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1.
Nan Fang Yi Ke Da Xue Xue Bao ; 43(4): 516-526, 2023 Apr 20.
Article in Chinese | MEDLINE | ID: covidwho-20239030

ABSTRACT

OBJECTIVE: To establish a rapid detection and genotyping method for SARS-CoV-2 Omicron BA.4/5 variants using CRISPPR-Cas12a gene editing technology. METHODS: We combined reverse transcription-polymerase chain reaction (RT-PCR) and CRISPR gene editing technology and designed a specific CRISPPR RNA (crRNA) with suboptimal protospacer adjacent motifs (PAM) for rapid detection and genotyping of SARS- CoV-2 Omicron BA.4/5 variants. The performance of this RT- PCR/ CRISPPR-Cas12a assay was evaluated using 43 clinical samples of patients infected by wild-type SARS-CoV-2 and the Alpha, Beta, Delta, Omicron BA. 1 and BA. 4/5 variants and 20 SARS- CoV- 2-negative clinical samples infected with 11 respiratory pathogens. With Sanger sequencing method as the gold standard, the specificity, sensitivity, concordance (Kappa) and area under the ROC curve (AUC) of RT-PCR/CRISPPR-Cas12a assay were calculated. RESULTS: This assay was capable of rapid and specific detection of SARS- CoV-2 Omicron BA.4/5 variant within 30 min with the lowest detection limit of 10 copies/µL, and no cross-reaction was observed in SARS-CoV-2-negative clinical samples infected with 11 common respiratory pathogens. The two Omicron BA.4/5 specific crRNAs (crRNA-1 and crRNA-2) allowed the assay to accurately distinguish Omicron BA.4/5 from BA.1 sublineage and other major SARS-CoV-2 variants of concern. For detection of SARS-CoV-2 Omicron BA.4/5 variants, the sensitivity of the established assay using crRNA-1 and crRNA-2 was 97.83% and 100% with specificity of 100% and AUC of 0.998 and 1.000, respectively, and their concordance rate with Sanger sequencing method was 92.83% and 96.41%, respectively. CONCLUSION: By combining RT-PCR and CRISPPR-Cas12a gene editing technology, we successfully developed a new method for rapid detection and identification of SARS-CoV-2 Omicron BA.4/5 variants with a high sensitivity, specificity and reproducibility, which allows rapid detection and genotyping of SARS- CoV-2 variants and monitoring of the emerging variants and their dissemination.


Subject(s)
COVID-19 , Humans , CRISPR-Cas Systems , Genotype , Reproducibility of Results , Reverse Transcriptase Polymerase Chain Reaction , SARS-CoV-2/genetics , RNA , COVID-19 Testing
2.
2nd International Conference on Biological Engineering and Medical Science, ICBioMed 2022 ; 12611, 2023.
Article in English | Scopus | ID: covidwho-2322741

ABSTRACT

The development and implementation of vaccines are expected to reduce the incidence of the death to a certain extent and control the spread of the COVID-19. At the national level, different countries have adopted different measures on vaccination according to national conditions and policies to control the COVID-19, which have different degrees of impact. This study selects data on vaccination in the US and the UK from March 2021 to May 2022, explores the differences between the death and vaccination in two countries by building multiple linear regression models respectively. Research indicates that people vaccination in the US has a greater effect on new death than UK. When people vaccination drops by 7.648e-06 units, new death increases by one unit. However, from the model of UK, when people vaccination drops by 1.406e-06 units, new death increases by one unit. From the analysis of the result, the difference between the US and the UK might be due to national policies, medical systems and public attitudes toward the government and vaccination. © 2023 SPIE.

