At the Crossroads of One Health: Lessons Learned from Foot and Mouth Disease in COVID-19 Pandemic

Foot-and-mouth disease (FMD) and Coronavirus Disease 2019 (COVID-19) are transboundary diseases caused by single-stranded positive-sense RNA viruses with similarities in genome replication and viral protein synthesis. In FMD, asymptomatic infection leads to carrier status and persistently infected animals that threaten the animals vaccinated with a trivalent inactivated whole virus vaccine. Similar information on COVID-19 is not yet available. As COVID-19 vaccination is introduced in January 2021 (since 16 January 2021 in India), its outcome can be assessed by the year-end;and while doing so, the experiences gained in the control of FMD in livestock worldwide can be applied, including monitoring of vaccination response, duration of immunity, level of herd immunity developed, and antigenic matching of the vaccine virus. Antigenic divergence of the virus is a major issue in FMD, and different geographical regions in the world use different virus strains in vaccine preparations to antigenically match circulating virus strains in respective regions for control of the disease. Non-synonymous mutations in the critical antigenic determinants of SARS-CoV-2 have been observed, and there is likely the existence/development of antigenic variants. Therefore, during the post-COVID-19 vaccination regime, it will be essential to monitor the suitability of the in-use vaccine strain region-wise from time to time, as there could be an eruption of isolated outbreaks in a country arising due to antigenic variation and variants. In the context of the present scenario of COVID-19 around the Globe and multiple ongoing efforts to develop suitable vaccine(s) to control the disease, it is a must to develop NSP-antibody (that differentiate infected from vaccinated) assays to differentiate infected from vaccinated individuals(DIVI;DIVA in veterinary epidemiology). The techniques used and experiences gained in ongoing FMD control programs in the endemic countries can be applied to COVID-19 control in a country;and finally, the Globe. After achieving the control of COVID-19, the aim would be to eradicate the virus, which will be tough even with vaccination, as the disease/infection may become endemic during the time to come. To achieve this, applying the principles of Progressive Control Pathway for Foot-and-Mouth Disease (PCP-FMD;FAO/OIE) to COVID-19 control will be beneficial in its control. The present review discusses the issue of control of COVID-19. © 2021 by the authors.

A Transfer Learning Approach for Diagnosis of COVID-19 Cases from Chest Radiography Images

The new coronavirus disease 2019 (COVID-19) pandemic completely changed individuals' daily lives and created economic disruption across the world. Many countries are using movement restrictions and physical distancing as their measures to slow down this transmission. Effective screening of COVID-19 cases is needed to stop the spreading of these diseases. In the first phases of clinical assessment, it was seen that patients with deformities in chest X-ray images show the signs of COVID-19 infection. Inspired from this, in this study, a novel framework is designed to detect the COVID-19 cases from chest radiography images. Here, a pre-trained deep convolutional neural network VGG-16 is used to extract discriminating features from the radiography images. These extracted features are given as an input to the Logistic regression classifier for automatic detection of COVID-19 cases. The suggested framework obtained a remarkable accuracy of 99.1% with a 100% sensitivity rate in comparison with other state-of-the-art classifier. © 2022 IEEE.

