BACKGROUND: Of the 2 million children living with HIV globally, 90% live in sub-Saharan Africa. Despite antiretroviral therapy, longstanding HIV infection is associated with several chronic complications in children including growth failure, particularly stunting and delayed puberty. Vitamin D deficiency, which is highly prevalent among children living with HIV in sub-Saharan Africa, has a further adverse impact on bone health. This trial aims to establish whether supplementation with vitamin D(3) and calcium carbonate improves musculoskeletal health among peripubertal children living with HIV. METHODS/DESIGN: We will conduct an individually randomised, double-blinded, placebo-controlled trial of weekly high-dose vitamin D(3) (20,000 IU) plus daily calcium carbonate (500mg) supplementation for 48 weeks. Eight hundred and forty children living with HIV aged 11C19 years taking ART for 6 months will be enrolled and followed up for 96 weeks. The primary outcome is total body less-head bone mineral content for lean mass adjusted for height (TBLH-BMC(LBM)) Z-score at 48 weeks, measured by dual-energy X-ray absorptiometry (DEXA). Secondary outcomes are DEXA-measured lumbar spine bone mineral apparent density Z-score, number of respiratory infections, lean muscle mass and grip strength at 48 and 96 weeks and TBLH-BMC(LBM) Z-scores at 96 weeks. Sub-studies will investigate the effect of the intervention on vitamin D(3) pathway metabolites and markers of bone turnover, intestinal microbiota, and innate and acquired immune function. DISCUSSION: This is the largest trial to date of vitamin D supplementation in children living with HIV. Intervening to address deficits in bone accrual in childhood is critical for optimising adolescent and early adult bone health and prevention of later adult osteoporotic fractures. Trial results will draw attention to the need to screen for and treat long-term comorbidities in children living with HIV in resource-limited settings. TRIAL REGISTRATION: Pan African Clinical Trials Registry PACTR20200989766029. Registered on 3 September 2020

FL[Formula: see text]-algebras are lattice-ordered algebras with two sets of residuated operators. The classes RA of relation algebras and GBI of generalized bunched implication algebras are subvarieties of FL[Formula: see text]-algebras. We prove that the congruences of FL[Formula: see text]-algebras are determined by the congruence class of the respective identity elements, and we characterize the subsets that correspond to this congruence class. For involutive GBI-algebras the characterization simplifies to a form similar to relation algebras. For a positive idempotent element p in a relation algebra [Formula: see text], the double division conucleus image [Formula: see text] is an (abstract) weakening relation algebra, and all representable weakening relation algebras (RWkRAs) are obtained in this way from representable relation algebras (RRAs). The class [Formula: see text] of subalgebras of [Formula: see text] is a discriminator variety of cyclic involutive GBI-algebras that includes RA. We investigate [Formula: see text] to find additional identities that are valid in all RWkRAs. A representable weakening relation algebra is determined by a chain if and only if it satisfies [Formula: see text], and we prove that the identity [Formula: see text] holds only in trivial members of [Formula: see text].

Recent application of Fourier transform near infra-red spectroscopy (FT-NIRS) to predict age in fish otoliths has gained attention among fisheries managers as a potential alternative to costly production ageing of managed species We assessed the age prediction capability of FT-NIRS scans in whole otoliths from red snapper, Lutjanus campechanus, collected from the US Gulf of Mexico and US Atlantic Ocean (South Atlantic) Otoliths were scanned with an FT-NIR spectrometer and resulting spectral signatures were regressed with traditionally estimated ages via partial least squares regression to produce calibration models, which were validated for predictive capability against test sets of otoliths Calibration models successfully predicted age with R2 ranging 0 94C0 95, mean squared error 1 8 years, and bias <0 02 years Percent agreement between FT-NIRS and traditional ages was lower than within-reader agreement for traditional estimates, but average percent error was similar and KolmogorovCSmirnov tests were not significantly different (p 0 06) between traditional and FT-NIRS predicted ages for optimal calibration models Ages >31 years were not well predicted, possibly due to light attenuation in the thickest otoliths Our results suggest that FT-NIRS can improve efficiency in production ageing for fisheries management while maintaining data quality standards

