a multidimensional strategy owing to groundwater fluoride and iron in a semi-arid region near the Indo-Bangladesh international frontier (preprint)

Groundwater quality in the semi-arid Hili border region at Indo-Bangladesh border was investigated in the post-monsoon season of 2021, succeeded by probabilistic health risk assessment of fluoride (F-) and iron (Fe) intake that breached respective safe limits in several samples. All water samples were found to be potable in terms of Ca2+, Mg2+, Cl-, SO42-, NO3- but F- and Fe exceeded prescribed safe limit for drinking in about 48% and 7% samples. Almost all the water samples were found to be good for irrigation in terms of Sodium Absorption Ratio (SAR), Soluble Sodium Percentage (SSP), Keely’s Index (KI), %Na and Magnesium ratio (MR). The Principal Component (PCA) /Factor Analysis (FA) identified three factors influencing groundwater quality, explaining about 71.8% of total variance and indicated that groundwater quality was primarily influenced by geochemical factors. Carbonate and silicate weathering were mainly responsible for dissolution of minerals in groundwater. Non-carcinogenic risk due to cumulative impact of F- and Fe intake was in the order of THI Children>THI Infant>THI Adult. As per Monte Carlo simulation run with 5000 trials to ascertain the order of probabilistic health risk, the most dominant governing factors behind non-carcinogenic risk caused by F- and Fe intake were their concentration (Ci) followed by ingestion rate (IR), and exposure duration (ED).

Leveraging health information helpline to sustain health-care delivery during the COVID pandemic: Experiences from a State in Eastern India.

Background: The unprecedented demands on health-care systems due to the COVID-19 pandemic made countries including India to switch toward alternative modes of health-care delivery. Objectives: The aim of this study was to describe the various COVID-related services delivered through 104 health information helpline (HIHL), located in Jharkhand during the pandemic. Methods: The de-identified secondary data from February 2020 to December 2021 related to COVID services delivered through HIHL were analyzed. Results: There was a significant increase in the COVID call volume during the first as well as the second wave. The HIHL has been able to guide the callers on testing, home isolation and follow-up, home-based teleconsultation, vaccination, timely referral, and support with logistic-related information. Conclusion: The 104 HIHL has played a critical role in sustaining health-care delivery during the pandemic, combating the "infodemic" and guiding the general public by providing authentic information.

A survey of hand hygiene practices among Indian medical undergraduates.

Background: Hand hygiene is the simplest and most effective method to prevent hospital acquired infections (HAI). Compliance with hand hygiene among health providers is, however, widely variable due to significant knowledge gaps and behavioral issues. The knowledge and practices of hand hygiene among medical undergraduate students, the future health workforce in the current COVID-19 pandemic will enable a reality check and ensure course correction at an early stage of their learning. Methods: An online questionnaire-based survey based on a standard, validated WHO 25-point (multiple-choice question and Yes/No answers) hand hygiene survey was undertaken among medical undergraduate students in an urban city from April to June 2020. Each correct response was awarded 1 point, and an incorrect response was awarded 0 points. The maximum achievable score was 25, and the minimum score was 0. Results: A total of 457 students with a mean age 20.24 ± 1.27 years completed the survey. A total of 415 (90.8%) students received hand hygiene training in the past three years. Overall 27.6% (n = 126) students had good knowledge, 65.4% (n = 299) had moderate and 7% (n = 32) had poor knowledge of hand hygiene practices. Conclusions: There were significant knowledge gaps regarding hand hygiene among medical undergraduate students in the midst of the COVID-19 pandemic. There is a need to strengthen existing teaching methods to positively impact behavioral change and potentially translate into better hand hygiene compliance among the future health workforce of the country.

Electrocardiographic manifestations in COVID-19 patients - an observational study from a tertiary care centre in north eastern India

