RHEUMATOID ARTHRITIS FLARE FOLLOWING COVID-19 VACCINATION IN MALAYSIAN POPULATION AND ITS ASSOCIATED RISK FACTORS

BackgroundFlare of Rheumatoid Arthritis (RA) following COVID-19 vaccination has been reported with a low occurrence observed in those patients with disease remission. However, no local data is available in our multi-ethnic Malaysian population.ObjectivesTo evaluate the prevalence of RA flare in Malaysian patients following COVID-19 vaccination and its associated risk factors.MethodsThis was a cross-sectional study assessing RA flare based on patient-reported disease flare through self-administered questionnaires and physician-reported flare. Patient self-reported disease flare was defined as ‘a sudden worsening of rheumatology condition or arthritis within 1 month post-vaccination' while physician-reported flare was defined as ‘an increment of disease activity score 28-joint documented within 3 months post-vaccination‘ from either a scheduled or unscheduled clinic visit. A total of 186 RA patients attended the rheumatology clinic in Hospital Putrajaya from May to July 2022 who completed the primary COVID-19 vaccination under the Malaysian National Vaccination Programme were recruited. Demographic data, disease parameters including serology for rheumatoid factor (RF) and anti-citrullinated peptide antibodies (ACPA), cessation of disease modifying anti-rheumatic drugs (DMARDs) around vaccination, type of vaccines and adverse events were examined using descriptive and univariate analyses.ResultsMajority (93%) of RA patients enrolled were female with a mean age of 58 years old (standard deviation, SD 12.2) and mean disease duration was 12 years (SD 7.7). More than half were seropositive (66% RF, 63% ACPA) with 47.4% had double seropositivity (RF and ACPA positive). All patients received DMARDs with the majority (71%) were on methotrexate (MTX), 21.5% were on leflunomide, 17.7% on other DMARDs, with a small proportion (14%) of patients were receiving prednisolone. Only 4.8% of patients were on biologics or targeted synthetic disease modifying anti-rheumatic drugs. Half of the patients were in remission prior to vaccination. 62% of patients received Pfizer-BioNTech vaccine as the primary vaccine, followed by Sinovac-CoronaVac (24.6%) and Oxford-AstraZeneca (13.4%) vaccines. A booster dose had been administered to 80% of patients, of which 88.7% was Pfizer-BioNTech vaccine. MTX therapy were discontinued in 39.4% of patients (n=52) post-vaccination for a week duration. The prevalence of RA flare was only 12.9% (n=24) in which 14 were self-reported and 10 were physician-reported flares (4 severe flare, 6 mild-moderate flare). Flare rates were higher during the first and second dose of vaccination with 29.2% respectively, and only 12.5% were reported after booster vaccination. Common vaccine adverse effects were fever (16.8%), myalgia (8.6%) and arthralgia (6.4%). There were no significant differences in the occurrence of flare post-vaccination between age, gender, disease activity prior to vaccination, types of vaccine, usage of MTX and prednisolone, and discontinuation of MTX post-vaccination. Although seropositivity did not exhibit statistically significant flare rate post vaccination, sub-analysis revealed four times higher rate of flare in those who has double positivity compared to seronegative RA patients (12% vs 4%).ConclusionPrevelance of RA flare post-COVID-19 vaccination in Malaysian RA population is low. No significant associated risk factors were identified although double seropositivity appeared to have higher number of flares.References[1]Bixio, R., Bertelle, D., Masia, M., Pistillo, F., Carletto, A. and Rossini, M. (2021), Incidence of Disease Flare After BNT162b2 Coronavirus Disease 2019 Vaccination in Patients With Rheumatoid Arthritis in Remission. ACR Open Rheumatology, 3: 832-833.[2]Li X, Tong X, Yeung WWY, Kuan P, Yum SHH, Chui CSL, Lai FTT, Wan EYF, Wong CKH, Chan EWY, Lau CS, Wong ICK. Two-dose COVID-19 vaccination and possible arthritis flare among patients with rheumatoid arthritis in Hong Kong. Ann Rheum Dis. 2022 Apr;81(4):564-568.Acknowledgements:NIL.Disclosure of InterestsNone Declared.

