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Background: People living with cancer are reported to be at increased risk of hospitalization and death following infection with acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This is proposed to be dependent on a combination of intrinsic patient and cancer factors such as cancer subtype, and emerging SARS-CoV-2 variants with differing pathogenicity. However, COVID-19 phenotype evolution across the pandemic from 2020 has not yet been systematically evaluated in cancer patients. Method(s): This study is a population-scale real-world evaluation of Coronavirus outcomes in the United Kingdom for cancer patients from 1st November 2020-31st August 2022. The cancer cohort comprises individuals from Public Health England's national cancer dataset, excluding individuals less than 18 years old. Case-outcome rates, including hospitalization, intensive care and casefatality rates were used to assess the evolution in disease phenotype of COVID-19 in cancer patients. Multivariable logistic regression models were fitted to compare risk of Coronavirus outcomes in the cancer cohort relative to the non-cancer population during the Omicron wave in 2022. Result(s): The cancer cohort comprised of 198,819 positive SARS-CoV-2 tests from 127,322 individual infections. Coronavirus case-outcome rates were evaluated by reference to 18,188,573 positive tests from 15,801,004 individual infections in the non-cancer population. From 2020 to 2022, the SARS-CoV-2 disease phenotype became less severe in both patients with cancer and the non-cancer population, though cancer patients remain at higher risk. In 2022, the relative risk of Coronavirus hospital admission, inpatient hospitalization, intensive care admission and mortality in cancer patients was 3.02x, 2.10x, 2.53x and 2.54x compared to the non-cancer population following multivariable adjustment, respectively. Higher risk of hospital admission and inpatient hospitalization were associated with receipt of B/T cell antibody and/or targeted therapy which also corresponded with an increased risk of Coronavirus mortality. Conclusion(s): The disease phenotype of SARS-CoV-2 in cancer patients in 2022 has evolved significantly from the disease phenotype in 2020. Direct effects of the virus in terms of SARS-CoV-2 hospitalization, intensive care and case fatality rates have fallen significantly over time. However, relative to the general population, people living with cancer and hematological malignancies remain at elevated risk. In order to mitigate the indirect effects of the SARS-CoV-2 pandemic in terms of disruption to cancer care, there should be increased focus on preventative measures. Used in conjunction with vaccination and early treatment programs, this will maximize quality of life for those with cancer during the ongoing pandemic and ensure the best cancer outcomes.
ABSTRACT
Since the Coronavirus Disease (COVID-19) pandemic, there have been several unusual presentations of mucormycosis in India, especially amongst immune-competent adults. COVID-19 infection has been found to have profound effects on the patient's immunity and some patients, though asymptomatic for COVID-19, can be infected by mucormycosis and develops dangerous complications. Skin involvement of the orbital, zygomatic and maxillary areas is a common occurrence in extensive cases of rhino-orbital mucormycosis, however, isolated involvement of the alar skin is an extremely rare occurrence in such patients. Paediatric cutaneous mucormycosis is by itself a rare entity, seen majorly in children with history of allogeneic hematopoietic stem cell transplantations, chemotherapeutic treatment, or patients with human immunodeficiency virus infections, herpes and other life-threatening viral infections. Patients receiving long-term steroid therapy are also predisposed to invasive fungal infections. This case was about a 10-year-old boy presented with a black crusted lesion over the nose to the otolaryngology outpatient department. The patient had history of contact with a COVID-19 positive individual. Examination revealed a necrotic patch over the palate and Non Contrast CT Scan of (NCCT) the paranasal sinuses showed pansinusitis. A KOH mount showed fungal elements and the patient underwent emergency debridement of nasal skin with endoscopic sinus and palatal debridement. Injectable liposomal Amphotericin-B was started. Over a period of one month, the patient showed significant clinical improvement. Though rare, sinonasal mucormycosis can present in the form of a cutaneous lesion which is an unconventional symptom. A general awareness amongst healthcare professionals, with a multidisciplinary approach, timely diagnosis and specialist intervention can improve outcomes in this sinister disease.Copyright © 2023 Journal of Clinical and Diagnostic Research. All rights reserved.