Financing the growth of Urban Chowk

Learning outcomes: ▪ Identify and explain the factors that contribute to the success of a restaurant business. ▪ Analyse different sources of entrepreneurial finance. ▪ Identify and explain local entrepreneur's expectations from a funding agency. ▪ Evaluate investment decision-making criteria for entrepreneurial funding agencies. Case overview/synopsis: Kartikey Rajput, the promoter of a food park Urban Chowk, was waiting for the Covid regulations in the country to be relaxed. The entrepreneur in him found a business opportunity to provide hygienic food with a beautiful ambience and floated a food park (Urban Chowk) with the support of his wife Nikita Agrawal in 2017 and the second edition amidst Covid in 2020. The business model was well-appreciated by food vendors as well as customers. Rajput could see future growth potential in urban India. But his aggressive business plan to open five food parks in different cities in the next three years was disrupted due to the Covid pandemic. The expansion required huge investments, and post-pandemic challenges were plenty. The decision to go beyond Ahmedabad required the selection of cities besides the major challenge of the financing choice. The new cities might have huge footfall potential but finding the right location at the right price was a different challenge. Rajput was also concerned with the sources of getting the required finances. The entrepreneur was contemplating and evaluating the alternative sources of finance available to a start-up. Complexity academic level: This case is appropriate for a graduate and post-graduate level programme in the courses like entrepreneurial finance, entrepreneurship and strategy. This case can also be used in an executive programme on management and Management Development Programmes (MDPs) on entrepreneurship or entrepreneurial finance. Supplementary materials: Teaching notes are available for educators only. Subject Code: CSS 1: Accounting and Finance. © 2022, Emerald Publishing Limited.

Predictive Value of Procalcitonin across Disease States within an Inpatient Veteran Population

Background. Procalcitonin (PCT) can be elevated with certain bacterial infections. Debate continues as to how to best use this biomarker to guide antibiotic use. The primary objective of this study was to evaluate the correlation of PCT levels and the presence of bacterial infection on admission in the total population and in different disease states. Methods. This was a multicenter retrospective cross-sectional study of patients admitted with specified infectious diagnoses to two VA Medical Centers from 4/1/ 2019 to 7/1/2021. Patients were stratified into 4 cohorts for analysis;those with COVID-19, sepsis from respiratory source-(S-R), sepsis from non-respiratory source (S-NR), and respiratory source without sepsis (R). Electronic medical records were reviewed to collect the following: initial procalcitonin, cultures, SIRS criteria, comorbidities (CKD, ESRD, HF, immunosuppressed, surgery within the 7 days), and c-reactive protein. PCT elevation was defined as >=0.25 ng/mL. The frequency of positive cultures within 72 hours was evaluated for patients with elevated and normal PCT levels to determine the diagnostic performance of PCT overall and for each cohort. Results. 632 of 664 patients were evaluated in this study. PCT is elevated twice as often in the septic groups as compared to the non-septic groups (figure 1). Positive predictive value (PPV) varies from 27% to 63% as compared to negative predictive value (NPV) 53%-79% among the disease state groups (figure 2). Although small numbers, the NPV of PCT improves to 83% in patients with elevated temperature and white blood cells (WBC) (figure 3). Conclusion. The findings that NPV of PCT appears to be better than PPV, support current recommendations against using this as a diagnostic tool, but rather as a tool to assist with antibiotic de-escalation. Further studies are necessary to confirm whether there are specific markers such as temperature or WBC which may improve the NPV. Our data suggests PCT is less helpful in identifying the presence or absence of bacterial infection in septic versus non-septic patients. (Figure Presented).

Early Intubation Reduces the Risk of Death Among COVID-19 Patients: An Observational Study

The objective of this study was to find the association of invasive mechanical ventilation, non-invasive mechanical ventilation (N.I.V) and high flow nasal canula (HFNC) with mortality in COVID 19 pneumonia patients with ARDS. This is an observational cohort study conducted among patients those who were infected with COVID19 infection and received ventilator support. This study was a single centred, conducted among COVID19 patients, who came to a tertiary hospital in Bhubaneswar, Odisha. All patients admitted with COVID19 infection and received mechanical ventilation in between August 2020 to November 2020 was included in this study. As this is an observational cohort study, any intervention not required. Only, data collectors collected all relevant patient data using an android-based data collection platform. 398 patients were found to be eligible for this study. Among them, only 24.47% patients received invasive mechanical ventilation and rest were on N.I.V (62.77%) and HFNC support (12.77%). 26 patients died among the 92 invasively ventilated patients, whereas the mortality rate among N.I.V group of patients (78.7%) was significantly higher. Increased TLC count, C-Reactive, Protein, Urea, Creatinine, Heart rate, Respiratory rate were mostly associated with increased mortality among non-invasively ventilated patients. Early intubation may decrease the risk of mortality in patients infected with severe COVID19 infection. Copyright © 2022 Oriental Scientific Publishing Company. All rights reserved.

