Comparing Molnupiravir to Nirmatrelvir/Ritonavir (Paxlovid) in the Treatment of Mild-to-Moderate COVID-19 in Immunocompromised Cancer Patients.

BACKGROUND: Nirmatrelvir/Ritonavir has been shown to reduce the risk of COVID-19 progression by 88% compared to placebo, while Molnupiravir reduced it by 31%. However, these two agents have not been compared head-to-head. We therefore compared the safety and efficacy of both agents for the treatment of mild-to-moderate COVID-19 in immunocompromised cancer patients. METHODS: We identified 240 cancer patients diagnosed with COVID-19 and treated with Molnupiravir or Nirmatrelvir/Ritonavir. Patients were matched using a 1:2 ratio based on age group (18-64 years vs. ≥65) and type of cancer. The collected data included demographics, comorbidities, and treatment outcome. RESULTS: Both groups had comparable characteristics and presenting symptoms. However, dyspnea was more prevalent in the Molnupiravir group, while sore throat was more prevalent in the Nirmatrelvir/Ritonavir group. The rate of disease progression was comparable in both groups by univariate and multivariable analysis. Treatment with Molnupiravir versus Nirmatrelvir/Ritonavir revealed no significant difference in disease progression by multivariable analysis (adjusted OR = 1.31, 95% CI: 0.56-3.14, p = 0.70). Patients who received Nirmatrelvir/Ritonavir, however, were significantly more prone to having drug-drug interactions/adverse events (30% vs. 0%, p < 0.0001). CONCLUSIONS: In the treatment of mild-to-moderate COVID-19 in cancer patients, Molnupiravir was comparable to Nirmatrelvir/Ritonavir in preventing progression to severe disease/death and rebound events, and it had a superior safety profile.

A first-in-class leucyl-tRNA synthetase inhibitor, ganfeborole, for rifampicin-susceptible tuberculosis: a phase 2a open-label, randomized trial.

New tuberculosis treatments are needed to address drug resistance, lengthy treatment duration and adverse reactions of available agents. GSK3036656 (ganfeborole) is a first-in-class benzoxaborole inhibiting the Mycobacterium tuberculosis leucyl-tRNA synthetase. Here, in this phase 2a, single-center, open-label, randomized trial, we assessed early bactericidal activity (primary objective) and safety and pharmacokinetics (secondary objectives) of ganfeborole in participants with untreated, rifampicin-susceptible pulmonary tuberculosis. Overall, 75 males were treated with ganfeborole (1/5/15/30 mg) or standard of care (Rifafour e-275 or generic alternative) once daily for 14 days. We observed numerical reductions in daily sputum-derived colony-forming units from baseline in participants receiving 5, 15 and 30 mg once daily but not those receiving 1 mg ganfeborole. Adverse event rates were comparable across groups; all events were grade 1 or 2. In a participant subset, post hoc exploratory computational analysis of 18F-fluorodeoxyglucose positron emission tomography/computed tomography findings showed measurable treatment responses across several lesion types in those receiving ganfeborole 30 mg at day 14. Analysis of whole-blood transcriptional treatment response to ganfeborole 30 mg at day 14 revealed a strong association with neutrophil-dominated transcriptional modules. The demonstrated bactericidal activity and acceptable safety profile suggest that ganfeborole is a potential candidate for combination treatment of pulmonary tuberculosis.ClinicalTrials.gov identifier: NCT03557281 .

Outcomes of Head and Neck Microvascular Free Tissue Transfer for Advanced Cutaneous Squamous Cell Carcinoma: A Comparison of Solid Organ Transplant Recipients to Nontransplant Patients.

