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Over the past century, synthetic polymers have had a transformative impact on human life, replacing nature-derived materials in many areas. Yet, despite their many advantages, the structure and function of synthetic polymers still appear rudimentary compared to biological matter: cells use dynamic self-assembly to construct complex materials and operate sophisticated macromolecular devices. The field of DNA nanotechnology has demonstrated that synthetic DNA molecules can be programmed to undergo predictable self-assembly, offering unparalleled control over the formation and dynamic properties of artificial nanostructures. Intriguingly, the principles of DNA nanotechnology can be applied to the engineering of soft programmable materials, bringing the abilities of synthetic polymers closer to their biological counterparts. In this perspective, we discuss the unique features of DNA-functionalized polymer materials. We describe design principles that allow researchers to build complex supramolecular architectures with predictable and dynamically adjustable material properties. Finally, we highlight two key application areas where this biologically inspired material class offers particularly promising opportunities: (1) as dynamic matrices for 3D cell and organoid culture and (2) as smart materials for nucleic acid sequencing and pathogen detection.
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Background: Serum interleukin 6 (IL-6) levels have been studied in the diagnostic evaluation of patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) disease (COVID-19). Methods: We studied the utility of treatment with tocilizumab in COVID-19 patients (n=19) with a negative nasopharyngeal swab real time reverse transcriptase polymerase chain reaction (RT-PCR) test for SARS-CoV-2 who had suggestive computed tomography (CT) findings, namely, COVID-19 Reporting and Data System (CO-RADS) 4,5. Results: Receiver operator characteristic (ROC) curve analysis showed that serum IL 6 at a cut-off of >56.9 pg/L was a predictor of mortality in nasopharyngeal swab RT-PCR negative patients with suggestive CT findings. Tocilizumab had no significant effect on the mortality. Conclusions: In nasopharyngeal swab RT-PCR negative patients with suggestive chest CT findings, elevated serum IL-6 levels > 56.9 pg/L predicted mortality. However, treatment with tocilizumab had no effect on mortality.
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COVID-19 pandemic caused by a novel coronavirus, SARS-CoV-2 has led to an unprecedented impact in terms of disease morbidity as well as mortality. Mutations in the SARS-CoV-2 have led to the emergence of viral variants throughout the globe after the first wave of the pandemic in early 2020. Multiple variants of SARS-CoV-2 have been reported with the B.1.1.7 (Alpha), B.1.351 (Beta), P.1 (Gamma), and B1.167.2 (Delta) being the major "variants of concern” owing to its increased transmission rates and greater virulence. These variants seem to spread more easily and quickly than other variants leading to higher number of cases of COVID-19, greater hospitalizations and potentially more deaths. These newer and more lethal variants have a survival advantage in terms of higher affinity for the host receptors, faster replication rates and immune escape. Emergence of these novel variants have led to multiple issues such as diagnostic difficulties, varied presentation, rapid spread with severe disease with worse outcomes. Another issue with these emerging variants is the ability of immune escape leading to breakthrough infections following vaccination or after a prior infection with SARS CoV-2. Genomic sequencing plays an important role in identification of novel variants which evolve over a period of time. Variants such as B.1.1.7 and B.1.617.2 due to their higher transmissibility can easily overrun the existing public health infrastructure leading to a catastrophe as experienced in the deadly second wave of the pandemic in UK and India. Emergence of these novel variants has to be tackled through global efforts which would include greater genomic sequencing and reducing the disease transmission thus decreasing chances of viral mutation. This has to be complemented by rapid large-scale vaccinations especially in high-risk individuals. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.
