ABSTRACT
This .study aims to define essential principles that the organization must follow in labour welfare during COVID-19. It is a vital facet of industrial relations, the extra dimension that provides satisfaction to workers in a way that no amount of money can do so. The government initiates statutory laws from time to time to bring about some uniformity in the basic facilities provided to industrial workers since it is not confident that all employers are progressive and provide basic welfare measures. Industrial hygiene has been defined as science and art devoted to the anticipation, recognition, evaluation, and control of those environmental factors or stress arising in or from the workplace, which may cause sickness, impaired health, and significant stress among workers or the citizens of the community. Because it is a labor-intensive sector, it has a greater emphasis on employee welfare. The authors choose a bakery industry personnel's stress analysis during COVID-19 for this research work. © 2023 by IGI Global. All rights reserved.
ABSTRACT
Most, if not all, the vaccine candidates designed to counteract COVID-19 due to SARS-CoV-2 infection require parenteral administration. Mucosal immunity established by vaccination could significantly contribute to containing the SARS-CoV-2 pandemic, which is spread by infected respiratory secretions. The world has been impacted on many fronts by the COVID-19 pandemic since early 2020 and has yet to recover entirely from the impact of the crisis. In late 2022 and early 2023, China experienced a new surge of COVID-19 outbreaks, mainly in the country's northeastern region. With the threat of new variants like XBB 1.5 and BF.7, India might experience a similar COVID-19 surge as China and needs to be prepared to avoid destruction again. An intranasal vaccine can elicit multiple immunological responses, including IgG neutralization, mucosal IgA production, and T-cell responses. In order to prevent further infection and the spread of COVID-19, local immune responses in the nasal mucosa are required. iNCOVACC is a recombinant vaccine vectored by an adenovirus that contains a SARS-CoV-2 spike protein that has been pre-fusion stabilized. This vaccine candidate has shown promise in both early and late-stage clinical trials. iNCOVACC has been designed for intranasal administration via nasal drops. The nasal delivery system was created to reduce expenses for those living in poor and moderate-income. © 2023, Editorial board of Journal of Experimental Biology and Agricultural Sciences. All rights reserved.
ABSTRACT
Introduction: Because of the limited donor pool, transplants are being done across the blood group and even HLA incompatibility barriers. But this comes at the cost of increased immunosuppression and the side effects. Effect of this intensified immunosuppression on the incidence of post transplant infections and the type of infection has not been studied extensively. Methods: We retrospectively analysed the incidence of infection in ABO incompatible transplants (ABOi) and compared it with propensity matched cohort of ABO compatible transplants(ABOc) over the same timeframe i.e. 2011 to April 2019. using hospital eHIS record system. Patients were matched with 1:2 ratio (ABOi: ABOc) for age (<60yr, >60yrs),sex, number of previous transplants, pretransplant infections, history of prior immunosuppression, diabetic status, NODAT, and induction agent used. Desensitization protocol for ABO incompatible transplant includes rituximab with double filtration plasmapheresis, plasmapharesis or immunoadsorption to target anti blood group titre of 8. Patient with high immunological risk (e.g.second transplant, HLA incompatible) receive ATG induction while others receive basiliximab induction. Valganciclovir prophylaxis was given only in patients with ATG induction. Results: [Formula presented] [Formula presented] During the study period 89 patients underwent ABOi transplants which were compared with 178 ABOc transplants. (Table1)Mean follow up duration was 50.45months (SD 26.8) in ABOi group and 49.47months (SD28.7) in ABOc group. 17% patients lost to follow up with their last follow up being more than 2 years before. Incidence of overall infections was similar in both the groups (59% (43/89) Vs 44.3% (79/178);p=0.6). (Table2) Incidence of urinary tract infections(UTI)was significantly more in ABOi group vs ABOc group.