Covid-19 Affected Workers of Micro, Small, and Medium Enterprises

Purpose: India announced the first lockdown starting from March 25, 2020, due to the outbreak of the COVID-19 pandemic. The Micro, Small and Medium Enterprises (MSMEs) have limited finances, workforce, and operations regarding products or services and do not have the resources to deal with such unexpected lockdowns. This study is to understand the impact of COVID-19 on the workers of MSMEs. Method: An e-questionnaire in the local language was circulated to 444 workers, out of which 426 participated in the study. Result: 98.6% of females earned Rs 5000 to 10000 per month. 95.6% females and 72.1% males saved less than Rs 2000 per month. 25.8% of micro 8.4% of small and 17.2% of the medium-scale workers were not aware of the updates on COVID-19. 70.55% of medium and micro-scale workers stayed at home compared to 45.1% of small-scale workers. 99.7% of micro and small and 93.8% of medium-scale workers regularly sanitized hands at the workplace. 41.9% micro, 84.2% small, and 69% of medium-scale workers said that the COVID-19 outbreak impacted their social life. The pandemic impacted 64.5% micro, 92.9% small, and 97.4% of medium-scale workers’ earnings. 80.6% micro, 97.3% small & 90.5% of medium-scale workers were provided financial assistance by their companies. 80% of medium and micro-scale workers & 94.9% of small-scale workers said they were satisfied with the response/action taken by local municipal authorities. Conclusion: The COVID-19 pandemic has impacted the socio-economic lives of MSME workers. There is an impact of information about the COVID19 outbreak shared by the Govt. of India and social media.

Process-based diagnostics of extreme pollution trail using numerical modelling during fatal second COVID-19 wave in the Indian capital

The world's worst outbreak, the second COVID-19 wave, not only unleashed unprecedented devastation of human life, but also made an impact of lockdown in the Indian capital, New Delhi, in particulate matter (PM: PM_2.5 and PM₁₀) virtually ineffective during April to May 2021. The air quality remained not only unabated but also was marred by some unusual extreme pollution events. SAFAR-framework model simulations with different sensitivity experiments were conducted using the newly developed lockdown emission inventory to understand various processes responsible for these anomalies in PM. Model results well captured the magnitude and variations of the observed PM before and after the lockdown but significantly underestimated their levels in the initial period of lockdown followed by the first high pollution event when the mortality counts were at their peak (∼400 deaths/day). It is believed that an unaccounted emission source was playing a leading role after balancing off the impact of curtailed lockdown emissions. The model suggests that the unprecedented surge in PM₁₀ (690 μg/m³) on May 23, 2021, though Delhi was still under lockdown, was associated with large-scale dust transport originating from the north west part of India combined with the thunderstorm. The rainfall and local dust lifting played decisive roles in other unusual events. Obtained results and the proposed interpretation are likely to enhance our understanding and envisaged to help policymakers to frame suitable strategies in such kinds of emergencies in the future.

COVID-19 and environmental -weather markers: Unfolding baseline levels and veracity of linkages in tropical India

The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is rapidly spreading across the globe due to its contagion nature. We hereby report the baseline permanent levels of two most toxic air pollutants in top ranked mega cities of India. This could be made possible for the first time due to the unprecedented COVID-19 lockdown emission scenario. The study also unfolds the association of COVID-19 with different environmental and weather markers. Although there are numerous confounding factors for the pandemic, we find a strong association of COVID-19 mortality with baseline PM_2.5 levels (80% correlation) to which the population is chronically exposed and may be considered as one of the critical factors. The COVID-19 morbidity is found to be moderately anti-correlated with maximum temperature during the pandemic period (-56%). Findings although preliminary but provide a first line of information for epidemiologists and may be useful for the development of effective health risk management policies.

Real-world treatment patterns and outcomes among metastatic cutaneous melanoma patients treated with ipilimumab

BACKGROUND

There is a scarcity of real-world data on treatment patterns and outcomes among advanced melanoma patients treated with immunotherapies including ipilimumab, an anti-CTLA-4 antibody approved since 2011.