Introduction : The Coronavirus disease 2019 (COVID-19) primarily involves respiratory system but may also affect the Cardiovascular System leading to abnormal ECGs. Its early recognition is crucial as it may be associated with increased mortality. Hence we aimed to find out various Electrocardiographic (ECG) manifestations of COVID- 19 patients admitted in a Tertiary Care Hospital and its relation to disease severity. Methods : We performed a hospital-based retrospective observational study between April, 2021 to November 2021 and analyzed the ECG changes at admission by three Cardiologists according to standard definitions and diagnostic criteria. Results : Out of 579 patients, ECG of 473 was available for analysis. ECG was normal in 227 (48%) and abnormal in 246 (52%) patients. Most common abnormal ECG finding in COVID19 patients was Sinus Tachycardia(19.5%) and less common findings were Sinus Bradycardia (5.3%), Incomplete Right Bundle Branch Block (RBBB) (3.2%), atrial fibrillation (2.5%), complete RBBB (2.3%), atrial premature complexes (2.3%), S1Q1T3 pattern (2.1%), first degree AV block (1.5%), ST-T wave changes (1.3%), Atrial flutter (1.1%). In mechanically ventilated patients, incidence of acute Right Ventricular Pressure Overload (RVPO) related ECG findings were more frequent. Conclusion : There is a wide spectrum of ECG manifestations in COVID-19 patients which varies depending upon the severity of COVID as well as prior Cardiovascular status, associated comorbidities and need for ventilatory support. Knowledge of ECG changes might help in risk stratification and triaging of COVID-19 patients.

SARS-COV-2 Mpro conformational changes induced by covalently bound ligands.

SARS-CoV-2's main protease (Mpro) interaction with ligands has been explored with a myriad of crystal structures, most of the monomers. Nonetheless, Mpro is known to be active as a dimer but the relevance of the dimerization in the ligand-induced conformational changes has not been fully elucidated. We systematically simulated different Mpro-ligand complexes aiming to study their conformational changes and interactions, through molecular dynamics (MD). We focused on covalently bound ligands (N1 and N3, ∼9 µs per system both monomers and dimers) and compared these trajectories against the apostructure. Our results suggest that the monomeric simulations led to an unrealistically flexible active site. In contrast, the Mpro dimer displayed a stable oxyanion-loop conformation along the trajectory. Also, ligand interactions with residues His41, Gly143, His163, Glu166 and Gln189 are postulated to impact the ligands' inhibitory activity significantly. In dimeric simulations, especially Gly143 and His163 have increased interaction frequencies. In conclusion, long-timescale MD is a more suitable tool for exploring in silico the activity of bioactive compounds that potentially inhibit the dimeric form of SARS-CoV-2 Mpro.Communicated by Ramaswamy H. Sarma.

Malaria vaccine: the tale of terror, triumph, tyranny, and trust

Malaria is an endemic disease in a true sense. It is an acute febrile disease caused due to the parasite Plasmodium. However, unlike COVID-19, it failed to raise an international concern or gain the scientific limelight. Most of the 200 million globally affected by malaria, half of them are from Africa. Four of the nations, Nigeria (25%), the Democratic Republic of the Congo (11%), Mozambique (5%), and Uganda (4%), account for half of the world's malaria burden and is the leading cause of illness and death. In 2019, an estimated 5-6 million people died of malaria - most of them are young children in sub-Saharan Africa. Many of the countries affected by malaria have the lowest economic status. In the malaria-endemic region, the most vulnerable groups are young children and pregnant women. The costs of malaria are enormous to individuals, families, communities, societies, and nations. After a struggle for three decades, the much-awaited malaria vaccine, RTS, S (brand name Mosquirix), was finally launched;but it came with its controversies and allegations. This review explored the different angles of this disease, the vaccine development, and the emerging debates.

Epigenetic perspectives associated with COVID-19 infection and related cytokine storm: an updated review.

PURPOSE: The COVID-19 pandemic caused by the novel Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) has put the world in a medical crisis for the past three years; nearly 6.3 million lives have been diminished due to the virus outbreak. This review aims to update the recent findings on COVID-19 infections from an epigenetic scenario and develop future perspectives of epi-drugs to treat the disease. METHODS: Original research articles and review studies related to COVID-19 were searched and analyzed from the Google Scholar/PubMed/Medline databases mainly between 2019 and 2022 to brief the recent work. RESULTS: Numerous in-depth studies of the mechanisms used by SARS-CoV-2 have been going on to minimize the consequences of the viral outburst. Angiotensin-Converting Enzyme 2 receptors and Transmembrane serine protease 2 facilitate viral entry to the host cells. Upon internalization, it uses the host machinery to replicate viral copies and alter the downstream regulation of the normal cells, causing infection-related morbidities and mortalities. In addition, several epigenetic regulations such as DNA methylation, acetylation, histone modifications, microRNA, and other factors (age, sex, etc.) are responsible for the regulations of viral entry, its immune evasion, and cytokine responses also play a major modulatory role in COVID-19 severity, which has been discussed in detail in this review. CONCLUSION: Findings of epigenetic regulation of viral pathogenicity open a new window for epi-drugs as a possible therapeutical approach against COVID-19.

