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Coronaviruses is a broad group of viruses that has the potential to cause mild or severe respiratory infections. Currently, there is no specific treatment for the treatment of COVID-19. The symptomatic treatment is generally given on case-to-case basis along with basic life supportive measures for management of COVID-19. There is an acute urgency of evaluating the pre-existing drugs to develop a convincing treatment for COVID-19 or at least to reduce its severity. 2-DG being inhibitor of both glycolysis and glycosylation appears as a promising therapeutic option. In the present chapter, the rationale of repurposing of 2-DG as a potential treatment option for the management of COVID-19 has been discussed. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2023.
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Introduction: During the different wave of pandemic, due to various reasons self-medication practices among the public increased. Medical students are prone to such practices due to relevant background knowledge, and access to drugs. This study assessed the self-medication practice among the medial students during the different waves of pandemic of south Gujarat. Material and Methods: This descriptive study was conducted during May to June 2022 through self-administered form among medical students of south Gujarat, India. Study questionnaire included general de-mography;most frequently practice of self-medication. drug and the reason behind it. Result: Out of total 512 respondents, 381 (74.4%) did self-medication during the pandemic. 358 individuals (94.0%) did self-medication at least one drug since the start of pandemic. The most commonly utilizing medi-cines as prophylactic was Ayurvedic preparation, Multivitamins, Zinc and Vitamin C. For treatment of symptoms during the pandemic paracetamol (650 mg) was frequently used specially for body ache and fever. The main source of information of self-medication was internet. Conclusion: This study depicted common self-medication practices among medical students during the pan-demic. It is a significant health issue especially during the pandemic times, with high consumption reported as a prevention or treating symptoms of COVID-19. © 2023, MedSci Publications. All rights reserved.
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Background: During COVID-19 pandemic, education of children was continued in online mode for an extended period of time. Research from India in the beginning of pandemic indicated that teachers faced numerous challenges while adapting to this new mode of teaching. However, no prior study from India evaluated perspective of teachers regarding online classes and their psychosocial well-being during school reopening phase, which started in Feb 2022. During this period both online and offline classes were being conducted and thus presented the opportunity for better comparison of effects of both systems. Schools still revert to online mode of teaching periodically, but it remains to be seen if it benefits the teachers and students. Methods: It was a cross-sectional online survey-based study. Self-designed questionnaires assessing perspectives of teachers regarding online classes and psychosocial impact were administered. Depression, Anxiety, and Stress Scale-21 was used to measure psychological distress. Results: N = 708 school teachers participated in this survey. A total of 96% of them preferred offline mode of teaching. Several disadvantages of online classes were listed such as connectivity issues, poor interaction with students, poor concentration, and knowledge transfer. Due to online classes, most of them reported increase in working hours, and decrease in leisure time and quality of life. The teachers who conducted online classes (either alone or combined with offline classes), who were employed in private schools and those with lesser family income, had significantly higher psychological distress. Conclusion: According to school teachers, online classes carried many disadvantages. Online classes also decreased the psychosocial well-being of teachers.
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Background: COVID-19 infection is a disease caused by severe acute respiratory syndrome coronavirus 2. The manifestations, effects, and severity of the infection are varied in different waves, especially during pregnancy. Material(s) and Method(s): The study was conducted in two equal time periods during the first and second waves. During the first wave, the period of study was between June and August 2020 corresponding to the peak of the first wave, and in the second wave, the study period was between May and July 2021 corresponding to the peak of the second wave. Result(s): A total of 3,791 pregnant women was screened for COVID-19 infection during the first wave and second wave, the pregnant mothers with COVID-19 positive were 4.2 (n = 163) and 5.1% (n = 191), respectively. Around 60% were antenatal mothers and 37% were postnatal mothers who were COVID-19-positive. The predominant age group affected was between 20 and 25 years of age. Gestational diabetes mellitus (GDM), gestational hypertension, anemia, previous lower segment cesarean section (LSCS), postdated pregnancy, and past history of infertility were the high-risk factors observed during the study. Hypoxia was observed in 15% of patients in the second wave. About 49.7% (n = 95) of the COVID-19-positive mothers in the second wave required steroids, anticoagulants, and antiviral drugs. Conclusion(s): The incidence of COVID-19 infection was mild and asymptomatic during the first wave and symptomatic as well as with complications during the second wave. The disease severity, intensive care unit (ICU) admissions, duration of stay, LSCS delivery, and need for antivirals, anticoagulants, and steroids were more during the second wave of COVID-19.Copyright © The Author(s). 2023.