OBJECTIVE

To evaluate ipilimumab and postipilimumab treatment patterns and outcomes among patients with advanced melanoma in Australia, Germany, Italy and Spain, following regulatory approval.

METHODS

Retrospective multicentre, multinational, observational chart review study. Data were extracted from the start of ipilimumab therapy until the end of at least 40 weeks of follow-up, or death.

RESULTS

Data from 371 patients (Australia, 103; Germany, 152; Italy, 76; Spain, 40) were analysed. Mean age was 65 years; 62% were male. Eastern Cooperative Oncology Group performance status (ECOG PS) was 0 or 1 for 94%. In 67%, ipilimumab was initially received as second-line or later therapy. Patients received on average 3.4 ipilimumab doses. The ipilimumab-refractory cohort comprised of 226 patients. Of these, 17% in Australia, 47% in Germany, 29% in Italy and 14% in Spain received another antimelanoma treatment after ipilimumab including chemotherapy in 26% and BRAF/other kinase inhibitors in 11%. Ipilimumab-refractory patients who received postipilimumab treatment showed a 40% reduced hazard of dying than those not receiving treatment after ipilimumab (HR 0.60; 95% CI 0.43-0.83), after adjustment for potential confounders.

CONCLUSION

During the time observed, ipilimumab was mainly used as second-line or later therapy. A significant proportion of patients received postipilimumab therapy, most of which was chemotherapy. Nevertheless, overall survival following progression on ipilimumab treatment remained poor, highlighting the need for research to develop more effective end-of-life treatment options.

Platelet Na,K-adenosine triphosphatase as a tissue marker of hyperthyroidism

Platelet Na(+),K(+)-adenosine triphosphatase (ATPase) activity was measured in 34 (15 males, 19 females) healthy subjects, 89 (35 males, 54 females) hyperthyroid patients, and 34 (7 males, 27 females) treated hyperthyroid patients to assess the potential of this measurement as a tissue marker and diagnostic test for hyperthyroidism. Platelet Na(+),K(+)-ATPase activity was measured in platelet lysates by the rate of release of phosphate from adenosine triphosphate (ATP) in the presence and absence of ouabain. Platelet Na(+),K(+)-ATPase activity (median and range) in the hyperthyroid group (271, 169 to 821 pmol/h/g protein) was significantly higher compared with the healthy group (125, 74 to 185 micromol/h/g protein, P <.001 by Mann-Whitney U test). The treated hyperthyroid group had slightly, but significantly higher, free triiodothyronine (FT3) and free thyroxine (FT4), as well as platelet Na(+),K(+)-ATPase activity (147, 98 to 246 micromol/h/g protein, P <.05). If a platelet Na(+),K(+)-ATPase activity of 190 micromol/h/g protein was used as a cut off value, the specificity and sensitivity were 90% and 93%, respectively. We conclude that platelet Na(+),K(+)-ATPase may be a useful tissue marker of hyperthyroidism.

Probing Static Structure of Colloid-Polymer Suspensions with Multiply Scattered Light

Time-dependent measurements of light propagation were conducted in aqueous dispersions of 523 nm diameter polystyrene at concentrations between 0.1 and 0.4 solids volume fraction in order to assess how particle correlation is influenced by depletion interactions arising from the addition of soluble polyethyleneoxide (PEO). In the absence of polymer, the transport scattering length can be predicted from Mie scattering theory and the Percus-Yevick (P-Y) model for static structure of a dense hard-sphere colloidal solution. Depletion forces arising from the addition of PEO of varying molecular weights influenced the spatial ordering of the dispersion and caused a further increase in the transport scattering length beyond that predicted by hard-sphere static structure factor but similar to that predicted by the mean sphere approximation (MSA) to the P-Y model described by Ye et al. (1996). Onset of flocculation occurred with increased PEO addition and correlated with PEO molecular weight. Phase separation was noted by no further change in the transport scattering length, except when flocculation was induced by the highest molecular weight PEO. The use of time-dependent measurements of light propagation in dense systems provides an alternative to small-angle light, neutron, and X-ray scattering characterization of interaction potentials in dense, multiply scattering samples and promises further fruitful investigation of colloidal particle interactions in suspensions. Copyright 1999 Academic Press.

