Role of mouthwash in prevention of Covid-19: A review

The corona virus disease 2019 (COVID-19) caused by severe acute respiratory syndrome corona virus 2 (SARSCoV-2), first detected in Wuhan, Hubei province of China, has emerged rapidly as a health crisis that has challenged health systems and health professionals all over the world. Transmission occurs primarily through droplet spread or contact routes. Due to these characteristics dental staff and dental practitioners are considered to be at the highest risk of acquiring SARS-CoV-2 infection because of their prolonged face to face exposure to patients and exposure to respiratory secretions and aerosols produced during procedures like ultrasonic scaling and cavity/access preparation using a high-speed air rotor with water jet cooling systems. Antiseptic mouthwashes have been widely used as a standard measure before routine dental treatment, especially preoperatively. They have an essential role in reducing the number of microorganisms in the oral cavity. Hence, present review of literature provides details on role of mouthwash in prevention of Covid-19 transmission.Copyright © 2020 Ubiquity Press. All rights reserved.

Effect of Cholesterol on Biomimetic Membrane Curvature and Coronavirus Fusion Peptide Encapsulation.

Biomimetic cubic phases can be used for protein encapsulation in a variety of applications such as biosensors and drug delivery. Cubic phases with a high concentration of cholesterol and phospholipids were obtained herein. It is shown that the cubic phase structure can be maintained with a higher concentration of biomimetic membrane additives than has been reported previously. Opposing effects on the curvature of the membrane were observed upon the addition of phospholipids and cholesterol. Furthermore, the coronavirus fusion peptide significantly increased the negative curvature of the biomimetic membrane with cholesterol. We show that the viral fusion peptide can undergo structural changes leading to the formation of hydrophobic α-helices that insert into the lipid bilayer. This is of high importance, as a fusion peptide that induces increased negative curvature as shown by the formation of inverse hexagonal phases allows for greater contact area between two membranes, which is required for viral fusion to occur. The cytotoxicity assay showed that the toxicity toward HeLa cells was dramatically decreased when the cholesterol or peptide level in the nanoparticles increased. This suggests that the addition of cholesterol can improve the biocompatibility of the cubic phase nanoparticles, making them safer for use in biomedical applications. As the results, this work improves the potential for the biomedical end-use applications of the nonlamellar lipid nanoparticles and shows the need of systematic formulation studies due to the complex interplay of all components.

Comparison and outcomes of dusting versus stone fragmentation and extraction in retrograde intrarenal surgery: results of a systematic review and meta-analysis.

Introduction: Lithotripsy during retrograde intrarenal surgery (RIRS) can be achieved either by fragmentation and extraction or dusting with spontaneous passage. We aimed to perform a systematic review on the safety and stone-free rate after RIRS by comparing the techniques of dusting vs fragmentation/extraction. Material and methods: This review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. The inverse variance of the mean difference and 95% Confidence Interval (CI), Categorical variables were assessed using Cochran-Mantel-Haenszel Method with the random effect model and reported as Odds Ratio (OR) and 95% CI. Statistical significance was set at p <0.05. Results: There were 1141 patients included in 10 studies. Stone size was up to 2.5 cm All studies used holmium laser for lithotripsy. Meta-analysis showed no significant difference in surgical time (MD -5.39 minutes 95% CI -13.92-2.31, p = 0.16), postoperative length of stay (MD -0.19 days 95% CI -0.60 - -0.22, p=0.36), overall complications (OR 0.98 95% CI 0.58-1.66, p = 0.95), hematuria (OR 1.01 95% CI 0.30-3.42, p = 0.99), postoperative fever (OR 0.70 95% CI 0.41-1.19, p = 0.19) and sepsis (OR 1.03 95% CI 0.10-10.35, p = 0.98), immediate (OR 0.40 95% CI 0.13-1.24, p = 0.11) and overall stone-free rate (OR 0.76 95% CI 0.43-1.32, p = 0.33), and retreatment rate (OR 1.35 95% CI 0.57-3.20, p = 0.49) between the groups. Conclusions: This systematic review infers that urologists can safely use either option of fragmentation and basket extraction or dusting without extraction to achieve similar outcomes as both techniques are similar for efficacy and safety.

