Diagnosis and treatment of spontaneous splenic rupture associated with severe acute respiratory syndrome coronavirus 2. TT -.

Coronavirus disease 2019 (COVID - 19)is an acute viral disease caused by severe acute respiratory syndrome coronavirus 2 (SARS - CoV - 2)infection and is mainly transmitted through the respiratory tract. It not only invades the respiratory system of human body, but also damages various organs and systems. Evidence has shown that there may be a causal association between SARS - CoV - 2 and spontaneous splenic rupture. This article recognizes the possibility of SARS - CoV - 2 - associated spontaneous splenic rupture and discusses its pathogenesis and related diagnosis and treatment regimens, so as to avoid missed diagnosis and misdiagnosis in clinical practice.Copyright © 2022 by the Author(s).

Real world experience of drug-drug interactions for HCV patients receiving pan-genotypic direct-acting antivirals in the era of COVID-19 pandemic

Background and Aims: The treatment of chronic hepatitis C (CHC) has evolved from genotype-specific to pan-genotypic direct acting antivirals (DAAs) with high efficacy and safety. However, drug-drug interactions (DDIs) must be avoided when used in combination with other medications, especially with the possible concomitant use of COVID-19 infection antivirals during the COVID-19 pandemic. This study aimed to access the potential DDIs of concomitant drugs with pan-genotypic DAAs and COVID-19 infection antivirals, and actual incidence of DDIs in real-world experience. Method(s): From January 2022 to October 2022, consecutive 116 HCV patients receiving pan-genotypic DAAs were retrospectively enrolled in Taipei Veterans General Hospital. The number of comedications and their potential DDIs with three pan-genotypic DAA regimens and three COVID-19 infection antivirals were analyzed. The actual incidence of DDIs during DAAs treatment were also investigated. Result(s): The mean age was 60.9 years old, with male predominant (55.2%). Of them, 12 (10.3%) patients had cirrhosis, and 24 (20.7%) patients had diabetes mellitus. Most patients were within Child-Pugh class A (109/116, 94.0%). The distribution of HCV genotypes was 8.6% in GT 1a, 36.2% in GT 1b, 39.7% in GT 2, 6.9% in GT 6, and 8.6% in indeterminate genotype, respectively. Of them, 43 (37.1%) patients received GLE/PIB, 69 (59.5%) received SOF/VEL 7plusmn;RBV, and 4 (3.4%) received SOF/VEL/VOX as DAAs regimen. Noteworthy, four patients had COVID-19 infection during DAAs treatment course. The rates of ETVR and SVR12 were 97.6% and 95.3%. The mean number of concomitant medications was 2.01. The distribution of concomitant drugs was 64.7% with no concomitant drug, 11.2% with 1-3 drugs, 11.2% with 4-6 drugs, 9.5% with 7-9 drugs, and 3.4% had more than 9 drugs, respectively. In potential contraindicated (red) DDI class, GLE/PIB was the most prevalent (7.3%), followed by SOF/VEL/VOX (6.4%), and SOF/VEL (1.8%) for non-cirrhosis and compensated cirrhosis patients;and no red DDI occurred in decompensated cirrhosis patients. In addition, the percentage of patients without potential DDIs was higher with SOF/VEL (79.8%) than with the other regimens. The potential red DDIs were predominantly with lipid-lowering agents for DAAs. For potential red DDI class with COVID-19 infection antivirals, Nirmatrelvir/Ritonavir was the most prevalent (6%), followed by Remdesivir (0.9%), and no potential DDIs with Molnupiravir. For COVID-19 antivirals, the potential red DDIs was mainly with central nervous system drugs. Finally, the actual incidence of DDIs during DAAs treatment showed no red DDI occurred for all patients, and GLE/PIB was the most prevalent (93%) of no potential DDIs. Conclusion(s): The potential DDIs between these comedications differed, with the most potential DDIs occurring with GLE/PIB and Nirmatrelvir/Ritonavir. After careful assessment of comedications and their potential DDIs, the actual incidence of DDIs could be reduced, and optimize safety in real-world practice.

