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Develop your business with Virtual reality organization      
Hiverlab Pte Ltd

Hiverlab Pte Ltd

April 29, 2020
Virtual reality, the idealized next step in both gaming and simulations. With the rise of Oculus Rift, HTC Vive, Sony's Project Morpheus and the recent One plus Cardboard virtual reality is beginning to find a place in the consumer household, rather than with only arcades and technology enthusiasts.Such massive market potential is likely the driving force behind the broad range of companies jumping on the VR scene. Everyone from Sony to Valve are currently developing or have released early products, such a range of heavy hitting gaming companies is a sign that Virtual Reality Company Singaporehas a place. Whilst this anticipated growth is impressive, it remains to be seen if this new technology will be purely a passing fad or a long-term gaming option. According to this report the constant increase in technology, such as 3D effects and motion tracking are pushing the rise of virtual reality. Whilst increasing disposable incomes are letting more and more households give this new technology a try. On the flip-side the cost of these technologies, demonstrated by Valve stating that their HTC Vive is aimed at the high-end consumer is expected to harm growth and widespread adoption. The worldwide spread of VR is obviously concentrated within North America and Europe, with both representing 69% of the revenue share. Though surprisingly Asia is slated as the region of highest potential due to the growing online involvement and presence of Sony, who have easy to Asia for their Project Morpheus. This single report highlights that VR has huge potential, both for the companies producing them and the consumers. Yet ultimately it will depend on the content that will be available for these machines and the cost of them. At the current time an average consumer will not spend the equivalent of an Xbox One or PlayStation 4 for a machine that offers only a limited range of games. Though if games such as the "Keep Talking and Nobody Explodes" demonstrate anything, it is that the right sort of game style can work seamlessly with headset VR. We look forward to the day that Call of Duty can be played on a Best Virtual Reality Companiesmachine, or maybe that wouldn't be such a good idea.Source URL : - https://penzu.com/p/0fa011fcFor more info : - Best Augmented Reality Companies
Confronto fra diversi modelli di calcolo per la valutazione del rischio sanitario-amb...
Noemi Cennamo

Noemi Cennamo

June 26, 2020
Il rischio è definito come la probabilità di insorgenza di effetti indesiderati per persone/cose, causati da particolari eventi, e può essere valutato come il prodotto tra la pericolosità (probabilità di accadimento dell’evento) e il danno atteso. Tra le differenti tipologie di rischio, nel presente lavoro si fa riferimento a quello ambientale. Il D.Lgs. 152/06, guarda al rischio sanitario-ambientale, derivante dall’impatto dei contaminanti presenti nelle matrici ambientali sulla salute umana. I siti contaminati costituiscono una problematica attuale e dunque si necessita di un’adeguata valutazione, al fine di individuare e quantificare i rischi associati ad un evento di contaminazione. L'obiettivo è effettuare un confronto tra software facendo riferimento ad un caso studio di un sito contaminato da idrocarburi in Spagna. 
The Delta K method alone is not sufficient to determine best clustering solutions for...
Kathryn Stankiewicz
Kate Vasquez

Kathryn Stankiewicz

and 3 more

April 29, 2020
The software program STRUCTURE relies on a Bayesian iterative clustering algorithm to group samples using multi-locus genotype data and is one of the most cited tools for determining population structure. To infer the optimal number of clusters from STRUCTURE output, the ΔK method is often applied. However, a recent study relying on modeled microsatellite data suggested that this method has a downward bias in its estimation of K and is sensitive to uneven sampling. If this finding holds for empirical microsatellite datasets, conclusions about the scale of gene flow may have to be revised for a large number of studies. Here, we apply recently described estimators of K to re-estimate gene flow in 41 empirical microsatellite datasets; 15 from a broad range of taxa and 26 focused on a complex study system, coral. These datasets included 35 species, spanning seven continents, from diverse biological systems across the Tree of Life. After comparison of alternative estimates of K (Puechmaille statistics) with traditional (ΔK and posterior probability) estimates, we conclude that ΔK alone is insufficient for determining the most optimal number of clusters and sampling evenness does not necessarily predict agreement with traditional estimators. To better infer population structure, we suggest a combination of visual inspection of STRUCTURE plots and calculation of the alternative estimators at various thresholds in addition to ΔK. Differences between estimators could reveal patterns with important biological implications, such as the potential for more population structure than previously estimated, as was the case for many studies reanalyzed here.
Distribution of genetic variation underlying adult migration timing in steelhead of t...
Erin Collins
John Hargrove