BACKGROUND: Patients with solid organ transplant (SOT) are at increased risk of developing aggressive cutaneous malignancies due to their immunosuppression, particularly cutaneous squamous cell carcinoma (cSCC). PURPOSE: There is limited data regarding SOT patients with locally advanced cSCC requiring radical surgery and microvascular free tissue transfer (MVFTT). Our objectives were to characterize outcomes in SOT patients and compare them with a non-SOT cohort. STUDY DESIGN: This is a retrospective cohort study of patients undergoing MVFTT for advanced cSCC of the head and neck between January 2016 and May 2020 at a tertiary referral center. Patients who underwent MVFTT as part of curative intent surgery for advanced cSCC during the study were considered for inclusion. Exclusion criteria included distant metastasis, palliative intent treatment, age less than 18 years, and lip primaries. PREDICTOR: The predictor variable was SOT status. A cohort of non-SOT patients was matched to the SOT cohort based on age, smoking status, tumor stage, and defect size. MAIN OUTCOME VARIABLES: The primary reconstructive outcome was the major surgical complications and secondary outcome measures included major medical complications and minor surgical complications. The primary oncologic outcome was overall survival and the secondary outcome was disease-specific survival. The primary predictor was transplant status. COVARIATES: Covariates included patient comorbidities, prior treatment, tumor stage, type of reconstruction, pathologic findings, and adjuvant therapy. ANALYSIS: Continuous and categorical variables were compared using Student's T test and Fisher's exact test. Survival was calculated using the Kaplan-Meier method and differences in survival between groups were calculated using the log-rank test. Statistical significance was set a priori at P ≤ .05. RESULTS: Fourteen SOT and 14 matched non-SOT patients met inclusion criteria. There was not a statistically significant difference in the rate of major surgical complications (7 vs 7%, P = .74) between the SOT and non-SOT cohorts. Rates of minor (21 vs 43%, P = .26) wound complications and medical complications (0 vs 14%, P = .24) were also similar between the SOT and non-SOT cohorts. Locoregional recurrences and distant metastasis were more common for SOT patients, though this was not statistically significant. Overall survival was significantly worse for SOT patients (21.7 vs 31.0 months, P = .04), though there was not a significant difference in disease-free survival (9.8 vs 31.0 months, P = .17). CONCLUSIONS AND RELEVANCE: MVFTT in the management of SOT patients with locally advanced head and neck cSCC demonstrates similar complication rates with non-SOT patients. While survival and oncologic outcomes are worse in the SOT cohort, aggressive surgical intervention with MVFTT can be performed with comparable complication rates to patients without a history of SOT.

Internet of Everything and Digital Twin enabled Service Platform for Cold Chain Logistics.

The proliferation of the e-commerce market has posed challenges to staff safety, product quality, and operational efficiency, especially for cold chain logistics (CCL). Recently, the logistics of vaccine supply under the worldwide COVID-19 pandemic rearouses public attention and calls for innovative solutions to tackle the challenges remaining in CCL. Accordingly, this study proposes a cyber-physical platform framework applying the Internet of Everything (IoE) and Digital Twin (DT) technologies to promote information integration and provide smart services for different stakeholders in the CCL. In the platform, reams of data are generated, gathered, and leveraged to interconnect and digitalize physical things, people, and processes in cyberspace, paving the way for digital servitization. Deep learning techniques are used for accident identification and indoor localization based on Bluetooth Low Energy (BLE) to actualize real-time staff safety supervision in the cold warehouse. Both algorithms are designed to take advantage of the IoE infrastructure to achieve online self-adapting in response to surrounding evolutions. Besides, with the help of mobile and desktop applications, paperless operation for shipment, remote temperature and humidity (T&H) monitoring, anomaly detection and warning, and customer interaction are enabled. Thus, information traceability and visibility are highly fortified in this way. Finally, a real-life case study is conducted in a pharmaceutical distribution center to demonstrate the feasibility and practicality of the proposed platform and methods. The dedicated hardware and software are developed and deployed on site. As a result, the effectiveness of staff safety management, operational informatization, product quality assurance, and stakeholder loyalty maintenance shows a noticeable improvement. The insights and lessons harvested in this study may spark new ideas for researchers and inspire practitioners to meet similar needs in the industry.

Effect of muscle fatigue of the thoracic erector spinae on neuromuscular control when performing the upper extremity functional tasks in people with adolescent idiopathic scoliosis.