Investigation of static structure factor in dense suspensions by use of multiply scattered light

Near-infrared, frequency-domain photon migration measurements of phase shift are used to derive accurate values of isotropic scattering coefficients in concentrated, interacting suspensions of aqueous polystyrene microspheres with volume concentrations ranging from 1% to 45% by solids and mean diameters ranging from 135 to 500 nm. Under conditions of high ionic strength, the isotropic scattering coefficient can be quantitatively predicted by the Percus-Yevick model for hard-sphere interactions and Mie theory. In addition, the attractive interactions between scatterers arising from the addition of soluble poly(ethylene glycol) with molecular weights of 100 and 600 K cause hindered scattering. The increases in static structure and decreases in isotropic scattering coefficient agree with that predicted by Mie theory and the depletion interaction model developed by Asakura and Oosawa [J. Chem. Phys. 22, 1255 (1954)]. These results demonstrate the success of monitoring interaction between particles by use of multiple-scattered light and the necessity of incorporating models for these interactions when predicting scattering of dense, concentrated suspensions.

Antibody repertoire development in fetal and neonatal piglets. I. Four VH genes account for 80 percent of VH usage during 84 days of fetal life

VDJ rearrangement and VH gene usage during fetal development in 35 outbred piglets was examined by PCR amplification of VDJs; VDJs were subsequently characterized by hybridization with VH-specific gene probes and by sequencing. VDJ rearrangement was first seen in the fetal liver on day 30 of a 114-day gestation. Four VH genes (V(H)A, V(H)B, V(H)C, and V(H)E) accounted for approximately 80% of all VH gene usage regardless of gestational age, choice of piglet, or lymphoid tissue tested; D(H)A and D(H)B were used in >90% of the fetal VDJs examined. Evidence of somatic hypermutation during fetal development was not found. The proportion of the four prominent fetal VH genes did not differ significantly between cDNA and DNA, suggesting the absence of selective B cell differentiation. A comparison of recombination signal sequences, flanking sequences, and framework sequences of these fetal genes with other germline VH genes of swine offered no clue as to their selective usage. N-region additions were prominent on day 40 but not on day 30, suggesting that the onset of terminal deoxynucleotidyltransferase activity occurs after 30 days of fetal development. These collective findings indicate that the preimmune, "natural Ab" repertoire of the fetal piglet is largely restricted to the use of four nonpolymorphic and nonmutated VH genes and two nonmutated DH segments. This suggests that the preimmune repertoire of swine is either highly restricted or almost entirely determined by junctional diversity in complementarity-determining region-3.

Antibody Repertoire Development in Fetal and Neonatal Piglets. I. Four VH Genes Account for 80 Percent of VH Usage During 84 Days of Fetal Life

VDJ rearrangement and VH gene usage during fetal development in 35 outbred piglets was examined by PCR amplification of VDJs; VDJs were subsequently characterized by hybridization with VH-specific gene probes and by sequencing. VDJ rearrangement was first seen in the fetal liver on day 30 of a 114-day gestation. Four VH genes (VHA, VHB, VHC, and VHE) accounted for ~80% of all VH gene usage regardless of gestational age, choice of piglet, or lymphoid tissue tested; DHA and DHB were used in &gt;90% of the fetal VDJs examined. Evidence of somatic hypermutation during fetal development was not found. The proportion of the four prominent fetal VH genes did not differ significantly between cDNA and DNA, suggesting the absence of selective B cell differentiation. A comparison of recombination signal sequences, flanking sequences, and framework sequences of these fetal genes with other germline VH genes of swine offered no clue as to their selective usage. N-region additions were prominent on day 40 but not on day 30, suggesting that the onset of terminal deoxynucleotidyltransferase activity occurs after 30 days of fetal development. These collective findings indicate that the preimmune, “natural Ab” repertoire of the fetal piglet is largely restricted to the use of four nonpolymorphic and nonmutated VH genes and two nonmutated DH segments. This suggests that the preimmune repertoire of swine is either highly restricted or almost entirely determined by junctional diversity in complementarity-determining region-3.

