Association between Usage of Prophylactic AYUSH Medicines and Disease Severity in COVID-19 Patients: A Retrospective Cohort Study.

BACKGROUND: Prior vaccination is often studied for its impact on individuals' post-infection prognosis. Ayurveda, Yoga, Unani, Siddha and Homeopathy (AYUSH) medicines, advised by the Government of India as prophylaxis during the first wave of the coronavirus disease 2019 (COVID-19) pandemic, were consumed by the masses in 2020. A study was therefore undertaken to observe any association between the prior usage of AYUSH prophylactic medicines and post-infection severity as reported by recovered COVID-19 individuals. METHODS: This was a retrospective, multi-centre, cohort study conducted in 21 cities of India from 5th August to 30th November 2020. Data from recovered COVID-19 patients, of either sex or any age, captured information about AYUSH prophylactic medicines intake prior to infection, disease severity, symptomatology, duration of complaints, etc. The study participants were grouped into AYUSH intake and non-intake. Primary composite outcome was the disease clinical course. Secondary clinical outcomes were the rate of and time to clinical recovery. RESULTS: Data of 5,023 persons were analysed. Ayurveda or homeopathic prophylactic medicines were consumed by more than half of the study participants: that is, 56.85% (n = 1,556) and 56.81% (n = 1,555) respectively. The overall adjusted protective effect (PE) of AYUSH prophylactic intake against moderate/severe forms of COVID-19 disease was 56.7% (95% confidence interval [CI], 48.7 to 63.50; p < 0.001). Adjusted PE for homeopathy and Siddha was 52.9% (95% CI, 42.30 to 61.50; p < 0.001) and 59.8% (95% CI, 37.80 to 74.10; p < 0.001), respectively. A statistically significant association was found between AYUSH prophylactic medicine intake and clinical recovery more frequently by the 3rd day of illness (χ2 = 9.01; p = 0.002). Time to resolution of symptoms in the AYUSH intake group was on average 0.3 days earlier than in the non-intake group (p = 0.002). CONCLUSION: AYUSH prophylactics were associated with statistically significant levels of protection against COVID-19 disease severity. Amongst these, previous intake of homeopathy or Siddha medicines was associated with some protection against moderate/severe illness and with a somewhat quicker clinical recovery. Prospective studies with experimental research design are needed to validate the findings of this study. STUDY REGISTRATION: Clinical Trials Registry-India (CTRI/2020/08/027000).

Modes and Mechanisms of Pacific Decadal-Scale Variability.

The modes of Pacific decadal-scale variability (PDV), traditionally defined as statistical patterns of variance, reflect to first order the ocean's integration (i.e., reddening) of atmospheric forcing that arises from both a shift and a change in strength of the climatological (time-mean) atmospheric circulation. While these patterns concisely describe PDV, they do not distinguish among the key dynamical processes driving the evolution of PDV anomalies, including atmospheric and ocean teleconnections and coupled feedbacks with similar spatial structures that operate on different timescales. In this review, we synthesize past analysis using an empirical dynamical model constructed from monthly ocean surface anomalies drawn from several reanalysis products, showing that the PDV modes of variance result from two fundamental low-frequency dynamical eigenmodes: the North Pacific-central Pacific (NP-CP) and Kuroshio-Oyashio Extension (KOE) modes. Both eigenmodes highlight how two-way tropical-extratropical teleconnection dynamics are the primary mechanisms energizing and synchronizing the basin-scale footprint of PDV. While the NP-CP mode captures interannual- to decadal-scale variability, the KOE mode is linked to the basin-scale expression of PDV on decadal to multidecadal timescales, including contributions from the South Pacific.

Volcanically Triggered Ocean Warming Near the Antarctic Peninsula.

