Sustainable Enterprise Development in the Manufacturing Sector: Flexible Employment and Innovation in China

Since the COVID-19 outbreak, the scope and market size of flexible employment in sustainable enterprise development have significantly increased worldwide, yet academic literature offer little information about the outcomes and moderators of flexible employment in China. The paper advances current knowledge and empirically addresses this gap by examining the effects of flexible employment on enterprise innovation input and output, with information technology capability and labor regulation as unexplored moderators. Based on data from 1179 manufacturing enterprises in China, this paper uses the OLS method to conduct empirical tests. The results show that (1) flexible employment has positively contributed to sustainable enterprise development by facilitating innovation inputs and outputs;(2) superior enterprise information technology capabilities and strict labor regulations were significant moderating factors in this relationship. The findings provide credible evidence for enterprises to pursue flexible employment as an inexhaustible impetus for sustainable economic and enterprise development.

THE USE OF JANUS KINASE INHIBITORS ANTI-INTERLEUKIN THERAPY IN THE RUSSIAN FEDERATION WITH COVID-19: PHARMACOEPIDEMIOLOGICAL SRUDY

The objective of this study was to assess the volume of consumption of anti-interleukins and janus kinase inhibitors in the period 2018–2021, used as well as preventive pathogenetic therapy of COVID-19.Materials and methods. Based on actual sales data in the segments of public procurement (including regional and federal preferential drug provision) and retail sales segment in the period 2018–2021, obtained from the IQVIA database. All data was recalculated into the number of established daily doses (DDDs), with the calculation of pharmacoepidemiological indicators «Incidence of prescribing drugs», «Cumulative risk of prescribing drugs», as well as «Prescribing prevalence per year» for tocilizumab, olokizumab, levilimab, sarilumab, kanakinumab, anakinra, baricitinib, tofacitinib and upadacitinib. Results and discussion. The growth of total sales volumes was demonstrated in all market segments, but mostly in the segment of regional purchases, primarily related to the purchase of these groups of medicines for COVID-19 therapy in the period 2020–2021. It was demonstrated that the increase in the number of cases, accompanied by the expansion of prescribing preventive pathogenetic therapy, led to a twofold increase in the number of new cases of prescribing of janus kinase inhibitors and an increase in this indicator for anti-interleukins by 1.5 times, taking into account the estimated number of patients with moderate and severe COVID-19. The cumulative risk of prescribing these classes of drugs increased proportionally: for JAK inhibitors from 14 to 32%, and for anti-IL drugs from 38 to 69%. Calculations showed that the proportion of people over 18 years of age in the Russian Federation who received at least one dose of janus kinase inhibitors and anti-interleukins increased many times, in 1000 times and 500 times. Conclusions. Taking into account the expansion of the use of these groups of medicines, careful monitoring of information about their safety is required. © 2023, HIV Infection and Immunosuppressive Disorders.All Rights Reserved.

The efficiency of COVID-19 vaccines among taiwanese patients with varied comorbidities

Background/Aims: The global pandemic of COVID-19 has caused tremendous loss of human life since 2019. Vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is one of the best policies to control the pandemic. The vaccination efficacy in Taiwanese patients with different comorbidities is elusive and to be explored. Method(s): Uninfected subjects who received 3-doses of mRNA vaccines (Moderna, BioNTech), non-replicating viral vector-based vaccines (AstraZeneca, AZ) or protein subunit vaccines (Medigen COVID-19 vaccine, MVC) were prospectively enrolled. SARSCoV2- IgG spike antibody level was determined (Abbott [SARS-CoV- 2 IgG II]) within 3 months after the last dose of vaccination. Charlson Comorbidity Index (CCI) was applied to disclose the association of vaccine titer and underlying comorbidities. Result(s): A total of 824 subjects were enrolled in the current study. The mean age was 58.9 years and males accounted for 48.7% of the population. The proportion of CCI with 0-1, 2-3 and>4 was 52.8% (n = 435), 31.3% (n = 258) and 15.9% (n = 131), respectively. The most commonly used vaccination combination was AZ-AZ-Moderna (39.2%), followed by Moderna-Moderna-Moderna (27.8%) and AZAZ- BioNTech (14.7%), respectively. The mean vaccination titer was 3.11 log BAU/mL after a median 48 days of the 3rd dose. Subjects of male gender, lower body mass index, chronic kidney disease, higher CCI, and receiving AZ-AZ based vaccination were likely to have a lower titer of antibody. There was a decreasing trend of antibody titer with the increase of CCT (trend P<0.001). Linear regression analysis revealed that AZ-AZ-based vaccination (beta: 0.341, 95% confidence intervals [CI]: 0.144, 0.21, P<0.001) and higher CCI (beta: - 0.055, CI: - 0.096, - 0.014, P = 0.009) independently correlated with low IgG spike antibody levels. Conclusion(s): Patients with more comorbidities had a poor response to 3 doses of COVID-19 vaccination. Further studies are warranted to clarify the efficacy of booster vaccination in the population. The vaccine titer did not differ between patient with or without chronic liver disease.