Examining college students' food security coping strategies and experiences during the COVID-19 pandemic

College students' food situations may have been disrupted by the COVID-19 pandemic, which could have affected their health and well-being. However, little is known about how the pandemic impacted students' food experiences and how students coped with food-related disruptions, particularly from the student's own perspective. This study reviews data from 571 undergraduates who attended public colleges during Fall 2021 and Spring 2022 and wrote a narrative about the pandemic's impact on their food experiences. Most students indicated they experienced a wide range of food difficulties and adapted new food practices. Despite these challenges, students emphasized proactive coping strategies and positive pandemic outcomes rather than difficulties and negative outcomes. These findings have implications for students' long-term health and well-being. © 2023 John Wiley & Sons Ltd.

A Developing Crisis in Hunger: Food Insecurity within 3 Public Colleges before and during the COVID-19 Pandemic

During the COVID-19 pandemic, food insecurity increased across the United States, with college students being particularly vulnerable. This study surveyed 1989 undergraduates attending three public colleges before and during the first year of the pandemic. At all times, students' food insecurity was related to worse academic performance, greater housing insecurity, poorer psychological and physical health, and less access to healthcare. Compared to pre-pandemic students, during-pandemic students reported greater use of and fewer barriers to food programs, spending more on and and receiving more government aid for food, experiencing more academic difficulties due to food insecurity, having greater housing insecurity, and enduring less access to healthcare. © 2022 Taylor & Francis Group, LLC.

A Reinforcement Learning Variable Neighborhood Search for the Robust Dynamic Bayesian Network Optimization Problem under the Supply Chain Ripple Effect

Due to the impact of the global COVID-19, numerous industries have suffered from the disruption propagating along the supply chain, i.e. the ripple effect. To reduce adverse impact of the ripple effect, supply chain (SC) risk management under it is becoming an increasingly hot topic in both practice and research. In our former research, a robust dynamic bayesian network (DBN) approach has been developed for disruption risk assessment, whereas the solution methods adopted before (commercial solvers and simulated annealling algorithm) are not efficient enough, especially for large-size instances. For this reason, a new reinforcement learning variable neighborhood search (QVNS) is developed for solving the robust DBN optimization model, where the Q-learning algorithm is implemented to select the most efficient neighborhood structure in different stages of the search process. We conduct computational experiments on randomly generated instances, which indicates that Q-learning algorithm can improve significantly the performance of the VNS on large-size instances of the robust DBN optimization problem. Copyright (C) 2022 The Authors.

Impact of Hypertension on Long-Term Humoral and Cellular Response to SARS-CoV-2 Infection

Background: It was shown that hypertension delays SARS CoV-2 viral clearance and exacerbates airway hyper-inflammation in the respiratory tract. However, it is unknown whether hypertension determines the long-term cellular and humoral response to SARS CoV-2. Method(s): Health care workers (HCWs) after an outbreak of SARS CoV-2 infections were recruited. Two groups were analyzed, infected and fully vaccinated HCWs. Clinical data were recorded. Blood was drawn and the humoral and cellular immune responses were examined. Result(s): 5-14 months (median 7 months) after detection of SARS CoV-2 infection, blood was taken to analyze humoral response (S1 IgG and SARS CoV-2 neutralizing antibodies) and cellular (T cell responses to SARS-CoV-2 with Lymphocyte Transformation Test). Infected hypertensive HCWs more often developed anosmia, myalgia and needed to be hospitalized as compared to non-hypertensive HCWs. The long-term humoral and cellular immune response was significantly strengthened in hypertensive versus normotensive infected HCWs. Multivariant regression analysis revealed that only hypertension but not age, BMI, sex, diabetes, smoking, COPD, asthma and time between PCR positivity and blood taking was independently associated with the humoral and cellular response to SARS CoV-2 infection. Conclusion(s): In conclusion, SARS CoV-2 infection strengthened humoral and cellular immune response to SARS CoV-2 infection in hypertensive HCWs independent of other risk factors and also severity of symptoms.

In the Zone: An Analysis of the Music Practices of Remote Software Developers

Background: Listening to music is a common practice among software developers. Music listening after work can help release work-related stress;while listening to music at work can improve work efficiency and make tedious work more enjoyable. The working environment of developers in the past few years has changed dramatically due to the vast adoption of remote and hybrid work policies. Aims: We aim to understand how listening to music at work affects remote developers' perceived productivity and creativity. Method: We investigated 130 software developers and collected their music listening habits during remote work in a questionnaire. We studied the impact of listening to music on developers' creativity and productivity while working remotely during the COVID-19 pandemic. Results: Our survey data suggests that developers generally feel more productive and creative when listening to music during remote working conditions. Conclusion: We found that developers who listen to music feel more productive and creative while working remotely due to reducing environment distractions. © 2022 Association for Computing Machinery.