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IoT seems to be the trending solution in all sectors notably because of the yield in productivity, efficiency, effective strategies, and results that are associated with adapting to this technology. These positive results are enormously experienced in one of the crucial sectors which determine and ensure the prolonged healthy life expectancy of mankind. It is well noted that a lot of work has been done on this topic in Academia and Corporate field all over the world but this paper will present a selective review that has been done so far by the Academic world as a scholarly article and a resource for the Health Sector in Fiji to earnestly integrate smart technologies in its architecture. © 2022 IEEE.
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During this pandemic outbreak of COVID-19, the whole world is getting severely affected in respect of population health and economy. This novel virus has brought the whole world including the most developed countries to a standstill in a very short span like never before. The prime reason for this unexpected outburst of COVID-19 is lack of effective medicine and lack of proper understanding of the influencing factors. Here, the authors aim to find the effect of epidemiological factors that influence its spread using a fuzzy approach. For the same, a total of nine factors have been considered which are classified into risk and preventive factors. This fuzzy model supports to understand and evaluate the impact of these factors on the spread of COVID-19. Also, the model establishes a basis for understanding the effect of risk factors on preventive factors and vice versa. It is worth mentioning that this is the first attempt to analyze the effect of clinical and epidemiological factors with respect to COVID-19 using a fuzzy approach.
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Virtual digital assets including cryptocurrencies, non-fungible tokens and decentralized financial asset have been initially used as an alternative currency but are currently being purchased as an asset and hedging instruments. Exponentially growing trading volume witnesses the growing inclination of investors towards these assets, and this calls for volatility analysis of these assets. In this reference, the present study assessed and compared the volatility of returns from investment in virtual digital assets, equity and commodity market. Daily closing prices of selected cryptocurrencies, non-fungible tokens and decentralized financial assets, stock indices and commodities have been analysed forthe post-covid period. Since returns were observed to be heteroscedastic, autoregressive conditional heteroscedastic models have been used to assess the volatility. The results indicate a low correlation of commodity investment with all other investment opportunities. Also, Tether and Dai have been observed to be negatively correlated with stock market. This indicates the possibility of minimizing risk through portfolio diversification. In terms of average returns, virtual digital assets are discerned to be better options than equity stock or commodity yet the variance scenario of these investment avenues is not very rosy. The volatility parameters reveal that unlike commodity market, virtual digital assets have got a significant impact of external shocks in the short-run. Further, the long run persistency of shocks is observed to be higher for the UK stock market, followed by Ethereum, Tether and Dai. The present analysis is crucial as the decision about its acceptance as legal tender money is still sub-judice in some countries. The results are expected to provide insight to regulatory bodies about these assets. © Author(s) 2022.
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COVID-19 brought substantial shifts in market dynamics and consumer behaviour. It drove enterprises to innovate and alter their business models, culminating in the emergence of the dynamic eCommerce model, often known as D2C. Direct-to-consumer (D2C) businesses such as Made.com, Typology, Patch Plants, and Glossier flourished well in 2021, with an average growth rate of 19.2%. Additionally, Indian D2C startups such as boAt, Mamaearth, Wakefit, and Country Delight have earned approximately Rs. 100 crores revenue in a relatively short time, with an estimate of the Indian D2C industry to expand up to $100 billion by 2027 based on the current trend. Thus, this chapter seeks to comprehend the D2C model, its benefits, obstacles, and a viable approach for adopting the D2C model in light of the shifting competitive landscape and favorable environment for online purchases. © 2023 by IGI Global. All rights reserved.