ABSTRACT
As the global economy grapples with the advent of novel coronavirus and its variants, the aftermath has left all industries with ongoing uncertainties and incalculable loss of life and livelihood in most countries worldwide. In such unpredictable situations, the insurance industry and governments worldwide have become the prominent source of optimism to sail through the situation. This applies to the insurance industry globally, which is currently in the grip of fear due to the COVID-19 outbreak and anticipating significant economic slowdown and hardship because insurance rides on the back of other Industries. Therefore, to overcome a few of the tenacious roadblocks due to the COVID outbreak, Insurers will be forced to reassess all aspects of their business life cycle and take necessary steps to continue operations with minimum disruption. Precisely, the impact of COVID on General Insurers and Life and Health Insurers varied depending on the lines of business, product lines, and a bouquet of benefits offered by the insurers. The pandemic has taken a hit on new gross written premiums on specific lines of business, such as medical, travel, commercial, and business insurance. Few lines of business such as motor and home have remained muted during the COVID timeframe. However, the claims volumes for personal insurance (e.g., motor) have significantly decreased due to the lockdown and travel restriction;the industry has witnessed the highest claims volumes in life and health compared to the past several decades. They say, "As every dark cloud has a silver lining,” it has given an opportunity to many insurers to develop new products (e.g., Pay Mile Auto insurance) and push toward greater productivity, i.e., digital capability across product range which will result in an elevated position to understand and address to the customer and intermediary self-service (such as Portals) and implicit and explicit needs. Notably, the Insurance industry is likely to lean toward offering personalized yet custom-made products and services, which are sharply focused on preventative care and embracing digitalization across the value chain. Besides enabling scalability and connectivity, insurers are strategically focused on digitizing the core of the business and cloud implementation;automation across the insurance value chain is necessary to compete successfully with new innovative product development or inclusive business models. Around the globe, the insurance industry is continuously putting a deep focus on revitalizing the technology paradigm to grow and strive to achieve cost-effectiveness amid emerging markets, rapidly changing economic conditions and stiff competition from Insurtech. According to industry experts across geographies, growth may be a balanced blend of preventative and protective approaches, with a gamut of new and improved services and products, and insurers are deeply fostering redefining service-oriented strategies and innovative products. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
ABSTRACT
As the global economy grapples with the advent of novel coronavirus and its variants, the aftermath has left all industries with ongoing uncertainties and incalculable loss of life and livelihood in most countries worldwide. In such unpredictable situations, the insurance industry and governments worldwide have become the prominent source of optimism to sail through the situation. This applies to the insurance industry globally, which is currently in the grip of fear due to the COVID-19 outbreak and anticipating significant economic slowdown and hardship because insurance rides on the back of other Industries. Therefore, to overcome a few of the tenacious roadblocks due to the COVID outbreak, Insurers will be forced to reassess all aspects of their business life cycle and take necessary steps to continue operations with minimum disruption. Precisely, the impact of COVID on General Insurers and Life and Health Insurers varied depending on the lines of business, product lines, and a bouquet of benefits offered by the insurers. The pandemic has taken a hit on new gross written premiums on specific lines of business, such as medical, travel, commercial, and business insurance. Few lines of business such as motor and home have remained muted during the COVID timeframe. However, the claims volumes for personal insurance (e.g., motor) have significantly decreased due to the lockdown and travel restriction;the industry has witnessed the highest claims volumes in life and health compared to the past several decades. They say, “As every dark cloud has a silver lining,” it has given an opportunity to many insurers to develop new products (e.g., Pay Mile Auto insurance) and push toward greater productivity, i.e., digital capability across product range which will result in an elevated position to understand and address to the customer and intermediary self-service (such as Portals) and implicit and explicit needs. Notably, the Insurance industry is likely to lean toward offering personalized yet custom-made products and services, which are sharply focused on preventative care and embracing digitalization across the value chain. Besides enabling scalability and connectivity, insurers are strategically focused on digitizing the core of the business and cloud implementation;automation across the insurance value chain is necessary to compete successfully with new innovative product development or inclusive business models. Around the globe, the insurance industry is continuously putting a deep focus on revitalizing the technology paradigm to grow and strive to achieve cost-effectiveness amid emerging markets, rapidly changing economic conditions and stiff competition from Insurtech. According to industry experts across geographies, growth may be a balanced blend of preventative and protective approaches, with a gamut of new and improved services and products, and insurers are deeply fostering redefining service-oriented strategies and innovative products. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
ABSTRACT
COVID-19 (Corona Virus Disease 2019) is a pandemic which has been spreading exponentially around the globe. Many countries had adopted stay-at-home or lockdown policies to control its spreading. However, prolonged stay-at-home can cause worse effects like economic crises, unemployment, food scarcity, and mental health problems of individuals. EasyBand2.0 is a wearable personal safety device that helps in social distancing and also helps in safe mobility. Under the IoMT (Internet of Medical Things) framework the wearable EasyBand2.0 device helps in social distancing, it avoids human-to-human contact and helps maintain a safer distance. EasyBand2.0 uses the Low Power BLE technology to sense distance between two user devices and alert them based on the distance and time spent in proximity. Safe mobility of people is also important as travel is resumed in all forms. This paper proposes a software application along with the easy band to further be integrated with a system that works based on GPS (Global Positioning System) or GIS (Geographic Information System) to provide travel logging for contact tracing without exposing personal data. A CARS (Context Aware Recommendation System) based safe zone recommender system is proposed in this paper to aid safe mobility. © 2022 IEEE.