Outcomes of LEGA-C programs: a review of implementation science projects toward HCV elimination by 2030 in Asia

Background and Objectives: The WHO has identified HCV infection as a public health threat and set a global target for HCV elimination by 2030, yet currently only 11 countries are on track to achieve HCV elimination targets. Up to 60% of HCV + patients are lost to follow-up and remain untreated and this has likely been further exacerbated by the COVID-19 pandemic, which may have reduced HCV treatment urgency, causing many patients to delay care. To achieve the WHO goal, still many patients need to be screened and linked to care. Gilead has been running Local Elimination Programs Leading to Global Action in HCV (LEGA-C) to support implementation science projects toward HCV elimination. Here, we explore the outcomes of LEGA-C programs for patients with HCV especially in Asia. Method(s): The outcomes and impact were measured through the number of studies and patients to be reached;steps in the care cascade as well as efficacy of each model were assessed along with the presentations and publications from each study. Result(s): In total,[120 studies were supported. Of these, 18 have completed or are ongoing in Asia. Through July 2022, 175,192 persons were screened, 6,287 were HCV + and enrolled in a study, and 3,768 received treatment. A simplified screening and linkage to care/ minimal monitoring model was investigated in 8 studies and demonstrated that linkage to care with minimal monitoring could achieve antiviral response comparable to standard practice.[i] Four test-and-treat studies showed that aggressive screening and on-site treatment promotes HCV microelimination.[ii] Three outreach-andcallback studies showed demonstrated the feasibility of recruiting persons to HCV screening programs in community settings.[iii] Seven studies focused on special populations, and 4 of them described the characteristics of special populations with higher rates of HCV infection. Publications from these studies in Asia include 14 full articles, and these papers were cited a total of 56 times. Conclusion(s): The ongoing LEGA-C initiative is demonstrably contributing to the understanding, treatment, and ultimate elimination of HCV. Innovative ideas, active promotion of HCV testing, disease education, patient navigation, and care coordination in these programs led to increased screening and rates of linkage to care. Adopting and adapting effective strategies from these programs may be a feasible way to increase treatment numbers and improve patient outcomes, thus contributing to meeting the WHO goal of HCV elimination in Asia.

COVID-19 ACE2 related to hepatocellular carcinoma in single cell analyses and immuno-cancer microenvironment infiltrated with macrophage