3.
Iaq 2020: Indoor Environmental Quality Performance Approaches, Pt 2 ; 2022.
Article in English | Web of Science | ID: covidwho-2308179

ABSTRACT

Worldwide concern has been focused on the airborne disease of the COVID-19 pandemic. This study investigated the effect of the limited space air stability on the mechanism of SARS-CoV-2 spreading in the interpersonal breathing microenvironment using an unsteady computational fluid dynamics (CFD) method. A validated numerical model was employed to simulate the transient SARS-CoV-2 releasing process from normal breathing activity. The computational domain was divided into an interpersonal breathing microenvironment and the rest macroenvironment. A displacement ventilation system was implemented with 1.5 ACH, 3 ACH, 7.4 ACH and 9 ACH. Two standing CSPs (Computational Simulated Person) were placed in the middle of the macroenvironment face-to-face with a relative distance of 1 m. Simulation results indicated that in stable cases, the exhaled SARS-CoV-2 tended to accumulate in the interpersonal breathing microenvironment and resulted in a relatively high infection risk for people;whereas in cases where unstable air presented, SARS-CoV-2 concentration was significantly reduced. The unstable conditions lowered the risk of person-to-person transmission in confined spaces. Also, it was found that unstable cases performed better in energy efficiency in comparison with the stable conditions.

4.
Imaging Science Journal ; 69(5-8):319-333, 2021.
Article in English | Web of Science | ID: covidwho-2309548

ABSTRACT

At present, there are problems of low detection efficiency and accuracy in chest CT images of COVID-19 as well as limited computational power of deep learning model training. Developing a classical-to-quantum (CQ) ensemble model with transfer learning to efficiently detect patients with COVID-19 using chest CT images.: Attributes were extracted from chest CT scans using pre-trained networks ResNet50, VGG16 and AlexNet, while dressed quantum circuits were used as classifiers. The overall accuracy of the CQ method based on three aforementioned networks on the chest CT dataset is 83.2%, 86.2% and 85.0%, respectively. The proposed ensemble model has a precision of 89.0% for pneumonia samples, an overall accuracy of 88.6% and a pneumonia class recall rate of 83.0%. In addition, to further verify the robustness of the ensemble model, breast ultrasound and brain tumour images were used in it. The suggested ensemble approach is effective for classifying and detecting medical pictures with complicated features, particularly for detecting COVID-19 patients using chest CT images.

5.
56th Annual Hawaii International Conference on System Sciences, HICSS 2023 ; 2023-January:6442-6451, 2023.
Article in English | Scopus | ID: covidwho-2305511

ABSTRACT

This study investigates the effect of social media (SM) use purposes and user characteristics on individual psychological wellbeing (PWB) during the coronavirus pandemic (COVID-19). Informed by the uses and gratifications theory and PWB research, this study analyzed survey data collected from 282 SM users aged 18 through 59 from a minority-serving university in the United States in March-April 2020. Our quantitative data analysis showed that social media can be used to improve the quality of personal experiences during the COVID-19 crisis through three mechanisms-connectedness (i.e., social), engagement (i.e., collaborative), and entertainment (i.e., hedonic). However, the effect varied by gender, SM usage level, and individual concern about COVID-19 risk. The findings contribute to the literature and offer implications in technology use for enhancing public mental health during crises. © 2023 IEEE Computer Society. All rights reserved.

6.
55th Annual Hawaii International Conference on System Sciences, HICSS 2022 ; 2022-January:5125-5134, 2022.
Article in English | Scopus | ID: covidwho-2294157

ABSTRACT

Access to technology is essential to educational success in today's digitized society, but disparities in access to technology can handicap students. This study examines to what extent this digital divide exists among underserved students in online instruction during COVID-19 and in their adoption of free Technology Loaner programs. Focusing on underserved students that are characterized by their generational status, minority background or low income, we predict that underserved college students will show lower levels of technology access and higher levels of free technology adoption than their counterparts. However, the quantitative analysis of survey data (n=258) collected from a U.S. minority-serving university provides mixed, surprising results. Follow-up analysis of qualitative data from 10 interviews offers us further insights and partial explanations for these unexpected results. Our study suggests that individual background should be considered in designing a policy to mitigate digital divide and enhance student learning in online education. © 2022 IEEE Computer Society. All rights reserved.