Explosive volcanic eruptions are the largest non-anthropogenic perturbations for Earth's climate, because of the injection of sulfate aerosols into the stratosphere. This causes significant radiation imbalances, resulting in surface cooling for most of the globe. However, despite its crucial importance for Antarctic ice sheet mass balance, the response of the Southern Ocean to eruptions has yet to be understood. After the eruption of Mt. Pinatubo in 1991, much of the Southern Ocean cooled; however, off the Antarctic Peninsula a warming of up to 0.8 °C is found in the observations. To understand the physical mechanisms associated with this counter-intuitive response, we combine observational analysis from the Mt. Pinatubo eruption with the Last Millennium Ensemble (850-1850) conducted with the Community Earth System Model. These results show not only that the observed warming off the Peninsula following the Mt. Pinatubo eruption is consistent with the forced response to low-latitude eruptions but further, that this warming is a response to roughly 16% weakening of subsurface Weddell Gyre outflow. These changes are triggered by a southward shift of the Southern Hemisphere polar westerlies (∼2°latitude). Our results suggest that warming induced by future volcanic eruptions may further enhance the vulnerability of the ice shelves off the Antarctic Peninsula.

The amplifying influence of increased ocean stratification on a future year without a summer.

In 1816, the coldest summer of the past two centuries was observed over northeastern North America and western Europe. This so-called Year Without a Summer (YWAS) has been widely attributed to the 1815 eruption of Indonesia's Mt. Tambora and was concurrent with agricultural failures and famines worldwide. To understand the potential impacts of a similar future eruption, a thorough physical understanding of the YWAS is crucial. Climate model simulations of both the 1815 Tambora eruption and a hypothetical analogous future eruption are examined, the latter occurring in 2085 assuming a business-as-usual climate scenario. Here, we show that the 1815 eruption drove strong responses in both the ocean and cryosphere that were fundamental to driving the YWAS. Through modulation of ocean stratification and near-surface winds, global warming contributes to an amplified surface climate response. Limitations in using major volcanic eruptions as a constraint on cloud feedbacks are also found.

Binocular eye tracking with the Tracking Scanning Laser Ophthalmoscope.

The development of high magnification retinal imaging has brought with it the ability to track eye motion with a precision of less than an arc minute. Previously these systems have provided only monocular records. Here we describe a modification to the Tracking Scanning Laser Ophthalmoscope (Sheehy et al., 2012) that splits the optical path in a way that slows the left and right retinas to be scanned almost simultaneously by a single system. A mirror placed at a retinal conjugate point redirects half of each horizontal scan line to the fellow eye. The collected video is a split image with left and right retinas appearing side by side in each frame. Analysis of the retinal motion in the recorded video provides an eye movement trace with very high temporal and spatial resolution. Results are presented from scans of subjects with normal ocular motility that fixated steadily on a green laser dot. The retinas were scanned at 4° eccentricity with a 2° square field. Eye position was extracted offline from recorded videos with an FFT based image analysis program written in Matlab. The noise level of the tracking was estimated to range from 0.25 to 0.5arcmin SD for three subjects. In the binocular recordings, the left eye/right eye difference was 1-2arcmin SD for vertical motion and 10-15arcmin SD for horizontal motion, in agreement with published values from other tracking techniques.

Differential relationships between D1 and D2 dopamine receptor expression in the medial preoptic nucleus and sexually-motivated song in male European starlings (Sturnus vulgaris).

Converging data in songbirds support a central role for the medial preoptic nucleus (POM) in motivational aspects of vocal production. Recent data suggest that dopamine in the POM plays a complex modulatory role in the production of sexually-motivated song and that an optimal level of dopamine D1 receptor stimulation is required to facilitate singing behavior. To further explore this possibility, we used quantitative real-time PCR to examine relationships between mRNA expression of D1 as well as D2 receptors in the POM (and also the lateral septum and Area X) and sexually-motivated singing behavior in male European starlings. Results showed that both males with the highest and lowest D1 expression in the POM sang significantly less than males with intermediate levels of expression. Furthermore, singing behavior rose linearly in association with increasing levels of D1 expression in POM but dropped abruptly, such that individuals with D1 expression values higher than the mean sang very little. Analysis of birds with low and intermediate levels of D1 expression in POM revealed strong positive correlations between D1 expression and song but negative relationships between D2 receptor expression and song. These findings support prior work suggesting an optimal level of POM D1 receptor stimulation best facilitates sexually-motivated singing behavior. Results also suggest that D2 receptors may work in opposition to D1 receptors in POM to modify vocal production.

Sexually-motivated song is predicted by androgen-and opioid-related gene expression in the medial preoptic nucleus of male European starlings (Sturnus vulgaris).

