Characterizing the Entities in Harmful Memes: Who is the Hero, the Villain, the Victim?

Memes can sway people's opinions over social media as they combine visual and textual information in an easy-to-consume manner. Since memes instantly turn viral, it becomes crucial to infer their intent and potentially associated harmfulness to take timely measures as needed. A common problem associated with meme comprehension lies in detecting the entities referenced and characterizing the role of each of these entities. Here, we aim to understand whether the meme glorifies, vilifies, or victimizes each entity it refers to. To this end, we address the task of role identification of entities in harmful memes, i.e., detecting who is the 'hero', the 'villain', and the 'victim' in the meme, if any. We utilize HVVMemes - a memes dataset on US Politics and Covid-19 memes, released recently as part of the CONSTRAINT@ACL-2022 shared-task. It contains memes, entities referenced, and their associated roles: hero, villain, victim, and other. We further design VECTOR (Visual-semantic role dEteCToR), a robust multi-modal framework for the task, which integrates entity-based contextual information in the multi-modal representation and compare it to several standard unimodal (text-only or image-only) or multi-modal (image+text) models. Our experimental results show that our proposed model achieves an improvement of 4% over the best baseline and 1% over the best competing stand-alone submission from the shared-task. Besides divulging an extensive experimental setup with comparative analyses, we finally highlight the challenges encountered in addressing the complex task of semantic role labeling within memes. © 2023 Association for Computational Linguistics.

Repurposing Methylene Blue for the Management of COVID-19: Prospects, Paradox, and Perspective

COVID-19 onslaught has led to widespread morbidity and mortality globally. Another major concern, especially in developing countries like India, has been the development of fungal superinfection and colonization of other pathogens in hospitalized COVID-19 patients. Even though an armamentarium of repurposed, antiviral, anticytokine, and antifungal drugs is available to manage the disease progression, no single drug and/or therapy has provided positive clinical outcomes with efficacy and affordability. Therefore, it is imperative to explore innovative approaches for standalone treatment and/or adjunct therapeutic regimes based on our current understanding of disease prognosis. Low-income and emerging economies have less resources to protect themselves against the COVID-19-induced health and economic crisis. With the continuously evolving nature of coronavirus, a cost-effective strain independent mechanism that could be delivered easily even in a nonhealthcare setting is an urgent need of the hour. Methylene blue appears an apt candidate as it is an FDA-approved safe drug that is economically viable and easily available. Since MB has a long-standing history of being used in clinical setup for diverse medical applications and possesses intrinsic anti-inflammatory, anticytokine, and antifungal properties, this study analyzes prospects of its use in the management of COVID-19. Paradox and prospects of MB applications for the management of COVID-19, with or without fungal superinfections, are also discussed. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2023.

SARS-CoV-2 infection disrupts trophoblast function and placental syncytial barrier integrity via its accessory protein, ORF3a