Erin Collins

and 3 more

May 04, 2020
Fish migrations are energetically costly, especially when moving between fresh and saltwater, but are a viable strategy for Pacific salmon and trout (Oncorhynchus spp.) due to the advantageous resources available at various life stages. Anadromous steelhead (O. mykiss) migrate vast distances and exhibit variation for migration phenotypes that have a genetic basis at candidate genes known as greb1L and rock1. We examined the distribution of genetic variation at 13 candidate markers spanning greb1L, intergenic, and rock1 regions versus 246 neutral markers for 113 populations (n = 9,471) of steelhead from inland and coastal lineages in the Columbia River. Patterns of population structure with neutral markers reflected genetic similarity by geographic region as demonstrated in previous studies, but candidate markers clustered populations by predominate genetic variation associated with migration timing. Mature alleles for late migration had the highest frequency overall in steelhead populations throughout the Columbia River, with only 9 of 113 populations that had a higher frequency of premature alleles for early migration. While a single haplotype block was evident for the coastal lineage, we identified multiple haplotype blocks for the inland lineage. The inland lineage had one haplotype block that corresponded to candidate markers within the greb1L gene and immediately upstream in the intergenic region, and the second block only contained candidate markers from the intergenic region. Haplotype frequencies had similar patterns of geographic distribution as single markers, but there were distinct differences in frequency between the two haplotype blocks for the inland lineage. Redundancy analyses were used to model environmental effects on allelic frequencies of candidate markers and significant variables were migration distance, temperature, isothermality, and annual precipitation. This study improves our understanding of the spatial distribution of genetic variation underlying migration timing in steelhead as well as associated environmental factors and has direct conservation and management implications.
Boost NOx removal by perovskite-based catalyst in NSR-SCR diesel aftertreatment syste...
Jon Onrubia-Calvo
Beñat Pereda-Ayo

Jon Onrubia-Calvo

and 4 more

April 29, 2020
DeNOx activity of 0.5% Pd–30% La0.5Ba0.5CoO3/Al2O3 formulation is analysed in single-NSR and combined NSR–SCR systems, using response surface methodology (RSM). Operational maps are built for any combination of reaction temperature in the NSR and SCR beds and H2 concentration. A 4% Cu/SAPO-34 is used as the SCR catalyst. Results for single-NSR allows tuning operational conditions in coupled NSR-SCR technology to maximize NOx-to-N2 conversion, with minimum NH3 and N2O productions. Control of H2 concentration and temperature in the NSR system allows generating the stoichiometric amount of NH3 to eliminate NOx slipping. The tuned coupled NSR–SCR system achieves high N2 yield under wide operational range (T=175–425 °C; CH2=2–4%). Specifically, N2 yield reaches 92% when NSR and SCR catalysts work at 300 °C and 3% H2 is injected, with NH3 slip and N2O production nearly zero. This provides a promising alternative for NOx removal in diesel aftertreatment systems.
Coronavirus  (COVID-19): A Patient Experience - Administrative services on the frontl...
Head and Neck Editor

