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Purpose: Preliminary data indicate that pregnant women infected with COVID-19 are at increased risk of pregnancy complications (US Centers for Disease Control and Prevention, October 2022). Information on the real-world safety of COVID-19 vaccination in pregnancy is essential. We sought to describe preliminary results for pregnancy status among pregnancy registry participants enrolled in an ongoing safety study of the Pfizer-BioNTech COVID-19 vaccine to date. Method(s): This study uses data from the Organization of Teratology Information Specialists (OTIS) Pregnancy Registry as part of the Vaccines and Medications in Pregnancy Surveillance System (VAMPSS) which enrolls pregnant women residing in the US or Canada. Data are captured through maternal interviews and the ion of medical records. The study population for this descriptive analysis includes Registry participants who met eligibility criteria on or after December 11, 2020, the date the US Food and Drug Administration granted emergency-use authorization for the Pfizer-BioNTech vaccine. The target sample size is 1,100 pregnant women who received any dose of the Pfizer-BioNTech vaccine from 30 days prior to the last menstrual period through the end of pregnancy, and 900 comparison women who received no COVID-19 vaccine in pregnancy. Result(s): Among pregnant women participating in the Registry between 11 December 2020 and 22 July 2022, 1,100/1,100 participants (100.0% of the target sample) were enrolled as part of the Pfizer-BioNTech COVID-19 vaccine exposure cohort, and 635/900 participants (70.6% of the target sample) were enrolled in the comparator cohort. As of 22 July 2022, 858 (78.0%) in the vaccine exposure cohort and 313 (34.8%) in the comparator cohort had completed pregnancies. Descriptive data indicated numerically similar percentages of pregnancies ending in at least one liveborn infant, spontaneous abortions, stillbirths, and elective terminations across the exposed cohort stratified by trimester of the earliest dose of the Pfizer-BioNTech COVID-19 vaccine received in pregnancy, and overall in the unexposed comparator cohort. Conclusion(s): Preliminary data have not identified any new safety concerns thus far for pregnant women who receive the Pfizer-BioNTech COVID-19 vaccine during pregnancy. Funding(s): This study was conducted as a collaboration between the University of California San Diego and Pfizer. Pfizer is the study sponsor.
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Background: The US Food and Drug Administration under an Emergency Use Authorization approved use of Paxlovid (nirmatrelavir and ritonavir) for the treatment of mild-to-moderate COVID-19 in adults and children with a positive test for SARS-Co-2 and who are at high risk for progression to severe COVID-19. Pregnant women are at increased risk of severe complications resulting from COVID-19 infection;however, minimal data on the safety of Paxlovid in human pregnancy are available. Objective(s): The objectives of this study are to assess risks of major congenital malformations, spontaneous abortion, elective termination, stillbirth, preterm delivery, small for gestational age infants at birth, or infants who were small for age at one year in pregnancies/infants prenatally exposed to Paxlovid in pregnancy compared to individuals who did not receive this treatment. Design(s): This study involves prospective data from the Organization of Teratology Information Specialists (OTIS) Pregnancy Registry which enrolls pregnant women residing in the US or Canada and captures data through maternal interviews and ion of medical records. Result(s): Among pregnant women participating in the OTIS Pregnancy Registry as of February 1, 2023, 59 reported exposure to Paxlovid in pregnancy;25.4% exposed within 30 days prior to the last menstrual period and through the first trimester, 42.4% exposed in second trimester, and 32.2% exposed in the third trimester. As of January 2023, 17 of those enrolled have completed pregnancy outcomes. One was lost to follow-up. Of the remainder, there were no adverse pregnancy outcomes reported. Conclusion(s): Very limited data are available on this potentially beneficial treatment in pregnancy. To date, no serious signals for this exposure have been detected.