Problem: Although it is rare for a SARS-CoV-2 infection to transmit vertically to the fetus during pregnancy, there is a significantly increased risk of adverse pregnancy outcomes due to maternalCOVID- 19. However, there is a poor understanding of such risks because mechanistic studies on how SARS-CoV-2 infection disrupts placental homeostasis are significantly lacking. The SARS-CoV-2 proteome includes multiple structural and non-structural proteins, including the non-structural accessory proteinORF3a. The roles of these proteins in mediating placental infection remain undefined. We and others have shown that autophagy activity in placental syncytium is essential for barrier function and integrity. Here, we have used clinical samples and cultured trophoblast cells to evaluate syncytial integrity of placenta exposed to SARS-CoV-2. The objective of our study was to investigate potential mechanisms through which SARS-CoV-2 impairs placental homeostasis and causes adverse pregnancy outcomes. We tested the central hypothesis that an essential SARS-CoV-2 non-structural and accessory protein, ORF3a, uniquely (amongst multiple viral proteins tested) with a novel three-dimensional structure andwith no homology to any other proteins is a key modulator of placental trophoblast cell dynamics via autophagy and intracellular trafficking of a tight junction protein (TJP), ZO-1. Method(s): We used clinical samples and cultured trophoblast cells to evaluate syncytial integrity of placentas exposed to SARS-CoV- 2. Autophagic flux was measured in placental villous biopsies from SARS-CoV-2-exposed and unexposed pregnant women by quantifying the expression of autophagy markers, LC3 and P62. Trophoblast cells (JEG-3, Forskolin-treated JEG-3, HTR8/SVneo, or primary human trophoblasts (PHTs)) were transfected with expression plasmids encoding SARS-CoV-2 proteins including ORF3a. Using western blotting, multi-label immunofluorescence, and confocal imaging, we analyzed the effect of ORF3a on the autophagy, differentiation, invasion, and intracellular trafficking of ZO-1 in trophoblasts. Using coimmunoprecipitation assays, we tested ORF3a interactions with host proteins. t-tests and one-way analyses of variance (ANOVAs) with post hoc tests were used to assess the data, with significance set at P < .05. Result(s): We discovered :1) increased activation of autophagy, but incomplete processing of autophagosome-lysosomal degradation;2) accumulation of protein aggregates in placentas exposed to SARS-CoV- 2. Mechanistically, we showed that the SARS-CoV-2 ORF3a protein, uniquely 3) blocks the autophagy-lysosomal degradation process;4) inhibits maturation of cytotrophoblasts into syncytiotrophoblasts (STBs);5) reduces production ofHCG-beta, a key pregnancy hormone that is also essential for STB maturation;and 6) inhibits trophoblast invasive capacity. Furthermore, ORF3a harbors an intrinsically disordered C-terminus withPDZ-bindingmotifs.We show for the first time that, 7) ORF3a binds to and co-localizes with the PDZ domain of ZO-1, a junctional protein that is essential for STB maturation and the integrity of the placental barrier. Conclusion(s): Our work outlines a new molecular and cellular mechanism involving the SARS-CoV-2 accessory protein ORF3a that may drive the virus's ability to infect the placenta and damage placental syncytial integrity. This implies that the mechanisms facilitating viral maturation, such as the interaction of ORF3a with host factors, can be investigated for additional functionality and even targeted for developing new intervention strategies for treatment or prevention of SARS-CoV-2 infection at the maternal-fetal interface.

Global inequality and global crises: Past and present

The developed, developing, and least developed countries have been experiencing differing levels of inequality over the years. The economic and financial crises have also been aggravating the extent of inequality. The Sustainable Development Goal (SDG) 10 emphasizes reducing inequality that is prevalent within and amongst the countries. The COVID-19 pandemic is expected to reverse the progress made so far in reducing inequality. Hence, the average Gini coefficient is expected to increase by 6% for emerging and developing countries. Therefore, the present study aims to undertake an analysis of the impact of past crises and the current COVID-19 crisis on global inequalities. The world inequality database has been utilized for analyzing the impact. This study will certainly enable the policymakers to implement policies with the help of which the SDG 10 can ultimately be achieved by 2030. © 2022, IGI Global. All rights reserved.

Experiences of patients from minority ethnic backgrounds in the stem cell transplant pathway during COVID-19

