Evolution of Knowledge and Attitudes Regarding Fertility Service Utilization

Objective: To evaluate the temporal evolution of knowledge and attitudes regarding fertility service utilization in the United States. Material(s) and Method(s): 1000 women (21-45 years, stratified by age </= or > 35 years) were surveyed using an 82-item Internet-based questionnaire in April 2021. 50% had at least one child and 50% had interest in future childbearing. This cohort was compared to historical controls from a similar survey administered in 2016 (n=1000) using parametric tests. Multivariable linear regression was performed to evaluate differences in accepted costs. Result(s): Compared to historical controls, this cohort had a greater proportion of Hispanic and Black participants and those who reported lower-level education status, use of government-subsidized insurance, and being single. Despite consideration of the impact of the COVID-19 pandemic, likelihood to consider planned oocyte cryopreservation (OC) was similar between 2021 and 2016 (21.3% vs. 21.6%, p=0.87). In 2021, there was increased awareness of OC (92.3% vs. 87.2%), what the process entails (41.9% vs. 29.8%), and objectively assessed knowledge of associated costs (1.06/2 points vs. 0.68/2 points) despite decreased knowledge of OC efficacy (0.91/2 points vs. 0.99/2 points) and reproductive health (1.71/5 points vs. 2.40/5 points) (all p<0.01). Fewer participants cited relationship stability, completed education, and age as factors important in deciding when to pursue childbearing (82.1% vs. 91.7%;56.8% vs. 70.7%;69.2% vs. 79.6%;respectively;all p<0.01). If unable to conceive, women were less likely than previously reported to seek help from a specialist (74.2% vs. 82.0%) or adopt children (63.7% vs. 72.2%) and were more likely to use donor gametes (sperm: 32.7% vs. 25.4%;oocyte: 30.7% vs. 24.3%) (all p<0.01). When asked about the minimum success rate of achieving a pregnancy if OC cost $10,000, 77.5% of the cohort accepted a minimum 50% chance of success compared to 91.1% in 2016, with 44.1% of the cohort accepting a minimum of 80% success compared to 55.9% in 2016 (both p<0.01). A success rate less than 80% was more likely to be acceptable to those likely to consider OC (COC) compared to those unlikely to consider (NOC) (65.9% vs. 53.0%, p<0.01). A success rate less than 50% was not considered more acceptable by COC compared to NOC (25.5% vs. 21.7%, p=0.25), despite this being the case in 2016. COC were overall accepting of a lower minimum success rate compared to NOC (p<0.01). In a model considering demographic and knowledge differences, participants in 2021 reported an acceptable minimum success rate that was on average 11.1% less than historical controls (p<0.01). Conclusion(s): Likelihood to consider OC has remained constant, while third-party reproduction options have become more accepted. Despite improved awareness of the OC process, a disconnect exists between willingness to pay for OC and realistic success rates. Impact Statement: Understanding of and willingness to pay for OC has evolved in the decade since the experimental label on OC was removed, highlighting opportunities to provide more cost-effective and efficient fertility services. Support: Financial support for survey distribution was provided by Pennsylvania Hospital Resident Research Funding. Copyright © 2022

Identification of Compounds from Curcuma longa with In Silico Binding Potential against SARS-CoV-2 and Human Host Proteins Involve in Virus Entry and Pathogenesis