Randal S. Weber, MD

April 29, 2020
Judy Overton, BFA, MLAProgram Manager, Office of Patient Experience OfficerThe University of Texas M.D. Anderson Cancer CenterT. Boone Pickens Academic Tower1400 Pressler StHouston, Texas 77030 Kathy Denton, BS, MED, PhDThe University of Texas M.D. Anderson Cancer Center,Director, Patient ExperienceThe University of Texas M.D. Anderson Cancer CenterT. Boone Pickens Academic Tower1400 Pressler StHouston, Texas 77030 Michael Frumovitz, MD, MPHGynecologic Oncology and Reconstructive MedicineThe University of Texas M.D. Anderson Cancer CenterDan L. Duncan Building1155 Pressler StHouston, Texas 77030 Carol Lewis, MD Department of Head and Neck SurgeryThe University of Texas M.D. Anderson Cancer CenterT. Boone Pickens Academic Tower1400 Pressler StHouston, Texas 77030 Sarah Christensen, MADirector, Patient EducationThe University of Texas M.D. Anderson Cancer CenterDan L. Duncan Building1155 Pressler StHouston, Texas 77030 Jaymesson Bezerra, MSHAManager, Patient RelationsThe University of Texas M.D. Anderson Cancer CenterRotary House International 1600 Holcombe BlvdHouston, Texas 77030 Chris HernandezExec. Director, Patient Services, Patient AdvocacyThe University of Texas M.D. Anderson Cancer CenterAnderson West1515 Holcombe BlvdHouston, Texas 77030 Michele S. WalkerAssoc. Dir, Pt Advo & Pt Rel, Patient AdvocacyThe University of Texas M.D. Anderson Cancer CenterAnderson West1515 Holcombe BlvdHouston, Texas 77030 Janice P. Finder, BSN, MSN, RNDirrector, Patient Exp Clin Services, askMDAndersonThe University of Texas M.D. Anderson Cancer CenterMid Campus Building 1MC7007 Bertner AvenueHouston, Texas 77054 Ashlyn A. Proske, BSProgram Manager, askMDAndersonThe University of Texas M.D. Anderson Cancer CenterMid Campus Building 1MC7007 Bertner AvenueHouston, Texas 77054 Sanchita Jain, MBAInnovation Strategist, InnovationThe University of Texas M.D. Anderson Cancer CenterMid Campus Building 1MC7007 Bertner AvenueHouston, Texas 77054 Julai Whipple, BAInnovation Designer, InnovationThe University of Texas M.D. Anderson Cancer CenterMid Campus Building 1MC7007 Bertner AvenueHouston, Texas 77054 Wendi L. Martinez, ADN, BSN, RNDir QA & Perf Improvement, Inst Cancer Care InnovationThe University of Texas M.D. Anderson Cancer CenterMid Campus Building 1MC7007 Bertner AvenueHouston, Texas 77054 Jarod EskaInst Cancer Care InnovationThe University of Texas M.D. Anderson Cancer CenterMid Campus Building 1MC7007 Bertner AvenueHouston, Texas 77054 Elizabeth W. Sutherland, MPASPhysician Asst, Surgical OncologyThe University of Texas M.D. Anderson Cancer CenterT. Boone Pickens Academic Tower1400 Pressler St.Houston, Texas 77030 Lisa L. Triche, DNP, MS, RNAdvanced Prac Registered Nurse, Pediatrics - Patient CareThe University of Texas M.D. Anderson Cancer CenterAnderson East1515 Holcombe BlvdHouston, Texas 77054Elizabeth A. Garcia, BSN, MPA, RNAssoc VP, Patient Experience, Ofc of Chief Operating OfficerThe University of Texas M.D. Anderson Cancer Center1515 Holcombe BlvdUnit 1485Houston, Texas 77030Corresponding Author:Randal Weber, MD Chief Patient Experience Ofc, Chief Patient Experience OfficerThe University of Texas M.D. Anderson Cancer CenterT. Boone Pickens Academic Tower1400 Pressler StHouston, Texas 77030
Revealing past and future land-cover transitions from 1985 to 2036 in the drylands of...
Bibizahra Mazloum
Saied Pourmanafi

Bibizahra Mazloum

and 4 more

April 29, 2020
Land serves as a vital production resource, and therefore, land planning plays an important role in sustainable land-use design. Increasing the global population alters landscapes via land-use and land-cover change across different landscapes, including the drylands. Iran includes large areas of dryland, where the population increased by 60% from 1985 to 2016. Further population increase in Iran would require more land resources to be allocated for human needs. However, the pace and patterns of these changes remain unclear. The aim of this study was to map land-cover change from 1985 to 2016 and predict future land-cover change in the Zayandehrood ecologic sub-basins of Central Iran. By using multiseasonal Landsat imagery, nine thematic classes were mapped with a random forest classifier for 1985, 1998, and 2016 with an overall accuracy of 80% for each period. Classification results revealed that from 1985 to 2016 residential areas doubled and industrial areas increased at the expense of rangelands. Our study also revealed cropland expansion at the expense of rangelands, cropland abandonment and contraction of croplands due to residential and industrial development. Prediction of changes by 2036 with a multi-layer perceptron neural network and Markov chain analysis revealed further expansion of industries and residencies particularly nearby the protected areas such as Ghamashlu Wildlife Refuge. Predicted contraction of some degraded agricultural lands and concomitant agricultural expansion in the agricultural frontier by 2036, underscore the importance of sustainable land management in highly arid areas of Iran and improvement of the strategies for the protection of rangelands.
Impact of the COVID-19 outbreak on routine obstetrical management: a cohort study
Raanan Meyer
Gabriel Levin

