ABSTRACT
Over the course of COVID-19, the global growth of the hospitality and restaurant (H&Rs) sector has declined. During this difficult period, this sector's overall performance declined. As a result, this industry must adopt fresh approaches to seize the potential and overcome the obstacles at this pivotal moment. One of these difficulties is figuring out how to evaluate H&Rs' effectiveness using a variety of factors. This study evaluates the performance of 45 significant H&R businesses operating in India using the Data Envelopment Analysis (DEA) method. The Basic DEA models usually do not disclose the improvement in the capability of different DMUs as these models calculate only radial efficiency. In this paper, the New Slack Model (NSM) of DEA has been employed to examine the efficiency of the different 45 large-scale Indian Hotels and Restaurants (H&Rs). The NSM model cognate the input and output slacks straight away. In this study, four inputs: Capital employed, Gross fixed assets, Current assets, and Operating costs, and two outputs: Operating income and Profit before depreciation, interest, and tax (PBDIT) are considered. The data for the study has been collected from the Prowess database of the Centre for Monitoring Indian Economy (CMIE). The study indicates that only 65.58% of H&R are technically efficient which shows that some resources are unutilized and therefore there is a huge scope for an upswing. To validate the stability of results sensitivity analysis is also carried out.
Subject(s)
COVID-19ABSTRACT
Understanding the quality of immune repertoire triggered during natural infection can provide vital clues that form the basis for development of humoral immune response in some individuals capable of broadly neutralizing pan SARS-CoV-2 variants. We assessed the diversity of neutralizing antibody responses developed in an unvaccinated individual infected with ancestral SARS-CoV-2 by examining the ability of the distinct B cell germline-derived monoclonal antibodies (mAbs) in neutralizing known and currently circulating Omicron variants by pseudovirus and authentic virus neutralization assays. The ability of the antibodies developed post vaccination in neutralizing Omicron variants was compared to that obtained at baseline of the same individual and to those obtained from Omicron breakthrough infected individuals by pseudovirus neutralization assay. Broadly SARS-CoV-2 neutralizing mAbs representing unique B cell lineages with non-overlapping epitope specificities isolated from a single donor varied in their ability to neutralize Omicron variants. Plasma antibodies developed post vaccination from this individual demonstrated neutralization of Omicron BA.1, BA.2 and BA.4 with increased magnitude and found to be comparable with those obtained from other vaccinated individuals who were infected with ancestral SARS-CoV-2. Development of B cell repertoire capable of producing antibodies with distinct affinity and specificities for the antigen immediately after infection capable of eliciting broadly neutralizing antibodies offers highest probability in protecting against evolving SARS-CoV-2 variants.
Subject(s)
Breakthrough PainABSTRACT
Background In contrast to the first wave, the second COVID-19 wave has taken a huge toll affecting maternal outcomes adversely. The aim of this study was to investigate the consequences of the severity of maternal disease on perinatal outcomes and the risk of vertical transmission and to find out the factors associated with adverse fetomaternal outcomes. Materials and methods This was an ambispective observational study including COVID-19 infected pregnant patients;20-40 years of age irrespective of gestational age admitted at Government Institute of Medical Sciences, UP, India. The patients were divided into two groups: CW 1 (COVID-19 Wave 1): Patients admitted between April 1, 2020 and December 31, 2020 and CW 2 (COVID-19 Wave 2): Patients admitted between April 1, 2021 to May 31, 2021. Data in two groups were compared and analyzed with respect to the clinical profile, laboratory parameters, fetomaternal outcome and the risk of vertical transmission of COVID-19 infection. Results We included 134 eligible patients in the CW1 group and 58 in the CW2 group. Significantly more patients were symptomatic in CW2 (23.1% versus 60.3%, p= <0.001). In CW2, maternal neutrophil-lymphocyte ratio (NLR), C-reactive protein (CRP) and D-Dimer were significantly raised along with abnormal chest x-rays. There was a significant increase in maternal mortality in CW2 (1.5% vs 13.7%;p≤0.001). A total of 76 patients delivered in CW1 and 26 in CW2 with increased incidence of cesarean section (43.4%;42.3%), preterm deliveries (28.2%;37%) and low birth weight (34.6%;25.9%) in both waves, the difference among two groups being statistically insignificant. Compared to CW1, perinatal mortality was significantly increased in CW2 (2.2% vs 15.5%;p<0.001). Though nasopharyngeal swab tested positive in four neonates in CW1 and two neonates in CW2, no evidence of vertical transmission was observed even with increased severity of maternal illness. On regression analysis, D-Dimer and CRP were found to have a positive association with maternal and perinatal mortality. Conclusion The severity of maternal illness proportionately affects the neonatal outcome with no impact on the risk of vertical transmission of infection. D-Dimer and CRP have emerged as independent predictors for maternal and perinatal mortality and hence can be utilized in obstetrics decision-making.