The hinge deletion allelic variant of porcine IgA results from a mutation at the splice acceptor site in the first C alpha intron

Recently published genomic and cDNA sequences for porcine IgA suggested that the splice acceptor site in the C alpha 1-C alpha 2 intron was an AA rather than an AG dinucleotide. This possibility was tested in an in vitro HeLa cell splicing system using an RNA substrate corresponding to the genomic DNA with the putative AA splice site. Data indicated that splicing occurred at a cryptic AG site 12 nucleotides into the C alpha 2 domain rather than at the AA site. The possibility that swine B cells could use either site was tested by preparing the cDNAs from 13 different samples representing nine animals and amplifying the segment from the first C alpha 1 nucleotide to nucleotide 532 in C alpha 2 (genomic DNA numbering system). Analysis on a 6% polyacrylamide sequencing gel revealed two polynucleotide products in most samples that differed by the expected 12 nucleotides, suggesting that swine could use both splice sites. Sequence analysis confirmed that the shorter form was spliced at the downstream site and the larger form at the apparent upstream AA site. However, when the genomic DNA from an animal expressing only the longer polynucleotide was cloned and sequenced, the upstream splice acceptor site was AG not AA. Thus the data suggested that porcine IgA occurred in two allelic forms, designated IgAa and IgAb, which differ by an apparent G to A mutation in the last nucleotide of intron 1 resulting in a short-hinged (two amino acids, IgAb) variant, in which the downstream cryptic splice site is used, as well as a "normal-hinged" (six amino acids, IgAa) variant. Evidence that IgAa and IgAb are allelic was confirmed by genotypic analyses of progeny from matings of IgAa/IgAb heterozygotes. Evidence that both transcripts are functional was confirmed by showing that serum IgA levels were similar in animals homozygous for each variant.

The hinge deletion allelic variant of porcine IgA results from a mutation at the splice acceptor site in the first C alpha intron

Recently published genomic and cDNA sequences for porcine IgA suggested that the splice acceptor site in the C alpha 1-C alpha 2 intron was an AA rather than an AG dinucleotide. This possibility was tested in an in vitro HeLa cell splicing system using an RNA substrate corresponding to the genomic DNA with the putative AA splice site. Data indicated that splicing occurred at a cryptic AG site 12 nucleotides into the C alpha 2 domain rather than at the AA site. The possibility that swine B cells could use either site was tested by preparing the cDNAs from 13 different samples representing nine animals and amplifying the segment from the first C alpha 1 nucleotide to nucleotide 532 in C alpha 2 (genomic DNA numbering system). Analysis on a 6% polyacrylamide sequencing gel revealed two polynucleotide products in most samples that differed by the expected 12 nucleotides, suggesting that swine could use both splice sites. Sequence analysis confirmed that the shorter form was spliced at the downstream site and the larger form at the apparent upstream AA site. However, when the genomic DNA from an animal expressing only the longer polynucleotide was cloned and sequenced, the upstream splice acceptor site was AG not AA. Thus the data suggested that porcine IgA occurred in two allelic forms, designated IgAa and IgAb, which differ by an apparent G to A mutation in the last nucleotide of intron 1 resulting in a short-hinged (two amino acids, IgAb) variant, in which the downstream cryptic splice site is used, as well as a "normal-hinged" (six amino acids, IgAa) variant. Evidence that IgAa and IgAb are allelic was confirmed by genotypic analyses of progeny from matings of IgAa/IgAb heterozygotes. Evidence that both transcripts are functional was confirmed by showing that serum IgA levels were similar in animals homozygous for each variant.

