Lived Experiences of Adult Asian Indian Immigrants in Central Ohio with Type Two Diabetes

Research shows that prevalence of Type Two Diabetes Mellitus in Asian Indians is the highest amongst various ethnicities. The purpose of this study was to gain an in-depth understanding of the lived experiences of adult Asian Indian immigrants living in central Ohio who have Type Two Diabetes. The perceptions of this ethnic subgroup were studied through formal interviews with nine participants, the sample size. Data saturation, when no new themes were emerging from data, had been reached with the ninth participant. Interviews were audio taped and later transcribed and translated for analysis. Interview transcripts were coded and analyzed for themes. Follow-up interviews were conducted for four participants to further clarify and verify points of interest in data. To summarize, two major themes were observed in the data: A majority of the study participants experienced transitions or changes in their lives due to Diabetes. Also, they had to control their diet to manage Diabetes. Amongst these themes, participants’ stated the importance of restricting diet, exercising more, taking medication. They also stated feeling tiredness, pain, or less energy than before. Furthermore, the participants experienced various other feelings associated with lifestyle changes such as feeling good with more exercise or feeling like they did not have enough time to exercise in some cases. Overall, the participants expressed many thoughts and feelings regarding their lived experiences with Diabetes. This can help health care professionals better understand the perceptions of an ethnic group that is greatly affected by Diabetes. By better understanding the perceptions and lived experiences, the provider is able to design more efficient culturally competent interventions that can help lead to better health outcomes for this ethnic group.Ohio State University College Of NursingNo embarg

BIOCHEMICAL STUDY TO ANALYSE SALIVARY COPPER IN ORAL SUB-MUCOUS FIBROSIS PATIENTS WITH ARECANUT CHEWING HABIT

Oral Sub-Mucous Fibrosis (OSMF); a collagen disorder is the most prevalent precancerous condition with high malignant transformation rate. This disease is caused by number of factors, however a complete etiopathogenesis of the disease is not known. Copper a trace element present in arecanut has shown its impact in collagen production through its role as coenzyme in a biochemical processes. Therefore, we have undertaken this study to establish relation of copper in etiopathogenesis of OSMF

Clinical profile of patients presenting with heart failure with preserved ejection fraction

Background: Evaluate the clinical profile of patients presenting with heart failure having normal or preserved ejection fraction and to determine the prevalence of comorbid illnesses in these patients.Methods: The study was carried out on patients that presented with heart failure at the Vadilal Sarabhai hospital, Ahmedabad between September 2014-2016. Heart failure patients with normal ejection fraction (>50%) were selected. Socio-demographic, vital signs, data of 2D Echocardiography and Tissue Doppler study were collected. The patients were classified as per the Echocardiographic study into four categories. Different laboratory parameters were compared in patients with respect to (a) grade of Hypertension (b), grade of anemia (c), HbA1c levels. Statistical analysis was done using the SPSS software v20. Mann-Whitney and Kruskal-Wallis tests were performed to compare the means between different study groups.Results: Out of the 70 patients, a majority (47%) belonged to the Grade 2 (pseudo-normalized) group of diastolic dysfunctions with most of them having only dyspnea and pedal edema (33%). 58.6% patients required intensive care for at least one day. Regarding co-morbidities 27 (38.6%) had hypertension, 34 (48.6%) were diabetic and 49(70%) had anemia. Patients with higher grade of dysfunction had higher HbA1c (p=0.023) and worsening anemia (p=0.003).Conclusions: Authors concluded that it is of prime importance to find, prevent and treat the comorbidities along with targeted therapies for HFpEF. Further evaluation can be done for clinical applicability of different markers including HbA1c and U.ACR for renal dysfunction in HFpEF

