BioMed

Human posture and range of motion (ROM) measurements are important health indicators for identifying abnormalities from various disorders (e.g., scoliosis, musculoskeletal disorders, pain syndromes). A viable real-time mobile application for measuring body posture and ROM is currently lacking. To address this need, a novel Android smartphone augmented-reality-based application was developed and evaluated to enable real-time AprilTag2 marker measurement at the point of patient contact (Biomechanical Augmented Reality-Marker, BAR-M). Mobile app performance was evaluated on a body opponent bag (BOB) and 15 healthy participants by comparing smartphone app and Vicon motion analysis output (pelvis, shoulder, arm, torso angles). A Samsung Galaxy smartphone recorded live video, calculated AprilTag orientations and angle of “a line connecting the center of two tags”, and displayed outcomes in real time. For the BOB test, the absolute difference between Vicon and smartphone angles were 0.09° ± 0.05° for hip, 0.09° ± 0.06° for shoulder, and 0.69° for arm abduction. For the participant test, the absolute mean angle differences were 1.70° ± 0.23° for hip, 1.34° ± 0.27° for shoulder, and 11.18° ± 3.68° for arm abduction. Overall, the app obtained valid and reliable angle measurements for postural and ROM assessments using the smartphone’s front camera. Arm abduction results were affected by clothing movement that caused Vicon markers to move differently from AprilTag markers. Thus, with appropriate measurement methods, this real-time smartphone app is a viable tool to facilitate immediate clinical decision making based on human posture and ROM assessments. Full article

Sequestering and reprogramming of cellular metabolism represents one of the principal hallmarks of several cells. Antimicrobial peptides have been shown to exhibit selective anticancer activities. In this study, the secreted metabolome of HeLa cells under action of the antimicrobial peptide Crotamine from the venom of the South American rattlesnake Crotalus durissus terrificus was evaluated. Crotamine has been shown to be selective for highly proliferating cells and is able to extend the in vivo lifespan. The present study using a cell line of cervical cancer, HeLa cells, provide insights into how Crotamine acts in cell metabolism. NMR spectroscopy was used to identify and quantify relative metabolite levels, which are associated with Crotamine uptake. Statistical analysis reveals that Crotamine dramatically affects metabolites related to glycolysis, metabolism and biosynthesis of amino acids and pyruvate metabolism. The developed machine learning model is found to be robust by ROC curve analysis, suggesting that the metabolic state of HeLa cells treated with Crotamine is different from the control samples. To account for metabolite levels, it is suggested that Crotamine would have to act on glycolysis, which, in turn, affects several other metabolic pathways, such as, glutathione metabolism, TCA cycle and pyruvate metabolism. The observed metabolic changes shed light into the mode of Crotamine function. Full article

Obesity in America is a public health crisis that will continue to impact the country at an individual, social, and economic level unless we address the disease with dietary modifications to reduce or prevent its development. Nutritional interventions designed for obesity treatment are constantly evolving. Berries, which are a rich source of polyphenols, have been suggested as a potential bioactive component, as they have been reported to have anti-obesity effects. Therefore, this review will provide an overview of epidemiological studies to introduce the idea of berries for health promotion. Studies conducted in both rodents and humans are summarized. This review includes an overview of the physiological responses associated with berry consumption, including the effects on the composition of the gut microbiota in humans and rodents, which demonstrate how berry consumption may provide a protective effect against obesity and its related comorbidities. However, these findings have yet to be translated into feasible, long-term nutrition intervention in humans. Future research into different berries and their components will identify effective, accessible functional food options that can augment nutritional interventions. Full article

At-home rapid antigen test (RAT) kits for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are valuable public health tools during the present coronavirus disease (COVID-19) pandemic. They provide fast identification of coronavirus infection, which can help to reduce the transmission rates and burden on the healthcare system. However, they have lower sensitivity compared to the reverse transcription polymerase chain reaction (RT-PCR) tests. One of the reasons for the lower sensitivity is due to the RAT color indicators being indistinct or invisible to the naked eye after the measurements. For this reason, we present a proof of concept of a novel approach, through which we investigated anonymously provided at-home RAT kit results by using our in-house open-source image processing scripts developed for affordable Raspberry Pi computer and Raspberry Pi HQ camera systems. Therefore, we aimed at minimizing the human-related analysis errors for such kits and believe that the present computer vision-based assessment framework can contribute to reducing delayed quarantines of infected individuals and the spread of the current infectious disease. Full article

