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The high infection capacity and rapid mutations in coronavirus disease 2019 (COVID-19) has been no stranger to many. The etiological agent that contributed to this global health crisis is by no means the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). COVID-19 is characterized by an episode of immune fluctuations, followed by hyperactivation of inflammatory responses, known as the cytokine storm. The rapid progression of the COVID-19 pandemic calls for new and promising antiviral therapeutics. Repositioning anticancer drugs against the virus is very much explored due to the common similar pathways or targeting structures, opening new windows for many possibilities. As such, the repurposing of zidovudine for Friend leukemia virus and ouabain for Ebola virus are among the successful examples. Other potential FDA-approved anticancer drugs to be repositioned for COVID-19 include imatinib, saracatinib, and homoharringtonine, which have been studied for other coronaviruses in the past. Furthermore, current anticancer drugs like carmofur, carfilzomib, zotatifin, plitidepsin, and toremifene have gained interesting outcomes with respect to SARS-CoV-2. It is well recognized that to achieve viral replication, viruses antagonise or hijack host proteins and signaling pathways to gain productive infection, with SARS-CoV-2 indeed being no exception. This review aims to discuss the drug repositioning approaches concerning previously established anticancer drugs on viruses, especially on SARS-CoV-2. We accentuate this idea with specific examples of how potential anticancer inhibitors can effectively be used against SARS-CoV-2 as well as the limitations and future perspectives of drug repositioning. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2023.
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Pandemic fatigue has threatened the efforts to contain the coronavirus disease 2019 (COVID-19) worldwide;thus, government-mandated preventive measures have declined. The Japanese government has implemented several methods to address COVID-19′s spread, including hand hygiene, mask requirements, and social distancing. This study is the first to examine the socioeconomic factors affecting Japan's decline in COVID-19 prevention measures. It utilized the Preference Parameters Study of the Osaka University Institute of Social and Economic Research data of the 2021 and 2022 waves. With approximately 1580 observations, we detected a 10%, 4%, and 13% decline in hand hygiene practice, mask-wearing, and social distancing, respectively, between January 2021 and January 2022. Men were more likely to dislike the hand hygiene practice and mask-wearing and were also more reluctant to maintain social distancing. Moreover, financially satisfied individuals were positively associated with a decrease in the hand hygiene practice, while those with greater assets were more likely to dislike maintaining social distancing. People who exercised regularly were less likely to abandon the hand hygiene practices. Our results highlighted the significance of selective prevention programs targeting specific groups to promote compliance and lead to more effective pandemic management and less fatigue or discontentment. © 2023 by the authors.
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With COVID-19 outbreak globally several studies on livelihoods and food systems are conducted in consistent manner. India being an agrarian economy, the impact of pandemic on agricultural sector and farmers needs a great focus. The present exploratory study on Livelihood security (LS) was carried out in Telangana, India among Suryapet and Rangareddy districts purposively with 160 respondents selected through multistage random sampling during 2021. Livelihood Security Index was used with 7 sub-indicators and it depicted that only one sub-indicator i.e., economic security contributing less than 50% to LS and majority of the respondents have moderate level of livelihood security (42.5%) with overall mean value of 0.628. The determinants of LS were identifi ed through Multivariate regression analysis model and found 14 predictors were fitted in model responsible for 62.8% variance in the dependent variable (LS). The regression model revealed that Family size, educational years, Livestock holding, Social Participation, annual family income, mass media exposure, and Risk orientation were most aided predictor variables in the improvement of livelihood security during COVID-19 with educational years having greater beta-value. R2 standardized linear graph was plotted against the LS and the significant predictor value demonstrating the distribution of respondents over graph according to their livelihood security with R2 linear value 0.606. Thus, during COVID-19 more livelihood options for diversification of income can aid in increase of LS. The present study concluded by suggesting policy implications to ensure livelihood security among farming communities during pandemic.
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The COVID-19 pandemic is raging across the globe, with the total active cases increas-ing each day. Globally over 63 million COVID-19cases and more than 1.4 million deaths have been reported to WHO. Throughout the world, academicians, clinicians and scientists are working tirelessly on developing a treatment to combat this pandemic. The origin of novel SARS-CoV-2 virus still remains foggy but is believed to have originated from a bat coronavirus RaTG13 with which it shares approximately 96% sequence similarity. In the present review, the authors have pro-vided an overview of the COVID-19 pandemic, epidemiology, transmission, developments related to diagnosis, drugs and vaccines, along with the genetic diversity and lifecycle of the SARS-CoV-2 based on the current studies and information available.Copyright © 2022 Bentham Science Publishers.
