Assessment of front-line healthcare workers' Knowledge, Attitude and Practice after several months of COVID-19 pandemic

BACKGROUND

Frontline healthcare workers (F-HCWs) are at the forefront of medical care providers against the novel coronavirus 2019 (COVID-19) pandemic which has life-threatening potentials. Inadequate knowledge and incorrect attitudes among HCWs can directly influence practices and lead to delayed diagnosis, poor infection control practices, and spread of disease.

OBJECTIVES

The aim of this study was to assess the knowledge, attitude and practice (KAP) regarding the COVID-19 pandemic among the frontline healthcare workers (F-HCWs) working at a tertiary care hospital situated in eastern Uttar Pradesh and to identify the factors significantly associated with KAP.

METHODS

A cross-sectional study was conducted among 260 health care providers across eastern Uttar Pradesh including Basti city during December 2020. Data was collected using a self-primed pretested questionnaire from the FHCWs working at a tertiary care hospital of eastern Uttar Pradesh. In this survey, a convenience sampling method was adopted. 12 items on knowledge, 10 items on attitude, and 5 items on practices related to COVID-19. The other variables consisted of 4 items on socio-demographic attributes, p-value and 95% confidence intervals (CIs) were performed to assess the attitude and practices in relation to knowledge.

RESULTS

Of the total 260 study population, 228 were interviewed online, 32 were self-administered. Knowledge and attitude of the nursing staff were highest but practice score was best for residents. Among different age groups knowledge, attitude and practices scores were highest for 35-45, 45-60 and 25-35 age groups respectively. Respondents having 5-10 years of experience had the best knowledge and the attitude score was highest for HCWs having 10-20 years' experience but the practice score was higher for HCWs having more than 20 years' work experience. Overall knowledge score of respondents having strong correlation with attitude (p<0.05) and to the practice (p<0.05).

CONCLUSION

In this survey many F-HCWs reported adequate overall knowledge with a positive attitude and adopted appropriate practices. The F-HCWs with a higher level of education and more years of experience in health care facilities had better KAP towards COVID-19.

Effects of ethylenediurea (EDU) on apoplast and chloroplast proteome in two wheat varieties under high ambient ozone: an approach to investigate EDU's mode of action

Rising tropospheric ozone (O₃) is a serious threat to plants and animals in the present climate change scenario. High tropospheric O₃ has the capability to disrupt cellular organelles leading to impaired photosynthesis and significant yield reduction. Apoplast and chloroplast are two important cellular components in a plant system. Their proteomic response with ethylenediurea (EDU) treatment under tropospheric O₃ has not been explored till date. EDU (an organic compound) protects plants exclusively against harmful O₃ effects through activation of antioxidant defense mechanism. The present study investigated the mode of action of EDU (hereafter MAE) by identifying proteins involved in apoplast and chloroplast pathways. Two wheat varieties viz. Kundan and PBW 343 (hereafter K and P respectively) and three EDU treatments (0= control, 200, and 300 ppm) have been used for the study. In apoplast isolates, proteins such as superoxide dismutase (SOD), amino methyltransferase, catalase, and Germin-like protein have shown active role by maintaining antioxidant defense system under EDU treatment. Differential expression of these proteins leads to enhanced antioxidative defense mechanisms inside and outside the cell. Chloroplast proteins such as Rubisco, Ferredoxin NADP- reductase (FNR), fructose,1-6 bis phosphatase (FBPase), ATP synthase, vacuolar proton ATPase, and chaperonin have regulated their abundance to minimize ozone stress under EDU treatment. After analyzing apoplast and chloroplast protein abundance, we have drawn a schematic representation of the MAE working mechanism. The present study showed that plants can be capable of O₃ tolerance, which could be improved by optimizing the apoplast ROS pool under EDU treatment.

Effects of ethylenediurea (EDU) on regulatory proteins in two maize (Zea mays L.) varieties under high tropospheric ozone phytotoxicity

Rising tropospheric ozone is a major threat to the crops in the present climate change scenario. To investigate the EDU induced changes in proteins, two varieties of maize, the SHM3031 and the PEHM5, (hereafter S and P respectively) were treated with three EDU applications (0= control, 50 and 200 ppm) (hereafter 0= A, 1 and 2 respectively) (SA, S1, S2, PA, P1, P2 cultivar X treatments). Data on the morpho-physiology, enzymatic activity, and protein expression (for the first time) were collected at the vegetative (V, 45 DAG) and flowering (F, 75 DAG) developmental stages. The tropospheric ozone was around 53 ppb enough to cause phytotoxic effects. Protective effects of EDU were recorded in morpho-physiologically and biochemically. SOD, CAT and APX together with GR performed better under EDU protection in SHM3031 variety than PEHM5. The protein expression patterns in SHM3031 at the vegetative stage (28% proteins were increased, 7% were decreased), and at the flowering stage (17% increased, 8% decreased) were found. In PEHM5, a 14% increase and an 18% decrease (vegetative stage) whereas a 16% increase and a 20% decrease (flowering stage) were recorded in protein expression. Some protein functional categories, for instance, photosynthesis, carbon metabolism, energy metabolism, and defense were influenced by EDU. Rubisco expression was increased in SHM3031 whereas differentially expressed in PEHM5. Germin like protein, APX, SOD, and harpin binding proteins have enhanced defense regulatory mechanisms under EDU treatment during prevailing high tropospheric O₃. The present study showed EDU protective roles in C4 plants as proven in C3.

