Efficacy of Vagal nerve stimulation on anxiety among elderly retired teachers during COVID-19 pandemic.

BACKGROUND: Excessive fear, worry and behavioral disturbances define anxiety, with particular significance attributed to vagal nerve, a crucial transmitter of information to the brain regions governing anxiety. Highlighting the importance of vagal nerve, transcutaneous auricular vagal nerve stimulation (TaVNS) emerges as a tolerable and safe technique. The success of non-invasive vagal nerve stimulation in alleviating anxiety underscores the pivotal role of the vagal nerve. OBJECTIVES: The purpose of this study was to assess the effectiveness of physiotherapy interventions in mitigating anxiety among retired teachers during the COVID-19 pandemic, emphasizing the relevance of targeting the vagal nerve for improved mental well-being. METHODS: 60 retired teachers diagnosed with anxiety were chosen through random allocation. Participants were divided into two groups: Group A (Experimental group) received transcutaneous auricular vagal nerve stimulation (TaVNS), and Group B (Control group) underwent the Jacobson relaxation technique. Intervention period spanned 4 weeks, with four sessions per week, lasting 30 minutes. The outcome measures included Generalized Anxiety Disorder-7 (GAD-7) questionnaire and salivary cortisol levels. RESULTS: Following the 4-week intervention, both groups exhibited a significant reduction in Generalized Anxiety Disorder-7 (GAD-7) scores and salivary cortisol levels (P <  0.001). Notably, Group A demonstrated a significantly higher effectiveness rate compared to Group B. CONCLUSION: The study concludes that transcutaneous auricular vagal nerve stimulation (TaVNS) is effective in reducing anxiety among retired teachers. Transcutaneous auricular vagal nerve stimulation (TaVNS) proves to be a powerful and effective intervention in alleviating anxiety among retired teachers, emphasizing its potential significance in enhancing mental well-being.

Impact of mobile phone usage on dynamic postural control among South Indian college students.

BACKGROUND: Smartphones are a technical marvel that rapidly evolved to play an important role in our lives. One downside to smartphone use is that it significantly worsens posture. It is believed that using a smartphone while walking increases the risk of cognitive decline and the loss of dynamic balance needed to perform functional tasks. OBJECTIVE: The objective of the study was to determine the impact of smartphone usage on dynamic postural control among South Indian college students. METHODS: The study was carried out in a private college with 400 invited students through online social media platforms. The four-square step test and SAS-SV were used to determine the impact of smartphone usage on dynamic postural control. The students were informed about the study process. A total of 250 participants were included based on the inclusion criteria. RESULTS: There was a high percentage of agreement on smartphone usage on dynamic postural control measured with SAS-SV, revealing statistical significance with a mean value of 41.532 and SD of 10.010886. The four-square step test with a mean value of 22.5 and SD of 1.8995878 also proved significant impact. A positive correlation was found between smartphone usage and dynamic postural control, which was analysed using Pearson's correlation coefficient of 0.90130. CONCLUSION: A significant correlation was noted between mobile usage and dynamic balance. Smartphones can have a negative impact on dynamic balance by distracting users from their surroundings and increase the risk of falls.

Anxiety's correlation with sleepiness and memory among security officers during the COVID-19 pandemic.

BACKGROUND: In the working population especially among older adults, anxiety problems have grown dramatically. This element has a significant impact on employee absenteeism and problems with physical and mental health. It was widely known that security personnel had several physical and mental difficulties during their various work hours. It is important to investigate the effects of anxiety on them. OBJECTIVE: The present study aims to provide insights into the prevalence of anxiety disorders and explore the correlations between anxiety symptoms, sleep, and memory during the COVID-19 pandemic. METHODS: To conduct a cross-sectional study, 42 older adult participants between the ages of sixty to seventy years were chosen and the procedure was explained.Data were gathered by giving instructions on how to complete the self-reported Generalized Anxiety Disorder Assessment -7 (GAD-7), the Epworth Sleepiness Scale, and the revised Everyday Memory Questionnaire. RESULTS: A total of 36 out of 42 participants (85.71%) experienced moderate to severe anxiety. Anxiety and sleep had a correlation of 0.8, while anxiety and memory had a correlation of 0.87 with a positive EMQ-R relationship. Moreover, there was a statistically significant association between sleep and memory, with a positive correlation of 0.73. CONCLUSION: The study concludes that, there is a substantial prevalence of anxiety accompanied by notable insomnia and memory problems in elderly security officers. Our findings indicate a clear relationship between sleep disturbances, memory issues, and most prevalent anxiety symptoms. These results emphasize the importance of incorporating mental health assessments and addressing an effective treatment for anxiety.

