Infectivity, Morbidity, Emerged Variants of SARS-CoV-2 and Vaccination in Indian Perspectives from First Wave to Second Wave of COVID-19

More than one year since coronavirus disease 2019 was declared a deadly disease by World Health Organization, the deadly severe acute respiratory syndrome Coronavirus 2 continues to disrupt public life worldwide. Several nations have seen a two-wave design in revealed instances of COVID 19 pandemic, with a first wave of infection during early 2K20 followed by the ongoing second wave. An investigation of the predominance of COVID-19 in India from the first wave to the second wave was utilized to characterize critical contrasts, infection patterns, lethality, and therapeutic measures through extensive vaccination pan-India free of cost. The quantitative transmission brought about COVID-19, including meteorological boundaries and topographical locale information, was gathered using web search tools and available literature and substantiated by factual advanced numerical tools. Experimental information showed that the qualities of the infection impacts do change between the two-time frames. The examination between the first wave and second wave, where COVID-19 flare-ups were now turning out to be scourged, was contemplated. Contrasts in age reach and seriousness of the infection have been accounted for, albeit the relative qualities of the two waves remain to a great extent obscure. The present investigation recommends that variability in environmental temperature and moisture contents may not be the significant components influencing the COVID-19 mortality during different waves of infection. The second wave of COVID-19 is influencing a large portion of the world, and especially the middle age group person relies on the principal top. © 2022 by the authors.

Forensic Science in the United States II: Forensic Pathology and the Medical Examiner/Coroner Systems

[...]Part III will address the key strengths and challenges for forensic science in the US as well as look at future directions for the field. Forensic pathologists in the US are physicians certified by the American Board of Pathology (ABP;Tampa, FL) in both anatomic and FPath. [...]by definition, an FP is a physician who has formal training and certification for determining the cause and manner of death. Currently, FPs receive extensive training and are certified to oversee death investigations, perform postmortem examinations, write autopsy reports, complete death certificates, and testify about their findings in a court of law. A 2020 publication exploring this problem called for a renewed recognition of hospital autopsies as the practice of medicine and even reinstating reimbursement of this procedure by the Centers for Medicare and Medicaid Services (a part of the US Department of Health and Human Services) [6].

Household Transmission of SARS-CoV-2 from Humans to Pets, Washington and Idaho, USA.

SARS-CoV-2 likely emerged from an animal reservoir. However, the frequency of and risk factors for interspecies transmission remain unclear. We conducted a community-based study in Idaho, USA, of pets in households that had >1 confirmed SARS-CoV-2 infections in humans. Among 119 dogs and 57 cats, clinical signs consistent with SARS-CoV-2 were reported for 20 dogs (21%) and 19 cats (39%). Of 81 dogs and 32 cats sampled, 40% of dogs and 43% of cats were seropositive, and 5% of dogs and 8% of cats were PCR positive. This discordance might be caused by delays in sampling. Respondents commonly reported close human‒animal contact and willingness to take measures to prevent transmission to their pets. Reported preventive measures showed a slightly protective but nonsignificant trend for both illness and seropositivity in pets. Sharing of beds and bowls had slight harmful effects, reaching statistical significance for sharing bowls and seropositivity.

Decision support system to evaluate ventilation in the acute respiratory distress syndrome (DeVENT study)-trial protocol.

BACKGROUND: The acute respiratory distress syndrome (ARDS) occurs in response to a variety of insults, and mechanical ventilation is life-saving in this setting, but ventilator-induced lung injury can also contribute to the morbidity and mortality in the condition. The Beacon Caresystem is a model-based bedside decision support system using mathematical models tuned to the individual patient's physiology to advise on appropriate ventilator settings. Personalised approaches using individual patient description may be particularly advantageous in complex patients, including those who are difficult to mechanically ventilate and wean, in particular ARDS. METHODS: We will conduct a multi-centre international randomised, controlled, allocation concealed, open, pragmatic clinical trial to compare mechanical ventilation in ARDS patients following application of the Beacon Caresystem to that of standard routine care to investigate whether use of the system results in a reduction in driving pressure across all severities and phases of ARDS. DISCUSSION: Despite 20 years of clinical trial data showing significant improvements in ARDS mortality through mitigation of ventilator-induced lung injury, there remains a gap in its personalised application at the bedside. Importantly, the protective effects of higher positive end-expiratory pressure (PEEP) were noted only when there were associated decreases in driving pressure. Hence, the pressures set on the ventilator should be determined by the diseased lungs' pressure-volume relationship which is often unknown or difficult to determine. Knowledge of extent of recruitable lung could improve the ventilator driving pressure. Hence, personalised management demands the application of mechanical ventilation according to the physiological state of the diseased lung at that time. Hence, there is significant rationale for the development of point-of-care clinical decision support systems which help personalise ventilatory strategy according to the current physiology. Furthermore, the potential for the application of the Beacon Caresystem to facilitate local and remote management of large numbers of ventilated patients (as seen during this COVID-19 pandemic) could change the outcome of mechanically ventilated patients during the course of this and future pandemics. TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT04115709. Registered on 4 October 2019, version 4.0.

What is new in respiratory monitoring?