Covid Device (Covid Operation Vital Information Delivery device) (Adult Module-Version One) for Covid and Post Covid Condition Management Cum Research Through Test Run of a Dynamic Software Incorporated Dedicated Device: A Collaborative Operation Cum Implementation Research Under Digital Health Mission Initiative of India

Aim and background: Due to the resurgence of COVID cases many doctors, medical students, and nurses from varied backgrounds, many a time novice to COVID management are deployed in turn from time to time at different COVID care centers and hospitals across India, before they are properly trained and skilled for effective management of COVID and post COVID syndromes, as the disease is relatively new, leading to non-uniform management and documentation. COVID being a contagious disease with newer symptomatology and ongoing research outputs suggesting new guidelines from time to time, which sometimes are conflicting in nature for novice healthcare workers. For uniform and appropriate management to reduce morbidity and mortality, it mandates a unique and effective solution towards guided and error-free disease management, authentic high volume data capture for future research and to trace patient to post COVID condition in the community outside the hospital, virtual patient counselling cum relative visit, generation of the daily patient bulletin, simultaneous teleround of multiple units, and sharing patient's data across multiple specialities and investigation areas. Objective: To have all these above-mentioned facilities over one platform, we aim to test run a cloud-based dynamic mobile application based dedicated device, the C O V I D Device (Covid Operation Vital Information Delivery device) across many hospitals in India simultaneously for COVID and post COVID syndrome management and data retrieval for research. Materials and methods: Two institutes, namely IMS and SUM Hospital and ITER have collaborated to design a cloud-based device having recent COVID guidelines on the management of adult COVID patients. The software has been incorporated into a dedicated handheld device (tablet or android mobile phone), the COVID Device in a dynamic way (when new symptomatology surfaces and new research outcomes on management are published). The important modules pertaining to this COVID Device are Web-based application for Registration Desk and Device-based application for Doctor's Module/Care-givers Module and Patient's/Patient's relative's module. Results: In a pilot, we have successfully test run the COVID device on virtual patients and 2 actual patients in a secondary level COVID ICU and HDU to examine the different functionality of the cloud-based application, namely error-free and guided patient management without missing any point, daily patient relative's counselling and virtual patient visiting by relatives, generating daily patient bulletin, simultaneous tele round of multiple units, and sharing patient's data across multiple specialities and investigation areas and tracing patient to the community after discharge to enquire about post COVID condition and retrieval of data across all module and incorporation of new guideline in a dynamic way and checking the facilities for incorporating other modules namely pediatric module. Conclusion: COVID Device (Adult module) is a very effective tool for COVID and post COVID condition management and research. It has the potential to incorporate other modules namely obstetric, pediatric, and neonatal modules. If used across all hospital of India, it will be a real boost to digital health mission and centralized COVID data management and research in India.

Educational Technology: A Last Resort to Academia Amid Pandemic

That a pandemic like COVID-19 would occur and wreak such havoc on humanity, almost incapacitating their life and lifestyle, was inconceivable. However, in the yet uncertain post-COVID-19 world, among all things that must have changed for better, would certainly be the way academia shall exploit educational technologies to impart quality online education to the students locked at home. The inordinate delay in starting life as normal has forced teachers and parents alike to explore efficient ways to facilitate online teaching using various technological channels. It is observed that while students from urban areas across India have coped up with the situation quite well, using the resources at hand, students from rural areas, with ill-equipped infrastructure, are finding it tough to continue their studies. Lack of facilities like smartphones, Internet connection, and a robust mobile network are some of the major challenges that hamper the academic progress of the rural students. The present study aims to assess the preparedness of students, teachers and educational institutions to adopt digital education during the pandemic. It looks into the impact of the COVID-19 pandemic on education. It further analyses opportunities and challenges for online education during this pandemic and offers key suggestions for the future days in academics in post-COVID-19 era. The findings of this study shall assist the concerned authorities in evaluating the preparedness of parents and teachers to continue education of the students, residing in urban as well as rural areas, in such unforeseen home-bound situations and suggest measures in that direction. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Work Environment,Stress andburnout among Security Personnel during Covid 19 Pandemic