Adolescent idiopathic scoliosis (AIS) disrupts spinal alignment and increases the intrinsic demand for active stabilization to maintain postural stability. Understanding the paraspinal muscle fatigability and its effects on spinal alignment and kinematics informs the importance of paraspinal muscle endurance for postural stability. This study aims to investigate the effects of fatigue of thoracic erector spinae on the spinal muscle activity and spinal kinematics in individuals with scoliosis. Spinal muscle activity, posture and mobility measured by electromyography and surface tomography were compared between 15 participants with scoliosis and 15 age- and gender-matched healthy controls during unilateral shoulder flexion and abduction with and without holding a 2-kg weight and performed before and after a fatigue task (prone isometric chest raise). No between-groups difference was found for the spinal extensor endurance. Erector spinae activity at the convex side of AIS group was significantly higher than that at their concave side and than that of healthy controls during shoulder elevations, regardless of the fatigue status. Significant decreases in translational and rotational mobility were found at convex side of AIS group during weighted abduction tasks after fatigue. In contrast, a significant increase in rotational mobility was demonstrated at convex side of AIS participants during weighted flexion tasks after fatigue. Our results revealed a comparable level of spinal extensor endurance between individuals with or without AIS. The increase in muscle activation post-fatigue provides no additional active postural stability but may increase the risk of back pain over the convex side in individuals with scoliosis. Findings highlight imbalances in muscles and the potential implications in optimising neuromuscular activation and endurance capacity in the rehabilitation for AIS patients. Future research is needed to investigate if endurance training of the convex-sided back extensors could optimize the impaired neuromuscular control in the AIS patients.

Synchronization of Shop-Floor Logistics and Manufacturing Under IIoT and Digital Twin-Enabled Graduation Intelligent Manufacturing System.

Logistics interfaces with manufacturing throughout the entire production process need synchronous operations. For achieving integrated organization and operations between manufacturing and logistics, this article introduces the concept of shop-floor logistics and manufacturing synchronization with four principles, including: 1) synchronization-oriented manufacturing system; 2) synchronized information sharing; 3) synchronized decision making; and 4) synchronized operations. The marriage of the principles rendered the development of an overall framework of the Industrial Internet of Things (IIoT) and digital twin-enabled graduation intelligent manufacturing system (GiMS). A mixed-integer programming-based synchronization mechanism is proposed under GiMS. To meet the requirement of fast decision making in real-life shop-floor logistics and manufacturing synchronization problems, an equivalent constraint programming model is developed and tested. The observation and analysis of the case company show the advantage of the proposed concept and approach with the best performance regarding key performance indicators. The concept of synchronization provides an insight for understanding the interaction of logistics and manufacturing at the operational level. This article potentially enables manufacturers to reevaluate and develop their manufacturing planning and control strategies in the IIoT and digital twin-based manufacturing environment.

Vaccination saves lives: a real-time study of patients with chronic diseases and severe COVID-19 infection.

OBJECTIVES: This study aims to describe the demographic and clinical profile and ascertain the determinants of outcome among hospitalized coronavirus disease 2019 (COVID-19) adult patients enrolled in the National Clinical Registry for COVID-19 (NCRC). METHODS: NCRC is an on-going data collection platform operational in 42 hospitals across India. Data of hospitalized COVID-19 patients enrolled in NCRC between 1st September 2020 to 26th October 2021 were examined. RESULTS: Analysis of 29 509 hospitalized, adult COVID-19 patients [mean (SD) age: 51.1 (16.2) year; male: 18 752 (63.6%)] showed that 15 678 (53.1%) had at least one comorbidity. Among 25 715 (87.1%) symptomatic patients, fever was the commonest symptom (72.3%) followed by shortness of breath (48.9%) and dry cough (45.5%). In-hospital mortality was 14.5% (n = 3957). Adjusted odds of dying were significantly higher in age group ≥60 years, males, with diabetes, chronic kidney diseases, chronic liver disease, malignancy and tuberculosis, presenting with dyspnoea and neurological symptoms. WHO ordinal scale 4 or above at admission carried the highest odds of dying [5.6 (95% CI: 4.6-7.0)]. Patients receiving one [OR: 0.5 (95% CI: 0.4-0.7)] or two doses of anti-SARS CoV-2 vaccine [OR: 0.4 (95% CI: 0.3-0.7)] were protected from in-hospital mortality. CONCLUSIONS: WHO ordinal scale at admission is the most important independent predictor for in-hospital death in COVID-19 patients. Anti-SARS-CoV2 vaccination provides significant protection against mortality.