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Abstract: COVID 19 pandemic is one of the biggest challenge to health system of developing as well as developed countries. Because of the novelty of the virus, limited data were available regarding perinatal outcome. The objective of this study is to find out the perinatal outcome in COVID-19 infected mothers who delivered during COVID Pandemic. Methodology: A cross sectional study was carried out at PCMC'S Post-Graduate Institute and YCM Hospital Pune (Maharashtra) from 1 May 2020 to 31 October 2021 which was a dedicated COVID hospital during COVID pandemic. A total of 362 maternity patients (including 5 twin pregnancies) having COVID 19 infection who gave birth to 367 Newborns were studied. Maternal COVID -19 infection was diagnosed either by RTPCR test or Rapid Antigen test. Demographic variables, maternal symptoms, labour and neonatal outcome were recorded. RT PCR of neonates at birth was performed. Data was analyzed statistically by using Epi Info Software. Aim: To analyze the perinatal outcome among COVID-19 infected mothers who delivered during Covid pandemic. Objectives: Study was conducted with the primary objective to analyze the labour outcome, maternal symptoms and secondarily to study maternal demographic profile and to compare disease severity during 1st and 2nd wave of COVID and to detect possibility of vertical transmission of COVID-19 in neonates of covid positive mothers. Results: 74.2% patients from young reproductive age (21-30 years age) were affected. All socioeconomic classes were affected. 61% patients were multigravida. Normal BMI was noted in 49.8%. 28.2% deliveries were preterm. Caesarean section rate was 50.5%. Following obstetric high risk factors were noted-anaemia in 34.2% followed by previous LSCS in 26.2% cases and preeclampsia in 18.7%Overall 54.6% patients were asymptomatic while 45.4% were symptomatic. Symptomatology between 1st and 2nd wave showed statistical significance (p value < .05%) for mild, moderate and severe symptoms. Myalgia, cough, fever and fatigue were common presenting symptoms. 14% patients required ICU/HDU care. HDU/ICU requirement showed statistical significance (p value < .05) between 1st and 2nd wave. Overall maternal mortality was 1.1% (4 maternal deaths in 2nd wave) with no mortality in 1st wave.96.4% were live births. Birth weight was more than 2.5 kg in 62% cases and 21.3% cases required NICU. Vertical transmission of COVID was seen in 1.1% cases. Conclusion: Pregnant patients with moderate and severe disease are at higher risk of perinatal complications. ICU/HDU management with multidisciplinary management may reduce morbidity and mortality. Neonatal affection due to COVID may not be severe but may increase prematurity due to iatrogenic intervention.