7.
Adverse Drug Reactions Journal ; 22(6):360-365, 2020.
Article in Chinese | EMBASE | ID: covidwho-2294155

ABSTRACT

Objective: To analyze the occurrence and risk factors of drug-induced liver injury (DILI) in patients with novel coronavirus pneumonia (COVID-19). Method(s): The medical records of patients with COVID-19 who were discharged from the First Hospital of Changsha from January 15 to March 7, 2020 were collected and the patients were divided into the DILI group and the non-DILI group based on DILI diagnostic criteria. Basic information of patients in the 2 groups including gender, age, underlying diseases, classification of COVID-19, liver function test results on admission and after medication, drug use, time to DILI onset after medication, and treatments and outcomes of DILI were recorded and compared. The incidence of DILI in patients with COVID-19 was calculated, and the factors whose P<0.05 in inter-group comparison were included in the multivariate logistic regression analysis to calculate the odds ratio (OR) and95% confidence interval (CI). Result(s): A total of 203 discharged patients with COVID-19 met the inclusion criteria. Of them, 36 patients developed DILI, the incidence was 17.73%. Between the DILI group and the non-DILI group (167 patients), the differences were statistically significant in gender distribution, proportion of patients with underlying diseases such as hypertension, fatty liver, and cholelithiasis, clinical classification of COVID-19, and the kinds of drug use (P<0.05 for all), but not statistically significant in levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total bilirubin (TBil) on admission (P>0.05 for all). The levels of ALT and AST in patients in the DILI group after medication were higher than those before medication, and the differences were statistically significant (P<0.001 for all). The median time for time to DILI onset after medication was 8 (6, 11) days and none of the patients had obvious clinical signs and symptoms. After the occurrence of DILI, 16 patients stopped the suspicious drugs and received liver-protective treatments, 6 patients only stopped the suspicious drug without additional treatments, and 14 patients received liver-protective treatments without drug withdrawal. Among the 36 patients in the DILI group, liver function were improved in 34 patients but did not returned to normal in 2 patients when they were discharged from the hospital. Multivariate logistic regression analysis showed that male (OR=3.939, 95%CI: 1.426-10.883, P=0.008), being severe and critical in clinical classification (OR=6.433, 95%CI: 2.411-17.162, P<0.001), fatty liver (OR=3.815, 95%CI: 1.298-11.215, P=0.015), cholelithiasis (OR=16.347, 95%CI: 1.267-210.990, P=0.032), and the kinds of drug use >8 (OR=10.181, 95%CI: 3.606-28.744, P<0.001) were the independent risk factors of DILI in patients with COVID-19. Conclusion(s): The incidence of DILI in COVID-19 patients discharged from the First Hospital of Changsha is 17.73%. Male, being severe and critical in clinical classification of COVID-19, fatty liver, cholelithiasis, and the kinds of drug use >8 are the independent risk factors for DILI patients with COVID-19.Copyright © 2020 by the Chinese Medical Association.

8.
Infectious Diseases and Immunity ; 3(1):36-39, 2023.
Article in English | Scopus | ID: covidwho-2287217

ABSTRACT

The pandemic of coronavirus disease 2019 is "not over,"in fact, the "dynamic clearing"policy for SARS-CoV-2 control and prevention in China has been firmly enforced. This study aimed to analyze the clinical symptoms and dynamic viral RNA changes in 2021 at Guangzhou Eighth People's Hospital. This study showed that 31.4% of the patients (695/2212) tested negative for viral RNA from admission to the final release from quarantine. Of all negative cases, 86.5% (601/695) remained in the hospital for no more than 5 days and were asymptomatic or mild. Among the remaining 402 patients who stayed for no more than 5 days, 76.4% (307/402) were viral RNA retest positive during the isolation stage. However, 96.4% of the peak viral RNA (296/307) was over Ct = 33 cycles during the isolation stage. © Wolters Kluwer Health, Inc. All rights reserved.