Raanan Meyer

and 3 more

April 29, 2020
Objectives: our department was the first in Israel to construct a separate, designated complex for its COVID-19-exposed patients. We aimed to evaluate the effect of the COVID-19 pandemic infection control measures on obstetrical care in the emergency department and delivery unit. Design: cohort study. Setting: tertiary medical center. Population: pregnant women attending the obstetrical emergency department (ED). Methods: February-March 2020 data were collected and compared to a parallel period in 2019. Main outcome measure: rate of referrals, deliveries, mode of delivery, neonatal outcomes. Results: During February-March 2020, 3,897 women were referred to the ED, compared to 4,067 in the previous year. Mean duration of treatment until decision and referral indications did not differ between 2020 and 2019 (207 vs. 220 minutes, p=0.26; urgent referrals: 58.8% vs. 59.2%, p=0.83). Per-week comparison showed a significant reduction in ED referrals only in the last week of the period [337 (2020) vs. 515 (2019), p<0.001]. The proportion of women admitted to the delivery unit in active labor was higher in the last three weeks (39.1% vs. 28.2%, p=0.005), and the rate of discharge was inversely correlated (45.8% vs. 56.7%, p=0.01). Deliveries number and proportions of spontaneous onset of labor, trials of labor, preterm delivery, post-term deliveries, operative vaginal and cesarean deliveries did not differ between February-March of 2020 and 2019. In the per-week comparison, the number of deliveries did not differ between the periods. Conclusion: With timely preparation and proper management, high-level routine obstetrical care during the COVID-19 outbreak can be maintained.
Butterfly-plant interaction – a dicey ménage à trois?
Mareike Jezek

Mareike Jezek

April 29, 2020
Commentary based on Paniagua Voirol et al. (2020) Plant responses to insect eggs are not induced by egg-associated microbes, but by a secretion attached to the eggs
A case of early neonate tuberculosis in a three weeks old calf in Ethiopia
Getnet Mekonnen
Balako Gumi

Getnet Mekonnen

and 6 more

April 29, 2020
Bovine tuberculosis is a chronic disease rarely observed in an early age. Our observation of tubercle lesions in the lungs of a three week old calf and confirmation of Mycobacterium bovis strains illustrate that the progression of tuberculosis in neonates can be rapid under natural conditions, contributing to transmission within-herds.
Anticancer drugs and COVID-19 antiviral treatments in cancer patients: what can we sa...
Paul Gougis
Charlotte Fenioux

Paul Gougis

and 6 more

April 29, 2020
To the editor,The rapid emergence of COVID-19 pandemics worldwide is of particular concern for fragile populations who are more at risk of acute respiratory distress syndrome and death. Patients treated for malignant hemopathy and solid cancers have a four times higher risk of hospitalization due to influenza infection, and a ten times higher risk of death. This fragility could be due to their age, multiple associated comorbidities, lymphopenia, or the immunosuppressive action of a broad spectrum of anticancer drugs.[1] Therefore, anticancer drugs should be used carefully in this population. Without further safety data, it might be unsafe to treat SARS-CoV-2 positive patients who have COVID-19 symptoms with anticancer drugs known to increase infections or harvesting immunosuppressive properties. We summarized in the table (part A) drug classes that have been reported to increase either neutropenia or infections. Regarding patients tested positive who have recovered from their symptoms, clinical data is missing. It is currently not clear if cancer treatments should be stopped, and if so, the time needed to resume it safely.In any of these settings, clinical trials and incoming standard of care could lead to the prescription of antiviral drugs concomitant to non-immunosuppressive anticancer treatments. Similar to previous works reporting interactions between HIV antiretrovirals and anticancer drugs,[2] these two classes of medications have a narrow therapeutic index and can have pharmacological interactions. Some of them are substrates or interact with hepatic cytochrome P450 cytochrome isoenzymes (CYP), particularly CYP3A4, and pharmacokinetic interactions could lead to supra or infratherapeutic concentrations. For example, enzalutamide, a nonsteroidal antiandrogen prescribed for prostate cancer, is both a CYP3A4 substrate and inducer. Ritonavir, on the other hand, is a pharmacokinetic booster of lopinavir contained in Kaletra, which is explored as a COVID-19 treatment. Ritonavir is a substrate and also a potent inhibitor of CYP3A4. Thus, enzalutamide and ritonavir could interfere with each other’s metabolism, decrease or increase each other’s clearance, and be responsible for severe toxicities or decreased efficacy. Favipiravir, an anti-EBOV drug, also a candidate for the COVID-19 treatment, is an inhibitor of CYP2C8,[3] and therefore may increase anticancer drug metabolized through this pathway, such as dabrafenib and enzalutamide. Furthermore, CYP3A4 induction could lead to sustained CYP3A4 increased activity for up to 1 week after discontinuation. Dabrafenib or enzalutamide, two CYP3A4 inducers, could significantly decrease hydroxychloroquine concentration during the first week of wash-out.Among pharmacodynamic interactions, QT interval prolongation could be of particular interest. Hydroxychloroquine, which is currently widely prescribed as an anti-coronavirus drug, or azithromycin, are two drugs known to prolong QT interval. Concomitant use of QT-prolonging anticancer drugs could lead to Torsade-de-Pointes and be fatal. Caution should be observed in this case, and electrocardiographic monitoring should be implemented to monitor QT interval duration during combination therapy.Similarly, anticancer drugs could potentiate nephrotoxicity and hepatotoxicity of antiviral treatments.The table (part B) summarizes pharmacokinetic and pharmacodynamics interactions between some currently tested drugs against COVID-19 and anticancer drugs.
Is Inhaled Furosemide A Potential Therapeutic For COVID-19?
Anja Brennecke
Laura Villar