A Domestic Trash Detection Model Based on Improved YOLOX.

Domestic trash detection is an essential technology toward achieving a smart city. Due to the complexity and variability of urban trash scenarios, the existing trash detection algorithms suffer from low detection rates and high false positives, as well as the general problem of slow speed in industrial applications. This paper proposes an i-YOLOX model for domestic trash detection based on deep learning algorithms. First, a large number of real-life trash images are collected into a new trash image dataset. Second, the lightweight operator involution is incorporated into the feature extraction structure of the algorithm, which allows the feature extraction layer to establish long-distance feature relationships and adaptively extract channel features. In addition, the ability of the model to distinguish similar trash features is strengthened by adding the convolutional block attention module (CBAM) to the enhanced feature extraction network. Finally, the design of the involution residual head structure in the detection head reduces the gradient disappearance and accelerates the convergence of the model loss values allowing the model to perform better classification and regression of the acquired feature layers. In this study, YOLOX-S is chosen as the baseline for each enhancement experiment. The experimental results show that compared with the baseline algorithm, the mean average precision (mAP) of i-YOLOX is improved by 1.47%, the number of parameters is reduced by 23.3%, and the FPS is improved by 40.4%. In practical applications, this improved model achieves accurate recognition of trash in natural scenes, which further validates the generalization performance of i-YOLOX and provides a reference for future domestic trash detection research.

Building demolition waste management through smart BIM: A case study in Hong Kong.

Hong Kong's construction industry, known for its massive building infrastructure, produces an enormous amount of waste every year, the vast majority of which is disposed for landfills. Therefore, some effective operational measures and waste management policies have been implemented. However, enormous waste remains a concern for stakeholders and exert pressure on the limited capacity of Hong Kong's landfills. Though previous research discusses Building Information Modelling (BIM) application for construction waste management enhancement, the BIM model has not been widely implemented for building demolition with waste management. Hence, as a response to the aforementioned shortcomings, this paper develops a conceptual framework that allows collecting, maintaining, and analyzing comprehensive information through Smart BIM that uses advanced technologies such as Internet of Things (IoT) and capable of reacting to user activities such as waste quantitative assessment, demolition process planning, optimal disposal route selection, and waste management strategy are executed. The advantages of the proposed framework are shown in a case study benefit-cost analysis based on three planned reuse and recycling-rate scenarios that explain on- and off-site recycling methods. The results show that the proposed framework will pave the way for generating sustainable waste disposal practices by providing technical and decision-making support functionalities to engineers and planners in the construction industry.

Mechanisms associated with the rapid decline in sea ice cover around a stranded ship in the Lazarev Sea, Antarctica.

In the satellite data era starting from 1979, the extent of Antarctic sea ice increased moderately for the first 37 years. However, the extent decreased to record low levels from 2016 to 2020, with the drop being greatest in the Weddell and Lazarev Seas of the Southern Ocean. An important question for the scientific fraternity and policymakers is to understand what ocean-atmospheric processes triggered such a rapid decline in sea ice. We employ in-situ, satellite, and atmospheric reanalysis data to examine the causative mechanism of anomalous sea ice variability in the Lazarev Sea at a time of ice growth in the annual cycle (March-April 2019), when a cargo ship was stuck in extensive ice cover and freed following the unusual decline in sea ice. High-resolution Sentinel-1 synthetic aperture radar captured a distinct view of the ship location and track within extensive ice cover of fast sea ice, dense pack ice, and icebergs in the Lazarev Sea on 27 March 2019. Subsequently, the sea ice cover declined and reached the fourth lowest extent in the entire satellite record during April 2019 which was 25.6% lower than the long-term mean value of 2.65 × 106 km2. We show that the anomalous sea ice variability was due to the occurrence of eastward-moving polar cyclones, including a quasi-stationary explosive development that impacted sea ice through extreme changes in ocean-atmospheric conditions. The cyclone-induced dynamic (poleward propagation of ocean waves and ice motion) and thermodynamic (heat and moisture plumes from midlatitudes, ocean mixed layer warming) processes coupled with high tides provided a conducive environment for an exceptional decline in sea ice over the region of ship movement.