The importance of Early Childhood (EC) educators' wellbeing has been brought into sharp focus during the COVID-19 pandemic, as educators have navigated numerous additional stressors while providing education and care services for some children and ongoing support for many others learning at home. This study aimed to explore the impact of the pandemic on EC educators' wellbeing and educator-child relationships, as growing evidence shows the influence of these factors on children's developmental outcomes. In July 2020, members of a Research Network of EC Professionals-who previously identified educator wellbeing as a priority issue-were invited to participate in an online survey. The survey included two published, validated scales: the Early Childhood Professional Wellbeing scale (ECPW) and the Student-Teacher Relationship Scale (modified). Survey items about educators' experiences during the pandemic were also included. Two hundred and thirty-two EC educators from across Australia completed the survey, mostly from Victoria where lockdowns were most severe. Linear regression analysis demonstrated stronger professional wellbeing was associated with less conflict in educator-child relationships and lower risk of staff turnover. This was more likely to be experienced by senior or more experienced staff. Although a negative impact of COVID-19 was reported, ECPW scores were relatively high, and organizational structures supporting professional wellbeing were most strongly associated with lower risk of turnover (r = 0.63, p < 0.001). Findings highlight that supporting EC educators' wellbeing is essential for workforce retention, and for promoting quality educator-child relationships which are central to young children's learning and development.

In 2019, as in prior years, Medicaid physician fees remained well below Medicare and private insurance fees despite growth in Medicaid enrollment. Low Medicaid physician fees have important implications in terms of access to care for Medicaid enrollees and the effects of proposals to expand coverage through a Medicaid buy-in program or a Medicaid-like public option.

Scientists all over the world are facing a challenging task of finding effective therapeutics for the coronavirus disease (COVID\19). One of the fastest ways of finding putative drug candidates is the use of computational drug discovery approaches. The purpose of the current study is to retrieve natural compounds that have obeyed to drug\like properties as potential inhibitors. Computational molecular modelling techniques were employed to discover compounds with potential SARS\CoV\2 inhibition properties. Accordingly, the InterBioScreen (IBS) database was obtained and was prepared by minimizing the compounds. To the resultant compounds, the absorption, distribution, metabolism, excretion and toxicity (ADMET) and Lipinski's Rule of Five was applied to yield drug\like compounds. The obtained compounds were subjected to molecular dynamics simulation studies to evaluate their stabilities. In the current article, we have employed the docking based virtual screening method using InterBioScreen (IBS) natural compound database yielding two compounds has potential hits. These compounds have demonstrated higher binding affinity scores than the reference compound together with good pharmacokinetic properties. Additionally, the identified hits have displayed stable interaction results inferred by molecular dynamics simulation results. Taken together, we advocate the use of two natural compounds, STOCK1N\71493 and STOCK1N\45683 as SARS\CoV\2 treatment regime.

CONTEXT: The number of reported cases with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) vaccineCinduced subacute thyroiditis (SAT) and Graves disease (GD) is growing. However, active debate continues about managing such side effects and the safety of repeat or booster doses of the vaccines in such cases. OBJECTIVES: This study aims to present long-term clinical follow-up of SARS-CoV-2 vaccineCinduced SAT or GD cases and provide data regarding the safety of revaccinations. METHODS: Patients diagnosed with SARS-CoV-2 vaccineCinduced SAT or GD were included. Data regarding the long-term clinical follow-up of SARS-CoV-2 vaccineCinduced SAT and GD cases and outcomes of repeat or booster SARS-CoV-2 vaccinations were documented. The literature, including cases of SARS-CoV-2 vaccineCinduced SAT or GD, was reviewed. RESULTS: Fifteen patients with SARS-CoV-2 vaccineCinduced SAT and 4 with GD were included. Pfizer/BioNTech COVID-19 vaccine (BNT162b2) was associated with symptoms in a majority of cases with SAT and all with GD. Median time from vaccination to symptom onset was 7 and 11.5 days, respectively, while 7 and 2 patients required medical treatment in SAT and GD groups, respectively. Remission was documented in 10 SAT patients, with a median time to remission of 11.5 weeks. No exacerbation/recurrence of SAT occurred in 7 of 9 patients who received a repeat vaccination dose, while symptoms of SAT worsened following the second vaccination in 2 cases. None of the patients experienced severe side effects that could be associated with revaccinations. CONCLUSIONS: Revaccinations appear to be safe in patients with SARS-CoV-2 vaccineCinduced SAT cases, while more evidence is needed regarding SARS-CoV-2 vaccineCinduced GD.

