ABSTRACT
Coronavirus-induced disease-19 (COVID-19), caused by SARS-CoV-2, is still a major global health challenge. Human endogenous retroviruses (HERVs) represent retroviral elements that were integrated into the ancestral human genome. HERVs are important in embryonic development as well as in the manifestation of diseases, including cancer, inflammation, and viral infections. Here, we analyze the expression of several HERVs in SARS-CoV-2-infected cells and observe increased activity of HERV-E, HERV-V, HERV-FRD, HERV-MER34, HERV-W, and HERV-K-HML2. In contrast, the HERV-R envelope is downregulated in cell-based models and PBMCs of COVID-19 patients. Overexpression of HERV-R inhibits SARS-CoV-2 replication, suggesting its antiviral activity. Further analyses demonstrate the role of the extracellular signal-regulated kinase (ERK) in regulating HERV-R antiviral activity. Lastly, our data indicate that the crosstalk between ERK and p38 MAPK controls the synthesis of the HERV-R envelope protein, which in turn modulates SARS-CoV-2 replication. These findings suggest the role of the HERV-R envelope as a prosurvival host factor against SARS-CoV-2 and illustrate a possible advantage of integration and evolutionary maintenance of retroviral elements in the human genome.Copyright © 2023 The Authors.
ABSTRACT
With the simultaneously connected 26.66 billion devices worldwide, the Internet of Things (IoT) is becoming a vast field of research and helping hand to every individual. However, when IoT and Artificial Intelligence (AI) and machine learning (ML) consolidate, it results in smart applications and future revolutions that are known as Artificial Intelligent of Things (AIoT). Similarly, the unmanned aerial vehicle (UAV) domain is also developing daily, helping many unrest people in the healthcare industry. One step towards developing the healthcare industry is the use of UAV devices like drones embedded with AIoT to work autonomously in the healthcare industry. This can help the healthcare industry in many ways. This chapter proposes an algorithm to recast these UAV drones to autonomous UAV drones and use them as intelligent or smart for various healthcare purposes like COVID-19. The proposed autonomous UAV drone uses Raspberry Pi 3, a Hubney, and a bearing formula to automatically determine the direction of the UAV movement, making it work without any controller. Also, the comparative study presented in this chapter highlighted the benefits of this proposed algorithm with others present in the literature.
ABSTRACT
BACKGROUND: Hyperviscosity syndrome (HVS) is an infrequent but life-threatening complication of multiple myeloma (MM) and classically presents with the triad of mucosal bleed neurological and visual disturbances. HVS is typically associated with Immunoglobulin M (IgM) MM and very rarely may complicate IgG MM. Even suspicion of HVS necessitates therapy based on clinical severity rather than the calculated degree of viscosity. While plasmapheresis promptly decreases serum viscosity by 30-50% early initiation of antimyeloma therapy is crucial to prevent rebound phenomena. AIM OF THE STUDY: In this context, we report a case of IgG MM which despite being complicated by HVS had gratifying outcome attributable to early clinical suspicion and consequent prompt therapeutic intervention. METHOD(S): Case report - A 60-year-old lady presented with headache altered sensorium blurring of vision and bleeding from both nostrils of two days duration. She also had breathlessness on exertion and generalized fatigue for one month. Clinical evaluation was remarkable for pallor hypertension (blood pressure - 160/96 mm Hg) tachypnea (respiratory rate - 26/minute) with blood clots in nostrils bleeding from gums dry tongue and skin bruising on the arms. Besides altered mentation neurological evaluation revealed bilateral venous congestion and perivenular flame-shaped hemorrhages on direct ophthalmoscopy. There were no features of heart failure peripheral lymphadenopathy or organomegaly. Her initial blood sampling was difficult as blood was rapidly clogging during sampling itself. After rapid saline infusion, samples could be drawn and processed. Hemogram showed normocytic normochromic anemia (hemoglobin-6.3%g/ dL) thrombocytopenia (platelets -71 000/mm3) and rouleaux formation without hemolysis or blast cells on peripheral blood smear. SARS-CoV-2 PCR was negative. She had reversal of albumin-globulin ratio (total protein -10.6 g/dL;albumin -2.1 g/dL) hypercalcemia (corrected calcium - 14 mg/dL) and raised creatinine of 2.5 mg/dL. Her coagulation profile was essentially normal. Computed tomography images of head chest and abdomen were essentially normal. Further evaluation revealed M-spike (5.3%gm/dL) on