Background: Hepatocellular carcinoma (HCC) is the second leading cause of malignancy-related mortality and the fifth most common worldwide. Immuno-cancer microenvironment (ICME) was highlighted recently because scientists want to unlock the detailed mechanism in carcinogenesis pathway and find the novel interactions in ICME. Besides, single cell analysis could mitigate the interrupted signals between cells and tissues. On the other hand, COVID-19 angiotensin I converting enzyme (ACE) previously was reported associated with cancer. However, the robust association between COVID-19 and HCC ICME is still unaddressed. Aim(s): We plan to investigate the COVID-19 ACE relevant genes to HCC ICME regarding survival. Method(s): We used Reactome for COVID-19 ACE gene pathway mapping and explored the positive relevant gene expression. DISCO website was applied for single cell analyses using the above-collected genes from Reactome. Finally, we implanted the biomedical informatics into TIMER 2.0 for ICME survival analyses. Result(s): In Fig. 1, the gene-gene interaction mapping was shown. We collected 13 genes (CPB2, ACE2, AGT, MME, ANPEP, CPA3, ENPEP, GZMH, CTSZ, CTSD, CES1, ATP6AP2, and AOPEP) for further single cell relevant analyses, in Table 1, with detailed expression level (TPM). Among the above 13 genes, AGT, GZMH, CTSZ, CTSD, CES1, and ATP6AP2 were strongly expressed in liver tissue. We then applied the initial 13 genes to TIMER 2.0 for HCC ICME 2-year survival analyses. CPA3 and GZMH low expressions with high macrophage infiltration in HCC ICME showed significantly worse 2-year cumulative survival [hazard ratio (HR):CPA3 2.21, p-value 0.018;GZMH 2.07, p-value 0.0341]. ACE2, CPB2, AGT, MME, ANPEP, ENPEP, CTSZ, CTSD, CES1, and ATP6AP2 high expressions with high macrophage infiltration in HCC ICME revealed significantly worse 2-year cumulative survival. Conclusion(s): We demonstrate that ACE2 was strongly associated with HCC clinical survival with macrophage infiltration. However, the bidirectional translational roles about ACE2 relevant genes in HCC should be documented.

Outpatient Versus Inpatient Robotic Assisted Radical Prostatectomy: Complications, Time Driven Activities Based Costing and Patient Satisfaction

INTRODUCTION AND OBJECTIVE: Radical prostatectomy lengths of stay decreased with ketorolac analgesia and adoption of robotic assisted radical prostatectomy (RARP). During the COVID-19 pandemic, the transition to outpatient RARP freed up critically needed hospital beds. The healthcare cost reduction afforded by the shift to outpatient RARP and its effect on patient satisfaction has yet to be explored. We compared healthcare costs, patient satisfaction and complications for outpatient vs. inpatient RARP. METHOD(S): We identified and compared a series of consecutive RARP performed as outpatient vs. inpatient and determined the capacity cost rate for every resource, including personnel, equipment, and space. After the lifting of hospital restrictions, men were given the option of inpatient vs. outpatient RARP. We also administered a validated Patient Satisfaction Outcome Questionnaire (PSOQ) postoperatively and compared median scores in perceived outcomes and satisfaction. A time-driven activity-based costing (TDABC) analysis was applied to compare the total costs of care for RARP performed. Finally, we captured complications within 30 days of surgery using the Clavien-Dindo classification. We used multivariable regression to adjust for age, race, BMI, and ASA classification to assess the impact of outpatient vs. inpatient RARP on complications. RESULT(S): There were no significant differences in patient characteristics for outpatient (n=145) vs. inpatient (n=80) RARP. When given the choice, 86.6% of men elected for outpatient vs. inpatient RARP. Outpatient RARP netted a $1387 (13.5%) cost reduction compared to inpatient RARP. There were no significant differences in outpatient vs. inpatient median satisfaction survey scores or complications within 30 days (11.0% vs. 11.3%, p=0.961). CONCLUSION(S): Outpatient RARP can be safely performed, with similar outcomes and compared to inpatient RARP. Outpatient RARP has significantly lower costs compared to inpatient RARP while maintaining similar patient satisfaction outcomes.

Molecular mimicry of the receptor-binding domain of the SARS-CoV-2 spike protein: from the interaction of spike-specific antibodies with transferrin and lactoferrin to the antiviral effects of human recombinant lactoferrin.

The pathogenesis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection involves dysregulations of iron metabolism, and although the mechanism of this pathology is not yet fully understood, correction of iron metabolism pathways seems a promising pharmacological target. The previously observed effect of inhibiting SARS-CoV-2 infection by ferristatin II, an inducer of transferrin receptor 1 (TfR1) degradation, prompted the study of competition between Spike protein and TfR1 ligands, especially lactoferrin (Lf) and transferrin (Tf). We hypothesized molecular mimicry of Spike protein as cross-reactivity of Spike-specific antibodies with Tf and Lf. Thus, strong positive correlations (R2 > 0.95) were found between the level of Spike-specific IgG antibodies present in serum samples of COVID-19-recovered and Sputnik V-vaccinated individuals and their Tf-binding activity assayed with peroxidase-labeled anti-Tf. In addition, we observed cross-reactivity of Lf-specific murine monoclonal antibody (mAb) towards the SARS-CoV-2 Spike protein. On the other hand, the interaction of mAbs produced to the receptor-binding domain (RBD) of the Spike protein with recombinant RBD protein was disrupted by Tf, Lf, soluble TfR1, anti-TfR1 aptamer, as well as by peptides RGD and GHAIYPRH. Furthermore, direct interaction of RBD protein with Lf, but not Tf, was observed, with affinity of binding estimated by KD to be 23 nM and 16 nM for apo-Lf and holo-Lf, respectively. Treatment of Vero E6 cells with apo-Lf and holo-Lf (1-4 mg/mL) significantly inhibited SARS-CoV-2 replication of both Wuhan and Delta lineages. Protective effects of Lf on different arms of SARS-CoV-2-induced pathogenesis and possible consequences of cross-reactivity of Spike-specific antibodies are discussed.