Cancer stem cells (CSCs) are a small population of heterogeneous tumor cells with the capacity of self-renewal and aberrant differentiation for immortality and divergent lineages of cancer cells. In contrast to bulky tumor cells, CSCs remain less differentiated and resistant to therapy even when targeted with tissue-specific antigenic markers. This makes CSCs responsible for not only tumor initiation, development, but also tumor recurrence. Emerging evidence suggests that CSCs can undergo cell senescence, a non-proliferative state of cells in response to stress. While cell senescence attenuates tumor cell proliferation, it is commonly regarded as a tumor suppressive mechanism. However, mounting research indicates that CSC senescence also provides these cells with the capacity to evade cytotoxic effects from cancer therapy, exacerbating cancer relapse and metastasis. Recent studies demonstrate that senescence drives reprogramming of cancer cell towards stemness and promotes CSC generation. In this review, we highlight the origin, heterogeneity and senescence regulatory mechanisms of CSCs, the complex relationship between CSC senescence and tumor therapy, and the recent beneficial effects of senotherapy on eliminating senescent tumor cells.

The clinical manifestations of COVID-19 are heterogeneous: 46.4% of patients admitted into hospital reported to have at least one comorbidity. Comorbidities such as COPD, diabetes, hypertension and malignancy predispose patients with Covid-19 to adverse clinical outcomes. Alpha 1-antitrypsin deficiency (AATD) is a genetic disorder caused by pathological mutation(s) in the SERPINA1 gene resulting in an imbalance in proteinase activity which may lead to premature emphysema and COPD. Our aim was to investigate whether people with severe AAT deficiency (AATD) have an increased risk of (severe) COVID-19 infection. We collected data on COVID-19 symptoms, laboratory-confirmed infection, hospitalization and treatment by means of a telephone survey, directly administered to Italian severe AATD subjects in May 2020. We then compared our findings with data collected by the Istituto Superiore di Sanit on the total population in Italy during the same period. We found an higher frequency of SARS-CoV-2 infection in our cohort (3.8%) compared to national data regarding infection, thus giving severe AATD a relative risk of 8. 8 (95%CI 5.1-20,0; p<0.0001) for symptomatic SARS-CoV-2 infection. Moreover, the relative risk (RR) was higher in AATD patients with pre-existing lung diseases (RR 13.9; 95%CI 8.0-33.6; p<0.001), but with a similar death rate (1 in 8, 12.5%) compared to the general population (13.9%; RR 0.9). These preliminary findings highlight the importance of close surveillance in the spread of COVID-19 in patients with severe AATD and underlines the need for further studies into the role of the antiprotease shield in preventing SARS-Cov-2 infection.

In Japans response to the coronavirus disease 2019 (COVID-19), virus testing was limited to symptomatic patients due to limited capacity, resulting in uncertainty regarding the spread of infection and the appropriateness of countermeasures. System dynamic modelling, comprised of stock flow and infection modelling, was used to describe regional population dynamics and estimate assumed region-specific transmission rates. The estimated regional transmission rates were then mapped against actual patient data throughout the course of the interventions. This modelling, together with simulation studies, demonstrated the effectiveness of inbound traveler quarantine and resident self-isolation policies and practices. A causal loop approach was taken to link societal factors to infection control measures. This causal loop modelling suggested that the only effective measure against COVID-19 transmission in the Japanese context was intervention in the early stages of the outbreak by national and regional governments, and no social self-strengthening dynamics were demonstrated. These findings may contribute to an understanding of how social resilience to future infectious disease threats can be developed.