Effect of vagus nerve stimulation (taVNS) on anxiety and sleep disturbances among elderly health care workers in the post COVID-19 pandemic.

BACKGROUND: Healthcare workers (HCWs) have been significantly impacted by the pandemic. Elderly health care workers carry out a variety of duties at work and have years of clinical expertise. Anxiety and insomnia are among the more commonly encountered problems in senior physicians and other geriatric medical professional populations. OBJECTIVE: The study aims to determine the effect of vagal nerve stimulation on anxiety and sleep disturbances among geriatric medical professionals. METHOD: 42 Participants were enrolled in this study based on the inclusion and exclusion criteria. The participants were divided into two groups using the closed envelope approach, and they took part in therapy sessions lasting 30 minutes, three times per week for a period of four weeks. The Experimental group A received non-invasive transcutaneous auricular vagal nerve stimulation(taVNS) and Control group A received Jacobson's progressive muscle relaxation technique. RESULTS: With a p value of 0.001, transcutaneous auricular vagal nerve (taVNS) stimulation significantly improved sleep quality and reduced anxiety after 4 weeks.The post-intervention assessment revealed a highly significant improvement in Group A, with a T value of 251 (p < 0.001). CONCLUSION: The findings suggest that taVNS may be an effective intervention for addressing anxiety and sleep issues in geriatric medical professionals. These results contribute to the exploration of non-invasive strategies to enhance the well-being of healthcare professionals working in demanding environments.

Proliferation and migration of ML1 follicular thyroid cancer cells are inhibited by IU1 targeting USP14: role of proteasome and autophagy flux.

USP14 is a deubiquitinating enzyme involved in protein degradation by interacting with the proteasome and removal of poly-ubiquitin chains on target proteins. USP14 can influence cellular processes such as cell survival, DNA repair, ER stress, endocytosis, and the inflammatory response. USP14 further plays a role in tumor growth, and the inhibition of USP14 by compounds such as IU1 may affect cancer cell migration and invasion. Here we have studied the mechanisms for the action of IU1 in ML1 follicular thyroid cancer cells, comparing them with control, primary thyroid cells. Treatment with IU1 reduced proliferation of ML1 cells in a concentration-dependent manner, and more prominently than in control cells. IU1 decreased basal migration of ML1 cells, and after stimulation of cells with the bioactive compound, sphingosine-1-phosphate. The sphingosine-1-phosphate receptor 3 was increased in ML1 cells as compared with control thyroid cells, but this was not influenced by IU1. Further studies on the mechanism, revealed that IU1 enhanced the proteasome activity as well as LC3B-dependent autophagy flux in ML1 cells with an opposite effect on control thyroid cells. This indicates that IU1 elicits a cell-type dependent autophagy response, increasing it in ML1 cancer cells. The IU1-mediated stimulation of autophagy and proteasomes can likely contribute to the reduced cell proliferation and migration observed in ML1 cells. The precise set of proteins affected by IU1 in ML1 thyroid and other cancer cells warrant further investigations.

The Interaural Time Difference for High-Pass Filtered Noise and Its Relationship With Brainstem Dysfunction and Disability in Multiple Sclerosis.

