The Internet of Medical Things (IoMT) is the gathering and implementation of healthcare tools connected to public healthcare technology infrastructure via Internet-based communications systems. Medical devices with wireless fidelity allow machine-to-machine interaction which is the basis of IoMT. The smart use of resources allowed by the IoMT has raised the prospects of both the technical and consumer communities. The IoMT healthcare system turns everyday physical objects, medical devices that surround us into a smart entrenched healthcare system. It is well known that an effective healthcare monitoring system can detect health conditions abnormalities in time and make diagnoses using wearable body sensors network. Despite significant progress within the monitoring device industry, there is still limited widespread integration of wearable body sensors network into medical practice. However, the design of an IoMT healthcare system, such as security, authentication, and data exchange, presents many challenges. Therefore, this chapter proposes an architecture of an intelligent IoMT healthcare system for monitoring patients’ health using a wearable body sensor network. The system will use ensemble tree-based learning to disclose patterns and knowledge on patient health condition and its possible preventions. The proposed method advises and alerts medical personnel in real-time about the changing of the health condition of patients to suggest preventive measures in saving lives. The integration of the IoMT-based wearable body sensors network shows improvement in patients’ health conditions.

IoMT-Based Wearable Body Sensors Network Healthcare Monitoring System

The continuing crisis of Coronavirus-19 disease (COVID-19) has changed our lives considerably; imposing the need for various modifications for organizations and individuals to cope up in this testing time. This study is undertaken to have an insight on how organizations and individuals adapt to these changes and challenges. The impact of coronavirus on human body is well known and more research is underway but what it does to the human behavior and the psychosocial effects are yet to be unraveled. To dive deep into the behavioral consequences of such pandemic, 23 in-depth interviews (Male 12; female 13, average age of 39 years) were conducted with middle level managers in public and private service industry of Riyadh, Saudi Arabia. Using the Conservation of resource theory (COR), this paper explores the employeeâ€™s perception of different types of stressors and examine a variety of coping mechanisms including the type of organizational support provided during this crisis. The findings of the interview suggest that the stress levels were moderate to high among all the participants. The main themes emerged from the interviews were categorized into five; (i) Triggers of stress (ii) Organizational support (iii) Coping strategies and resources (iv) Blurred boundaries during WFH and (v) Positivity in this crisis. The study presents an integrated Stress Model with key triggers, coping strategies (resources), organization support and outcome. The triggers inducing stress includes fear of unknown, ineffective communication at work, lack of clarity and direction, interruptions during WFH resulting in loss of resources like time and energy. All this might disturb employeeâ€™s mental health leading to prolonged stress or even psychosomatic diseases. Therefore, it is an important issues which need to be given priority in all organizations. The findings support the notion that there is a dire need for psycho-social support, community support and an effective system of organizational support to sustain employeeâ€™s emotional and mental wellbeing. The findings of the study are valuable and have urgent policy implications for devising a special EAP for crisis like COVID-19 and any future cases. Although the lockdown would be gradually eased, organizations need to rethink about different alternatives to work. The need of the hour is to be more agile and flexible to foster creativity and innovation.

/pdf/impact-of-covid-19-on-employee-behavior-stress-and-coping-2fhx4cqo8f.pdf

Impact of COVID-19 on Employee Behavior: Stress and Coping Mechanism During WFH (Work From Home) Among Service Industry Employees

Diabetic kidney disease (DKD) is the most common diabetic complication and is a leading cause of end-stage kidney disease. Increasing evidence shows that DKD is regulated not only by many classical signaling pathways but also by epigenetic mechanisms involving chromatin histone modifications, DNA methylation, and non-coding RNA (ncRNAs). In this review, we focus on our current understanding of the role and mechanisms of ncRNAs, including microRNAs (miRNAs) and long non-coding RNAs (lncRNAs) in the pathogenesis of DKD. Of them, the regulatory role of TGF-β/Smad3-dependent miRNAs and lncRNAs in DKD is highlighted. Importantly, miRNAs and lncRNAs as biomarkers and therapeutic targets for DKD are also described, and the perspective of ncRNAs as a novel therapeutic approach for combating diabetic nephropathy is also discussed.

/pdf/non-coding-rnas-as-biomarkers-and-therapeutic-targets-for-5f2my7n0bd.pdf

Non-Coding RNAs as Biomarkers and Therapeutic Targets for Diabetic Kidney Disease.

Reactive oxygen species (ROS) are involved in physiological cellular processes including differentiation, proliferation, and apoptosis by acting as signaling molecules or regulators of transcription factors. The maintenance of appropriate cellular ROS levels is termed redox homeostasis, a balance between their production and neutralization. High concentrations of ROS may contribute to severe pathological events including cancer, neurodegenerative, and cardiovascular diseases. In recent years, approaches to target the sources of ROS production directly in order to develop tool compounds or potential therapeutics have been explored. Herein, we briefly outline the major sources of cellular ROS production and comprehensively review the targeting of these by small-molecule inhibitors. We critically assess the value of ROS inhibitors with different mechanisms-of-action, including their potency, mode-of-action, known off-target effects, and clinical or preclinical status, while suggesting future avenues of research in the field.

Small-Molecule Inhibitors of Reactive Oxygen Species Production.