Low Rate of Spontaneous Closure in Premature Infants Discharged with a Patent Ductus Arteriosus: A Multicenter Prospective Study.

OBJECTIVES: To assess the rate of spontaneous closure and the incidence of adverse events in infants discharged home with a patent ductus arteriosus. STUDY DESIGN: In a prospective multicenter study, we enrolled 201 premature infants (gestational age of 23-32 weeks at birth) discharged home with a persistently patent ductus arteriosus (PDA) and followed their PDA status at 6-month intervals through 18 months of age. The primary study outcome was the rate and timing of spontaneous ductal closure. Secondary outcomes included rate of assisted closure and the incidence of serious adverse events. RESULTS: Spontaneous ductal closure occurred in 95 infants (47%) at 12 months and 117 infants (58%) by 18 months. Seventeen infants (8.4%) received assisted closure with surgical ligation or device assisted occlusion. Three infants died (1.5%). Although infants with spontaneous closure had a higher mean birth weight and gestational age compared with infants with a persistent PDA or assisted closure, we did not identify other factors predictive of spontaneous closure. CONCLUSIONS: Spontaneous closure of the PDA occurred in slightly less than one-half of premature infants discharged with a patent ductus by 1 year, lower than prior published reports. The high rate of assisted closure and/or adverse events in this population warrants close surveillance following discharge. TRIAL REGISTRATION: ClinicalTrials.gov: NCT02750228.

Radiological and functional evidence of the bronchial spread of tuberculosis: an observational analysis.

BACKGROUND: Direct bronchial spread of tuberculosis was extensively described in pre-antibiotic human pathology literature but this description has been overlooked in the post-antibiotic era, in which most pathology data come from animal models that emphasise the granuloma. Modern techniques, such as [18F]2-fluoro-2-deoxy-D-glucose (FDG) PET-CT scans, might provide further insight. Our aim was to understand normal early tuberculosis resolution patterns on pulmonary PET-CT scans in treated patients with tuberculosis who were subsequently cured. METHODS: In this observational analysis, we analysed data from PredictTB, an ongoing, prospective, randomised clinical trial that examined sequential baseline and week 4 FDG-PET-CT scans from participants successfully treated (sputum culture negative 18 months after enrolment) for drug-susceptible pulmonary tuberculosis in South Africa and China. Participants who were aged 18-75 years, GeneXpert MTB/RIF positive for tuberculosis and negative for rifampicin resistance, had not yet started tuberculosis treatment, had not been treated for active tuberculosis within the previous 3 years, and met basic safety laboratory criteria were included and participants with diabetes, HIV infection, or with extrapulmonary tuberculosis including pleural tuberculosis were excluded. Scans were assessed by two readers for the location of tuberculosis lesions (eg, cavities and consolidations), bronchial thickening patterns, and changes from baseline to week 4 of treatment. FINDINGS: Among the first 124 participants (enrolled from June 22, 2017, to Sept 27, 2018) who were successfully treated, 161 primarily apical cavitary lesions were identified at baseline. Bronchial thickening and inflammation linking non-cavitary consolidative lesions to cavities were observed in 121 (98%) of 124 participants' baseline PET-CT scans. After 4 weeks of treatment, 21 (17%) of 124 participants had new or expanding lesions linked to cavities via bronchial inflammation that were not present at baseline, particularly participants with two or more cavities at baseline and participants from South Africa. INTERPRETATION: In participants with pulmonary tuberculosis who were subsequently cured, the location of cavitary and non-cavitary lesions at baseline and new lesions at week 4 of treatment suggest a cavitary origin of disease and bronchial spread through the lungs. Bronchial spread from cavities might play a larger role in the spread of pulmonary tuberculosis than has been appreciated. Elucidating cavity lesion dynamics and Mycobacterium tuberculosis viability within cavities might better explain treatment outcomes and why some patients are cured and others relapse. FUNDING: Bill & Melinda Gates Foundation, European and Developing Countries Clinical Trials Partnership, China Ministry of Science and Technology, National Natural Science Foundation of China, and National Institutes of Health. TRANSLATIONS: For the Chinese, Afrikaans and Xhosa translations of the abstract see Supplementary Materials section.