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The COVID-19 pandemic has disrupted lives and livelihoods all over the world by its myriad of twists and turns. The causative SARS coronavirus 2 continues to defy the imagination by its rapid evolution from the Alpha to Delta to Omicron variants. This book by an international and multi-disciplinary team of virologists, infectious diseases and public health physicians aims to uncover the scientific basis underpinning the virus characteristics, as well as the clinical and public health management of COVID-19. The ten chapters address and discuss a broad range of key topics including viral evolution, clinical management, diagnostic methodologies, aerosol transmission, public health containment measures, vaccination, pathophysiology, and omics analyses. More generally, the book can serve as a useful reference guide on many future scientific issues and questions that will continue to arise as humanity learns to confront and co-exist with COVID-19. © 2023 by World Scientific Publishing Co. Pte. Ltd.
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The never-ending race for survival between the virus and its host continues to be a major challenge for biologistsas well as healthcare professionals. Owing to their simple genome organization, capacity for replication, mutation and adaptation - viruses can evolve rapidly, thereby posing a constant threat to human and other animal hosts The animal-human species barrier constitutes a considerable hurdle for zoonotic viruses, and often shields humans from the risk of new outbreaks. However, modern lifestyles and advanced technology have diminished geographic barriers, exposing humans to outbreaks initiated in one part of the world, and amplifying the associated health risks and economic losses across the globe. The novel SARS-CoV-2 outbreak that originated from Wuhan, China at the end of 2019 highlights that humans are continuously living under the threat of emerging zoonotic viruses. The Coronavirus disease 2019 (COVID-19) pandemic continues unabated despite theavailability and deployment of multiple approved vaccines and supportive therapies. Moreover, SARS-CoV-2 variants have emerged which contain mutations that promote viral transmissibility and/or virulence. Furthermore, these new variants have raised concerns over the protective efficacy of current vaccines and the susceptibility of unvaccinated individuals. This chapter discusses the potential causes and factors that influence viral fitness and host selection leading to the emergence of easily transmissible and highly pathogenic SARS-CoV-2 variants. © 2023 by World Scientific Publishing Co. Pte. Ltd.
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On 30 January 2020, the World Health Organization (WHO) characterized the novel severe acute respiratory syndrome Coronavirus 2 (SARSCoV- 2) outbreak as a Public Health Emergency of International Concern. Subsequently, on 11 March 2020, WHO declared the global spread of Coronavirus disease 2019 (COVID-19) as a pandemic triggered by this causative virus. This COVID-19 pandemic has impacted lives and livelihoods worldwide, resulting in unprecedented social disruption and economic losses. In order to design and develop effective diagnostics, vaccines and therapeutic interventions against SARS-CoV-2, it is imperative to understand the molecular and cellular mechanisms underpinning the complex interactions between this virus, its variants, and its infected hosts. This chapter provides an overview on the classification, genomic organization and evolution of SARS-CoV-2 (including the emergence of variants from Alpha to Omicron), and summarizes existing and emerging testing strategies. With unprecedented speed, an array of conventional and new COVID-19 vaccines has been developed, evaluated in clinical trials, and administered to billions worldwide. Current and novel antiviral drugs and immunomodulatory approaches are discussed for the therapeutic and prophylactic management of SARS-CoV-2 infections. Finally, much remains for humanity to discover and learn as the world must continue to adapt and live with endemic COVID-19 and SARSCoV- 2 evolution. © 2023 by World Scientific Publishing Co. Pte. Ltd.
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Students at universities are experiencing food insecurity, which may be associated with health behaviors. In a pilot study to build a survey that assesses food insecurity and health behaviors among undergraduates, we distributed the survey before (Wave 1;fall 2019) and during (Wave 2;summer 2020) COVID-19. During Wave 1, 41% of students reported food insecurity and 61% met criteria for poor sleep. In Wave 2, 26% reported food insecurity and 49% met criteria for poor sleep. Students experiencing food insecurity were more likely to report poor sleep. This survey will inform recruitment and design of a scaled-up multi-campus study. (100/100 words). © 2022 Taylor & Francis Group, LLC.
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Mobile robots have been used in warehouses worldwide as a means for distribution of goods and gained demand after the Covid19 labor issue. This paper proposes an Autonomous Mobile Robot (AMR) to navigate in a warehouse environment to its target location using LIDAR. The method used to solve this problem is a deep reinforcement learning algorithm called deep Q-network (DQN) to detect and avoid obstacles and reach the target location. DQN is used as it is desired for solving complex tasks. Training of the DQN algorithm is carried out in ROS Gazebo environment using LIDAR-based robot model. The LIDAR sensor detects the obstacles and the odometer sensor helps to find the distance between the target location are used as inputs for training the algorithm and optimal actions are taken based on the two inputs. A reward policy is awarded when an obstacle is avoided and reaches the target location. The results show that mobile robot can successfully navigate in an unknown environment through simulation and real life. © 2022 IEEE.