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Background: Mammographic screening programmes reduce breast cancer mortality, but detect many small tumours with favourable biological features which may not progress during a woman's lifetime. Screen-detected cancers are treated with standard surgery and adjuvant therapies, with associated morbidities. There is a need to reduce overtreatment of good prognosis tumours and numerous studies have evaluated the omission of radiotherapy in this context. However, there is little evidence to support surgical de-escalation, although percutaneous minimally invasive treatment approaches have been described. Vacuum-assisted excision (VAE) is in widespread use for management of benign lesions and lesions of uncertain malignant potential. SMALL (ISRCTN 12240119) is designed to determine the feasibility of using this approach for treatment of small invasive tumours detected within the UK NHS Breast Screening Programme (BSP). Method(s): SMALL is a phase III multicentre randomised trial comparing standard surgery with VAE for screendetected good prognosis cancers. The main eligibility criteria are age >=47 years, unifocal grade 1 tumours with maximum diameter 15mm, which are strongly ER/PR+ve and HER2-ve, with negative clinical/radiological axillary staging. Patients are randomised 2:1 in favour of VAE or surgery;with no axillary surgery in the VAE arm. Completeness of excision is assessed radiologically, and if excision is incomplete, patients undergo open surgery. Adjuvant radiotherapy and endocrine therapy are mandated in the VAE arm but may be omitted following surgery. Co-primary end-points are: 1. Noninferiority comparison of the requirement for a second procedure following excision 2. Single arm analysis of local recurrence (LR) at 5 years following VAE Recruitment of 800 patients will permit demonstration of 10% non-inferiority of VAE for requirement of a second procedure. This ensures sufficient patients for single arm analysis of LR rates, where expected LR free survival is 99% at 5 years, with an undesirable survival probability after VAE of 97%. To ensure that the trial as a whole only has 5% alpha, the significance level for each co-primary outcome is set at 2.5% with 90% power. The Data Monitoring Committee will monitor LR events to ensure these do not exceed 3% per year. Secondary outcome measures include time to ipsilateral recurrence, overall survival, complications, quality of life and health economic analysis. A novel feature of SMALL is the integration of a QuinteT Recruitment Intervention (QRI), which aims to optimise recruitment to the study. Recruitment challenges are identified by analysing recruiter/patient interviews and audiorecordings of trial discussions, and by review of trial screening logs, eligibility and recruitment data and study documentation. Solutions to address these are developed collaboratively, including individual/group recruiter feedback and recruitment tips documents. Result(s): SMALL opened in December 2019, but recruitment halted in 2020 for 5 months due to COVID-19. At 7st July 2022, 142 patients had been randomised from 26 centres, with a randomisation rate of approximately 45%, and a per site recruitment rate of 0.4-0.5 patients/month, approaching the feasibility recruitment target of 144 patients. Drawing from preliminary QRI findings and insights from patient representatives, a recruitment tips document has been circulated (on providing balanced information about treatments, encouraging recruiters to engage with patient preferences, and explaining randomisation). Individual recruiter feedback has commenced, with wider feedback delivered across sites via recruitment training workshops. Conclusion(s): Despite pandemic-related challenges, SMALL has an excellent recruitment rate to date and is expected to have a global impact on treatment of breast cancer within mammographic screening programmes.
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Introduction: COVID-19 disease is caused by SARS COV-2 virus. Though it primarily affects the lower respiratory tract, reports have indicated that specific cutaneous manifestations are associated with COVID-19. Objective(s): To evaluate the persistent dermatologic long term sequelae of SARS-CoV-2 infection, among recovered COVID-19 infected patients. Method(s): Baseline data were retrospectively collected from patient's medical records from the department of dermatology over 1 year (January 2021-January 2022), at a designated tertiary care centre. The demographic data, severity of COVID disease, and pre-existing cutaneous and systemic co-morbidities were noted. Dermatologic, hair and nail manifestations were recorded. The results were statistically analyzed. Result(s): Record of total 972 patients were analyzed in our study, with 432 males and 340 females. Out of these, 88 cases (9.05%) had skin manifestations, of which 35 (39.77%) were male, and 53 (60.22%) were females. About 50% of cases experienced long term skin diseases after 6 months of the recovery. The majority, 47 (53.4%) of patients with skin manifestations, were in the age group of 30-50 years, followed by 31 (35.22 %) of patients in the 50 years age and above group. Urticaria and Pruritus were the most common manifestations 26 (29.5%), followed by telogen effluvium 24 (27.7%), herpes zoster 16(18.1%), pityriasis rosea, acneform eruptions, acral erythema, irritant contact dermatitis, palmar keratoderma, aphthous ulcer with lip crackling, eruptive pseudo angiomatosis, aquagenic keratoderma, and others. Conclusion(s): Prevalence of cutaneous, hair and nail manifestations among COVID-19 patients was 88 (9.05%) in our study. More extensive research is required to establish our knowledge on the relation between skin and COVID-19.Copyright © 2023, Dr Yashwant Research Labs Pvt Ltd. All rights reserved.