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Infection with severe acute respiratory syndrome coronavirus (SARS-CoV-2) and the resultant syndrome COVID-19 has wrecked the entire world. The disease mostly manifests as mild viral pneumonia but in a small proportion of patients it can produce an intense inflammatory and prothrombotic state leading to multiorgan failure and even death. Varying incidences of venous thromboembolism (VTE) have been found in COVID-19 patients. This review describes the role of various pharmacological agents used prophylactically as well as therapeutically for thromboembolism in such patients. The anticoagulants which are administered as antithrombotic therapy can be used parenterally (heparin and direct thrombin inhibitors) or orally (direct oral thrombin inhibitors). The mechanism of action, pharmacology, usage, and adverse effects of such agents has been discussed especially in the context of ongoing COVID-19 pandemic. As a result of various completed and ongoing clinical trials, scientific community has collected promising evidence and formulated guidelines regarding the role of anticoagulants in COVID-19 patients. © The Author(s), under exclusive licence to Springer Nature Singapore Pte Ltd. 2021.
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Public transportation is not safe during the COVID-19 pandemic even after post lockdown, because it will be very hard to maintain social distancing in public transport. The COVID-19 pandemic is a worldwide pandemic because of which it became risky to allow public transportation without the proper mechanism to maintain social distancing. So to resolve this problem we came up with an idea of making an intelligent application to schedule the timings of transportation, avoiding over occupancy of public transport, providing them the shortest route to reach their desired destination, providing them proper guidelines, also providing them the information of the nearest hospitals for any emergency. In the proposed work, we have tested the result on 100 random users from various locations, determined the shortest distance of the vehicles, booked online tickets based on mask detection, and maintained the social distancing based on government guidelines. We have applied only 50% ticket booking for maintaining the social distancing and the ticket validation system has been checked with the user's images and it was successfully able to distinguish between masked and unmasked images. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.
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Background: With the emergence of the coronavirus 2019 (COVID-19) pandemic, it was essential to determine the impact of this disease on pregnant women and neonatal outcomes. In this study, we present a series of nine cases of pregnant women with COVID-19 disease requiring intensive care unit (ICU) admission. Method(s): We retrospectively collected clinical data of pregnant women with COVID-19 disease admitted to ICU between September 2020 and September 2021. Result(s): Most common presenting symptom was cough. Two patients had no respiratory symptoms at presentation. Five of the nine patients required invasive mechanical ventilation. Seven patients required caesarean section, four of whom delivered preterm. There were no maternal or neonatal deaths. Conclusion(s): Although maternal and neonatal outcomes reported in our study are encouraging, it is imperative to emphasize the importance of an individualized, multidisciplinary approach, and good healthcare infrastructure for optimal management of this group of patients.Copyright © The Author(s) 2023.
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This introduction presents an overview of the key concepts discussed in the subsequent chapters of the book. This book provides a fairly comprehensive analysis of contemporary issues in international trade and development. It covers issues like the provisioning of the public good and its implication in a liberalised regime, crime and corruption, skilled-unskilled wage inequality, income distribution and unemployment, environmental regulation, role of educational capital, informal sector, international fragmentation and exportable quality etc. The book explains how different interconnected measures of globalisation, land augmenting technological progress and adverse supply shocks arising due to COVID-19 play a major role not only in determining skilled-unskilled wage disparity and unemployment of skilled labour but also in income distribution in general. It shows how the inflow of foreign direct investment (FDI) exerts a favourable impact on average low-skilled wage as well as on the relative wage inequality although the unemployment situation of urban unskilled workers may worsen. © 2023 selection and editorial matter, Kausik Gupta and Jayanta Kumar Dwibedi;individual chapters, the contributors. All rights reserved.
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The demand for ophthalmic diagnosis and monitoring equipment is high due to day-by-day increasing eye-related diseases. These diseases are growing very fast due to changes in lifestyle, the aging crowd, and chronic diseases. During COVID-19, old ophthalmic diagnostic devices failed to fulfill the patients' needs due to social distancing and took more diagnosis time, making patients uncomfortable and unsatisfied to visit the clinic. Seeing all these problems during the COVID-19 time, patients are demanding personalized healthcare services and clinical home services to protect themselves from the COVID-19 virus attack. To fulfill the mass personalized needs and easily accesses clinical services from the patient's home, there is a requirement to embrace Industry 5.0 with its emerging digital technologies. The current work is based on the theoretical view of Industry 5.0 in ophthalmology and its supporting digital technology, various models and challenges faced by the healthcare system in ophthalmology during the COVID-19 pandemic time, limitations of the study, and its future scope, digital metrology, and strength, limitation, opportunities, and threat analysis in brief. © 2023, Metrology Society of India.