(23.5% (21/89) vs 11.79% (21/178);p=0.019). Cytomegalovirus infections (CMV) were significantly more in ABOi group 12.3% (11/89) as compared to ABOc group 5% (9/187) (p=0.04). All the patients with CMV infection were CMV IgG positive pretransplant except 2, one from ABOc group who was CMV IgG negative and another from ABOi group who’s pretransplant CMV serology was unavailable. There was no significant difference in incidence of fungal infection, pneumocystis infection, diarrheal infections (other than CMV),pneumonia (other than CMV, PCP, fungal), Herpes, BKV infection. Incidence of post-transplant tuberculosis (3.3% (3/89) Vs 2.8% (5/178);p=1.0) and SARS COV2 infections (12.3% (11/89) vs 9% (16/178);p=0.39 was similar in both the groups. Patient survival was similar in both the groups i.e.95.5% but death censored graft loss was significantly more in ABOi group 0.9% (8/89) as compared ABOc group 0.3% (5/178) p=0.03. Reason of graft loss in all the patients was immunological and not infection. Infection was cause for death in three ABOi patients and four ABOc patients. Conclusions: Overall incidence of infections in ABOi transplants was similar to Abo compatible transplant. Incidence of UTIs and CMV infections were significantly higher in ABOi group. No conflict of interest
ABSTRACT
CASE: A 52-year-old male with a past medical history of asthma and uncontrolled OSA presented to the ED ten days after diagnosis of COVID-19 with worsening dyspnea. He had a history of fluticasone propionate and fluticasone salmeterol use for asthma exacerbations. He endorsed cough, fever, chills, and diarrhea, and denied chest pain, leg edema, and anosmia.Vitals showed oxygen saturation of 65%. CBC demonstrated leukopenia consistent with COVID- 19 infection. Blood labs showed hyperglycemia (blood sugar 182 mg/dL, hemoglobin A1c 9.6%). Bilateral crackles were noted on exam. He was placed on high-flow nasal cannula (HFNC) immediately due to critical hypoxemia. CT PE was negative;CXR revealed bilateral opacities consistent with COVID-19 pneumonia. He started on dexamethasone and remdesivir and was admitted to the MICU for acute hypoxemic respiratory failure. Notably, the patient had no known diagnosis of diabetes mellitus and was started on sliding scale insulin and Lantus. Barcitinib was added in the MICU in addition to linezolid and cefepime for fear of bacterial superinfection but were discontinued after receiving negative cultures. He was transferred out of the MICU four days later after successful weaning of oxygen but soon returned due to worsening oxygen needs. New leukocytosis prompted a repeat respiratory culture, which grew mold on the preliminary read. Voriconazole was initiated due to concern for Aspergillus infection and was continued with confirmation on the final read. Repeat CT showed left pneumomediastinum, right apical pneumothorax, and worsening bilateral opacities. Despite ongoing treatment, the patient required NC at rest and HFNC with minimal exertion. He was discharged home with HFNC. IMPACT/DISCUSSION: CAPA is a result of opportunistic fungal infection, causing devastating disease in the immunocompromised. A crucial risk factor is the use of high-dose corticosteroids for a prolonged period. The diagnosis of CAPA is based on a combination of imaging, microbiology, and clinical presentation. Peripheral nodules, air crescent, reverse halo sign, nodular consolidation, ground-glass opacities, crazy paving pattern, pleural effusion, and pulmonary cysts have been reported among CAPA patients. A fungal culture and galactomannan test from respiratory specimens can aid in early diagnosis. The usual presenting symptoms of CAPA include refractory fever, pleuritic chest pain, or dyspnea. Voriconazole is a first-line anti-Aspergillus agent. CONCLUSION: Clinical presentation of CAPA is often subtle but associated with high morbidity and mortality. Multiple reports add support to our observation that CAPA can be a result of worsening COVID-19 pneumonia. Early diagnosis and treatment are vital to prevent worse clinical outcomes. Physicians should demonstrate a heightened awareness of the risk of developing CAPA in critically ill COVID-19 patients. Clinicians should exercise low thresholds to identify and treat CAPA, especially in patients on high-dose steroids long-term.