Growth, physiological and proteomic responses in field grown wheat varieties exposed to elevated CO2 under high ambient ozone

The present study investigated growth, biochemical, physiological, yield and proteomic changes in 3 wheat varieties exposed to elevated CO₂ (515 ppm) in a background of high ambient ozone in field. Ethylenediurea (EDU) was used as antiozonant. Average ozone concentration was 59 ppb and was sufficient enough to exert phytotoxic effects. Elevated carbon dioxide (eCO₂) and EDU application individually or in combination negated the adverse effects of ozone by modulating antioxidants and antioxidative enzymes. Differential leaf proteomics revealed that at vegetative stage major changes in protein abundance were due to EDU treatment (47, 52 and 41 proteins in PBW-343, LOK1 and HD-2967, respectively). Combined treatment of eCO₂ and EDU was more responsible for changes in 37 proteins during flowering stage of PBW-343 and LOK1. Functional categorization revealed more than 60% differentially abundant protein collectively belonging to carbon metabolism, protein synthesis assembly and degradation and photosynthesis. At both the growth stages, LOK1 was more responsive to eCO₂ and combined treatment (eCO₂ + EDU). HD-2967 was more positively responsive to EDU and combined treatment. eCO₂ in combination of EDU protected these varieties against high ambient O₃.

Proteomic changes may lead to yield alteration in maize under carbon dioxide enriched condition

In the present study, the effect of elevated CO2 on growth, physiology, yield and proteome was studied on two maize (Zea mays L.) varieties grown under Free-air CO2 enrichment. Growth in high CO2 (530 ppm) did not affect either photosynthesis or pigment contents in both varieties. Reduced MDA content, antioxidant and antioxidative enzymes levels were observed in both varieties in response to high CO2. PEHM-5 accumulated more biomass than SMH-3031 under eCO2. PEHM-5 also had more seed starch and total soluble sugar than SMH-3031. However, SMH-3031 had increased number of seed per cob than PEHM-5. Interestingly, thousand seed weight was significantly increased in PEHM-5 only, while it was decreased in SMH-3031 under eCO2. We observed increased seed size in PEHM-5, while the size of the SMH-3031 seeds remained unaltered. Leaf proteomics revealed more abundance of proteins related to Calvin cycle, protein synthesis assembly and degradation, defense and redox homeostasis in PEHM-5 that contributed to better growth and yield in elevated CO2. While in SMH-3031 leaf, proteins related to Calvin cycle, defense and redox homeostasis were less abundant in elevated CO2 resulting in average growth and yield. The results showed a differential response of two maize varieties to eCO2.

Proteomics unravel the regulating role of salicylic acid in soybean under yield limiting drought stress

Drought is a major concern for sustainable yield under changing environment. Soybean, an economically important oil and protein crop, is prone to drought resulting in yield instability. Salicylic acid (SA), a multifaceted growth hormone, modulates a series of parallel processes to confer drought tolerance thereby relieving yield limitations. The present study was performed in soybean plants treated with SA (0.5 mM) through seed pretreatment under drought regimes: severe stress (50% RWC) and moderate stress (75% RWC), and rehydration. Differential leaf proteome profiling with morphological, physiological and antioxidative metabolism studies were performed at two developmental stages (vegetative and flowering). This explained the tolerance attribution to soybean throughout the development attaining yield stability. Abundance of proteins involved in photosynthesis and ATP synthesis generated energy driving metabolic processes towards plant growth, development and stress acclimation. Carbon (C) metabolism proteins involved in growth, osmoregulation and C partition relieved drought-induced C impairment under SA. Defensive mechanisms against redox imbalance and protein misfolding and degradation under stress were enhanced as depicted by the abundance of proteins involved in redox balance and protein synthesis, assembly and degradation at vegetative stage. Redox signaling in chloroplast and its interplay with SA signaling triggered different defense responses as shown through thioredoxin protein abundance. Amino acid metabolism proteins abundance resulted in increased osmoprotectants accumulation like proline at initial stage which contributed later towards N (nitrogen) remobilization to developing sink. At later stage, abundance of these proteins maintained redox homeostasis and N remobilization for improved sink strength. The redox homeostasis was supported by the increased antioxidative metabolism in SA treated plants. The downregulation of proteins at flowering also contributed towards N remobilization. Yield potential was improved by SA under drought through acclimation with enhanced N and C remobilization to sink as demonstrated by increased yield parameters like seed number and weight per plant, thousand seed weight and harvest index. The potential of SA in conferring drought tolerance to plants to maintain sustainable yield possess future research interests.