Background: Stem cell transplantation is a potentially life-saving intervention for patients with blood cancer. Research suggests that there are existing disparities in access, care and treatment experiences, with patients identifying with a minority ethnic heritage reporting greater disadvantage compared to patients from white British, Irish or Northern European backgrounds. Although we know that the COVID-19 pandemic has been challenging for patients, less is known about the experiences of patients from specific ethnic communities. Method(s): In this research, we undertook 1-1, semi-structured interviews with eight patients within the stem cell transplant pathway who identify with a minority ethnic background. Interviews took place online, between May and November 2021. The interview questions explored views on aspects of the pandemic, including access and experience of care delivery, intervention, mental health and financial impact. Interviews were transcribed verbatim and analysed using reflexive thematic analysis. Result(s): The majority of patient participants were female (75%), and identified with a Black African or Caribbean heritage (75%). Four themes were identified from the data: (1) 'Lack of suitable donors' described the challenges of finding a stem cell donor and the importance of raising awareness of stem cell donation specifically within minority ethnic communities;(2) 'Experiences of care' explored patients' experiences of the healthcare system from pre-diagnosis to post-treatment, including how the COVID-19 pandemic had made some aspects of care easier but acted to disrupt others;(3) 'Intense and unpredictable process' described the nature of living with blood cancer and how this has impacted upon patients' lives including the extent to which they had been able to access and make use of advice to help keep them safe during the pandemic;and (4) 'Coping mechanisms' identified the factors which helped patients' to understand and adjust to living with their diagnosis and the treatment process. Conclusion(s): Patients in the stem cell transplant pathway often experience intense treatment regimens, debilitating symptoms and long hospital stays, which has a significant impact on their lives. Minority ethnic patients describe facing additional challenges in relation to health inequalities both within and outside of the pandemic. Seeking support from family, peers or community organisations can help buffer the negative impacts of living with blood cancer and multiple disadvantages, but such support was more difficult to access during the pandemic. This had psychological consequences for patients who are already within an intense emotional journey. Pandemic recovery plans should address mental health support as a priority.

Qualitative Analysis of Psychological Framework of Online Classes during Covid-19 using NVIVO

The purpose of this paper is to present the results of a study on whether or not online teaching-learning is a viable option for ensuring the quality of education in the future. The pandemic situation has brought major challenges to the educational institutions and institutions have to ensure that learning continues uninterrupted through virtual platforms using current technologies and tools. The theoretical framework for the survey is derived from secondary sources such as research papers, newspaper articles, and magazine articles on the topic. ProQuest and EBSCO were used for this. The study combines exploratory and descriptive methods. The paper shows that the future of the online education is not sustainable;it is just a situational arrangement and soon will be replaced by the old, traditional offline pattern, if the situation allows. © 2023, Rajarambapu Institute Of Technology. All rights reserved.

ID: 206479 An Evaluation of Psychological Wellbeing in Neuromodulation Patients During a Global Pandemic

Introduction: Bart's Neuromodulation Centre is a center of excellence for research and innovation. In the UK, the NICE 159 guidelines have highlighted the importance of psychological and multidisciplinary assessment to ascertain the suitability of patients for Neuromodulation. The global pandemic of Covid-19 has had far-reaching physical, psychological, and socioeconomic implications. Despite the various limitations of running services during a pandemic, Barts Neuromodulation Centre maintained the importance of multidisciplinary assessment in the selection of patients suitable for this form of therapy. This paper presents psychological wellbeing outcomes of neuromodulation patients during this unprecedented period. Method(s): Data collection was gathered remotely between January 2021 to December 2021.N=178 completed questionnaires. The mean age was 55 years and 63% were female. Data was collected at baseline and in addition, post-implant data was obtained at 1,3,6 and 12 month follow up. As per NHS England outpatient guidance (2020), all data was completed remotely. All collected data was anonymized and data was stored on an encrypted database. Result(s): Results showed a 78% decrease in depression scores from baseline to 2 years+ and a 76% decrease in anxiety scores from baseline to 2 years+. Conclusion(s): The data demonstrates significant improvements in psychological wellbeing as shown in depression and anxiety scores after SCS therapy. Despite the global pandemic, there remains a strong demand for SCS and encouragingly showed significant improvements in psychological wellbeing. It would be useful to explore ways to improve patient compliance and explore broader parameters of outcomes. Disclosure: Angie Alamgir, PHD: None, Serge Nikolic, MD: None, Habib Ellamushi: None, Amin Elyas, FRCS: None, Joanne Lascelles, Clinical nurse specialist: None, Kavita Poply, PHD: None, Sanskriti Sharma: None, Alia Ahmad, MSc: None, Vivek Mehta: NoneCopyright © 2023

