Experiences of delivering virtual therapy groups for children with osteogenesis imperfecta during the Covid-19 pandemic

OBJECTIVE: To explore the experiences of a virtual group therapy programme for children with Osteogenesis Imperfecta (OI) who were unable to access face to face therapy due to a global pandemic. In a regional OI service up to 3 face to face 6-week therapy groups are offered for children during summer school holidays. Throughout the Covid-19 pandemic, OI children were at risk of deconditioning due to government restrictions in school attendance, exercise and socialisation. An alternative means of delivering therapy was required. METHOD(S): 30 families with school age children were invited to attend a virtual therapy group. Following initial interest from 21 children, 14 (age range 4-14 years) participated in a 5 week therapy group. Children were split into 3 age groups (4-7/8-12/13-14). Weekly 75 minute sessions comprised functional gross and fine motor activities. Educational elements with opportunities to explore thoughts and feelings were included. Each group were set a challenge to compete a virtual race from Bristol to Lands' End, recording their distance (walking, wheeling, cycling) throughout the week. Feedback was collected from participants and parents. RESULT(S): Feedback was received from 12/14 of attendees and parents and 4/7 who did not attend. Reasons for non-attendance included anxiety around video calls, other commitments and injuries. Of those that attended 100% (n=12) enjoyed the group and reported increased activity levels. Scavenger Hunt was cited as the favourite activity. 16.6% (n=2) children reported discussion on personal feelings uncomfortable. 16.6% (n=2) reported exercises were hard. 100% (n=9) of parents reported no significant difficulties with IT. Parent reported benefits included positive social interaction with other children with OI (66%, n=6), improving routine in preparation for school return (55%, n=5). Challenges for therapy team included identifying appropriate IT platform, choosing activities appropriate for various abilities and virtual instruction. Successes included time efficiency, full inclusion regardless of geographic location, increased activity levels of children with OI in preparation for school return. CONCLUSION(S): A safe, socially distanced method of delivering group therapy during a pandemic was achieved. Virtual therapy can be a useful adjunct, however this should not replace face to face therapy where possible.

Effect-Directed Profiling of Akebia quinata and Clitoria ternatea via High-Performance Thin-Layer Chromatography, Planar Assays and High-Resolution Mass Spectrometry.

Two herbal plants, Akebia quinata D. leaf/fruit and Clitoria ternatea L. flower, well-known in traditional medicine systems, were investigated using a non-target effect-directed profiling. High-performance thin-layer chromatography (HPTLC) was combined with 11 different effect-directed assays, including two multiplex bioassays, for assessing their bioactivity. Individual active zones were heart-cut eluted for separation via an orthogonal high-performance liquid chromatography column to heated electrospray ionization high-resolution mass spectrometry (HPLC-HESI-HRMS) for tentative assignment of molecular formulas according to literature data. The obtained effect-directed profiles provided information on 2,2-diphenyl-1-picrylhydrazyl scavenging, antibacterial (against Bacillus subtilis and Aliivibrio fischeri), enzyme inhibition (tyrosinase, α-amylase, ß-glucuronidase, butyrylcholinesterase, and acetylcholinesterase), endocrine (agonists and antagonists), and genotoxic (SOS-Umu-C) activities. The main bioactive compound zones in A. quinata leaf were tentatively assigned to be syringin, vanilloloside, salidroside, α-hederin, cuneataside E, botulin, and oleanolic acid, while salidroside and quinatic acids were tentatively identified in the fruit. Taraxerol, kaempherol-3-rutinoside, kaempferol-3-glucoside, quercetin-3-rutinoside, and octadecenoic acid were tentatively found in the C. ternatea flower. This straightforward hyphenated technique made it possible to correlate the biological properties of the herbs with possible compounds. The meaningful bioactivity profiles contribute to a better understanding of the effects and to more efficient food control and food safety.

The clinical utility of CD163 in viral diseases.