serum protein electrophoresis raised IgG (4.69 g/dL) increased kappa light chain (kappa 171 mg/L lambda 24.3 mg/L;ratio -7) on serum-free light chain assay monoclonal band of IgG Kappa on serum immune-fixation electrophoresis. Bone marrow aspiration revealed 60% plasma cells (Figure-1) with sheets of plasma cell on bone marrow biopsy having kappa-restriction on immunohistochemistry thereby confirming multiple myeloma and ruled out remote possibility of lymphoplasmacytic lymphoma-related HVS. In view of presumptive HVS complicating multiple myeloma patient was managed with urgent plasmapheresis and consequently initiated on bortezomib-based anti-myeloma triplet therapy including lenalidomide and dexamethasone (VRd) besides supportive therapy for hypercalcemia and acute kidney injury. After three sessions of plasmapheresis patient showed complete resolution of symptoms of HVS with remarkable change in plasma color (Figure-2). Her acute kidney injury also recovered by day-7, and she went home walking on day-10 of her hospitalization. Two months later she was tolerating her chemotherapy well with complete resolution of hypergammaglobulinemia. Six months later she is in complete remission and is being planned for autologous hematopoietic stem cell transplant. RESULT(S): Discussion - Classical triad of HVS include mucosal bleed, neurological disorders, and visual disturbances.5 Presence of oro-nasal bleed mandates thorough retinal evaluation since hemorrhages may occur without visual symptomatology. Furthermore, clinical signs include hypertension, congestive heart failure5, priapism6, and decreased hearing merit consideration. Structure of protein is an important determinant of viscosity, whereby spherical proteins rotate through plasma and contribute very little and large linear proteins spin end over end and raise viscosity disproportionatel . Likewise, IgM (molecular weight of 950 Kd) has a high axial length-to-width ratio and, therefore, raises plasma viscosity at levels above 5 g/ dL. IgA circulates as a dimer, and results in HVS at levels above 7 g/dL7. HVS complicating IgG MM with IgG circulating as a monomer (molecular weight of 180 Kd) is rare and accounts for less than 5% of cases and requires IgG level usually above 10 g/dL7. Even presumptive suspicion of HVS necessitates therapy based on clinical severity rather than the calculated degree of viscosity as correlation between serum viscosity and clinical manifestation is not precise;nevertheless, symptoms attributable to HVS are rare if serum viscosity is less than 4 centipoise (CP) [normal value -1.5 CP]. With rapid symptomatic relief following plasmapheresis, absence of further therapeutic and prognostic implications and logistic constraints, serum viscosity and Ig G subtyping8 couldn't be estimated in the index case. As IgM is predominantly limited to intravascular space (over 80%), only a single session of plasma exchange (removal of 1-1.5 plasma volume) typically, decrease plasma viscosity by 30% to 50%, and reduce IgM level by 60%9 and is generally sufficient to abate acute symptoms in patients with IgM-related HVS. In contrast, maximum of three sessions of plasmapheresis10 may be needed in IgG-related HVS (due to late and less efficient removal of IgG as it is near equally distributed between the intravascular space and extravascular space) or if the viscosity remains over six CP11. Although International Myeloma Working Group does not specifically identify HVS as myeloma-defining event, clearly its presence warrants Bortezomib-based chemotherapy for rapid decline of Ig levels.5 However, pharmacological treatment should never be considered as an alternative to plasma exchange for immediate hyperviscosity reduction.5 Moreover, patients with HVS tend to have plasma volume expansion;hence, actual anemia may be partially dilutional. Consequential red blood cell transfusion can have negative rheological impact of adding red cells to the circulation and further increase in blood viscosity and worsen HVS.5 Therefore, red blood cell transfusion is recommended only after blood viscosity reduction. Symptomatic HVS consequent to IgG MM with IgG levels below 5 g/dL7 is infrequent and hence reported for its novelty. Moreover, early clinical suspicion of HVS and consequent pre-emptive plasmapheresis (even before completion of work-up of MM) may improve clinical outcome as evident in the index case. CONCLUSION(S): To conclude, neurological dysfunction at presentation of MM with / without mucosal bleed and visual disturbance should caution us toward an albeit infrequent, yet devastating complication of HVS, which is otherwise potentially reversible subject to early clinical suspicion and prompt initiation of appropriate therapy.