ID: 218293 Real World Outcome Data in Pandemic: A Tertiary Care Neuromodulation Centre UK- 12 Months Data

Introduction: Covid-19 was classed as a global pandemic by the World Health Organization (WHO) in March 2020. This had an overwhelming effect on the National Health Services (NHS) in the United Kingdom resulting in the disruption and subsequent prioritization of the elective recovery services. Despite the various limitations of delivering services during a pandemic, Barts Neuromodulation Centre maintained the importance of multidisciplinary assessment in the selection of patients suitable for this form of therapy. We present the data on our continued activity through pandemic, dependent on the performance feasibility. The aim of this effectiveness project was to evaluate the post SCS outcome data during covid-19 pandemic. Method(s): This was a telephone and in person data collection of patient responses to standardized and validated pain outcome questionnaires following SCS implant performed at St Bartholomew's Hospital, London during January-December 2021. Data was collated from a tertiary Neuromodulation center at Barts Health NHS Trust, UK. Patients completed the questionnaires prior to SCS implant and post implant 1, 3, 6, and 12 month follow- up appointments with our neuromodulation specialists Results: Two hundred and fifteen patients underwent face to face or telephonic consultation during January to December 2021 for the follow ups. Total 178 patients registered their responses with F:M being 63%:37% and the average age 55 years. At each time point, the following number of patients completed: baseline n= 52;1 month n= 27;3 months n=28;6-month n= 21 and 12 months, n= 26. We demonstrate that NRS pain scores reduced by 43%, ODI disability improved by 35%, HADS anxiety reduced by 45%, depression reduced by 46%, PSQ sleep improved by 77% and EQ5D quality of life improved by 66% at 12 months when compared to baseline. There were no serious adverse events reported through this time. Conclusion(s): To our knowledge, this is one of the first reported real-world post SCS outcome data of prospective follow ups. We demonstrate safe delivery of services and data collection feasibility through pandemic. Moreover, our patient cohort showed improvement in the all dimensions of chronic refractory pain following SCS therapy despite clinical burden of COVID-19. Disclosure: Alia Ahmad: None, Angie Alamgir, PHD: None, Sanskriti Sharma: None, Joanne Lascelles, Clinical nurse specialist: None, Amin Elyas, FRCS: None, Helen Bonar: None, Serge Nikolic, MD: None, Habib Ellamushi: None, Vivek Mehta: None, Kavita Poply, PHD: NoneCopyright © 2023

Acknowledgment of patient in sense behaviors using bidirectional ConvLSTM

Recognizing patient activity in real-time from video or images collected by a CCTV camera available in the hospital during a Covid-19 situation has proven challenging. The dilemma of patient activity recognition is identifying and recognizing a patient's various actions in a series of videos. The process presented in our paper needs to achieve unrestricted, generic behavior in videos. Detecting events in any video is often difficult because we use Bidirectional ConvLSTM to create a robust patient in the sense behaviors (PSB) framework capable of eliminating certain barriers. To begin this paper by proposing a new Bidirectional ConvLSTM for establishing a stable PSB scheme. Our proposed model is capable of accurately predicting patient's behaviors like seated, standing, and so on. Using Bidirectional ConvLSTM, learning information from a pre-trained model is an excellent place to start for rapidly developing a new PSB system using a current PSB database, as both the source and target datasets are critical. All parameters are frozen in a pre-trained PSB device. Then, using the UCI and HMDB51 dataset to train the model, variables and local relations are progressively fixed. A novel PSB framework is developed using the target dataset. Relevant tests are conducted using commonly used research indices to assess prediction precision accuracy. They acknowledge six patient's behavior with a weighted accuracy rate of 92%. For recognizing novel activity, laying, the precision of a corresponding prediction is the best, 91%, of all six test results. The proposed work uses bidirectional ConvLSTM with modified activation layers to sense the patients' behavior. This article may be a patient activity recognition system to identify an individual. It takes a clip of COVID-19 patients as input and looks for matches inside the hold-on images.