The objective of this article was to conduct a systematic review of the literature to contrast the existing evidence regarding the relationship between periodontal disease (PD) and diabetes mellitus (DM) with the possibly increased risk of SARS-CoV-2 infection, as well as to establish a hypothesis that explains the ways in which this interaction could take place. A literature search up from 1 January 2020 to 21 March 2021 was conducted in three electronic databases, namely, PubMed, Web of Science, and Scopus, in order to identify studies on periodontal disease alone or in conjunction with diabetes mellitus, reporting any relation with SARS-CoV-2 infection as a primary outcome. Only articles published in the English language were included. Due to the lack of studies, we decided to collect all the theoretical and clinical evidence suggesting a possible biological pathway evidencing the relationship among PD, DM, and SARS-CoV-2 infection. From a total of 29 articles, 12 were included for final review studies (five reviews, two hypotheses, one Special Issue, one perspective, one commentary, one case-control study, and one case report). In addition, this systematic review article hypothesizes the correlation between PD and type 2 diabetes mellitus (T2DM) by expression of angiotensin-converting enzyme 2 (ACE2) in periodontal tissue and the risk of SARS-CoV-2 infection. T2DM is a metabolic disorder characterized by high blood glucose levels resulting from altered insulin secretion or action. Likewise, periodontitis and T2DM are inflammatory disorders with a bidirectional association, and both diseases have a similar immunomodulatory cascade and cytokine profile. ACE2 is a crucial component of the renin-angiotensin system (RAS) and the key factor of entry in the cells by the new SARS-CoV-2. ACE2 is widely distributed in the lung and kidneys, and interestingly has a great distribution in the oral cavity, principally in the tongue and periodontal tissue. ACE2 in periodontal tissue plays a crucial role between health and disease. Moreover, the ACE2/Ang-(1-7)/MasR axis is downregulated in the dysbiotic and inflammatory periodontal environment. Nevertheless, the balance of ACE2 activity is modified in the context of concurrent diabetes, increasing the expression of ACE2 by the uncontrolled glycemia chronic in T2DM. Therefore, the uncontrolled hyperglycemia possibly increases the risk of developing periodontitis and triggering overexpression of ACE2 in periodontal tissue of T2DM patients, with these events potentially being essential to SARS-CoV-2 infection and the development of mild-to-severe form of COVID-19. In this sense, we would like to point out that the need for randomized controlled trials is imperative to support this association.

Should We Be Concerned about the Association of Diabetes Mellitus and Periodontal Disease in the Risk of Infection by SARS-CoV-2? A Systematic Review and Hypothesis

The major clinical associations with the progression of diabetic kidney disease (DKD) are glycemic control and systemic hypertension. Recent studies have continued to emphasize vasoactive hormone pathways including aldosterone and endothelin which suggest a key role for vasoconstrictor pathways in promoting renal damage in diabetes. The role of glucose per se remains difficult to define in DKD but appears to involve key intermediates including reactive oxygen species (ROS) and dicarbonyls such as methylglyoxal which activate intracellular pathways to promote fibrosis and inflammation in the kidney. Recent studies have identified a novel molecular interaction between hemodynamic and metabolic pathways which could lead to new treatments for DKD. This should lead to a further improvement in the outlook of DKD building on positive results from RAAS blockade and more recently newer classes of glucose-lowering agents such as SGLT2 inhibitors and GLP1 receptor agonists.

https://www.mdpi.com/1422-0067/21/6/2218/pdf

Glucose and Blood Pressure-Dependent Pathways–The Progression of Diabetic Kidney Disease

Cardiovascular disease (CVD), the leading cause of morbidity and mortality, represents a major global health and economic burden worldwide [1, 2]. The World Health Organization report has projected that approximately half of all deaths in developed countries will be due to CVD by 2020. CVD is a multifactorial disorder, which encompasses a broad range of injuries of the vasculature and heart including atherosclerosis, coronary heart disease leading to myocardial infarction, peripheral vascular disease, stroke, aneurysms, and cardiomyopathy [3–6] (Fig. 10.1). There is no single cause for CVD, but there are a range of risk factors, which increase the likelihood for clinical manifestations of cardiovascular disease. These risk factors for CVD include obesity, dyslipidemia, diabetes, hypertension, smoking, and aging as well as a positive family history and environmental factors [5, 7–9]. A significant number of studies have shown a close association among these cardiovascular risk factors. Indeed, hypertension, dyslipidemia, obesity, insulin resistance, and chronic hyperglycemia often coexist and synergistically enhance the risk for CVD-related deaths [1, 5, 7, 8]. Reports suggest that diabetes increases the risk of stroke and myocardial infarction with diabetic patients demonstrating a 1.7 times higher risk of CVD death than nondiabetic individuals [1]. In addition, the risk for CVD including coronary disease and stroke is elevated with a rise in blood pressure [8, 10]. Smoking is an avoidable risk factor of CVD, and a person’s risk of CVD mortality can be reduced by 36% over 2 years upon cessation of smoking [11]. The burden of CVD risk increases with age and can be decreased partly by modifying and monitoring other coexisting CVD risk factors [12]. CVD can also result from environmental and demographic factors. The high prevalence of CVD and its risk factors among the general population have motivated research investigating the pathological mechanisms of CVD and to develop novel approaches to prevent the progression of this disease. This has led to a better understanding of the underlying pathogenic mechanisms for the development and progression of CVD.

Madhura Bose

Papers

Glucose and Blood Pressure-Dependent Pathways–The Progression of Diabetic Kidney Disease

Modulation of Oxidative Stress in Cardiovascular Diseases