Telemedicine adoption and utilization among financially distressed patients with cancer during the COVID-19 pandemic: Insights from a longitudinal nationwide survey

Background: Telemedicine use during the COVID-19 pandemic among financially distressed patients with cancer, with respect to the determinants of adoption and patterns of utilization, has yet to be delineated. We sought to systematically characterize telemedicine utilization in financially distressed patients with cancer during the COVID-19 pandemic. Methods: We conducted an analysis of survey data assessing the use of telemedicine in patients with cancer during the COVID-19 pandemic collected by Patient Advocate Foundation (PAF) from May 2020 to December 2020. Primary study outcome was telemedicine utilization rate. Secondary outcomes were independent predictors of telemedicine utilization patterns, volume, and utilization preferences. Multivariate and poisson regression analyses were used to identify predictive factors. Results: Of the 1,390 respondents, 627 completed two survey waves and were included in this study. Telemedicine adoption during the pandemic was reported by 67% of patients, with most (63%) preferring video visits. Younger age (odds ratio, 6.07;95% CI, 1.47-25.1), and higher comorbidities (odds ratio, 1.79;95% CI, 1.13-2.65) were independent predictors associated with telemedicine adoption. Younger age (19-35 yrs.) (incidence rate ratios [IRR], 1.78;95%CI, 24-115%) and higher comorbidities (≥3) (IRR;1.36;95%CI, 20-55%) were independent predictors associated with higher utilization volume. As area deprivation index increased by 10 units, the number of visits decreased by 3% (IRR 1.03, 95%CI, 1.03-1.05). Conclusions: The rapid adoption of telemedicine may exacerbate existing inequities, particularly among vulnerable financially under-resourced patients with cancer. Policy-level interventions are needed for the equitable and efficient provision of this service.

Virtual Screening of Anti Severe Acute Respiratory Syndrome Coronavirus 2 Drugs Targeting Main Protease

Molecular docking technology was employed to predict and exploit potential main protein inhibitors of novel coronavirus ribonucleic acid dependent ribonucleic acid polymerase by virtual screening of twenty hundred thousand natural molecules in ZINC database. By targeting main protease of novel coronavirus by Schrodinger Maestro software and molecular dynamic simulation, the affinity and stability of the complex formed between the compound and the main protease of novel coronavirus were carefully analyzed. Base on high-throughput virtual screening, twelve compounds with higher molecular docking score were selected from twenty hundred thousand compounds database, compound ZINC000096222420 has the highest docking score of -8.693. The results from molecular dynamic simulation and binding free energy calculation reveal that the structure of the complex is highly stable, which has high potential to accelerate the development of anti-severe acute respiratory syndrome coronavirus 2 drugs. © 2022 Indian Pharmaceutical Association. All rights reserved.

Novel Strategies to Combat Post-Traumatic Osteoarthritis (PTOA)

This program project addresses the overarching clinical need for effective treatments to delay or prevent the development of post-traumatic osteoarthritis (PTOA), a leading cause of disability for military service members and Veterans. The overarching goal is to test the hypothesis that prolonged inflammatory responses to joint injury contribute to progressive cartilage degeneration and subsequent development of PTOA. Consequently, our program project evaluates several innovative strategies to modulate joint inflammation through: [1]cellular and molecular treatments acutely and early after ACL injury in patients and in animal models (Projects 1, 2 and 3), [2] rehabilitation intervention in patients early after ACL reconstruction (ACLR) and prior to OA onset (Project 4), and [3] localized gene therapy for sustained administration of anti-inflammatory therapy in an equine model of PTOA (Project 5). Project 1 will examine the mechanisms by which plasmin and fibrinolysis sustain inflammation and contribute to PTOA. Project 2 will conduct a randomized controlled clinical trial to see whether inhibition of fibrinolysis using tranexamic acid (TXA) acutely after ACL injury reduces inflammation and delays joint degeneration in humans. To address widespread interest in the use of stem cells in the treatment and prevention of OA, Project 3 will evaluate the anti-inflammatory and disease-modifying effects of induced pluripotent stem cell (iPSC)-derived rejuvenated human MSC from ACL injured patients. Project 4 will integrate the use of novel quantitative (qMRI) MRI UTE-T2* mapping to evaluate whether an innovative active feedback gait retraining program can reduce both inflammatory and structural markers of elevated OA risk after ACLR. Finally, Project 5 will evaluate the effects of intra-articular anti-inflammatory gene therapy to prevent PTOA. This multidisciplinary program aims to reduce the disease burden of PTOA.