Background: Odisha was also affected by the spread of the novel coronavirus (SARS-Cov-2), responsible for the COVID-19 disease. For its mitigation the health system in a tertiary care institution was frantically deploying all personnel like from health , security, food handlers , dealing with transportation. Objective: Our aim was to assess exposure, perceptions, workload, and possible burnout of Security personnel during the COVID-19 pandemic and to suggest specific recommendations based on the study findings. Methodology: The type of study was a cross sectional study, placed at Cuttack district in Odisha. Time Period of this study was Aprilto June 2021. 465 were finally included in the study. On the days of the mental health status assessment security personnel's were appraised and accordingly a predesigned, pretested questionnaire was implemented to them. Results: 57.5% males and 67.2% females were at the risk of burn out while 38.4% and 32.4% were at the edge of severe burn out. There was a significant difference in the mean score between those aged less than 30 years at F (5.434, 2) and those between 30 to 50 years as well as those aged above 50 years with p- value 0.008 and 0.009 respectively. Conclusions: Specific strategies have to be recommended and adapted like changing work pattern taking breaks, avoiding overtime, balance work with life. The task should include different skills to cope with stress, time managementand social support from family, friends and peer. Besides this various relaxation strategies to promote fitness, developunderstanding of life, counseling, better sleep, exercise, and good balanced nutrition.

A Study on Shift Towards Digitalization of Medical Reimbursement by Insurance Companies during COVID Like Pandemic Situation

Health insurance is an agreement in which an insurance company guarantees to pay for the insurer's medical expenses in the event of hospitalization. Purchasing a health insurance policy is important as the medical costs required for treatment are very expensive these days. This involves paying a small amount each year to reduce stress in the event of a medical emergency. Claiming health insurance is a very tedious process. As insurance companies require all documents like hospital medical certificate signed by a medical doctor, a certificate of discharge, medical prescriptions etc., at that time for verification. People face problems in collecting all the documents including debts and receipts. In the current COVID like pandemic situations, it is even worse if one needs to visit a hospital to collect documents. Insurance companies require all that documents to be authentic without being programmed. Insurance companies sometimes insist that documents may be duplicates. These situations create a major problem for people. That is why a website is introduced to help people get through this boring process and will reduce paperwork to avoid data mismatch and deception to get the wrong results. The health Insurance Scheme provides coverage to the policyholder for medical expenses in the event of a medical emergency including the cost of surgery, day care costs, and critical illness etc. This is done by an individual. Taking the conventional scenario into account, whenever a person claims insurance, the insurance company wants the original documents from the hospital. In the case of COVID, it is very dangerous for a person to visit a hospital to collect physical documents. As it also involves handling documents by hospital staff and can be the cause of the spread of the virus. On the other hand, through the website, a person can gain access to his or her documents whenever required, even staying at home or through a remote place, without having to return to the hospital repeatedly, in turn protecting themselves from getting COVID contaminated. Even if the hard copy of the receipt is lost, the hospital records would always remain available for the users through the website. © 2021 IEEE.