O objetivo da revis?o sistemtica foi investigar a eficcia e a seguran?a de tratamentos com antivirais para COVID-19, SARS e MERS Ao todo, 22 estudos foram includos: 1 ensaio clnico, 16 sries de casos e 5 relatos de caso Os antivirais mais utilizados foram lopinavir / ritonavir, oseltamivir, ribavirina e arbidol Todos os estudos usaram outras terapias, como antibiticos, imunoglobulina, interferon, glicocorticoides, metilprednisolona e medicamentos antiparasitrios e antifngicos, alm da terapia antiviral para pacientes com COVID-19 No nico ECR includo, os pacientes que receberam lopinavir / ritonavir tiveram um processo de recupera??o semelhante aos pacientes que receberam tratamento padr?o Os desfechos de mortalidade em 28 dias e carga viral de RNA n?o foram significativamente diferentes entre os dois grupos Dentre os achados dos demais estudos, vale destacar que estudos de sries e relatos de casos n?o avaliam a eficcia de medicamentos, e que em geral as amostras foram pequenas O estudo de Guan, com 1099 pacientes, chegou a conclus?o que oseltamivir foi ineficaz na diminui??o da taxa de admiss?o na UTI, na necessidade de ventila??o e na taxa de mortalidade entre os pacientes O estudo de Shang, com 416 pacientes, indicou que medicamentos antivirais n?o tm efeito na taxa de mortalidade de pacientes com COVID-19 O estudo de Li, com cinco crian?as com COVID-19, indicou que os agentes antivirais n?o alteraram o resultado ou a dura??o da interna??o A revis?o cita outros estudos que foram publicados com os pacientes ainda sob tratamento, sem o desfecho final dessas popula??es Quanto a busca por ensaios clnicos para SARS e MERS, foram encontrados protocolos, mas nenhum resultado publicado

The kidney is not typically the main target of severe acute respiratory syndrome coronavirus 2, but surprisingly, acute kidney injury (AKI) may occur in 4C23% of cases, whereas the dialysis management of AKI from coronavirus 2019 has not gained much attention The severity of the pandemic has resulted in significant shortages in medical supplies, including respirators, ventilators and personal protective equipment Peritoneal dialysis (PD) remains available and has been used in clinical practice for AKI for &amp;gt;70 years;however, it has been used on only a limited basis and therefore experience and knowledge of its use has gradually vanished, leaving a considerable gap The turning point came in 2007, with a series of sequential publications providing solid evidence that PD is a viable option As there was an availability constraint and a capacity limit of equipment/supplies in many countries, hemodialysis and convective therapies became alternatives However, even these therapies are not available in many countries and their capacity is being pushed to the limit in many cities Evidence-based PD experience lends support for the use of PD now

The coronavirus (COVID-19) pandemic has halted economic activity worldwide, hurting firms and pushing them toward bankruptcy This paper provides a unified fram

INTRODUCTION: Studies using geospatial data to understand LGBTQ+-friendly sexual health and wellness resource availability have often focused on services catered to adults. While HIV rates have increased in adolescents in recent years, few studies have explored disparities in resource access for adolescent gay and bisexual men (AGBMSM). METHODS: We used geospatial data of resources (collected and verified 2017C2018) from the iReach app to understand disparities in resource access for AGBMSM within and between 4 high HIV prevalence corridors in the US. RESULTS: AGBMSM in non-metro areas had access to fewer resources and some rural counties had no LGBTQ+ -friendly resources. Corridors comprising states with legacies of punitive laws targeting sexual and gender minorities demonstrate stark geographic disparities across the US. CONCLUSIONS: Policy-makers must understand the granularity of disparities within regions. Online resources may be able to surmount LGBTQ+ resource deserts. However, physical access to LGBTQ+ -friendly services must be improved as a fundamental strategy for reducing HIV among AGBMSM. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13178-021-00660-0.

This paper aims to identify the parameters of an original modified SEIR model for the COVID-19 epidemic's course in France by using publicly available data and applying such an identified model for the prediction of the SARS-CoV-2 virus propagation under different conditions of confinement. For this purpose, an interval predictor is designed, allowing variations and uncertainties in the model parameters to be taken into account.

