Testing in the workplace: finding a path through a pandemic

Clinical Trial in a Dish for Space Radiation Countermeasure Discovery

The Borderplex region has been profoundly impacted by the COVID-19 pandemic. Borderplex residents live in low socioeconomic (SES) neighborhoods and lack access to COVID-19 testing. The purpose of this study was two-fold: first, to implement a COVID-19 testing program in the Borderplex region to increase the number of residents tested for COVID-19, and second, to administer a community survey to identify trusted sources of COVID-19 information and factors associated with COVID-19 vaccine uptake. A total of 4071 community members were tested for COVID-19, and 502 participants completed the survey. COVID-19 testing resulted in 66.8% (n = 2718) positive cases. The community survey revealed that the most trusted sources of COVID-19 information were doctors or health care providers (67.7%), government websites (e.g., CDC, FDA, etc.) (41.8%), and the World Health Organization (37.8%). Logistic regression models revealed several statistically significant predictors of COVID-19 vaccine uptake such as having a trusted doctor or health care provider, perceiving the COVID-19 vaccine to be effective, and perceiving that the COVID-19 vaccine does not cause side-effects. Findings from the current study highlight the need for utilizing an integrated, multifactorial approach to increase COVID-19 testing and to identify factors associated with COVID-19 vaccine uptake in underserved communities.

The Coronavirus Response in India – World's Largest Lockdown

Mainstream Media’s Obsession with Africa

Early Response to COVID-19

The role of placebo in clinical trials for drug development in inflammatory bowel disease [IBD] was the topic of a panel discussion held during the 10th Congress of the European Crohn's and Colitis Organisation [ECCO], in Barcelona, Spain, in 2015. Panellists discussed a number of issues around placebo-controlled trials in IBD, noting issues such as difficulties with recruitment, leading to less then representative patient populations in clinical studies. It was noted that, whereas the easiest answer may be to drop placebo, it is much more complicated than that. The relevance of placebo is affected by a number of factors, including the phase of the trial, as well as the nature of the drug. In most cases where placebo has been left out in drug development, it has been for trials involving a new formulation, a new dosing schedule, or a biosimilar, for example. The panel agreed that placebo-controlled trials are of particular importance early in the development programme, perhaps not so much in phase III, although placebo is important for monitoring safety. The current trial paradigm, in which patients remain on a plethora of, likely ineffective and toxic, background medication, was also questioned. The applicability of placebo in the paediatric population was also discussed. The overall consensus from this panel discussion was that placebo is still necessary in clinical trials in inflammatory bowel disease, but there remain questions as to how and when placebo should be used.

Value of information techniques form an alternative framework for study design, based on the uncertainty in long term costs and benefits associated with different treatment approaches. Given a set of candidate study designs, the optimal design is that which maximises the expected net benefit of sampling (ENBS). Much contemporary discussion has focussed on the potential for using value of information in designing randomised clinical trials for drug development. However, this approach could theoretically be used to design research to improve clinical practice after treatment strategies have been adopted, where long term costs and benefits are still subject to uncertainty. Surgery is recognised as being vital in the treatment of early breast cancer. However, in the UK many elderly women are instead treated with primary endocrine therapy. According to NICE guidance, this constitutes undertreatment. For women with limited life expectancy or frailty, less intensive therapeutic approaches may be beneficial. However, more research is required to ensure that treatments are chosen appropriately. This poster presents a case study of using value of information methods to design a study to address this problem. The use of Bayesian evidence synthesis techniques and simulation allow for the calculation of ENBS of a wide range of study designs, including experimental and observational designs. A key methodological challenge in this case study is specifying a sensible representation of current beliefs about heterogeneity in outcomes given limited evidence. The computational cost of these methods remains a barrier to implementation, though more efficient algorithms are in development.