ABSTRACT
SETTING AND PARTICIPANTS: This innovative program included Underrepresented Minority (URM) Medical students, faculty and medical student peer mentors at the Medical College of Wisconsin (MCW) by using virtual platform of Zoom and communication through emails. DESCRIPTION: Mentorship and scholarship are crucial for success in academic medicine. URM students often have difficulty finding adequate mentorship support to aid in their scholarly productivity and professional development. This challenge has been compounded by the COVID-19 pandemic. Acknowledging the challenge, our team created a platform for URM students to get early and easy access to dedicated mentors who are devoted to their academic success, share similar backgrounds, and will support scholarly productivity. A pilot program was successfully completed in the academic year of 2020- 2021 and was expanded to academic year of 2021-2022. The program included URM medical students at MCW. The interested students completed a survey prior to the session indicating their past research experience and their expectation from the participation in the program. Students with research experience participated as peer mentors whereas Faculty were recruited based on their interest in mentoring URM students. A virtual workshop was held to introduce the cohort of students to the platform and explore the various means of scholarship including writing case report and letter to the editor. It was attended by 16 URM students with 6 student peer mentors and 9 faculty mentors. After the workshop, we created a MentorMentee model where medical students(M1/M2) were paired with a peer mentor(M3/M4) and a faculty mentor to create teams to work on 15 scholarly projects(mainly case reports). Kern Institute is providing financial assistance for dissemination. EVALUATION: For the academic year of 2020-2021, two faculty and two peer mentors were connected virtually with four URM medical students. The students completed three case reports that were presented at National SHM meeting and one letter to the editor during the two-month pilot program. Overall student feedback was remarkably positive regarding increased mentorship and scholarly opportunities. Based on the feedback, we developed the program including URM medical Students and faculty mentors. Students in the cohort were involved in at least one scholarly project and this program was successful in submitting 15 case reports to National meetings (ACP/SHM/SGIM) and students were able to secure research opportunities. There was exponential growth in scholarly productivity and collaboration from the previous year. DISCUSSION / REFLECTION / LESSONS LEARNED: Our URM mentorship program has highlighted the crucial role of mentorship in promoting scholarly productivity among URM students. Despite minimal prior research experience, creating a platform with dedicated mentors and mentees can create supportive environment to facilitate scholarly productivity in a short time frame. We aim to expand this platform for diverse specialty-oriented opportunities.
ABSTRACT
CASE: A previously healthy, 27-year-old Caucasian male presented with erythema and edema in his extremities. He endorsed multiple years of injecting heroin into numerous areas from his chest to his toes, including both upper extremities. The patient was seen six months ago at local urgent care for swelling of both of his dorsal feet and a small abscess with surrounding cellulitis of the right hand. He was given a dose of Ceftriaxone and a 2-week course of Augmentin, which he completed with moderate improvement. A month prior to his presentation, he reported that this swelling started asymmetrically;it started in his legs, then in his right arm, and then in his left arm. He denied any discharge from any site on his skin. He last injected heroin the morning of his admission. He denied fever, shortness of breath, pleuritic chest pain, orthopnea, dyspnea on exertion, and any urinary symptoms. On presentation, he was afebrile and saturated 98% on room air. His extremities were warm, normal capillary refill, and distal pulses were strong and symmetric. There were also pitting edema in the right hand with associated volar erythema, pitting edema in the right foot, and left-hand edema with a punctate area around the mid-arch with associated tenderness to palpation without overlying redness, crepitus, or fluctuance. Blood cell count revealed mild leukocytosis to 12.0. CMP was unremarkable. While the infectious disease team was consulted for further evaluation, he was started on cefazolin 1g for 10 days. The urine drug screen was positive for benzodiazepines, THC, cocaine, and opiates. HIV negative, Covid negative, and blood cultures showed no growth. Histoplasma/ Blastomyces urine antigens were negative. Urinalysis without evidence of proteinuria, and transaminases were within the normal limit. Ultrasound showed occlusive cephalic vein thrombosis in the right upper extremities. Cefazolin was discontinued. Based on the presentation, the history, and the evaluation, it was concluded to be Puffy Hand Syndrome. IMPACT/DISCUSSION: Puffy hand syndrome is a form of lymphedema caused via the sclerosing nature of intravenously administered drugs, which our patient extensively utilized. Described by Abeles in 1965 as seen in New York prisoners, it affects between 7 to 16% of intravenous drug users. Its pathology is suspected to be caused due to a combination of lymphatic and venous insufficiency. Differential diagnosis of this syndrome involves identification of infection alongside cardiac or renal insufficiency, and edematous scleroderma. Treatment is mostly symptomatic. Patients are advised to stop IV drug use. Long-term use of low-stretch bandages and compression may be useful in decreasing the puffiness of the extremities. CONCLUSION: With the quality of care for drug addicts being a critical area of interest, this case displays a common drug abuse complication clinicians raise awareness for. This observation presents an opportunity to identify a possible drug abuser and intervene accordingly.
