Viral Infections and the Kidney

Viral infections are associated with a number of renal diseases in children resulting in significant morbidity and mortality worldwide. The role of viral infections in the pathogenesis of kidney disease has been largely based on clinical and histologic kidney findings in temporal association with a systemic viral infection and the demonstration of kidney cells infected with viral particles. Viral infections associated with productive viral replication in the kidney of immunocompromised hosts are of particular concern for children. Here, we will discuss the epidemiology, pathogenesis, outcomes, and treatment of the most relevant kidney diseases associated with viral infections in children, excluding those occurring in kidney transplant recipients, which are discussed elsewhere in this textbook (see chap. 84, Renal transplantation: infectious complications). Well-defined associations between a viral infection and kidney disease have been made for the hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV-1), hantaviruses, and the new coronavirus SARS-CoV-2. In children with immunodeficiency states, herpes viruses, polyomavirus, and adenovirus have been recognized to induce kidney diseases. The roles of other viruses in the pathogenesis of kidney diseases are not clearly defined and remain speculative. With increasing application of molecular techniques, the understanding of the role of viruses in the pathogenesis of kidney diseases is expected to increase. In addition, more specific antiviral treatments and vaccines are currently under development and are expected to improve the outcome of viral-mediated kidney diseases in children. © Springer Nature Switzerland AG 2009, 2016, 2022.

Genetic advances and therapeutic perspectives for male infertility

Many studies demonstrate a significant decline in sperm parameters in Western men with an average annual decline of 1.4% in sperm count observed between 1973 and 2011. This decline is mainly caused by increasing exposure to many environmental factors, but these factors often come in addition to pre-existing genetic defects. During this period, techniques for medically assisted procreation (ART) have made great progresses and allow many couples to compensate for this drop in reproductive parameters. ART success rate now seem to have reached a plateau and new practices must emerge to continue improving the management of infertile men. For fifteen years, highthroughput sequencing techniques have revolutionized the diagnosis of genetic diseases. These techniques are now applied to infertility to better diagnose and support the care of infertile men. These improvements currently only apply to the most severe cases of male infertility, but allow us to improve our knowledge on sperm pathophysiology. The last few years have also seen the emergence of the use of clinical mRNA, which has proven to be so effective in the fight against Covid-19 infection and whose scope concerns all medical specialties. We believe that diagnostic advances combined with advances in biotherapies will, in the medium term, make it possible to treat certain cases of male infertility of genetic origin. We present below the recent advances in the field of the genetics of male infertility and the therapeutic possibilities that could follow. Copyright © 2022 John Libbey Eurotext. de nombreuses études démontrent un déclin important des paramètres spermatiques chez l'homme occidental avec en moyenne une baisse annuelle de 1,4 % de la numération spermatique observée entre 1973 et 2011. Ce déclin est principalement causé par une exposition grandissante à de nombreux facteurs environnementaux, mais ces facteurs viennent souvent se surajouter à des défauts génétiques préexistants. Pendant cette période, les techniques de prise en charge en procréation médicalement assistée (AMP) ont grandement progressé et permettent pour beaucoup de couples de compenser cette baisse des paramètres reproductifs. Les taux de réussite de l'AMP semblent maintenant avoir atteint un plateau et de nouvelles pratiques doivent émerger pour poursuivre l'amélioration de la prise en charge de l'homme infertile. Depuis une quinzaine d'années, les techniques de séquençage haut débit révolutionnent le diagnostic des maladies génétiques. Ces techniques sont maintenant appliquées à l'infertilité pour mieux diagnostiquer et accompagner les hommes infertiles. Ces améliorations ne s'appliquent pour l'instant qu'aux cas les plus sévères, mais permettent d'améliorer nos connaissances sur la physiopathologie spermatique. Ces dernières années ont également vu émerger l'utilisation des ARNm dans un contexte clinique, qui s'est révélée efficace pour lutter contre la Covid-19 et dont le champ d'application concerne l'ensemble des spécialités médicales. Nous pensons que les avancées diagnostiques conjuguées aux avancées des biothérapies permettront à moyen terme de soigner certains cas de stérilité masculine d'origine génétique. Nous présentons ci-après les avancées récentes dans le champ de la génétique de l'infertilité masculine et les possibilités thérapeutiques qu'elles pourraient apporter. Copyright © 2022 John Libbey Eurotext. Copyright © 2022 John Libbey Eurotext.