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Natural products are versatile moiety in the drug discovery and development, however, their synthesis being one of the major challenges in this field. In this regard, an environment friendly synthesis of 1-benzoyl-9H-pyrido[3,4-b] indole-3-carboxamide β-carboline derivatives has been reported via Pictet-Spengler reaction of tryptophan methyl ester with 2-oxoaldehydes in water as solvent. Natural products Stellarines A and Stellarines B having anti-inflammatory activity against iNOS inhibition (IC50 value of 19.3 and 18.6 μM) isolated from the root of Stellaria dichotoma L. var. lanceolata Bunge were also synthesized from β-carboline derivatives using amidation followed by Buchwald coupling. The synthetic strategy has advantage of using non toxic and inexpensive materials for producing excellent yields. These functionalized β-carboline carboxamide derivatives have been evaluated against SARS-CoV-2 Mpro(7BQY) using molecular docking studies. © 2023 Wiley-VCH GmbH.
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Introduction: Lung Ultrasound (LUS) can track interstitial changes of COVID-19 pneumonia (CP) in the acute phase. CT has been used to evaluate the development of lung fibrosis post CP but its use is associated with increased ionising radiation. Aims and Objectives: We conducted a prospective single-centre pilot to assess the utility and feasibility of using serial LUS in adult patients recovering from CP. We hypothesize that LUS may provide a safe and acceptable alternative to CT imaging for the outpatient follow-up of these patients. Method(s): 21 subjects provided consent on the day of hospital discharge (D0) and were followed up for 83 days. High-resolution CT was performed on Day 83 and correlated with LUS on Days 0/41/83. Serum Ferritin, LDH, CRP, D-Dimer (Days 0/41/83), Spirometry (Day 41/83) and Quality of Life measures (EQ-5D Day 41/83) were obtained. 3 clinicians reviewed and scored the LUS images independently;CT scoring was performed by 2 thoracic radiologists blinded to the LUS findings. Result(s): 19 subjects completed the study (10 males [52%];mean age: 52 years [range:37-74]). LUS scores were significantly lower at Days 83 and 41 compared to Day 0 (Mean = 1.5 [D83] / 2.8 [D41] / 10.9 [D0] p<0.0001). Ground glass change was the most common finding on CT at Day 83. Correlation between LUS with HRCT at Day 83 was weak (Pearson r2=0.44). However a better correlation was observed in % change of LUS scores and KCO at Day 84 compared to Day 42 (r2=0.64). Conclusion(s): LUS may be a useful point of care tool for the assessment of patients recently recovered from CP. However its role in the evaluation of post CP lung fibrosis requires further study.
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The early detection and treatment of COVID-19 infection are necessary to save human life. The study aims to propose a time-efficient and accurate method to classify lung infected images by COVID-19 and viral pneumonia using chest X-ray. The proposed classifier applies end-to-end training approach to classify the images of the set of normal, viral pneumonia and COVID-19-infected images. The features of the two infected classes were precisely captured by the extractor path and transferred to the constructor path for precise classification. The classifier accurately reconstructed the classes using the indices and the feature maps. For firm confirmation of the classification results, we used the Matthews correlation coefficient (MCC) along with accuracy and F1 scores (1 and 0.5). The classification accuracy of the COVID-19 class achieved was about (97 +/- 0.03)% with MCC score (0.9151 +/- 0.002). The classifier is distinguished with great precision between the two nearly correlated infectious classes (COVID-19 and viral pneumonia). The statistical test suggests that the obtained results are statistically significant as p < 0.05. The proposed method can save time in the diagnosis of lung infections and can help in reducing the burden on the medical system in the time of the pandemic. Copyright © 2023 National Taiwan University. National Taiwan University.