ABSTRACT
Following the COVID-19 Pandemic, traditional offline education has shifted to the online model. Hence, studying anatomy in a 3D view without visiting virtual laboratories can benefit medical students in the online education system. Similarly, a 3D view of furniture items can help enhance customers’ shopping experience while shopping online. Our Android Application will leverage an Augmented Reality Camera to place 3D models in the user's space. To achieve this, we seek to predict the 3D model from a 2D image by using a Differentiable Renderer with PyTorch3D. Previously, Machine Learning Frameworks called Generative Adversarial Networks (3D GAN) used Variational Autoencoder to generate a 3D model corresponding to an input image. This approach was further improved by Hierarchical Surface Prediction (HSP) that used Convolutional Neural Networks (CNN) to predict Volumetric Pixels for the object surface rather than the object volume, reducing the computational power in contrast to 3D GAN. Finally, the Differentiable Renderer came into being and eliminated the drawbacks of 3D GAN and HSP techniques. The latter approaches only considered voxels for 3D Modelling;however, Differentiable Renderer uses Machine Learning to predict the texture and lighting of the model as well. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
ABSTRACT
Background: Alternative medicine systems in India are growing with the advancement of research and pharmaceuticals. The disease – COVID-19 has still no specific treatment modality and the pandemic is continuing. Among the alternative medicine systems, which one is searched more with a connection to the pandemic, are still unknown. Aims and Objectives: This study aimed to assess the global and Indian internet search volume of alternative system medicine – Ayurveda, Yoga, Unani, Siddha, and Homeopathy during the past 2 years of the pandemic (March 2020– March 2022). Materials and Methods: On the Google Trends website (https://trends.google.com), we used the following combination of phrases to search the trend and compare the trends: “COVID Ayurveda,” “COVID Yoga,” “COVID Unani,” “COVID Siddha,” and “COVID Homeopathy.” The data were filtered with the date range from April 1, 2020 to March 31, 2022. First, the data were collected for the whole world and then India. All the comma separated values were downloaded for further data analysis. Results: Globally, there were two spikes of searching the COVID and Yoga in the second wave and third wave. Search for homeopathy and Ayurveda also showed two peaks during the first and second waves. In India, there were three spikes of search volume for yoga in three waves. The search for homeopathy showed a peak in the first wave. We found a significant positive correlation between global searches and Indian searches. This indicates a correlated demand or knowledge-seeking regarding alternative medicine. Conclusion: People around the world search for alternative medicine as a possible treatment method for COVID-19. The most common search was for Yoga, followed by homeopathy and Ayurveda in the global population. In India, yoga was the highest searched method followed by homeopathy and Ayurveda.
ABSTRACT
COVID-19 (Coronavirus Disease-19), a disease caused by the SARS-CoV-2 virus, was declared a pandemic by the World Health Organization on March 11, 2020. To solve the global problem of analysis of different variants of COVID-19 genome sequences, there is a need to develop intel-ligent, scalable machine learning techniques that can process and analyze important COVID-19 protein data by utilizing the Big Data framework. For this, we have first proposed a feature extraction approach for COVID-19 protein data named Scalable Distributed Co-occurrence-based Probability-Specific Feature extraction approach (SDCPSF). The proposed SDCPSF approach is executed on the Apache Spark cluster to preprocess the massive COVID-19 protein sequences. The proposed SDCPSF represents each variable-length COVID-19 protein sequence with fixed length six dimensions numeric feature vectors. Then the extracted features are used as input to the kernelized fuzzy clustering algorithms, i.e., KSRSIO-FCM and KSLFCM, which efficiently performs clustering of big data due to its in-memory cluster computing technique and thus forms clusters of COVID-19 genome sequences. Furthermore, the performance of KSRSIO-FCM is compared with another scalable clustering algorithm, i.e., KSLFCM, in terms of the Silhouette index (SI) and Davies-Bouldin index (DBI). © 2022 IEEE.
