Longitudinal Analysis of Biologic Correlates of COVID-19 Resolution: Case Report.

While the biomarkers of COVID-19 severity have been thoroughly investigated, the key biological dynamics associated with COVID-19 resolution are still insufficiently understood. We report a case of full resolution of severe COVID-19 due to convalescent plasma transfusion. Following transfusion, the patient showed fever remission, improved respiratory status, and rapidly decreased viral burden in respiratory fluids and SARS-CoV-2 RNAemia. Longitudinal unbiased proteomic analysis of plasma and single-cell transcriptomics of peripheral blood cells conducted prior to and at multiple times after convalescent plasma transfusion identified the key biological processes associated with the transition from severe disease to disease-free state. These included (i) temporally ordered upward and downward changes in plasma proteins reestablishing homeostasis and (ii) post-transfusion disappearance of a subset of monocytes characterized by hyperactivated Interferon responses and decreased TNF-α signaling. Monitoring specific dysfunctional myeloid cell subsets in peripheral blood may provide prognostic keys in COVID-19.

Machine learning based COVID -19 disease recognition using CT images of SIRM database.

The COVID-19 pandemic, probably one of the most widespread pandemics humanity has encountered in the twenty first century, caused death to almost 1.75 M people worldwide, impacting almost 80 M lives with direct contact. In order to contain the spread of coronavirus, it is necessary to develop a reliant and quick method to identify those who are affected and isolate them until full recovery is made. The imagery knowledge has been shown to be useful for quick COVID-19 diagnosis. Though the scans of computational tomography (CT) demonstrate a range of viral infection signals, considering the vast number of images, certain visual characteristics are challenging to distinguish and can take a long time to be identified by radiologists. In this study for detection of the COVID-19, a dataset is formed by taking 3764 images. The feature extraction process is applied to the dataset to increase the classification performance. Techniques like Grey Level Co-occurrence Matrix (GLCM) and Discrete Wavelet Transform (DWT) are used for feature extraction. Then various machine learning algorithms applied such as Support Vector Machines (SVM), Linear Discriminant Analysis (LDA), Multi- Level Perceptron, Naive Bayes, K-Nearest Neighbours and Random Forests are used for classification of COVID-19 disease detection. Sensitivity, Specificity, Accuracy, Precision, and F-score are the metrics used to measure the performance of different machine learning models. Among these machine learning models SVM with GLCM as feature extraction technique using 10-fold cross validation gives the best classification result with 99.70% accuracy, 99.80% sensitivity and 97.03% F-score. We also ran these tests on different data sets and found that the results are similar across those too, as discussed later in the results section.

Biologic correlates of beneficial convalescent plasma therapy in a COVID-19 patient reveal disease resolution mechanisms.

BACKGROUND: While the biomarkers of COVID-19 severity have been thoroughly investigated, the key biological dynamics associated with COVID-19 resolution are still insufficiently understood. MAIN BODY: We report a case of full resolution of severe COVID-19 due to convalescent plasma transfusion in a patient with underlying multiple autoimmune syndrome. Following transfusion, the patient showed fever remission, improved respiratory status, and rapidly decreased viral burden in respiratory fluids and SARS-CoV-2 RNAemia. Longitudinal unbiased proteomic analysis of plasma and single-cell transcriptomics of peripheral blood cells conducted prior to and at multiple times after convalescent plasma transfusion identified the key biological processes associated with the transition from severe disease to disease-free state. These included (i) temporally ordered upward and downward changes in plasma proteins reestablishing homeostasis and (ii) post-transfusion disappearance of a particular subset of dysfunctional monocytes characterized by hyperactivated Interferon responses and decreased TNF-α signaling. CONCLUSIONS: Monitoring specific subsets of innate immune cells in peripheral blood may provide prognostic keys in severe COVID-19. Moreover, understanding disease resolution at the molecular and cellular level should contribute to identify targets of therapeutic interventions against severe COVID-19.