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During the time of COVID-19, the growth of the Hotels and Restaurants (H&Rs) sector fall down throughout the world. The overall performance of this sector falls during this challenging time. Therefore, this sector has to adopt new strategies to make the best use of the opportunities and counter the challenges in this crucial time. One of these challenges is how to assess the performance of H&Rs based on multiple criteria. Keeping this in view, this paper attempts to evaluate the efficiency of 45 large-scale H&R companies operating in India using the data envelopment analysis (DEA) technique. DEA-based CCR and BCC models are employed to evaluate the efficiency on the bases of recyclable input and output variables. The study is carried out with four input and two output variables. On an average, 78.30% H&Rs are found to be technically efficient (TE) which suggests a possible improvement of 21.70%. The stability of results is also carried out using recyclable input and output that suggest the importance of the used variables for the overall improvement of the efficiency of the deployed H&Rs. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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Background: Elevated Faecal Calprotectin (FCP) is established as a valuable tool in differentiating Inflammatory Bowel Disease (IBD) from Irritable bowel syndrome (IBS) and monitoring IBD activity. Initial implementation studies in the UK demonstrated benefit from repeat testing to exclude false positives. This is not currently mandated by IBD consensus guidelines. Growing waiting times are increasing pressure to include a single result in straight to test pathways. No one level for significant elevation is defined with levels between 100-250ug/g used We present our experience of the real-world utility of FCP used in a primary care referral pathway Methods: From Jan 2021-Nov 2022, new referrals were streamed into a rapid access 'Inception IBD' clinic on the basis of symptoms and raised FCP. A repeat FCP (kit sent in advance) was brought to the first appointment, with same day processing using the Buhlmann fCAL Turbo Test. Results and accompanying diagnosis and outcome data was collected prospectively. There was no standardised testing interval but median time from referral to review was 34 days Results: A single FCP was available for 425 patients with a final diagnosis Two pre-treatment FCPs were available in 185. Median initial FCP was 949ug/g in those subsequently diagnosed with IBD (Ulcerative colitis 1162ug/g, Crohn's 893ug/g) vs 353ug/g in those without IBD This difference heightened on retesting, with median FCP in IBD 749ug/g vs 34ug/g in non-IBD (Fig 1). FCP fell between 1st and 2nd measurement in 88.6% of patients who had IBD excluded In IBD, baseline FCP showed strong correlation with established disease activity markers (Fig 2) Baseline FCP levels were significantly higher in IBD patients who went on to require biologic treatment (Mann-Whitney U 2763, p<0.001) A variety of FCP cut-off values were assessed (Fig 4). A two sample >200ug/g cut off performed best as assessed by Area Under the Curve (AUC). However, sensitivity fell to 81.5% at this level Of 15 IBD patients who didn't have two FCPs >200ug/g, 7 had an increase between the 1st and 2nd FCP (median 147 vs 487ug/g). The remaining 8 comprised 4 ileal Crohn's, 3 mild proctitis and 1 stricturing colonic Crohn's in whom FCP failed to correlate with disease activity Overall, 83% (48/58) of patients with increasing 1st to 2nd FCP were diagnosed with IBD Conclusion(s): Our data supports repeat testing of FCP to avoid unnecessary investigations adding to post COVID endoscopy backlogs. A cut off of two values >200ug/g had the best overall performance but can miss a small number of IBD cases, particularly those with isolated ileal disease or a more indolent disease course. This cut off should not be used in those with a marked increase between 1st and 2nd result, where IBD is likely.