Polymorphism of clinical manifestations, experience of diagnosis and treatment of multisystem inflammatory syndrome associated with COVID-19 in children

Purpose - to analyze the literature data on possible variants of the course of pediatric multisystem inflammatory syndrome (PIMS-TS) in children;to describe our own experience in the diagnosis and treatment of some cases of PIMS-TS in children of different age groups;to present possible variants of clinical manifestations of the above disease;to draw attention to the need for early diagnosis and team care and treatment of such children. This novel clinical syndrome later identified as PIMS-TS temporally associated with SARS-CoV-2. In contrast with KD, PIMS-TS appears to occur in children at an older age with a predominance of gastrointestinal symptoms, hemodynamic instability, and myocardial dysfunction. However, the exact pathomechanism remains to be understood. Nevertheless, the post-viral immunological reaction is postulated to be the underlying mechanistic underpinnings. The paper describes the clinical course of the disease in a 5-year-old boy who complained of abdominal pain and hyperthermia, and the disease was masked by surgical pathology. The phenomena of intoxication syndrome, polyserositis, skin manifestations in the form of a polymorphic rash, hyperemia of the conjunctiva, swelling of the feet and hands increased in dynamics. The course of the disease in a 10-year-old girl who had symptoms of a viral infection is also described. However, upon going to the hospital, both children were diagnosed with a serious condition, they were hospitalized and given appropriate treatment. Therefore, the multifaceted nature of the PIMS-TS' course underlines the need for early recognition and multispecialty care and management. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. © 2022 Group of Companies Med Expert, LLC. All rights reserved.

Jing Si Herbal Drink as a prospective adjunctive therapy for COVID-19 treatment: Molecular evidence and mechanisms

Background: SARS-CoV-2 has led to a sharp increase in the number of hospitalizations and deaths from pneumonia and multiorgan disease worldwide;therefore, SARS-CoV-2 has become a global health problem. Supportive therapies remain the mainstay treatments against COVID-19, such as oxygen inhalation, antiviral drugs, and antibiotics. Traditional Chinese medicine (TCM) has been shown clinically to relieve the symptoms of COVID-19 infection, and TCMs can affect the pathogenesis of SARS-CoV-2 infection in vitro. Jing Si Herbal Drink (JSHD), an eight herb formula jointly developed by Tzu Chi University and Tzu Chi Hospital, has shown potential as an adjuvant treatment for COVID-19 infection. A randomized controlled trial (RCT) of JSHD as an adjuvant treatment in patients with COVID-19 infection is underway Objectives: This article aims to explore the efficacy of the herbs in JSHD against COVID-19 infection from a mechanistic standpoint and provide a reference for the rational utilization of JSHD in the treatment of COVID-19. Method(s): We compiled evidence of the herbs in JSHD to treat COVID-19 in vivo and in vitro. Result(s): We described the efficacy and mechanism of action of the active ingredients in JSHD to treat COVID-19 based on experimental evidence. JSHD includes 5 antiviral herbs, 7 antioxidant herbs, and 7 anti-inflammatory herbs. In addition, 2 herbs inhibit the overactive immune system, 1 herb reduces cell apoptosis, and 1 herb possesses antithrombotic ability. Conclusion(s): Although experimental data have confirmed that the ingredients in JSHD are effective against COVID-19, more rigorously designed studies are required to confirm the efficacy and safety of JSHD as a COVID-19 treatment.Copyright © 2021

How do Three-layer Surgical Masks Prevent SARS-CoV-2 Aerosol Transmission?