What are People in Bali Doing in Pandemic: Understanding the Shape of Health Behavior and the Pitutur Tua

In the early occurrence of the Covid-19 pandemic, Indonesian and the world regarded Bali having a unique mechanism. Balinese or Bali residents are assumed excellently immune or difficulty infected from Covid-19. Interestingly, Balinese do not show overwhelmed panic as occurs in other areas although the Covid-19 cases in Bali are not low. There are various reasons why Balinese's actions to protect their health consider beliefs, religion, and culture. This paper is a survey of the Balinese's distinctive perception and behavior to face Covid-19. The information was gained from comments, opinions, and information about typical behavior posted on mass media and social media. The main source of the information was the WhatsApp groups of Banjar community (60 people), Bali academicians (76 people), Hindu organization alumni (113 people), and Bali medical staff (30 people). This study collected the information and conversations during early months of the pandemic in 2020 and 2021 when the Covid-19 cases skyrocketed and the government implemented the Community Activities Restrictions Enforcement (PPKM). This study concludes that the belief in the power of nature makes the sincerity and acceptance more easily appear. Moreover, tradition strengthens the trust. Support in social life also increases cooperative actions to the rules or advices of the Bali government and the custom village assembly to protect society from the pandemic.Copyright © 2021 Muslim OT et al.

Experience of Using Remdesivir in Patients with Novel Coronavirus Infection.

Timely, effective, and safe antiviral therapy in COVID-19 patients reduces complications, disability and mortality rates. The greatest concern with remdesivir is the risk of drug-induced liver injury, including in patients whose liver function is compromised by COVID-19. The aim of the study was to investigate the efficacy and safety of remdesivir in patients with confirmed SARSCoV-2 infection who had been admitted to an infectious diseases hospital in the Volgograd region in March 2022. Material(s) and Method(s): the authors carried out an open, non-randomised, single-arm study using medical records of 234 patients who had been diagnosed with "U07.1 COVID-19, virus identified" and prescribed remdesivir upon admission. The effectiveness of therapy was evaluated using two criteria: the need for oxygen supplementation or ventilatory support, or mortality. The authors conducted the evaluation on days 7, 14, and 28 using the six-point ordinal severity scale by Y. Wang et al. The safety of therapy was assessed on the basis of complaints and changes in laboratory findings. Result(s): for the patients prescribed remdesivir at admission, the 7-day mortality rate was 3.0%, the 14-day mortality rate was 5.6%, and the 28-day mortality rate was 7.3%. With the exception of a patient with myocardial infarction, all the patients who had been hospitalised with mild COVID-19 and prescribed remdesivir did not require oxygen therapy and/or transfer to intensive care and were discharged following recovery. The patients with moderate to severe COVID-19 had the 14-day mortality rate of 6.4% and the 28-day mortality rate of 8.6%. 17 patients (7.2%) discontinued remdesivir prematurely for various reasons, including adverse drug reactions. Remdesivir therapy of 5-10 days was associated with an increase in ALT activity by 2.7 +/- 0.8 times in 15.9% of patients with mild COVID-19, by 3.8 +/- 1.8 times in 20.4% of patients with moderately severe COVID-19, and by 4.8 +/- 2.7 times in 24% (12/50) of patients with severe COVID-19. In two patients (0.9%), the increase exceeded 10-fold the upper limit of normal. Conclusion(s): the obtained results support recommending remdesivir to patients with mild, moderate and severe COVID-19, including those with moderately elevated baseline activity of hepatic transaminases.Copyright © NEICON ISP LLC. All rights reserved.