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Purpose: The purpose of this paper is to investigate the influencing factors of generation Z (Gen Z) consumers' revisit intentions to robotic restaurants in the post-pandemic times. Design/methodology/approach: Using a sample of Gen Z consumers with dining experiences in an Indian restaurant using service robots, the study empirically tests a research framework based on stimulus–organism–response theory. Findings: The study explains how Gen Z consumer's perceptions of functional attributes (i.e. perceived usefulness and perceived ease of use), socio-emotional attribute (i.e. perceived safety) and relational attribute (i.e. trust) shape their attitude, which in turn leads to their evaluations of performance outcomes and intention to revisit the robotic restaurants. The findings also indicate that perceived risk reduction of viral infection moderates the impact of performance outcomes on revisit intention. Originality/value: Due to the outbreak of COVID-19 pandemic, the changing preferences of consumers have resulted in an increase in demand for restaurants offering robotic services. To support the long-term viability of service robots in restaurant services, the current study investigates what elements of service robots can determine consumers' intentions to revisit the robotic restaurants during post-pandemic times. © 2023, Emerald Publishing Limited.
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Due to the spread of COVID-19 all around the world, there is a need of automatic system for primary tongue ulcer cancerous cell detection since everyone do not go to hospital due to the panic and fear of virus spread. These diseases if avoided may spread soon. So, in such a situation, there is global need of improvement in disease sensing through remote devices using non-invasive methods. Automatic tongue analysis supports the examiner to identify the problem which can be finally verified using invasive methods. In automated tongue analysis image quality, segmentation of the affected region plays an important role for disease identification. This paper proposes mobile-based image sensing and sending the image to the examiner, if examiner finds an issue in the image, the examiner may guide the user to go for further treatment. For segmentation of abnormal area, K-mean clustering is used by varying its parameters.Copyright © 2022 Inderscience Enterprises Ltd.
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Introduction: The Coronavirus Disease-2019 (COVID-19) pandemic placed an enormous strain on the healthcare system. Data on the impact of COVID-19 on the utilization and outcomes of structural heart disease (SHD) interventions in the United States are scarce. Method(s): The National Inpatient Sample from 2016 to 2020 was queried to identify adult admissions for transcatheter aortic valve replacement (TAVR), left atrial appendage occlusion (LAAO), and transcatheter end-to-end repair (TEER). The primary outcome was temporal trends of procedure utilization rate per 100,000 admissions over quarters from 2016 to 2020. The secondary outcomes were adjusted rates of in-hospital mortality, major complications, and length of stay (LOS). Result(s): Among 434,630 weighted admissions (TAVR: 305,550;LAAO: 89,300;TEER: 40,160), 95,010 admissions (22%) were during the COVID-19 era. There was a decline during the second quarter of 2020 followed by an increase to the pre pandemic levels (TAVR: 220 to 253, LAAO: 57 to 109, and TEER:31 to 36 per 100,000 admissions, Ptrend<0.001) (Figure). There were no differences in the mortality or major complication rates. Median LOS has decreased in TAVR (4 days to 1 day) and in TEER (3 days to 1 day) but remained stable in LAAO (1 day). Conclusion(s): This nationwide analysis showed that SHD interventions decreased during the early waves of COVID-19 pandemic. There was a significant reduction in hospital LOS without differences in in-hospital mortality or complication rates during the pandemic. These data suggest that hospitals adapted to the unprecedent challenges during the pandemic to provide advanced cardiac care to patients. [Formula presented]Copyright © 2023
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The COVID-19 second wave created very terrible and outrageous situation in India. As a result, many families are living in abject poverty and living a miserable life, and it has also created an impact not only in the Indian economy but also in the worldwide economy. Experts say that the third wave is coming, and the variant name is Delta variant, which is the most terrible bitter truth, and there may be more terrible and critical situations soon. In this chapter, we are analyzing past COVID-19 data in order to create awareness to the people for COVID-19 second wave conditions and precautions to Delta variant. In this chapter, we are analyzing COVID-19 cases such as confirmed cases, cured patients cases, and death rate in India, as well as which states have top highest cases occurred and death rate occurred in India by using machine learning algorithm. © 2022 Scrivener Publishing LLC.