ABSTRACT
BACKGROUND: Acute kidney injury (AKI) is a major risk factor for mortality in ICU patients. The aim of this study was to evaluate the spectrum and outcomes of non-COVID related AKI admitted to non-COVID intensive care units of a tertiary care hospital during COVID pandemic. AIM OF THE STUDY: To study the Spectrum and Outcomes of Acute Kidney Injury in a Non-COVID Intensive Care Unit during COVID Pandemic METHODS: Patients were prospectively enrolled from February 2020 to June 2021 using a predesigned standardized pro forma as per the inclusion and exclusion criteria. Demographic details, comorbid conditions, biochemical parameters, urine output system affection, renal replacement therapy (RRT) details, and fluid replacement were recorded. Outcome measures assessed were serum creatinine at transfer-out from ICU serum creatinine at discharge days of ICU stay and days of hospital stay death/ discharge and requirement of RRT after discharge. RESULT(S): 200 patients of AKI getting admitted to ICU were included in this study. Diabetes mellitus (19.5%) was the most common comorbidity. AKI was most seen in the post-surgery setting (33%), and severe non-surgical sepsis (37%). The most important risk factors predicting in-hospital mortality in AKI patients were hepatic dysfunction (HR-3.471, p = 0.001), septicemia (HR-3.342, p = 0.0001), age >60 years (HR-4.000, p = 0.026), higher baseline SOFA score (HR-1.107, p = 0.001), anemia (HR-0.879, p = 0.003), and reduced serum iron levels (HR- 0.982, p = 0.001). CONCLUSION(S): Presence of age >60 years, hepatic dysfunction, septicemia, higher baseline SOFA score, anemia, and reduced serum iron emerged to be the most important predictors of mortality among intensive care requiring AKI patients. The surgical AKI incidence was less due to lesser number of elective surgeries during the COVID pandemic.
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The Covid-19 pandemic has caused severe economic depression and has disrupted the supply chains of various industries. The automobile industry which contributes significantly to the Indian economy was gravely hit due to the lockdowns, semiconductor shortage and the uncertainty associated with the pandemic. This research paper analyses the effect of Covid-19 on the automobile sales in India using the time series modelling approach. The data recorded by SIAM from 2012 to 2019 was used to develop the Autoregressive Integrated Moving Average (ARIMA) model following the Box-Jenkins methodology. ARIMA model (2, 1, 3) was chosen as it had the lowest AIC and BIC criteria. This model was used to forecast the sales from 2020 to 2021 to give a picture of the expected automobile sales had the pandemic not occurred. The forecasted data from the model developed has then been compared with actual automobile sales data during the pandemic to gauge the level of impact Covid-19 had on the Indian automobile industry. The paper also explores the associated challenges that the automobile industry had to face due to the pandemic. © 2022 The authors and IOS Press.
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The COVID-19 pandemic has changed the way the teaching-learning process was conducted. From elementary to tertiary the education system had to change gears to online teaching mode. Neither the teachers nor the students were prepared for this external eventuality which made it necessary to adapt to the new realities. E-learning influences the global education system significantly but not in India where e-Learning has been practised previously through various portals such as University Grants Commission, Massive Open Online Course (MOOC) platforms and National Programme for Technology Enabled Learning (NPTEL). The article aims to identify effective learning methodology to increase the learning engagement of pupils in the online environment. For the study, we collected responses from 1233 students from five undergraduate and postgraduate management colleges at Indore in the state of Madhya Pradesh in India. The questionnaire method of data collection was adopted and random sampling was used for data acquisition. All the respondents had completed at least six months of online classes and a one-semester exam following the national lockdown in the country. Respondents, aged between 18-26 years, had completed at least five three-credit courses online representing about 150 hours of online class interaction with different teachers. Data obtained from online learners were analysed for establishing the relationship between teacher support and the learners' online engagement. A structural equation model is attempted to delineate the important variables of learning in online teaching environments. © 2022 RJ4All.
ABSTRACT
The COVID 19 pandemic has an unprecedented effect on the world and has caused a huge death toll and miseries. It has mani-fest itself from disruption of normalcy to an economic slowdown and has impacted people in all walks of life. There is a growing body of evidence regarding a spike in depression and anxiety in the general public, due to the pandemic, and its negative impact on their daily lives due to death and economic hardships. It is not easy to handle the stress arising out of the pandemic and its ramifications. It is even more difficult for people with mental health challenges. The evidence has been pointing towards an in-crease in suicide in a high-risk population. The crisis is real, and efforts should be focused on ameliorating the risk in vulnerable populations. Patients need to be educated and trained to adopt lifestyle changes to deal with the rapidly evolving situation and restructure thought processes and utilize healthy coping skills, keeping them from slipping through the cracks. Communities and agencies need to work on strategies and policies that have been proven effective in preventing suicide and may have to come up with new measures to keep up with the emerging demands and challenges and work towards suicide prevention and zero suicide. © IJCRR.