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With the unexpected rise of the COVID-19 pandemic, a vast majority of organizations and institutions have shifted to online modes of communication, especially educational institutions. Many hurdles popped up in due course of time, preventing the successful conduction of online examinations. Today, there is an application for each and everything and the number of users is steeply escalating. With such high rising demands and new necessities, it has become quite important to make sure the applications are easily available anytime and anywhere. Ensuring minimum downtime, frequent updates without any disruptions, and making it easily available for both developers and consumers are must-haves now. Satisfying these requirements over a monolithic architecture is not assured, hence, the microservices architecture is adopted, thus opening the door for new possibilities. This being the foundation of this project, an amalgam of how the web application we used is divided into microservices, containerization of each of them followed by pod deployment and finally using Kubernetes for service exposing and orchestration is presented in this paper. In short, an online exam monitoring system that can identify any abnormal behavior by test takers while being capable of tackling varying traffic loads is fault-tolerant and handles disaster recovery. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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With the unexpected rise of the COVID-19 pandemic, a vast majority of organizations and institutions have shifted to online modes of communication, especially educational institutions. Many hurdles popped up in due course of time, preventing the successful conduction of online examinations. Today, there is an application for each and everything and the number of users is steeply escalating. With such high rising demands and new necessities, it has become quite important to make sure the applications are easily available anytime and anywhere. Ensuring minimum downtime, frequent updates without any disruptions, and making it easily available for both developers and consumers are must-haves now. Satisfying these requirements over a monolithic architecture is not assured, hence, the microservices architecture is adopted, thus opening the door for new possibilities. This being the foundation of this project, an amalgam of how the web application we used is divided into microservices, containerization of each of them followed by pod deployment and finally using Kubernetes for service exposing and orchestration is presented in this paper. In short, an online exam monitoring system that can identify any abnormal behavior by test takers while being capable of tackling varying traffic loads is fault-tolerant and handles disaster recovery. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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The COVID-19 emerged as a pandemic and affected many nations. World Health Organization [WHO] declared it as a worldwide pandemic alert on March 11, 2020, people had to stay indoors with lockdowns imposed, turning all daily activities to a halt. The lockdown was lifted in phase by manner from June 2020 as the cases were in control. A rise in pandemic was observed in many countries again in 2021, it was termed as the second wave of COVID-19. In India daily cases reached the mark of 4 lakhs in April 2021. This resulted in increased demand for oxygen supplies and other medical equipment’s to tackle the situation. With this, social media or the microblogging platforms like Twitter became a popular means of expressing emotions, making request for help and a daily information channel. The present study analyses the Twitter data extracted using Twitter API. It analyses and classifies people's sentiments related to the supply of oxygen during the second wave of the pandemic in India. The paper analyses the sentiment of the tweets for Indian users from June 20th, 2021, to June 26th, 2021, using Natural language processing (NLP) and Machine Learning (ML) techniques. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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Study question Does adding gonadotropin-releasing hormone agonist (GnRHa) to hCG trigger increases the number of high-grade embryos in GnRH antagonist protocol in fresh non-donor IVF? Summary answer Final oocyte maturation triggered by dual trigger increases the number of MII oocytes thus transferring good-quality embryos and cryopreserving surplus embryos compared to hCG trigger. What is known already hCG has been conventionally used as a ‘faux’ LH surge to bring about final oocyte maturation due to structural similarity between the two. GnRH agonist, on the other hand, induces a more physiological gonadotropin surge for follicular maturation, but is associated with luteal phase deficiency. Recent studies have shown that combining GnRHa with hCG trigger improves oocyte maturation and embryo quality with the added benefit of a luteal phase support, thereby improving IVF outcomes in terms of both embryological and reproductive outcomes. Study design, size, duration A single-center, open