ABSTRACT
Aim: Withania somnifera Dunal (WS), known as Ashwagandha and AYUSH-64, a polyherbal formulation are repurposed for the management of COVID-19. The extensive use of these botanicals as home remedy along with other drugs for managing multifarious disease conditions is increasing over nations. This raises high chances of herb-drug interactions (HDIs) which may be beneficial, harmful, or even fatal. Therefore, current study aimed to explore the CYP mediated herb-drug interactions (HDIs) of Ashwagandha and AYUSH-64 along with case example of remdesivir to harness the best of these HDIs for integrative management of COVID-19 Materials: and Methods The aqueous extract of Ashwagandha and AYUSH-64 were characterized by LC-MS/MS. The in-silico pharmacokinetic (ADME) parameters were studied by using ADME tool. The in-vitro CYP-450 (CYP3A4, 2C8, 2D6) inhibition studies of WS and AYUSH-64 alone and in combination with a remdesivir were carried out resembling clinically scenario. Results: Total of 11 and 24 phytoconstituents were identified from the aqueous extract of Aswagandha and AYUSH-64. The in-silico ADME studies revealed that most of the phytoconstituents showed good oral bioavailability, drug likeliness, GI affinity and some of them displayed CYP-450 inhibitory activity. The in-vitro CYP-450 studies of remdesivir showed moderate inhibitory effect on CYP3A4, 2C8, 2D6. The aqueous extract of Aswagandha did not show any inhibitory activity towards all the studied CYP’s alone and in combination with remdesivir (IC50 >100µg/ml). Whereas, AYUSH-64 also followed the same trend but showed moderate inhibitory effect on CYP2C8 (IC50 <100µg/ml). Conclusion: Aswagandha did not exhibit HDIs with the CYP3A4, CYP2C8 and CYP2D6 thereby seem to be safe to co-administer with respective substrates. Whereas, AYUSH-64 only showed moderate HDIs towards CYP2C8 substrate among studied CYP enzymes. Caution is therefore warranted for prescribing AYUSH 64 along with CYP2C8 substrate drugs.
Subject(s)
COVID-19 , Muscular DiseasesABSTRACT
The application of artificial intelligence is machine learning which is one of the current topics in the computer field as well as for the new COVID-19 pandemic. Researchers have given a lot of input to enhance the precision of machine learning algorithms and lot of work is carried out rapidly to enhance the intelligence of machines. Learning, a natural process in human behaviour that also becomes a vital part of machines as well. Besides this, another concept of deep learning comes to play its major role. Deep neural network (deep learning) is a subgroup of machine learning. Deep learning had been analysed and implemented in various applications and had shown remarkable results thus this field needs wider exploration which can be helpful for further real-world applications. The main objective of this paper is to provide insight survey for machine learning along with deep learning applications in various domains. Also, some applications with new normal COVID-19 blues. A review on already present applications and currently going on applications in several domains, for machine learning along with deep neural learning are exemplified.
ABSTRACT
Innovative strategies are required to manage COVID-19 in the communities. Back to Roots was a collaborative, community-based pilot intervention project in the British Asian community. To assess the efficacy and safety of Ayurveda intervention in relieving symptoms of mild-to-moderate COVID-19, a community based participatory research framework was used. Prospectively 28 patients were enrolled with confirmed COVID-19 clinical stages of mild-to-moderate COVID-19, symptomatic, and between 20 to 70{square}years of age. Routine management was followed by all patients managing at home, additionally patents taking Ayurveda intervention for 14 consecutive days. The efficacy and safety of Ayurveda intervention were evaluated. There were suggestions of Ayurvedas advantage in improved symptoms relief, clinical recovery in 7 days. However, a control group was not included but data triangulations from separate usual care found the difference statistically significant. Ayurveda intervention may potentially have a beneficial effect on patients with COVID{square}19, especially for those with mild to moderate symptoms. A further definitive large{square}scale clinical trial is necessary.
Subject(s)
COVID-19ABSTRACT
Background: Guduchi Ghan Vati (aqueous extract of Tinospora cordifolia) is an essential herbal plant in Indian traditional medicine (Ayurveda) that is well documented as an immunomodulator and antimicrobial agent. A recent in silico study found the therapeutic efficacy of Guduchi against SARS-CoV-2. Based on available evidence, we conducted a feasibility study of the safety and efficacy of Guduchi Ghan Vati in asymptomatic patients with covid-19. Patients and methods: An open label, feasibility trial was conducted on 46 patients in the hospital setting. A single-arm study with no control group and blinding was executed in Jodhpur, Rajasthan, India. All patients orally received 2 tablets (1000 mg) twice daily for 2 weeks. Clinical parameters were collected at baseline, day 3, day 7 and day 14. Patients were continuously monitored for side effects and adverse reactions during the study period. . Results: Out of 46 asymptomatic patients included in the study, 40 completed the 14-day follow-up period. None developed any Covid-19 symptoms after admission to the hospital. On day 3 post-treatment, viral clearance was reported in 16 (32.5%) patients. By the end of D-7, 38 (95%) patients had viral load disappearance. Follow-up at D-14 showed that all participants tested negative. Conclusion: In adult patients with asymptomatic Covid-19, Gudhuchi Ghan Vati could be effective. Randomized controlled trials with larger sample sizes in patients with Covid-19 are urgently needed to confirm the definite benefit with Ayurveda.