Spark Analysis Based on the CNN-GRU Model for WEDM Process.

Wire electrical discharge machining (WEDM), widely used to fabricate micro and precision parts in manufacturing industry, is a nontraditional machining method using discharge energy which is transformed into thermal energy to efficiently remove materials. A great amount of research has been conducted based on pulse characteristics. However, the spark image-based approach has little research reported. This paper proposes a discharge spark image-based approach. A model is introduced to predict the discharge status using spark image features through a synchronous high-speed image and waveform acquisition system. First, the relationship between the spark image features (e.g., area, energy, energy density, distribution, etc.) and discharge status is explored by a set of experiments). Traditional methods have claimed that pulse waveform of "short" status is related to the status of non-machining while through our research, it is concluded that this is not always true by conducting experiments based on the spark images. Second, a deep learning model based on Convolution neural network (CNN) and Gated recurrent unit (GRU) is proposed to predict the discharge status. A time series of spark image features extracted by CNN form a 3D feature space is used to predict the discharge status through GRU. Moreover, a quantitative labeling method of machining state is proposed to improve the stability of the model. Due the effective features and the quantitative labeling method, the proposed approach achieves better predict result comparing with the single GRU model.

A supply chain disruption recovery strategy considering product change under COVID-19.

A recent global outbreak of Corona Virus Disease 2019 (COVID-19) has led to massive supply chain disruption, resulting in difficulties for manufacturers on recovering their supply chains in a short term. This paper presents a supply chain disruption recovery strategy with the motivation of changing the original product type to cope with that. In order to maximize the total profit from product changes, a mixed integer linear programming (MILP) model is developed with combining emergency procurement on the supply side and product changes by the manufacturer as well as backorder price compensation on the demand side. The model uses a heuristic algorithm based on ILOG CPLEX toolbox. Experimental results show that the proposed disruption recovery strategy can effectively reduce the profit loss of manufacturer due to late delivery and order cancellation. It is observed that the impact of supply chain disruptions is reduced. The proposed model can offer a potentially useful tool to help the manufacturers decide on the optimal recovery strategy whenever the supply chain system experiences a sudden massive disruption.

Development of radio-frequency identification (RFID) sensors suitable for smart-monitoring applications in sewer systems.

Sanitary and stormwater sewers are buried assets that play important roles in the prevention of diseases and the reduction of health risks for our societies. Due to their hidden nature, these assets are not frequently assessed and maintained to optimal conditions. The lack of maintenance can cause sewer blockages and overflows that result in the release of pathogens into the environment. For cities, monitoring sewer conditions on a large-scale can be costly, time-consuming, and labor-intensive if using current low-throughput technologies, such as dye testing or closed-circuit television. Alternatively, smart sensor systems can provide low-cost, high-throughput, and automatic data-driven features for real-time monitoring applications. In this study, we developed ultrahigh-frequency radio-frequency identification (UHF RFID)-based sensors that are flushable and suitable for sanitary and stormwater pipes quick surveys. 3D printed RFID sensors were designed to float at the water-air interface and minimize the water interference to RF signal communications. The optimal detection range was also determined to support the design and installation of the reader in various utility holes. Field trials demonstrated that the UHF RFID system is a low-cost, high-throughput, and robust solution for monitoring blockage, illicit-connection, and water flow in sewer networks.

Fourteen-day PET/CT imaging to monitor drug combination activity in treated individuals with tuberculosis.