Taiwan dermatological association recommendations for coronavirus disease of 2019 vaccination in patients treated with immunotherapeutics

This article aims to present current COVID-19 vaccination considerations for patients on immunotherapeutics for the management of immune-mediated dermatological diseases and summarize the recommendations relevant to clinical practice in Taiwan. These Taiwan Dermatological Association (TDA) recommendations are intended to be dynamic in nature and serve as an interim guide to optimize patient care at this current juncture. It is expected that our clinical practice would continually evolve and be informed by new evidence that emerges in this pandemic. © 2021 Dermatologica Sinica Published by Wolters Kluwer-Medknow.

Patientacceptance and satisfaction with telemedicine in female pelvic medicine and reconstructive surgery

Objective: The COVID-19 pandemic sparked rapid and widespread implementation of telemedicine, the practice of delivering medical care remotely using two-way, real-time interactive communication. Our goal was to assess patients' acceptance, satisfaction, and desire for future use of telemedicine among women seeking care for pelvic floor disorders (PFDs). Methods: We performed a structured telephone survey of new patients, who underwent video-only visits, and established patients who underwent a realtime video or audio-only telemedicine visit based on their preference when non-urgent, in-person visits were suspended. We designed two surveys (audio-only and real-time video) that included questions on demographics;level of comfort;overall satisfaction with the telemedicine visit;access and comfort with technology;desire to use telemedicine in the future;and perceived utility (Table 1). Student's t-tests and chi-squared tests were used to compare characteristics and survey responses between all three groups (Established audio-only, Established real-time video, and New real-time video participants) as well as Established audio-only vs real-time video participants. Results: Results: Between April and June 2020, we conducted telemedicine visits with 233 patients, 132 (65%) of whom agreed to participate in our survey (63 (47.7%) audio-only, 69 (52.3%) video, including 35 Established, and 34 New patients). Mean age of participants was 62.6 ± 15.2 years. The majority identified as white (77.3%), married (65.9%), college educated or higher (62.1%), were insured by Medicare (56.8%), and resided a mean distance of 47 miles from in-person office locations. The most common chief complaints were POP and UI (48.8%). Overall, most participants (96.4%) described being 'very' or 'somewhat satisfied' with telemedicine in addressing their needs and 'very' or 'somewhat comfortable' sharing personal information with providers in a telemedicine visit (94.7%). Additionally, Established patient participants in both audio-only and video groups reported feeling 'equal' or 'much more comfortable' (83%) and 'connected' (77.6%) to their provider during the telemedicine visit compared to in-person office visits. Though real-time video was associated with greater perceived quality of care (Table 1), both groups expressed a desire to use telemedicine in the future (88.6%). Conclusions: Conclusion: Women presenting with PFDs were satisfied with both real-time video and audio-only telemedicine visits. Both groups expressed interest in continuing to use telemedicine in the future. Telemedicine is a wellaccepted option for providing care with the potential to reduce geographical barriers for women with PFDs and limited access to subspecialty care.

