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This paper reports a study on the statistics for particulate matter pollution (PM2.5) and the COVID-19 lockdown in the Kathmandu valley. The PM2.5 decreased during the COVID-19 pandemic lockdown periods 2020 compared to the average value of the previous three years (2017, 2018, and 2019). Further, analysis of active fire and air mass trajectory for April and May in 2019 and 2020 shows that the particulate matter trend associated with Kathmandu is not directly influenced by the long-range transport of wind carrying aerosols from the active fire regions. Statistical tests indicate a reduction of particulate matter pollution during the period.
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Fertilizer is an essential commodity traded in international and domestic markets and spatial competition is important feature impacting interfirm rivalry. In the case of North American fertilizer, numerous plants have been announced to either expand or open new plants (nitrogen-based fertilizer plants), exerting competitive pressures on an industry with surplus capacity but highly competitive in terms of production costs and technology. Proposed new plants and expansions are being induced by changes in the composition of crops, changes in the price of natural gas which affects the cost of producing domestic anhydrous ammonia. Developments in the fertilizer industry have become more volatile in the post-COVID period, and concurrent with the escalation in fuel prices, the Ukraine invasion, related embargoes on Russian trade, the world's largest exporter, and operations of the Grain Corridor. The purpose of this study is to quantify risks for plant expansion (brownfield and greenfield) of nitrogen fertilizer plants in North America, given the spatial competition and the corresponding dynamic market boundaries. Specifically, we quantify risks associated with fertilizer plant expansions, identify the optimal locations of new plants, and characterize spatial competition as a result of new entrants. A model is specified that integrates Geographical Information Systems (GIS) data into a stochastic mixed-integer network spatial optimization model using Monte Carlo simulations to account for risk in the random variables. The results are reprocessed into GIS for interpretation. The impact of risk in these variables results in market boundaries that are random. Specifically, competition for these new plants has embedded risks for new entrants on the probability of production and market penetration. © 2023 The Author(s)
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Coronavirus disease-2019 (COVID-19), a global pandemic, has currently infected more than 247 million people around the world. Nowadays, several receptors of COVID-19 have been reported, and few of them are explored for drug discovery. New mutant strains of COVID-19 are emerging since the first outbreak of disease and causing significant morbidity and mortality across the world. Although, few drugs were approved for emergency uses, however, promising drug with well-proven clinical efficacy is yet to be discovered. Hence, researchers are continuously attempting to search for potential drug candidates targeting the well-established enzymatic targets of the virus. The present study aims to discover the antiviral compounds as potential inhibitors against the five targets in various stages of the SARS-CoV-2 life cycle, i.e., virus attachments (ACE2 and TMPRSS2), viral replication, and transcription (M-pro, PLpro and RdRp), using the most reliable molecular docking and molecular dynamics method. The ADMET study was then carried out to determine the pharmacokinetics and toxicity of several compounds with the best docking results. To provide a more effective mechanism for demonstrating protein-ligand interactions, molecular docking data were subjected to a molecular dynamic (MD) simulation at 300 K for 100 ns. In terms of structural stability, structure compactness, solvent accessible surface area, residue flexibility, and hydrogen bond interactions, the dynamic features of complexes have been compared.
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We examine to what extent relaxing occupational licensing results in labor mobility. For this, we consider the case of the Nurse Licensure Compact (NLC). NLC permits registered nurses and licensed practical/vocational nurses to have one multistate license enabling them to practice in their state of residency and other NLC states (compact states) without obtaining additional licenses. The nursing profession has led the way among the healthcare professions in establishing and implementing an interstate practice model, yet how it affects the mobility of practitioners remains unanswered. As of March 2021, 34 states are within the compact. We exploit the state-level staggered adoptions of compact and use the regression method to estimate the compacts’ impact on the mobility of registered nurses and licensed practical/vocational nurses. We find an 11% increment in the mobility of registered nurses and licensed practical/vocational nurses within the compact states. During the COVID-19 pandemic, among other policies, joining to compact may help relax the urgent needs of health care professionals. © 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
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Background: When the novel coronavirus - SARS-CoV-2 - started to spread globally, there was a call for social and behavioral scientists to conduct research to explore the wider socio-cultural contexts of coronavirus disease 2019 (COVID-19), to understand vulnerabilities, as well as to increase engagement within communities to facilitate adoption of public health measures. In this manuscript, we describe the protocol for a study conducted in Indonesia, Nepal, and Vietnam. In the study, we explore how the COVID-19 pandemic is affecting individuals and their communities. We focus on the wider health and economic impacts of COVID-19, in particular emerging and increased burden on mental health, as well as new or deepened vulnerabilities in the communities. The introduction of vaccines has added another layer of complexity and highlights differences in acceptance and inequalities around access.
