Design of a University Pandemic Response Decision Support System

The global effort to combat the COVID-19 pandemic has changed how people conduct their daily lives. Institutions of higher education have been greatly impacted by these changes and must find ways to adapt to this new environment. Universities are a unique case because they must control disease spread, while maintaining the same or similar quality of education. The University Pandemic Response Decision Support System (UPRDSS) is a system designed to help universities pick the most suitable method for instruction delivery when faced with any pandemic. Using George Mason University as a case study, the goal was to design a system that allows university administrations to make an educated operations decision. The UPRDSS achieves this by simulating the spread of disease, analyzing learning outcome data, and using a multi-attribute utility function to determine the most appropriate method of instruction that enables positive learning and health outcomes.

So Pathogenic or So What?—A Brief Overview of SIV Pathogenesis with an Emphasis on Cure Research

HIV infection requires lifelong antiretroviral therapy (ART) to control disease progression. Although ART has greatly extended the life expectancy of persons living with HIV (PWH), PWH nonetheless suffer from an increase in AIDS-related and non-AIDS related comorbidities resulting from HIV pathogenesis. Thus, an HIV cure is imperative to improve the quality of life of PWH. In this review, we discuss the origins of various SIV strains utilized in cure and comorbidity research as well as their respective animal species used. We briefly detail the life cycle of HIV and describe the pathogenesis of HIV/SIV and the integral role of chronic immune activation and inflammation on disease progression and comorbidities, with comparisons between pathogenic infections and nonpathogenic infections that occur in natural hosts of SIVs. We further discuss the various HIV cure strategies being explored with an emphasis on immunological therapies and “shock and kill”.

Efek Obat Imunosupresan Pada Pasien Autoimun dengan COVID-19 (A Scoping Review of The Clinical Evidence)

The main modality in autoimmune disease is a long-term immunosuppressant treatment aiming to control disease progression and increase patient life expectancy. This scoping review aims to evaluate the effect of immunosuppressant treatment in autoimmune patients with COVID-19 on clinical outcomes and disease progression. This scoping review was conducted following the PRISMA extension for scoping review (PRISMA-ScR) guidelines. The Pubmed and Science Direct databases are used to find articles that match the study objectives. Thirteen articles met the inclusion criteria, and all of them were classified as observational studies. Most immunosuppressant treatments are the disease-modifying anti-rheumatic drugs (DMARD) and glucocorticoids. The highest number of autoimmune patients with rheumatoid arthritis (RA) was 43.4%, systemic lupus erythematosus (SLE) 13.6%, and others was 43%. Autoimmune patients with COVID-19 taking immunosuppressant medications, particularly glucocorticoids, significantly increased the risk of hospitalization and the use of ventilators. However, there was no mention of the dosage and duration of immunosuppressant therapy in most of the studies. In general, the use of immunosuppressant drugs was not associated with an increased risk of COVID-19 infection and mortality compared with the general population. Increasing age and comorbidities were associated with poor clinical outcomes. In conclusion, autoimmune patients with COVID-19 who are taking immunosuppressant therapy particularly glucocorticoid exacerbate clinical outcomes. Periodic clinical monitoring and appropriate pharmacological interventions are required in autoimmune patients with COVID-19 to improve clinical outcomes and prevent death.Keywords: Autoimmune, COVID-19, Immunosuppressant, Clinical outcome.

Toxicity of Legiayu incense as Insecticide and Larvicide Against Aedes aegypti Mosquitoes Mortality