The outbreak of coronavirus disease (COVID-19), which comes with several comorbidities, was declared a pandemic in early 2020 by World Health Organization (WHO). Glucocorticoids that are used in severe cases of COVID-19 as therapeutic measures may lead to opportunistic fungal infections in such patients. Mucormycosis is one of these infections and mostly occurs in immune-compromised patients such as those who undergo transplant surgeries. However, it rarely develops in COVID-19 patients, although many cases of COVID-19-associated mucormycosis (CAM) have been found in developing nations, like India. CAM usually develops between 15 days to a few months after hospitalization or complete recovery from coronavirus disease. It is an uncommon yet serious infection that further agitates the severe symptoms of COVID-19 disease. Patients with diabetes mellitus and other comorbidities are likely to be at a higher risk for developing mucormycosis. Concurrent glucocorticoid therapy possibly heightens the risk as it increases blood glucose levels. Dentists, as frontline healthcare workers, maybe the first to be presented with oral manifestations and therefore need to pay special attention. In light of the available pieces of evidence, this review highlights the basics of the underlying condition starting from the pathology, causative factors, and clinical manifestations, including the oral cavity, to diagnosis, treatment, and prevention of mucormycosis with both conventional and advanced approaches. We limited this study to the basic and established methods of CAM management and treatment along with the statistical updates. Other antifungal drugs and novel microbiological peptides are in development and need future studies for their elucidation. Full article

The global prevalence of diabetes exceeds half a billion people globally. The Diabetes Prevention Program, a 27-site, randomized clinical trial demonstrated that dietary and other lifestyle changes can prevent more than half (58%) of diabetes cases. Implementation of dietary recommendations can be challenging for those who are not food secure. In a review on the intersection of food insecurity (FI) and diabetes (date range through May 2014), the authors concluded that the lack of access to sufficient, safe, and nutritious food impairs the ability of those with diabetes to implement the dietary modifications required to manage the condition. A challenge to diabetes self-management among this population was adverse social determinants of health. This study assessed insights gleaned about the association between FI and suboptimal glycemic control among adults with type 2 diabetes from research published after May 2014. Conflicting evidence emerged regarding the impact of FI on HbA1c levels among adults with type 2 diabetes. Glycemic control was impacted by social and medical factors. Potential areas for further research are also presented. Full article

Vaccination has been the most effective approach in the fight against COVID-19 pandemic. More than half of the world’s population has been vaccinated and sufficient data is available to analyze the impact of COVID-19 vaccines around the globe. In this paper, we present a correlation analysis between administered vaccine doses and COVID-19 cases/deaths in Europe. The correlation analysis is performed considering different types of vaccinations, different age groups and different COVID-19 variants (including the prevalent Delta and Omicron variants). We present a detailed analysis for 30 European countries giving various insights such as efficacy of six different vaccines, effect of vaccinating different age groups and how the correlation evolves as different COVID-19 variants emerge. Full article

Opportunistic invasive fungal infections (IFI) have been described in severe SARS-CoV-2 infection. COVID-19-related cytokine storm, immune dysregulation and lymphopenia may increase IFI susceptibility in comorbid patients. We described the case of a 64-year-old man with respiratory failure due to SARS-CoV-2 infection complicated with disseminated cryptococosis. We analyzed the role played by the SARS-CoV-2-associated lymphopenia and the cumulative risk factors that lead to secondary infection by Cryptococcus neoformans, and its part in the dysregulation of the immunity response. Full article