9.
Chinese Journal of Neuromedicine ; 19(11):1185-1188, 2020.
Article in Chinese | EMBASE | ID: covidwho-2283530

ABSTRACT

COVID-19 is the latest and most severe epidemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Besides the respiratory system, the effects of SARS-CoV-2 on central and peripheral nervous systems have been recognized by more and more people. Clinically, patients with COVID-19 have been reported from mild anosmia and hypoesthesia to acute necrotizing hemorrhagic encephalopathy and Guillain-Barre syndrome. In order to facilitate clinicians to recognize the nerve injury of COVID-19 patients and give timely treatment to these patients, this paper reviews the latest research progress on the possible pathways of nerve injury, clinical manifestations and pathogenesis of COVID-19 patients.Copyright © 2020 by the Chinese Medical Association.

10.
International Journal of Online Pedagogy and Course Design ; 12(1), 2022.
Article in English | Scopus | ID: covidwho-2256902

ABSTRACT

With the rapid development of information technologies, virtual reality-Assisted language learning (VRALL) has caught much attention across the world, particularly during the COVID-19 pandemic. Nevertheless, few review studies aimed to understand the influence of virtual reality (VR) on learning outcomes in terms of each language element. This literature review study selected and analyzed 23 studies from the perspective of language learning aspects, main users of VR technology, and the impact of VR on each learning aspect. The results revealed that (1) vocabulary learning and tertiary education gained the most attention in academia;(2) VR promoted pronunciation learning, listening skills, and speaking skills;(3) VR was a mixed blessing for vocabulary learning, reading skills, and writing skills. Future research could explore the solutions to improve the effectiveness of VR and highlight interdisciplinary cooperation. © 2022 IGI Global. All rights reserved.

11.
China Tropical Medicine ; 22(9):816-820, 2022.
Article in Chinese | Scopus | ID: covidwho-2164284

ABSTRACT

Objective To investigate the dynamic changes and clinical significance of specific antibodies in patients with coronavirus disease 2019 (COVID-19). Methods A retrospective study was conducted to collect 141 adult COVID-19 survivors who were followed up in the Eighth Hospital affiliated to Guangzhou Medical University from February 6, 2020, to March 24, 2021. The patients were divided into severe group (severe and critical) and non-severe group (light and ordinary) according to the diagnosis at discharge. The antibody changes of the two groups were compared and analyzed at 1 week, 2 weeks, 1 month, 3 months, 6 months and 1 year after discharge. Results After discharge from hospital, the positive rate of IgG in the severe group was 95.00% after 1 week and 100.00% in the following year, in the positive rate of IgG in the non-severe group was 59.50% after 1 week, 90.08% in 6 months and 76.03% in one year. The level of serum IgG in the severe group was significantly higher than that in non-severe group (Z=-2.441, P=0.015). One-year follow-up: the serum IgG in the severe group was significantly higher than that in the non-severe group (Z=-3.410, P=0.001). The serum IgM level of the severe group after one year follow-up was lower than that of the six months follow-up, the difference was statistically significant (Z=-2.259, P=0.024). The serum IgG and IgM level of the non-severe group after one year follow-up was lower than that of the six months follow-up, the difference was statistically significant (Z=-7.37, P<0.01;Z=3.850, P<0.01). Conclusion The level of serum protective antibody in COVID-19 patients remained high within 6 months after discharge, and remained stable within 1 year after discharge. The antibody titers in the severe group were significantly higher than those in the non-severe group and lasted for at least one year. COVID-19 survivors receive 1 year of natural immune protection, and patients with critical conditions receive immunity for longer periods of time. © 2022 The authors.