Anja Brennecke

and 7 more

May 04, 2020
The potentially lethal COVID-19 infection caused by the novel Severe Acute Respiratory Disease Coronavirus-2 (SARS-CoV-2) has evolved into a global crisis. There are two major processes that lead to the morbidity and mortality of this disease: initially the viral infection, followed by a host inflammatory response that frequently results in excessive secretion of inflammatory cytokines (e.g. IL-6, IL-8, IL-10, TNFα), developing into a self-targeting toxic “cytokine storm” in which the lungs fill with inflammatory secretions causing critical pulmonary tissue damage. Even though the search for a vaccine and anti-viral agents has already been initiated, the de novo development of a safe, COVID-19 specific solution may take years; regrettably, the need for a therapeutic that is available immediately is growing daily. Therefore, repurposing an already approved drug offers a promising approach to address this urgent need. A truly effective therapeutic, however, should be available not only for the single individual in a developed country, but also for the many people in developing countries. As presented in this review, inhaled furosemide, a small molecule capable of inhibiting IL-6, IL-8 and TNFα within the lung, may be an agent capable of treating the COVID-19 cytokine storm in both resource-rich and developing countries. Furosemide is a “repurpose-able” small molecule therapeutic, that is safe, easily synthesized, handled and stored, and is available in reasonable quantities worldwide.
Relationship between electrical gap after Maze procedure and atrial arrhythmia and ab...
Keisuke Suzuki
Koji Miyamoto

Keisuke Suzuki

and 17 more

April 29, 2020
Introduction: There are few reports of the characteristics, mechanisms, and outcomes of atrial tachycardia (AT) and atrial fibrillation (AF) ablation after cardiac surgery and concomitant Maze procedures. This study investigated the mechanisms and long-term outcomes of AT and AF ablation after various Maze procedures, especially we examined in detail whether the arrhythmia after Maze procedure was due to gap or not. Methods and Results: We analyzed 37 consecutive cases with AT and AF after cardiac surgery and Maze procedure between 2007 and 2019. Fifty-nine atrial arrythmias were induced in 37 consecutive cases, and 49 of those atrial arrythmias were mappable ATs. Forty-two ATs was related to the Maze procedure in the 49 mappable ATs (87.5%). All 37 consecutive cases had residual electrical conductions (gaps) in the Maze lines (88 gaps; 2.4±1.2 gaps/patient). Forty-two of 88 gaps (47.7%) were associated with gap-related ATs. The most common gap-related ATs in this study were peri-mitral atrial flutter in 22 cases. The median follow-up period after ablation was 3.6±3.2 years (median, 2.1 years; interquartile range, 0.89-6.84). The Kaplan-Meier analysis of freedom from recurrent atrial arrhythmia after Maze procedure was 79.9% at 1-year follow up and 69.3% at 4-year follow up. Conclusions: Reentry was the main mechanism of AT after cardiac surgery and concomitant various Maze procedures, and AT were largely related to the gap in the Maze line between mitral valve anulus and pulmonary vein isolation line. Catheter ablation of AT after various Maze procedures seemed to be effective and safe during long-term follow-up.
Soil Environmental Quality in Nan Ling Commodity Grain Base based on Radar Chart
Hai Biao Dong
Guang Hui Zhang

Hai Biao Dong

and 3 more

April 29, 2020
Nan Ling commodity grain base is a national high-standard farmland demonstration area. Scientific evaluation of soil environmental quality is of important significance to plan land resources rationally to improve the quality and efficiency of agricultural production. This paper try to apply the Radar Chart–a visual graphic data analysis method–to the assessment of soil environmental quality. In the assessment, a new idea was introduced that area and perimeter of radar chart represents the soil environmental quality and the difference between the qualities of the soil environmental quality indicators respectively. Different from the other assessment methods,the Radar Chart method transforms data into graphics and through an intensive analysis of graphics, the data information can be retained and excavated more fully. It was proved through this case study that the application of Radar Chart method to the assessment of soil environmental quality is feasible and it is more intuitive, efficient, comprehensive and fine. The results indicated that the soil environmental quality at depth of 0-60cm in low mountain area of Nan ling commodity grain base is the second grade while that in the hilly and plain area are both the first grade. The indicators of poor soil environmental quality in low mountain area are Cd and As, those in hilly area are Cd、As and Hg, and that in plain area is Cd; The difference between the qualities of the soil environmental indicators in low mountain area is more significant than that in hilly area and plain area.
Weed management for the land-scape scale restoration of global temperate grasslands:...
Talia Humphries
Singarayer Florentine