Graphical The three-layer surgical mask was recognized by the World Health Organization as an effective-protection tool for reducing SARS-CoV-2 transmission during the COVID-19 pandemic;however, the contribution of each layer of this mask to the particle size–dependent filtration performance resistance remains unclear. Here, both experimental work and numerical simulation were conducted to study the role of each mask layer in particle size–dependent filtration and respiratory resistance. By using scanning electron microscopy images of a commercial three-layer mask, composed of two spun-bond and one melt-blown nonwoven polypropylene fabric layers, four representative models were constructed, in which the computational fluid dynamics of multiphase flow were performed. The pressure drop of all models under different flow conditions was measured next. Numerical simulation was then verified by comparing the experimental results in the present study and other theoretical works. The filtration efficiency of the spun-bond polypropylene nonwoven fabric layer was much lower than that of the melt-blown nonwoven polypropylene fabric layer for the particle diameter in the range of 0.1–2.0 μm. Both the spun-bond and melt-blown nonwoven polypropylene fabric layers demonstrated extremely low filtration efficiency for particles was less than 0.3 μm in diameter, with the maximum filtration efficiency being only 30%. The present results may facilitate rational design of mask products in terms of layer number and structural design.

Status of contamination with Delta novel coronavirus in isolation wards

Objective: To evaluate the status of contamination with novel coronavirus pneumonia in isolation wards, so as to provide scientific basis for developing reasonable strategies of environmental disinfection in isolation wards. Methods: The samples were systematically collected from isolation wards of COVID-19. The samples were collected from the surface of the environment, hands of patients and gloves of medical staff by cotton swab wiping method. SARS-CoV-2 nucleic acid test was performed and analyzed by real-time fluorescence quantitative polymerase chain reaction assay. Results: A total of 517 samples were collected. Twenty samples collected from isolation wards were tested positive among 490 environmental samples, with the positive rate of 4.08%. Two positive samples were from hands of 27 patients and medical shaff, with the positive rate of 7.41%. There was significant difference in the positive rate of environmental samples between samples in the ward and outside the ward (X~2=5.198,P=0.023). Conclusion: Rational planning of the layout and process of the isolation ward, strict implementation of daily environmental disinfection and hand hygiene system can effectively reduce the degree of contamination of the isolation ward environment by SARS-COV-2, which can cut off the route of virus transmission, reducing the risk of nosocomial infection of medical staff.

[The impact of BMI on the course of the acute SARS-COV-2 infection and the risks that emerge during the first year after the hospital discharge. Subanalysis evidence of the AKTIV and AKTIV 2 registries].

BACKGROUND: There is enough evidence of the negative impact of excess weight on the formation and progression of res piratory pathology. Given the continuing SARS-CoV-2 pandemic, it is relevant to determine the relationship between body mass index (BMI) and the clinical features of the novel coronavirus infection (NCI). AIM: To study the effect of BMI on the course of the acute SARS-COV-2 infection and the post-covid period. MATERIALS AND METHODS: AKTIV and AKTIV 2 are multicenter non-interventional real-world registers. The АКТИВ registry (n=6396) includes non-overlapping outpatient and inpatient arms with 6 visits in each. The АКТИВ 2 registry (n=2968) collected  the  data  of  hospitalized  patients  and  included  3  visits.  All  subjects  were  divided  into  3  groups:  not  overweight  (n=2139), overweight (n=2931) and obese (n=2666). RESULTS: A higher BMI was significantly associated with a more severe course of the infection in the form of acute kidney injury (p=0.018), cytokine storm (p<0.001), serum C-reactive protein over 100 mg/l (p<0.001), and the need for targeted therapy (p<0.001) in the hospitalized patients. Obesity increased the odds of myocarditis by 1,84 times (95% confidence interval [CI]: 1,13-3,00) and the need for anticytokine therapy by 1,7 times (95% CI: 1,30-2,30).The  patients  with  the  1st  and  2nd  degree  obesity,  undergoing  the  inpatient  treatment,  tended  to  have  a  higher  probability  of  a  mortality  rate.  While  in  case  of  morbid  obesity  patients  this  tendency  is  the  most  significant  (odds  ratio  -  1,78; 95% CI: 1,13-2,70). At the same time, the patients whose chronical diseases first appeared after the convalescence period, and those who had certain complaints missing before SARS-CoV-2 infection, more often had BMI of more than 30 kg/m2 (p<0,001).Additionally, the odds of death increased by 2,23 times (95% CI: 1,05-4,72) within 3 months after recovery in obese people over the age of 60 yearsCONCLUSION.  Overweight  and/or  obesity  is  a  significant  risk  factor  for severe  course  of  the  new  coronavirus  infection  and  the associated cardiovascular and kidney damage Overweight people and patients with the 1st and 2nd degree obesity tend to have a high risk of death of SARS-CoV-2 infection in both acute and post-covid periods. On top of that, in case of morbid obesity patients this tendency is statistically significant. Normalization of body weight is a strategic objective of modern medicine and can contribute to prevention of respiratory conditions, severe course and complications of the new coronavirus infection.