Comprehensive review about automatic classification of medicinal plants

The word Taxonomy is the way of Classification. It is the science of naming and classifying all the living organisms as well as extinct organisms of the world. Swedish Botanist Carlous Linnaeus was the father of taxonomy;Out of 17000 plant species present in India, more than 7600 plants are medicinal plants. Indigenous Indian medicines are formulations of traditional knowledge and medicinal plant extracts. The traditional knowledge is transferred from one generation to other generations which is used as drug for various diseases, instead of relying on what is the ingredients and proportions these drugs are based on traditional knowledge. These drugs involve the use of plant extract. The World Health Organization (WHO), leading agency in health care found that 80 % population in low economic output countries depend on traditional medicine for their essential health care[1]. In the current era of pandemic medicinal plant species like citrus spp, allium sativum, allium cepa found effective in management of COVID 19. As per WHO guidelines, In the field of medicinal research where clinical trials are used for new drug discovery, there is need of continuous supply of authenticated products which are correctly identified, classified, and verified [1]. Traditional identification and classification methods are not quick, efficient and reliable. Automated Classification of medicinal Plants help to conserve knowledge of medicinal plant species, share it from one generation to next generation and help the whole society to improve the knowledge about medicinal plants. The paper presents traditional and recent trends using Computer vision and machine learning for classifying medicinal plant species. The main focus is on Leaf image as input. It presents the challenges as well as opportunities in identifying and classifying medicinal plant species by performing comprehensive review of traditional methodologies. © 2023 Author(s).

Solanaceous Plants for Immunomodulation

In the era of COVID pandemic, it is highly desirable to improve body's immune responses. Many of the diseases including COVID impact the immune system and make it defenseless. There is a growing interest of herbal medicine around the world owing to effective pharmacological actions attributed by its unique phytocompounds. Majority of the immunomodulatory drugs including both immunosuppressor and immuno-stimulators are synthetic organic compounds having side effects. Therefore, there is a growing interest to use plant-based products to regulate immune responses. The present chapter deals with the recognition of members of the family Solanaceae for their use as potential immunomodulators. There are quite a few reports of active phytocompounds isolated from different solanaceous plants that have a myriad of medicinal properties. Various phytochemicals such as phenolic compounds, flavonoids, alkaloids, terpenes, lactones, and glycosides have been shown to have various therapeutic effects on human body owing to their ability to influence body's immune system. The present chapter will give a comprehensive overview of plant-based therapeutics of solanaceous plants including withanolides isolated from Withania somnifera and Physalis sps, capsaicinoids isolated from Capsicum, and lycopene from tomato. Solanaceae is one of the superfamily having huge repertoire of plants belonging to major food crops utilized throughout the world (tomato, potato, capsicum etc.) as well as in medicine category. Besides several members of the Solanaceae family such as Physalis sps, Atropa sps, Datura stramonium, and Solanum xanthocarpum have potential phytomolecules belonging to alkaloids, terpenoids, and steroid category, which are recognized as medicines. This chapter will also give a critical overview of the possibilities, facts, and prospects of the use of members of Solanaceae family as potential future immunomodulatory drugs. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2022.

About the Results of Vaccination against COVID-19 for Employees of a Cheboksary Medical Organization

Relevance. In the 21st century, humanity is faced with a pandemic unprecedented in recent history, which brought with it huge losses. All the efforts of world science are aimed at ensuring that the new coronavirus infection becomes vaccine-controlled. The Ministry of Health of Russia included vaccination against COVID-19 in the national calendar of preventive vaccinations. The most vulnerable and significant in the epidemiological chain are representatives of socially active, intensively communicating professions, including medical workers. Aims. The aim of the study was to assess the degree of severity of the post-vaccination immune response in employees of a medical organization vaccinated with the Gam-COVID-Vac preparation, who had not been ill and did not have antibodies before vaccination. Materials & Methods. The post-vaccination immunity of 80 vaccinated employees was assessed 42–62 days after the start of vaccination and 6 months later;assessment of the safety of vaccination with the Gam-Kovid-Vak vector vaccine;selection of optimal screening tests for laboratory examination of persons before the planned vaccination. The results of the PCR test for the detection of SARS-CoV-2 RNA (at the post-vaccination stage four times with an interval of 7 days) and the determination of M and G immunoglobulins to SARS-CoV-2 by the ELISA method were analyzed, post-vaccination complications and reactions were assessed at different stages, monitoring the state of health and assessing the dynamics of the post-vaccination immune response. Results. A study conducted after 6 weeks showed the high immunological efficacy of the Gam-Covid-Vac vaccine;100% of those vaccinated with one or two components of the vaccine had class G antibodies to SARS-CoV-2. Vaccination did not cause severe reactions during the observation period;among the side effects, general complaints and local pains at the injection site prevailed, which were of a short-term nature and did not have a significant impact on the health status and habitual rhythm of life of the participants. The resistance of those vaccinated to a new coronavirus infection decreased over time and amounted to 97.1% three months after vaccination and 95.6% after 6 months. COVID-19 disease in vaccinated employees (7.4% of cases of the number of vaccinated) was of moderate severity, did not lead to the development of pneumonia and respiratory failure, and did not require hospitalization. Conclusions. The results obtained allow us to conclude that the effectiveness of vaccination against COVID-19 is quite high. Revaccination is well tolerated clinically and «amplifies» the immune response when exposed to SARS-CoV-2. Immunization of employees of medical organizations is necessary, because. this focus group is the most epidemiologically potentially dangerous in terms of the spread of infection. © 2023, Numikom. All rights reserved.