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Introduction: Coronavirus disease associated mucormycosis (CAM), perturbed a lot by reaching to epidemic proportions particularly during the second wave of the pandemic. Material and Methods: This was a retrospective, observational study of patients with COVID-19-associated mucomycosis admitted in April-May 2021 at a tertiary care teaching hospital. Demographic profile, clinical and laboratory parameters were recorded Multidisciplinary treatment including antifungals and surgical interventions were noted. Results: This study included 98patients of mucormycosis, diagnosed on the basis of clinical and radiological findings and later were confirmed by microbiological investigations. Out of 98 patients, 72 had rhino orbital, 24 had rhino-orbitalcerebral and 2 had pulmonary mucormycosis. Twelve had coinfection of covid 19 while 86 had developed mucormycosis within 3 weeks. Conclusion: CAM has posed as a continuum of challenges faced during the pandemic of covid 19. This rare and life threatening complication requires high index of suspicion for early diagnosis. Multidisciplinary involvement and timely interventions including antifungal pharmacotherapy, stringent glycemic control and surgical debridement can reduce the mortality. Mucormycosis is uniformly associated with low iron levels but role of zinc needs to be further studied. © 2022 Journal of Association of Physicians of India. All rights reserved.
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Background: The long-term effects of COVID on the lungs remain unclear, but, given the extent of the pandemic, it has the potential to become a significant chronic global health problem .Aim of our study was to ascertain the proportion of patients with moderate to severe pneumonia but without mechanical ventilation who have compromised exercise capacity, pulmonary function test and presence of radiological abnormalities and to study any correlation between clinical features with radiological abnormalities. Methods: In a hospital-based study, COVID-19 patients with moderate and severe pneumonia were followed 3 months after discharge and assessed with chest computed tomography (CT) imaging, 6 minute walk test and pulmonary function tests. Results: A total of 102 participants were enrolled, including64 patients who had recovered from moderate disease and 38 patients from severe COVID-19. The patients with critical disease and who required mechanical ventilation or who had previously known chronic lung disease were excluded. High proportion of patients of both groups showed radiological abnormalities and deranged pulmonary function tests 3 months after recovery from acute illness which had significant correlation with severity of disease. Conclusions: Pulmonary function and radiological abnormalities remained in significant propotion of patients 3 months after recovery from COVID-19 that needs more attention on pulmonary rehabilitation and long term follow up of these patients. © 2021 Journal of Association of Physicians of India. All rights reserved.
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Introduction: Coronavirus Disease-2019 (COVID-19) is caused by the Severe Acute Respiratory Coronavirus-2 (SARS-CoV-2) which is an enveloped positive-sense single-stranded RNA virus. Initial steps of the infection involve binding of the spike protein(S) of the virus to Angiotensin Converting Enzyme-2 (ACE-2) receptor on the mucosal surfaces of various organs like lungs, kidney, heart, intestine. Pathogenesis of complications are still poorly understood. Aim: This study was designed to find out the baseline biochemical parameters at the time of admission which may predict outcome in COVID-19 patients. Materials and Methods: This observational study was conducted in a dedicated COVID-19 hospital, Dr. Ram Manohar Lohia Institute of Medical Sciences (Dr. RMLIMS), Lucknow, Uttar Pradesh, India, from 1st July, 2020 to 30th November, 2020 . A total of 109 moderate to severe COVID-19 pneumonia patients who required Intensive Care Unit (ICU) admission, were enrolled. Based on their outcome, patients were divided into two groups: “Survived” and “Expired”. Biochemical characteristics of patients were compared among the two groups using univariate and multivariate analysis. Results: On Univariate analysis Coagulation profile, Prothrombin Time (PT), International Normalised Ratio (INR), Activated Partial Thromboplastin Time (APTT) and D-Dimer vales were raised significantly in the expired group. Among other acute phase reactants Lactate Dehydrogenase (LDH), C-Reactive Protein (CRP), Interleukin-6 (IL-6), and Creatinine Phosphokinase-MB (CPKMB) were raised in expired group and this difference was significant statistically too. On Multivariate analysis among all acute phase reactant only IL-6 was increased significantly. All other variables were found to be non-significantly associated with mortality, statistically (p-value<0.05). Conclusion: Baseline biochemical parameters have prognostic values in COVID-19 patients. Raised IL-6 levels can be viewed as an independent predictor of mortality among COVID-19 patients at the time of admission in ICU.