Community-based DHF vector control has been implemented in Indonesia but has not yet obtained optimal results. Thus, in the community choosing synthetic insecticides to control disease vectors. However, irregular and excessive use of insecticides has a toxic effect and resistance to mosquitoes. Burning mosquito coils and incense containing synthetic dyes and fragrances have the potential to reduce environmental quality. Therefore, this research was conducted to analyze the toxicity of Legiayu incense as an insecticide and larvicide against Aedes aegypti mosquito mortality. The research design is experimental with a completely randomized design. Testing was conducted by providing exposure to smoke and ash of Legiayu incense five times on twenty-five Aedes aegypti mosquitoes. Statistical analysis used one-way ANOVA, LSD, and probit test. The test result as insecticide value (p=0.000) effective exposure for 20 minutes with a durability of 6 hours. The test result as larvicide value (p=0.000) effective exposure for 24 hours. Thus, exposure toismoke and ash of iLegiayuiincense has a very noticeable effect on the mortality of Aedes aegypti mosquitoes. Exposureito Legiayu incense smoke obtained an LT50 value of 0,9012 ≤ 5 (super toxic category) with a time of 15 minutes 39 seconds, coefficient determination of 99.24%, and correlation coefficient of 99.62% while exposure to the ash of Legiayu incense obtained LT50 value of 0,05896 ≤ 5 (super toxic category) with time 19 hours 15 minutes 34 seconds, coefficient determination and correlation coefficient of 100%. Histopathological test results showed that Legiayu incense smoke did not cause tissue degeneration, necrosis, hyperplasia, and metaplasia in the lung tissue of mice (mus musculus) within a period of 12 weeks. Thus, Legiayu incense is effective as insecticides and larvicides against Aedes aegypti mosquitoes. Legiayu incense has potential substitute for mosquito repellent coils, temephos, and synthetic incense circulating in the market.

Global burden of gynecological cancers

Gynecological cancers include malignant tumours arising from reproductive organs in women including ovaries, uterus, vagina vulva, and cervix. Cervical cancer is reported to be the most common cancer while the vagina is reported to have the lowest incidence all around the world. According to the World Health Organization report Asia has the highest rate of gynecological cancers followed by Africa, Europe, Latin America, North America, and the lowest rate is observed in Oceania. The rate was predicted to rise in the upcoming years. Thus appropriate strategies are needed to be adopted to control disease outcomes and adopt preventive strategies.

Pathogenetic trial of boric acid in bean and tomato plants

Background: homeopathy is held in organic agriculture as a means to control disease and plagues. However, different from doctors, who have works on materia medica and repertories available to choose the most suitable homeopathic medicine for each patient, agronomists do not yet have an equivalent Homeopathic Materia Medica of Plants (HMMP) describing symptoms observed in plants. Aim: the aim of this study was to carry out a homeopathic pathogenetic trial (HPT) in plants comparing the effects elicited by boric acid in ponderable dose and dilution 6cH in two different plant species, namely bean and tomato cultivars. Methods: 4 tests were carried out, 2 on tomato and 2 on bean plants, which received 1 to 6 applications of treatments. Results: there were differences between both species regarding their sensitiveness to boric acid. None of the tomato plants that received Boron 6cH showed symptoms, differently from bean plants. On the other hand, in tests of ponderable doses of boric acid, tomato plants exhibited 3 symptoms more than bean plants. A higher number of bean plants exhibited symptoms with boric acid in ponderable dose than in dilution 6cH). Nos ensaios com feijoeiro, um maior número de plantas apresentou sintomas após o tratamento com ácido bórico na dose ponderal do que com ácido bórico 6cH. Conclusions: these results suggest that the elaboration of a HMMP must take into account the species in which symptoms were obtained. Moreover, HPTs in plants must be carried out with both ponderable doses and high dilutions in order for differences in sensitiveness among species be better identified.

Surgical Margins Status and Prognosis after Resection of Oral Cavity Squamous Cell Carcinoma: Results from a Taiwanese Nationwide Registry-Based Study

(1) Background: The optimal cutoff value that maximizes the prognostic value of surgical margins in patients with resected oral cavity squamous cell carcinoma has not yet been identified. (2) Methods: Data for this study were retrieved from the Taiwan Cancer Registry Database. A total of 13,768 Taiwanese patients with oral cavity squamous cell carcinoma were identified and stratified according to different margin statuses (0, 0.1–4 and > 4 mm). The five-year local control, disease-specific survival and overall survival rates were the main outcome measures. (3) Results: The 5-year local control, disease-specific survival and overall survival rates of patients with close margins (0 and 0.1–4 mm) were significantly lower than those observed in patients with clear margins (> 4 mm; all p values < 0.001). In multivariate analysis, margin status, depth of invasion and extra-nodal extension were identified as independent adverse prognostic factors for 5-year local control. (4) Conclusions: A thorough assessment of surgical margins can provide a reliable prognostic prediction in patients with OCSCC. This has potential implications for treatment approaches tailored to the individual level. The achievement of clear margins (>4 mm) should be considered a key surgical goal to improve outcomes in this patient group.