Bispecific T-Cell Engager (BiTE) Antibody Based Immunotherapy for Treatment of Relapsed Refractory Multiple Myeloma (RRMM): A Systematic Review of Preclinical and Clinical Trials

Background: Current research criteria for Alzheimer’s disease (AD) include cerebrospinal fluid (CSF) biomarkers into the diagnostic algorithm. However, spreading their use to the clinical routine is still questionable.Objective: To provide an updated, systematic and critical review on the diagnostic utility of the CSF core biomarkers for AD.Data sources: MEDLINE, PreMedline, EMBASE, PsycInfo, CINAHL, Cochrane Library, and CRD.Eligibility criteria: (1a) Systematic reviews with meta-analysis; (1b) Primary studies published after the new revised diagnostic criteria; (2) Evaluation of the diagnostic performance of at least one CSF core biomarker.Results: The diagnostic performance of CSF biomarkers is generally satisfactory. They are optimal for discriminating AD patients from healthy controls. Their combination may also be suitable for mild cognitive impairment (MCI) prognosis. However, CSF biomarkers fail to distinguish AD from other forms of dementia.Limitations: (1) Use of clinical diagnosis as standard instead of pathological postmortem confirmation; (2) variability of methodological aspects; (3) insufficiently long follow-up periods in MCI studies; and (4) lower diagnostic accuracy in primary care compared with memory clinics.Conclusion: Additional work needs to be done to validate the application of CSF core biomarkers as they are proposed in the new revised diagnostic criteria. The use of CSF core biomarkers in clinical routine is more likely if these limitations are overcome. Early diagnosis is going to be of utmost importance when effective pharmacological treatment will be available and the CSF core biomarkers can also be implemented in clinical trials for drug development.

Background: The world witnessed a sudden outbreak of a new strand of a deadly disease that rapidly spread throughout the globe. The spread of coronavirus (COVID-19) first originated in Wuhan, Hubei province of China in December 2019. This virus strain extended quickly throughout China and became a pandemic in the country. On March 11, 2020, the World Health Organisation (WHO) confirmed the COVID-19 novel coronavirus as a universal pandemic. Methods: Appropriate keywords were included in Scopus, PubMed, and Google Scholar to identify the available data. Result: Due to the rapid spread and fatality of the COVID-19, the 2020 Olympic Games formally slated for July 24 until August 9, 2020, will commence on July 23 to August 8, 2021. In March 2020, most of the European professional sports leagues, including football, were discontinued for the predictable future. Conclusion: Football resumption after the lockdown was challenging because of the inability to affirm the health status of the players when they return to their clubs. Every measure must be clear to reduce the risk of the disease and to clarify the response strategy about self-protection to the public. The sport organizing-bodies control-outlines for sports events should be strategized based on the laydown sports rules and quarantine protocols. National public health organizations and sports associations should work together to protect every level of human health and sport all over the world.

Tuberculosis (TB) is a severe global threat killing more than one million people annually (WHO). With a successful TB control programme in place, there has been a decrease in the number of TB cases and deaths globally over recent years. The World Health Organisation (WHO) End TB Strategy has been momentously shocked by the COVID-19 pandemic and it seems that any success made over recent years is likely to be reversed. We are now more than one year into the pandemic, and the effect COVID-19 has had on TB services is devastating. Hospitals typically dedicated to TB have been converted to COVID-19 hospitals and diagnostic laboratories focus on COVID-19 testing rather than TB. Delivery of TB care is being prioritised for people who have active TB disease whereas prevention and diagnosis of latent TB infection (LTBI) is being put on hold. This pause can lead to an increase in TB cases and transmission. Here, we discuss the connection between SARS-CoV-2 infection and latent TB and highlight the importance of TB prevention management in LTBI post-COVID-19 patients. Community engagement and contact tracing are of high importance in fighting TB in the post-COVID19 era. Getting back on track with TB progress is essential, thus further modelling on the COVID-19 impact on TB burden and its determinants is critical.

