Royal College of Physicians of Edinburgh

Data sharing not applicable to this article as no datasets were generated or analysed during the current study.

<h3>Abstract</h3> <h3>Background</h3> Respiratory diseases such as chronic obstructive pulmonary disease (COPD) have been associated with increased risk of severe SARS-CoV-2 infection, but the mechanisms and putative immune pathways are unclear. Besides, increased levels of several immune mediators in patients with severe coronavirus disease 19 (COVID-19) have been reported. <h3>Objective</h3> To perform an immunoproteomic profiling of dysregulated plasma proteins in patients with asthma and COPD and to evaluate their relationship with biomarkers of severe COVID-19. <h3>Methods</h3> 92 protein biomarkers were quantified in 315 plasma samples from adult subjects (age 40-90 years) including 118 asthmatics, 99 COPD patients and 98 healthy controls, that have been recruited in two reference pneumology clinics in Colombia before the beginning of the COVID-19 pandemic. <h3>Results</h3> Forty-one plasma proteins showed differences between patients and controls. Asthmatic patients have increased levels in IL-6 and CCL3 while COPD patients have a broader systemic inflammatory dysregulation driven by HGF, OPG, and several chemokines (CXCL9, CXCL10, CXCL11, CX3CL1, CXCL1, MCP-3, MCP-4, CCL3, CCL4 and CCL11). Functional annotation revealed their enrichment in chemokine signaling pathways related with response to viral infections. Some of these proteins were found up-regulated upon SARS-Cov-2 infection of Calu-3 cells. Also, HPG, CXCL9, CXCL10, IL-6, MCP-3, TNF and EN-RAGE have been found increased in patients with severe COVID-19. HGF, the most significant protein in this study as well as its correlated proteins could be associated with the increased risk of severe COVID-19 in COPD patients. <h3>Conclusions</h3> Asthma and COPD patients have altered plasma levels of proteins that have been found associated with increased risk of severe COVID-19. The reasons for sharing these profiles with this infection are unknown, but our study suggest that adult patients with asthma and COPD have a systemic dysregulation in chemokine networks that could make them more susceptible to severe COVID-19.

Einstein famously claimed that "the most incomprehensible thing about the universe is that it is comprehensible." This statement suggests that no amount of scientific explanation will suffice to make sense of the bizarre situation of the human mind within the universe. So what are the actual roles of awe and wonder within the framework of contemporary science? How, for instance, do awe and wonder inform scientists' understanding of the phenomena they are researching? What aspects of contemporary science are more likely to elicit wonder, and why? Is science rechanneling our innate thirst for knowledge and understanding toward more concrete and palpable realities, or is it aggravating the tension between truth and meaning by revealing the scope of our ignorance when it comes to probing the ultimate nature of reality? Physicist Marcelo Gleiser, experimental psychologist Tania Lombrozo, and physician Gavin Francis analyze the impact of awe and wonder on their own work and on the mindsets of their colleagues carrying out leading-edge scientific research.

The traditional Medical Education ecosystems are largely centralised and confined to the boundaries of academic institutions. Rather than promoting efficiency and global forward thinking, a number of medical institutions have become inwardly focused, confining themselves to their own institutional rules and frameworks. In the past two years, the utility of blockchain in the higher education setting has been extensively studied. A blockchain is essentially a distributed, immutable, trustworthy, decentralised database that keeps an irreversible, time-stamped record of transfer of value between users for every operation that has ever been carried out on its network. This has traditionally been used in cryptocurrency transactions, however, with the rise of blockchain based Decentralised Applications (DApps), the potential benefits of this ground-breaking technology in higher education are now being explored. Although still in the early developmental stages, blockchain holds promising potential for use in medical education. Some of these are budding hypothesis while in other areas, we have witnessed real, tangible progress. This article analyses the potential use cases for blockchain deployment in medical education ecosystems, to improve the efficiency, security, functionality and effectiveness of existing infrastructures. We conclude the essay by proposing how blockchain can eliminate the growing problem of fraudulent academic accreditations