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The current work seeks to explore the relevant factors that influence intention to use FinTech, i.e., perceived risk, benefit and trust keeping perceived effect of COVID-19 as moderator in India. Data have been collected using a structured questionnaire. The data collected have been validated using the validity and reliability techniques. Factor analysis and path analysis have been performed to test the research model, and finally, interactive moderation effects of the COVID-19 have been examined. Outcomes of the study showed that intention to use FinTech services has positively significant impact with perceived benefits and trust and negatively significant impact with perceived risk. The findings identify the key dimensions related to factors effecting intention to use FinTech and therefore, must be paid attention to by service providers in motivating their consumer to use financial technology. In addition, results will assist managers at FinTech companies to understand the importance of these services during COVID-19 pandemic. © 2023, The Author(s), under exclusive licence to Springer Nature Limited.
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Background Acute bacterial pericarditis is rare and can decompensate quickly to cardiac tamponade and cardiac arrest. Targeted antibiotic therapy, pericardiocentesis, and pericardiotomy are the cornerstones of management. Case 51-year-old male presented with 2-weeks of progressive chest pain, cough, and fatigue. A month prior he tested positive for COVID-19. On exam he was tachycardiac, tachypneic, and normotensive. JVD and peripheral edema were present. Labs revealed elevated WBC, BNP, HS-troponin, and ESR/CRP. Blood cultures were positive for methicillin susceptible Staphylococcus aureus (MSSA). Echo showed a large pericardial effusion with a swinging heart. ECG showed diffuse ST elevations and PR depression. He was not clinically in tamponade but shortly after became bradycardic and had a PEA arrest. Emergent bedside pericardiocentesis was performed, and after 9-minutes of ACLS, ROSC was attained. Pericardial fluid grew MSSA. Decision-making Vancomycin and cefepime were started and tapered to cefazolin to cover MSSA bacteremia and pericarditis. Repeat blood cultures were negative. A month after discharge he had no cardiac symptoms and echo showed minimal pericardial fluid. Conclusion In patients with COVID-19 and pericardial effusion, bacterial pericarditis can be secondary to contiguous spread from lung parenchyma or myopericarditis with superimposed infection, or due to primary pericarditis. This is the second reported case of spontaneous purulent pericarditis with MSSA. [Formula presented]Copyright © 2023 American College of Cardiology Foundation
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Ambient intelligence refers to the combination of pervasive ubiquitous computing, big data and artificial frameworks, IoT, sensor networks, and human-computer interaction (HCI) technologies. This technology paves the way for a futuristic world in which sensors incorporated into everyday devices create a smart envi-ronment that is seamlessly adapted to customer requirements and wishes. With patient health status records and patient electronic medical record (EMR), updates can help to provide a better and more straightforward narrative for the healthcare sector. It can assist healthcare workers, such as physicians and nurses, in providing quality care by analyzing patient data, such as prior treatments, allergic reactions, and more. Ambient intelligence helps the elderly in countries with a higher population of senior citizens by remotely monitoring their health and enabling them to live independently through ambient assisted living (AAL) technology. In this chapter, a case study related to the COVID disaster will be discussed with the help of ambient intelligence and new technologies. © 2023 Scrivener Publishing LLC.