Systematic analyses of the resistance potential of drugs targeting SARS-CoV-2 main protease (preprint)

Drugs that target the main protease (Mpro) of SARS-CoV-2 are effective therapeutics that have entered clinical use. Wide-scale use of these drugs will apply selection pressure for the evolution of resistance mutations. To understand resistance potential in Mpro, we performed comprehensive surveys of amino acid changes that can cause resistance in a yeast screen to nirmatrelvir (contained in the drug Paxlovid), and ensitrelvir (Xocova) that is currently in phase III trials. The most impactful resistance mutation (E166V) recently reported in multiple viral passaging studies with nirmatrelvir showed the strongest drug resistance score for nirmatrelvir, while P168R had the strongest resistance score for ensitrelvir. Using a systematic approach to assess potential drug resistance, we identified 142 resistance mutations for nirmatrelvir and 177 for ensitrelvir. Among these mutations, 99 caused apparent resistance to both inhibitors, suggesting a strong likelihood for the evolution of cross-resistance. Many mutations that exhibited inhibitor-specific resistance were consistent with distinct ways that each inhibitor protrudes beyond the substrate envelope. In addition, mutations with strong drug resistance scores tended to have reduced function. Our results indicate that strong pressure from nirmatrelvir or ensitrelvir will select for multiple distinct resistant lineages that will include both primary resistance mutations that weaken interactions with drug while decreasing enzyme function and secondary mutations that increase enzyme activity. The comprehensive identification of resistance mutations enables the design of inhibitors with reduced potential of developing resistance and aids in the surveillance of drug resistance in circulating viral populations.

Nanoformulations targeting immune cells for cancer therapy: mRNA therapeutics

The approved worldwide use of two messenger RNA (mRNA) vaccines (BNT162b2 and mRNA-1273) in late 2020 has proven the remarkable success of mRNA therapeutics together with lipid nanoformulation technology in protecting people against coronaviruses during COVID-19 pandemic. This unprecedented and exciting dual strategy with nanoformulations and mRNA therapeutics in play is believed to be a promising paradigm in targeted cancer immunotherapy in future. Recent advances in nanoformulation technologies play a prominent role in adapting mRNA platform in cancer treatment. In this review, we introduce the biologic principles and advancements of mRNA technology, and chemistry fundamentals of intriguing mRNA delivery nanoformulations. We discuss the latest promising nano-mRNA therapeutics for enhanced cancer immunotherapy by modulation of targeted specific subtypes of immune cells, such as dendritic cells (DCs) at peripheral lymphoid organs for initiating mRNA cancer vaccine-mediated antigen specific immunotherapy, and DCs, natural killer (NK) cells, cytotoxic T cells, or multiple immunosuppressive immune cells at tumor microenvironment (TME) for reversing immune evasion. We highlight the clinical progress of advanced nano-mRNA therapeutics in targeted cancer therapy and provide our perspectives on future directions of this transformative integrated technology toward clinical implementation.