The gold-standard method to identify the presence of COVID-19 is the RT-PCR. However, the imaging diagnostic has been requested when there is suspicion of disease’s presence and/or the inflammatory phase of the disease begins. Ths artices described the most common manifestations and patterns of lung abnormality on computed X-Ray (CXR), computer tomography (CT) and Ultrasound of the chest in COVID-19. Notwithstanding the RT-PCR is the gold-standard diagnostic method for COVID-19, the CT has been shown an essential tool to identify pneumonia and the complications of COVID-19 in a patient. This review article aimed to summarize the radiological findings of COVID-19 researches for the following three principal areas: (1) radiological performance in the detection of COVID-19; (2) radiological role in the diagnosis of COVID-19; and (3) radiological function in the monitoring of COVID-19. We searched the articles in the main database (PubMed/Medline, Elsevier Science Direct, Scopus, Isi Web of Science, Embase, Exerpta Medica, UptoDate, Lilacs, Novel Coronavirus Resource Directory from Elsevier), in the high-impact international scientific Journals (Scimago Journal and Country Rank - SJR - and Journal Citation Reports - JCR), such as The Lancet, Science, Nature, The New England Journal of Medicine, Physiological Reviews, Journal of the American Medical Association, Plos One, Journal of Clinical Investigation, and in the data from Center for Disease Control (CDC), National Institutes of Health (NIH), National Institute of Allergy and Infectious Diseases (NIAID) and World Health Organization (WHO). We prior selected meta-analysis, systematic reviews, article reviews and original articles in this order. We reviewed 121 articles and used 57 for this paper from March to May 2020, using the terms coronavirus, SARS-CoV-2, novel coronavirus, Wuhan coronavirus, severe acute respiratory syndrome, 2019-nCoV, 2019 novel coronavirus, n-CoV-2, covid, n-Sars-2, COVID-19, corona virus, coronaviruses, diagnostic, radiology, imaging, computed tomography, chest, CT, X-Ray, with the tools MeSH (Medical Subject Headings), AND, OR, and characters [,“,; /., to ensure the best review topics. We concluded that the imaging method to detect the features of COVID-19 plays an important role in the diagnosis and follow up of the patient with COVID-19 pneumonia. Despite CT has a better sensitivity when compared to CRX and ultrasound, the portable CRX and portable ultrasound could be a new tool with minimal risk of contamination and with good sensitivity.

Background: The global spread of the coronavirus since 2019 has caused significant concern. Objectives: In this study, we aimed to investigate the clinical manifestations and laboratory findings of children infected with the alpha, beta, delta, and omicron strains. Methods: We included all patients who were referred to Mofid Children's Hospital during the peak of the alpha strain in November 2020, the beta strain in April 2021, the delta strain in August 2021, and the omicron strain in February 2022, corresponding to the national peaks of four SARS-CoV-2 variants of concern (VOC). All patients had a positive nasopharyngeal PCR test and were admitted to the emergency ward. We analyzed the collected data using SPSS software. Results: A total of 649 patients were included in this survey, of whom 58.1% were male. The most and least frequent clinical manifestations were fever and skin presentation, respectively. The mean white blood cell count (WBC) was 8423.9 ± 5427.3. The mean values for C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were 30.14 ± 20.07 and 38 ± 22.6, respectively. There was no significant association between coronavirus type, age, and gender. Gastroenteritis, urinary tract infection, and croup showed a statistically significant positive correlation with delta, beta, and omicron (P-values of < 0.003, 0.000, and 0.000, respectively). Cough was more frequent in patients infected with alpha and beta subtypes, while lymphocyte counts were elevated in patients suffering from delta, omicron, and alpha. C-reactive protein and ESR levels were significantly increased in patients with delta infection, and in patients with omicron infection, CRP levels were significantly elevated. Conclusions: Our study revealed that the different strains of COVID-19, corresponding to the World Health Organization (WHO) peak of VOCs, can cause variable clinical symptoms in children. These findings could be helpful in the diagnosis of COVID-19.