Across vertebrates, communication conveys information about an individual's motivational state, yet little is known about the neuroendocrine regulation of motivational aspects of communication. For seasonally breeding songbirds, increases in testosterone in spring stimulate high rates of sexually-motivated courtship song, though not all birds sing at high rates. It is generally assumed that testosterone or its metabolites act within the medial preoptic nucleus (POM) to stimulate the motivation to sing. In addition to androgen receptors (ARs) and testosterone, opioid neuropeptides in the POM influence sexually-motivated song production, and it has been proposed that testosterone may in part regulate song by modifying opioid systems. To gain insight into a possible role for androgen-opioid interactions in the regulation of communication we examined associations between sexually-motivated song and relative expression of ARs, mu opioid receptors (muORs), and preproenkephalin (PENK) in the POM (and other regions) of male European starlings using qPCR. Both AR and PENK expression in POM correlated positively with singing behavior, whereas muOR in POM correlated negatively with song. Furthermore, the ratio of PENK/muOR expression correlated negatively with AR expression in POM. Finally, in the ventral tegmental area (VTA), PENK expression correlated negatively with singing behavior. Results support the hypothesis that ARs may alter opioid gene expression in POM to fine-tune singing to reflect a male's motivational state. Data also suggest that bidirectional relationships may exist between opioids and ARs in POM and song, and additionally support a role for opioids in the VTA, independent of AR activity in this region.

Status-appropriate singing behavior, testosterone and androgen receptor immunolabeling in male European starlings (Sturnus vulgaris).

Vocalizations convey information about an individual's motivational, internal, and social status. As circumstances change, individuals respond by adjusting vocal behavior accordingly. In European starlings, a male that acquires a nest site socially dominates other males and dramatically increases courtship song. Although circulating testosterone is associated with social status and vocal production it is possible that steroid receptors fine-tune status-appropriate changes in behavior. Here we explored a possible role for androgen receptors. Male starlings that acquired nest sites produced high rates of courtship song. For a subset of males this occurred even in the absence of elevated circulating testosterone. Immunolabeling for androgen receptors (ARir) was highest in the medial preoptic nucleus (POM) in males with both a nest site and elevated testosterone. For HVC, ARir was higher in dominant males with high testosterone (males that sang longer songs) than dominant males with low testosterone (males that sang shorter songs). ARir in the dorsal medial portion of the nucleus intercollicularis (DM) was elevated in males with high testosterone irrespective of dominance status. Song bout length related positively to ARir in POM, HVC and DM, and testosterone concentrations related positively to ARir in POM and DM. Results suggest that the role of testosterone in vocal behavior differs across brain regions and support the hypothesis that testosterone in POM underlies motivation, testosterone in HVC relates to song quality, and testosterone in DM stimulates vocalizations. Our data also suggest that singing may influence AR independent of testosterone and that alternative androgen-independent pathways regulate status-appropriate singing behavior.

Does gender moderate the exercising personality? An examination of continuous and stage-based exercise.

For nearly 60 years, researchers have examined the relationship between personality traits and exercise participation. Rhodes and Smith (2006), using meta-analytic procedures reported that extraversion, conscientiousness, and neuroticism were significantly related to exercise participation (Personality correlates of physical activity: A review and meta-analysis. British Journal of Sports Medicine, 40, 958-965). Gender as a moderator of the personality and exercise relationship remained inconclusive. In addition, researchers have suggested that the stage approach may lend greater insight as to the importance of personality. The investigator's primary purpose was to determine whether gender moderated the personality and exercise relationship. The secondary purpose was to determine the importance of personality within a stage approach. Participants were 827 females and 657 males college-aged students who completed measures of the "big five" personality traits and two exercise measures. The results indicated that gender was not a moderator and that the stage approach offers insight as hypothesized differences resulted in personality between intentional exercisers and non-exercising individuals as well as within exercising individuals.

The Kiwi hoop for Boyle-Davies gag suspension during tonsillectomy.

We describe an alternative method of suspending the Boyle-Davis gag during tonsillectomy. Use of the traditional Draffin's bipod for positioning patients during tonsillectomy is associated with a number of difficulties. These include limited height adjustment and problems with slipping during operation. We describe an alternative arrangement for suspension of the Boyle-Davis gag. This arrangement has been successfully used for many years, and offers advantages because of its stability and adjustability.