Macrophage activation and hypercytokinemia are notable presentations in certain viral infections leading to severe disease and poor prognosis. Viral infections can cause macrophage polarization into the pro-inflammatory M1 or anti-inflammatory M2 phenotype. Activated M1 macrophages usually restrict viral replication whereas activated M2 macrophages suppress inflammation and promote tissue repair. In response to inflammatory stimuli, macrophages polarize to the M2 phenotype expressing hemoglobin scavenger CD163 surface receptor. The CD163 receptor is shed as the soluble form, sCD163, into plasma or tissue fluids. sCD163 causes detoxification of pro-oxidative hemoglobin which produces anti-inflammatory metabolites that promote the resolution of inflammation. Hence, increased CD163 expression in tissues and elevated circulatory levels of sCD163 have been associated with acute and chronic inflammatory diseases. CD163 and other macrophage activation markers have been commonly included in the investigation of disease pathogenesis and progression. This review provides an overview of the involvement of CD163 in viral diseases. The clinical utility of CD163 in viral disease diagnosis, progression, prognosis and treatment evaluation is discussed.

The potential role of scavenger receptor B type I (SR-BI) in SARS-CoV-2 infection.

Scavenger receptor type B I (SR-BI), the major receptor for high-density lipoprotein (HDL) mediates the delivery of cholesterol ester and cholesterol from HDL to the cell membrane. SR-BI is implicated as a receptor for entry of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2). SR-BI is colocalized with the angiotensin-converting enzyme 2 (ACE2) increasing the binding and affinity of SARS-CoV-2 to ACE2 with subsequent viral internalization. SR-BI regulates lymphocyte proliferation and the release of pro-inflammatory cytokines from activated macrophages and lymphocytes. SR-BI is reduced during COVID-19 due to consumption by SARS-CoV-2 infection. COVID-19-associated inflammatory changes and high angiotensin II (AngII) might be possible causes of repression of SR-BI in SARS-CoV-2 infection. In conclusion, the downregulation of SR-BI in COVID-19 could be due to direct invasion by SARS-CoV-2 or through upregulation of pro-inflammatory cytokines, inflammatory signaling pathways, and high circulating AngII. Reduction of SR-BI in COVID-19 look like ACE2 may provoke COVID-19 severity through exaggeration of the immune response. Further studies are invoked to clarify the potential role of SR-BI in the pathogenesis of COVID-19 that could be protective rather than detrimental.

Dietary food antioxidants and their radical scavenging activity: A review

Food antioxidants can prevent or/and delay free radical formation which is responsible for oxidative stress. Nowadays, natural remedy becomes the highest concern in many countries, as well as discouraging the intake of synthetic counterparts to avoid the burden of side effects on human health. Regular intake of dietary antioxidants could help to improve the fitness of the body, and subsequently make the body more competitive in its fight against diseases through enhanced immune response. The present review thus summarised recent knowledge on the dietary source of antioxidants, and also mechanism of action and functionalities on human health benefits. Due to the proven ability to restore mitochondrial function and cellular redox balance, food antioxidants also have great potential as natural therapies against COVID-19. However, the numbers of trials are still limited. There must be more tests with the hope that these compounds will mitigate the COVID-19 and similar outbreaks in the future © All Rights Reserved

Maternal fructose boosts the effects of a Western-type diet increasing SARS-COV-2 cell entry factors in male offspring.

Fructose-rich beverages and foods consumption correlates with the epidemic rise in cardiovascular disease, diabetes and obesity. Severity of COVID-19 has been related to these metabolic diseases. Fructose-rich foods could place people at an increased risk for severe COVID-19. We investigated whether maternal fructose intake in offspring affects hepatic and ileal gene expression of proteins that permit SARS-CoV2 entry to the cell. Carbohydrates were supplied to pregnant rats in drinking water. Adult and young male descendants subjected to water, liquid fructose alone or as a part of a Western diet, were studied. Maternal fructose reduced hepatic SARS-CoV2 entry factors expression in older offspring. On the contrary, maternal fructose boosted the Western diet-induced increase in viral entry factors expression in ileum of young descendants. Maternal fructose intake produced a fetal programming that increases hepatic viral protection and, in contrast, exacerbates fructose plus cholesterol-induced diminution in SARS-CoV2 protection in small intestine of progeny.