Safety and Efficacy of the NVX-CoV2373 COVID-19 Vaccine at Completion of the Placebo-Controlled Phase of a Randomized Controlled Trial.

BACKGROUND: The recombinant protein-based vaccine, NVX-CoV2373, demonstrated 89.7% efficacy against COVID-19 in a phase 3, randomized, observer-blinded, placebo-controlled trial in the United Kingdom. The protocol was amended to include a blinded crossover; data to the end of the placebo-controlled phase are reported. METHODS: Adults aged 18-84 years received two doses of NVX-CoV2373 or placebo (1:1) and were monitored for virologically confirmed mild, moderate, or severe COVID-19 (onset from 7 days after second vaccination). Participants who seroconverted to immunoglobulin G (IgG) against the nucleocapsid protein and did not meet criteria for symptomatic COVID-19 were classified as having asymptomatic disease. Secondary outcomes included anti-spike (S) IgG responses, wild-type virus neutralization, and T-cell responses. RESULTS: Of 15185 participants, 13989 remained in the per-protocol efficacy population (6989 NVX-CoV2373, 7000 placebo). At a maximum of 7.5 months (median, 4.5 months) postvaccination, there were 24 cases of COVID-19 among NVX-CoV2373 recipients and 134 cases among placebo recipients, a vaccine efficacy of 82.7% (95% CI: 73.3-88.8). Vaccine efficacy was 100% (17.9-100.0) against severe disease and 76.3% (57.4-86.8) against asymptomatic disease. High anti-S and neutralization responses to vaccination were evident, together with S-protein-specific induction of interferon-γ secretion in peripheral blood T cells. Incidence of serious adverse events and adverse events of special interest were similar between groups. CONCLUSIONS: A two-dose regimen of NVX-CoV2373 conferred a high level of ongoing protection against asymptomatic, symptomatic, and severe COVID-19 through >6 months postvaccination. A gradual decrease of protection suggests that a booster dose may be indicated.

Emerging investigator series: moving beyond resilience by considering antifragility in potable water systems

It is inherently difficult to plan water systems for a future that is non-predictive. This paper introduces a novel perspective for the design and operation of potable water systems under increasing water quality volatility (e.g., a relatively rapid and unpredicted deviation from baseline water quality). Increased water quality volatility and deep uncertainty stress water systems, confound design decisions, and increase the risk of decreased water system performance. Recent emphasis on resilience in drinking water treatment has partly addressed this issue, but still establishes an adversarial relationship with change. An antifragile system benefits from volatile change. By incorporating antifragility, water systems may move beyond resilience and improve performance with extreme events and other changes, rather than survive, or fail and quickly recover. Using examples of algal blooms, wildfires, and the COVID-19 pandemic, this work illustrates fragility, resilience, and antifragility within physicochemical process design including clarification, adsorption and disinfection. Methods for increasing antifragility, both individual process options and new system design tools, are discussed. Novel physicochemical processes with antifragile characteristics include ferrate preoxidation and magnetic iron (nano)particles. New design tools that allow for systematic evaluation of antifragile opportunities include artificial neural networks and virtual jar or pilot "stress testing". Incorporating antifragile characteristics represents a trade-off with capital and/or operating cost. We present a real options analysis approach to considering costs in the context of antifragile design decisions. Adopting this antifragile perspective will help ensure water system improved performance during extreme events and a general increase in volatility.

The Sri Lankan Crisis An Outcome of Populist Macroeconomics and Family-run Polity?