There were worries that the COVID-19 pandemic could result in a shortage of supplies of some drugs. We aimed to analyze if the COVID-19 pandemic resulted in the availability drop of different cardiodiabetological medicaments. Special attention was put to combined therapies and to investigate the general availability of these drugs. Data were obtained from the Polish startup company GdziePoLek regarding the availability of 121 cardiodiabetolocigal drugs divided into 23 separate categories in Polish pharmacies. The period of the analysis was limited from 1 January 2019 to 31 December 2020. The threshold of a 20% decrease of median availability was set to found drugs with the most severe drop in availability during the COVID-19 pandemic. We also identified medicaments with a median availability of less than 50%. We identified two drugs with the most severe drop in availability level during COVID-19 pandemics: acenocoumarol (decrease by 52.0%) and nitrendipine (decrease by 98.3%). In 2019 and 2020, 27 of 121 drugs had a median availability lower than 50%. The limited availability concerned the most novel agents and polypills, mostly non-insulin antidiabetic drugs. The decrease in drug availability in Poland was not as severe as expected. Accessibility to some novel non-refunded medicaments is limited. Full article

Background: Recent studies have highlighted the relationship between EDs and COVID-19 and have shown how the change in daily dynamics and lifestyle together with the forced isolation regime have worked as psychopathological risk factors. Prolonged isolation, as an effect of the lockdown, has generated anxieties and fears related to the loss of control, increasing food restrictions. Aim: The aim of this study was to evaluate the impact of COVID-19 on symptoms, body image and the relationship between the onset of symptoms and the second block of the pandemic period. Methods: A total of 14 female patients (mean age = 18.71; SD = 5.59) with anorexia nervosa in treatment before the COVID-19 outbreak contributed to this study. The evaluation included the EDI-3, BUT and Disgust Scale-R questionnaires for general psychopathology, personality and ED severity indexes. Results: A total of 30% of patients reported increased symptoms during lockdown, and 88.2% passed the clinical cut-off on the general psychological maladaptation scale (EDI-3–GPMC > 26p), showing widespread dissatisfaction with body image and increased diet-related stress. Conclusions: Preliminary data on these specific vulnerability factors combined with stressful situations—in our case, the isolation due to the COVID-19 pandemic—can help in the design of personalized preventive and therapeutic approaches. Full article

The definition of the word “pain” has recently been changed by the International agency for the studies of pain (IASP), to include also non-verbal and pre-verbal people. During the COVID pandemic, we have seen a new category of people who cannot speak: in many countries, anxiety and isolation and the cuts to home-assistance and to many hospital services, have brought to de-crease the explicit request for healthcare. This is a problem to be solved and an important alert about what is still an unsatisfactory response given by the national healthcare systems: the care of those who are most frail and voiceless. In this article, this scenario is described, and proposals for a future improvement of pain treatment for those who cannot speak are described. The first is to create a “Medicine of Abundance”: it is possible to avoid wastes in healthcare, and with these funds, a better welcoming of people in hospitals, a better stay, and more motivated personnel can be provided. Abundance is a right of the poorest and sickest even more than the general population; when people are at their ease, they can express better their wishes and their sufferings. The hospital should become a place of hospitality, its walls should be the first care for the sick: now in too many cases it is a cold hub/container of services. The second proposal is having caregivers always measure the pain level in hospitalized patients before taking decisions on implementing or withdrawing medical treatments, in particular those that can accelerate their end-of-life; this is called the “pain principle”. Full article

Multimorbid patients represent a special population of vulnerable individuals who suffer from two or more long-term conditions. They are a very prevalent group with an increased risk of death from COVID-19. The present study aimed to identify the sociodemographic and clinical determinants of multimorbidity of underlying conditions that increase the risk of severe COVID-19 in chronic adult individuals by analyzing data from the Portuguese National Health Survey 2019. The inclusion sample consisted of 7859 adult residents in Portugal who had at least one chronic condition. The health conditions considered for multimorbidity were CKD, COPD, heart conditions, diabetes mellitus, obesity, and smoking. In Portugal, approximately 6 out of every 10 individuals with chronic diseases suffer from one or more conditions that are on the list of those at increased risk of severe COVID-19 disease, and approximately 2 out of every 10 individuals have multimorbidity. Obesity and diabetes are the most frequent risk factors. Timely interventions (e.g., regular medical follow-up for preventive health services and health information) targeting multimorbidity in males and individuals with low educational levels, a poor health status, and low functionality may help to reduce the risk of severe COVID-19 and post-COVID-19 sequelae, and to improve health in a large proportion of the population. Full article