Impact of Ethylene diurea (EDU) on growth, yield and proteome of two winter wheat varieties under high ambient ozone phytotoxicity

The present study evaluated the impact of high ambient O₃ on morphological, physiological and biochemical traits and leaf proteome in two high-yielding varieties of wheat using ethylene diurea (EDU) as foliar spray (200 and 300 ppm). Average ambient ozone concentration was 60 ppb which was more than sufficient to cause phytotoxic effects. EDU treatment resulted in less lipid peroxidation along with increased chlorophyll content, biomass and yield. EDU alleviated the negative effects of ozone by enhancing activities of antioxidants and antioxidative enzymes. Two dimensional electrophoresis (2DGE) analysis revealed massive changes in protein abundance in Kundan at vegetative stage (50% proteins were increased, 20% were decreased) and at flowering stage (25% increased, 18% decreased). In PBW 343 at both the developmental stages about 15% proteins were increased whereas 20% were decreased in abundance. Higher abundance of proteins related to carbon metabolism, defense and photorespiration conferred tolerance to EDU treated Kundan. In PBW343, EDU provided incomplete protection as evidenced by low abundance of many primary metabolism related proteins. Proteomic changes in response to EDU treatment in two varieties are discussed in relation to growth and yield.

Salicylic acid mediated growth, physiological and proteomic responses in two wheat varieties under drought stress

Salicylic acid (SA) induced drought tolerance can be a key trait for increasing and stabilizing wheat production. These SA induced traits were studied in two Triticum aestivum L. varieties; drought tolerant, Kundan and drought sensitive, Lok1 under two different water deficit regimes: and rehydration at vegetative and flowering stages. SA alleviated the negative effects of water stress on photosynthesis more in Kundan. SA induced defense responses against drought by increasing antioxidative enzymes and osmolytes (proline and total soluble sugars). Differential proteomics revealed major role of carbon metabolism and signal transduction in enhancing drought tolerance in Kundan which was shifted towards defense, energy production and protection in Lok1. Thioredoxins played important role between SA and redox signaling in activating defense responses. SA showed substantial impact on physiology and carbon assimilation in tolerant variety for better growth under drought. Lok1 exhibited SA induced drought tolerance through enhanced defense system and energy metabolism. Plants after rehydration showed complete recovery of physiological functions under SA treatment. SA mediated constitutive defense against water stress did not compromise yield. These results suggest that exogenously applied SA under drought stress confer growth promoting and stress priming effects on wheat plants thus alleviating yield limitation.

BIOLOGICAL SIGNIFICANCE

Studies have shown morphological, physiological and biochemical aspects associated with the SA mediated drought tolerance in wheat while understanding of molecular mechanism is limited. Herein, proteomics approach has identified significantly changed proteins and their potential relevance to SA mediated drought stress responses in drought tolerant and sensitive wheat varieties. SA regulates wide range of processes such as photosynthesis, carbon assimilation, protein metabolism, amino acid and energy metabolism, redox homeostasis and signal transduction under drought. Proteome response to SA during vegetative and reproductive growth gave an insight on mechanism related water stress acclimation for growth and development to attain potential yield under drought. The knowledge gained can be potentially applied to provide fundamental basis for new strategies aiming towards improved crop drought tolerance and productivity.

"Breast within a breast" sign: Mammary hamartoma

Breast hamartomas are uncommon benign tumors of the breast. Imaging appearance of a breast hamartoma can vary widely. "Breast within a breast" sign on mammography is considered pathognomonic of this unusual entity. We describe mammographic and Magnetic Resonance Imaging (MRI) appearance of a case of hamartoma breast.

Effect of pressure on superconductivity in the indium-doped topological crystalline insulator SnTe

We report on the impact of hydrostatic pressure on the superconductivity of optimally (indium)-doped SnTe which is established to be derived from a topological crystalline insulating phase. Single crystals of Sn(1-x)In(x)Te were synthesized by a modified Bridgman method that exhibited maximum superconducting Tc of 4.4 K for x = 0.5. Hydrostatic pressure up to 2.5 GPa was applied on the crystals of Sn0.5In0.5Te, and electrical resistivity as a function of temperature and pressure was measured. We observed a decrease in the onset superconducting transition temperature from 4.4 K to 2.8 K on increasing pressure from ambient to 2.5 GPa. The normal state resistivity also decreased abruptly by an order of magnitude at 0.5 GPa but for higher pressures, it decreased marginally. From onset, offset and zero resistivity values, dTc/dP of ∼ -0.6 K GPa(-1) was confirmed. The low temperature normal state resistivity followed T(2) dependence suggesting Fermi liquid behaviour both for ambient and high pressure data. This increase in metallic characteristics accompanied by normal state Fermi liquid behaviour is in accordance with a 'dome structure' for Tc variation with varying carrier concentration.