Subject(s)
COVID-19ABSTRACT
Background Coronavirus disease 2019 (Covid-19) has been declared global emergency with immediate safety, preventative and curative measures to control the spread of virus. Confirmed cases are treated with clinical management as they are diagnosed but so far, there is no effective treatment or vaccine yet for Covid-19. Ayurveda has been recommended by preventative and clinical management guidelines in India and several clinical trials are ongoing. But there is no study to assess impact of Ayurveda on Covid-19. Methods Objective of present study was to evaluate the clinical outcome in Covid-19 confirmed asymptomatic to mild symptomatic patients who had received Ayurveda and compare with control (who has not received Ayurveda or any support therapy). Patients having Ayurveda intervention (Guduchi Ghan Vati-extract of Tinospora cordifolia) were included from Jodhpur Covid Care Centre and non-recipients were taken from Jaipur Covid Care Centre between May 15 to June 15, 2020. Total 91 patients, who were asymptomatic at the time of hospital admission and between 18 -75 years of age, were included in the study to analyse retrospectively. Results In control group, 11.7% developed mild symptoms after average 1.8 days and none in Ayurveda group reported any symptoms. Significant difference was reported between the group of patients taking Guduchi Ghan Vati (n=40) and patients in standard care (n=51) in terms of virologic clearance at day-7 (97.5% vs 15.6% respectively; p=0.000), at day 14 (100% vs 82.3%) days to stay in hospital ( 6.4 vs 12.8 respectively; p< 0.0001) . Conclusion Results of the study suggest that Guduchi Ghan Vati, a common and widely used Ayurveda preparation, could benefit treating asymptomatic Covid-19 patients. Larger, randomised controlled Trials are required to confirm the findings. Keywords: Ayurveda, Guduchi Ghan
Subject(s)
COVID-19ABSTRACT
Background: Pain management services and support programs have been closed during pandemic. Self-management options, particularly for chronic pain, is required which can be undertaken at ones own convenience and without leaving home. Objectives: To evaluate the impact of tele-yoga therapy on patients suffering with chronic pain reducing pain intensity, disability, anxiety and depression. Material and methods: In total 18 patients with different chronic pain diagnosis were recruited to individual yoga Therapy sessions twice a week at home (tele-yoga) using a videoconference app. Each participant followed set of practices every day at home. Main outcome measures included pain intensity, pain disability, anxiety and depression scores. Data were collected at baseline and after 6-weeks of intervention. Results: There were significant improvement in pain intensity from Baseline to 6-weeks (P<0.001); also pain disability (P<0,001). Both scores of anxiety and depression reduced at the end of intervention period (P<0,001; P<0,001). Conclusions: Pilot results suggest that tele-yoga therapy may be an effective tool to self-manage chronic pain and related functional and psychological impacts. Further larger studies, randomized, controlled trials are needed to confirm the preliminary outcome.
Subject(s)
Anxiety Disorders , Pain , Depressive Disorder , Chronic Pain , Tooth, Impacted , COVID-19ABSTRACT
Children (less than 19 years) account for 20% of the US population but currently represent less than 2% of coronavirus disease 2019 (COVID-19) cases. Because infected children often have few or no symptoms and may not be tested, the extent of infection in children is poorly understood. METHODS During the March 18th-May 15th 2020 Louisiana Stay At Home Order, 1690 blood samples from 812 individuals from a Childrens Hospital were tested for antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein. Demographics, COVID-19 testing, and clinical presentation abstracted from medical records were compared with local COVID-19 cases. RESULTS In total, 62 subjects (7.6%) were found to be seropositive. The median age was 11 years with 50.4% female. The presenting complaint of seropositive patients was chronic illness (43.5%). Only 18.2% had a previous positive COVID-19 PCR or antibody test. Seropositivity was significantly associated with parish (counties), race, and residence in a low-income area. Importantly, seropositivity was linearly correlated with cumulative COVID-19 case number for all ages by parish. CONCLUSION In a large retrospective study, the seropositivity prevalence for SARS-CoV-2 in children in Louisiana during the mandated Stay At Home Order was 7.6%. Residence location, race, and lower socioeconomic factors were linked to more frequent seropositivity in children and correlated to regional COVID-19 case rates. Thus, a significant number of children in Louisiana had SARS-CoV-2 infections that went undetected and unreported and may have contributed to virus transmission.