PURPOSE: Just noticeable difference for interaural time difference (JND-ITD) is a sensitive test to detect silent lesions and neural asynchrony along the auditory pathways among individuals with multiple sclerosis (MS), but it has not been studied with brainstem functional system scores (BFSS) and expanded disability status scale (EDSS). The study aims to assess the usefulness of JND-ITD thresholds in individuals with MS and relate to brainstem magnetic resonance imaging (MRI) lesions, BFSS, and disability (EDSS). METHOD: Standard group comparison design was adapted to compare the JND-ITD thresholds between individuals with MS (n = 45) and age and gender-matched healthy participants (n = 45). All participants underwent case history, neurological examination including BFSS and EDSS scoring, MRI brain imaging, minimental state examination, routine audiological evaluation, and ITD testing for high-pass filtered noise stimuli. RESULTS: Of the 36 MS participants with abnormal JND-ITD thresholds, 22 (48.9%) participants could not identify maximum JND-ITD values (1,280 µs) in the ITD task. Abnormal JND-ITDs thresholds (139-1,280 µs) were obtained in 14 (31.11%) participants with MS. The JND-ITD thresholds were significantly different between the healthy and MS group. No significant association was found between the presence of ITD abnormality with the presence of brainstem lesions (MRI) and brainstem dysfunction (BFSS). Also, this study did not find any relationship between JND-ITD thresholds with disability (EDSS). CONCLUSIONS: This study supports the findings that JND-ITD for high-pass filtered noise is a sensitive test to detect lesions along the auditory system. Even though JND-ITD thresholds did not relate with BFSS and EDSS scores, JND-ITD abnormalities can be of great value in identifying lesions along the auditory system, especially in the early stages of MS, when clinical neurological examination does not show any signs of brainstem dysfunction, disability, and MRI without any lesions in the brain.

Usefulness of masseter vestibular evoked myogenic potentials in identifying brainstem dysfunction among individuals with multiple sclerosis.

OBJECTIVE: The present study aimed to investigate the findings of cervical, ocular and masseter vestibular evoked myogenic potentials (cVEMP, oVEMP and mVEMP) among Multiple sclerosis (MS) and correlate with clinical and MRI findings. DESIGN: Standard group comparison research design. STUDY SAMPLE: Individuals with relapsing-remitting MS (n = 45) and age-sex-matched controls (n = 45) were the participants. All of them underwent case history, neurological examination, cVEMP, oVEMP and mVEMP testing. MRI was obtained only for MS participants. RESULTS: Abnormal result on at least one vestibular evoked myogenic potential (VEMP) sub-type was evidenced in 95.56% of participants whereas, unilateral or bilateral abnormal result on all three VEMP sub-types was observed in 60% of participants. The mVEMP abnormality was higher (82.22%) than cVEMP (75.56%) and oVEMP (75.56%) abnormalities but the differences were not significant (p > 0.05). There was no significant association of VEMP abnormalities with the presence of the brainstem symptoms, the brainstem signs, or the MRI lesions (p > 0.05). In the MS group, 38% had normal brainstem MRI; however, mVEMP, cVEMP and oVEMP abnormalities were evidenced in 82.4%, 64.7% and 52.94%, respectively. CONCLUSIONS: Among the three VEMP sub-types, mVEMP appears to be of greater value in identifying silent brainstem dysfunction undetected by clinical and MRI findings in the MS population.

Explainable sequence-to-sequence GRU neural network for pollution forecasting.

The goal of pollution forecasting models is to allow the prediction and control of the air quality. Non-linear data-driven approaches based on deep neural networks have been increasingly used in such contexts showing significant improvements w.r.t. more conventional approaches like regression models and mechanistic approaches. While such deep learning models were deemed for a long time as black boxes, recent advances in eXplainable AI (XAI) allow to look through the model's decision-making process, providing insights into decisive input features responsible for the model's prediction. One XAI technique to explain the predictions of neural networks which was proven useful in various domains is Layer-wise Relevance Propagation (LRP). In this work, we extend the LRP technique to a sequence-to-sequence neural network model with GRU layers. The explanation heatmaps provided by LRP allow us to identify important meteorological and temporal features responsible for the accumulation of four major pollutants in the air ([Formula: see text], [Formula: see text], [Formula: see text], [Formula: see text]), and our findings can be backed up with prior knowledge in environmental and pollution research. This illustrates the appropriateness of XAI for understanding pollution forecastings and opens up new avenues for controlling and mitigating the pollutants' load in the air.

Prevalence of impaired upper extremity neural mobility among smart device users during the COVID-19 pandemic.