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Background: Severe acute respiratory syndrome coronavirus 2 (SARSCoV2) has been associated with several neuro-ophthalmic manifestations. We report a case of bilateral longitudinally extensive optic perineuritis suspected due to SARSCoV2. Case Presentation: A 32-year-old woman developed headaches, photophobia, pulsatile tinnitus, and blurred vision 8 d after having a positive SARS-CoV-2 qualitative polymerase chain reaction (PCR) testing for coronavirus disease 2019 (COVID-19). She was diagnosed with and treated for idiopathic intracranial hypertension (IIH) elsewhere. Repeat evaluation at our institution showed a poor visual acuity in both eyes with Frisen grade II papilledema and cotton wool spots on fundoscopic examination. Orbital magnetic resonance imaging (MRI) showed bilateral longitudinally extensive optic nerve sheath enhancement. Repeat lumbar puncture revealed an elevated cerebrospinal fluid (CSF) opening pressure and protein, a finding that is incompatible with the diagnosis of IIH. Myelin oligodendrocyte glycoprotein, aquaporin-4 (AQP4)-IgG antibodies, and other serological tests for optic neuritis were unremarkable. Her visual acuity partially improved after corticosteroids. With the growing association of demyelinating disorders and COVID-19, unremarkable serological workup, and temporal relation of the patient's symptoms to the infection, we believe that her diagnosis is SARS-CoV-2 associated bilateral optic neuritis. Conclusion(s): There is a growing association between demyelinating disorders and COVID-19 and COVID-19 vaccination, and it is essential to recognize CSF abnormalities that are incompatible with a diagnosis of IIH, such as increased protein in our case, and may lead to an incorrect diagnosis.Copyright © 2023 The Authors. Clinical and Experimental Neuroimmunology published by John Wiley & Sons Australia, Ltd on behalf of Japanese Society for Neuroimmunology.
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Since the outbreak of the novel coronavirus (SARS-CoV-2) disease COVID-19 (also known as 2019-nCoV) caused by SARS-CoV-2 in the end of 2019, it has spread rapidly in worldwide. Besides developing effective vaccines, it is urgent to develop safe and effective anti-SARS-CoV-2 drugs to fight this disease. Paxlovid, molnupiravir, sotrovimab and bebtelovimab are urgently authorized by FDA have been proved to be effective against Omicron. This manuscript mainly reviews the recent progress of effective inhibitors against the virus in the world, including receptor inhibitors, antibodies, natural product inhibitors, synthetic inhibitors and broad-spectrum antiviral drugs that are effective against other RNA viruses. © 2023, Chinese Pharmaceutical Association. All rights reserved.
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Under the dual influence of the rapid development of education informatization and the severe impact of COVID-19, online training has become a normal way of professional learning for teachers. Teaching presence and learning engagement, as important factors affecting learning effect, have received extensive attention from educational researchers and practitioners. Based on a teacher education MOOC, this study conducted a questionnaire survey on 169 rural teachers who participated in this MOOC, and explored the relationship and mechanism of teaching presence, learning motivation and learning engagement perceived by rural teachers. This study found that there was a significant positive correlation between teaching presence, learning motivation, and learning engagement, and learning motivation played a partial mediating role in teaching presence and learning engagement. In the following MOOCs for teacher education, MOOC designers should enhance the sense of teaching presence from three aspects: learning design, learning organization, and learning intervention, and stimulate the learning motivation of rural teachers, so as to achieve the occurrence of deep online learning for rural teachers. © 2022 ACM.
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Baicalin is a kind of extraction from herb, and had treatment effects in some disease, however, it has been unclear that it's effects in preeclampsia (PE). The aim of our work was to evaluate baicalin's effects in PE treatment and relative mechanisms in vivo. Using hypoxia to make PE cell model. First step, using difference baicalin concentration to treat. Next step, transfecting si-miRNA-19a to discuss miRNA-19a's effects in baicalin's treatment to PE. Measuring cell proliferation, apoptosis, invasion and migration by CCK-8, flow cytometer, transwell and wound healing assay. Relative protein and gene expression by WB and RT-qPCR assay. Analysis correlation between miRNA-19a and PTEN by dual-luciferase reporter gene assay. Compared with NC, cell proliferation was significantly depressed with apoptosis significantly increasing and invasion cell number and wound healing rates were significantly down-regulation. miRNA-19a expression was significantly down-regulation, PTEN expression was significantly up-regulation, and p-AKT and p-PI3K expressions were significantly down-regulation. With baicalin supplement, the cell's biological activities including cell proliferation, invasion and migration were significantly up-regulation with miRNA-19a increasing. Meanwhile, PTEN protein expression was significantly depressed and p-AKT and p-PI3K proteins expression were significantly increased (p < 0.001, respectively). By dual-luciferase reporter gene assay, miRNA-19a could target PTEN in cell lines. Baicalin had effects to improve PE with miRNA-19a/PTEN axis in vivo study.