Talia Humphries

and 4 more

April 29, 2020
Globally, temperate grasslands have been significantly altered and subsequently degraded as a result of increased human population, urbanisation, and agriculture. Weeds now dominate most of these ecosystems, resulting in the loss of ecosystem services, reduced carrying capacity for farmers, and loss of habitat for native animals. This paper reviews the literature of temperate grassland restoration efforts from across the globe, and observes what techniques and combinations have been used successfully and unsuccessfully to reduce weed dominance and promote native recruitment and establishment. The findings of this review clarify that weed management should be ongoing in all projects, while optimal revegetation methods and grazing regimes are specific to site location and study scope. There is a need for an increase in long-term monitoring of restoration projects in order to make assumptions with greater confidence.
C4 grasses adapted to low precipitation habitats show traits related to greater mesop...
VARSHA S PATHARE
Balasaheb Vitthal Sonawane

VARSHA PATHARE

and 3 more

April 29, 2020
In habitats with low water availability, a fundamental challenge for plants will be to maximize photosynthetic C-gain whilst minimizing transpirational water-loss. This tradeoff between C-gain and water-loss can in part be achieved through the coordination of leaf-level photosynthetic and hydraulic traits. To test the relationship of photosynthetic C-gain and transpirational water-loss we grew under common growth conditions 18 C4 grasses adapted to habitats with different mean annual precipitation (MAP) and measured leaf-level structural and anatomical traits associated with mesophyll conductance (gm) and leaf hydraulic conductance (Kleaf). The C4 grasses adapted to lower MAP showed greater mesophyll surface area exposed to intercellular air spaces (Smes) and adaxial stomatal density (SDada) which supported greater gm. These grasses also showed greater leaf thickness and vein-to-epidermis distance which may lead to lower Kleaf. Collectively, these leaf traits associated with gm and Kleaf scaled positively with photosynthetic rates (Anet) and leaf-level water-use efficiency (WUE) with low MAP adapted grasses exhibiting greater Anet and WUE. In summary, we identify a suite of leaf-level traits that appear important for adaptation of C4 grasses to habitats with low MAP and may be useful to identify C4 species showing greater Anet and WUE in drier conditions.
Pharmacokinetic considerations on the repurposing of ivermectin for treatment of COVI...
Ricardo Pena Silva
Stephen Duffull

Ricardo Pena Silva

and 5 more

April 29, 2020
Hundreds of researchers are working to develop a vaccine and are evaluating drugs to mitigate the adverse health and economic consequences of COVID-19 (Coronavirus disease 19) worldwide. If novel compounds are found, geopolitical and economic variables will determine their introduction to communities. Therefore, finding low-cost and widely accessible drugs for prevention or treatment of COVID-19 would be ideal.A recent study found that ivermectin, an FDA-approved anti-parasitic drug, has inhibitory effects on replication of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)1. Ivermectin has broad anti-viral activity through inhibition of viral proteins including importin α/β1 heterodimer and integrase protein2. Caly and colleagues reported that the addition of ivermectin at a concentration of 5 micromolar (μM) (twice the reported IC50) to Vero-hSLAM cells, 2 hours post infection with SARS-CoV-2, resulted in a reduction in the viral RNA load by 99.98% at 48 hours1. The authors suggested that this drug could reduce the viral load in infected patients, with potential effect on disease progression and spread.While the findings by Caly and colleagues provide some promise, there is no evidence that the 5 μM concentration of ivermectin used by Caly and colleagues in their in vitro SARS-CoV-2 experiment, can be achieved in vivo . The pharmacokinetics of ivermectin in humans is well described (Figure 1)3-5, and even with the highest reported dose of approximately 1700 µg/kg (i.e. 8.5 times the FDA-approved dose of 200 μg/kg), the maximum plasma concentration was only 0.28 µM5. This is 18 times lower than the concentration required to reduce viral replication of SARS-CoV-2in vitro . Ivermectin accumulation in tissues is mild and would not be sufficient to achieve the antiviral effect with conventional doses6. Although high doses of ivermectin in adults or children are well tolerated5,7, the clinical effects of ivermectin at a concentration of 5 μM range are unknown and may be associated with toxicity. Consequently, ivermectin has in vitroactivity against SARS-CoV-2 but this effect is unlikely to be observedin vivo using current dosing.Amidst fear of the pandemic, the public and some physicians are now using ivermectin off-label for prophylaxis or as adjuvant therapy for COVID-19. Because ivermectin is only commercially available as a 3 or 6 mg tablets or a 6 mg/ml oral suspension, in order to administer a high dose, some people may experiment with more concentrated veterinary formulations. These actions are not based on clinical trials and have motivated cautionary statements from institutions such as the FDA against the use of pharmaceutical formulations of ivermectin intended for animals as therapeutics in humans 8.Potential avenues for further investigation into repurposing ivermectin for SARS-CoV-2 may be to: (i) develop an inhaled formulation to efficiently deliver a high local concentration in the lung, whilst minimizing systemic exposure; and (ii) evaluate more potent ivermectin analogs (e.g. doramectin) which may also inhibit SARS-CoV-2. These are areas for research – clearly, further studies are needed before ivermectin can be used for the prevention and treatment of COVID-19. As recently discussed in BJCP, this highlights the critical need to consider pharmacological principles to guide in vitro testing when repurposing old drugs for therapeutic use against COVID-199.
Analysis of Urgent Neurologic In-Hospital Consultations in A Large Tertiary Hospital...
Jiafang Wang
Ming Ren