Computed tomography severity score as a predictor of disease severity and mortality in COVID-19 patients: A systematic review and meta-analysis.

BACKGROUND: Prediction of outcomes in severe COVID-19 patients using chest computed tomography severity score (CTSS) may enable more effective clinical management and early, timely ICU admission. We conducted a systematic review and meta-analysis to determine the predictive accuracy of the CTSS for disease severity and mortality in severe COVID-19 subjects. METHODS: The electronic databases PubMed, Google Scholar, Web of Science, and the Cochrane Library were searched to find eligible studies that investigated the impact of CTSS on disease severity and mortality in COVID-19 patients between 7 January 2020 and 15 June 2021. Two independent authors looked into the risk of bias using the Quality in Prognosis Studies (QUIPS) tool. RESULTS: Seventeen studies involving 2788 patients reported the predictive value of CTSS for disease severity. The pooled sensitivity, specificity, and summary area under the curve (sAUC) of CTSS were 0.85 (95% CI 0.78-0.90, I2 =83), 0.86 (95% CI 0.76-0.92, I2 =96) and 0.91 (95% CI 0.89-0.94), respectively. Six studies involving 1403 patients reported the predictive values of CTSS for COVID-19 mortality. The pooled sensitivity, specificity, and sAUC of CTSS were 0.77 (95% CI 0.69-0.83, I2 = 41), 0.79 (95% CI 0.72-0.85, I2 = 88), and 0.84 (95% CI 0.81-0.87), respectively. DISCUSSION: Early prediction of prognosis is needed to deliver the better care to patients and stratify them as soon as possible. Because different CTSS thresholds have been reported in various studies, clinicians are still determining whether CTSS thresholds should be used to define disease severity and predict prognosis. CONCLUSION: Early prediction of prognosis is needed to deliver optimal care and timely stratification of patients.  CTSS has strong discriminating power for the prediction of disease severity and mortality in patients with COVID-19.

VISAL-A novel learning strategy to address class imbalance.

In the imbalance data scenarios, Deep Neural Networks (DNNs) fail to generalize well on minority classes. In this letter, we propose a simple and effective learning function i.e, Visually Interpretable Space Adjustment Learning (VISAL) to handle the imbalanced data classification task. VISAL's objective is to create more room for the generalization of minority class samples by bringing in both the angular and euclidean margins into the cross-entropy learning strategy. When evaluated on the imbalanced versions of CIFAR, Tiny ImageNet, COVIDx and IMDB reviews datasets, our proposed method outperforms the state of the art works by a significant margin.

Human rabies control in the era of post-COVID-19: a call for action.

Following the COVID-19 pandemic, there has been a sharp increase in rabies cases and deaths. Rabies outbreaks are being reported worldwide. Multiple disruptions in Rabies control occurred during the pandemic, significantly affecting lower-income countries. Countries need to develop specific action plans to become 'rabies free' by 2030.

Overcoming Food Service Industries Post-Covid -19

The COVID-19 pandemic might impact consumer demand for food Service industries. These impacts relate to the structure of preferences in the context of a pandemic, income and time constraints, and price effects. Discussion includes accounting for differential impacts of COVID-19 on demand for foodservice across socio-demographic characteristics in India, and several high-level issues and observations related to where and how to impact home consumption. My thinking leads me to conclude that demand-side factors will account for most of the changes, we see in Out home consumption. These demand-side effects will be dominated by income effects, the opportunity cost of time, and longer planning horizons on the part of the Food Service Business. In the present time only the foodservice Industry not doing well in the post COVID scenario. Let's be honest, even if tomorrow, the coronavirus moved out, people will still be avoiding ordering food or visiting restaurants or hotels for dining out -for a longer time to come. Small voting on Twitter that was reacted to by 10346 respondents showed more than half (53%) people saying no to ordering food while 13 % said that they may order and the rest 34% said they will continue to order food. This was before the Pizza delivery boy news came. The same goes for any service industry like movie halls/ malls. It is not just the food service industry but as a matter of fact whole of travel and tourism is going to suffer the hostile response of corona. From Movie halls to malls wherever there was interaction, people confined in close spaces, things will have to be reinvented, with newer techniques to minimize human interaction. In this paper, we shall have look at the problems that the foodservice industry will face and maybe suggest a way out It's been difficult for many operators and the only experience that for best understanding, how to come out of this situation is the learning's from past recessions or economic struggles while Pandemic time. And common sense will teach industries that starting a business in hard economic times is a bad idea and shows challenges to commercial viability, in the current situation has caused businesses to close and now needing to re-open, this is no different from starting a new business during hard times. Something one would normally advise against Overcoming this challenge will truly define the entrepreneurs amongst them.