Post-traumatic Osteomyelitis of the Rib-point of Care In children, Presenting with chest Wall Pain.

Introduction: The rib osteomyelitis is a very rare entity and it hardly accounts for 1% of all cases of osteomyelitis. In this case report, we are presenting a case of acute osteomyelitis of rib in a very young child, with a previous history of mediocre trauma over the chest wall. Case Report: It is a case report of a young boy, who had sustained the blunt injury over the chest wall. The X-ray was unremarkable. After sometime, he presented to the hospital with the pain over the chest wall. Now, the X-ray showed the signs of rib osteomyelitis. Conclusion: In children, the clinical presentation of rib osteomyelitis is very non-specific. Sometimes, the injury while playing, which is very usual in this age group may create the confusion. Hence, it may need high index of suspicion by the physician to include is as a possible diagnosis.

Vaccination boosts protective responses and counters SARS-CoV-2-induced pathogenic memory B cells.

Much is to be learned about the interface between immune responses to SARS-CoV-2 infection and vaccination. We monitored immune responses specific to SARS-CoV-2 Spike Receptor-Binding-Domain (RBD) in convalescent individuals for eight months after infection diagnosis and following vaccination. Over time, neutralizing antibody responses, which are predominantly RBD specific, generally decreased, while RBD-specific memory B cells persisted. RBD-specific antibody and B cell responses to vaccination were more vigorous than those elicited by infection in the same subjects or by vaccination in infection-naïve comparators. Notably, the frequencies of double negative B memory cells, which are dysfunctional and potentially pathogenic, increased in the convalescent subjects over time. Unexpectedly, this effect was reversed by vaccination. Our work identifies a novel aspect of immune dysfunction in mild/moderate COVID-19, supports the practice of offering SARS-CoV-2 vaccination regardless of infection history, and provides a potential mechanistic explanation for the vaccination-induced reduction of "Long-COVID" symptoms.

Tailoring the electronic structure and magnetic properties of pyrochlore Co2Ti1-xGexO4: a GGA +Uab initiostudy.

We report the electronic structure and magnetic properties of Co2Ti1-xGexO4(0 ⩽x⩽ 1) spinel by means of the first-principle methods of density functional theory involving generalized gradient approximation along with the on-site Coulomb interaction (Ueff) in the exchange-correlation energy functional. Special emphasis has been given to explore the site occupancy of Ge atoms in the spinel lattice by introducing the cationic disorder parameter (y) which is done in such a way that one can tailor the pyrochlore geometry and determine the electronic/magnetic structure quantitatively. For all the compositions (x), the system exhibits weak tetragonal distortion (c/a≠ 1) due to the non-degeneratedz2anddx2-y2states (egorbitals) of the B-site Co. We observe large exchange splitting (ΔEX∼ 9 eV) between the up and down spin bands oft2gandegstates, respectively, of tetrahedral and octahedral Co2+(4A2(g)(F)) and moderate crystal-field splitting (ΔCF∼ 4 eV) and the Jahn-Teller distortion (ΔJT∼ 0.9 eV). These features indicate the strong intra-atomic interaction which is also responsible for the alteration of energy band-gap (1.7 eV ⩽Eg⩽ 3.3 eV). The exchange interaction (JBB∼ -4.8 meV, for (x,y) = (0.25, 0)) between the Co2+dominates the overall antiferromagnetic behaviour of the system for all 'x' as compared toJAA(∼-2.2 meV, for (x,y) = (0.25, 0)) andJAB(∼-1.8 meV, for (x,y) = (0.25, 0)). For all the compositions without any disorderness in the system, the net ferrimagnetic moment (Δµ) remains constant, however, increases progressively with increasingxdue to the imbalance of Co spins between the A- and B-sites.

Fibular Hypoplasia, Talar Aplasia, Absent Proximal Tibial Growth Plate and Oligosyndactyly (Variant of Fibular Aplasia, Tibial Campomelia, and Oligosyndactyly Syndrome) - Paucity of Case Reports with Evolving Definition.