Benefits of magnetic resonance image scanning in progressive, bilateral, sensorineural hearing loss: a case of leptomeningeal haemosiderosis.

OBJECTIVE: Magnetic resonance imaging is a routine investigation in cases of asymmetric sensorineural hearing loss, but it is not routinely used to investigate bilateral sensorineural hearing loss. METHOD: This case report illustrates the benefits of magnetic resonance image scanning in the latter patient group. RESULTS: A 53-year-old man with rapidly progressive, symmetrical, bilateral, sensorineural hearing loss was found also to have anosmia, imbalance and incoordination. Magnetic resonance image scanning demonstrated leptomeningeal haemosiderosis. Progressive, bilateral, sensorineural hearing loss is the most common presentation of this condition and magnetic resonance imaging is the diagnostic investigation of choice. CONCLUSION: There are potential treatments for leptomeningeal haemosiderosis which prevent further irreversible damage, if a bleeding source can be found. Hearing loss may be due to cochlear or retrocochlear pathology. Cochlear implantation may be indicated.

Neurotensin inversely modulates maternal aggression.

Neurotensin (NT) is a versatile neuropeptide involved in analgesia, hypothermia, and schizophrenia. Although NT is released from and acts upon brain regions involved in social behaviors, it has not been linked to a social behavior. We previously selected mice for high maternal aggression (maternal defense), an important social behavior that protects offspring, and found significantly lower NT expression in the CNS of highly protective females. Our current study directly tested NT's role in maternal defense. Intracerebroventricular (i.c.v.) injections of NT significantly impaired defense in terms of time aggressive and number of attacks at all doses tested (0.05, 0.1, 1.0, and 3.0 microg). Other maternal behaviors, including pup retrieval, were unaltered following NT injections (0.05 microg) relative to vehicle, suggesting specificity of NT action on defense. Further, i.c.v. injections of the NT receptor 1 (NT1) antagonist, SR 48692 (30 microg), significantly elevated maternal aggression in terms of time aggressive and attack number. To understand where NT may regulate aggression, we examined Fos following injection of either 0.1 microg NT or vehicle. Thirteen of 26 brain regions examined exhibited significant Fos increases with NT, including regions expressing NT1 and previously implicated in maternal aggression, such as lateral septum, bed nucleus of stria terminalis, paraventricular nucleus, and central amygdala. Together, our results indicate that NT inversely regulates maternal aggression and provide the first direct evidence that lowering of NT signaling can be a mechanism for maternal aggression. To our knowledge, this is the first study to directly link NT to a social behavior.

Deletion of corticotropin-releasing factor binding protein selectively impairs maternal, but not intermale aggression.

Corticotropin-releasing factor (CRF) binding protein (CRF-BP) is a secreted protein that acts to bind and limit the activity of the neuropeptides, CRF and urocortin (Ucn) 1. We previously selected for high maternal defense (protection of offspring) in mice and found CRF-BP to be elevated in the CNS of selected mice. We also previously determined that both CRF and Ucn 1 are potent inhibitors of offspring protection when administered centrally. Thus, elevated CRF-BP could promote defense by limiting endogenous actions of CRF or Ucn 1. To test this hypothesis, we crossed the deletion for CRF-BP into the mice selected for high maternal defense and evaluated offspring protection and other maternal behaviors. CRF-BP knockout (KO) mice exhibited significant deficits in maternal aggression relative to wild-type (WT) mice in three different measures. Other maternal features were almost identical between groups, including dam and pup weight, litter size, nursing time, and pup retrieval. Both groups performed similarly in a forced swim stress test and aggression in both groups was reduced following the swim test. Virgin KO female mice exhibited higher levels of anxiety-like behavior in terms of decreased time in the light portion of the light/dark box test. For males, no differences in light/dark box or swim test were found. However, increased anxiety-like behavior in male KO mice was identified in terms of contact and approach to a novel object both with and without previous exposure to the swim test. No differences in isolation induced resident intruder male aggression were found between groups. Together, these results indicate that loss of CRF-BP selectively impairs maternal, but not intermale aggression and that loss of the gene induces anxiety-like behavior in males and females, but there are sex differences in terms of how that anxiety is revealed.

17beta-estradiol regulates the secretion of TGF-beta by cultured human dermal fibroblasts.