BACKGROUND: Both the development of various countries and people's health were impacted by the unforeseen global COVID-19 outbreak. Many countries prefer to do their daily business online. Although it was incredibly useful at the time, it still had a problem that was not properly addressed, especially among the student population. OBJECTIVE: The objective of this study was to examine the prevalence of upper extremity neural mobility among students who were using smart devices during the COVID-19 pandemic. METHODS: 458 students who had previously taken home-based online classes during the COVID-19 pandemic and used a smart device for more than six hours were included in this study. The study was conducted in three phases. After being examined in the first two stages of the study, a total of 72 people were chosen for the final phase. Peripheral nerve mobility tests were performed on these 72 subjects. RESULTS: This study observed that 15.72% of smart device users have been affected by forward neck posture and impaired peripheral nerve mobility in the cervical spine. CONCLUSION: The study concludes that forward neck posture is associated with impaired peripheral nerve mobility among smart device users who were in home-based online classes during the COVID-19 pandemic lockdown. Hence, we suggest an appropriate treatment strategy focusing on preventing the forward neck posture through timely analysis and self-care therapies.

Improving work life balance among female educationists during the COVID-19 lockdown.

BACKGROUND: The entire education industry switched from offline to online modes as a result of the coronavirus outbreak. Numerous teachers who were diagnosed with musculoskeletal, psychological, and other neurodegenerative diseases have reported increased exhaustion, lack of sleep, a decline in quality of life (QoL), a decrease in physical activity, and excessive stress from online classes during the COVID-19 lockdown, especially women. OBJECTIVE: The aim of this study is to evaluate the effectiveness of three-modal exercise on fatigue, sleep, QoL as well as to determine the relationship between age, disease severity, disease stage and working years with women diagnosed with Parkinson's disease (PD). METHODS: In this randomized controlled trial, 44 female educators in stages I-II with PD who were between the ages of 40 and 60 volunteered. For a total of 36 sessions over the course of six weeks, Group A received a three-modal fitness program through online video sessions, whereas Group B received Nordic walking. The outcome measures included the Fatigue Severity Scale, Parkinson's Disease Sleep Scale, and Parkinson's Disease Quality of Life Questionnaire-39. RESULTS: Age, Hoehn and Yahr scale, working years, and PD in years did not correlate with each other (p > 0.50). The three-modal exercise experimental Group A showed statistically significant improvement in QoL (p 0.001), sleep (p 0.001), and fatigue (p 0.001). CONCLUSION: Women in the field of education who participated in a three-modal exercise programme for PD reported a significant improvement in their level of exhaustion, sleep patterns, and quality of life.

Pelvic floor dysfunction and its impact on quality of life among female health care employees.

BACKGROUND: In today's fast-paced world, both men and women have to be equally competent to handle their responsibilities in order to look after their family members and children. In this pace of competency women tend to forget to take care of their own health and face many health issues, including pelvic floor dysfunction. OBJECTIVE: This study aimed to analyse the prevalence rate of pelvic floor dysfunction among the working women in regards to their age and body mass index as well as their quality of life. METHODS: One hundred sixty one post-partum working female participants from the medical fraternity were involved in this study after their consent was obtained. Pelvic floor muscle strength was assessed and their quality of life measured using King's health questionnaire. RESULTS: There was a strong correlation between the pelvic floor muscle dysfunction and its impact on the quality of life among the females with increasing age. Significant statistical significant difference of P(<0.0001) was noted. CONCLUSION: Pelvic floor dysfunction among females has a direct impact on their quality of life.

Langevin Cooling for Unsupervised Domain Translation.

Domain translation is the task of finding correspondence between two domains. Several deep neural network (DNN) models, e.g., CycleGAN and cross-lingual language models, have shown remarkable successes on this task under the unsupervised setting-the mappings between the domains are learned from two independent sets of training data in both domains (without paired samples). However, those methods typically do not perform well on a significant proportion of test samples. In this article, we hypothesize that many of such unsuccessful samples lie at the fringe-relatively low-density areas-of data distribution, where the DNN was not trained very well, and propose to perform the Langevin dynamics to bring such fringe samples toward high-density areas. We demonstrate qualitatively and quantitatively that our strategy, called Langevin cooling (L-Cool), enhances state-of-the-art methods in image translation and language translation tasks.