Social Work Practice during the COVID-19 Pandemic Learning from the Scavenger Community

This paper attempts to draw lessons for social work practice from the lived experiences of the scavenger community during the COVID-19 pandemic in India. The findings are based on the data gathered through interviews with key members of the Movement for Scavenger Community (MSC) across five sweeper colonies from five different states. The authors observe that the COVID-19 pandemic exposed caste vulnerabilities as inimical to the scavenger community. Social work intervention based on principles of social justice can enhance people's capabilities to reclaim their rights to lead a life of dignity. © 2022 Tata Institute of Social Sciences. All rights reserved.

Outdoor recreation alters terrestrial vertebrate scavenger assemblage and carrion removal in a protected Mediterranean wetland

Outdoor recreation has increased in recent decades, with an intensification after the COVID-19 lockdown. Previous studies have shown that disturbances from this activity may affect species behaviour and fitness, but its effect on ecological processes has been overlooked. Here, we test the impact of outdoor recreation on terrestrial vertebrate scavenger assemblage and scavenging patterns in El Hondo Natural Park, a Mediterranean wetland located in south-eastern Spain. We placed 185 carcasses monitored with camera traps between February 2020 and May 2021 in two areas: 'public access area', where visitors can freely access and carry out outdoor recreation, and 'restricted area', where visitors are not allowed. Our results showed that outdoor recreation altered the scavenger assemblage composition, especially affecting large species such as raptors. Non-native species scavenged almost four times more often on carcasses in public access areas than in the restricted areas, showing that human activities promote the presence of non-native species. Furthermore, vertebrates completely consumed 68.2% of the carcasses in the restricted area, decreasing to 46.7% in the public access area. In the restricted area, consumption time was shorter (111.8 vs. 157.5 h) and consumed biomass by vertebrate scavengers was larger (73.9 vs. 52.2%) than in public access area, evidencing that outdoor recreation also affects scavenging processes. Our study shows that outdoor recreation profoundly alters not only the scavenger assemblage but also key ecological processes such as carrion removal. This highlights the urgency of regulating tourism and maintaining restricted areas to preserve biodiversity and ecological processes, especially in highly anthropized landscapes.

Human Cell-Camouflaged Nanomagnetic Scavengers Restore Immune Homeostasis in a Rodent Model with Bacteremia.

Bloodstream infection caused by antimicrobial resistance pathogens is a global concern because it is difficult to treat with conventional therapy. Here, scavenger magnetic nanoparticles enveloped by nanovesicles derived from blood cells (MNVs) are reported, which magnetically eradicate an extreme range of pathogens in an extracorporeal circuit. It is quantitatively revealed that glycophorin A and complement receptor (CR) 1 on red blood cell (RBC)-MNVs predominantly capture human fecal bacteria, carbapenem-resistant (CR) Escherichia  coli, and extended-spectrum beta-lactamases-positive (ESBL-positive) E. coli, vancomycin-intermediate Staphylococcus aureus (VISA), endotoxins, and proinflammatory cytokines in human blood. Additionally, CR3 and CR1 on white blood cell-MNVs mainly contribute to depleting the virus envelope proteins of Zika, SARS-CoV-2, and their variants in human blood. Supplementing opsonins into the blood significantly augments the pathogen removal efficiency due to its combinatorial interactions between pathogens and CR1 and CR3 on MNVs. The extracorporeal blood cleansing enables full recovery of lethally infected rodent animals within 7 days by treating them twice in series. It is also validated that parameters reflecting immune homeostasis, such as blood cell counts, cytokine levels, and transcriptomics changes, are restored in blood of the fatally infected rats after treatment.

Scavenger receptor A in immunity and autoimmune diseases: Compelling evidence for targeted therapy.