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Since the outbreak of the novel coronavirus (SARS-CoV-2) disease COVID-19 (also known as 2019-nCoV) caused by SARS-CoV-2 in the end of 2019, it has spread rapidly in worldwide. Besides developing effective vaccines, it is urgent to develop safe and effective anti-SARS-CoV-2 drugs to fight this disease. Paxlovid, molnupiravir, sotrovimab and bebtelovimab are urgently authorized by FDA have been proved to be effective against Omicron. This manuscript mainly reviews the recent progress of effective inhibitors against the virus in the world, including receptor inhibitors, antibodies, natural product inhibitors, synthetic inhibitors and broad-spectrum antiviral drugs that are effective against other RNA viruses.
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Since the outbreak of the novel coronavirus (SARS-CoV-2) disease COVID-19 (also known as 2019-nCoV) caused by SARS-CoV-2 in the end of 2019, it has spread rapidly in worldwide. Besides developing effective vaccines, it is urgent to develop safe and effective anti-SARS-CoV-2 drugs to fight this disease. Paxlovid, molnupiravir, sotrovimab and bebtelovimab are urgently authorized by FDA have been proved to be effective against Omicron. This manuscript mainly reviews the recent progress of effective inhibitors against the virus in the world, including receptor inhibitors, antibodies, natural product inhibitors, synthetic inhibitors and broad-spectrum antiviral drugs that are effective against other RNA viruses. © 2023, Chinese Pharmaceutical Association. All rights reserved.
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Background: Under the current situation of COVID-19 pandemic, more medical resources are assigned to the prevention and control of the pandemic, while relatively less attention is paid to patients with chronic diseases. Previous studies reported that COVID-19 deaths were mainly observed among male patients with multiple comorbidities, and the major comorbidities were hypertension, diabetes, coronary heart disease, cerebral infarction, and chronic bronchitis, all of which are chronic diseases. As one of the most common chronic diseases that occurs in male, no report regarding how COVID-19 impacts gout patients psychologically due to the general susceptibility, their mental state and willingness to adhere to ULT treatment and the actual ULT adherence so far. This study aims to assess urate-lowering therapy adherence and the relationship with medication beliefs, self-efficacy, depression, anxiety, and COVID-19 pandemic-related concern in Chinese gout patients during the COVID-19 outbreak. Method(s): The cross-sectional study employed a total of 101 gout patients receiving urate-lowering therapy to evaluate adherence, medication beliefs, self-efficacy, depression, anxiety, and COVID-19 pandemic-related concern via a mobile app-based questionnaire. Statistical analysis was performed using SPSS 22.0. Result(s): 101 valid responses were included in the statistical analysis. Patients' adherence rate to urate-lowering therapy during the COVID-19 outbreak was 22.8%, higher than that in normal periods (9.6%). Compared with adherent groups, non-adherent gout patients had shorter disease duration, lower self-efficacy, lower Necessity about urate-lowering therapy score, higher Concerns about urate-lowering therapy score, and smaller Necessity-Concerns differential. Depression and anxiety rates (3.0% and 5.0%, respectively) during the COVID-19 break were lower than that in normal periods. Additionally, depression, anxiety, as well as COVID-19 pandemic-related concern (27.7%) were not related to ULT adherence. Conclusion(s): Adherence rate to urate-lowering therapy in Chinese gout patients during the COVID-19 outbreak was 13.2%, higher than normal times, but still very poor. Except for a little concern about being more susceptible to the virus, patients' mental state is relatively good. While the country puts great efforts in COVID-19 prevention and control, attention must also be paid to the medication management of patients with chronic diseases such as gout.
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Since the outbreak of the novel coronavirus (SARS-CoV-2) disease COVID-19 (also known as 2019-nCoV) caused by SARS-CoV-2 in the end of 2019, it has spread rapidly in worldwide. Besides developing effective vaccines, it is urgent to develop safe and effective anti-SARS-CoV-2 drugs to fight this disease. Paxlovid, molnupiravir, sotrovimab and bebtelovimab are urgently authorized by FDA have been proved to be effective against Omicron. This manuscript mainly reviews the recent progress of effective inhibitors against the virus in the world, including receptor inhibitors, antibodies, natural product inhibitors, synthetic inhibitors and broad-spectrum antiviral drugs that are effective against other RNA viruses. © 2023, Chinese Pharmaceutical Association. All rights reserved.