INTRODUCTION: Fibular aplasia, tibial campomelia, and oligosyndactyly (FATCO) syndrome is a rare disorder with unknown molecular basis. Since it is a rare disorder, so it is commendable to report the each case, due to its sporadic incidence and paucity of the standardized management protocol for their management. CASE REPORT: It is a case report of newly born male baby, whose anxious parents presented to the outpatient department with a deformity in the left lower limb. This resembled the FATCO syndrome. After clinico-radiological workup, it was categorized as a variant of FATCO syndrome. CONCLUSION: Counseling of parents should be done and let them realize that what is inescapable with this syndrome and what is bound to happen during the treatment.

Adaptive Neural-Network Control of MIMO Nonaffine Nonlinear Systems With Asymmetric Time-Varying State Constraints.

In this paper, a novel robust adaptive barrier Lyapunov function (BLF)-based backstepping controller has been proposed for a class of interconnected, multi-input-multi-output (MIMO) unknown nonaffine nonlinear systems with asymmetric time-varying (ATV) state constraints. The design involves a neural-network-based online approximator to cope with uncertain dynamics of the system. To tune its weights, a novel adaptive law is proposed based on the Hadamard product. A theorem has also been proposed to have the bounds on virtual control signals beforehand. This theorem eliminates the need for tedious offline computation for the feasibility condition on the virtual controller in BLF-based controller design. To overcome the problem of unknown control gain in the nonaffine system, Nussbaum gain has been used during the design. A simulation study on the robot manipulator in task space has been performed to illustrate the effectiveness of the proposed methodology.

Coronavirus lockdown helped the environment to bounce back.

As the transmission of novel corona virus (COVID-19) increases rapidly, the whole world adopted the curfew/lockdown activity with restriction of human mobility. The imposition of quarantine stopped all the commercial activity that greatly affects the various important environmental parameters which directly connected to human health. As all the types of social, economic, industrial and urbanization activity suddenly shut off, nature takes the advantages and showed improvement in the quality of air, cleaner rivers, less noise pollution, undisturbed and calm wildlife. This research aims to discuss the COVID-19 effect on the global environment. The outcome of this research says that "Although coronavirus vaccine is not available coronavirus itself is earth's vaccine and us humans are the virus".

The potential of arbuscular mycorrhizal fungi in C cycling: a review.

Arbuscular mycorrhizal fungi (AMF) contribute predominantly to soil organic matter by creating a sink demand for plant C and distributing to below-ground hyphal biomass. The extra-radical hyphae along with glomalin-related soil protein significantly influence the soil carbon dynamics through their larger extent and turnover period need to discuss. The role of AMF is largely overlooked in terrestrial C cycling and climate change models despite their greater involvement in net primary productivity augmentation and further accumulation of this additional photosynthetic fixed C in the soil. However, this buffering mechanism against elevated CO2 condition to sequester extra C by AMF can be described only after considering their potential interaction with other microbes and associated mineral nutrients such as nitrogen cycling. In this article, we try to review the potential of AMF in C sequestration paving the way towards a better understanding of possible AMF mechanism by which C balance between biosphere and atmosphere can be moved forward in more positive direction.

Osteoporotic Vertebral Compression Fracture and Single Balloon Extrapedicular Kyphoplasty: Findings and Technical Considerations.