12.
Acta Veterinaria et Zootechnica Sinica ; 53(9):2819-2832, 2022.
Article in Chinese | EMBASE | ID: covidwho-2080952

ABSTRACT

The 13th Five-Year National Key Research and Development Program has established a key project of "Prevention and Control of Major Animal Diseases, Efficient and Safe Husbandry Technology Research and Development" (Animal Project), which supported scientific and technological innovation research in the field of animal epidemic prevention and control, efficient and safe breeding and breeding environment treatment. This project carried out the design of "whole chain design and integrated implementation" according to basic research, key technology research and development and integrated demonstration to solve the important basic theory and technical bottleneck of animal breeding in China. Based on the method of bibliometric, a statistical analysis was conducted of the papers supported mainly by the project to master the research progress and hot spots of the special project in basic research and frontier theory. Moreover, the future key research direction and development trend in the field of animal husbandry and veterinary medicine was discussed in combination with the layout of animal husbandry and veterinary related projects in the 14th Five-Year Plan. The results showed that this special funded papers had achieved breakthrough research in the basic research fields of major animal diseases and zoonotic diseases such as the COVID-19, Zika virus and African Swine Fever Achievements: Agriculture-related universities and scientific research institutes cooperate closely and have made great contributions;International cooperation is not only with the United States and other developed countries, but also closely cooperated with developing countries such as Pakistan and Egypt related to the "Belt and Road" initiative. The probability of publishing high-quality papers which cooperated with scientific research teams in developed countries has increased significantly;Research hotspots mainly focus on epidemiology, pathogen replication and evolution, drug resistance, pathogen and host interaction and network regulation, immune and pathogenic mechanisms, cross-species transmission, etc. The livestock and poultry special project focuses on the research direction of the prevention and control of major livestock and poultry diseases and efficient and safe breeding, and has made important research progress in major basic theories, supporting the research and application demonstration of key core technologies. The 14th Five-Year National Key Research and Development Program will make a comprehensive layout in the field of animal seed industry innovation, prevention and control of animal diseases, purification and eradication, nutrition regulation and efficient breeding, waste resource utilization and green breeding, breeding equipment and intelligent breeding. Copyright © 2022 Editorial Board, Institute of Animal Science of the Chinese Academy of Agricultural Sciences.

13.
Chinese Journal of Evidence-Based Medicine ; 22(8):932-947, 2022.
Article in Chinese | EMBASE | ID: covidwho-2006473

ABSTRACT

Objective To evaluate the evidence of the experience with medical sewage treatment procedures in medical institutions in China. Methods Databases including CNKI, WanFang Data, PubMed, Web of Science, and EBSCO were electronically searched to collect studies on the medical sewage treatment process, flow, and specifications in medical institutions in China. We used the quality evaluation system to classify and grade the experiences based on the principles and methods of evidence-based science and performed a descriptive analysis. Results After the SARS pandemic in 2003, China systematically established and standardized the technical criteria of medical sewage treatment and discharge. Moreover, a prevention system for the epidemic using medical sewage was constructed, which guaranteed that the quality of medical sewage treatment and discharge would meet the criteria and protect the citizens, and the technical specifications of medical sewage treatment would progress and increase strictly. At present, medical sewage treatment in medical institutions in China was based on mechanical and biological methods, and disinfection was mainly performed using chlorine and its compounds, ozone, and ultraviolet light. Conclusion The COVID-19 pandemic requires a higher quality of medical sewage treatment and discharge criteria for medical institutions in China. To meet these criteria, all medical institutions in China should check, replace, and update their old facilities;strengthen personnel training and effectively ensure the quality of medical sewage treatment.