labelled, randomized controlled trial including 100 normal responder patients between 21-38 years undergoing IVF using GnRH antagonist protocol between January 2020 to August 2021. The study excluded patients with the presence of other variables of adverse outcomes like diminished ovarian reserve (AFC < 5 or AMH < 1.2 ng/ml), endocrine disorders, thin endometrium (<6mm), previous history of uterine surgeries, and high responders. Participants/materials, setting, methods 100 patients undergoing fresh IVF cycle using GnRH antagonist protocol were randomized after informed consent to receive either dual trigger (Leuprolide acetate 1 mg + rhCG 250 mcg, n = 50) or single hCG trigger (rhCG 250 mcg, n = 50). Oocyte retrieval was done 35-37 hours after trigger followed by IVF/ICSI, as indicated. Oocyte and embryo grading was done using Istanbul consensus. Analysis was done by ITT. Outcomes were analyzed using Independent t-test and Chi-square test. Main results and the role of chance The baseline characteristics were comparable in both arms. the number of MII oocytes retrieved (7.82 versus 5.92, p = 0.003) and the number of day-3 grade-1 embryos (4.24 versus 1.8, p < 0.001) were higher in the dual trigger group, whereas fertilization rates between the two groups (91.82% versus 88.51%, p=NS) were comparable. Consequently, the number of embryos cryopreserved (2.68 versus 0.94, p < 0.001) were significantly higher in the dual trigger group. However, the implantation rate between the two groups (21% versus 19.6%, p = 0.770) was comparable. The serum LH levels 12 hours post trigger were measured in both the arms and as expected, high serum LH values were documented in the dual trigger group (46.23 mIU/ml vs 0.93 mIU/ml, p < 0.0001). Limitations, reasons for caution Due to the impact of the Covid-19 pandemic causing an intermittent pause in IVF services at our center, a smaller sample size of 100 patients could be enrolled in the study, and reproductive outcomes in terms of live births and cumulative live births could not be assessed Wider implications of the findings This study, though small, has contributed to some evidence of redesigning the dual trigger in all antagonist cycles, with the exception of high responders and PCOS patients. The addition of GnRHa to hCG trigger has led to the possibility of cryopreserving surplus embryos thereby increasing the cumulative live births. Trial registration number CTRI/2020/08/027030
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Background: : To help reduce heart failure (HF) readmissions and improve patient outcomes, the Madison VA established a Nurse Practitioner (NP) led Heart Failure Access Clinic (HFAC) to provide patient follow-up within 4-7 days of discharge. Studies have demonstrated medication discrepancies and delayed implementation of guideline-directed medical therapy as potential contributors to 30-day hospital readmission. Thus, a clinical pharmacy specialist (CPS) was incorporated into the Madison VA HFAC model to focus on optimizing medication regimens. The purpose of this project is to evaluate the impact of an interdisciplinary NP-CPS HFAC versus a NP HFAC on 30-day patient outcomes. Methodology: A retrospective chart review was completed for all patients hospitalized with a primary discharge diagnosis of acute on chronic systolic heart failure (ADHF) at the Madison VA and seen in a HFAC after discharge between November 2019 and November 2020. Patients with LVEF greater than 50% and those discharged to hospice were excluded. During the early period of the COVID-19 pandemic (mid-March through July 2020), patients were seen by the NP only. Outcomes and interventions for patients who attended an interdisciplinary NP-CPS HFAC were compared to those who attended the NP HFAC. Primary outcomes included rehospitalization, emergency department (ED) visit, and all-cause mortality at 30 days. Secondary outcomes included HF medication adjustments, identification of inappropriate medications in patients with HF, medication discrepancies, alerts to another provider for follow up, referral to another service, or referral to HF CPS for continued optimization of GDMT. Results: A total of 90 veterans met the inclusion criteria;43 were seen in the NP HFAC and 47 were seen in the interdisciplinary NP-CPS HFAC. The incidence of adverse 30-day outcomes in this patient cohort was very low (readmission 5.6%, ED visit 1.1%, death 1.1%) and there were no significant between group differences. Statistically significant secondary outcomes favoring the interdisciplinary HF clinic included identification of medication discrepancies (P=<0.0001), alert to another providers for follow up (P=0.004), as well as referral to the HF CPS for continued medication titration (P=0.02). Conclusion: Patients seen in the interdisciplinary NP-CPS HFAC and HP HFAC had similarly low 30-day hospital readmission rates, ED visits and mortality. Involvement of a CPS in the HFAC led to more frequent identification of medication discrepancies, notification to providers regarding medication issues, and referral to a HF CPS for timely GDMT optimization. Further analysis is warranted to assess the impact of these early CPS interventions on long-term patient outcomes.