Clinical and Anamnestic Characteristics, Cardiovascular Pharmacotherapy and Long-term Outcomes in Multimorbid Patients after COVID-19

Aim. To study the clinical and anamnestic characteristics, pharmacotherapy of cardiovascular diseases (CVD) and long-term outcomes in post-COVID-19 patients with cardiovascular multimorbidity (CVMM), enrolled in the prospective hospital registry. Material and methods. In patients with confirmed COVID-19 included in the TARGET-VIP registry, the CVMM criterion was the presence of two or more CVDs: arterial hypertension (AH), coronary heart disease (CHD), chronic heart failure (CHF), atrial fibrillation (AF). There were 163 patients in the CVMM group and 382 - in the group without CVD. The information was obtained initially from hospital history sheet, and afterwards - from a telephone survey of patients after 30-60 days, 6 and 12 months, from electronic databases. The follow-up period was 13.0 +/- 1.5 months.Results. The age of post-COVID patients with CVMM was 73.7 +/- 9.6 years, without CVD - 49.4 +/- 12.4 years (p<0.001), the proportion of men was 53.9% and 58.4% (p=0.34). In the group with CVMM the majority of patients had AH (92.3-93.3%), CHD (90.4-91.4%), and minority - CHF (42.7-46.0%) and AF (42.9-43.4%). The combination of 3-4 CVDs prevailed (58.9-60.3%). The proportion of cases of chronic non-cardiac pathologies was higher in the CVMM group (80.9%) compared to the group without CVD (36.7%;p<0.001). The frequency of proper cardiovascular pharmacotherapy during the follow-up period decreased from 56.8% to 51.3% (p for trend = 0.18). The frequency of anticoagulant therapy in AF decreased significantly: from 89.1% at the discharge from the hospital to 56.4% after 30-60 days (p=0.001), 57.1% and 53.6% after 6 and 12 months of monitoring (p for a trend <0.001). There were no other significant changes in the frequency of other kinds of the proper cardiovascular pharmacotherapy (p>0.05). There were higher rate of all-cause mortality among patients with CMMM (12.9% vs 2.9%, p<0.001) as well as rates of hospitalization (34.7% and 9.9%, p<0.001) and non-fatal myocardial infarction (MI) - 2.5% vs 0.5% (p=0.048). The proportion of new cases of CVD in the groups with CVMM and without CVD was 5.5% and 3.7% (p=0.33). The incidence of acute respiratory viral infection (ARVI)/influenza was higher in the group without CVD - 28.3% vs 19.0% (p=0.02). The proportion of cases of recurrent COVID-19 in groups with CVMM and without CVD was 3.7 % and 1.8% (p=0.19).Conclusion. Post COVID-19 patients with CVMM were older and had the bigger number of chronic non-cardiac diseases than patients without CVD. The quality of cardiovascular pharmacotherapy in patients with CVMM was insufficient at the discharge from the hospital with following non-significant decrease during 12 months of follow-up. The frequency of anticoagulant therapy in AF decreased by 1.6 times after 30-60 days and by 1.7 times during the year of follow-up. The proportion of new cases of CVD was 5.5% and 3.7% with no significant differences between compared groups. The rate of all-cause mortality, hospitalizations and non-fatal MI was significantly higher in patients with CVMM, but the frequency of ARVI/influenza was significantly higher in patients without CVD. Recurrent COVID-19 was registered in 3.7% and 1.8% of cases, there were no significant differences be-tween compared groups.

INCLUSION OF REAMBERIN INTO COMPREHENSIVE OUTPATIENT REHABILITATION SCHEME FOR PATIENTS WITH SARS-CoV-2 ASSOCIATED PNEUMONIA

Effectiveness of the inclusion of reamberin in the complex rehabilitation of patients suffering of pneumonia caused by SARS-CoV-2 was evaluated at the outpatient stage. The data of 162 patients who received the rehabilitation treatment including, in addition to pharmacological benefits, exercise therapy and vacuum labile massage, were analyzed. In addition, patients of the main group (n = 82) received reamberin (1.5%, intravenously in a volume of 500 mL) for 10 days. The biochemical parameters of blood were studied in dynamics, and the blood oxygenation was monitored by the Stange and Genchi tests and the pulse oximetry. The quality of life was assessed in terms of the SF-36 questionnaire. The inclusion of reamberin in the complex rehabilitation contributed to improvement of the main biochemical parameters of blood (the levels of aspartate aminotransferase, alanine aminotransferase, and gamma-glutamyl transpeptidase decreased 1.2, 1.7, and 1.9 times, respectively, p0.5) and caused a more pronounced increase in the external respiration function (on the average by 8.4 sec according to the Stange test and by 9.1 sec according to the Genchi test), which was accompanied by positive trends in the quality of life indicators (according to the SF-36 questionnaire) in terms of physical functioning (by 5.1 points) and general health status (by 3.76 points. The obtained clinical and laboratory data, together with good tolerance of the drug, allow us to recommend the inclusion of reamberin in rehabilitation regimens for patients with pneumonia caused by SARS-CoV-2. Copyright © 2022 Izdatel'stvo Meditsina. All rights reserved.