OBJECTIVE: To evaluate the functional and radiological outcome of balloon kyphoplasty and to endorse the unilateral single balloon extrapedicular kyphoplasty as practically more feasible and safer method in comparison to the conventional methods. METHODS: Totally, 81 patients were presented to our center with osteoporotic vertebral compression fracture. Among these, 59 patients (61 vertebrae) were enrolled with stable wedge osteoporotic compression fracture. Pre-operatively percentage of vertebral height loss and kyphotic angle were calculated and single balloon extrapedicular kyphoplasty was performed in all cases. RESULTS: Postoperatively, anterior vertebral height improved to 79.61% of normal subjects. In our study, the mean segmental kyphosis correction following balloon kyphoplasty was 14.27°. Overall incidence of cement leak in our study was 15.25%. CONCLUSION: Although we encountered the few difficulties, but this technique holds the safety and feasibility measures. Furthermore, it is effective in restoring anterior vertebral height, alignment and angle of kyphosis.

Arbuscular mycorrhiza: a viable strategy for soil nutrient loss reduction.

Arbuscular mycorrhiza fungi's (AMF) role in plant nutrition and stress management is well known, but very few researches and studies have been conducted so far on the fungal ability to reduce different nutrient losses (runoff, leaching and volatilization) from the soil system. This important ecosystem service of AMF had been neglected largely. From the recent findings, it has been confirmed that mycorrhizal symbiosis has potential to check the losses of applied nutrients. The role of soil biota in nutrient cycling is indispensable and determines the nutrient availability to plants. Among these biota, AMF's association with plants is the most prevalent, but the exact mechanisms followed by AMF in nutrient cycling, transformation and reducing nutrient loss ability are still inconclusive. In this review, we will try to unlock this particular aspect of AMF which is important to achieve global food demand in a sustainable way.

Long-term quality of life postacute kidney injury in cardiac surgery patients.

BACKGROUND: Acute renal failure after cardiac surgery is known to be associated with significant short-term morbidity and mortality. There have as yet been no major reports on long-term quality of life (QOL). This study assessed the impact of acute kidney injury (AKI) and renal replacement therapy (RRT) on long-term survival and QOL after cardiac surgery. The need for long-term RRT is also assessed. MATERIALS AND METHODS: Patients who underwent cardiac surgery between 2005 and 2011 (n = 6087) and developed AKI (RIFLE criteria, n = 570) were included. They were propensity-matched 1:1 to patients without renal impairment (control). Data were prospectively collected, and health-related QOL questionnaire was sent to patients who were alive at least 1-year postoperatively at the time of the study. RESULTS: There was no significant difference in the preoperative characteristics between the two groups (age, gender, left ventricular ejection fraction, procedure, urgency, logistic Euroscore), respectively. Median follow-up was 52 months. Survival data were available in all patients. Questionnaires were returned in 64% of eligible patients. Long-term survival was significantly lower, and QOL, in particular the physical aspect, was significantly worse for the AKI group as compared to non-AKI group (38.8 vs. 44.2, P = 0.002), especially so in patients who required RRT. In alive respondents, despite an 18% (66/359) incidence of ongoing renal follow-up, the need for late RRT was only in 1.1% (4/359). CONCLUSION: AKI and especially the need for RRT following cardiac surgery are associated with increased long-term mortality as well as worse quality of life in a propensity-matched control group.

Giant-cell Tumor of Metacarpal in the Skeletally Immature Patient and Free Osteoarticular Metatarsal Transfer: Review of Literature with Case Report.

INTRODUCTION: In the customary wisdom, it is conceded that giant-cell tumor (GCT) is a pathology of fused epiphysis, but there are literatures available to depict that even though rare bit, but it occurs in the skeletally immature patients. Here, we are presenting a rare case of GCT of the fifth metacarpal in the skeletally immature patient. CASE REPORT: It is a case report of a 13-year-old girl with the history of swelling over her right hand for 5 months. X-ray revealed that there was an osteolytic fusiform expansible lesion. The biopsy sent and it conferred the diagnosis of GCT. Dorsal approach used for the enbloc resection of the fifth metacarpals (except at the base) and partial excision of the surrounding muscles done. The capsule and collateral ligament of the fifth metacarpophalangeal joint were left. The fourth metatarsal was harvested from the foot along with its capsule and collateral ligament of the metatarsophalangeal joint and sutured to the counter capsuloligamentous structure at the recipient site. CONCLUSION: In our case, we are presenting the GCT of metacarpal in a skeletally immature patient, which was managed by osteoarticular graft. Management by autologous metatarsal graft is a nontraditional approach. We bring it to the horizon of knowledge to discuss the clinical and radiological presentation with surgical as well as functional outcome.