Severe acute respiratory syndrome coronavirus 2 and associated coronavirus disease 2019 is a newly identified human coronavirus has imposed a serious threat to global health. The rapid transmission of severe acute respiratory syndrome coronavirus 2 and its ability to spread in humans have prompted the development of new approaches for its treatment. Severe acute respiratory syndrome coronavirus 2 requires RNA-dependent RNA polymerases for life cycle propagation and Spike (S)-protein for attachment to the host cell surface receptors. The virus enters the human body with the assistance of a key functional host receptor dipeptidyl peptidase-4 primed by transmembrane serine protease 2 which are putative targets for drug development. We performed screening of 267 compounds from Curcuma longa L. (Zingiberaceae family) against the viral S-protein and RNA-dependent RNA polymerases and host receptor proteins dipeptidyl peptidase-4 and transmembrane serine protease 2 using in silico molecular docking. Compounds C1, ((4Z,6E)-1,5-dihydroxy-1,7-bis(4-hydroxy-3-methoxyphenyl)hepta-4,6-dien3-one) and C6 ((4Z,6E)-1,5-dihydroxy-1-(4-hydroxy-3-methoxyphenyl)-7-(4-hydroxyphenyl)hepta-4,6-dien-3-one) exhibited tight binding to the S1 domain of the Spike protein than VE607 and with RNA-dependent RNA polymerase protein more effectively than ribavirin and remdesivir. These compounds also interacted with the human host proteins dipeptidyl peptidase-4 and transmembrane serine protease 2 with higher efficiency than standard inhibitors sitagliptin and camostat mesylate. The lead compounds showed favorable free binding energy for all the studied protein-ligand complexes in Molecular mechanics/Generalized born model and solvent accessibility analysis. Besides, other Curcuma longa compounds C14 and C23 exhibited almost similar potential against these target proteins. The structure based optimization and molecular docking studies have provided information on some lead Curcuma longa compounds with probability for advancement in preclinical research.

InuAid Chest X-rays AI Product: Respiratory diseases detection using Artificial Intelligence to significantly improve productivity and quality of diagnosis

The spread of Covid-19 virus around the world has taken many lives, quarantined people and shattered many industries. Due to high transmissibility of the virus and its silent incubation period in human beings, detection of the virus plays an important role to control its spread and to plan diagnostic and preventive measures. Laboratory tests such as Polymerase Chain Reaction (PCR) take more time and hence there is a need for rapid and accurate diagnostic methods to detect the virus to prevent its spread and combat it. Today PCR tests were used for diagnosing purposes and the chest x-ray was only used as the follow up of patients, hence these studies on the chest x-rays of patients with Covid-19 pneumonia or any other disease are still limited to the literature and must be improved in the future. In this project, the goal is to build an application for healthcare workers to monitor the health of lungs using the chest x-ray images of patients. The algorithm must be very accurate because it deals with the lives of people. Here we used computer vision and deep learning techniques in this project. The focus is to classify chest x-ray images and segment the abnormal region and to get more insights on the images from the available datasets. The diagnostic accuracy is the challenging part and to increase the detection efficiency due to the limited open-source data available. The data was collected from the internet. On classification, the trained model was able to achieve 93.10% accuracy and F1 Score of 0.93 after using transfer learning technique with pneumonia images. On segmentation, the Intersection Over Union value was found to be 0.91 on the validation data. © 2021 ACM.

Bariatric surgery is safe during COVID-19 pandemic

Background: The Coronavirus Disease 2019 (COVID-19) pandemic has massively affected bariatric surgical practises across the world. Aim: This report aims to show the effects of the pandemic on bariatric practices in the UK during the early phase of the pandemic. Methods: Bariatric surgeons in United Kingdom (UK) were contacted;seven bariatric units and 20 collaborators agreed to participate in this project. The data includes patients' demographics, type and number of operations, bariatric endoscopic procedures, management of complications, emergency and revisional bariatric surgery. Statistical analysis was used to assess the differences among the categories and to compare the data to the 6th report outcomes provided by British Obesity and the Metabolic Surgery Society 2017-2018 (NBSR). Further analysis of mortality between pre pandemic era and June 2020-June 2021 was performed. Results: A total of 430 bariatric procedures were conducted from 1 January 2020 to 31 March 2020 in seven hospitals in UK. The mean age of the patients was 43.3 years. The mean body mass index was 46.75 kg/m2. 314 (73%) of the patients were women and 116 (27%) were men. The following procedures were performed: 118 (27.4%) Laparoscopic Sleeve Gastrectomy (LSG), 114 (26.5%) One Anastomosis Gastric Bypass (OAGB), 76 (17.6%) Roux En-Y Gastric Bypass (RYGB), 61 (14.18%) Gastric Balloon and 15 (3.5%) Adjustable Gastric Band. 176 bariatric endoscopy procedures were performed for different indications. 26 (6.04%) revisional surgeries and 20 (4.6%) emergency bariatric surgeries were performed. 24 (5.58%) patients had Grade I-IV Clavien-Dindo complications. No mortality was reported. There was a significant difference in the number of operations for each of LSG, RYGB and OAGB in these seven hospitals compared to the data provided by the British Obesity and Metabolic Surgery Society (BOMSS) 2017-2018 .Only one patient was diagnosed with COVID-19, who was successfully treated and discharged home. Only one mortality was reported during June 2020 untill June 2021.There was no significant difference in moratlity between pre and post pandemic, p>0.5. Conclusions: This data reveals safe bariatric practices during the early phase of COVID-19. Copyright © Celsius Publishing House.