Jiafang Wang

and 2 more

April 29, 2020
Objectives: To analyze the current condition of the urgent neurologic in-hospital consultations, which may help junior doctors to manage diseases related to neurology and carry out emergency consultation. Methods: We conducted a retrospective study of urgent neurologic in-hospital consultations in a large tertiary hospital for four consecutive years (Jan 1, 2014 to Dec 31, 2017). Through the electronic medical record system, the clinical data of patients who received in-patient consultation in emergency neurology department were reviewed and analyzed. Results: A total of 1,437 cases (age range 9 to 103 years old with average age 60.3-year old, Male 54.6%) were included in the study, 57.5% of cases met the urgent consultation criteria. The departments applying for urgent consultation involved 29 clinical departments. The most common reasons of urgent consultation were disturbance of consciousness (36.0%), tic/stiffness (13.6%), limb weakness (8%) and mental disorders (5.6%).Urgent consultation diseases were divided into three categories: neurological diseases (77.8%), non-neurological diseases (10.4%), and unknown diseases (11.8%).Common neurological disorders were urgent cerebrovascular disease (33.6%), epilepsy/status epilepticus (15.8%), and metabolic or infection, toxic encephalopathy (14.9%). Conclusions: Most cases of the urgent neurologic consultation met the urgent neurologic consultation criteria. Non-neurologic junior physicians should clinically enrich their knowledge of neurological diseases.
Clinical pharmacology aspects in patients treated with TNF inhibitors during SARS-Cov...
Antonio Vitiello
Chiara Pelliccia

Antonio Vitiello

and 3 more

April 29, 2020
In this period of global pandemic caused by SARS-Cov-2, it is of paramount importance to recognize all risk factors that may increase the likelihood of infection. In addition to the risk factors known as pre-existing diseases and old age, risk factors could be drug treatments for chronic diseases, such as immunomodulating drugs that can alter immune defences and response to infectious agents. Antibodies that inhibit tumor necrosis factor (TNF) such as adalimumab infliximab etanercept and golimumab have been used for over 20 years in severe cases of autoimmune diseases such as rheumatoid arthritis, inflammatory bowel disease or ankylosing spondylitis. Due to their mechanism of action they reduce inflammation and can stop the progression of the disease by inhibiting a key factor of inflammation such as Tumor Necrosis Factor (TNF). In this article we want to examine the possible correlation between therapy with TNF inhibitors and the increased risk of SARS-CoV-2 infection, and the possible paradoxical therapeutic efficacy in patients with ongoing infection, especially in phase two and three. We express our opinion on this very complex and sensitive topic which is the subject of discussion among physicians and experts, based on current knowledge of the literature. Keywords: TNF inhibitors, SARS-Cov-2, immunomodulating, infection, hyperinflammatory
An Update on Novel COVID-19  Pandemic; A  Battle between Humans and Virus
Suneel Prajapati