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To explore laryngeal function of tracheostomised patients with COVID-19 in the acute phase, to identify ways teams may facilitate and expedite tracheostomy weaning and rehabilitation of upper airway function. Consecutive tracheostomised patients underwent laryngeal examination during mechanical ventilation weaning. Primary outcomes included prevalence of upper aerodigestive oedema and airway protection during swallow, tracheostomy duration, ICU frailty scores, and oral intake type. Analyses included bivariate associations and exploratory multivariable regressions. 48 consecutive patients who underwent tracheostomy insertion as part of their respiratory wean following invasive ventilation in a single UK tertiary hospital were included. 21 (43.8%) had impaired airway protection on swallow (PAS ≥ 3) with 32 (66.7%) having marked airway oedema in at least one laryngeal area. Impaired airway protection was associated with longer total artificial airway duration (p = 0.008), longer tracheostomy tube duration (p = 0.007), multiple intubations (p = 0.006) and was associated with persistent ICU acquired weakness at ICU discharge (p = 0.03). Impaired airway protection was also an independent predictor for longer tracheostomy tube duration (p = 0.02, Beta 0.38, 95% CI 2.36 to 27.16). The majority of our study patients presented with complex laryngeal findings which were associated with impaired airway protection. We suggest a proactive standardized scoring and review protocol to manage this complex group of patients in order to maximize health outcomes and ICU resources. Early laryngeal assessment may facilitate weaning from invasive mechanical ventilation and liberation from tracheostomy, as well as practical and objective risk stratification for patients regarding decannulation and feeding.
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Introduction: Legionella pneumophila is an opportunistic pathogen that is a key contributor to drinking water-associated disease outbreaks in the United States. Prolonged water stagnation periods in building plumbing systems due to low occupancy, especially during building shutdowns, breaks, and holidays, can lead to water quality deterioration and (re)colonization of buildings with L. pneumophila. Water monitoring in buildings typically relies on grab samples with small datasets. Methods: In this study, a larger dataset was created by sampling a Leadership in Energy and Environmental Design (LEED)-certified data-rich commercial building for L. pneumophila and physical-chemical water quality during the COVID-19 pandemic after reduced building occupancy. A proxy for human occupancy rates using WIFI logins was recorded throughout the study period. Results: L. pneumophila was observed in grab samples taken throughout the building, where concentrations generally increased with greater distances from the building point of entry to locations throughout the building. Factors conducive to microbial growth were identified in the building including fluctuations in water temperatures, lack of chlorine residual, a low water heater setpoint, colonized water-saving fixtures, prolonged stagnation throughout the building;especially in an expansion tank designed to reduce pressure issues during demand fluctuations, and the presence of oversized softener tanks with ion exchange resin that contributed to chlorine residual removal as well as colonization of the resin with L. pneumophila. Discussion: Flushing and thermal disinfection alone did not resolve the problem, and replacement of the expansion tank ultimately resolved the L. pneumophila issue. As ad-hoc approaches are logistically- and time-intensive, more proactive approaches are needed for informing preventative and corrective actions for reducing the risk of exposure to opportunistic pathogens in the building plumbing. Copyright © 2023 Joshi, Richard, Levya, Harrison, Saetta, Sharma, Crane, Mushro, Dieter, Morgan, Heida, Welco, Boyer, Westerhoff and Hamilton.
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Coronavirus Disease 2019 is occurred as a challenging disease among the scientist worldwide. The disease is developed at an extensive level. Thus, the disease must be detected, reported, isolated, diagnosed and cured at initial phase for mitigating its growth rate. This research paper is conducted on the basisof predicting covid-19 ML algorithms. The methods of predicting this disease consist of diverse stages inwhich data is added as input, pre-processed, attributes are extracted and data is classified. This research work focuses on gathering the authentic dataset which get pre-processed for the classification. In the phase of feature extraction,PCA and k-mean algorithms are applied. The votingclassification method is applied in this work in which GNB, BNB, RF and Support Vector Machine algorithms are integrated. Python is executed to implement the introduced method. Diverse metrics are considered to analyze the outcomes. Using supervised machine learning, we create this model. The branch of ML focuses on implementing intelligent models so that various complicated issues can be tackled. The introduced method offers higher accuracy, precisionand recall in comparison with other classifiers. © 2022 IEEE.