ABSTRACT
Background: Currently, the Coronavirus disease (COVID-19) pandemic is posing a serious threat to global health. Although approved COVID-19 vaccines have been claimed to provide a high degree of protection against getting seriously ill and dying from the disease, they are not in the approach of all people especially those from the least developed countries like Nepal. Desperation within people has led to increased use of medicinal plants to cure the miscellaneous symptoms of COVID-19 and to prevent infection without proper knowledge of their phytochemical and pharmacological properties. Methods: Based on the online and interpersonal inquiries with 59 COVID-19 survivors and 111 inhabitants of Buddhabhumi Municipality, Kapilvastu, Nepal, the ethnomedicinal data were collected and summarized using descriptive statistics like frequency, percentage tables, and graphs. For each medicinal plant species, the frequency of citation (FC) and relative frequency of citation (RFC) were calculated along with a radar chart for the top 15 cited species with their phytochemical and pharmacological properties. Results: This study documented 41 species of medicinal plants belonging to 24 different families and 37 genera were used. Herbs were predominant among other life-forms and leaves were highly used among other plant parts. Turmeric (Curcuma longa, with the highest frequency of citation of 0.80) was the most frequently used species. Most of the respondents (44%) obtained medicinal plants from their home gardens. Family, friends, and neighbors were the primary sources of information the respondents followed. Interestingly, all of the 15 most frequently cited medicinal plants were reported to have both antiviral and anti-inflammatory properties and 14 of them were proclaimed to be immunomodulatory. Conclusion: Therefore, we conclude from the survey and available literatures that medicinal plants play a significant role against viral infections. © 2021, Ilia State University, Institute of Botany, Department of Ethnobotany. All rights reserved.
ABSTRACT
TOPIC: Education, Research, and Quality Improvement TYPE: Original Investigations PURPOSE: Asthma is a common illness affecting 8% of the US population and costing $81.9 billion per year. Due to its chronic and variable nature, asthmatics need frequent medication adjustments, making management challenging for both physicians and patients. Patients can control their asthma with an asthma action plan (AAP), which has directions for daily assessment, medications, and steps to detect and treat exacerbations. Self-management using AAPs is associated with a reduction in hospital admissions and ED visits by 40% and 20%, respectively. Despite evidence that AAPs are efficacious, the exact reason for their success is not known. We hypothesized that AAPs increase patient confidence managing asthma and that this is a reason for AAPs success. Our study explored whether AAP use increases confidence in self-management and asthma control. METHODS: Patients with a physician diagnosis of asthma were recruited. An eight-question Likert Scale survey developed prior gauged confidence about asthma management. At the initial visit, each patient completed the survey, received a personalized AAP, and was taught to use a peak flow meter. The same survey was given at a follow-up scheduled at the provider’s discretion. Asthma control was assessed pre and post-AAP use with the Asthma Control Test (ACT), a validated measure of asthma control. An ACT score of ≥ 19 indicates good control. All data was collected using REDCap. Results were calculated using the student t-test. RESULTS: We recruited 71 patients, and 17 were excluded for lack of follow-up. Post-AAP use, confidence using a peak flow meter increased by 45%, with 93% (50/54) rating confidence at ≥ 3 (4 being ‘strongly agree I am confident’). Fifteen percent more patients felt confident managing exacerbations, with 95% (51/54) rating confidence at ≥ 3. A 15% increase was seen in knowing asthma triggers, with 89% (48/54) rating confidence at ≥ 3. Confidence understanding medications was not impacted by AAPs, with 94% (51/54) of patients rating confidence at ≥ 3 pre and post-AAP use. Mean pre and post-AAP survey scores were 23.28 and 25.89, respectively. AAP use was associated with significantly higher mean survey scores (25.89±4.16, p =.0001). ACT data was available for 87% (47/54) of patients and 68% (32/47) scored a ≥ 19 on the follow-up ACT. Mean pre and post-AAP scores were 18.49 and 20.11, respectively. AAP use was associated with significantly higher mean ACT scores (20.11±3.35, p =.0043). CONCLUSIONS: This is the first study that shows AAP use increases patient confidence in asthma management. All but one survey question gauged at measuring increased confidence improved post-AAP use. Understanding of asthma medications likely did not see improved confidence due to a lack of discussion about this during AAP education at the initial visit. AAP use resulted in an improved mean ACT score. It is unclear if this is due to AAP use or changes made in medications. Limitations include the variable time interval for follow-up and the lack of ongoing assessment to account for the variable nature of asthma control. CLINICAL IMPLICATIONS: With an increasing reliance on telemedicine during the COVID-19 pandemic, the importance of self-management has been brought to the forefront. AAPs are a simple and effective tool that help physicians hand control over care to their patients. The routine use of AAPs can revolutionize how providers approach asthma management and reduce asthma morbidity. DISCLOSURES: No relevant relationships by Pankhuri Jha, source=Web Response No relevant relationships by Jessica Most, source=Web Response
ABSTRACT
This paper describes a novel data analysis algorithm for increasing the range and accuracy of non-invasive IR based temperature sensors that have been widely used to check for elevated body temperatures (EBT) during the Corona pandemic. Our algorithm considers factors like humidity, distance, ambient temperature, and emissivity. A device was made that could deploy the algorithm and perform tasks like EBT detection, mask detection, face detection and face recognition and subsequently store the inferences of all these models on a cloud or local sever accessible via http requests. © 2021 IEEE.