14.
Journal of Clinical Oncology ; 40(16), 2022.
Article in English | EMBASE | ID: covidwho-2005714

ABSTRACT

Background: Fatigue is common in patients undergoing radiotherapy (RT). Melatonin, an inexpensive natural supplement, may improve symptoms and attenuate the side effects of RT. The effect of melatonin for prevention of fatigue and other symptoms was evaluated in a double-blind placebo-controlled trial. Methods: Early-stage or ductal carcinoma in-situ breast cancer patients ≥ 18 years, female, Eastern Cooperative Oncology Group performance status (ECOG PS) < 3, hemoglobin ≥9 g/dL. RT with curative intent, randomized 1:1 to melatonin 20 mg or oral placebo, starting night before RT initiation until 2 weeks post-RT. Sample size of 142 evaluable patients in each arm for 80% power and interim analysis at mid recruitment using the unified family method rho = 0.3. Randomization stratified to RT duration (< 3 weeks, ≥3 weeks) and prior chemotherapy. Primary outcome : Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue subscale after completion of RT with additional scores measured at baseline, 2 and 8 weeks post-RT. Secondary outcomes : FACIT-F subscales, Edmonton Symptom Assessment System (ESAS) and Patient Reported Outcomes Measurement Information System (PROMIS) Fatigue-Short Form 8a. Secondary analyses reported using an F-test at a 5% significance level. Results: For this interim analysis, 85 patients screened;80 randomized;39 received melatonin and 38 placebo. 72 included in the analysis as 5 patients had no post baseline FACIT score. Characteristics of age, race, and ECOG PS similar in both arms. Treatment X time for FACIT-Fatigue not significant for melatonin compared to placebo (p .83). FACIT physical, emotional, and functional wellbeing scores not significantly different (p .35, .62, and .71) but showing a trend for social well-being (p .06). PROMIS scores not changed over time (p .34). ESAS individual symptoms of anxiety, well-being, drowsiness, poor appetite, nausea, pain, shortness of breath, sleep and tiredness not significant, except for depression (p.04). However, a decrease of 0.01 unit in depression score is not considered clinically significant. No grade 3 or 4 adverse events. No participants died during study, 2 died after study completion from breast cancer recurrence. 16 withdrew prior to study completion because of adverse events, unrelated hospitalizations, RT discontinuation, and COVID-19 precautions. Trial was stopped based on statistical analysis demonstrating no difference for primary outcome and imminent expiry of available drug. Discontinuation was approved by Data Safety Monitoring Committee. Conclusions: Melatonin did not prevent fatigue in patients with early stage breast cancer undergoing RT. Melatonin also demonstrated no benefit for other symptoms, except depression. Analysis showed little evidence of an effect, and the trial was terminated early.

15.
Engineering Construction and Architectural Management ; : 33, 2022.
Article in English | Web of Science | ID: covidwho-1927485

ABSTRACT

Purpose This paper aims to explore the key risk factors affecting the Personnel Localization Management of international construction projects under the major public emergencies represented by the novel coronavirus pneumonia pandemic (hereinafter COVID-19) and how the public emergency affected the Personnel Localization Management from three levels: staff turnover rate, the number of different personnel, the salary and performance of workers. The paper also helps to enhance the construction enterprises' response capacity of major public emergencies and provides a comprehensive framework of optimization strategies for the Personnel Localization Management of international construction projects (hereinafter projects). Design/methodology/approach The main research method of this paper is the case study, and ten representative international construction projects are selected for case study in China construction enterprises (hereinafter CCE). And this study used the failure mode and effects analysis (FMEA) and comparative analysis to find out all potential risk factors under the COVID-19 and analyze how the epidemic affects the Personnel Localization Management of projects which based on the primary data from 10 projects obtained through in-depth interviews and the secondary data from China First Metallurgical Group and Central South Construction Group's Overseas Enterprise. Findings The findings show that the outbreak of the major public emergencies not only greatly increased eight risk factors but also directly led to an increase in staff turnover rate. Meanwhile, the numbers of Chinese and local managers and workers are all affected, and an increase in the number and the salary performance of local workers can be reduced, to a certain extent, to the cost-to-output ratio of the projects. The findings would help construction enterprises better cope with Personnel Localization Management and enhance the response capacity of major public emergencies. Research limitations/implications This study will broaden researchers' horizons regarding "Personnel Localization Management under major public emergencies" and "risk factors of Personnel Localization Management in an international context." Furthermore, construction enterprises looking for a better mechanism of Personnel Localization Management can benefit from research findings and lessons learned from the authors' case study during or before an outbreak of major public emergency. Lastly, the framework of optimization strategies for Personnel Localization Management can be used both for research purposes and practice issues in international construction projects. Practical implications The findings from the authors' case study offer the direction for international construction enterprises in China and other countries to formulate effective measures, strengthen overseas business and establish a crisis management mechanism for Personnel Localization Management under major public emergencies, and the findings provide emergency plans for projects to improve the public crisis handling capacity and respond to major public emergencies such as the COVID-19. Social implications This study analyzes the impact of the COVID-19 on the Personnel Localization Management of international construction projects from the perspective of personnel. This study provides a theoretical reference for the international construction industry to actively respond to major public emergencies. Besides, the research is conducive to improving the emergency response mechanism in the construction industry, and further promoting the high-quality and globalized development of international construction. Originality/value This study provides other researchers with a comprehensive understanding of the risk factors affecting the Personnel Localization Management of projects under the COVID-19 and insight for further research on localization management, risk management, and project management.