The impact of sars-cov2 infection in children with liver disease: An international observational registry study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) on children with underlying liver disease (LD) is unknown. We aim to report outcomes for pediatric patients with LD from the joint North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) and the Society of Pediatric Liver Transplantation (SPLIT) SARS-CoV2 registry Methods: We collected data from patients younger than 21 years with LD from 6 countries and laboratory-confirmed SARS-CoV2 infection reported to a multicenter observational cohort study between April 2020 and May 2021. Results: Seventy-three (59% male,55% white, 23% Hispanic) children with a median age of 9 years were reported in the registry. The most common causes of LD were biliary atresia (22%) followed by autoimmune hepatitis (16%) and non-alcoholic fatty liver disease (16%). Five patients (7%) presented in acute liver failure (ALF);all recovered without the need for a liver transplant. Four patients presented with multisystem inflammatory syndrome in children (2 with ALF, 2 without ALF) with one death reported. The most common presenting symptoms were constitutional (49%) including fever and fatigue followed by respiratory symptoms (47%). Twenty two percent (n=16) of patients were asymptomatic at the time of diagnosis. Twentythree percent had radiologic evidence of pneumonia and 14% reported co-infections. Median peak INR was 1.4, peak total bilirubin 2.9 (mg/dl), peak ALT 129 (IU/l) and nadir albumin 3.1 (g/dl). Sixty-four percent of patients required hospitalization;40% (n=19) in the ICU and 60% (n=28) non-ICU for a median of 6 and 7 days, respectively. Twenty-two percent of patients required respiratory support including mechanical ventilation (n=6), high-frequency oscillatory ventilation (n=3), highflow nasal cannula (n=5) and regular nasal cannula (n=2) for a median of 6 days. Nine patients required vasoactive agents, 3 required renal replacement therapy and 2 patients required ECMO. Sixty-six percent did not receive any SARSCoV2 directed treatment. Twelve (16%) patients developed new liver-related complications including ascites (n=9), GI bleeding (n=2), encephalopathy (n=3), progression of endstage liver disease (n=2) and infection (n=1). There were a total of 3 (4.1%) deaths (20yr, 17yr and 6month of age at time of death) reported secondary to acute on chronic liver failure with respiratory failure and multiorgan failure Conclusion: Contrary to healthy children, almost 2/3rd pediatric patients with LD testing positive for SARS-CoV2 required hospitalization with death reported in 4% of cases. Acute liver failure is rare with SARS-CoV2 infection with recovery reported without the need for liver transplantation. Close monitoring is needed due to an increased risk of underlying liver disease complications and death, particularly in children with end-stage liver disease awaiting transplantation.

Regulation of SARS CoV-2 host factors in the kidney and heart in rats with 5/6 nephrectomy: Effects of salt, ARB, dipeptidyl peptidase 4 inhibitor, and SGLT-2 blocker

Background: Host factors such as angiotensin-converting enzyme 2 (ACE2) and the transmembrane protease, serine subtype 2 (TMPRSS2) are important factors for SARSCoV-2 infection. Clinical and pre-clinical studies demonstrated that RAAS-blocking agents can be safely used during a SARS-CoV-2 infection but it is unknown if DPP-4 inhibitors or SGLT2-inhibitors may promote COVID-19 by increasing the host viral entry enzymes ACE2 and TMPRSS2. Methods: We investigated telmisartan, linagliptin and empagliflozin induced effects on renal and cardiac expression of ACE2, TMPRSS2 and key enzymes involved in RAAS (REN, AGTR2, AGT) under high-salt conditions in a non-diabetic experimental 5/6 nephrectomy (5/6 Nx) model. In the present study, the gene expression of Ace2, Tmprss2, Ren, Agtr2 and Agt was assessed with qRT-PCR and the protein expression of ACE2 and TMPRSS2 with immunohistochemistry in the following experimental groups: Sham+normal diet (ND)+placebo (PBO);5/6Nx+ND+ PBO;5/6Nx+2% salt-diet (HSD)+PBO;5/6Nx+HSD+telmisartan;5/6Nx+HSD+linagliptin;5/6Nx+HSD+empagliflozin. Results: In the kidney the expression of Ace2 was not altered on mRNA level under disease and treatment conditions. The renal TMPRSS2 levels (mRNA and protein) was not affected, whereas the cardiac level was significantly increased in 5/6 Nx rats. Intriguingly, the elevated TMPRSS2 protein expression in the heart was significantly normalized after treatment with telmisartan, linagliptin and empagliflozin. Conclusions: Overall, our study indicated that there is no upregulation regarding host factors potentially promoting SARS CoV-2 virus entry into host cells when the SGLT2 inhibitor empagliflozin, telmisartan and the DPP4 blocker linagliptin are used. The results obtained in a preclinical, experimental non-diabetic kidney failure model need confirmation in ongoing interventional clinical trials.