A Mechanistic Review on Plant-derived Natural Inhibitors of Human Coronaviruses with Emphasis on SARS-COV-1 and SARS-COV-2.

Coronaviruses have been receiving continuous attention worldwide as they have caused a serious threat to global public health. This group of viruses is named so as they exhibit characteristic crown-like spikes on their protein coat. SARS-CoV-2, a type of coronavirus that emerged in 2019, causes severe infection in the lower respiratory tract of humans and is often fatal in immunocompromised individuals. No medications have been approved so far for the direct treatment of SARS-CoV-2 infection, and the currently available treatment options rely on relieving the symptoms. The medicinal plants occurring in nature serve as a rich source of active ingredients that could be utilized for developing pharmacopeial and non-pharmacopeial/synthetic drugs with antiviral properties. Compounds obtained from certain plants have been used for directly and selectively inhibiting different coronaviruses, including SARS-CoV, MERS-CoV, and SARS-CoV-2. The present review discusses the potential natural inhibitors against the highly pathogenic human coronaviruses, with a systematic elaboration on the possible mechanisms of action of these natural compounds while acting in the different stages of the life cycle of coronaviruses. Moreover, through a comprehensive exploration of the existing literature in this regard, the importance of such compounds in the research and development of effective and safe antiviral agents is discussed. We focused on the mechanism of action of several natural compounds along with their target of action. In addition, the immunomodulatory effects of these active components in the context of human health are elucidated. Finally, it is suggested that the use of traditional medicinal plants is a novel and feasible remedial strategy against human coronaviruses.

Contributions of human ACE2 and TMPRSS2 in determining host-pathogen interaction of COVID-19

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is at present an emerging global public health crisis. Angiotensin converting enzyme 2 (ACE2) and trans-membrane protease serine 2 (TMPRSS2) are the two major host factors that contribute to the virulence of SARS-CoV-2 and pathogenesis of coronavirus disease-19 (COVID-19). Transmission of SARS-CoV-2 from animal to human is considered a rare event that necessarily requires strong evolutionary adaptations. Till date no other human cellular receptors are identified beside ACE2 for SARS-CoV-2 entry inside the human cell. Proteolytic cleavage of viral spike (S)-protein and ACE2 by TMPRSS2 began the entire host-pathogen interaction initiated with the physical binding of ACE2 to S-protein. SARS-CoV-2 S-protein binds to ACE2 with much higher affinity and stability than that of SARS-CoVs. Molecular interactions between ACE2-S and TMPRSS2-S are crucial and preciously mediated by specific residues. Structural stability, binding affinity and level of expression of these three interacting proteins are key susceptibility factors for COVID-19. Specific protein-protein interactions (PPI) are being identified that explains uniqueness of SARS-CoV-2 infection. Amino acid substitutions due to naturally occurring genetic polymorphisms potentially alter these PPIs and poses further clinical heterogeneity of COVID-19. Repurposing of several phytochemicals and approved drugs against ACE2, TMPRSS2 and S-protein have been proposed that could inhibit PPI between them. We have also identified some novel lead phytochemicals present in Azadirachta indica and Aloe barbadensis which could be utilized for further in vitro and in vivo anti-COVID-19 drug discovery. Uncovering details of ACE2-S and TMPRSS2-S interactions would further contribute to future research on COVID-19.