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Since the outbreak of COVID-19 pandemic in 2020, a dramatic loss of human life has occurred and this trend presents an unprecedented challenge to public health, economic systems and social operations. Hence, it is urgent for us to take some countermeasures to restrain and dispel epidemic diffusion to the uttermost. Data freshness plays an inevitable role in timely infestor determination during this process. However, existing works pay little attention to optimizing this indicator in health monitoring. To make up this research gap, in this paper, we propose a mixed game-based Age of Information (AoI) optimization scheme, where the edge-based wireless technologies and AI-empowered diagnostic bots are adopted. Firstly, we establish the system model for Epidemic Prevention and Control Center (EPCC)-based health state monitoring network, where ultimate biosensing data is transmitted from AI bots via edge servers. Then, upon deriving AoI expression with a closed form, the minimization goal between edge servers and bots is specified. Simultaneously, we reformulate the AoI optimization problem from the mixed game viewpoint (i.e., coalition formation game and ordinary potential game), and then propose two algorithms for cooperative order-based bot deployment and stochastic learning-based channel selection. Finally, compared with the typical baselines, the experiment result shows our scheme can reach the lower AoI value for biosensing data transmission under different parameter settings. IEEE
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Background: To evaluate the efficacy and safety of different treatment modalities of regorafenib in patients with previously treated metastatic colorectal cancer (mCRC) in the real-world setting. Methods: Individual patient data were retrieved from three leading oncology centers in China from January 2016 to March 2021. The primary endpoint was progression-free survival (PFS), and secondary endpoints were overall survival (OS) and safety. Results: The characteristics of patients who received treatment are shown in the table. Twenty-one patients received regorafenib combined with capecitabine as the second-line treatment for those who cannot visit hospital for their chemotherapies because of the COVID-19 pandemic. The median PFS and median OS were 8 (95% CI 4.36 -11.00) months and 26.9 (95%CI 20.54 -NR) months. 101 patients received regorafenib and 69 patients received regorafenib plus immune checkpoint inhibitor (ICIs) as third or higher line treatment, the overall response was 4.1%(7/170), including one complete response. Patients combined with ICIs have longer PFS than those with regorafenib monotherapy (median PFS = 3.3 versus 2.1 months;p = 0.01). Starting dose was 80, 120 and 160 mg in 64, 40 and 39 patients, respectively. Dose reduction was observed in 43.3% (39/79) of patients receiving 120 and 160 mg as the initial dose. Conclusions: Different treatment modalities of regorafenib all showed promising efficacy and safety in the treatment of mCRC. Regorafenib combination is better than regorafenib monotherapy. Regorafenib combined with capecitabine provided a new treatment strategy during the epidemic but requires further investigation.
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SETTING AND PARTICIPANTS: The curriculum was offered to Internal Medicine (IM) residents and took place in Boston and surrounding communities. DESCRIPTION: This program was developed by IM residents in collaboration with clinical education faculty, physician leaders in health equity, and community partners. It identifies and enhances multiple aspects of residency training to reinforce learning on Social Determinants of Health (SDH). Our curriculum offers four key components. 1) Dedicated discussion of health disparities and institutional/community resources incorporated into existing ambulatory curriculum modules. 2) Resident-led walking tours of neighborhoods around Health Centers focused on the history, health disparities, and resources unique to each community. 3) Residency-wide conferences featuring healthcare innovations that address social determinants of health, including a community health van delivering COVID-19 tests and vaccines. 4) A novel resident-designed, two week elective incorporating patient-centered work with community based initiatives to allow identification of social determinants and tangible work to reduce their adverse effects on health. EVALUATION: Quantitative evaluations are assessed via pre- and postinnovation surveys. Sixty-nine of 85 (81%) interns completed the preinnovation survey. Only 56% felt that their prior SDH education was adequate and 25% felt that they had a good understanding of health disparities in Boston. Merely 4% were familiar with resources available in the local healthcare system. Over 98% of responders indicated interest in learning more about health disparities in Boston and available resources to address SDH needs. A post-innovation survey will be distributed after the first year of the curriculum. One of three planned community walking tours has been piloted with positive feedback. Further qualitative feedback will be collected as more walking tours and ambulatory lectures are completed. Feedback on conferences by guest speakers will be collected by the residency via focus groups. DISCUSSION / REFLECTION / LESSONS LEARNED: The environment in which individuals live, work, and build community;access to adequate housing, healthy food, living wages, social support, and healthcare;language and marginalization affect health. Understanding how these social determinants impact health outcomes, leveraging community resources to address them, and advocating for health equity are essential elements of the practice of medicine and residency training. This sentiment is reflected in our survey of interns and in the ACGME Guidelines. An effective way of incorporating SDH education into residency training is via a multimodal resident-led initiative that helps residents identify social determinants and describe programs that reduce their adverse impact on health. This initiative began as two residents' interest in learning more about their community and patients. It now serves as a model for weaving SDH into GME curriculum through didactics, conferences, community focused tours, and a clinical elective.