A comparison between some methods of analysis count data by using R-packages

The Poisson regression model is a simple count data model that combines regression models in which the response variable is in the form of counts rather than fractional numbers in generalized linear models (GLMs). Three models (Poisson regression, quasi-Poisson regression, and negative binomial regression) were compared in r packages and applied to a sample of COVID-19 data in this study. The Poisson regression model was shown to be the best and most efficient of the other models. © 2023 Author(s).

Harvesting Renewable Energy from Foot Pedal Using Rotational Electromagnetic Induction Flywheel

Philippines is one of the highest electricity prices in the ASEAN where harnessing renewable energy using wasted human effort is necessary. The global pandemic COVID-19 is spreading and because of this, establishments have required sanitation. The study's main objective is to Develop a Rotational Electromagnetic Induction Flywheel using Foot Pedal as Actuation to Harvest Renewable Energy. T-test was used to validate the results using the battery percentage of a power bank as the parameter, where there is a significant difference between single and multiple actuations with an attached mechanical dispenser and without. The system was able to harness an average of 0.30992 Watt-hour and 6.11476 Watt-hour in 5 daily trials for single and multiple controlled set-ups without mechanical dispenser respectively. An average of 0.2441 Watt-hour and 5.0027 Watt-hour for single and multiple controlled set-ups with mechanical dispenser correspondingly. Lastly, an average of 3.2924 Watt-hour in 5 daily trials for uncontrolled set-up. © 2023 IEEE.

Impact of Covid-19 on Mental Health among Medical Students

Background: The COVID-19 pandemic is a major health crisis affecting several nations. Such widespread outbreaks are associated with adverse mental health consequences. Objective(s): To conduct a survey-based assessment of mental health among medical students during the COVID-19 pandemic. Aimed at identifying severity levels of depression and anxiety, stressors related to the pandemic, and barriers students experienced in handling the pandemic-related stress. Method(s): An analytical cross-sectional study was chosen as the study design for this research to study the association between demographic social and mental health among medical students during the pandemic COVID-19. Result(s): The results of this study were collected by respondents through questionnaires as the respondents were needed to answer about 16 questions and the main question was asked mostly about their mental health condition during the pandemic COVID-19. 101 respondents participated in the study. Discussion(s): the impact of COVID-19 on mental health among medical students has been studied. Due to the long-lasting pandemic situation and numerous measures such as lockdown and stay-at-home orders, COVID-19 brings negative impacts on higher education of medical students, self and social isolation, disconnection from friends and teachers resulting in more medical students than ever experiencing feelings of helplessness, isolation, grief, anxiety and depression. The issue of mental health is not only relevant but crucial. Demand for health support services has increased exponentially as a result. Conclusion(s): In this study, severity levels of depression and anxiety, stressors related to the pandemic, and barriers students experienced in handling the pandemic-related stress have increased due to many factors such as social isolation, own health and the health of loved ones, financial difficulties, suicidal thoughts, depressive thoughts, class workload, changes in living environment, eating patterns and sleeping habits.Copyright © RJPT. All right reserved.