INTRODUCTION: Scavenger receptor A (SR-A) is reported to be involved in innate and adaptive immunity and in recent years, the soluble form of SR-A has also been identified. Intriguingly, SR-A displays double-edged sword features in different diseases. Moreover, targeted therapy on SR-A, including genetic modulation, small molecule inhibitor, inhibitory peptides, fucoidan, and blocking antibodies, provides potential strategies for treatment. Currently, therapeutics targeting SR-A are in preclinical studies and clinical trials, revealing great perspectives in future immunotherapy. AREAS COVERED: Through searching PubMed (January 1979-March 2022) and clinicaltrials.gov, we review most of the research and clinical trials involving SR-A. This review briefly summarizes recent study advances on SR-A, with particular concern on its role in immunity and autoimmune diseases. EXPERT OPINION: Given the emerging evidence of SR-A in immunity, its targeted therapy has been studied in various diseases, especially autoimmune diseases. However, many challenges still remain to be overcome, such as the double-sworded effects and the specific isoform targeting. For further clinical success of SR-A targeted therapy, the crystal structure illustration and the dual function discrimination of SR-A should be further investigated. Nevertheless, although challenging, targeting SR-A would be a potential effective strategy in the treatment of autoimmune diseases and other immune-related diseases.

Aerosol Reduction of 2 Dental Extraoral Scavenger Devices In Vitro.

OBJECTIVE: Since the outbreak of SARS-CoV-2, aerosol control in the operatory has become a key safety issue in dentistry. The utilisation of extraoral scavenger devices (EOSs) is one of the various approaches to in-treatment aerosol reduction in dentistry. The use and efficacy of EOSs in dental settings, however, are still a matter of debate in the literature and there are still open questions about their proper use. Thus, research into this area is essential to inform dental practice. The objective of this study was to examine the aerosol reduction efficacy of two different EOS in vitro. METHODS: Two commercially available EOSs were tested during modeled dental treatment in a setup that previously proved to generate high aerosol load. Measurements were done in two particle size ranges: 5.6-560 nm (the full range of the spectrometer) and 60.4-392.4 nm (a range that is especially relevant to the spread of SARS-CoV-2 with aerosol). RESULTS: Both devices managed to reduce the aerosol load to a statistically significant extent as compared to the scenario when only a high-volume evacuator and a saliva ejector (and no EOS) were used. CONCLUSIONS: Within the limitations of the study, the results support the assumption that EOSs for aerosol reduction increase in-treatment safety in the dental operatory.