Prevalence of work-related musculoskeletal disorders among health care professionals: A systematic review.

BACKGROUND: Work-related musculoskeletal disorders (WRMSDs) are one of the main causes of morbidity among healthcare professionals. It has various secondary consequences on productivity by diminishing the quantity and quality of work completed by the affected personnel, in addition to having a primary impact on the individual with pain and discomfort. OBJECTIVE: The study aims to determine the overall prevalence rate of WRMSD among dentists, physiotherapists, and surgeons and also identify the commonly affected regions of the body about specific health care professions among each of the three professions, as recorded by the cross-sectional studies performed in various countries and regions of the world. METHODS: A systematic search strategy was framed following the PRISMA guidelines based on the present inclusion and exclusion criteria. A critical search of articles was conducted during June 2020 in CINAHL (DOAJ), PubMed, Google Scholar Scopus, PEDro databases and SAGE journals. RESULTS: Out of the 42 articles that met the eligibility criteria, there were 39 cross-sectional studies, 2 pilot cross-sectional surveys and 1 prospective cohort study with one-year follow-up. All studies included in this review used various survey tools for recording the demographic details and measuring the prevalence of WRMSDs and other outcome factors. CONCLUSION: We conclude that all three health care professionals (dentists, physiotherapists and surgeons) are highly prone to develop WRMSDs with surgeons and dentists being more vulnerable when compared to physiotherapists. The lower back and neck are identified as the two most commonly affected regions among all three professionals.

To pretrain or not? A systematic analysis of the benefits of pretraining in diabetic retinopathy.

There is an increasing number of medical use cases where classification algorithms based on deep neural networks reach performance levels that are competitive with human medical experts. To alleviate the challenges of small dataset sizes, these systems often rely on pretraining. In this work, we aim to assess the broader implications of these approaches in order to better understand what type of pretraining works reliably (with respect to performance, robustness, learned representation etc.) in practice and what type of pretraining dataset is best suited to achieve good performance in small target dataset size scenarios. Considering diabetic retinopathy grading as an exemplary use case, we compare the impact of different training procedures including recently established self-supervised pretraining methods based on contrastive learning. To this end, we investigate different aspects such as quantitative performance, statistics of the learned feature representations, interpretability and robustness to image distortions. Our results indicate that models initialized from ImageNet pretraining report a significant increase in performance, generalization and robustness to image distortions. In particular, self-supervised models show further benefits to supervised models. Self-supervised models with initialization from ImageNet pretraining not only report higher performance, they also reduce overfitting to large lesions along with improvements in taking into account minute lesions indicative of the progression of the disease. Understanding the effects of pretraining in a broader sense that goes beyond simple performance comparisons is of crucial importance for the broader medical imaging community beyond the use case considered in this work.

Efficacy of physiotherapy management on burnout syndrome amongst IT professionals during the COVID-19 pandemic.

BACKGROUND: Burnout is a state of emotional, physical, and mental exhaustion caused by excessive stress. Burnout weakens the energy of an individual which reduces productivity and leaves this individual helpless, hopeless, cynical, and resentful. Thus, an early diagnosis of this syndrome has to be done and ways to prevent the level of progression and complication of burnout syndrome has to be planned. OBJECTIVE: To determine the efficacy of self-supervised Jacobson's relaxation technique along with Bhastrika Pranayama in reducing the level of burnout among the work-from-home IT professionals during the COVID-19 pandemic. METHOD: Thirty participants with burnout syndrome were randomly divided into two groups (15 participants in each group) using random allocation. The experimental group received Jacobson's relaxation technique along with Bhastrika Pranayama, whereas the control group received diaphragmatic breathing exercises and chest expansion exercises. Pre-test and post-test values using Maslach Burnout Inventory were used to interpret the results. RESULTS: Data collected were analyzed statistically by the Wilcoxon Signed Rank Test. It shows that there is a significant reduction in the level of burnout in the experimental group when compared to the control group at a p-value of 0.001. CONCLUSION: From the results, it is concluded that Jacobson's relaxation technique along with diaphragmatic breathing exercises showed significant improvement in the reduction of burnout levels.