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Background: The present study was conducted to assessthe effect of digital eye strain due to online mode of teaching in school children during COVID Pandemic. Materials & methods:A cross sectional study was conducted among school children during the period 2020-2022to assessthe refractive errors during COVID Pandemic. A total of 4393 (1442,1532, 1419) schoolchildren were enrolled and examined for refractive errors during the year 2020,2021,2022 respectively. Prevalence of various refractive errors was assessed based on refractive error study in children (RESC) survey group. Results:There were 2324(52.9%) male and 2069(47.0%) female students. Ocular examination depicted enhancement of refractive errors in all the age groups. However among the children in the age group of 9 to 12 years, refractive errors were detected among 612/1507(43.1%) children. Conclusion: There has been an increase in use of digital devices after the initiation of the COVID-19 lockdown, and has resulted in deterioration of ocular health of school going children.
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This research focuses on analysing the sentiments of people pertaining to severe periodic outbreaks of COVID-19 on two junctures – First Wave (Mar’20 & Apr’20) and Second Wave (Jun’21 & Jul’21)-since the first lockdown was undertaken with a view to curb the vicious spread of the lethal SARS-Cov-2 strain. Primarily, the objective is to analyse the public sentiment – as evident in the posted tweets - relating to the different phases of the pandemic, and to illuminate how keeping an eye on change in the tenor and tone of discussions can help government authorities and healthcare industry in raising awareness, reducing panic amongst citizens, and planning strategies to tackle the monumental crisis. Considering the daily volume of social media activity, in our project, we scoped to analyse the Tweets related to the two different pandemic stages – The First wave and the Second wave – by implementing Text Mining and Sentiment Analysis, subfields of Natural Language Processing. To manually extract tweets from the platform, we used Twitter API coupled with Python’s open-source package using a set of COVID-19-related keywords. Crucially, before finalising the project pipeline, we conducted a thorough secondary research to find the solutions and methodologies implemented in our area of interest. We listed the current works and attempted to plug the gaps in those via our experiment. We used several classification and boosting algorithms to create a framework to distinguish the textual data of the tweets. Relevant scope, limitations, and room for improvements have been discussed comprehensively in the upcoming sections. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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Purpose: This meta-analysis and systematic review was conducted to highpoint the current literature and establish data relating the mortality of coronavirus disease 2019 (COVID-19) in patients with and without asthma. Search criteria: The Scopus, Embase, PubMed, medRxiv. org and Google Scholar databases were explored for studies associating the clinical results with and without asthmatic patients diagnosed with COVID-19. Mortality data were summarizing with the Mantel-Haenszel OR with 95% CI in a randomeffects model. Five retrospective studies encountered the inclusion criteria. A meta-analysis of data from 1181 asthmatic patients and 8,847 nonasthmatic patients specified that the presence of asthma had no extensive consequence on mortality rate (OR = 0.96;95% CI 0.70-1.30;I2 = 0%;p = 0.79). Result: Results were steady in a sensitivity analysis. A descriptive examination of other clinical outcomes selected no modification in the duration of hospitalization and the risk of intensive care unit (ICU) transfer between asthmatic and nonasthmatic patients. Conclusion: Asthma may not upsurge the mortality of COVID-19.
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OBJECTIVE: To describe the relationship between type 2 diabetes and all-cause mortality among adults with coronavirus disease 2019 (COVID-19) in the critical care setting. RESEARCH DESIGN AND METHODS: This was a nationwide retrospective cohort study in people admitted to hospital in England with COVID-19 requiring admission to a high dependency unit (HDU) or intensive care unit (ICU) between 1 March 2020 and 27 July 2020. Cox proportional hazards models were used to estimate 30-day in-hospital all-cause mortality associated with type 2 diabetes, with adjustment for age, sex, ethnicity, obesity, and other major comorbidities (chronic respiratory disease, asthma, chronic heart disease, hypertension, immunosuppression, chronic neurological disease, chronic renal disease, and chronic liver disease). RESULTS: A total of 19,256 COVID-19-related HDU and ICU admissions were included in the primary analysis, including 13,809 HDU (mean age 70 years) and 5,447 ICU (mean age 58 years) admissions. Of those admitted, 3,524 (18.3%) had type 2 diabetes and 5,077 (26.4%) died during the study period. Patients with type 2 diabetes were at increased risk of death (adjusted hazard ratio [aHR] 1.23 [95% CI 1.14, 1.32]), and this result was consistent in HDU and ICU subsets. The relative mortality risk associated with type 2 diabetes decreased with higher age (age 18-49 years aHR 1.50 [95% CI 1.05, 2.15], age 50-64 years 1.29 [1.10, 1.51], and age ≥65 years 1.18 [1.09, 1.29]; P value for age-type 2 diabetes interaction = 0.002). CONCLUSIONS: Type 2 diabetes may be an independent prognostic factor for survival in people with severe COVID-19 requiring critical care treatment, and in this setting the risk increase associated with type 2 diabetes is greatest in younger people.