A RECOMBINANT BIO-HDL (CER-001) CAN PREVENT SARS-COV2-INDUCED RENAL DYSFUNCTION BY RESTORING SR-BI SIGNALLING

BACKGROUND AND AIMS: Replication of the enveloped SARS-COV2 virus can alter lipidomic composition and metabolism of infected cells [1]. These alterations commonly result in a decline in HDL, total cholesterol and LDL, and an increase in triglyceride levels in COVID-19 patients. Furthermore, the 'cytokine storm' subsequent to release of inflammatory cytokines can severely impair lipid homeostasis. Importantly, decreased HDL-cholesterol correlates with severity of COVID-19 infection and represents a significant prognostic factor in predicting poor clinical outcomes [2]. Similarly, it has been observed that COVID-19 patients' recovery is accompanied by a rise in serum HDL levels. Pharmacological intervention that aims to restore ApoA-1 or functional HDL particles may have beneficial roles for clinical outcome of COVID-19 patients and has recently been approved for compassionate use [3]. SARS-CoV 2 spike proteins S1 and S2 can bind free cholesterol and HDL-bound cholesterol, facilitating virus entry by binding the ACE2 co-receptor Scavenger Receptor-BI (SR-BI) [4]. When activated at the trans-membrane level, SR-BI signalling culminates in Ser1173-eNOS phosphorylation with both anti-inflammatory and anti-apoptotic effect. We hypothesized that SARS-COV2 binding promoted SR-BI internalization, so that it could not exert its essential protective function. Therefore, the aim of this study is to evaluate the effects of CER-001, a mimetic HDL, in antagonizing this process. METHOD: Endothelial and tubular (RPTEC) cells were exposed to S1, S2 and S1 + S2 (50-250 nM) with or without CER-001 (CER-001 50-500 ug/mL) and cholesterol (10-50 uM). Apoptosis tests (MTT and AnnV/PI) were performed. Internalization of SR-BI, ACE2 with S1 and activation of eNOS was evaluated by FACS analysis. SR-BI and ACE2 expression were evaluated on kidney biopsies from COVID-19 patients. RESULTS: At concentrations used, the exposition of S1, S2 and S1 + S2 in the presence of CER-001 and cholesterol did not induce apoptosis of endothelial cells and RPTEC. Endothelial and tubular cells stimulated by S1, in presence of cholesterol, showed an increased intracellular level of SR-BI and ACE-2, with significantly reduced eNOS phosphorylation compared to baseline (P < 0.05). The treatment with CER-001 reversed trans-membrane SR-BI levels and eNOS phosphorylation to baseline values. The detection of S1 spike protein by endothelial cells immunohistochemistry revealed an increased level in S1-exposed cells with cholesterol and reduced S1 intracellular positive staining in CER-001-exposed cells (P < 0.05). Interestingly, S1-exposed cells without cholesterol appeared not to be capable of mediating S1 spike protein internalization. Consistent with in vitro results, analysis of renal biopsies from COVID-19 patients with proteinuria showed increased SR-BI and ACE-2 cytoplasmic signals and reduced expression at the apical domain of injured tubules. CONCLUSION: Our data confirmed the key role of lipid profile in SARS-COV2 infection, evaluating the molecular signalling involved in HDL metabolism and inflammatory processes, and could offer new therapeutic strategies for COVID-19 patients. (Figure Presented).

An investigation of the use of dexrazoxane as a cardioprotectant in UK Teenage and Young Adult (TYA) Cancer Centres

Introduction: Around 1 in 10 childhood cancer survivors who receive an anthracycline develop a symptomatic cardiac event over time.1 Dexrazoxane, a free radical scavenger, has been shown to reduce surrogate markers of cardiac damage in children and young people receiving anthracycline chemotherapy.2 In February 2020, NHS England (NHSE) published a new clinical commissioning policy entitled: “Dexrazoxane for preventing cardiotoxicity in children and young people (under 25 years) receiving high-dose anthracyclines or related drugs for the treatment of cancer”.1 Given uncertainties regarding the robustness of the supporting data,1,2 a general unfamiliarity with the product and the timing of the publication of the policy (at the start of the COVID-19 pandemic) we hypothesised that these factors may all have impacted on the speed and degree of its adoption. Consequently we decided to undertake a survey of practice, with the aim of exploring awareness of the policy and use of the drug amongst UK TYA centres. Methods: A short questionnaire was designed using the www.onlinesurveys.ac.uk platform. The questionnaire was sent electronically to senior oncology/ haematology pharmacists from all 17 TYA Cancer Centres in the UK in March 2021 and was kept open for six weeks to allow centres sufficient time to respond. Responses were transferred to Microsoft Excel for data analysis. Results: Responses were received from all 17 UK TYA centres. All centres in England (n=13) were either very aware (69%) or somewhat aware (31%) of the dexrazoxane commissioning policy. The majority (three out of four) of the centres from the devolved nations were unaware of the policy. Five centres (29%) had used dexrazoxane as a cardioprotectant since February 2020 and a further five centres (29%) were considering its use. Reasons for not using the drug included: unconvinced by efficacy data (n=4), concerned re short and long-term side effects (n=3). Of those centres that had used the drug, three had only given it to 1-3 patients, one centre had given it to 7-9 patients and one centre had given it to >9 patients. None of the centres had a TYA Unit policy or guideline for the use dexrazoxane as a cardioprotectant, although two were in the process of writing one. Furthermore, although stipulated in the commissioning policy, only three out of five centres using the drug required MDT discussion prior to use. From a clinical perspective, there was a lack of consensus as to when in the treatment pathway to start the drug (i.e. with cycle one of chemotherapy or when a threshold dose had been reached). And from a practical perspective, concerns were raised about the short shelf-life of dexrazoxane and the workload implications for aseptic units. Conclusions: Despite generally good awareness of the dexrazoxane commissioning policy, use of the drug by TYA centres has been limited to date and clinical practice has not uniformly matched the recommendations contained within the policy. Further work is required to explore reasons for the slow and variable uptake and to also investigate potential differences in practice between TYA and paediatric centres.