Prevalence of burnout syndrome among Work-From-Home IT professionals during the COVID-19 pandemic.

BACKGROUND: Many countries adopted a complete or partial lockdown to prevent the spread of COVID-19, and various professions started to work-from-home. People who work-from-home experience constant stress which leads to burnout syndrome. Burnout can be defined as a chronic stress-induced occupational syndrome resulting in fatigue, decreased job productivity, and poor motivation towards the job. OBJECTIVE: This research work primarily focuses on exploring the prevalence of burnout syndrome among IT professionals who work-from-home and to determine the impact of burnout in different gender and age-groups during the COVID-19 pandemic. METHODS: Using snowball sampling method 934 IT professionals were selected based on selection criteria, explained about the study processes, and instructed to submit an online survey consist of Maslach Burnout Inventory scale (MBI) through mail, social media, or through a researcher by direct interview. RESULTS: Descriptive statistics were used to interpret the data. In 25-30 years age-group, men were affected (93%) less than women (94%) and also in 31-35 years age-group, men were affected (96%) less than women (98%). Overall burnout scores of men were 94% and women were 96%. Results indicate female IT professionals were more prone experience burnout syndrome than Male population. CONCLUSIONS: From the results, it is concluded that 95% of the IT professionals are suffering from burnout, where women are more prevalent to burnout when compared to male. It is also suggested that an early, routine and frequent assessment of physical status, mental status and burnout syndrome is essential to maintain mental health.

Impact of COVID-19 online classes on morningness-eveningness personality among adult college students: A survey study.

BACKGROUND: COVID-19 emerged as a serious pandemic in 2019 and billions of people were infected. Various precautionary methods were taken to contain the spread of virus such as social distancing, public lockdown, sanitation, and closure of schools and colleges. Many colleges started online classes to resume their syllabus and to complete the course curriculum. These evening online sessions resulted in late night sleep, long term mobile/computer exposure, and disturbed sleep pattern. OBJECTIVE: The present study aimed to determine the impact of COVID-19 online classes on morningness- eveningness personality and to compare it with different age groups, gender, and body mass index. METHODS: The cluster sampling method was used to collect the subjects from the total of 1153 adult college students, 897 subjects were selected based on the selection criteria and instructed to submit an online survey consists of the Morningness-eveningness Questionnaire and demographic and anthropometric data through mail, social media, or through a researcher by direct interview. RESULTS: The mean score for the 897 participants is 56.7, indicating intermediate morningness-eveningness personality type. On comparing the different groups, the youngest group (18-20 years) scored 4.23%(mean = 46.7), female subjects scored 6.13%(mean = 58.1), the underweight 2.67%(mean = 59.2) and overweight groups scored 2.89%(mean = 59.7) indicating definite eveningness. Among the 897 collected samples of the population 8.13%of the subjects experienced definite eveningness, 14.93%has moderate eveningness, 17.38%are under intermediate category, 22.4%have moderate morningness, and 37.11%have definite morningness. CONCLUSIONS: Subjects with eveningness personality have high risk of developing mental illness, thus it's important to determine the eveningness personality among student population to avoid serious complications in later age.

Removal of accumulated hard tissue debris from mesial root of mandibular molars evaluated using micro-CT - a systematic review and network meta-analysis.

Aim The aim of this systematic review and network meta-analysis was to identify the best irrigant activation technique (IAT) for the removal of accumulated hard tissue debris (AHTD) from the mesial root of mandibular molars evaluated using micro-CT studies.Methods The research question was based on the PICO format. Four electronic databases - PubMed, Scopus, Embase and Web of Science - were searched for articles up to June 2020. Selected articles were assessed for bias using the Joanna Briggs Institute Critical appraisal tool. The network meta-analysis using a fixed-effects model and SUCRA ranking were performed. The quality of the evidence was assessed using the CINeMA framework.Results Eleven studies were included for qualitative synthesis while seven were included for quantitative synthesis. The risk of bias of all included articles was low. The results based on SUCRA values revealed the IAT shock wave-enhanced emission photoacoustic streaming (100%) resulted in the greatest reduction of the volume of AHTD from mesial roots of mandibular molars. Ranking of the other IATs was as follows: photon-induced photoacoustic streaming (87%), laser-activated irrigation (79.3%), XP EndoFinisher (71.2%), ultrasonically activated irrigation (59.6%), apical negative pressure (42.3%), EasyClean (37.4%), EDDY (26.2%), EndoActivator (24.2%), self-adjusting file (11.6%) and needle irrigation (11.3%).Conclusion None of the IATs rendered the root canals completely free of AHTD. The laser-activated irrigation groups fared better than all other interventions in reducing AHTD from the mesial roots of mandibular molars. The confidence rating ranged from low to high for indirect evidence and moderate to high for mixed evidence. Results must be interpreted with caution due to the laboratory nature of the included studies.