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Introduction: Coronavirus Disease-2019 (COVID-19) has been a major cause of apprehension, morbidity, and mortality in 2020. It had been postulated that associated co-morbid conditions in COVID-19 patients increase the severity of COVID-19 which leads to six times more chances of hospitalisation than patients without co-morbid condition. Mortality is also 12 times higher in such patients. Aim: To find out the association between co-morbidities and mortalities due to COVID-19 pneumonia. Materials and Methods: A prospective, observational study was conducted in a tertiary teaching institute of North India which was designated Level 3 (L-3) facility for treatment of COVID-19 patients. All 109 COVID-19 patients confirmed by Reverse Transcriptase - Polymerase Chain Reaction(RT-PCR), admitted in Intensive Care Unit (ICU) from 1st July 2020 to 30th November 2020 formed the sample of the study. Data were taken regarding past history, clinical histories and examinations and ICU care and treatments. Based on their final outcome at the end of ICU care, patients were divided into 2 groups-group 1 (Non-survivor or Expired) and group 2 (Survived) and intergroup differences were studied. results: COVID-19 infection was about three times more common in males. Severe category of COVID-19 patients had higher mortality (59.2 % of severe category expired during hospital course, 1.7% patients expired in moderate category group). Most common co-morbidities were hypertension (n=48, 46.8%) and diabetes (n=51, 44%). Multivariate analysis showed that co-morbidities in the form of chronic liver disease (OR -0.127(0.024-0.681, p-value 0.016)) and post tubercular sequel (OR 0.036(0.003-0.442, p-value 0.009)) were less likely to occur in COVID-19 patients who survived, thus making these co-morbidities significant contributor to the adverse outcomes in COVID-19 patients. More number of co-morbidities in a patient were associated with higher chance of mortality and this trend was significant statistically (p-value<0.001). conclusion: Patients with multiple co-morbidities, chronic liver disease and post tubercular sequel were associated with higher mortality in COVID-19 patients.
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Introduction: Severe acute respiratory syndrome coronavirus 2 has caused a worldwide pandemic. This study was aimed to describe the clinico-demographic, hematological, and comorbidity profile in a group of coronavirus disease 2019 (COVID-19) patients at a tertiary care center in north India. Materials and Methods: We conducted a prospective, single-center collection of data regarding clinico-epidemiological, hematological parameters, and comorbidity profile of COVID-19 patients admitted at a tertiary care facility. Results: Data from 200 patients with COVID-19 were collected and analyzed. The median age of the patients was 48 years, with 63% males, and 78% patients were from urban area. Ten patients were smokers while 11 patients were alcoholic. The occupation of 20.6% of patients was related directly or indirectly with medical or allied professions. The most common mode of transmission of COVID-19 was direct close contact with microbiologically confirmed patients. Fever (n = 93;46.5%) was the most common presenting symptom and the median duration of onset of symptoms before admission were 3.5 days (range 2-6 days). In hematological profile, lymphopenia (n = 48;24%) had been the most common documented finding. Comorbidities were present in 39 (19.5%) patients, of which diabetes mellitus (n = 25;12.5%) was the most common. Furthermore, the case fatality rate in our study was 1.5%. Conclusion: Among all patients of COVID-19 at our center, the characteristic findings included high proportion of male patients with younger to middle-age group, diabetes as most common comorbidity and people who were directly or indirectly in contact with the health-care system were more prone for developing the disease.