A COVID-19 smoker’s paradox was identified during the early days of the COVID-19 pandemic—many studies reported that smokers appeared to be protected against SARS-CoV-2 infections. Conversely, other studies added to the smoker’s paradox controversy with findings of increased risk for COVID-19 in heavy smokers. Ciliary beat frequency (CBF) within the ciliated epithelium of the nasal tract can be stimulated to a higher frequency and provide increased protection against transient exposure to airway irritants. Smokers as well as non-smokers exposed to secondhand tobacco smoke were found to have higher CBFs. However, with extended exposure to irritants, persistent upregulated CBF can damage and remodel the epithelial layer with fewer protective cilia. Additionally, mucociliary clearance (MCC), the innate defense mechanism of the respiratory system, traps particles and pathogens within the mucous layer of the epithelium and propels them out of the airways through ciliary activity. However, this mechanism becomes defective as disease progresses, increasing susceptibility to viral respiratory infections. This paper proposes that a smoker’s paradox associated with SARS-CoV-2 infection in COVID-19 patients may be mediated by upregulated ciliary beating frequency and mucociliary clearance with transient exposure to tobacco smoke, and downregulated CBF and MCC with extended exposure to tobacco smoke. Full article

COVID-19 remains a major world health problem, and its clinical manifestations can vary from an oligosymptomatic form to severe pulmonary infection, which can require invasive ventilation and is strictly related to death. Identifying risk factors for adverse outcomes is essential for performing adequate care and contrasting high mortality. Chronic kidney disease (CKD) is a widespread comorbidity and is a known risk factor for death during SARS-CoV-2 infection. The present study evaluates the death risk assessment during the COVID-19 pandemic in (CKD) patients, considering the baseline value of an estimated glomerular filtration rate (eGFR) and other possible risk factors. We retrospectively assessed the mortality risk in 150 patients with COVID-19 between 1 October and 31 December 2020. We evaluated eGFR, haemoglobin, albumin, uric acid, cholesterol, triglycerides, and significant risk factors, such as diabetes mellitus and cardiovascular disease in every patient. We had 53 deaths (35.3%) during the observational period, significantly related to age, eGFR, albumin, and baseline nephropathy. In the multivariable analysis, only baseline eGFR and age were independent predictors of death during SARS-CoV-2 infection, with an OR equal to 0.96 and 1.067, respectively. In conclusion, by our analysis, age, and the baseline eGFR were the only reliable predictors of death during COVID-19 in CKD patients. Full article

The outbreak of the COVID-19 epidemic has focused enormous attention on the genetics of viral infection and related disease. Since the beginning of the pandemic, we focused on the collection and integration of SARS-CoV-2 databases, which contain information on the structure of the virus and on its ability to spread, mutate, and evolve; data are made available from several open-source databases. In the past, we gathered experience on human genomics data by building models and integrated databases of genomic datasets (representing, e.g., mutations, gene expression profiles, epigenetic signals). We also coordinated the development of a data dictionary describing the clinical phenotype of the COVID19 disease, in the context of a very large consortium. The main objective of this paper is to describe the content of the data dictionary and the process of data collection and organization. We also argue that—in the context of the COVID-19 disease—interoperability between the three domains of viral genomics, clinical phenotype, and human host genomics is essential for empowering important analysis processes and results. We call for actions that could be performed to link these data. Full article

The pandemic caused by the new coronavirus in 2019, now called SARS-CoV-2 or COVID-19 disease, has become a major public health problem worldwide. The main method of diagnosing SARS-CoV-2 infection is RT-PCR, but medical imaging brings important quantitative and qualitative information that complements the data for diagnosis and prediction of the clinical course of the disease, even if chest X-rays and CT scans are not routinely recommended for screening and diagnosis of COVID-19 infections. Identifying characteristics of medical images, such as GGO, crazy paving, and consolidation as those of COVID-19 can guide the diagnosis, and can help clinicians in decisions in patient treatment if an RT-PCR result is not available rapidly. Chest radiographs and CT also bring information about the severity and unfavorable evolution potential of the disease. Radiomics, a new research subdomain of A.I. based on the extraction and analysis of shape and texture characteristics from medical images, along with deep learning, another A.I. method that uses neural networks, can offer new horizons in the development of models with diagnostic and predictive value for COVID-19 disease management. Standardizing the methods and creating multivariable models that include etiological, biological, and clinical data may increase the value and impact of using radiomics in routine COVID-19 evaluation. Recently, proposed complex models that may include radiological features or clinical variables have appeared to add value to the accuracy of CT diagnosis by radiomix and are likely to underlie the routine use of radiomic in COVID-19 management. Full article