In late December 2019, China's local office of the World Health Organization (WHO) reported a case of pneumonia of unknown cause in Wuhan City.In January 2020, the disease caused by 2019-nCoV was defined as COVID-19.Some reports stated that more than half of COVID-19 patients have liver disease of varying degrees.We hypothesized that liver injury might be common in Intensive Care Unit (ICU) patients.The current study scrutinized the changes in the liver function tests alanine transaminase (ALT), aspartate transaminase (AST), and total bilirubin in patients with and without COVID-19 admitted to the ICU at University Hospital.Methods: There were 100 patients diagnosed with COVID-19 and 80 non-COVID-19 patients who were admitted to the ICU in this retrospective study.The study was conducted between March 15, 2020, and November 15, 2021 (20 months).Inclusion criteria for the control (n=80) and study groups (n=100) were to be older than 18 years of age and not have any liver disease.In addition, another inclusion criterion for the study group was having a diagnosis of COVID-19.AST, ALT, and total bilirubin results were obtained from a data recording system named "Pusula" used in Medipol Mega University Hospital.Data was analyzed by GraphPad Prism v. 5.0 statistical program, and p<0.05 was considered statistically significant.Results: Findings demonstrated that ALT and AST levels were significantly higher in patients with COVID-19 when compared with patients without COVID-19 (p<0.05).Total bilirubin was also observed as elevated in patients with COVID-19.However, this elevation was not significant (p>0.05). Discussion and Conclusion:In conclusion, it can be stated that COVID-19 may cause hepatosteatosis resulting in liver damage.However, further studies are needed to elucidate possible mechanisms of liver injury in COVID-19 patients and their significance for clinical prognosis.

BACKGROUND At the beginning of December 2019, a series of cases of viral profile pneumonia were reported in the city of Wuhan, China. In January 2020, a new type of betacoronavirus was identified as responsible for these pneumonias, which was called Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV2), while the disease produced by it was called coronavirus disease of 2019 or COVID19. The first series of cases indicated fever (83-98 %), cough (59-82 %) and dyspnea (31-69 %) as the most frequent symptoms in hospitalized patients, while neurological symptoms such as myalgias (11-44%), headache (6-13 %), dizziness (9 %) or confusion (8 %) were also common. The epidemiological, clinical and pathophysiological characteristics of headache caused by SARS-CoV2 remained unknown. OBJETIVE The objectives of this project were: 1) To estimate the prevalence of headache in patients with SARS-CoV2 infection; 2) to analyze whether the presence of headache in COVID19 patients had prognostic implications for mortality; 3) to describe the phenotypic characteristics of headache in COVID19 patients; and 4) to analyze whether patients with headache had differences in their cytochemical profile. METHODS To address these objectives, three observational studies were carried out, one with a retrospective cohort study, a case-control study, and a cross-sectional study nested in a prospective cohort. The studies were carried out in a public tertiary university hospital. The three studies had common inclusion criteria and all consecutive patients admitted to said hospital with a confirmed diagnosis of SARS-CoV2 infection were screened for eligibility. In the third study, the sampling was done by randomly selecting one in every five patients. The study period was between March 8 and April 11, 2020. The diagnosis was done according to the protocols and definitions of the World Health Organization (WHO). Data were collected from medical records or by telephone. Baseline variables (demographics, comorbidity, previous treatments, modified Rankin scale), intermediate variables (presenting symptoms, laboratory parameters upon admission and results of imaging work-up) and prognostic variables (severity, need for intensive care, mortality) were retrieved and analyzed. RESULTS: A total of 576 hospitalized patients with a diagnosis of COVID19 were included, among whom 137 (24 %) patients reported headache. In multivariate analysis, patients with headache had a lower risk of in-hospital all-cause mortality (OR: 0.39, 95 % CI: 0.17-0.88, p=0.007). In the study of the clinical phenotype, 130 patients were included. Headache was described as bilateral in 85 %, frontal in 83 %, and oppressive in quality in 62 %. The mean intensity described on a visual analogue scale was 7 out of 10. The criteria of the current edition of the International Classification of Headache Disorders (ICHD-3) for headache attributed to systemic viral infection were met in 94 % of the patients, tension-type headache phenotypic criteria were met in 54 % of the patients and migraine phenotypic criteria were met in 25 % of the patients. In the comparison of inflammatory parameters between COVID19 patients with and without headache, 104 patients were analyzed, among whom 29 (28 %) had headache. After adjusting the values for age, sex, baseline situation, and severity of the COVID-19 disease, interleukin-10 values remained higher in patients with headache (3.3 vs. 2.2 ng/dL, p=0.042). CONCLUSIONS: Headache is a common symptom in patients with SARS-CoV2 infection. Its phenotype is nonspecific and may resemble tension-type headache and/or migraine. Its presence is associated with a better prognosis, possibly as a consequence of a more efficient immune response.