Missed and Lost to Follow-up Cases in HIV Positive Patients and the Impact of Lockdown During COVID-19 Pandemic on Adherence to Anti-retroviral Therapy at ART Center, Jhansi, Uttar Pradesh

Background: Anti-retroviral therapy (ART) for HIV has changed a highly fatal disease to a chronic manageable condition. National technical guidelines by NACO say that adherence of >95%(optimal) is required for optimal viral load suppression which is a challenge both for the patient and the health system.Objectives: This study was conducted to determine the reasons for missed and lost to follow-up (LFU) cases and to assess the impact of the COVID pandemic on ART adherence.Settings and Design: Cross-sectional study conducted at ART center, Jhansi.Methods and Material: 357 patients were administered a self-designed questionnaire after taking informed consent to enquire about the reasons for missing doses and LFU and whether they missed treatment during the lockdown.Statistical analysis used: the results were expressed in frequencies and percentages and appropriate statistical tests were applied.Results: 72% HIV patients had optimal adherence and 6.7% were on second-line treatment. Out of 357 patients, 56 had missed treatment and 10 were LFU. The main reasons for the missing were run out of pills, busy with other things and being away from home. The number of episodes of missed and LFU increased during the pandemic. The main problems faced were lack of transport (24), fear of catching the disease (7), no money to hire a vehicle (5).Conclusions: Constant monitoring and handholding of those with suboptimal adherence is required. Travel allowance to such patients and regular counseling will help to ensure adherence. Long-term solutions include vocational rehabilitation and awareness programs to reduce stigma and discrimination.

Psychological Impact of E-Learning among Students: A Survey

Aim: This study is conducted to know the psychological impact of e learning among the students. Background(s): From the time of very first beginning of civilization to modern days before corona pandemic situation, most of the students of India are very much used to with the offline mode of learning. But now the situation is changed totally. They are getting themselves adapted to the online mode of learning as per need of time. In this changed scenario they are totally disconnected from their usual life with frames schools teachers and society. This situation wreaks havoc to their psychology. Methodology: This study is conducted with primary data in form of online survey. It was conducted with a pre formed questionnaire. 428 responses were collected for the present study. With advanced Excel software statistical analysis done. Outcome(s): Results show that students have shown negative impression on online learning and still they are not ready totally psychologically. Still positive answers show neck to neck result, which signifies increasing interest towards e learning. More practices and awareness required before further implementation.Copyright © 2020 Ubiquity Press. All rights reserved.

Bioinformatics in Diagnosis of COVID-19

Improved diagnostics aided by AI and bioinformatics tools are playing a significant role in contributing to the ongoing coronavirus disease 2019 (COVID-19) pandemic. These has also improved the understanding of virology of other infectious viral particles such as the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. The undying efforts of the scientific community of various streams including the medicine, biology, public health, bioinformatics, and computer science have resulted in the rapid development of several tools and techniques for diagnosis. These efforts have resulted in high-throughput technologies such as Next-Generation Sequencing for detecting the genome of SARS-CoV-2, databases storing SARS-CoV-2 genomes and variants, bioinformatics software tools, and databases to analyze and store host-virus interactions were developed. These developments have also led to giving an impetus to therapeutics action plans due to identification of COVID-19 biomarkers. This has also paved the path for bioinformatics strategies for drug repurposing to combat this dreadful infection. This chapter focuses on the various bioinformatics and computational tools developed and used in COVID diagnosis. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Healthcare Seeking Behaviour of Hospitalised COVID-19 Patients During Second Wave in Tertiary Care Hospital of Northern India