17.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 57(5): 455-461, 2022 May 09.
Article in Chinese | MEDLINE | ID: covidwho-1818247

ABSTRACT

Today, there is greater awareness on the association between oral diseases and respiration diseases after the outbreak of COVID-19. However, confusion regarding the oral health management and medical risk prevention for patients with chronic airway diseases has been remained among dental clinicians. Therefore, the dental experts of the Fifth General Dentistry Special Committee, Chinese Stomatological Association, combined with the experts of respiratory and critical care medicine, undertook the formation of consensus on the oral health management of patients with chronic airway diseases in order to help dental clinicians to evaluate medical risks and make better treatment decision in clinical practice. In the present consensus report, the relationship of oral diseases and chronic airway diseases, the oral health management and the treatment recommendations of patients with chronic airway diseases are provided.


Subject(s)
COVID-19 , Oral Medicine , Consensus , Humans , Oral Health
18.
Cancer Research ; 82(4 SUPPL), 2022.
Article in English | EMBASE | ID: covidwho-1779458

ABSTRACT

Background: Adjuvant endocrine therapy remains the standard of care for patients (pts) with early stage, HR+ BC who can safely omit chemotherapy based on RS results;however, the role of NET remains unclear. There are limited data regarding the optimal duration of treatment with NET and the ideal patient (pt) population for NET in terms of age and RS result. This question rose to critical importance amidst the COVID-19 pandemic, during which NET was utilized more broadly in attempts to delay surgery or chemotherapy while preserving optimal pt outcomes. This study re-examines the use of NET among a cohort of pts with HR+ BC randomized to NET or neoadjuvant chemotherapy (NCT) based on RS (performed on initial core biopsy specimens). Methods:Data were pooled from two independent studies performed at Emory's Winship Cancer Institute and Massey Cancer Center at Virginia Commonwealth University (VCU) from 2010-2012. These studies evaluated rates of clinical and pathologic complete response (pCR) among pts with early stage, HR+ BC assigned to treatment groups based on RS results. Pts with RS 0-10 received NET (Group (Grp) A), RS 11-24/25 (Emory 11-24 vs VCU 11-25) were randomized to NET (Grp B) or NCT (Grp SC), and those with RS 25/26-100 received NCT (Grp D). Associations between RS result, neoadjuvant therapy and pCR in the breast, lymph nodes (LN) and breast plus LN were evaluated using Fisher's exact test. Results:109 pts were included in this analysis. The Emory cohort was younger (median age 56 years (yrs) vs 63 yrs in VCU cohort) and more diverse (37.5% African American (AA) vs 18.6% AA in VCU cohort). The pts were predominantly post-menopausal (69.6% Emory vs 83.1% VCU). Nodal status among the Emory cohort was evenly divided with 50% N0 and 50% N+, while the majority of VCU pts were N0 (76.3% N0 vs 22.0% N+). Pts were grouped based on RS result: RS <11 (18% Emory vs 20.3% VCU), RS 11-24/25 (36% Emory vs 55.9% VCU) and RS 24/25 or higher (46% Emory vs 23.7% VCU). Pts with low RS result were older (median 64 yrs vs 59 yrs among RS > 24/25) with higher percentage of low-grade tumors (47.6% grade 1 vs 5.4% grade 1 among RS >24/25). With regard to pCR, there were no significant differences among pts with low or intermediate RS results, as no pts in these groups achieved pCR in the breast or breast + LN (Table). Pts with RS result 25/26-100 (Grp D) were the only pts shown to achieve pCR in breast + LN (18.9%, p= 0.0043 across groups). Notably, while pts on the Emory study received longer courses of NET (median 10 months vs 5.5 months), there were no significant differences in pCR across RS result subgroups noted between the two institutions. Conclusion:Our results demonstrate that the use of Oncotype DX Breast Recurrence Score® or other genomic assays in the neoadjuvant setting may help guide treatment decisions when considering the use of NET versus NCT. Pt age and length of endocrine therapy as well as pt preferences should be considered when determining neoadjuvant treatment plans. There are currently ongoing studies evaluating the use of NET with CDK4/6 inhibitors that will offer further insight into optimal neoadjuvant treatment strategies in HR+ BC. Subsequent phase III evaluation of the role of genomic assays in the neoadjuvant setting is feasible and may help determine whether NET + CDK 4/6 inhibitors could replace NCT for pts with higher RS values.