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The COVID-19 outbreak has led to an influx of research studies focusing on the new norm of online teaching–learning in higher education. However, much less is known about how this profound shift in pedagogy has impacted school education especially among rural children of India. The present study is an attempt to understand the barriers and challenges that teachers of Public-funded (PF) elementary schools face while teaching online. We developed a semi-structured questionnaire and administered it to teachers of PF elementary schools in rural areas of Uttar Pradesh, India, using the online survey method. Thematic analysis of the responses we received (N = 203) reveals five broad themes, namely physical environmental constraints, socio-environmental limitations, parental support, issues of effective learning and health and well-being hazards. These findings have several implications for developing appropriate online teaching methods and making policy interventions to enhance learners' as well as educators' experiences. © 2021 ASPE.
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It is well recognized that there emerged a trend of inward-looking trade policies even before the COVID pandemic crippled the world. These were reflected in both BREXIT and US-China trade conflicts. As countries become inward-oriented, usually local prices start rising. With this backdrop, this paper explores how rising local prices are likely to affect employment in the short and long runs when we accommodate for the finite change in a general equilibrium structure whereby sectors not only contract but might also close down altogether due to the capital reallocation effect following a price incentive. © 2022 International Association for Economic Theory.
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Background: Isolated tracheobronchial mucormycosis (ITBM) is an uncommonly reported entity. Herein, we report a case of ITBM following coronavirus disease 2019 (COVID-19) and perform a systematic review of the literature. Case description and systematic review: A 45-year-old gentleman with poorly controlled diabetes mellitus presented with cough, streaky haemoptysis, and hoarseness of voice 2 weeks after mild COVID-19 illness. Computed tomography and flexible bronchoscopy suggested the presence of a tracheal mass, which was spontaneously expectorated. Histopathological examination of the mass confirmed invasive ITBM. The patient had complete clinical and radiological resolution with glycaemic control, posaconazole, and inhaled amphotericin B (8 weeks). Our systematic review of the literature identified 25 additional cases of isolated airway invasive mucormycosis. The median age of the 26 subjects (58.3% men) was 46 years. Diabetes mellitus (79.2%) was the most common risk factor. Uncommon conditions such as anastomosis site mucormycosis (in two lung transplant recipients), post-viral illness (post-COVID-19 [n = 3], and influenza [n = 1]), and post-intubation mucormycosis (n = 1) were noted in a few. Three patients died before treatment initiation. Systemic antifungals were used in most patients (commonly amphotericin B). Inhalation (5/26;19.2%) or bronchoscopic instillation (1/26;3.8%) of amphotericin B and surgery (6/26;23.1%) were performed in some patients. The case-fatality rate was 50%, primarily attributed to massive haemoptysis. Conclusion: Isolated tracheobronchial mucormycosis is a rare disease. Bronchoscopy helps in early diagnosis. Management with antifungals and control of risk factors is required since surgery may not be feasible. © 2022 Wiley-VCH GmbH.