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Automatic segmentation of COVID-19 lesions is essential for computer-aided diagnosis. However, this task remains challenging because widely-used supervised based methods require large-scale annotated data that is difficult to obtain. Although an unsupervised method based on anomaly detection has shown promising results in [1], its performance is relatively poor. We address this problem by proposing a pixel-level and affinity-level knowledge distillation method. It obtains a pre-trained teacher network with rich semantic knowledge of CT images by constructing and training an auto-encoder at first, and then trains a student network with the same architecture as the teacher by distilling the teacher's knowledge only from normal CT images, and finally localizes COVID-19 lesions using the feature discrepancy between the teacher and the student networks. Besides, except for the traditional pixel-level distillation, we design the affinity-level distillation that takes into account the pairwise relationship of features to fully distill effective knowledge. We evaluate this method by using three different COVID-19 datasets and the experimental results show that the segmentation performance is largely improved when it is compared with the other existing unsupervised anomaly detection methods. © 2022 IEEE
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In the face of public emergencies, how to better manage public opinion and maintain social stability is an important research content. Based on the background of the new epidemic in 2020, this paper explores how social emotions are transmitted among the government, the media and the public under public emergencies. Through natural language processing technology, this paper analyzes the relevant policies and media opinions of China, Britain and the United States under the new epidemic situation, and uses mf-dcca model to test the internal cross correlation. The results of the experiment unexpectedly found that a country’s government policy and the country’s media have a high degree of consistency in emotional orientation, and when the country’s social mood has abnormal fluctuations, the media will make adverse emotional statements, thus hedging the impact of some extreme policies on the society. From the perspective of emotion, this study provides a further theoretical basis for the relationship between the government and the public, proposes another control role of the media in emergencies, and discusses the relevant methods of media hedging government policies in the impact of social emotions. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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Objective: Our department rapidly adopted a telemedicine option for outpatient evaluation of women with pelvic floor disorders during the pandemic. Our objective was to determine the proficiency of telemedicine in diagnosis of pelvic floor disorders and if an initial telemedicine visit impacted the rate of surgical management compared to an in-person evaluation. Methods: We performed a retrospective cohort study of all new patients referred to a single attending provider in female pelvic medicine at a tertiary care referral center who were seen via a telemedicine visit in the first 2 months of telehealth adoption during the COVID pandemic. New telemedicine patients were then compared to patients seen for a new in-person visit over the same time period the previous year. Via chart review, we collected demographic data, primary diagnoses rendered following visit completion and treatment (medical versus surgical) chosen. We compared the rate of surgical posting, number of visits from initial visit until the date of surgery, and rate of surgery cancellation in women seen for a pelvic floor disorder as a new in-person versus by telemedicine. Results: A total of 310 new patient visits were queried: 182 (59%) that took place in person between June 1 and July 30, 2019 and 128 via telemedicine over the same timeframe in 2020 (41%). Table 1 presents comparative demographic data, primary diagnoses and surgical procedures that resulted in each cohort. For women with a diagnosis of stress or mixed urinary incontinence, the rate of surgical posting for a sling procedure in-person- v. by telemedicine was 25% and 38%, P = 0.176. For women with a diagnosis of pelvic organ prolapse, the rate of surgical posting in-person v. by-telemedicine was 42% and 47%, P = 0.578. The median total number of outpatient visits required from initial visit to day of surgery was 2 in both groups, and the rate of surgery cancellation was 26% (in-person) and 12%(telemedicine), P = 0.168. Conclusions: New patient visits conducted via telemedicine resulted in similar rates of accurate surgical postings for both urinary incontinence and pelvic organ prolapse despite the absence of a pelvic examination. This data is useful for continuation of telemedicine platforms post pandemic.