This paper provides a review of a selection of papers published in the Journal of Clinical Monitoring and Computing in 2020 and 2021 highlighting what is new within the field of respiratory monitoring. Selected papers cover work in pulse oximetry monitoring, acoustic monitoring, respiratory system mechanics, monitoring during surgery, electrical impedance tomography, respiratory rate monitoring, lung ultrasound and detection of patient-ventilator asynchrony.

Myocardial Perfusion Imaging After Severe COVID-19 Infection Demonstrates Regional Ischemia Rather Than Global Blood Flow Reduction.

Background: Acute myocardial damage is common in severe COVID-19. Post-mortem studies have implicated microvascular thrombosis, with cardiovascular magnetic resonance (CMR) demonstrating a high prevalence of myocardial infarction and myocarditis-like scar. The microcirculatory sequelae are incompletely characterized. Perfusion CMR can quantify the stress myocardial blood flow (MBF) and identify its association with infarction and myocarditis. Objectives: To determine the impact of the severe hospitalized COVID-19 on global and regional myocardial perfusion in recovered patients. Methods: A case-control study of previously hospitalized, troponin-positive COVID-19 patients was undertaken. The results were compared with a propensity-matched, pre-COVID chest pain cohort (referred for clinical CMR; angiography subsequently demonstrating unobstructed coronary arteries) and 27 healthy volunteers (HV). The analysis used visual assessment for the regional perfusion defects and AI-based segmentation to derive the global and regional stress and rest MBF. Results: Ninety recovered post-COVID patients {median age 64 [interquartile range (IQR) 54-71] years, 83% male, 44% requiring the intensive care unit (ICU)} underwent adenosine-stress perfusion CMR at a median of 61 (IQR 29-146) days post-discharge. The mean left ventricular ejection fraction (LVEF) was 67 ± 10%; 10 (11%) with impaired LVEF. Fifty patients (56%) had late gadolinium enhancement (LGE); 15 (17%) had infarct-pattern, 31 (34%) had non-ischemic, and 4 (4.4%) had mixed pattern LGE. Thirty-two patients (36%) had adenosine-induced regional perfusion defects, 26 out of 32 with at least one segment without prior infarction. The global stress MBF in post-COVID patients was similar to the age-, sex- and co-morbidities of the matched controls (2.53 ± 0.77 vs. 2.52 ± 0.79 ml/g/min, p = 0.10), though lower than HV (3.00 ± 0.76 ml/g/min, p< 0.01). Conclusions: After severe hospitalized COVID-19 infection, patients who attended clinical ischemia testing had little evidence of significant microvascular disease at 2 months post-discharge. The high prevalence of regional inducible ischemia and/or infarction (nearly 40%) may suggest that occult coronary disease is an important putative mechanism for troponin elevation in this cohort. This should be considered hypothesis-generating for future studies which combine ischemia and anatomical assessment.

Insights into the origin, transmission and outbreak of coronavirus disease (covid 19): A recent study

Present pandemic situation due to the appearance of COVID-19 has put the world in a miserable condition. More than 2.5 million people have been infected with the causal strain of coronavirus SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2). The first case of COVID-19 infection was reported in China in December 2019. Scientists are searching the effective tool to combat this virus. The study has been undertaken by the scientists towards finding effective medicine, vaccine as well as robust techniques to detect this virus. Besides development of new treatment, the application of clinical data analytics has also been observed for the off-label use of the already available medications. As a part of the real time application of science and technology, several clinical trials has been in process to extract the best answer against COVID-19. In present article, a comprehensive review has been carried out to conscripting the available knowledge about discovery, genomic structure, mechanism of infection and clinical features of SARS-CoV-2. Presently available procedures for detection of this virus have been highlighted. Besides these, available treatments which have been explored by the researchers worldwide, includes precisely convalescent plasma therapy, monoclonal antibody therapy as well as antiviral medications along with their regulatory status, have been discussed elaborately which will definitely enrich the global understanding as well as proficient ability to combat this pathogens. © 2020 Chemical Publishing Co.. All rights reserved.

How Human Factors Can Help Preserve Democracy in the Age of Pandemics.

OBJECTIVE: To describe user-centered voting systems that would support the safe conduct of voting in a pandemic environment. BACKGROUND: The COVID-19 pandemic has complicated our democratic processes. Voters and poll workers feel threatened by the potential dangers of voting in business-as-usual polling stations. Indeed, significant problems were encountered in the recent 2020 primary elections in Wisconsin, where the National Guard had to be mobilized because so few poll workers reported to work, and more than 90% of polling places had to remain closed. METHOD: We describe a number of possible user-centered solutions that would help protect voters and poll workers in times of pandemic, and also report the results of a survey that asked voters and poll workers about what kinds of systems might make them willing to vote. RESULTS: Political as well as safety considerations will need to be considered as these safer voting solutions are designed since, surprisingly, the kinds of solutions preferred depend on the political affiliation of the voters. CONCLUSION: Human factors professionals have a large role to play in realizing the safe, successful implementation of these user-centered systems. Good human factors analysis can help minimize the risk to voters and poll workers. Moreover, human factors methods can help safeguard democracy by creating safe and well-engineered environments that are conducive to voting in the age of pandemics. APPLICATION: Creating safe and effective voting solutions that protect voters and poll workers during pandemic outbreaks is crucial to the preservation of democracy.