Analysis of COVID-19 in India using a vaccine epidemic model incorporating vaccine effectiveness and herd immunity.

COVID-19 will be a continuous threat to human population despite having a few vaccines at hand until we reach the endemic state through natural herd immunity and total immunization through universal vaccination. However, the vaccine acts as a practical tool for reducing the massive public health problem and the emerging economic consequences that the continuing COVID -19 epidemic is causing worldwide, while the vaccine efficacy wanes. In this work, we propose and analyze an epidemic model of Susceptible-Exposed-Infected-Recovered-Vaccinated population taking into account the rate of vaccination and vaccine waning. The dynamics of the model has been investigated, and the condition for a disease-free endemic equilibrium state is obtained. Further, the analysis is extended to study the COVID-19 spread in India by considering the availability of vaccines and the related critical parameters such as vaccination rate, vaccine efficacy and waning of vaccine's impact on deciding the emerging fate of this epidemic. We have also discussed the conditions for herd immunity due to vaccinated individuals among the people. Our results highlight the importance of vaccines, the effectiveness of booster vaccination in protecting people from infection, and their importance in epidemic and pandemic modeling.

INNOVATIVE USE OF TELEHEALTH TO MANAGE COVID-19 INFECTED OUTPATIENTS BY A VETERANS HEALTH CARE CENTER

STATEMENT OF PROBLEM/QUESTION: In the spring of 2020 during the initial outbreak of COVID-19, the Rocky Mountain Regional VA (RMR) was tasked with ensuring the health of infected veterans. The RMR COVID-19 Telehealth Clinic was developed to support veterans in the community diagnosed with COVID-19, identify those with clinical deterioration requiring a higher level of care, and encourage appropriate isolation protocols. DESCRIPTION OF PROGRAM/INTERVENTION: Patients were stratified by risk factors (obesity, CHF, DM, cancer, CAD, HTN, age > 64) and clinical status into 3 tiers, with high-risk (Tier 3) receiving daily telehealth, moderate-risk (Tier 2) telehealth every other day, and low-risk (Tier 1) telehealth every three or more days. Providing care seven days a week, Tier 1 veterans were contacted by nurses and advanced practitioners, while Tier 2 and 3 veterans were managed predominantly by resident physicians and attendings, who provided clinical care for exacerbations of chronic disease as well as comprehensive care of COVID-19 infection. Hypoxic patients were provided oxygen and closely monitored with pulse oximeters. MEASURES OF SUCCESS: Between April 13 to October 5, 2020, 351 veterans testing positive for COVID-19 were followed. Thirty-eight were excluded (26 were outside study dates, 7 covid negative, 5 never received care). Charts for the remaining 313 patients were retrospectively evaluated for demographic data, comorbid conditions, duration of follow-up, and interventions provided, including prescribing and managing medications, referrals for emergency services, and escalating tiers. FINDINGS TO DATE: Of the cohort, 88% were male, 43% obese, 34% over age 64, 40% HTN, and 27% DM. Veterans were followed for 10.4 days on average. Approximately 54% were assigned to Tier 1, 29% to Tier 2, and 16% to Tier 3. Medications were prescribed for 45% and 27% of Tier 3 and Tier 2 patients respectively, and emergency care was advised for 22% and 20% of Tier 3 and Tier 2 veterans. Of Tier 1 patients, medications were ordered on 5%, emergency care recommended for 3%, and only 7% were escalated to Tier 2. Of the five deaths that occurred, two were directly attributed to COVID-19. KEY LESSONS FOR DISSEMINATION: A dedicated telehealth clinic for veterans with Covid-19 appropriately identified patients into low, moderate, and high-risk categories based on risk factor assessment. Low-risk patients were safely followed with intermittent telehealth emphasizing self-care and isolation, avoiding unnecessary Emergency Department visits. More frequent monitoring of symptoms and pulse oximetry in moderate to high-risk patients facilitated identification of patients with clinical deterioration requiring emergency evaluation and avoiding admissions for at-risk clinically stable patients. Tiered management resulted in judicious utilization of health care resources during a critical time marked by scarcity of hospital beds and personal protective equipment.