Estrogen plays an important role in skin homeostasis, as demonstrated by the changes seen in the skin of post-menopausal women, changes reversed by HRT. Estrogen also has a role in wound healing, since estrogen deficiency as occurs post-menopausally and in ovariectomised animals, is associated with a reduced rate of wound healing. Estrogen appears to modulate all phases of wound healing with effects on inflammatory cells, epithelialization, angiogenesis, extracellular matrix deposition and tissue remodelling. This study was designed to investigate the effects of 17beta-estradiol on cultured human dermal fibroblasts using an in vitro wound-healing assay. The end points investigated were cell migration, proliferation, total collagen secretion and active TGF-beta1 secretion. 17beta-estradiol significantly increased the migration and proliferation of cultured dermal fibroblasts following mechanical wounding, although the secretion of total soluble collagen was not altered. An increase in TGF-beta1 was demonstrated by unwounded confluent dermal fibroblast monolayers in response to 17beta-estradiol, but paradoxically, a decrease in the secretion of TGF-beta1 was demonstrated in the mechanically wounded dermal fibroblasts. These results identify human dermal fibroblasts as estrogen target cells and provide further evidence for a role by which estrogen regulates this particular cell type as part of the wound-healing process. However, the paradoxical nature of the effect of estrogen on TGF-beta1 secretion following mechanical wounding suggests that the cellular mechanism of action is complex. A greater understanding of the cell-specific action of estrogen may help to develop therapies that will improve cutaneous wound healing in the future.

The Pattern Glare Test: a review and determination of normative values.

Pattern glare is characterised by symptoms of visual perceptual distortions and visual stress on viewing striped patterns. People with migraine or Meares-Irlen syndrome (visual stress) are especially prone to pattern glare. The literature on pattern glare is reviewed, and the goal of this study was to develop clinical norms for the Wilkins and Evans Pattern Glare Test. This comprises three test plates of square wave patterns of spatial frequency 0.5, 3 and 12 cycles per degree (cpd). Patients are shown the 0.5 cpd grating and the number of distortions that are reported in response to a list of questions is recorded. This is repeated for the other patterns. People who are prone to pattern glare experience visual perceptual distortions on viewing the 3 cpd grating, and pattern glare can be quantified as either the sum of distortions reported with the 3 cpd pattern or as the difference between the number of distortions with the 3 and 12 cpd gratings, the '3-12 cpd difference'. In study 1, 100 patients consulting an optometrist performed the Pattern Glare Test and the 95th percentile of responses was calculated as the limit of the normal range. The normal range for the number of distortions was found to be <4 on the 3 cpd grating and <2 for the 3-12 cpd difference. Pattern glare was similar in both genders but decreased with age. In study 2, 30 additional participants were given the test in the reverse of the usual testing order and were compared with a sub-group from study 1, matched for age and gender. Participants experienced more distortions with the 12 cpd grating if it was presented after the 3 cpd grating. However, the order did not influence the two key measures of pattern glare. In study 3, 30 further participants who reported a medical diagnosis of migraine were compared with a sub-group of the participants in study 1 who did not report migraine or frequent headaches, matched for age and gender. The migraine group reported more symptoms on viewing all gratings, particularly the 3 cpd grating. The only variable to be significantly different between the groups was the 3-12 cpd difference. In conclusion, people have an abnormal degree of pattern glare if they have a Pattern Glare Test score of >3 on the 3 cpd grating or a score of >1 on the 3-12 cpd difference. The literature suggests that these people are likely to have visual stress in everyday life and may therefore benefit from interventions designed to alleviate visual stress, such as precision tinted lenses.

Vertical imbalance induced by prism-ballasted soft toric contact lenses fitted unilaterally.

Fitting a prism-ballasted soft toric contact lens unilaterally may potentially induce a vergence error that the subject cannot compensate. In the present study, a prism-ballasted (1.5Delta base down) soft toric contact lens was fitted in the right eye only of 10 subjects with normal binocular vision. The effect on binocular vision was evaluated by measuring vertical phoria adaptation and vertical fixation disparity adaptation. The results show that the vertical vergence error induced was well compensated and fully adapted to. However, care might be needed when fitting these lenses unilaterally in subjects with vertical phoria-related problems.