ABSTRACT
The efficiency of pristine graphene (GN) in the delivery process of the Favipiravir (FPV) anti-COVID-19 drug was herein revealed within the FPVâ¯GN complexes in perpendicular and parallel configurations in terms of the density functional theory (DFT) method. Adsorption energy findings unveiled that the parallel configuration of FPVâ¯GN complexes showed higher desirability than the perpendicular one, giving adsorption energy up to -15.95 kcal mol-1. This favorability could be interpreted as a consequence of the contribution of π-π stacking to the overall strength of the adsorption process in the parallel configuration. Frontier molecular orbitals (FMO) findings demonstrated the ability of the GN nanosheet to adsorb the FPV drug by the alteration in the EHOMO, ELUMO, and Egap values before and after the adsorption process. Based on Bader charge results, the FPV drug and GN sheet exhibited electron-donating and -accepting characters, respectively, which was confirmed by the negative sign of the computed charge transfer (Qt) values. The FPV(R)â¯T@GN complex showed the most desirable Qt value of -0.0377e, which was in synoptic with the adsorption energy pattern. Electronic properties of GN were also altered after the adsorption of the FPV drug in both configurations, with more observable changes in the parallel one. Interestingly, the Dirac point of the GN sheet coincided with the Fermi level after the adsorption process, indicating that the adsorption process unaffected the presence of the Dirac point. The occurrence of the adsorption process was also noticed by the existence of new bands and peaks in the band structure and DOS plots, respectively. Short recovery time rendered the GN nanosheet an efficient FPV drug delivery system. The obtained findings provide new insight into the biomedical applications of the GN sheet as a promising drug delivery system.
ABSTRACT
Background: The Coronavirus Disease 2019 (COVID-19) pandemic has triggered a global emergency in all social realms, including but not restricted to the economy, health, and education. The health sector requires all healthcare professionals to be well-equipped with the latest advances in knowledge and research through Continuing Professional Development (CPD) and postgraduate training programs such as residencies and fellowships.1 These educational endeavors have been severely affected and potentially compromised since they heavily rely on learning through face-to-face interactive activities.2 Methods: This is a narrative review that discusses the utilization of distance learning in CPD and postgraduate training programs, and the potential for a more active utilization in the post- COVID-19 era as one of the effective tools to meet healthcare practitioners' education, training, and professional development needs. Results: Through this review, we propose a shift towards a more active utilization of online tools for on-site and distance healthcare training and CPD activities, via online platforms that offer video and audio facilities. The advantages of this approach include the flexibility of using such methods, being more convenient, cost-effective, as well as promising continuity even in challenging situations like the current pandemic, aiming at equipping healthcare personnel with the necessary skills and knowledge to ensure safe and effective care for their patients. This is in consideration to several key features for effective distance learning platforms.3 Figure 1 is a conceptual framework that summarizes this approach and addresses the problem, solutions, and challenges to overcome. Conclusion: The current traditional educational model of healthcare training, education, and CPD have been challenged in terms of its effectiveness and continuity, especially during complicated situations like the COVID-19 pandemic. Therefore, this model needs to evolve and utilize distance learning solutions in the era post-COVID-19, in order to guarantee its continuity to equip healthcare workers with the needful skills for safe and effective patient care.
ABSTRACT
Background: The COVID-19 pandemic was confirmed to have reached Tunisia on March 2nd, 2020, and has therefore disrupted oncology practice ever since. We report the main difficulties encountered by oncologists across the country during the pandemic. Methods: We conducted a national online survey on medical, surgical, and radiation oncologists to investigate their practice changes during the COVID-19 pandemic from March 2020 to January 2021. Results: 136 oncologists responded to the survey (surgical oncologists 35.8%, medical oncologists 37.8%, and radiation oncologists 26.4%);80% were working in public hospitals. Among oncologists working in the public sector, 59% were asked to join covid-19 units. Five percent stated that their cancer care units were requisitioned for the management of COVID-19 patients and therefore, their patients were referred to other hospitals to pursue their treatment. Moreover, when comparing the number of new cancer cases diagnosed during and before covid-19, 63% of the surveyed oncologists reported a decrease in the number of new cases while 27% stated that the number was stable. During the lockdown, 45% of the participants noted that only 25 to 50% of their patients attended the follow-up visits and that 83% of them missed their CT imaging appointments. On the other hand, 62% of the surveyed oncologists stated that their patients experienced delayed curative surgeries, and 41% had chemotherapy delays. Decreased consultations at the emergency oncology departments were reported by 88% of the oncologists. Besides, 40% of oncologists reported that they adopted telemedicine to monitor patients during the lockdown, and, 48 % stated that they participated in videoconferences to learn about patients’ management during the pandemic. Finally, 46% of the surveyed oncologists reported losing patients due to the COVID-19 infection, which was a trigger for anxiety symptoms in 35% of the participants. Conclusions: Oncologists reported deleterious effects of COVID-19 on oncology practice and patients’ management. Establishing standardized practice guidelines during the pandemic may help to decrease oncologists’ distress and reassure them about the appropriateness of their treatment policies. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
ABSTRACT
BACKGROUND: To date, the cytokine profile in children and adolescent with novel coronavirus disease 2019 (COVID-19) has not been reported. OBJECTIVES: We investigated serum levels of a panel of key cytokines in children and adolescent with COVID-19 pneumonia with a primary focus on "cytokine storm" cytokines such as interleukin (IL)-1ß, IL-6, IL-17, IL-2, IL-4, IL-10, interferon (IFN-γ), tumor necrosis factor (TNF)-α, and two chemokines interferon-inducible protein-10 (IP-10) and IL-8. We also studied whether these cytokines could be potential markers for illness severity in COVID-19 pneumonia. METHODS: Ninety-two symptomatic patients aged less than 18 years with confirmed COVID-19 pneumonia and 100 well-matched healthy controls were included in this multi-center study. For all patients, the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in respiratory fluid specimens was detected by real-time reverse-transcriptase polymerase chain reaction. We measured serum concentrations of studied cytokines by using flow cytometry. RESULTS: Patients with COVID-19 had significantly higher median IL-1ß, IL-6, IL-8, IL-10, IL-17, TNF-α, and IP-10 serum levels than did control children (all p < 0.01). Patients with severe COVID-19 pneumonia had significantly higher median IL-1ß, IL-6, and IP-10 serum levels as compared with those with moderate COVID-19 pneumonia; all p < 0.01. ROC analysis revealed that three of the studied markers (IL-6, IL-1ß, and IP-10) could predict severe COVID-19 pneumonia cases with the largest AUC for IL-6 of 0.893 (95% confidence interval: 0.84-0.98; p < 0.01). CONCLUSION: Our study shows that pediatric patients with COVID-19 pneumonia have markedly elevated serum IL-1ß, IL-6, IL-8, IL-10, IL-17, TNF-α, and IP-10 levels at the initial phase of the illness indicating a cytokine storm following SARS-CoV-2 infection. Moreover, serum IL-6, IL-1ß, and IP-10 concentrations were independent predictors for severe COVID-19 pneumonia.