Many have argued that the current Sri Lankan crisis was caused by the economic impact of the COVID-19 pandemic and the Ukraine war, and the country’s overdependence on predatory Chinese lending. Sri Lanka’s problems are more deep-rooted and have their origins in economic policy that focused on providing fiscal sops and a family-run political establishment that enabled the government to ignore sound advice. © 2022 Economic and Political Weekly. All rights reserved.

Estimation of Basic Reproduction Number and Herd Immunity for COVID-19 in India

In recent times, the rapid rise of the COVID-19 has imparted a devastating effect on human society. India has been perceiving the significant impacts of the COVID-19 in many ways. Estimation of basic reproduction number and herd immunity has become an important question which might support policy makers to take decisions for the improvement of the current scenario. In this chapter, the autoregressive integrated moving average (ARIMA) tool has been used to estimate confirm cases, discharge, deaths, and case fatality rate due to COVID-19 in India during March 1st–May 6th, 2020. The sequential bayesian (SB) method, Wallinga and Teunis approach (TD), exponential growth (EG), and maximum likelihood (ML) techniques are used to estimate the basic reproduction number and herd immunity due to COVID-19 in India. The findings are: basic reproduction number in earlier method as follows, 1.6998 (95% CI, 1.4595–1.9210), 1.8043 (95% CI, 1.6287–1.9894), 1.4685 (95% CI, 1.4672–1.4698) and 1.8931 (95% CI, 1.8655–1.9210) in SB, TD, EG, and ML, respectively. The estimations of herd immunity as follows for SB, TD, EG, and ML such as, 0.4116 (95% CI, 0.3148–0.4794), 0.4457 (95% CI, 0.3860–0.4973), 0.3190 (95% CI, 0.3184–0.3196), and 0.4717 (95% CI, 0.4639–0.4794), respectively. Results demonstrate the significant impact of epidemic dynamics of COVID-19 in India. © 2021, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

A Cross-sectional Study to Assess the Anxiety and Depression among Perinatal Mothers during the COVID-19 Pandemic

Purpose: Pregnancy, with its associated hormonal changes, leads to an increased risk of mental health problems. These are likely to be worsened by the socioeconomic effects of the coronavirus disease-2019 (COVID-19) pandemic. This study aims to find out the proportion of anxiety and depression in perinatal women and the associated risk factors during the pandemic in India, where mental health is a neglected domain. Methods: In a cross-sectional study spanning from March 2020 to July 2021, 124 patients who were pregnant or had delivered within 1 year were selected. The survey collected sociodemographic information and assessed the severity of anxiety and depression using the pretested and validated generalized anxiety disorder 7 and patient health questionnaire-9 (PHQ-9), respectively. The results were analyzed by suitable statistical tools and techniques. Results: Elevated anxiety and depression symptoms compared to similar pre-pandemic perinatal cohorts were observed. Anxiety (GAD), depression and both anxiety and depression were diagnosed in 31 (25%), 36 (29.03%), and 21 (16.94%) participants, respectively. Higher symptoms of anxiety and depression were associated with more concern about threats of COVID-19 to the life of mother and baby, concerns about not getting necessary medical and obstetric care during the lockdown, social isolation, and unemployment during a pandemic. Support and compassionate behavior of treating doctor was associated with lower psychological symptoms. Conclusion: COVID pandemic has had a definite impact on the mental health of perinatal mothers with elevated levels of anxiety and depression. So clinicians need to be more vigilant in this vulnerable group to facilitate early detection and management of anxiety and depression to prevent further morbidities in mother and her offspring.