Extracranial arterio-venous malformation presenting as a scalp swelling

It is a challenge to diagnose and treat extracranial arteriovenous malformations (AVMs) because of complex vascular malformations. AVMs are congenital vascular shunts with long standing expansion of vascular channels, collateralization of microcirculation and localized tissue infiltration. Even though the exact etiopathogenesis of AVMs remains undefined however newer genetic/molecular basis of the same are evolving. Any age can be affected by AVMs however it is seen to increase in dimension after an early period of inactivity. They may present at any age following an early quiescent period. Diagnosis is based on vascular staining, soft tissue expansions, progressive growth/ warmth and pulsations

Reconstituted B cell receptor signaling reveals carbohydrate-dependent mode of activation

Activation of immune cells (but not B cells) with lectins is widely known. We used the structurally defined interaction between influenza hemagglutinin (HA) and its cell surface receptor sialic acid (SA) to identify a B cell receptor (BCR) activation modality that proceeded through non-cognate interactions with antigen. Using a new approach to reconstitute antigen-receptor interactions in a human reporter B cell line, we found that sequence-defined BCRs from the human germline repertoire could be triggered by both complementarity to influenza HA and a separate mode of signaling that relied on multivalent ligation of BCR sialyl-oligosaccharide. The latter suggested a new mechanism for priming naïve B cell responses and manifested as the induction of SA-dependent pan-activation by peripheral blood B cells. BCR crosslinking in the absence of complementarity is a superantigen effect induced by some microbial products to subvert production of antigen-specific immune responses. B cell superantigen activity through affinity for BCR carbohydrate is discussed

Omicron infection enhances Delta antibody immunity in vaccinated persons

The extent to which Omicron infection(1–9), with or without previous vaccination, elicits protection against the previously dominant Delta (B.1.617.2) variant is unclear. Here we measured the neutralization capacity against variants of severe acute respiratory syndrome coronavirus 2 in 39 individuals in South Africa infected with the Omicron sublineage BA.1 starting at a median of 6 (interquartile range 3–9) days post symptom onset and continuing until last follow-up sample available, a median of 23 (interquartile range 19–27) days post symptoms to allow BA.1-elicited neutralizing immunity time to develop. Fifteen participants were vaccinated with Pfizer's BNT162b2 or Johnson & Johnson's Ad26.CoV2.S and had BA.1 breakthrough infections, and 24 were unvaccinated. BA.1 neutralization increased from a geometric mean 50% focus reduction neutralization test titre of 42 at enrolment to 575 at the last follow-up time point (13.6-fold) in vaccinated participants and from 46 to 272 (6.0-fold) in unvaccinated participants. Delta virus neutralization also increased, from 192 to 1,091 (5.7-fold) in vaccinated participants and from 28 to 91 (3.0-fold) in unvaccinated participants. At the last time point, unvaccinated individuals infected with BA.1 had low absolute levels of neutralization for the non-BA.1 viruses and 2.2-fold lower BA.1 neutralization, 12.0-fold lower Delta neutralization, 9.6-fold lower Beta variant neutralization, 17.9-fold lower ancestral virus neutralization and 4.8-fold lower Omicron sublineage BA.2 neutralization relative to vaccinated individuals infected with BA.1. These results indicate that hybrid immunity formed by vaccination and Omicron BA.1 infection should be protective against Delta and other variants. By contrast, infection with Omicron BA.1 alone offers limited cross-protection despite moderate enhancement

Efficacy of the ChAdOx1 nCoV-19 Covid-19 Vaccine against the B.1.351 Variant.