The Association Between Smart Technology, Artificial Intelligence, Robotics, and Algorithms (STARA) Awareness, Job Stress, Job Insecurity, and Job Satisfaction Among Hotel Employees During COVID-19 Pandemic

Despite the numerous advantages of implementing smart technology, expenses or negatives must be considered, with one of the most significant being the influence on personnel. A lot of studies have been undertaken to examine the influence of technological innovation on personnel. In the hospitality industry, research on service robots has grown, with a focus on customer-robot interactions. Despite this, studies on the influence of service robots on hotel employees are still at an early stage of development, especially in Indonesia. To fill the gap, the purpose of the study is to investigates the relationship between Smart Technology, Artificial Intelligence, Robotics, and Algorithms (STARA) awareness, job stress, job insecurity among hotel employees in Jakarta. Using quantitative approach, this study used convenient sample and involve 160 research participants. The research respondent was coming from various hotel employees located in Jakarta. Multiple regression analysis was used to analyze the data. The study found that there is a significant relationship between STARA awareness, job stress, job insecurity, and job satisfaction. The current study contributes to literature in the impact of technology adoption on service employees. This study is important because the findings provide an insight for hotel managers in developing technology implementation program in their businesses, especially the one that focuses on employees work behavior. © 2023 EDP Sciences. All rights reserved.

DSC Study of SARS-CoV-2 ORF10 Protein and Its Complexes with Water-Soluble Metal Phthalocyanines

A theoretical and experimental study of the interaction of the SARS-CoV-2 ORF10 protein with sulfosubstituted cobalt(II) and copper(II) phthalocyanines was carried out. The structures of the most probable complexes of metal phthalocyanines with the ORF10 protein were obtained by molecular docking methods. Cobalt(II) tetrasulfophthal ocyanine binds to the protein in the monomeric state, while the interaction ofORF1 0 with copper(II) tetrasulfophthalocyanine causes aggregation of the formed protein complexes, which was shown by the UV-Vis spectroscopy. Thermal denaturation of the ORF10 protein and its complexes with metal phthalocyanines was studied by differential scanning calorimetry. A joint analysis of the spectral and thermochemical data made it possible to propose a description of the mechanism of thermal denaturation ofthe ORF10 protein.

COVID-19 during Pregnancy: Prevalence, Predictors, and Impact on the Newborn

Background: The recent pandemic prompted a number of clinical trials to assess the efficacy and safety of medication use for the treatment for COVID-19. As pregnant women are excluded or vastly underrepresented in clinical research, there is a paucity of data on how pregnancy and perinatal outcomes are impacted by such medications. Considering that pregnant women are at increased risk for COVID-19 infection and that pregnancy is also associated with an increased risk of developing severe COVID-19, it is of utmost importance to assess the effect of gestational medications use for COVID-19 on pregnancy outcomes. Objective(s): The aims of this systematic review were to (1) determine and quantify COVID-19-specific and repurposed medication use during pregnancy, and (2) provide an overview of the pregnancy and neonatal outcomes that have occurred in COVID-19-positive pregnant women exposed to COVID-19-specific or repurposed medications compared to use in pregnant women without COVID-19;neonatal outcomes compared between COVID-19 positive pregnant women treated and untreated with these medications. Method(s): A systematic literature search was conducted in Ovid and executed in the following databases: MEDLINE, Embase, and Global Health. Search strategies applied combined database-specific subject headings and keywords relevant to the topic. Some subject headings used in databases were pregnancy outcome, COVID-19, SARS-CoV-2, pharmaceutical preparations, drugs, and prescription. Some keywords used for the searches were pregnancy outcome, neonatal outcome, coronavirus disease 2019, drug, medication, and treatment. For each database, keywords were searched within the , keyword heading word or heading words, and title fields. Restrictions were applied regarding the date of publication and searches were limited to English publications. Study selection was accomplished by two independent investigators (NSK, NAB). Only original research articles were considered for inclusion. Included studies investigated pregnancy or neonatal outcomes in women with COVID-19 receiving medication to treat COVID-19. A standardized extraction form was used to independently extract relevant information. Result(s): The literature search yielded a total of 344 records. After deduplication, 69 records were removed. The title and of 275 publications were screened.