Early bactericidal activity studies monitor daily sputum bacterial counts in individuals with tuberculosis (TB) for 14 days during experimental drug treatment. The rate of change in sputum bacterial load over time provides an informative, but imperfect, estimate of drug activity and is considered a critical step in development of new TB drugs. In this clinical study, 160 participants with TB received isoniazid, pyrazinamide, or rifampicin, components of first-line chemotherapy, and moxifloxacin individually and in combination. In addition to standard bacterial enumeration in sputum, participants underwent 2-deoxy-2-[18F]fluoro-d-glucose positron emission tomography and computerized tomography ([18F]FDG-PET/CT) at the beginning and end of the 14-day drug treatment. Quantitating radiological responses to drug treatment provided comparative single and combination drug activity measures across lung lesion types that correlated more closely with established clinical outcomes when combined with sputum enumeration compared to sputum enumeration alone. Rifampicin and rifampicin-containing drug combinations were most effective in reducing both lung lesion volume measured by CT imaging and lesion-associated inflammation measured by PET imaging. Moxifloxacin was not superior to rifampicin in any measure by PET/CT imaging, consistent with its performance in recent phase 3 clinical trials. PET/CT imaging revealed synergy between isoniazid and pyrazinamide and demonstrated that the activity of pyrazinamide was limited to lung lesion, showing the highest FDG uptake during the first 2 weeks of drug treatment. [18F]FDG-PET/CT imaging may be useful for measuring the activity of single drugs and drug combinations during evaluation of potential new TB drug regimens before phase 3 trials.

Pediatric Tracheal Lobular Capillary Hemangioma: A Case Report and Review of the Literature.

Chronic cough is a common complaint in the pediatric population and can have many different etiologies. We present a rare case of a tracheal lobular capillary hemangioma (LCH), also known as pyogenic granuloma, causing chronic cough in a child. In this case, the tracheal LCH was managed successfully with laser ablation. A review of the literature reveals only 2 other reported pediatric cases of tracheal LCH. Laryngoscope, 131:1729-1731, 2021.

The psychometric properties of the Revised Illness Perception Questionnaire (IPQ-R) regarding Internet gaming disorder in a general population of Chinese adults.

BACKGROUND AND AIMS: Internet gaming disorder (IGD) has been recognized as a mental illness. Cognitive and emotional illness representations affect coping and health outcomes. Very little is known about such perceptions related to IGD, in both general and diseased populations. This study examined the psychometric properties of the Revised Illness Perception Questionnaire (IPQ-R) for IGD in a general population that included mostly non-cases while a small proportion of the sample was IGD cases. METHODS: An anonymous cross-sectional telephone survey was conducted in a random sample of 1,501 Chinese community-dwelling adults (41.3% male; mean age = 40.42, SD = 16.85) in Macao, China. RESULTS: The confirmatory factor analysis identified a modified 6-factor model (i.e., timeline cyclical, consequences, personal control, treatment control, illness coherence, and emotional representations) of 26 items that showed satisfactory model fit and internal consistency. Criterion-related validity was supported by the constructs' significant correlations with stigma (positive correlations: timeline cyclical, consequence, emotional representations; negative correlations: illness coherence). Ever-gamers, compared to never-gamers, reported higher mean scores in the subscales of personal control and illness coherence, and lower mean scores in time cyclical, consequence, and emotional representations. Among the sampled gamers, probable IGD cases were more likely than non-IGD cases to perceive IGD as cyclical and involved more negative emotions. CONCLUSIONS: This study shows that the revised 26-item version of IPQ-R is a valid instrument for assessing illness representation regarding IGD in a general population of Chinese adults. It can be used in future research that examines factors of incidence and prevention related to IGD.

Current and future treatments for tuberculosis.

Guidelines on the treatment of tuberculosis (TB) have essentially remained the same for the past 35 years, but are now starting to change. Ongoing clinical trials will hopefully transform the landscape for treatment of drug sensitive TB, drug resistant TB, and latent TB infection. Multiple trials are evaluating novel agents, repurposed agents, adjunctive host directed therapies, and novel treatment strategies that will increase the probability of success of future clinical trials. Guidelines for HIV-TB co-infection treatment continue to be updated and drug resistance testing has been revolutionized in recent years with the shift from phenotypic to genotypic testing and the concomitant increased speed of results. These coming changes are long overdue and are sorely needed to address the vast disparities in global TB incidence rates. TB is currently the leading cause of death globally from a single infectious agent, but the work of many researchers and the contributions of many patients in clinical trials will reduce the substantial global morbidity and mortality of the disease.