Prevalence of Potential Drug-Drug Interactions with Ritonavir-Containing Covid-19 Medications among the Adult Patient Population in Australia: Analysis of Pharmaceutical Benefits Scheme 10% Sample (Pbs10) Claims

Intro: Oral antiviral agents with differing modes of action are now available for the treatment of COVID-19. However, potentially life-threatening drug-drug interactions (DDIs) may occur if patients' underlying co-morbidities are treated with medications that are contraindicated with ritonavir-containing antivirals. This study evaluated the prevalence and severity of potential DDIs (pDDIs) with ritonavir-containing COVID-19 oral antiviral therapy among the Australian population. Method(s): Adult patients supplied with >=1 medication between January 1, 2019, and December 31, 2019, were identified in the PBS10 dataset, a longitudinal, random 10% sample of the national Pharmaceutical Benefits Scheme (PBS) data for supplied prescriptions. Patients receiving medications that have pDDIs with a ritonavir-containing COVID-19 antiviral treatment were classified as the pDDI group, using data sources from University of Liverpool, Lexicomp, or the US Food and Drugs Administration. Finding(s): Over 1,434,000 patients in the PBS10 were supplied with >=1 medication during the study period. The majority (58.8%) had been prescribed at least one medication with pDDI with ritonavir-containing treatment. Among all patients with pDDIs, 43.3% of them were major or contraindicated, followed by moderate (15.1%), and minor pDDIs (1.9%). Patients with cancer had the highest prevalence of contraindicated or major pDDIs (79.5%), followed by dementia and/or Alzheimer's (77.2%), and diabetes (73.8%). Elderly patients (>=60 years old) also had a higher prevalence of contradicted or major pDDI (65.4%) than the general patient population. Conclusion(s): Our results demonstrated that one-third of the Australian adult population in the PBS10 dataset may be classified as contraindicated with ritonavir-containing COVID-19 therapies. The prevalence of pDDI is much higher in elderly patients and in patients with certain co-morbidities. Health care providers will need to evaluate patients carefully should they be eligible for COVID-19 oral antiviral treatments. Alternative therapies should be considered as patients may be precluded from being treated with ritonavir-containing therapies owing to pDDIs.Copyright © 2023

The diagnostic values of lung ultrasound for ARDS

OBJECTIVE: Acute respiratory distress syndrome (ARDS) is a critical disease commonly found in many clinical cases, with a mortality rate of approximately 50%. Early diag-nosis and intervention are important for improv-ing ARDS prognosis. In this study, the applica-tions of lung ultrasound in ARDS diagnosis and assessment are reviewed to clarify its key clini-cal values and application prospects. MATERIALS AND METHODS: According to the standard diagnosis of ARDS based on the Berlin definition, CXR or CT examination should be conducted. However, both the blurred images of the former, as well as the inconvenience and high risks of the latter, impose restrictions on their application in critically ill patients.RESULTS: Lung ultrasound was shown to im-prove safety, effectiveness, lacked radiation, can be performed bedside, and offers dynam-ic functionality.CONCLUSIONS: It may be a suitable approach to replace or complement traditional imaging ex-aminations with lung ultrasound.

Recipe4Health: Preliminary Analysis of an Integrative Approach to Address Social Isolation and Food Insecurity during COVID-19

Methods: This 16-week intervention conducted at community health centers combines integrative group medical visits with produce prescriptions. Participating patients are adults diagnosed with chronic conditions including diabetes, hypertension and depression. Virtual integrative group medical visits meet weekly in Spanish or English with health coach support between sessions. Participants also receive weekly doorstep delivery of fresh vegetables grown using regenerative agriculture. Ongoing mixed-methods data collection includes: 1) semi-structured interviews with program staff and patients, and 2) pre-and post-program patient surveys including the 8-Item UCLA Loneliness Scale and the 6-item USDA short form for household food insecurity. Preliminary quantitative analysis uses mixed-effects models to assess the effects of participation in the combined intervention (N=185). Qualitative analysis uses reflexive thematic analysis (N=35). Results: Qualitative interview data explored program implementation and stakeholders' experiences with Recipe4Health during COVID-19. Patients and staff reported that virtual group visits provided social connection and supported mental health. Weekly produce delivery increased food security and provided access to new and familiar foods. Preliminary quantitative analysis included 185 patients: 83% female;51% Latin, 27% Black;61% spoke English as primary language, 39% Spanish. Average loneliness scores decreased from 5.2 to 4.7 (p<.04), despite notable national inc1reases in isolation and loneliness during COVID-19. While food insecurity doubled nationwide, the proportion of study participants reporting food insecurity or marginal food security decreased from 79% to 54% (p<.01). Background: Food insecurity has been associated with social isolation;both have risen dramatically in the US during the COVID-19 pandemic. This project, Recipe4Health, is implementing and assessing the impact of integrative group medical visits and produce prescriptions for low-income adults with chronic conditions. Conclusion: Combining integrative group medical visits and produce prescriptions can improve key patient outcomes including loneliness and food security in a pandemic context.

New Progress of Glycosylation in Coronaviruses

The coronaviruses (CoVs), which are a family of positive-strand RNA viruses, infect the mammals and birds. Seven CoVs are responsible for human-to-human transmission, especially the SARS-CoV-2, thereby posing a daunting challenge to global public health security. As the most common modification in viral glycoproteins, glycosylation plays the crucial role in host recognition, immunity avoidance, virus replication, assembly and transmission. In this review, we summarized and discussed the latest studies about glycosylation in coronaviridae members. Focused on the spike protein, nearly one hundred of N/O-glycosyltion sites have been reported. The N-glycans from spike protein are dominated by the high-mannose and complex-type, while the O-glycosylation is rather complicated. Significantly, it is known that the viral glycosylation depend on host cells, thus the glycan pattern of the produced recombinant viral glycoproteins might be different from that of native viral proteins, which represent a crucial determinant for vaccine design. The latest results based on bioinformatics, biochip, mass spectrography and genetic technology facilitate the overall perspective for glycosylation researching in CoVs. By summarizing the distribution of glycosylation sites, the structure of glycans, the biological functions and the research technologies, this review will help promote diagnosis, treatment and vaccine development related to coronaviruses.

Life cycle assessment of recycling high-density polyethylene plastic waste

Increasing production and use of various novel plastics products, a low recycling rate, and lack of effective recy-cling/disposal methods have resulted in an exponential growth in plastic waste accumulation in landfills and in the environment. To better understand the effects of plastic waste, Life Cycle Analysis (LCA) was done to com-pare the effects of various production and disposal methods. LCA shows the specific effects of the cradle-to-grave or cradle-to-cradle scenarios for landfill, incineration, and mechanical recycling. The analysis clearly indicates that increasing recycling of plastics can significantly save energy and eliminate harmful emissions of various carcino-gens and GHGs into the environment. As recycling increases, the need for virgin-plastic production can be greatly reduced. Furthermore, the results of this study may help improve current mechanical recycling processes as well as potential future recycling methods, such as chemical recycling. Concerns about the current recycling/disposal methods for plastics have brought increasing attention to the waste accumulation problem. However, with the current COVID-19 pandemic, plastic accumulation is expected to increase significantly in the near future. A better understanding of the quantitative effects of the various disposal methods can help guide policies and future research toward effective solutions of the plastic waste problem. © 2021, Tech Science Press. All rights reserved.