BACKGROUND: Assessment of the safety and efficacy of vaccines against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in different populations is essential, as is investigation of the efficacy of the vaccines against emerging SARS-CoV-2 variants of concern, including the B.1.351 (501Y.V2) variant first identified in South Africa. METHODS: We conducted a multicenter, double-blind, randomized, controlled trial to assess the safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) in people not infected with the human immunodeficiency virus (HIV) in South Africa. Participants 18 to less than 65 years of age were assigned in a 1:1 ratio to receive two doses of vaccine containing 5×1010 viral particles or placebo (0.9% sodium chloride solution) 21 to 35 days apart. Serum samples obtained from 25 participants after the second dose were tested by pseudovirus and live-virus neutralization assays against the original D614G virus and the B.1.351 variant. The primary end points were safety and efficacy of the vaccine against laboratory-confirmed symptomatic coronavirus 2019 illness (Covid-19) more than 14 days after the second dose. RESULTS: Between June 24 and November 9, 2020, we enrolled 2026 HIV-negative adults (median age, 30 years); 1010 and 1011 participants received at least one dose of placebo or vaccine, respectively. Both the pseudovirus and the live-virus neutralization assays showed greater resistance to the B.1.351 variant in serum samples obtained from vaccine recipients than in samples from placebo recipients. In the primary end-point analysis, mild-to-moderate Covid-19 developed in 23 of 717 placebo recipients (3.2%) and in 19 of 750 vaccine recipients (2.5%), for an efficacy of 21.9% (95% confidence interval [CI], -49.9 to 59.8). Among the 42 participants with Covid-19, 39 cases (95.1% of 41 with sequencing data) were caused by the B.1.351 variant; vaccine efficacy against this variant, analyzed as a secondary end point, was 10.4% (95% CI, -76.8 to 54.8). The incidence of serious adverse events was balanced between the vaccine and placebo groups. CONCLUSIONS: A two-dose regimen of the ChAdOx1 nCoV-19 vaccine did not show protection against mild-to-moderate Covid-19 due to the B.1.351 variant. (Funded by the Bill and Melinda Gates Foundation and others; ClinicalTrials.gov number, NCT04444674; Pan African Clinical Trials Registry number, PACTR202006922165132)

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Short-Rate Models in a Negative Rates Regime: A Calibration Across Currencies

Over the past few years, central banks around the world have implemented aggressive expansionary monetary policy regimes to combat the global recession. As a result, rates have fallen sharply, and in some cases have entered unprecedented negative territory. Negative rates directly impact the pricing and quoting of debt instruments, both guided by underlying rate models grounded in the assumption of nonnegative rates. To reevaluate both processes, Russo and Fabozzi (2017) recalibrate three short-rate models -- Hull-White, shift-extended Cox-Ingersoll-Ross, and shift-extended squared Gaussian -- that guide the pricing of rate derivatives using EUR swaption prices quoted under three market quotation styles. The market quotation methods examined include Black, Bachelier, and shifted log-normal; while Black is the market standard, the latter two have recently stemmed from a need to account for negative rates. This thesis seeks to extend the study to other currencies, specifically USD, GBP, and JPY, as the negative rates regime extends globally and models must be adapted specifically to each currency. The goal is twofold: 1) to analyze relative errors in calibration across market quotes, thereby determining the robustness of each convention in calibration, and 2) to derive the optimal value of model parameters. Our results are promising, and coincide with those of Russo and Fabozzi. The new parameters are derived with relatively similar errors across all quotation styles, suggesting that the models can be effectively recalibrated under negative rates and that both existing and new quotation conventions are able to produce adequate calibration results

Engineering 2D and 3D Human Skeletal Muscle Models

Advancing 2D and 3D in vitro human skeletal muscle model designs that are simple and reproducible would provide a valuable method to extract relevant structural and functional data for use in disease modeling and drug therapy development. Such models could offer a method to investigate the initiation mechanisms behind Facioscapulohumeral Muscular Dystrophy (FSHD), an incurable genetic disorder that results in total loss of functional motility. This thesis describes the approach taken to create an in vitro model in 2D and 3D. The role of the substrate and extra cellular matrix are considered key in the 2D patterning of skeletal myoblasts, while the development of the hydrogel matrix for growing elongated myobundles is perfected in 3D. Attempts to optimize these models for the study of human skeletal muscles in vitro so they are consistently replicable have been made