ABSTRACT
Students are a high-risk group in a pandemic scenario like COVID-19, both as patients and as spreaders due to their attitudes and practices of very close association and utility-sharing among themselves. Schools and colleges in India have been closed since March 2020 till January 2021 and could just be reopened for higher classes for only three months in phases till April 2021. This has precipitated an unprecedented crisis in the lives of students and of educational organizations and institutions and the biggest headache for the ministries of higher education and the HRD ministry too. We conducted a KAP survey during the first COVID wave on March to May 2020 to analyze the risk factors involved in case of reopening of educational institutions. Accordingly we discuss the implications for policy decisions for such a highly sensitive group based on a study on over 500 students of the semi-urban locality of Bhadrak in Odisha, India. A questionnaire was prepared keeping in view the objectives of such a study by randomly picking students on campus, both boarders and day scholars, to collect the KAP-data from among the nearly 6000 students of the College. We find that most of the students are vulnerable to catch an infection and have the highest potential to spread it to many in no time. The appropriate measures before the final opening of schools and colleges would be (a) to have enough space for ensuring social distancing (b) sensitization and awareness drives through all means among students to inhibit spread of the infection and (c) the required increase in manpower to ensure the successful implementation of the above two.
ABSTRACT
Background: End-stage kidney disease (ESKD) impacts more than 785,000 Americans and often occurs with multiple comorbid conditions, especially cardiovascular diseases, which are the most common cause of death (COD) in ESKD. Many complications directly arise from ESKD, but its deadly impact can be overlooked. At our institution, the death certificate is completed by clinicians and a majority by clinical house staff. We reviewed the death certificates of ESKD autopsies to understand the clinicians' perspectives on the range of CODs in this clinical setting. Design: We searched our database for autopsies of adult ESKD patients (2012-2021) that had accessible death certificates. COVID-positive cases were excluded. We evaluated the COD section of death certificates and correlated them with autopsy findings. The frequency of autopsy findings directly identifying CODs or resulting in amendments of death certificates was also noted. Results: Of 68 autopsy reports, the majority of CODs reported in death certificates were related to sepsis/infection (30%), and cardiovascular diseases (26%). There was no documentation of ESKD in the majority (78%,53/68) of death certificates. Of these 53 cases, 89% had COD either due to fatal complications of ESKD (98%) or increased mortality of another comorbid condition due to the underlying ESKD. The remaining 11% had COD unrelated to ESKD. Among the fatal complications of ESKD, cardiovascular complications were the most commonly noted (72%) followed by sepsis (20%). Autopsy findings were used to identify the COD on death certificates in only 6% of cases. No amendments were made on any of these death certificates. Conclusions: ESRD is often not mentioned in death certificates, which underestimates its mortality burden. The death certificate is a source for mortality statistics and used by government for public health policy and allocation of research funding. Hence, accurate accounting of death certificates is essential for this complex and silent disease.
ABSTRACT
The pandemic has led to an unprecedented change in the way people shop and the mode of shopping. Our paper examines how the pandemic and quarantine precipitates those changes in shopping on e-commerce platforms and use of digital solutions. The literature already talks about the perceived benefits of online shopping such as awareness of utility, awareness of easy to use, awareness of marketing policy, awareness of price and cost. Thus, we have used our research paper to study the triggers of online shopping during COVID19. We administered self-administered Google surveys and as primary and secondary data source to develop the model of perceived benefits of e-shopping during quarantine. The finding of the paper shows that consumer associates e-shopping with value for money, safety, a mode of relaxing, stress release during the quarantine period. The pandemic has changed the global business paradigm irreversibly. It has slowly transformed all business to make them customer centric and digital ready. This paper underlines the how the business can create better value for the customer by working on the perceived benefits to cater them in an effective way. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
ABSTRACT
The recent spread of severe acute respiratory syndrome coronavirus 2 and its associated coronavirus disease has caused extensive public health concerns. University campuses are at higher risks since a lot of students are present inside the campus at a given point of time. Places where there are a lot of chances of spread of the infection in the campus include the entrance gate, canteen, library, photocopy center, seminar hall, etc. Strict actions must be taken against the violations of the covid-19 protocols which will ensure health safety and maintain hygiene in the campus. Doing this manually will be a tedious task. Owing to this problem, an attempt has been made to design a system to tackle the problem of following all the protocols and making everyone aware about the situation in the campus. This work proposes a system which will continuously monitor all these activities with the help of Computer Vision and Deep Learning. The collected CCTV cameras data has been checked in the real time mode using various object detection and object tracking models to identify and track the objects visible in the frame. This approach uses MobileNet and SSD Architecture along with the objection detection models to predict the desired output. Finally, based on the output the system checks for any violations and if encountered then it sends a text alert to the concerned authority. © 2021 IEEE.
