COVID-19 first anniversary review of cases, hospitalization, and mortality in the UK

Introduction: The first confirmed COVID-19 case in UK dates to 11 January 2020, exhibiting its first peak during April 2020. The country has since been hit by another wave in the winter 2020, almost at the first anniversary of the pandemic.Areas covered: An in-depth analysis of the COVID-19 positive cases in the UK throughout the year, hospitalizations, patients in critical care, and COVID-19 associated deaths.Expert opinion: The COVID-19 associated hospital admission accounts to 15% of total COVID-19 positive cases in November 2020. The percentage of total COVID-19 positive patients in the country died from the disease was under 4% in November 2020. Total deaths in England (all-cause) from June to October 2020 were similar to the historic averages. Age was the single most determinator of COVID-19 associated mortality, 50 years or older accounted for 98% of total COVID deaths. Age distribution of COVID-19 associated deaths in 2020 was similar to all-cause mortality age distribution in 2019. There was no significant improvement in the survival rate of COVID-19 patients receiving critical care. This prompts an urgent need to invest in novel antiviral therapeutics to save the most vulnerable in the society

Structure and Rheological Properties of Bovine Aortic Heart Valve and Pericardium Tissue: Implications in Bioprosthetic and Tissue-Engineered Heart Valves

Heart valve (HV) diseases are among the leading causes of cardiac failure and deaths. Of the various HV diseases, damaged HV leaflets are among the primary culprits. In many cases, impaired HV restoration is not always possible, and the replacement of valves becomes necessary. Bioprosthetic HVs have been used for the replacement of the diseased valves, which is obtained from the sources of bovine and porcine origin, while tissue-engineered heart valves (TEHV) have emerged as a promising future solution. The bioprosthetic valves are prone to become calcified, and thus they last for only ten to fifteen years. The adequate understanding of the correlations between the biomechanics and rheological properties of native HV tissues can enable us to improve the durability of the bioprosthetic HV as well as help in the development of tissue-engineered heart valves (TEHV). In this study, the structural and rheological properties of native bovine aortic HV and pericardium tissues were investigated. The microstructures of the tissues were investigated using scanning electron microscopy, while the rheological properties were studied using oscillatory shear measurement and creep test. The reported results provide significant insights into the correlations between the microstructure and viscoelastic properties of the bovine aortic HV and pericardium tissues.Scopu

Risk factors for multidrug-resistant tuberculosis in urban Pakistan: A multicenter case-control study

Objective: To evaluate risk factors for multidrug-resistant tuberculosis (MDR-TB) in an urban setting of Pakistan.DESIGN AND Methods: In this multicenter case-control study, patients aged 15years old or older with sputum culture and sensitivity (C/S) diagnosed with pulmonary MDR-TB were defined as cases, whereas patients aged 15years old or older with sputum C/S diagnosed and susceptible to pulmonary TB were regarded as controls. Fifty cases and 75 controls were enrolled from three tertiary-care hospitals in Karachi.Results: Multivariable logistic regression models showed that cases were more likely to have had a TB patient in the house prior to the diagnosis of MDR-TB (adjusted odds ratio [ORadj]=3.1, 95% confidence interval [CI]: 1.2, 8.3) or had a history of prior TB treatment (ORadj=4.2, 95% CI: 1.1, 15.4). Furthermore, cases compared with controls tended to be male (ORadj=3.6, 95% CI: 1.4, 9.7), 15-25years of age (ORadj=3.7, 95% CI: 1.2, 11.3), of Sindhi ethnicity (adjusted OR=9.1, 95% CI: 1.9, 43.4) or with low educational attainment (ORadj OR=5.5, 95% CI: 1.7-17.6, for no formal schooling; ORadj=3.8, 95% CI: 1.1-14.1, 1 for 1-5 school years).CONCLUSIONS: A TB patient in the house or a history of prior TB treatment was strongly associated with MDR-TB in this study. Furthermore, younger age, male gender, Sindhi ethnicity and poor educational attainment entailed a high risk for MDR-TB. Targeted educational intervention for patients and their contacts may minimize the noncompliance with prescribed TB treatment and lessen MDR-TB magnitude in settings like Karachi

Perceived sources of stress among Malaysian dental students

Objectives: The study objectives were to identify the stress levels and to explore the impact of students’ year of study and gender on the perceived sources of stress among Malaysian dental students. Methods: This was a cross-sectional study involving dental students from year one to year five from private and public universities in Malaysia. The study was formally approved by the Research and Ethics Committee, International Medical University Malaysia. Dental Environment Stress (DES) questionnaire was used for data collection and the gathered data were analyzed using SPSS® version 18. The Kruskal-Wallis and the Mann-Whitney U tests were used to compare stress items across various academic years and universities. Results: A total of five hundred and twenty nine (529) students participated in this study. Fear of failing the course at the end of year exams (mean stress level=5.57); concerns regarding completion of clinical work (mean=5.30); and examination results and grades (mean=5.27) were found as top stressors among dental students. Female students had higher stress scores than males with respect to personal issues, academic performance, educational environment and learning of clinical skills. Students from public universities had higher stress scores than their counterparts from private universities. Conclusion: The Malaysian dental students reported higher levels of stress. Present study identified stressors affecting dental students’ academic life, and highlights the importance of stress management programs and other measures to minimize the impact of stress on both academic and personal lives of the students