Zoom in - Virtual Summer Cleft Camp

Background/Purpose: This urban pediatric hospital has offered for the past 20 years a summer and winter camp experience for children affected with a cleft anomaly. The COVID pandemic in 2020 led our state to ban in early spring overnight camp programs. Our team had to re-imagine what a camp experience could be virtually and decided to offer a three-week virtual camp experience via a secured Zoom site. An email letter was sent to the camp mailing list, introducing the opportunity of Virtual Cleft Camp and inviting children to participate. Parents had to RSVP about their child's interest to attend our virtual camp. Once parents confirmed participation, they were sent the dates and times of the planned activities. The team's outreach coordinator partnered with the past summer/winter camp facility staff to plan the activities. Eighteen children participated in at least one of the camp activities;most participated in almost all activities. Each camper received a mailed package that contained a welcome letter, bingo cards, a box of Skittle candies labeled as bingo markers, package of word search activities, and other items. Some of the activities done over the three weeks included an arts and crafts project where they made a life map, Skittle Bingo, yoga, Happy Hour Word Search Races and a scavenger hunt. Despite having a virtual camp, the traditional bonding Sharing Circle, was more poignant, as campers shared their struggles and joys. We concluded with a Cleft Camp favorite, costume dance party, done virtually with two teams. Each team created a dance to a song of their choice and performed for everyone. After virtual camp, each camper and parent received evaluation forms to complete. Feedback was positive from both parents and campers;they commented on meaningful connections created, especially during these challenging times. Campers want to continue to have monthly virtual gatherings. Methods/Description: This introductory talk will detail how our Virtual Cleft Camp Program was developed, executed, funded and sustained. An overview of our monthly online activities and content will be presented along with evaluations from campers and parents.

Expansion of a Pathology Resident Wellness Initiative Amidst the COVID-19 Pandemic

Background: The focus on physician wellness and burnout continues to build in the era of the COVID-19 pandemic. The pre- COVID rate of burnout among pathology residents was reported to be approximately 46-52%, but there is little data on this group during the period of COVID-19. Amongst residents as a whole, the burnout rate during the COVID-19 pandemic is about 50%, with 69% of young healthcare workers (ages 18-29) reporting burnout. In addition to the limitations on direct social interaction, uncertainty pertaining to redeployment, risk of exposure to COVID-19, and future job security has added to the challenge of maintaining resident well-being during the pandemic. Design: An established Pathology Resident Wellness Initiative program at a large academic institution was expanded to address the well-being needs of pathology residents during the COVID-19 pandemic. With oversight from senior residents and department leaders, the Pathology Wellness Committee (PWC) planned both virtual and socially distanced in-person events to foster resident wellness while complying with safety guidelines. An annual Wellness Survey was modified in 2020 to assess resident well-being during the pandemic. Results: In compliance with COVID-19 safety guidelines, the PWC creatively designed social events including virtual yoga classes, an outdoor photo scavenger hunt, wellness hikes, holiday events, and periodically provided individually packaged meals and baked goods for residents. The Wellness Survey distributed during the pandemic revealed that 76% of residents felt satisfied or very satisfied with their relationships with coworkers, friends, and family despite social distancing guidelines. There was no significant change in the amount of residents who reported feeling cheerful (p=0.38), fulfilled (p=1.00), or appreciated (p=0.38) more than half of the time compared to pre-COVID results. Conclusions: The COVID-19 pandemic created many unique challenges for maintaining wellness during residency, including for pathology trainees. With expansion of an existing pathology resident Wellness Initiative, our Wellness Committee was able to creatively and safely continue to promote wellness objectives and adapt to the challenge of social distancing during the COVID-19 pandemic.