Impact of Covid-19 on Water Consumption: A Comparative Study

Clean water is one type of water-based resource that is of good quality and commonly used by humans for consumption or in carrying out their daily activities, including sanitation. The arrival of COVID-19 has increase water usage as hand washing is a must. However, according to the World Health Organization (WHO), several localities face higher infection risks due to water supply shortages resulted from the increased demand for treated water. Having a contingency plan to facilitate that change can reduce the probability of water supply shortages. However, existing literature lacks detailed insights on water usage changes during a pandemic and pandemic response model. Response plans that tackle changing water demands during a pandemic, using COVID-19 as a case study, are compelling. Hence, this paper aims to determine the impact of COVID-19 on treated water supply and demand in Pahang. The results reveal that the lockdown during COVID-19 has increased domestic water demand and decreased demand for non-domestic (i.e., commercial, industrial, and government building). The net effect of these changes varies from place to place, depending on the relative proportion of domestic and non-domestic water usage across the major economic sectors. The findings are helpful for future water management strategy plans in the study area. © 2023 American Institute of Physics Inc.. All rights reserved.

Unique vascular complication following extended VV-ECMO support

Objectives: To present an unusual complication related to prolonged ECMO support in a patient with COVID19 induced acute respiratory syndrome (ARDS). Method(s): Clinical chart review of the care process after obtaining the informed consent from the patient. Result(s): A 48-year-old female with COVID-19 infection during second wave of pandemic in August 2021 progressed to severe ARDS. She was put on VV-ECMO support after failing conventional therapy for refractory hypoxemia. Her cannulation configuration included a 25 F venous drainage cannula in the right femoral vein and a 21 F venous return cannula in the right Internal Jugular (IJ) vein. Cannulations were performed using the ;Seldinger technique;under USG guidance, and no difficulties or complications were reported. Her hospital course was notable for delirium, and intermittent bleeding from the cannula sites. After 80 days of support, she showed adequate respiratory improvement which allowed ECMO decannulation. She continued to show improvement, and was eventually discharged after 102 days of total hospital stay. During her 6 weeks follow-up clinic visit a palpable thrill was noted at the jugular ECMO cannula site. A CT angiogram of the neck demonstrated a large venous varix connecting the right IJ and the left common carotid artery with filling from the left common carotid artery. ECMO cannulation site complications such as aneurysm, clots, infections and stenosis are well known. What was unusual in this case is the nature of the aneurysm given that there were no arterial procedures performed on the left side of the neck. She was managed by an ;Amplatzer plug;to the carotid artery at the level of the connection to the varix without any complications. Conclusion(s): Longer duration of ECMO support needs careful follow-up for timely recognition and management of vascular complications. (Figure Presented).

Clinical characteristics, complications, and outcomes of severe COVID-19 ARDS patients supported by ECMO and triaged for lung transplantations

Objectives: More than 200 patients have benefited from lung transplantation who failed to recover from COVID-19-induced acute respiratory distress (ARDS) with conventional ventilatory support and/ or extracorporeal membrane oxygenation support (ECMO) in USA. We aim to share our experience and lessons learned at our institute through this case series. Method(s): After IRB approval, we performed a retrospective chart review and identified 37 patients who received ECMO for COVID-19 induced ARDS between May 2020 through January 2022. Out of these, 12 received a formal consultation from the transplant team. We studied patient characteristics, interventions during ECMO support, and evaluation outcomes. Result(s): Most of our patients had single organ failure i.e., lung, except for two who required dialysis after ECMO initiation. Six out of the 12 patients received bilateral lung transplant. One patient received the transplant before ECMO initiation. However, the patient required two runs of ECMO after the transplant due to postop complications from suspected COVID19 reinfection and deceased on postoperative day 101. All the patients after transplant had an expedited recovery except one who required prolonged hospitalization before starting physical therapy. The median length of hospital stay for the transplant group was 148 (89- 194) days and for the non-transplant group was 114 (58-178) days. The 30-day survival rate was 100% for the transplant group. At a median follow-up of 207 (0- 456) days after discharge, 5(83.3%) patients in the transplant group and 3(50%) patients in the nontransplant group were alive. In the non-transplant group, 4 patients received ECMO support for more than 75 days and at last follow-up 2 were alive and functioning well without needing new lungs. This asks for an objective prospective study to define the timeline of irreversibility of the lung injury. Conclusion(s): Lung transplantation is a viable salvage option in patients with COVI-19 induced irreversible lung injury. However, the irreversibility of the lung injury and the timing of lung transplant remains to be determined case-by-case. (Figure Presented).