COVID-19 Mixed Impact on Hospital Antimicrobial Stewardship Activities: A Qualitative Study in UK-Based Hospitals

Antimicrobial resistance (AMR) is a well-known global threat due to the subsequent increase in antimicrobial usage. Several antimicrobial stewardship (AMS) strategies have been implemented to curb irrational prescribing and reduce the AMR burden. However, since the beginning of the COVID-19 pandemic, it has enormously impacted the healthcare system and jeopardized public health, causing millions of deaths globally. Our semi-structured qualitative study aimed to explore the impact of COVID-19 on AMS activities in the UK hospitals. Seventeen interviews were conducted with health care professionals who were part of AMS teams (consultant medical microbiologists, infectious disease consultants, antimicrobial pharmacists). Interviews were audio-recorded and transcribed. An inductive thematic framework was adopted to analyse and create the themes. After agreement of the hierarchical framework definition, all transcripts were coded accordingly. Four main themes and 15 sub-themes were identified. These main themes were: (1) AMS activities or strategies before and during the pandemic; (2) challenges to implementing AMS activities before and during the pandemic; (3) information from public authorities on AMS during the pandemic; and (4) new AMS activities/strategies adopted during the pandemic. Staff vacancies, redeploying of AMS staff to other duties and meeting the burden related to the COVID-19 and lack of resources were the most frequently identified contributing factors to withheld AMS activities during the pandemic. However, modifications to the hybrid working environment, i.e., remote or flexible working, allowed for resumption of AMS activities including virtual ward rounds, virtual meetings and other activities. Further research needs to assess the impact of the hybrid delivery system on AMS activities

Hybrid Dy-NFIS & RLS equalization for ZCC code in optical-CDMA over multi-mode optical fiber

For long haul coherent optical fiber communication systems, it is significant to precisely monitor the quality of transmission links and optical signals. The channel capacity beyond Shannon limit of Single-mode optical fiber (SMOF) is achieved with the help of Multi-mode optical fiber (MMOF), where the signal is multiplexed in different spatial modes. To increase single-mode transmission capacity and to avoid a foreseen “capacity crunch”, researchers have been motivated to employ MMOF as an alternative. Furthermore, different multiplexing techniques could be applied in MMOF to improve the communication system. One of these techniques is the Optical Code Division Multiple Access (Optical-CDMA), which simplifies and decentralizes network controls to improve spectral efficiency and information security increasing flexibility in bandwidth granularity. This technique also allows synchronous and simultaneous transmission medium to be shared by many users. However, during the propagation of the data over the MMOF based on Optical-CDMA, an inevitable encountered issue is pulse dispersion, nonlinearity and MAI due to mode coupling. Moreover, pulse dispersion, nonlinearity and MAI are significant aspects for the evaluation of the performance of high-speed MMOF communication systems based on Optical-CDMA. This work suggests a hybrid algorithm based on nonlinear algorithm (Dynamic evolving neural fuzzy inference (Dy-NFIS)) and linear algorithm (Recursive least squares (RLS)) equalization for ZCC code in Optical-CDMA over MMOF. Root mean squared error (RMSE), mean squared error (MSE) and Structural Similarity index (SSIM) are used to measure performance results

Protective role of epiphytic fluorescent <i>Pseudomonas</i> on natural postharvest decay of tomato at room temperature

 Following harvest, tomato fruits are susceptible to attack by many fungal pathogens, but  healthy fruits may also  harbor beneficial microflora, which can delayed the spoilage  of fruit. In this study, 30 isolates of epiphytic fluorescent Pseudomonas  were isolated from healthy fruits of lemon, melon, grapefruit, tomato and orange. Twelve isolates were identified on molecular basis by amplifying 16S rDNA using a genus-specific primer set PA-GS-F 5’-GACGGGTGAGTAATGCCTA-3’ and PA-GS-R F 5’-CACTGGTGTTCCTTCCTATA-3’ on a conserved sequence of the genus Pseudomonas with a product size ~618 bp. Three potential isolates were examined for their ability to  delayed the  postharvest natural  spoilage and maintained the physiochemical properties during storage for fifteen days in season 2013 and 2014. All three isolates showed promising control of postharvest diseases of tomato in comparison with control in both seasons up to fifteen days of storage at room temperature (23±4 ºC, Rh 25-70%). The epiphytic bacterial isolates has delayed the fruit weight loss and maintained  fruit firmness, total solids, pH and titratable acidity. Isolates also slowed the accumulation of lycopene indicating their potential in controlling the major changes in physiochemical properties. In both season Pseudomonas treated tomatoes showed no or negligible infestation of common postharvest fungi and bacteria as compared to control and positive control (1% K-sorbate)