Chaput Tubercle Fracture in an Adult- A Rare Case Report.

Chaput tubercle fracture occurs at the antero-lateral position of the distal tibia in adult as a counterpart of adolescent Tillaux fracture. It is a case of adult male which presented to us with onset of acute pain, swelling and restricted movements of ankle after a road side accident. A clinical diagnosis of Chaput tubercle fracture was established after a CT-scan. The displaced fracture was managed by open reduction and internal fixation by screw. At the end of follow up, the foot and ankle ability score measured. Through this case report we convey that Chaput tubercle fracture in an adult is a rare entity.

Morphometry of distal end radius in the Indian population: A radiological study.

INTRODUCTION: The morphometry of distal end radius (DER) comprises the four necessary parameters: radial inclination, palmer tilt, radial height, and ulnar variance. The unblemished intellect about the morphometry is urged for the management of fracture of DER. The goal of our study was to determine the values of morphometric parameters of the DER from the adult Indian. MATERIALS AND METHODS: It was a single hospital- based observational cross-sectional, prospective study. Radial inclination, radial height, and ulnar variance were measured on posteroanterior view, and the measurement of palmer tilt was accomplished on the lateral view. All the statistical analysis was done by Microsoft XL 2007 (data add in function were installed for data analysis). T-test was used for comparing the means of the parameters. RESULTS: Two hundred and forty two (n = 242) X-rays were included in this study to analyze. The mean value (n = 242) of radial inclination was 23.27°± (standard deviation [SD]) 7.42° (range: 11.3-42.1°), palmer tilt 10.07° ± (SD) 5.28° (range: 1-16.9°), radial height 11.31 mm ± (SD) 4.9 mm (range: 7.1-30.4 mm), and ulnar variance 0.66 mm ± (SD) 2.46 mm (range: -2.4 to +4.1). CONCLUSION: This study may provide an inauguratory plinth to prosecute the further analytical research in the Indian population. Moreover, the data may also be used as a reference data for the anatomical alignment while treating the injuries of the DER in the Indian population.

Endoscopic vein harvest in patients at high risk for leg wound complications: A cost-benefit analysis of an initial experience.

BACKGROUND: A cost-benefit analysis of endoscopic vein harvesting (EVH) versus open vein harvest (OVH) was performed in patients at high risk for wound complications. METHODS: Risk factors for leg wound infection were identified as age older than 75 years, being a woman, body mass index > 28, having diabetes, being a smoker, and diagnosis of peripheral vascular disease. Patients who had at least 2 of these risk factors were selected for a pilot use of EVH and were matched to patients undergoing OVH (n = 50 patients/group). Costs incurred included costs of dressings, additional hospital stay, and costs for attending our outpatient wound clinic (OWC), amongst others. For the EVH group, there was the additional cost of the kit (£650 per patient). Data were prospectively collected. RESULTS: There were no significant differences in the preoperative characteristics between the 2 groups. During in-hospital stay, 18% (9 out of 50) versus 32% (16 out of 50) (P = .08) of patients (EVH vs OVH, respectively) had minor leg-wound suppurations. Patients in the OVH group had longer hospital stay (P = .01). Attendance at the OWC for leg-wound issues was 4% (2 out of 50) versus 48% (24 out of 50), respectively (P < .01), costing a total of £2,758 for the EVH group compared with £78,036 for the OVH group (P < .01). This amounted to cost savings of £42,778 (including EVH kit costs) favoring EVH. CONCLUSIONS: In patients at high-risk of leg wound complications, EVH was associated with significant cost-savings and less leg wound complications.