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The paper traces as the prime objective, the students’ perspective towards online studies amid COVID-19 pandemic outbreak which has turn out to be of utmost importance due to increased demand to opt for online learning as the only method of teaching and learning. It must also be addressed that the future of online learning is more promising and challenging as well. Overall rating for the acceptance towards online sessions, comfort level of students, ease of classes, access to and submission of the assignments and assessments, delivery of faculties, level of infrastructure available, existing technologies and internet connectivity of the students were recorded. Data was collected from the students of Department of Hospitality Management of a renowned deemed to be university in Dehradun, Uttarakhand, India through questionnaire over eight weeks lockdown period through 84 respondents between April and May 2021. The sample was made up of the undergraduate students. The paper shares a conceptual framework of Students’ Perspective towards Online Studies amid COVID-19 Outbreak. © 2022 American Institute of Physics Inc.. All rights reserved.
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Introduction: Acute myocarditis (AM) is uncommon but may be associated with significant acute deterioration, requiring emergency high-level tertiary level care. We therefore sought to examine the contemporary management of myocarditis presenting to a rural referral centre, comparing this to a recently proposed “risk-based approach” [1], providing a framework based on risk of deterioration, to help select those requiring transfer for tertiary level care. Methods: We conducted a retrospective review of all presentations coded as myocarditis to a rural Australian centre, between May 2019 and June 2021. Results: Twenty-four (24) patients were identified. Five of these were transferred for tertiary level care, all of whom had myocarditis confirmed on cardiac magnetic resonance imaging (CMRI). The estimated AM incidence was 43 per million. Factors associated with transfer were younger age (26 vs 49yrs, p=0.03) and higher troponin I rise (30,986 vs 6,124 ng/L, p=0.01). Reasons for transfer included cardiogenic shock, tachyarrhythmias, concern for potential deterioration, and diagnostic uncertainty. There was one mortality, unrelated to myocarditis. Applying the Ammirati risk-based criteria to transferred patients suggested 1 patient was high risk, 1 was medium risk and 3 were low risk but required CMRI for diagnostic clarity. Discussion: A risk-based model, based on clinical findings, echocardiography, and cardiac monitoring, safely selects patients requiring tertiary care. However, without routine use of CMRI, there may be the tendency to transfer some patients subsequently found to be low risk, thereby over-utilising resources. Planned wider availability of CMRI in rural settings might be expected to ameliorate this difficulty.
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Background: Malignant bowel obstruction (MBO) is common in advanced ovarian cancer (AOC). Treatment options are limited as majority of cases present with widespread, multilevel peritoneal dissemination and platinum-resistant disease. The benefit of Parenteral Nutrition (PN) in MBO is debated, given the limited overall survival (OS) of this patient group. Aim: to identify which clinical features correlate with improved survival in AOC and MBO, to support clinical decision-making. Methods: Retrospective review of patients admitted with MBO between April 2019 and October 2021 to a single tertiary cancer centre. Those with AOC established on PN with the aim to discharge home on PN were included. Univariate analysis for survival after commencing PN was performed using log-rank test. Results: 103 patients with MBO were identified with 33 patients excluded (PN not initiated, 15;PN withdrawn: covid service constraint, 5, acute medical event, 13). 70 patients were successfully established on PN and 49 discharged on PN;16 patients clinically deteriorated;5 returned to enteral diet. Median OS of patients that did not receive PN was 19 days, PN stopped due to general deterioration 39 days and 100 days (range 18-807) for those established on PN (p<0.0001). Clinical features associated with improved OS: no prior systemic therapy (p=0.0067), platinum sensitivity (p=0.043), ECOG performance status (PS) 1 vs 2-3 (p=0.004), falling modified Glasgow Prognostic Score (mGPS) during admission (p=0.0027). In the treatment naïve group, chemotherapy resolved MBO in 6/9 cases. In the pre-treated group, 60% of patients received subsequent chemotherapy (median duration 8 weeks), with early cessation due to toxicity and no clinical benefit. Only 1 patient achieved resolution of MBO on chemotherapy. Conclusions: PN may improve survival of patients with AOC in MBO. ECOG PS, platinum sensitivity and mGPS trend may be useful to select patients for PN. In those presenting with MBO at AOC diagnosis, PN can enable safe delivery of chemotherapy, which usually will resolve MBO. In pre-treated patients, PN is a life-long commitment and chemotherapy is largely ineffective in resolving MBO. Further research should focus on quality of life in patients receiving PN. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
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Introduction: The clinical and epidemiological presentations of patients with coronavirus disease 2019 (COVID-19) in India is still not well explored. We studied the epidemiological and clinical profile and outcomes of COVID-19 patients admitted to a tertiary care private hospital in Kerala, India. Methods: In this retrospective study, we analyzed data of 476 adult (≥18 years) COVID-19 patients admitted to a tertiary care hospital in Kerala from September 1, 2020 to March 31, 2021. The patients were categorized into mild, moderate, and severe cases and followed till discharge or death. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 23.0 with a significance set at P < 0.05. Results: The median age was 57 years (56% men). Mild, moderate, and severe cases accounted for 17%, 65%, and 18%, respectively. Around 75% had at least one comorbidity, and 51% had multiple comorbidities. The most common comorbidities were diabetes (45%), hypertension (44%), dyslipidemia (15%), and cardiac problems (12%). The elevated D-dimer values among patients in different categories were significantly different, with 74% in severe, 46% in moderate, and 19% in mild category patients. Serum ferritin, C-reactive protein, lactic acid dehydrogenase, and neutrophil to lymphocyte ratio values were significantly higher for severely ill patients. Thirty deaths (67% men) occurred during the study period, with a case fatality rate of 6.3%. Mortality mainly happened in the older age group (80%) and those with multimorbidity (90%). Conclusion: Age and multimorbidity are the major contributing factors for death in hospitalized COVID-19 patients. Generalization of the findings necessitates well-designed large-scale studies.