19.
Traditional Medicine and Modern Medicine ; 3(4):255-268, 2020.
Article in English | EMBASE | ID: covidwho-1582962

ABSTRACT

Glucocorticoids (GCs) have potential anti-inflammatory and immunosuppressive effects. There is plenty of controversy about the application of glucocorticoids in the treatment of coronavirus disease 2019 (COVID-19). This paper briefly summarizes the mechanism of glucocorticoids and their receptors and clinical applications in COVID-19. Through reviewing the current literature, our aim is to have a deeper understanding of the mechanism of GCs and their clinical applications, so as to find possible ways to enhance their efficacy and reduce drug resistance or side effects.

20.
Traditional Medicine and Modern Medicine ; 3(1):1-9, 2020.
Article in English | EMBASE | ID: covidwho-1582960

ABSTRACT

Based on the naming of diseases in the history and the nomenclature of diseases, especially that of novel human infectious diseases, in traditional Chinese medicine (TCM) and modern medicine, we put forward the following suggestions for the naming and severity classification of "coronavirus disease 2019 (COVID-19)": (1) Patients with only nucleic acids positive or nucleic acid positive as well as some of the symptoms but without any evidence of pneumonia should be diagnosed more generally such as "Novel coronavirus respiratory infection (NCRI)"or "Novel coronavirus infection (NCI)". (2) The manifestations concerning pneumonia can be used as the main basis for the classification of the severity of the disease. For instance, those with only nucleic acids positive or nucleic acid positive as well as mild symptoms are mild, those with nucleic acid positive as well as symptoms like fever and cough are moderate, those with nucleic acid positive as well as pneumonia are severe, those with severe symptoms as well as respiratory failure and multiple organ damage are critical. (3) Also, those with infections and clinical manifestations but no pneumonia can be called simple type, and those with pneumonia can be called pneumonia type. (4) Under the current background of integrative medicine, the naming of newly emerging infectious diseases by TCM should be changed from an ambiguous concept to a clearly defined one. It may define the disease according to the etiology, pathogenesis, clinical manifestation or prognosis of the disease, redefine the original concept in TCM and discard the excessively broad part, or carry out the common naming between TCM and modern medicine based on the specific pathogen. (5) According to the nomenclature of diseases in TCM plus that in modern medicine, the NCI may be named "Jihai (2019) - Pestilence"(Ji Hài (2019) - Yì Lì) in TCM.

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