Hyperinsulinaemia and Na+, K(+)-ATPase activity in thyrotoxic periodic paralysis

OBJECTIVE

Thyrotoxic periodic paralysis (TPP) usually follows a heavy carbohydrate meal and this may be explained by hyperinsulinaemia stimulating Na+, K(+)-ATPase activity. To clarify this the effect of glucose load on serum insulin concentration and platelet Na+, K(+)-ATPase activity in thyrotoxic periodic paralysis (TPP) was examined.

DESIGN

In all subjects a standard 75-g glucose tolerance test was done and blood samples were taken at 0, 1 and 2 hours.

SUBJECTS

Twenty-five healthy controls (8 M and 17 F), 17 uncomplicated thyrotoxic patients (7 M and 10 F), 15 TPP patients who presented with paralysis and 4 TPP patients after treatment with antithyroid drugs.

MEASUREMENTS

Plasma glucose was measured by the glucose oxidase method, serum insulin by radioimmunoassay and platelet Na+, K(+)-ATPase by the release of phosphate from ATP.

RESULTS

TPP patients showed glucose intolerance (area under the curve (AUC) 16.5 +/- 4.4 (mean +/- SD) in TPP compared to 12.9 +/- 4.5 in controls (P < 0.01)) and hyperinsulinaemia (AUC 189.6 +/- 100.6 vs 98.5 +/- 53.4, P < 0.001). In uncomplicated thyrotoxicosis the results were similar to that in healthy controls. Platelet Na+, K(+)-ATPase were significantly higher in thyrotoxic patients compared to controls and in TPP patients were even higher. Ingestion of glucose increased platelet Na+, K(+)-ATPase in all groups. AUC for platelet Na+, K(+)-ATPase in TPP patients were significantly higher than in uncomplicated thyrotoxicosis (601 +/- 99.3 vs 482 +/- 109.4, P < 0.01) or healthy controls (320 +/- 107.3). In the 4 TPP patients studied after antithyroid treatment the results were similar to healthy controls.

CONCLUSION

Patients with thyrotoxic periodic paralysis have hyperinsulinaemia and this is accompanied by higher Na+, K(+)-ATPase activity.

In vivo and in vitro sodium pump activity in subjects with thyrotoxic periodic paralysis

OBJECTIVE

To examine whether sodium pump activity plays a part in the pathogenesis of thyrotoxic periodic paralysis.

DESIGN

Measurement of platelet sodium-potassium ATPase and in vivo sodium pump activities in healthy subjects and thyrotoxic subjects with and without paralysis.

SETTING

University hospital in Hong Kong.

SUBJECTS

21 healthy subjects, 23 untreated thyrotoxic subjects, 13 untreated men with periodic paralysis, seven treated thyrotoxic subjects, and six treated men with periodic paralysis.

MAIN OUTCOME MEASURES

Platelet Na+, K(+)-ATPase activity and plasma rubidium concentration after oral loading.

RESULTS

Median (range) platelet Na+, K(+)-ATPase activity in thyrotoxic subjects was 253 (169-821) mumol inorganic phosphate/h/g protein--significantly higher than that in healthy subjects (134 (81-180) mumol/h/g protein; p less than 0.001). Na+, K(+)-ATPase activity in those with periodic paralysis was 374 (195-1196) mumol/h/g protein, again significantly higher than that in healthy subjects (p less than 0.001) and that in other thyrotoxic subjects (p less than 0.01) despite similar degrees of hyperthyroidism. Activities in treated thyrotoxic subjects with and without periodic paralysis were 148 (110-234) and 131 (86-173) mumol/h/g protein respectively. Mean (95% confidence interval) plasma rubidium concentration five hours after oral administration in thyrotoxic subjects (7.0 (6.6 to 7.5) mumol/l) was significantly lower than in healthy subjects (10.2 (9.5 to 10.9) mumol/l; p less than 0.001) and higher than in those with periodic paralysis (6.0 (5.7 to 6.3) mumol/l; p less than 0.01).

CONCLUSIONS

Sodium pump activity in untreated subjects with periodic paralysis is higher than in other thyrotoxic subjects, and this may be responsible for the hypokalaemia.