Did Mobility Affect the Spread of COVID-19 during the First Pandemic Wave: An Investigation for Indian States Using Dynamic Regression

The unprecedented Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2), or COVID-19, pandemic adversely affected all walks of life, causing loss of lives and livelihood. The disruptions caused to the economy, social well-being, and transportation systems are almost unfathomable. The scenario in India was grave during the first wave, where high-density urban conglomerations affected the most. Transmissions of the contagion due to human-to-human interactions forced the government to employ strict lockdown policies as an immediate measure to curb the spread. However, gradual relaxations on lockdowns during the initial stages in India demonstrated similar trends between the rise in mobility and COVID-19 positive cases. This study leverages publicly available activity-based mobility datasets to model and predict the number of virus-positive cases during the first pandemic wave in Indian states. Dynamic regression models, which consider the ripple effects of the response and explanatory variables as feedbacks to the response variable, are utilized to analyze the panel data. In addition to the mobility data, the cumulative number of COVID-19 cases is also related to the regional demographics and other information concerning the infection spread and testing data. The proposed model produces good short-term forecasts for Indian states. Findings from the study concerning mobility point to the positive effects of curtailing travel for the effective control of pandemic diffusion through human interactions. Comprehending the effects of mobility and testing rates on the reported number of cases is essential to devising strategies best suited for a region during such an instance. The methodology and contextual knowledge from the study can aid planners, decision-makers, and researchers to bolster support systems in the future. [ FROM AUTHOR] Copyright of Journal of Transportation. Part A: Systems is the property of American Society of Civil Engineers and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Consumer responses towards essential purchases during COVID-19 pan-India lockdown

Humanity experienced one of the worst crises in recent history due to the COVID-19 pandemic. The spread of the disease and the lockdown announced by the government of India created an emergency, disrupting the supply of essential commodities and creating panic and anxiety among the people. This paper aims at capturing the behavior of consumers purchasing essential commodities before and during the lockdown using an online questionnaire. Responses from 730 households covering 20 states in India were used. The data analysis revealed that consumers made a lesser number of trips during lockdown but purchased excess commodities considering the future uncertainties. The local family grocery stores, called kirana shops served well during the pandemic. During the lockdown, consumers made shorter trips by vehicles and walked extensively. Income was found to influence purchase behavior. The disruptions at the organized retail stores for in-store as well as online purchases were identified using factor analysis. Out of the three factors identified each for in-store and online purchases, perceived risk and vendor distrust had major influence respectively. The findings of this study give pointers to many infrastructure and policy initiatives that target tackling such emergencies in the future.

COVID-19 effects on urban driving, walking, and transit usage trends: Evidence from Indian metropolitan cities.

The outbreak of the COVID-19 pandemic disrupted all walks of life, including the transportation sector. Fear of the contagion coupled with government regulations to restrict mobility altered the travel behavior of the public. This study proposes integrating freely accessible aggregate mobility datasets published by tech giants Apple and Google, which opens a broader avenue for mobility research in the light of difficult data collection circumstances. A comparative analysis of the changes in usage of different mobility modes during the national lockdown and unlock policy periods across 6 Indian cities (Bangalore, Chennai, Delhi, Hyderabad, Mumbai, and Pune) explain the spatio-temporal differences in mode usages. The study shows a preference for individual travel modes (walking and driving) over public transit. Comparisons with pre-pandemic mode shares present evidence of inertia in the choice of travel modes. Association investigations through generalized linear mixed-effects models identify income, vehicle registrations, and employment rates at the city level to significantly impact the community mobility trends. The methods and interpretations from this study benefit government, planners, and researchers to boost informed policymaking and implementation during a future emergency demanding mobility regulations in the high-density urban conglomerations.

Analysis of the second wave of COVID-19 in India based on SEIR model.