Background: The Coronavirus Disease (COVID-19) pandemic continues its deadly reign all over the world. Devising effective strategies for detecting and controlling the infection has become ever more critical. Effective prevention and control of the pandemic is entirely dependent on human behavior in terms of practicing preventive and curative measures. During the second wave of COVID-19, people's perceptions of preventive and curative measures changed.Objective: To study healthcare-seeking behavior of hospitalized COVID-19 patients.Methods: Hospitalized patients due to COVID-19 in the month of March, April and May of 2021 were included in the study. Their attendants/close relatives were contacted telephonically to know about the admitted patients' healthcare-seeking behavior. Verbal consent was taken from attendants before the commencement of the interview, followed by informing them about the purpose of the interview.Results: Amongst the subjects, there were more males than females (67.5 vs 32.4%), age ranged between 18 to 88 with a mean value of 56.61 +/- 14.7 years. Self-medication was significantly associated with study subjects' mortality (p=0.03).Conclusion: Elderly people were having higher mortality rate than their younger counterparts. People were hesitant to visit primary care physicians after having symptoms of COVID-19.

Haikou restaurant: the entrepreneur's dilemma in the new normal

Learning outcomes: The purpose of this paper is to understand a new restaurant venture's target segment and create a consumer profile for the new restaurant;to design a positioning statement for the new restaurant;to appraise the marketing strategy and suggest improvements in the marketing mix of a new restaurant venture in the new normal;to discuss the augmentation of services by a new restaurant to compete effectively in the market;and to identify and discuss the vital marketing steps for opening a restaurant in the new normal. Case overview/synopsis: Kelvin, an ambitious and budding restaurateur, had high aspirations with great plans. V café was his first running venture. The income from V café was not enough to improve his social position. He wanted to open a new restaurant (Haikou) and earn more. Kelvin was well aware of COVID-19's current condition and its severe implications for the restaurant business. He did not have any experience in marketing a restaurant. So he was puzzled about understanding the target segment, positioning and marketing mix of the proposed restaurant in the new normal. Complexity academic level: The case will cater to business management students pursuing a postgraduate management program. The case can be applied in Marketing Management, Entrepreneurship, Hospitality Management and Services Marketing courses. The prerequisite for this case is a basic understanding of marketing concepts. Supplementary materials: Supplementary materials teaching notes are available for educators only. Subject code: CSS 8: Marketing. © 2023, Emerald Publishing Limited.

Tales from the Dark Side of Technology Acceptance: The Dark Triad and the Technology Acceptance Model

With the dramatic shifts in the workforce that have emerged in the post–COVID-19 world, workers' emotions have often presented very negatively, causing people to overtly display the dark aspects of their personality while at work. At the same time, organizations have been forced to adopt new technologies to fill the gaps in their desired outcomes and cope with changes in market demand. The ensuing clash between negative emotions and technological implementation may lead to intense conflicts and adverse work outcomes. This study hypothesizes a direct relationship between dark personality traits (narcissism, Machiavellianism, and psychopathy) and technology acceptance. Using a multiple regression model with a sample of general workers from various industries (n = 396), the study found that narcissism and psychopathy significantly impacted technology acceptance, while Machiavellianism did not. The findings offer valuable theoretical, practical, and managerial insights. © 2023, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Virtual consulting in the times of COVID-19