THE SCHN MHID HUB: THE LAUNCH OF A STATE-WIDE SPECIALISED SERVICE TO ENHANCE EDUCATION, INTEGRATION AND SERVICE PROVISION

Background: In 2019, NSW Health funded the Developmental Psychiatry Team to provide a limited consultation service, accessible to all of NSW with multidisciplinary staffing for 2 days/week. Objectives: To enhance services to children and adolescents with intellectual disability and autism and mental health problems through capacity building, specialist service provision and integration with mainstream services. Methods: Service agreement, referral criteria and a range of services were established and made available on a website. Findings: The COVID-19 pandemic made access more equitable by video conference enabling service partners to attend from different sites. In July 2020, an educational webinar was launched to 500 virtual attendees. Flexible service provision to paediatric and Child and Adolescent Mental Health Services (CAMHS) varies from email or telephone consultation to case supervision, to direct (video) or joint consultation. A medical referral ensures long-term medical case management. New cases (100) are seen per year, with evidence of improved functioning. Capacity building includes a growing library of webinars, a journal for the mental health (MH) of children and adolescents with intellectual or developmental disability, scholarships for training in Stepping Stones Parenting and The Westmead Feelings Program, and emotional learning for autism. Enhanced collaboration is growing with both paediatric and MH services, public and private. Conclusion: SCHN MHID Hub is part of the development of health and MH specialist intellectual disability service provision to enhance mainstream capacity as part of a state-wide plan. An independent iterative evaluation by the UNSW is underway, which should facilitate permanent funding.

Pandemic and the Monetary Policy in the Global North How Far Has the Main Street Been Influenced?

During the COVID-19 pandemic, expansionary economic policies played an important role in reviving the floundering global economy. In this context, the present paper looks at the effectiveness of monetary policy in the global North in stimulating real economic activity. In an ultra-low interest rate regime, the traditional monetary policy ceases to be effective. Therefore, many developed country central banks adopted a slew of unconventional monetary policy tools to tackle the recession. This paper analyses the unconventional monetary policy tools pursued by the global North with special reference to the United States and argues that the transmission channels of unconventional monetary policy tools to increase effective demand are not always automatic and straightforward. There is strong evidence that while these expansionary measures may have helped during the initial crisis, their effectiveness in reviving sustained economic activity in the medium run is doubtful. On the other hand, there are routes through which increased liquidity created by unconventional monetary policy tools has ended up in the financial sector, thereby leading to an asset price inflation that may not have a net beneficial impact on the real economy. © 2022 Economic and Political Weekly. All rights reserved.

Clinical characteristics and outcomes of COVID-19 patients in a tertiary hospital in Baguio City, Philippines.

OBJECTIVE: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), primarily targets the respiratory system. This study describes the characteristics associated with mortality among patients infected with SARS-CoV-2 at a single hospital in Baguio City, Philippines. METHODS: We reviewed medical records (including history, laboratory results and treatment regimen) of 280 confirmed COVID-19 patients admitted to a single hospital during March-October 2020. Clinical characteristics and outcomes (frequency and type of complication, recovery rate and mortality) were evaluated. Multiple logistic regression was used to analyse factors associated with mortality. RESULTS: The mean age of COVID-19 patients was 48.4 years and the female-to-male ratio was 1.8:1. Hypertension, cardiovascular disease (CVD) and diabetes were the most frequent comorbidities reported. Common presenting symptoms were respiratory and constitutional, with 41% of patients not reporting symptoms on admission. Patients with moderate, severe and critical disease comprised 45%, 8% and 4%, respectively. A total of 15% had complications, health care-associated pneumonia being the most frequent complication. The recovery rate was 95%; 5% of patients died, with multiorgan failure being the most common cause. The presence of CVD, chronic kidney disease, prolonged prothrombin time and elevated lactate dehydrogenase (LDH) were associated with mortality. DISCUSSION: Most COVID-19 patients in our population had asymptomatic to moderate disease on admission. Mortality from COVID-19 was associated with having CVD, chronic kidney disease, elevated LDH and prolonged prothrombin time. Based on these results, we emphasize that people should take all necessary precautions to avoid infection with SARS-CoV-2.