OBJECTIVE: To evaluate the effects of heat inactivation of blood samples at 56a?? for 30 min on the results of SARS-CoV-2 antibody detection using different methods. METHODS: This retrospective study was conducted in 11 patients with established diagnosis of COVID-19 and 10 patients with diseases other than COVID- 19 in our hospital. We collected samples of serum, plasma and whole blood from each patient between February, 12 and 18, 2020, and with a double- blind design, the samples were examined for SARS-CoV-2 antibodies before and after heat inactivation at 56 a?? for 30 min. In all the samples, the total SARS-CoV-2 antibodies were detected using immunochromatography, and the IgM antibodies were detected using fluorescence immunochromatography; the IgM and IgG antibodies in the serum and plasma samples detected with chemiluminescence immunoassay. We compared the detection results and analyzed the correlation of semi-quantitative detection results of IgM and IgG antibodies before and after heat inactivation of the samples. RESULTS: With immuno-chromatography, the coincidence rate of the total SARS-CoV-2 antibody detection before and after heat inactivation of the serum and plasma samples was 90.0% in COVID-19 cases and 100.0% in the negative cases, resulting in a total coincidence rate 95.2%; for the whole blood samples, the total coincidence rates of the total SARS-CoV-2 antibodies were 100.0%. For detection of IgM antibodies in the serum, plasma and whole blood samples using fluorescence immunochromatography, the coincidence rates in SARS-CoV-2-positive and negative cases and the total coincidence rate before and after inactivation were 100.0%, 0 and 47.6%, respectively. For detection of serum IgM and IgG antibodies and plasma IgG antibodies with chemiluminescence immunoassay, the coincidence rates in SARS-CoV-2-positive and negative cases and the total coincidence rate before and after inactivation were all 100.0%, and the total coincidence rate of plasma IgM antibodies was 95.2%. Pearson correlation analysis of the semi-quantitative results of IgM and IgG detection in the serum and plasma samples showed a correlation coefficient of 0.9999 (95%CI: 0.9998-1.000, P < 0.001) between the results before and after sample inactivation. CONCLUSIONS: Heat inactivation of blood samples at 56 a?? for 30 min does not obviously affect the results of immunochromatography and chemiluminescent immunoassay for detection of SARS-COV-2 antibodies but can reduce the risk of infection for the operators. Heat-inactivated samples can not be used in fluorescence immunochromatography for SARS-CoV-2 antibody detection.

AIMS AND METHOD: Mental health services have changed the way they operate during the COVID-19 pandemic. We investigated the challenges and innovations reported by staff working in services for people with intellectual disability and/or autism in National Health Service (NHS) and non-NHS sectors, and in in-patient and community settings. RESULTS: Data were drawn from 648 staff who participated in a UK-wide online survey. Issues around infection risk and mitigation were more important to those working in the NHS and in-patient settings. Community staff were more likely to express concern about the practicalities of a rapid shift to remote working and engaging patients remotely. Qualitative data revealed support for maintaining remote staff working and remote service provision post-pandemic. CLINICAL IMPLICATIONS: Given the current emphasis on community support for people with intellectual disability and/or autism, the focus of research and clinical practice should be the development of accessible and effective models of remote service provision.

There has been a high incidence of thromboembolic diseases in patients with coronavirus disease 2019 (COVID-19) pneumonia. We present a case of a healthy 32-year-old male with no past medical history who presented with shortness of breath, tested positive for COVID-19, and was found to have a large acute saddle pulmonary embolism.

With emergence of pandemic COVID-19, rapid and accurate diagnostic testing is essential. This study compared laboratory-developed tests (LDTs) used for the detection of SARS-CoV-2 in Canadian hospital and public health laboratories, and some commercially available real-time RT-PCR assays. Overall, analytical sensitivities were equivalent between LDTs and most commercially available methods.

OBJECTIVE: In this study, it was aimed to evaluate the Turkish validity and reliability of the Preschool Childrens Nutrition Screening Tool (NutriSTEP?), which is used to determine the nutritional status of children in the preschool period. SUBJECT/METHODS: The sample of the study consists of 333 parents with children aged 3C5 years old living in Turkey, who voluntarily agreed to participate in the study and answered the Turkish NutriSTEP? form online. The forward and backward translation method was applied for the language validity of the Turkish form. Expert opinion was sought for content validity. Factor analyzes were applied to determine the construct validity of the Turkish form. Original NutriSTEP? and Iran NutriSTEP? were evaluated to assess cut-points. To evaluate the reliability of the Turkish version, the testCretest method was used. RESULTS: As a result of expert opinion, the Content Validity Index was found to be 0.97. According to exploratory factor analysis, unlike the original NutriSTEP?, five sub-dimensions were obtained and the 13th question with a factor load of less than 0.30 was removed. According to the confirmatory factor analysis, it was shown that the scale was suitable for Turkish society. There were positive, high and statistically significant correlations between the NutriSTEP? scale testCretest scores (p < 0.01). CONCLUSION: The Turkish NutriSTEP? questionnaire is both valid and reliable for the screening of nutrition risk in preschool children of the Turkish population.