Hypothesis: Designation of Liposomal Scavenger System for Fight against 2019-nCoV.

2019 novel coronavirus (2019-nCoV), also known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or COVID-19 virus, is a member of the family Coronaviridae, which is responsible for the current pandemic of disease COVID-19. It is the seventh member of the family Coronaviridae which infects humans, after 229E, OC43, NL63, HKU1, SARS-CoV and Middle East respiratory syndrome coronavirus (MERS-CoV). Fever, dry cough and severe pneumonia are seen as common symptoms at the early stages of COVID-19. Some cases progress to acute respiratory stress syndrome, septic shock, organ failure, and death. The development of an effective treatment or vaccination for treating or preventing this lethal condition is an urgent need in order to fight this crisis. Up to now, some effective vaccines with different efficacy profiles have been introduced. Herein, we have theoretically designed a scavenger system for gathering 2019-nCoVs, breaking them, and re-introducing them to the immune system.

Scavenger Receptors in the Pathogenesis of Viral Infections.

Scavenger receptors (SR) are not only pattern recognition receptors involved in the immune response against pathogens but are also important receptors exploited by different virus to enter host cells, and thus represent targets for antiviral therapy. The high mutation rates of viruses, as well as their small genomes are partly responsible for the high rates of virus resistance and effective treatments remain a challenge. Most currently approved formulations target viral-encoded factors. Nevertheless, host proteins may function as additional targets. Thus, there is a need to explore and develop new strategies aiming at cellular factors involved in virus replication and host cell entry. SR-virus interactions have implications in the pathogenesis of several viral diseases and in adenovirus-based vaccination and gene transfer technologies, and may function as markers of severe progression. Inhibition of SR could reduce adenoviral uptake and improve gene therapy and vaccination, as well as reduce pathogenesis. In this review, we will examine the crucial role of SR play in cell entry of different types of human virus, which will allow us to further understand their role in protection and pathogenesis and its potential as antiviral molecules. The recent discovery of SR-B1 as co-factor of SARS-Cov-2 (severe acute respiratory syndrome coronavirus 2) entry is also discussed. Further fundamental research is essential to understand molecular interactions in the dynamic virus-host cell interplay through SR for rational design of therapeutic strategies.

Portable Health Monitoring Module using Machine Learning

Amidst the current covid-19 pandemic situation continuous health monitoring becomes important. In this work, we propose a low cost portable healthcare module which helps in tracking a patient's health conditions using various parameters such as heart rate, carbon dioxide exhalation, body temperature and electrical heart recording (ECG). This monitoring can be done autonomously without the presence of a doctor. This module is helpful in the health monitoring of patients who are in quarantine, or under treatment in a hospital. It can also be used for the health monitoring of elderly and diabled patients. In this work, we also compare some of the existing modules and draw a comparison. In addition to that we also compare different machine learning algorithms used for prediction of asthma. Our results for different algorithms have been quantified and we found that using K neighbors we got the maximum score of 87%. © 2021 IEEE.