COVID Recovery of FMCG Industries - India vs Globe

All the countries of the world are facing humanity's biggest crisis since World War II. Almost every country has been affected by the devastating Coronavirus disease (COVID-19). An outbreak from China has gone everywhere. In the last almost year, Corona's epicenter has been shifted from China to Europe to the United States. By this time, over 1.5 million people had been affected by COVID-19 and about 80,000 people had died worldwide. Indirectly, billions of people have been suffering from the impact of the global pandemic of COVID-19. What is disturbing is that the numbers likely stem from under-reporting, and may probably rise alarmingly in the weeks ahead if we factor in asymptomatic patients and rapid tests. Given that the pandemic-driven crisis is constantly changing, countries are desperate to flattening the curve for COVID-19. Surely, this Coronavirus has put the world economy at a major risk Coronavirus ravages the economic foundations of world trade. Commentators have identified this outbreak as an outcome of hyper-globalization or starting of de-globalization. However, the world is going to face recession;and the global losses, according to some commentators, may exceed World Wars I and II combined. At the same time, the falling world price of crude oil has added further anxieties. Several estimates are now available on the economic loss and post-COVID-19 growth path, and most of the estimates show that the world is already in an economic crisis. South and Southeast Asian countries are no exception. They are heavily affected, health or otherwise. Countries are under full or partial lockdown for the last few weeks. It is a global challenge and a global response is called for. Flattening the COVID-19 curve together helps everyone in an inclusive manner. Unlike the 2007-08 Global Financial Crisis, it is primarily a health crisis, which has given birth to an economic shock. Meanwhile, the world order has been changing fast. Several theories are being postulated. Anti-globalization rhetoric venom is now unfurled. In such unfolding "New Normal" of the world order, the consensus is that countries need to save the earth from the epidemic if we need to live together.

Trends in willingness to receive COVID-19 vaccines among healthcare workers in India: Findings from repeated cross-sectional national surveys.

Background: COVID-19 vaccination of the healthcare workers (HCWs) is a key priority in the fight against the SARS-CoV-2 pandemic. India launched its COVID-19 vaccination program in January 2021. We aimed to understand the trends in willingness to receive COVID-19 vaccines and its associated factors among HCWs in India. Methods: Using a repeated cross-sectional survey design, we collected information from HCWs in three critical time points: before (n = 937, October 2020), during (n = 1346, January 2021); and after (n = 812, May 2021) the introduction of COVID-19 vaccines in India. The third survey coincided with the peak of the second wave of COVID-19 pandemic in India. Findings: Of the study participants, 43.7, 60.2, and 73.2% were willing to receive COVID-19 vaccines during the first, second and third rounds of surveys, respectively. In multivariable logistic regression analysis, participants who trusted the health care system were more likely to report willingness to receive a COVID-19 vaccine; medical trust emerged as a significant factor in all the three rounds of surveys (First survey-aOR: 2.24, 95% CI: 1.67-2.99; Second survey-aOR: 3.38, 95% CI: 2.64-4.33; Third survey-aOR: 2.54, 95% CI: 1.65-3.91). Having confidence in domestic vaccines (Second survey-aOR: 2.21, 95% CI: 1.61-3.02; Third survey-aOR: 2.05, 95% CI: 1.24-3.37); and high perceived risk of contracting COVID-19 (Second survey-aOR: 1.48, 95% CI: 1.13-1.93; Third survey-aOR: 2.02, 95% CI: 1.31-3.13) were found to be associated with willingness to receive vaccines. Among socio-demographic characteristics, being married (aOR: 1.71, 95% CI: 1.08-2.71) and having high socio-economic status (aOR: 3.01, 95% CI: 1.65-5.51) emerged as significant factors associated with willingness to receive COVID-19 vaccines in the third round of the surveys. Interpretation: Willingness to receive COVID-19 vaccine increased with time, as the severity of the pandemic increased. To increase COVID-19 acceptance and coverage among HCWs, it is important to instill confidence in domestic vaccines and assist in accurate assessment of risk toward contracting COVID-19 infection.