Аsthma

Asthma is one of the most common respiratory tract diseases (about 7% of adults and about 10% of adolescents and children suffer from asthma in the Russian Federation). Astma frequencies of occurrence dont depend from sex or age in population. Numbers of asthmatic patients in the world increase every year. The majority of patients suffering asthma well respond to conventional therapies and successful control disease, but 20-30% of the patients have severe phenotypes asthma resisting for known medicines, therefore they achieve control for asthma very rare. Patients with severe asthma frequently need hospitalizations (up to 30%) and intensive care (4-7%). The clinical asthma guideline has goals to optimize patient care, up-to-date information about the epidemiology, etiology and pathogenesis of the disease. The text contains actual data about asthma classification, its clinical signs, modern diagnostics (clinical, laboratory and instrumental) inclunded the differential diagnostics of astma. There are chapters about asthma treatment, rehabilitation and prevention in the guideline. Authors detailed describe existing healthcare options for asthmatic patients and the features of diasgnostics and care in partial groups of population (adolescents, pregnant or nursing women, persons with occupational or exercise-induced or severe phenotype asthma). The clinical guideline are recommended for medical doctors (independendently from qualification), under- and postgraduate students, universities tutors, residents and researchers.

Liver Transplantation for Hepatocellular Carcinoma after Downstaging or Bridging Therapy with Immune Checkpoint Inhibitors

Liver transplantation offers excellent outcomes for patients with HCC. For those who initially present within the Milan criteria, bridging therapy is essential to control disease while awaiting liver transplant. For those who present beyond the Milan criteria, a liver transplant may still be considered following successful downstaging. Since the introduction of atezolizumab as part of the first-line treatment for HCC in 2020, there has been increasing interest in the use of ICIs as bridging or downstaging therapies prior to liver transplant. A total of six case reports/series have been published on this topic, with mixed outcomes. Overall, liver transplantation can be performed safely following prolonged ICI use, though ICIs may increase the risk of fulminant acute rejection early in the post-operative period. A minimal washout period between the last dose of ICI and liver transplantation has been identified as an important factor predicting transplant outcomes; however, further research is needed.

Measuring the impact of COVID-19 vaccination and immunity waning: a modelling study for Portugal

Vaccination strategies to control COVID-19 have been ongoing worldwide since the end of 2020. Understanding their possible effect is key to prevent future disease spread. Using a modelling approach, this study intends to measure the impact of the COVID-19 Portuguese vaccination strategy on the effective reproduction number and explore three scenarios for vaccine effectiveness waning. Namely, the no-immunity-loss, 1-year and 3-years of immunity duration scenarios. We adapted an age-structured SEIR deterministic model and used Portuguese hospitalisation data for the model calibration. Results show that, although the Portuguese vaccination plan had a substantial impact in reducing overall transmission, it might not be sufficient to control disease spread. A significant vaccination coverage of those above 5 years old, a vaccine effectiveness against disease of at least 80% and softer non-pharmaceutical interventions (NPIs), such as mask usage and social distancing, would be necessary to control disease spread in the worst scenario considered. The immunity duration scenario of 1-year displays a resurgence of COVID-19 hospitalisations by the end of 2021, the same is observed in 3-year scenario although with a lower magnitude. The no-immunity-loss scenario presents a low increase in hospitalisations. In both the 1-year and 3-year scenarios, a vaccination boost of those above 65 years old would result in a 53% and 38% peak reduction of non-ICU hospitalisations, respectively. These results suggest that NPIs should not be fully phased-out but instead be combined with a fast booster vaccination strategy to reduce healthcare burden.