Sphingolipids as Modulators of SARS-CoV-2 Infection.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of the COVID-19 pandemic with severe consequences for afflicted individuals and the society as a whole. The biology and infectivity of the virus has been intensively studied in order to gain a better understanding of the molecular basis of virus-host cell interactions during infection. It is known that SARS-CoV-2 binds to angiotensin-converting enzyme 2 (ACE2) via its spike protein. Priming of the virus by specific proteases leads to viral entry via endocytosis and to the subsequent steps in the life cycle of SARS-CoV-2. Sphingosine and ceramide belong to the sphingolipid family and are abundantly present in cell membranes. These lipids were recently shown to interfere with the uptake of virus particles of SARS-CoV-2 into epithelial cell lines and primary human nasal cells in culture. The mechanisms of action were partly different, as sphingosine blocked, whilst ceramide facilitated viral entry. Acid sphingomyelinase (ASM) is vital for the generation of ceramide and functional inhibition of ASM by drugs like amitriptyline reduced SARS-CoV-2 entry into the epithelial cells. Recent data indicates that serum level of sphingosine-1-phosphate (S1P) is a prognostic factor for COVID-2 severity. Further, stimulation of sphingosine-1-phosphate receptor 1 (S1PR1) might also constrain the hyper-inflammatory conditions linked to SARS-CoV-2. Here, we review recent exciting findings regarding sphingolipids in the uptake of SARS-CoV-2 and in the course of COVID-19 disease. More studies are required on the mechanisms of action and the potential use of antidepressant drugs and sphingolipid modifiers in SARS-CoV-2 infections and in the treatment of the more serious and fatal consequences of the disease.

Effectiveness of Brainstem Auditory Evoked Potentials Scoring in Evaluating Brainstem Dysfunction and Disability Among Individuals With Multiple Sclerosis.

Purpose The brainstem dysfunction in multiple sclerosis (MS) often causes significant functional impairment leading to disability. This study aims to explore modified brainstem auditory evoked potential (BAEP) scores based on the pattern of BAEP abnormalities and relate with brainstem symptoms, brainstem functional system scores (BFSS), brainstem lesions, and disability. Method Forty-five participants with relapsing-remitting MS and 45 age- and gender-matched healthy controls underwent case history assessment, otoscopic examination, pure-tone audiometry, and BAEP testing. Also, neurological examination (Expanded Disability Status Scale, FSS scales) and magnetic resonance imaging were carried out on MS participants. Patterns of BAEP abnormalities were categorized and converted to BAEP scores. Results Out of 45 participants' brainstem symptoms, BFSS > 1, brainstem lesions (magnetic resonance imaging), and BAEP abnormalities were observed in 75.6%, 42.2%, 62.2%, and 55.56% of participants, respectively. Waves V and III abnormalities were more common among MS participants and showed a significant difference from the control group in the Mann-Whitney U test. Chi-square test did not show a significant association of BAEP abnormalities with brainstem symptoms and lesions but showed significant association with BFSS. The mean and standard deviation of BAEP scores in MS participants were 1.73 + 2.37. All healthy controls showed BAEP scores of 0. BAEP scores in MS participants showed significant correlation with BFSS scores and predict Expanded Disability Status Scale scores. Conclusion BAEP scores based on the pattern of BAEP abnormality can be a valid and useful measure in evaluating brainstem functions and predicting disability in MS.