Bioconjugated Nanomaterial for Targeted Diagnosis of SARS-CoV-2

CONSPECTUS: Infectious diseases by pathogenic microorganisms are one of the leading causes of mortality worldwide. Healthcare and socio-economic development have been seriously affected for different civilizations because of bacterial and viral infections. According to the Centers for Disease Control and Prevention (CDC), pandemic in 1918 by the Influenza A virus of the H1N1 subtype was responsible for 50 to 100 million deaths worldwide. Similarly, the Asian flu pandemic in 1957, Hong Kong flu in 1968, and H1N1pdm09 flu pandemic in 2009 were responsible for more than 1 million deaths across the globe each time. As per the World Health Organization (WHO), the current pandemic by coronavirus disease 2019 (COVID-19) due to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) virus is responsible for more than 4.8 M death worldwide until now. Since the gold standard polymerase chain reaction (PCR) test is more time-consuming, the health care system cannot test all symptomatic and asymptomatic Covid patients every day, which is extremely important to tackle the outbreak. One of the significant challenges during the current pandemic is developing mass testing tools, which is critical to control the virus spread in the community. Therefore, it is highly desirable to develop advanced material-based approaches that can provide a rapid and accurate diagnosis of COVID-19, which will have the capability to save millions of human lives. Aiming for the targeted diagnosis of deadly virus, researchers have developed nanomaterials with various sizes, shapes, and dimensions. These nanomaterials have been used to identify biomolecules via unique optical, electrical, magnetic, structural, and functional properties, which are lacking in other materials. Despite significant progress, nanomaterial-based diagnosis of biomolecules is still facing several obstacles due to low targeting efficiency and nonspecific interactions. To overcome these problems, the bioconjugated nanoparticle has been designed via surface coating with polyethylene glycol (PEG) and then conjugated with antibodies, DNA, RNA, or peptide aptamers. Therefore, the current Account summarizes an overview of the recent advances in the design of bioconjugated nanomaterial-based approached as effective diagnosis of the SARS-CoV-2 virus and the SARS-CoV-2 viral RNA, antigen, or antibody, with a particular focus on our work and other's work related to this subject. First, we present how to tailor the surface functionalities of nanomaterials to achieve bioconjugated material for targeted diagnosis of the virus. Then we review the very recent advances in the design of antibody/aptamer/peptide conjugated nanostructure, which represent a powerful platform for naked-eye colorimetric detection via plasmonic nanoparticles. We then discuss nanomaterial-based surface-enhanced Raman scattering (SERS) spectroscopy, which has the capability for very low-level fingerprint identification of virus, antigen, and antibody via graphene, plasmonic nanoparticle, and heterostructure material. After that, we summarized about fluorescence and nanoparticle surface energy transfer (NSET)-based on specific identification of SARS-CoV-2 infections via CNT, quantum dots (QDs), and plasmonic nanoparticles. Finally, we highlight the merit and significant challenges of nanostructure-based tools in infectious diseases diagnosis. For the researchers who want to engage in the new development of bioconjugated material for our survival from the current and future pandemics, we hope that this Account will be helpful for generating ideas that are scientifically stimulating and practically challenging.

Biofunctional properties of traditional indian fermented milk foods for immunity boosting

Boosting immunity is the most important preventive measure to fight against different externally acquired infection like SARS- COV2 outbreak presently prevailing all over the world. Food plays a major role in enhancing immunity of the body. Fermented foods especially fermented milk foods are a great source of bioactive peptides that help in boosting immunity. India has a plethora of traditional fermented milk foods such as dahi, lassi, srhikhand, chhurpi etc. in its kitty which are having abundant biofunctional activities. They exhibit various health benefits especially immunomodulation, antimicrobial, antithrombotic and antioxidative properties which are mostly required to combat the detrimental effects of the pathogens. They are also a rich source of several vitamins and micronutrients required for boosting immunity. The present article focuses on the biofunctional properties of traditional Indian fermented milk foods which have the capability of enhancing immunity of the body. It also explores the way to fight against the SARS-COV2 virus by marinating proper immunity with simple available resources found in traditional Indian fermented milk foods. © 2021, Narendra Publishing House, Delhi, India.