Background: Confinement and economic uncertainty, along with disease-specific issues such as pain and suffering may uniquely impact rheumatology patients, putting non-COVID morbidity at par with COVID-related losses.Methods: We conducted a review of records to explore the clinical profile and interventions in rheumatology patients at a tertiary care center in Northern India to identify the potential problems and propose direction for the future.Results: In our experience spanning 5 weeks, among 508 rheumatology patients who sought teleconsultations, rheumatoid arthritis was the most common diagnosis (35.2'), and 43' were asked to continue the same treatment over tele consults, whereas investigations were awaited for another 16'. Nearly one-third (29.9') required an intervention, though this largely consisted of dose titrations (104 of 152, 68.4'). Certain diseases such as myositis were under-represented among consults (1.2') but over-represented (33.3') among admissions. Among the 54 patients who were asked to rate their teleconsultation experience, the voice and consultation quality were rated and average of 9.9 each, and 88.9' (48/54) said they would prefer teleconsultations until the pandemic is over.Conclusion: A sizeable proportion of rheumatology patients can be managed with teleconsultations, with some requiring greater assistance, calling for a triage protocol for the times ahead. With propositions for a deliberate transition into the realm of virtual consulting, chronic caregivers can hope to reach an optimal balance between e-consults and in-person visits.

Recurrent COVID-19 Waves and Lockdown: Impact on Daily Life and Mental Health of People in Nepal

Background. Lockdown is recognized as an effective measure in limiting the spread of coronavirus (COVID-19) throughout the world. However, recurrent COVID-19 infection and the extension of lockdown have threatened the livelihoods of people, mainly socioeconomic and mental health dimensions. Objective. The present study is aimed at identifying the impact of COVID-19 lockdown on the daily life and mental health of the general population of Nepal. Furthermore, the study identified the predictors of the mental health status of the people during COVID-19 lockdown. Methods. The study was conducted among 354 Nepalese people specifically the breadwinner of the family. Respondents completed the questionnaires related to the sociodemographic characteristics, COVID-19, and its impact on various aspects of life, including mental health via Depression, Anxiety, and Stress Scale-21 items (DASS-21). Data was collected through the web-based method, Google Forms questionnaire. Respondents were contacted through email and social networks (Facebook, Messenger, WhatsApp, and Viber) following a snowball approach. Data was analyzed using descriptive and inferential statistics. Logistic regression analysis was done to identify significant demographic, COVID-related, and socioeconomic factors associated with mental health outcomes. Results. Based on DASS-21 scores, the prevalence of depression, anxiety, and stress was 46.6% (mild: 22.3%, moderate: 16.7%, severe: 6.5%, and extremely severe: 1.1), 42.1% (mild: 10.2%, moderate: 18.6%, severe: 11.6%, and extremely severe: 1.7%), and 39% (mild: 16.7%, moderate: 12.7%, and severe: 9.6%), respectively. Various factors associated with COVID-19, its lockdown measures, and sociodemographic characteristics of the people were identified as the significant predictors of depression, anxiety, and stress among the general population of Nepal. Conclusion. The impact of COVID-19 lockdown on individuals' work, income, education, living standard, lifestyle, and consequently mental health is significant. The study findings warrant the importance of understanding the impact of the COVID-19 pandemic on individuals' all aspects of life and timely monitoring and appropriate intervention on risk groups to reduce the severity and chronicity of mental health problems.

Prevalence and diagnostic significance of novel 12-lead ECG patterns following COVID-19 infection in elite soccer players