Scientific rationale of Indian AYUSH Ministry advisory for COVID-19 prevention, prophylaxis, and immunomodulation

The current outbreak of COVID-19 is caused by the SARS-CoV-2 virus that has affected > 210 countries. Various steps are taken by different countries to tackle the current war-like health situation. In India, the Ministry of AYUSH released a self-care advisory for immunomodulation measures during the COVID-19 and this review article discusses the detailed scientific rationale associated with this advisory. Authors have spotted and presented in-depth insight of advisory in terms of immunomodulatory, antiviral, antibacterial, co-morbidity associated actions, and their probable mechanism of action. Immunomodulatory actions of advised herbs with no significant adverse drug reaction/toxicity strongly support the extension of advisory for COVID-19 prevention, prophylaxis, mitigations, and rehabilitation capacities. This advisory also emphasized Dhyana (meditation) and Yogasanas as a holistic approach in enhancing immunity, mental health, and quality of life. The present review may open-up new meadows for research and can provide better conceptual leads for future researches in immunomodulation, antiviral-development, psychoneuroimmunology, especially for COVID-19.Copyright © 2021, Institute of Korean Medicine, Kyung Hee University.

Detecting Ransomware Attacks in Cloud Environment Using Machine Learning-Based Intelligence System in COVID-19 Chaos

2020-2022 provided nearly ideal circumstances for cybercriminals, with confusion and uncertainty dominating the planet due to COVID-19. Our way of life was altered by the COVID-19 pandemic, which also sparked a widespread shift to digital media. However, this change also increased people's susceptibility to cybercrime. As a result, taking advantage of the COVID-19 events' exceedingly unusual circumstances, cybercriminals launched widespread Phishing, Identity theft, Spyware, Trojan-horse, and Ransomware attacks. Attackers choose their victims with the intention of stealing their information, money, or both. Therefore, if we wish to safeguard people from these frauds at a time when millions have already fallen into poverty and the remaining are trying to survive, it is imperative that we put an end to these attacks and assailants. This manuscript proposes an intelligence system for identifying ransomware attacks using nature-inspired and machine-learning algorithms. To classify the network traffic in less time and with enhanced accuracy, Genetic Algorithm (GA) and Particle Swarm Optimization (PSO), two widely used algorithms are coupled in the proposed approach for Feature Selection (FS). Random Forest (RF) approach is used for classification. The system's effectiveness is assessed using the latest ransomware-oriented dataset of CIC-MalMem-2022. The performance is evaluated in terms of accuracy, model building, and testing time and it is found that the proposed method is a suitable solution to detect ransomware attacks. © 2022 IEEE.

Put PEP into Telehealth: An Etiquette Framework for Successful Encounters

Key Words: Telehealth etiquette, webside manner, Advanced Practice Nursing, nursing, telehealth, telehealth education, telemedicine, nursing education, nurse patient experience, telehealth nursing, nursing faculty, telehealth quality Increased utilization of videoconferencing platforms to conduct meetingsand patient encounters has illuminated the need to focus on video etiquette. Telehealth Brief History of Telehealth Telehealth, as defined by the U. S. Health Resources and Services Administration (HRSA), is "the use of electronic and telecommunication technologies to support long-distance clinical health care, patient and professional health-related education, public health, and health administration" (U. S. Department of Health and Human Services [DHHSI. 2021. para 1). [...]the casual use of social media for interpersonal Interactions may have a negative effect on professional telehealth communication by reducing one's empathetic expression (Konrath et al.. Patient-Provider Communication Impact of Communication Communication has long been a key component of education for nursesand Is identified by the National Council of State Boards of Nursing (NCSBN) as fundamental to the practice of nursing (NCSBN. 20131.