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COVID-19, the disease caused by the newly-discovered SARS-CoV-2 virus, has quickly spread from China throughout the world since January 2020. Its potential severity, despite in a minority of cases, has paralysed healthcare systems struggling for adequate resources, as well as entire nations often forced to adopt radical measures, such as lockdowns and surveillance, to contain the disease and restrict its spread. Initially presenting as a respiratory infectious disease, it can not only progress to an acute respiratory distress syndrome, but also have multisystemic consequences. There are many proving theories as regards to the pathophysiology and there are currently no proven definitive treatments. Due to its high transmissibility and the risk of infecting healthcare workers, hospitals also had to rethink their organisation. We have completed a literature review of the sixteen months of the pandemic, with attention to pathophysiology, key epidemiological concepts, hospital organisation, critical care considerations, and finally current and prospective treatments.
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The COVID-19 pandemic resulted in changed emission regimes all over the world. India also imposed complete lockdown on all modes of travel and industrial activities for about 2 months from 25-March-2020 and later unlocked these activities in a phased manner. Here, we study signatures of emissions changes on levels of atmospheric trace gases and aerosols contributing to air pollution over multiple sites in India’s capital Delhi covering various lockdown and unlock phases using satellite data and in-situ observations. The resulting changes in the levels of these species were compared with respect to their average of 2015–2019 to attribute for year to year and seasonal changes. A clear impact of lockdown was observed for AOD, PM, NO2, CO, and SO2 as a result of emission changes, while changed precursor levels led to a change in O3 chemical regimes impacting its concentrations. A detailed analysis of FLEXPART trajectories revealed increased PM levels over Delhi in north-westerly air masses sourced to Punjab region all the way up to Pakistan. Changes in aerosols and NO2 were not only restricted to the surface but transcended the total tropospheric column. The maximum decrease in PM, NO2, CO, and SO2 was observed during the month of total lockdown in April. The lockdown impact varied with species e.g., PM10 and PM2.5 as well as locations even within the periphery of Delhi. While surface level aerosols and NO2 showed significant and almost similar changes, AOD showed much lower decrease than tropospheric column NO2. © Copyright © 2021 Mallik, Gadhavi, Lal, Yadav, Boopathy and Das.
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Radiologically confirmed, novel coronavirus disease 2019 (COVID-19)-related neurological manifestations are being reported with increasing frequency since the outbreak of the disease. We describe a 54-year-old male with COVID-19, who demonstrated radiological and clinical findings of posterior reversible encephalopathy syndrome(PRES). The proposed mechanism suggested for COVID-19-related PRES is a disease induced inflammatory storm, which causes endothelial injury, resulting in endothelialdysfunction (ED), interstitial fluid extravasation and cerebral edema. Key Words: COVID-19, Encephalopathy, Neurological complications, PRES.
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Frailty is a multi-system clinical syndrome characterized by reduced physiological reserve and increased vulnerability to stressors. There is now established evidence recognizing its incremental value as a predictor of suboptimal outcomes in patients undergoing transcatheter aortic valve replacement (TAVR) beyond conventional surgical risk scores and objective frailty assessment is integrated in major guidelines. Several frailty assessment tools have been developed and validated for use in patients undergoing TAVR with varying complexity, clinical pragmatism and outcomes assessed. In contemporary TAVR practice, frailty assessment guides patient selection, informs care requirements, and identifies those who may require supplemental treatment. Further opportunities to improve patient care in this area include identification of interventions that can mitigate the deleterious impact of frailty, evaluation of the role of frailty assessment in low surgical risk patients, and development of frailty management models that can be delivered virtually. In this review, we aim to provide an overview of the concept of frailty, the available assessment tools, peri-procedural considerations in frail patients undergoing TAVR and future directions.