Subject(s)
COVID-19/complications , COVID-19/mortality , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/mortality , Adolescent , Adult , Aged , Aged, 80 and over , Cohort Studies , Comorbidity , Critical Care/statistics & numerical data , England/epidemiology , Female , Hospital Mortality , Hospitalization , Humans , Intensive Care Units , Kidney Failure, Chronic/complications , Male , Middle Aged , Prognosis , Proportional Hazards Models , Retrospective Studies , Risk Factors , SARS-CoV-2 , Young AdultABSTRACT
COVID-19 thrashed the field of education with a greater challenge by sudden forced closure of educational institutions and to seek for alternative approaches in present mandatory forced physical distancing. The task of efficiently tune the learners to equip with global competencies and to nurture the skill for developing services to meet the utmost requirements of the society. As the present condition is uncertain and keeping this aspect in view, as a best compensation to the existing forced loss to learners, the educational institutions in India adopted virtual mode for regular teaching and learning processes. Virtual approach is not a new mode but it was confined to special learning aspects rather than traditional mode of teaching as of now. Under these circumstances, being an immediate alternative to the existing huge loss, several challenges need to be addressed such as the immediate adoption of this online pedagogy by engineering educators of different levels. The present paper describes the results of survey conducted on teachers of different levels and different specialisations conducted in July-August 2020. In the first phase of study, the survey is conducted among senior career educators regarding the faculty and learner confidence in technology enabled learning and in the second phase of study, the extent of interaction by the educators with the learners and parents and Technological Pedagogical Knowledge (TPK) ability of educators is studied. social contact during this period. Further, 90% of them trying their best to enhance their teaching skills by the effective utilization of online teaching aids to make it as best as conventional pedagogical process and 10% of them reported that they have not utilized online teaching aids at all. © 2021, Rajarambapu Institute Of Technology. All rights reserved.
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The detailed structural analysis of the ORF1ab polyprotein was carried out to study its Physiochemical characterization as well as its domain annotations. © The Author(s), under exclusive licence to Springer Nature Singapore Pte Ltd 2020.
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In order to develop any diagnostic or therapeutic protocol for COVID19 it is necessary to study the genome and proteome of the NCoV and annotate the proteins to identify its phylogeny and evolutionary relation with the other known organisms. The SARS NCoV and MERS Corona Virus belong to the Corona group of viruses and both are known to cause Respiratory illness. There is a very close similarity in the disease manifestation and mode of transmission in MERS and COVID forming basis for the comparison between the two organisms. Hence the proteins of novel Corona virus are compared with those of MERS Corona Virus (Fig. 3.1). © The Author(s), under exclusive licence to Springer Nature Singapore Pte Ltd 2020.
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Novel Corona Virus has become the talk and thought of the year disturbing the entire world with its new disease COVID. Being totally new, it has become a challenge to diagnose and treat the victims. Thus, it is necessary to understand in detail the genomics of the virus, thereby predicting its evolutionary relation to the other known organisms. This can provide an insight for the development of diagnosis and treatment methodology. In view of the importance of understanding the genetic make of NCoV, the current work was undertaken. The chapter deals in detail with the genomic sequence, important regions, conservations and variations in the genetic make up of the Novel Corona virus. © The Author(s), under exclusive licence to Springer Nature Singapore Pte Ltd 2020.
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COVID 19, a contagious respiratory disease caused by Novel Corona Virus 19 or Severe Acute Respiratory Syndrome Coronavirus 2 is a major concern of the decade. © The Author(s), under exclusive licence to Springer Nature Singapore Pte Ltd 2020.