Food Insecurity, Black Churches, and Black Household Vulnerabilities during COVID-19

Prior to the COVID-19 pandemic, food insecurity presented a threat to health outcomes for communities of color. The disproportional onslaught of COVID has exacerbated the food insecurity and health burden experienced by communities of color. The pandemic has revealed deeply race-ingrained inequities exemplified in economic inequities such as low levels of asset ownership, housing instability, and weak attachment to jobs that pay decent wages. In this essay, we use the framework of layered vulnerabilities to better understand the multiple factors that contribute to food insecurity and health outcomes in general as well as the cumulative effects of COVID. We conclude by highlighting the role of black churches as a community resource that mitigates food insecurity and the effects of such insecurity on black communities. © 2002 Taylor and Francis.

Assessment of COVID-19 aerosol transmission in a university campus food environment a numerical method

With the prevalence of COVID-19, the phenomenon of viruses spreading through aerosols has become a focus of attention. Diners in university dining halls have a high risk of exposure to respiratory droplets from others without the protection of face masks, which greatly increases the risk of COVID-19 transmis-sion. Therefore, the transmission mechanism of respiratory droplets in extremely crowded dining envi-ronments should be investigated. In this study, a numerical simulation of coughing at dining tables under two conditions was performed, namely the presence and absence of protective partitions, and the evaporation and condensation of aerosol droplets in the air were examined. By using the numerical method, we analyzed and verified the isolation effect of dining table partitions in the propagation of aero-sol droplets. The effect of changes in room temperature on the diffusion of coughed aerosols when par-titions were present was analyzed. We demonstrated how respiratory droplets spread through coughing and how these droplets affect others. Finally, we proposed a design for a dining table partition that min-imizes the transmission of COVID-19.(c) 2021 China University of Geosciences (Beijing) and Peking University. Production and hosting by

Validation of the Essential Frailty Toolset: Can Frailty Be Measured in the Virtual Clinic?

Background/Purpose: The Essential Frailty Toolset (EFT) is a valid measurement of frailty in people with heart valve disease. COVID-19 has prompted the transition to virtual health consultations and necessitates the validation of the virtual assessment of frailty to support treatment decision and improve outcomes. Methods/Results: We conducted a prospective observational cohort study to compare the measurement of EFT in person and virtual format within a maximum 2-week window of repeated measurements. The weighted Kappa tests was used to measure the agreement of EFT scores between assessments. We explored the effect of the sequence of measurement using the Cochran-Mantel-Haenszel statistic to test the general association between the timing of measurement and differences of EFT score. We recruited a sample of 85 patients, with a mean age of 81 +/- 6 years, including 51 men (60%);the primary valvular heart diseases were aortic stenosis (n=72, 84.7%), mitral regurgitation (n=5, 5.9%) and tricuspid regurgitation (n=8, 9.4%). The virtual measurement of frailty was conducted using a standardised protocol. The platform for virtual connection selected by patients was FaceTime (n=33, 38.8%) and Zoom (52, 61.2%);the median (IQR) number of days between the in-person and the virtual assessment was 5 (2, 9 ). The weighted Kappa estimate was 0.63 (95% CI 0.52, 0.75), indicating a strong agreement between the separate scores obtained. The test for the general association was non-significant (p=0.99), indicating a lack of evidence of detecting an association between EFT scores and the chronological order of assessment. Conclusion/Implications for Practice: The EFT can be reliably measured virtual in older patients with valvular heart disease. Future research is required to understand patients' perspectives of participating in this clinical assessment in a virtual clinic. [Formula presented] Copyright © 2022