Background: Identification of athletes with cardiac inflammation following COVID-19 can prevent exercise fatalities. The efficacy of pre and post COVID-19 infection electrocardiograms (ECGs) for detecting athletes with myopericarditis has never been reported. We aimed to assess the prevalence and diagnostic significance of novel 12-lead ECG patterns following COVID-19 infection in elite soccer players. Method(s): We conducted a multicentre study over a 2-year period involving 5 centres and 34 clubs and compared pre COVID and post COVID ECG changes in 455 consecutive athletes. ECGs were reported in accordance with the International recommendations for ECG interpretation in athletes. The following patterns were considered abnormal if they were not detected on the pre COVID-19 infection ECG: (a) biphasic T-waves;(b) reduction in T-wave amplitude by 50% in contiguous leads;(c) ST-segment depression;(d) J-point and ST-segment elevation >0.2 mV in the precordial leads and >0.1 mV in the limb leads;(e) tall T-waves >=1.0 mV (f) low QRS-amplitude in >3 limb leads and (g) complete right bundle branch block. Athletes exhibiting novel ECG changes underwent cardiovascular magnetic resonance (CMR) scans. One club mandated CMR scans for all 28 (6%) athletes, despite the absence of cardiac symptoms or ECG changes. Result(s): Athletes were aged 22+/-5 years (89% male and 57% white). 65 (14%) athletes reported cardiac symptoms. The mean duration of illness was 3+/-4 days. The post COVID ECG was performed 14+/-16 days following a positive PCR. 440 (97%) athletes had an unchanged post COVID- 19 ECG. Of these, 3 (0.6%) had cardiac symptoms and CMRs resulted in a diagnosis of pericarditis. 15 (3%) athletes demonstrated novel ECG changes following COVID-19 infection. Among athletes who demonstrated novel ECG changes, 10 (67%) reported cardiac symptoms. 13 (87%) athletes with novel ECG changes were diagnosed with inflammatory cardiac sequelae;pericarditis (n=6), healed myocarditis (n=3), definitive myocarditis (n=2), and possible/probable myocarditis (n=2). The overall prevalence of inflammatory cardiac sequelae based on novel ECG changes was 2.8%. None of the 28 (6%) athletes, who underwent a CMR, in the absence of cardiac symptoms or novel ECG changes revealed any abnormalities. Athletes revealing novel ECG changes, had a higher prevalence of cardiac symptoms (67% v 12% p<0.0001) and longer symptom duration (8+/-8 days v 2+/-4 days;p<0.0001) compared with athletes without novel ECG changes. Among athletes without cardiac symptoms, the additional yield of novel ECG changes to detect cardiac inflammation was 20% (n=3). Conclusion(s): 3% of elite soccer players demonstrated novel ECG changes post COVID-19 infection, of which almost 90% were diagnosed with cardiac inflammation during subsequent investigation. Most athletes with novel ECG changes exhibited cardiac symptoms. Novel ECGs changes contributed to a diagnosis of cardiac inflammation in 20% of athletes without cardiac symptoms.

Protein S Deficiency with Favourable Foetomaternal Outcome: A Case Report

Protein S is a multifunctional plasma protein, whose deficiency, results in a rare congenital thrombophilia, inherited in an autosomal dominant pattern. It can aggravate the hypercoagulable state of pregnancy, when it presents in parallel with the condition, leading to adverse maternal outcomes and foetal loss. A 35-year-old female third gravida having previous 2 deliveries by Lower Segment Caesarean Section (LSCS) presented to emergency at 10 weeks pregnancy with chief complaints of pain and swelling in left thigh since 4-5 days. After thorough investigations and work-up, the patient was diagnosed with Protein S deficiency. She was managed conservatively and was delivered by elective LSCS with bilateral tubal ligation at 38 weeks of gestation with good foetal and maternal outcomes.The rarity of Protein S deficiency along with the successful outcome of the pregnancy makes this a unique case.Copyright © 2023 Journal of Clinical and Diagnostic Research. All rights reserved.

High dietary iodine intake may contribute to the low death rate from COVID-19 infection in Japan with activation by the lactoperoxidase system

We draw the attention of readers and governments to the death rate from coronavirus disease 2019 in Japan, continuing as a fraction of that experienced by many other developed nations. We think this is due to the activity of the powerful, protective lactoperoxidase system (LPO) which prevents serious airborne infections. The LPO system requires iodine, which is liberally provided by the typical Japanese diet but lacking in many others. One might consider the Japanese experience an incredibly large, open-label study exhibiting the preventative power of a high-iodine diet. We predict this favourable trend will continue for Japan because deadly variants of the severe, acute respiratory syndrome coronavirus 2 will be with us, forever.Copyright © 2023 The Scandinavian Foundation for Immunology.