Role of Mitochondria in ADT-Induced Sarcopenia in Prostate Cancer Patients

Prostate cancer (PCa) is the most common cancer among men. Androgen deprivation therapy (ADT)is the standard treatment for advanced and metastatic PCa and nearly 400,000 men remain on androgen deprivation therapy (ADT) for advanced PCa in the U.S. Unfortunately, ADT also induces a decrease in muscle mass and function, known as sarcopenia, a condition that leads to decreased endurance, increased fatigue, falls, poor health-related quality of life (HR-QOL) and increased mortality. The mechanisms underlying the development of ADT-induced sarcopenia are incompletely understood and remain a significant barrier to the development of therapies for this condition. Mitochondria play an essential role in generating the adenosine triphosphate (ATP) needed for muscle contraction and abnormalities in mitochondria function have been reported in animal models of sarcopenia. The extent to which mitochondrial dysfunction mediates ADT-induced sarcopenia and muscle dysfunction is not known. The overall goal of this proposal is to establish the role of mitochondrial dysfunction on ADT-induced sarcopenia in patients with PCa. Our hypothesis is that ADT in men with PCa will induce mitochondrial dysfunction leading to sarcopenia. To test this hypothesis, we will carry out a pilot study of men with PCa undergoing ADT (n=60).As of August 26, 2020, we have enrolled seventeen research participants in the study. Research participant recruitment and performance of study visits were impacted beginning in March due to the COVID-19 epidemic. We are following local VA and UW communications closely to ensure we meet their recommended guidelines for resuming human subjects research

P-210: Oral ixazomib (Ixa), IV daratumumab (Dara), and dexamethasone (dex;IDd) in relapsed/refractory multiple myeloma (RRMM) patients (pts) with 1–3 prior therapies: phase 2 study interim analysis (IA)

Background: Proteasome inhibitors (PIs) & monoclonal antibodies are backbones of RRMM treatment;Ixa is approved with lenalidomide-dex for pts with ≥1 prior therapy, & Dara is approved in various regimens, including with bortezomib-dex (DVd). In CASTOR (DVd vs Vd), Vd was limited to 8 cycles;however, prolonged PI therapy is associated with improved outcomes. The IDd regimen with oral Ixa may enable longer-term PI therapy than with DVd. We evaluate IDd using a treat-to-progression approach. Methods: Ixa/Dara-naive RRMM pts receive Ixa 4 mg (days 1, 8, 15), Dara 16 mg/kg (days 1, 8, 15, 22, cycles 1–2;days 1, 15, cycles 3–6;day 1, cycles 7+), & dex 20 mg (days 1, 2, 8, 9, 15, 16, 22, 23) in 28-day cycles. The primary endpoint is ≥ very good partial response (VGPR) rate;secondary endpoints include overall response rate (ORR), progression-free survival (PFS), time to progression (TTP), overall survival (OS), & safety. We report data from the 2nd IA, conducted after ~50% of PFS events had occurred (data cutoff: 1/1/2021). Results: 61 pts were enrolled (median age 69 y, 19.7% aged ≥75 y;19.7% International Staging System stage III;26.2% high-risk cytogenetics [del(17p), t(4;14), t(14;16)], 42.6% expanded high-risk cytogenetics [high-risk &/or amp1q21]);59.0/26.2/14.8% of pts had received 1/2/3 prior lines. At data cutoff, pts had received a median of 16 IDd cycles;37.7% were ongoing. Relative dose intensity (RDI) of Ixa, Dara, & dex was 20%) TEAEs were diarrhea (39.3%), anemia (27.9%), thrombocytopenia (26.2%), & fatigue (21.3%);common (>5%) G≥3 TEAEs were pneumonia (11.5%), thrombocytopenia (11.5%), & anemia (8.2%). Infections & Infestations TEAEs were seen in 57.4% of pts (G≥3 24.6%) and were serious in 26.2%, including pneumonia (9.8%) and COVID-19/pneumonia (4.9%). Rate of peripheral neuropathy (PN) was 18.0% (1.6% G≥3). PN was 28.6% & 12.5%in pts with & without history of PN, respectively. Study drug dose modifications, reductions & discontinuations due to TEAEs were required in 57.4% (Ixa 36.1%, Dara 34.4%, dex 41.0%), 32.8%, & 9.8%of pts, respectively. Four pts died on study due to sudden death, COVID-19 pneumonia, septic shock, & COVID-19 (none were considered study drug-related). Conclusion: These IA data suggest IDd has a positive risk-benefit profile in RRMM pts, with a ≥VGPR rate of 30.5%, median PFS of 17.0 m, & a low rate of discontinuation due to TEAEs. The final analysis of this ongoing study is expected in 2022.