ABSTRACT
We make a critical objective analysis of the different management, treatment and prevention strategies employed the world over to tackle the COVID-19 pandemic and try to bring some insight into the fact that they all may ultimately be efficient host manipulation by the SARS-CoV-2 virus for purposes of its unrestrained propagation. We discuss issues relating to long term implications of host-pathogen coevolution and viral pandemic periodicity.
ABSTRACT
Without an effective vaccine, treatment, or therapy, the Coronavirus Disease 2019 (COVID-19) is spreading like fire and claiming lives. Countries began to adopt various strategies such as lockdown, mass testing, tracing, quarantine, sanitization, isolation, and treatment to contain COVID-19. However, it was soon realized that we need to take the help of powerful technologies to combat the spread of deadly COVID-19 until a vaccine or a drug is discovered. In this article, we discuss how the use of cutting edge technologies such as the Internet of Things (IoT), Big data, artificial intelligence (AI), unmanned aerial vehicles (UAVs)/drones, blockchain, robotics, autonomous ground vehicles, communication technologies in screening, testing, contact tracing, spread analysis, sanitization, and protocol enforcements can help prevent the COVID-19 spread.
ABSTRACT
We have proposed the concept of dispersed organisms as a way forward to have a deeper understanding of diseases and their eradication and also of evolution of life and of species. Taking COVID-19 as a dispersed organism we investigate its impact in the sociological and psychological realms as a conscious force on humanity to set it on the right track, both individually and collectively. The aftermath of COVID-19 is not going to be a repetition of that of Spanish flu a hundred years back. The implications for mankind are going to be profound. We discuss the well accepted notion of evolution of multicellulars from unicellulars and propose that the case may not be of evolution from pathogens as such, but of building progressively better quality nests by them, which we call the hosts for the pathogens. Infection of host is in reality only nesting for the pathogen. This turns evolutionary hierarchy upside down.
ABSTRACT
To understand diseases at a deeper level, we propose the concept of dispersed organisms as those having their constituent units spatially, and may be even temporally, separated in existence but still conforming to the definition of being an organic wholeness, having functionally dependent and non-spatio-temporally interconnected components. A living organism is characterized by elementary units (cells), each having the same DNA. This definition though specifically valid for multicellular complex organisms (eukaryotes), can very well be extended to include localized bacterial colonies as is evidenced by the phenomenon of quorum sensing, even though the DNA may only be partially identical. Starting with quorum sensing in bacteria as a preliminary indication, quantum entanglement among component units deriving from the same initial cause as a possible explanation, we draw upon a specific deeper vision of the causes of the Spanish flu pandemic of 1918-20 to establish the concept of dispersed organisms. We discuss the COVID-19 pandemic as a similar dispersed organism with its specific targets, severity, endemicity, span and consequences.
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We explore the issue of cyclicity of cosmic time and how it might be a recorder of all events by its identification with the cosmic mind. We differentiate absolute time, universal (cosmic) time and the relative time as three distinct categories in the objective domain of temporal reckoning. Taking the idea of time generated by fundamental quantum events through natural frequencies of microsystems, we analyze the issue of generation of the cyclic time of the cosmos itself due to events undergone by all its oscillating contents. We propose that such macrocosmic processes of generation of cosmic times by the frequency of repetitive cosmic events necessarily requires the intermediary of psychic fields which being metaphysical and transcending matter, encode all information in a detailed manner in a memory that transcends space and generates repetitive events with subjects which lead to emergence of cosmic objective time. As a result, spatial as well as temporal non-locality becomes a reality, while individual free will becomes an appearance only. The difficulty in comprehending these novel ideas and conceptions only proves that our perceptions are deeply conditioned by our everyday experiences with space and time. The duration, symptomatics, fatality and cyclicity of COVID-like pandemics can be understood on this basis to have a deeper significance transcending virology and epidemiology.
ABSTRACT
The RNA virus SARS-COV-2 that has led to the outbreak of the worst ever pandemic has one particular enhanced virulence factor, the spike protein in the Receptor Binding Domain (RBD). We discuss its evolution from earlier strains of respiratory infection causing viruses in terms of increased incubation period and symptomatic width. We propose that any disease can be considered as an evolving conscious organism having its own teleological evolutionary pathway, the pathogens, vectors and hosts being merely the vehicles of its transmission, and not its causes. In this perspective even if it is the result of some sinister design by genetic modification in laboratory, it still can be considered as its natural evolution only, in which the scientists themselves became its extended evolution and transmission vehicles, which made it defy the existing medical knowledge, methods, resources and efforts. In an expanded scheme the pathogens like SARS COV-2 are to be considered as predator species for their human hosts. We conclude that only with conscious awareness of expression of emotions keeping reasonable restrictions on oneself mankind can ever hope to address such pandemics.