China-plus-one: expanding global value chains

Purpose: China has emerged as an undisputed leader of global business and as a preferred hub for global value chains. However, recent threats of the trade war, the allegation of violation of intellectual property rights and more recently the COVID-19 pandemic seemed to have dampened China’s attractiveness. Multinational corporations may be contemplating diversifying their dependence on China – a strategy known as “China-Plus-One”. What could be possible destinations in Asia for such a diversification strategy? Design/methodology/approach: Towards understanding the “China-Plus-One” phenomenon, the authors use a methodology of arriving at an aggregate ranking of the major economies of emerging Asia. This is built on a few standard indices such as World Bank's Logistic Performance Index;World Bank’s Ease of Doing Business Indicator;World Economic Forum’s Global Competitiveness Index;Economic Complexity Index of the Harvard University;Economist Magazine’s Country Rating of Financial Strength;and Corruption Perception Index compiled by the Transparency International. Accordingly, the authors rank seven countries (namely, Thailand, Malaysia, India, Vietnam, Indonesia, the Philippines and Bangladesh) next to China as possible destinations for selecting the “Plus one” country. Findings: In the aggregate ranking, China ranks first followed by Thailand, Malaysia, Philippines, India, Indonesia, Vietnam and then Bangladesh. This sequence gives some pointers on the possible shifts from China as potential hubs of global value chains. The authors observe the following: first, it is challenging to move away from China in the short run;second, corporations could pursue a “China-plus-One” strategy, whereby they may move marginally from China and relocate part of their supply chain elsewhere;third, in looking for alternative locations, corporations may look for the following countries in emerging Asia, namely, Thailand, Malaysia, India, Vietnam, Indonesia, Philippines and Bangladesh. Originality/value: The aggregate ranking method applied in this paper is one of the first applications in the context of ranking developing Asian economies based on economic, logistics, supply chain, financial and corruption metrics. It is one of the first conceptual works in the domain of identifying possible diversification options for the “China-Plus-One” strategy that can be extended to include many context-specific rankings. © 2021, Emerald Publishing Limited.

Safety and Efficacy of NVX-CoV2373 Covid-19 Vaccine.

BACKGROUND: Early clinical data from studies of the NVX-CoV2373 vaccine (Novavax), a recombinant nanoparticle vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that contains the full-length spike glycoprotein of the prototype strain plus Matrix-M adjuvant, showed that the vaccine was safe and associated with a robust immune response in healthy adult participants. Additional data were needed regarding the efficacy, immunogenicity, and safety of this vaccine in a larger population. METHODS: In this phase 3, randomized, observer-blinded, placebo-controlled trial conducted at 33 sites in the United Kingdom, we assigned adults between the ages of 18 and 84 years in a 1:1 ratio to receive two intramuscular 5-µg doses of NVX-CoV2373 or placebo administered 21 days apart. The primary efficacy end point was virologically confirmed mild, moderate, or severe SARS-CoV-2 infection with an onset at least 7 days after the second injection in participants who were serologically negative at baseline. RESULTS: A total of 15,187 participants underwent randomization, and 14,039 were included in the per-protocol efficacy population. Of the participants, 27.9% were 65 years of age or older, and 44.6% had coexisting illnesses. Infections were reported in 10 participants in the vaccine group and in 96 in the placebo group, with a symptom onset of at least 7 days after the second injection, for a vaccine efficacy of 89.7% (95% confidence interval [CI], 80.2 to 94.6). No hospitalizations or deaths were reported among the 10 cases in the vaccine group. Five cases of severe infection were reported, all of which were in the placebo group. A post hoc analysis showed an efficacy of 86.3% (95% CI, 71.3 to 93.5) against the B.1.1.7 (or alpha) variant and 96.4% (95% CI, 73.8 to 99.5) against non-B.1.1.7 variants. Reactogenicity was generally mild and transient. The incidence of serious adverse events was low and similar in the two groups. CONCLUSIONS: A two-dose regimen of the NVX-CoV2373 vaccine administered to adult participants conferred 89.7% protection against SARS-CoV-2 infection and showed high efficacy against the B.1.1.7 variant. (Funded by Novavax; EudraCT number, 2020-004123-16.).