Physician's perception of E-consultation adoption amid of COVID-19 pandemic

Purpose The purpose of this paper is to investigate physicians' perceptions of e-consultation adoption, which has the potential to bridge existing gaps in the current health-care system, using the unified theory of acceptance and use of technology (UTAUT2) framework. Design/methodology/approach The judgemental sampling method was embraced to collect primary data from 337 physicians from Delhi-National Capital Region who had experience with e-consultation. A number of hypotheses was developed and tested using structural equation model based on UTAUT2. Findings The study's findings revealed an affirmative and significant relation between a physician's intention to embrace e-consultation and facilitating conditions, effort expectancy, social influence and performance expectancy;however, habit and experience are not significantly linked to it. Originality/value This study will not only add to the existing body of knowledge about e-consultation adoption, but it will also assist electronic health service providers in devising strategies to encourage the usage of e-consultation services in emerging economies such as India where people are deprived of the right to access better health care due to lack of physical infrastructure.

Moderating effect of gender on adoption of digital health consultation: a patient perspective study

Purpose: The purpose of this paper is to understand the factors influencing the adoption decision of patients towards digital consultation in India with gender as a moderating variable. This study is based on the unified theory of acceptance and use of technology (UTAUT2) framework for examining the factors influencing adoption decisions for digital consultation and to what extent this leads to continuous usage intention. Design/methodology/approach: Based on the UTAUT2 framework, this study proposed a set of hypotheses that were tested using structural equation modeling. This study was based on primary data collected from 462 sample respondents using the judgemental sampling method who had experience of using digital health consultation in India. Findings: Findings of this study revealed significant and positive causation in the behavioural intention (BI) of a patient to adopt digital health consultation arising out of performance expectancy, effort expectancy, social influence, facilitating condition and price value;however, habit is insignificantly associated with the same. Furthermore, the results of this study also revealed that the BI of a patient towards digital health consultation is significantly moderated by their gender. Originality/value: This study conceptually strengthens the present body of literature on the adoption behaviour by contributing certain new dimensions in the context of digital health consultations and will also help policymakers and service providers in crafting their strategy for promoting the adoption of digital health consultation. © 2021, Emerald Publishing Limited.

Covid-19 pandemic: A systematic review on the coronaviruses of animals and sars-cov-2

Coronaviruses (CoVs), classified into four genera, viz., alpha-, beta-, gamma-, and Delta-CoV, represent an important group of diverse transboundary pathogens that can infect a variety of mammalian and avian species including humans, animals, poultry, and non-poultry birds. CoVs primarily infect lung and gut epithelial cells, besides monocytes and macrophages. CoVs have high mutation rates causing changes in host specificity, tissue tropism, and mode of virus excretion and transmissions. The recent CoV zoonoses are SARS, MERS, and COVID-19 that are caused by the transmission of beta-CoVs of bats to humans. Recently, reverse zoonoses of the COVID-19 virus have been detected in dogs, tigers, and minks. Beta-CoV strains also infect bovine (BCoV) and canine species (CRCoV);both these beta-CoVs might have originated from a common ancestor. Despite the high genetic similarity between BCoV, CRCoV, and HCoV-OC43, these differ in species specificity. Alpha-CoV strains infect canine (CCoV), feline (FIPV), swine (TGEV and PEDV), and humans (HCoV229E and NL63). Six coronavirus species are known to infect and cause disease in pigs, seven in human beings, and two in dogs. The high mutation rate in CoVs is attributed to error-prone 3′-5′ exoribonuclease (NSP 14), and genetic recombination to template shift by the polymerase. The present compilation describes the important features of the CoVs and diseases caused in humans, animals, and birds that are essential in surveillance of diverse pool of CoVs circulating in nature, and monitoring interspecies transmission, zoonoses, and reverse zoonoses. © 2021, Editorial board of Journal of Experimental Biology and Agricultural Sciences. All rights reserved.