ABSTRACT
CONTEXT: The rapid emergence of COVID-19 could have direct and indirect impacts on food production systems and livelihoods of farmers. From the farming perspective, disruption of critical input availability, supply chains and labor, influence crop management. Disruptions to food systems can affect (a) planting area; and (b) crop yields. OBJECTIVES: To quantify the impacts of COVID-19 on major cereal crop's production and their cascading impact on national economy and related policies. METHODS: We used the calibrated crop simulation model (DSSAT suite) to project the impact of potential changes in planting area and grain yield of four major cereal crops (i.e., rice, maize, sorghum, and millet) in Senegal and Burkina Faso in terms of yield, total production, crop value and contribution to agricultural gross domestic product (GDP). Appropriate data (i.e., weather, soil, crop, and management practices) for the specific agroecological zones were used as an input in the model. RESULTS AND CONCLUSIONS: The simulated yields for 2020 were then used to estimate crop production at country scale for the matrix of different scenarios of planting area and yield change (-15, -10, -5, 0, +5, +10%). Depending on the scenario, changes in total production of four cereals combined at country levels varied from 1.47 M tons to 2.47 M tons in Senegal and 4.51 M tons to 7.52 M tons in Burkina Faso. The economic value of all four cereals under different scenarios ranged from $771 Million (M) to $1292 M in Senegal and from $1251 M to $2098 M in Burkina Faso. These estimated total crop values under different scenarios were compared with total agricultural GDP of the country (in 2019 terms which was $3995 M in Senegal and $3957 M in Burkina Faso) to assess the economic impact of the pandemic on major cereal grain production. Based on the scenarios, the impact on total agricultural GDP can change -7% to +6% in Senegal and - 8% to +9% in Burkina Faso. SIGNIFICANCE: Results obtained from this modeling exercise will be valuable to policymakers and end-to-end value chain practitioners to prepare and develop appropriate policies to cope or manage the impact of COVID-19 on food systems.
ABSTRACT
Novel coronavirus SARS-CoV-2 has infected 18 million people with 700,000+ mortalities worldwide and this deadly numeric figure is rapidly rising. With very few success stories, the therapeutic targeting of this epidemic has been mainly attributed to main protease (Mpro), whilst Papain-like proteases (PLpro) also plays a vital role in the processing of replicase polyprotein. Multifunctional roles of PLpro such as viral polypeptide cleavage, de-ISGlyation and immune suppression have made it a promising drug target for therapeutic interventions. Whilst there have been a number of studies and others are on-going on repurposing and new-small molecule screening, albeit previously FDA approved drugs viz. Chloroquine (CQ) and Hydroxychloroquine (HCQ) have only been found effective against this pandemic. Inspired by this fact, we have carried out molecular docking and dynamics simulation studies of FDA approved CQ and HCQ against SARS-CoV-2 PLpro. The end aim is to characterise the binding mode of CQ and HCQ and identify the key amino acid residues involved in the mechanism of action. Further, molecular dynamics simulations (MDS) were carried out with the docked complex to search for the conformational space and for understanding the integrity of binding mode. We showed that the CQ and HCQ can bind with better binding affinity with PLpro as compared to reference known PLpro inhibitor. Based on the presented findings, it can be anticipated that the SARS-CoV-2 PLpro may act as molecular target of CQ and HCQ, and can be projected for further exploration to design potent inhibitors of SARS-CoV-2 PLpro in the near future.