SARS-CoV-2 is one more virus that can affect the brain in one way or another. Now, we are only beginning to understand some mechanisms and the degree to which it can impact the nervous system. Considering the rapid accumulation of knowledge about multiple neurological and cognitive symptoms in COVID-19 patients, it seems useful to encourage the development of systematic approaches for the diagnosis, management and treatment of the cognitive aspects of COVID-19. From what is known at this time about the impact of COVID-19 on the brain, the presentation of long-term cognitive sequelae can be expected to be heterogeneous in nature and will depend at least in part on the severity of the disease at the stage acute COVID-19. The long-term essential characteristics of these sequelae will probably be related to a combination of causes and different neuropathological processes in the acute phase. The scope and severity of the current COVID-19 pandemic are unparalleled in modern society. The later implications for neurological function can be just as serious. Although the current focus is on the management of acute diseases, in the near future the focus should be on the long-term consequences of COVID-19 infection and its mitigation, hence the need for the development of systematic approaches for the management of the cognitive and neuropsychiatric aspects of COVID-19. Full article

Basildon and Thurrock University Hospital in the East of England region of the United Kingdom (UK) witnessed rapidly increasing numbers of pregnant women with diabetes, causing overburdened specialist clinics, poorer patient experience and worsening clinical outcomes. This prompted the multidisciplinary team’s remodelling of care pathways, launching the General ownership of Diabetes (GooD) Pregnancy Network in 2014. Contrary to the conventional limitation of care to specialist diabetes antenatal clinics, this novel initiative highlights the contemporary necessity to equip and empower all maternity stakeholders to deliver the basic care of gestational diabetes (GDM). It strategically connects a Midwife Tele-Clinic “hub” to Educating Gestational Diabetics Group Sessions (EGGS) and standard antenatal clinics. Patients were key partners, regularly participating in feedback surveys and promoting public awareness by co-producing local newspaper articles that served up their stories as case studies. Furthermore, the EGGS “faculty” includes a former GDM patient whose video testimony has inspired almost 2000 patients and their families, aiming to foster long term healthy lifestyle changes. The final summative evaluation in November 2019 showed the new culture of wider consciousness has shortened the “diagnosis to first consultation” intervals and eliminated overbooked specialist clinics (none since January 2016), without further worsening of clinical outcomes. It also boosted research recruitment and avoided additional running costs to the tune of GBP 66,384 a year. Full article

Severe Acute Respiratory Syndrome 2 (SARS-CoV-2) is a positive-sense single-stranded RNA coronavirus capable of causing potentially lethal pneumonia-like infectious diseases in mammals and birds. The main mechanisms by which SARS-CoV-2 spreads include airborne transmission (aerosols and droplets) and the direct exposure of tissues (conjunctival, nasal, and oral mucosa) to contaminated fluids. The aerosol formation is universal in dentistry due to the use of rotary instruments (handpieces), ultrasonic scalers, and air–water syringes. Several layers of infection control should protect key stakeholders such as dentists, dental staff, and patients. These include the utilization of personal protective equipment, high-volume evacuation systems, pre-procedural mouthwashes, rubber dam, and more recently, antimicrobial photodynamic therapy and intra-oral visible light irradiation. These non-specific light-based approaches are relatively simple, inexpensive, and effective against viruses, bacteria, and fungi. Therefore, the present perspective review discusses the current efforts and limitations on utilizing biophotonic approaches as adjunct infection control methods to prevent the transmission of SARS-CoV-2 in dental settings. In addition, the present perspective review may positively impact subsequent developments in the field, as it offers relevant information regarding the intricacies and complexities of infection control in dental settings. Full article