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Introduction: Recent data shows that when adults are discharged after hospitalization for acute heart failure (HF), a clinic follow up with either cardiology or general medicine within 7 days results in significantly lower chances of 30 day readmissions. We sought to analyze the trends of clinic follow up after acute HF hospitalization and the associated barriers and facilitators at our safety net hospital. Method(s): Data was extracted from the electronic medical records using ICD 9,10 codes for acute HF admissions between Jan 2019 and Dec 2021. Quarterly trends of rates of clinic follow up were analyzed over the past 3 years;t-test was used to assess for statistical significance. Multivariable logistic regression models were constructed to test the association between patient level factors and clinic follow up after adjusting for sociodemographic factors. A p value < 0.05 was used to establish significance. Result(s): Of 1,037 patients admitted for acute HF between 2019-2021, 29.5% were 65 years or older, 64.7% were males, 48.7% were Black and 16.6% were uninsured. Only 8% and 23.1% had a 7 and 14 day clinic follow up respectively. Of those with scheduled follow up 65% and 56% showed up to their appointments at 7 and 14 days respectively. Overtime we noted an increase in the proportion of encounters with a 7 day follow up although the effective follow up (after accounting for no-shows) remained unchanged. Patients that had an inpatient cardiology consult had higher odds of getting a 7 day follow up (OR=1.42, p value = 0.001) after adjusting for age, gender, insurance status and race (black > white, OR = 1.34, p<0.001). Conclusion(s): Our study showed that the effective 7 day follow up did not improve from 2019 to 2021 likely due to COVID19 pandemic. However, a significantly higher proportion of patients obtained 7 day appointments in the last quarter with room for improvement. Steps to increase follow up rates include intervening on the highlighted modifiable factors to achieve better results. (Figure Presented).
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Background: Cryptococcus lives in the environment all over the globe. Although it spreads via inhalation route still most of the exposed individuals never get sick as the majority of cases are seen in immunocompromised. Objective of this clinical case report is to highlight the rare fungal etiology associated with iliac bone abscess to avoid incorrect diagnosis and prompt management of case. Case Presentation: A 70-year-old elderly female presented with hip pain for a month duration, not relieved with analgesics in September, 2021. In MRI a well-defined irregularly marginated hyperintense focal lesion was found in left iliac bone with joint effusion suggestive of infective etiology, tubercular, or less likely metastasis. CT-guided biopsy reported occasional hyphae-like fragments giving an impression of acute on chronic osteomyelitis with suspicion of fungalinfection.Culture reported Cryptococcus ne oformans.Fungal markers and Beta-dglucan were indeterminate and Galactomannan was found negative for the sample. Extrapulmonary TB was ruled out by AFB staining, MGIT Culture, and GeneXpert MTB. Bone scan, tumor markers, and PET scan ruled out osteolytic lesion secondary to metastasis. Though PET Scan and HRCT thorax confirm pulmonary involvement giving a picture of bilateral interstitial lung disease along with multiple enlarged lymph nodes. Patient serum was found negative for HIV, HBV, and HCV. Liver and renal function tests were within normal range and in hematology, ESR was raised (50;normal range:0-20). Patient is hypertensive with HbA1c of 5.3. There was no history of travel, avian exposure, weight loss, and COVID-19 infection. Patient was started on voriconazole and considering generalized lymphadenopathy, a therapeutic trial of anti-tubercular therapy was started which was stopped within a week on patient non-compliance. Abscess resolved with voriconazole and patient was discharged. In February 2022, Patient presented with similar complaints. CT scan of this fluctuant nodule depicted hypoechoic lesion which was ultrasound-guided drained.Sections show many rounds of oval fungal organism which were found PASpositive with mucicarmine and alcian blue positive capsule.Budding yeast cells were seen on KOH mount and India ink preparation demon-strated capsule which was confirmed by Cryptococcal Antigen test giving an overall impression in favor of Cryptococcosis. Patient was started on oral fluconazole and Injection liposomal amphotericin B 250 mg for 14 days. Discussion and Conclusion(s): This is the first case of skeletal Cryptococcosis at our institution which was managed by antifungals without surgical debridement resulting in resolution of abscess. Isolated focal iliac bone cryptococcosis is unusual but may occur in immunocompetent with everyday exposure to the organism. Herein, Patient had bilateral lung involvement along with multiple lymphadenopathies with no evidence of TB bacilli which inferences that the isolate most likely originated from environmental bird droppings and has disseminated from pulmonary lesion to the iliac bone. The radiological findings of iliac cryptococcosis abscess were nonspecific.A definitive diagnosis was made on histopathological and fungal examinations of ultrasound-guided drained abscess. Patient will be followed in the near future for relapse or any other medical issues related to the case.