Methylene blue and hydroxocobalamin in a severely vasoplegic lung transplant recipient

INTRODUCTION: Vasoplegia is defined as a refractory shock state with profound hypotension in the setting of reduced systemic vascular resistance and high cardiac output. Lung transplantation is an arduous surgery often requiring cardiopulmonary bypass, which ultimately predisposes to vasoplegia. We detail the treatment of a patient with end-stage lung disease secondary to COVID-19 pneumonia undergoing lung transplant who developed vasoplegia. DESCRIPTION: The patient is a 36-year-old female who was admitted with profound hypoxemic respiratory failure secondary to COVID-19 pneumonia. Despite initial therapy, she remained ventilator-dependent with need for extracorporeal membrane oxygenation (ECMO) support. Given her single organ failure status - lungs being solely affected - she was promptly considered for lung transplant evaluation upon resolution of her active SARS-CoV-2 infection. She was ultimately deemed appropriate for listing and underwent subsequent transplant. The surgery required the use of cardiopulmonary bypass, given the extensive adhesions of the native COVID-19-infected lungs. The lungs were, unfortunately, quite necrotic, with multiple purulent pockets. She was profoundly hypotensive throughout the surgery and required massive fluid resuscitation, as well as multiple vasopressors. In the setting of this vasoplegia, she received multiple doses of methylene blue at 2 mg/kg, with only marginal improvement in blood pressure. Decision was made to add high-dose (5 g) hydroxocobalamin in an attempt to synergistically stabilize blood pressure. Intraoperatively, her blood pressure stabilized within hours;she remained on ECMO support and was transferred to the ICU postoperatively. Eventually, she was slowly weaned from her vasopressors, with stable blood pressure. DISCUSSION: Methylene blue mechanistically inhibits inducible nitric oxide synthase and guanylyl cyclase, while hydroxycobalamin acts as a nitric oxide scavenger. Both agents have been used independently to treat vasoplegia during cardiopulmonary bypass. Together, they may be used as a salvage therapy to improve blood pressure in refractory cases of shock seemingly exacerbated by the cytokine milieu promoted by recent SARS-CoV-2 infection.

Evaluation of Peronema canescens Leaves Extract: Fourier Transform Infrared Analysis, Total Phenolic and Flavonoid Content, Antioxidant Capacity, and Radical Scavenger Activity

BACKGROUND: Peronema canescens (Sungkai) leaves have been popular in Indonesia which contain various bioactive compounds with empirical therapeutic efficacy in dealing with COVID-19 and various other diseases. Total phenolic and flavonoid content and antioxidant activity using the DPPH method from P. canescens leaf extract have not been studied much. AIM: This research has several objectives. The first is to compare the results of qualitative phytochemical analysis of the ethanol extract of the leaves of P. canescens (EEPL). The second is to measure the total phenol and flavonoid content. The third is to test the FTIR and antioxidant activity of the ethanol extract of P. canescens leaves in vitro using the DPPH method. METHODS: Fresh plant material and simplicia, ethanol extract extracted by maceration method using 96% ethanol as solvent from P. canescens. The Dragendorff’s and Mayer test carried out the qualitative phytochemical analysis, FeCl3 test, Salkowski method, Liebermann–Burchard method, foam test, and NaOH reagent. The total phenolic and flavonoid levels were tested using the Folin–Ciocalteu method. In vitro antioxidant activity was carried out using the DPPH (1,1-diphenyl-2-picrylhydrazyl) method. RESULTS: The results of qualitative phytochemical screening showed that alkaloids, flavonoids, saponins, tannins, and steroids were detected in the extract of P. canescens. The spectra from the FTIR test results showed various absorbance peak values indicating the bonding of specific functional groups, namely: 418.12, 599.94, 666.67, 1036.39, 1159.52, 1224.16, 1348.95, 1454.19, 1600.87, 1732.00, 2923.13, and 3353.01 cm-1. In the test results, total phenolic content was as much as 5.64% (mgEAG/g) and total flavonoid content of 142,247 mgEQ/g in a sample of 1 mg extract, which was equivalent to 1 mg quercetin. EEPL has antioxidant activity with the DPPH IC50 method of 116.7865 ppm. CONCLUSION: The data obtained at this time can contribute to the exploitation of P. canescens leaves in the future as one of the nutraceutical products, supplements, and herbal medicines by specific industries related to improving the health status of the world community. The higher the bioactive substance in preparation, the more significant the effect of the pharmacological efficacy response. P. canescens ethanol extract has good total phenolic content, total flavonoid content, and antioxidant action.