India was under a grave threat from the second wave of the COVID-19 pandemic particularly in the beginning of May 2021. The situation appeared rather gloomy as the number of infected individuals/active cases had increased alarmingly during the months of May and June 2021 compared to the first wave peak. Indian government/state governments have been implementing various control measures such as lockdowns, setting up new hospitals, and putting travel restrictions at various stages to lighten the virus spread from the initial outbreak of the pandemic. Recently, we have studied the susceptible-exposed-infectious-removed (SEIR) dynamic modeling of the epidemic evolution of COVID-19 in India with the help of appropriate parameters quantifying the various governmental actions and the intensity of individual reactions. Our analysis had predicted the scenario of the first wave quite well. In this present article, we extend our analysis to estimate and analyze the number of infected individuals during the second wave of COVID-19 in India with the help of the above SEIR model. Our findings show that the people's individual effort along with governmental actions such as implementations of curfews and accelerated vaccine strategy are the most important factors to control the pandemic in the present situation and in the future.

COVID-19 Vaccination-Related Uptake on FDG PET/CT: An Emerging Dilemma and Suggestions for Management.

As mass COVID-19 vaccination is underway, radiologists are encountering transient FDG uptake in normal or enlarged axillary, supraclavicular, and cervical lymph nodes after ipsilateral deltoid vaccination. This phenomenon may confound interpretation in patients with cancer undergoing FDG PET/CT. In this article, we present our institutional approach for management of COVID-19 vaccine-related lymphadenopathy on FDG PET/CT according to early experience. We suggest performing PET/CT at least 2 weeks after vaccination in patients with a cancer for which interpretation is anticipated to be potentially impacted by the vaccination but optimally 4-6 weeks after vaccination given increased immunogenicity of mRNA vaccines and potentially longer time for resolution than lymphadenopathy after other vaccines. PET/CT should not be delayed when clinically indicated to be performed sooner. Details regarding vaccination should be collected at the time of PET/CT to facilitate interpretation. Follow-up recommendations for postvaccination lymphadenopathy are provided, considering the lymph node's morphology and likely clinical relevance. Consideration should be given to administering the vaccine in the arm contralateral to a unilateral cancer to avoid confounding FDG uptake on the side of cancer. Our preliminary experience and suggested institutional approach should guide radiologists in management of patients with cancer undergoing PET/CT after COVID-19 vaccination.

Dynamical modelling and analysis of COVID-19 in India

We consider the pandemic spreading of COVID-19 in India after the outbreak of the coronavirus in Wuhan city, China. We estimate the transmission rate of the initial infecting individuals of COVID-19 in India using officially reported data at the early stage of the epidemic with the help of the susceptible (S), exposed (E), infected (I), and removed (R) population model, the so-called SEIR dynamical model. Numerical analysis and model verification are performed to calibrate the system parameters with official public information about the number of people infected, and then to evaluate several COVID-19 scenarios potentially applicable to India. Our findings provide an estimation of the number of infected individuals in the pandemic period of timeline, and also demonstrate the importance of governmental and individual efforts to control the effects and time of the pandemic-related critical situations. We also give special emphasis to individual reactions in the containment process.

Unexpected Receptor Functional Mimicry Elucidates Activation of Coronavirus Fusion

Recent outbreaks of severe acute respiratory syndrome and Middle East respiratory syndrome, along with the threat of a future coronavirus-mediated pandemic, underscore the importance of finding ways to combat these viruses. The trimeric spike transmembrane glycoprotein S mediates entry into host cells and is the major target of neutralizing antibodies. To understand the humoral immune response elicited upon natural infections with coronaviruses, we structurally characterized the SARS-CoV and MERS-CoV S glycoproteins in complex with neutralizing antibodies isolated from human survivors. Although the two antibodies studied blocked attachment to the host cell receptor, only the anti-SARS-CoV S antibody triggered fusogenic conformational changes via receptor functional mimicry. These results provide a structural framework for understanding coronavirus neutralization by human antibodies and shed light on activation of coronavirus membrane fusion, which takes place through a receptor-driven ratcheting mechanism. Structural analysis of the SARS-CoV S and MERS-CoV S glycoproteins in complex with neutralizing antibodies from human survivors sheds light into the mechanisms of membrane fusion and neutralization