Suneel Prajapati

and 4 more

April 29, 2020
In the 21st century, human civilization, has witnessed three major epidemics caused by Coronaviruses namely severe acute respiratory syndrome coronavirus (SARS‑CoV) in 2003, Middle East respiratory syndrome coronavirus (MERS‑CoV) in 2012 and 2019‑novel coronavirus (2019‑nCoV) or coronavirus disease (COVID‑19) in 2019. Among these, COVID-19 has greater transmission and mortality rate.  2019‑nCoV belongs to a large family of positive sense single-stranded RNA viruses (+ssRNA) that can be isolated in different animal species. The most communal symptoms of COVID-19 include fever, cough, and shortness of breath during the incubation period (2-14 days) of infection. COVID-19 transmission is occurring from infected humans to close contact with one another through respiratory droplets, coughs, and sneezes of infected person. Moreover, the virus containing surfaces may also transmit the infection. Diagnosis is being carried out by collecting a nasopharyngeal swab or sputum specimen for detection of SARS-CoV-2 RNA by reverse-transcription polymerase chain reaction (RT-PCR). Rapid diagnosing methods are also under development which can diagnose COVID 19 in few minutes to hours. Currently, there is no specific cure or preventive therapeutics available. Hence, based upon limited in-vitro and anecdotal data, Chloroquine, or Hydroxychloroquine, Remdesivir, Lopinavir and Ritonavir are being employed in the management. Search for new specific anti-viral drugs from natural/synthetic origins is under full swing and many of them are currently used as chemotherapeutic drugs under clinical investigation. Yet, there is a strong need for development of vaccine, which may take several months to few years for the development.
Recent insights for the emerging COVID-19: drug discovery, therapeutic options and va...
Yuefei Zhu
Jia Li

Yuefei Zhu

and 2 more

April 29, 2020
SARS-CoV-2 has been marked as a highly pathogenic coronavirus of COVID-19 disease into the human population, causing over 2.8 million confirmed cases worldwide. As COVID-19 has posed a global threat with significant human casualties and severe economic losses, there is a pressing demand to further understand the current situation and develop rational strategies to contain the drastic spread of the virus. Although there are no specific antiviral therapies that have proven effective in randomized clinical trials, currently, the rapid detection technology along with several promising therapeutics for COVID-19 have mitigated its drastic transmission. Besides, global institutions and corporations have commenced to parse out effective vaccines for the prevention of COVID-19. Herein, the present review will give exhaustive details of extensive researches concerning the drug discovery and therapeutic options for COVID-19 as well as some insightful discussions of the status of COVID-19.
Exploration of novel heterofused 1,2,4-triazine derivatives in colorectal cancer
Justyna  Hermanowicz
Anna Szymanowska

Justyna Hermanowicz

and 11 more

April 29, 2020
Experimental Approach: Colorectal cancer (CRC) is the third leading cause of cancer-related deaths in men and in women. It’s expected to cause about 53,200 deaths during 2020. An effective drug for therapy and prognosis after surgery still does not exist. Therefore, the search for new lead structures and chemical entities for the development of new effective anticancer agents is an increasingly important task in medicinal chemistry. This trend of global research includes work on the use of 1,2,4-triazine scaffold as a source for the design of biologically relevant molecules with well-known broad biological applications. A series of new pyrazolo[4,3-e]tetrazolo[4,5-b][1,2,4]triazine sulfonamides were designed, synthesized, and assessed as anticancer activity agents. Experimental Approach: The impact of two selected compounds, MM-128, and MM-129 (MMs), were evaluated against human colon cancer in in vitro and in zebrafish embryo xenograft model. Key Results: Our results show that the new synthesized compounds effectively inhibit cell survival and DNA synthesis in both DLD-1 and HT-29 cell lines. Their effectiveness is much higher as compared with the standard chemotherapy used for colorectal cancer, i.e. 5-fluorouracil. Flow cytometry analysis after annexin V-FITC and propidium iodide staining revealed that apoptosis was the main response of colorectal cancer cells to MMs treatment. We also found that MM-129 effectively inhibits tumor development in both DLD-1 and HT-29 zebrafish xenografts. Conclusion and Implications: New pyrazolo[4,3-e]tetrazolo[4,5-b][1,2,4]triazine sulfonamides may be new candidates for further evaluation as chemotherapeutic agents against colorectal cancer.
ANTI-MÜLLERIAN HORMONE LEVELS AS A PREDICTOR OF FEMALE GENERAL HEALTH STATUS: A CROSS...
Antonio Quartucci
Enrico Papaleo

Antonio Quartucci

and 11 more

April 29, 2020
Objective: To assess the correlations between clinical and hormonal parameters and comorbidity burden in Caucasian women presenting for fertility treatment. Design: Cross-sectional study. Setting: Single academic reproductive medicine center. Patient: Cohort of 3163 single-ethnicity women seeking medical help for fertility treatment, who underwent centralized lab testing for fertility-related hormonal assessment. Intervention: Complete clinical and laboratory data from the entire cohort of patients were retrospectively analysed. Main outcome measures: Assessment of i) the comorbidity burden scored via the Charlson Comorbidity Index (CCI; categorized as 0 vs. 1 vs. >2); and, ii) the potential associations between CCI and clinical and hormonal parameters. Results: Descriptive statistics and regression models tested the associations between clinical and laboratory parameters and CCI. Of 3163, CCI=0, CCI=1 and CCI>2 were found in 2977 (94.1%), 113 (3.6%) and 73 (2.3%) patients, respectively. Age, gravidity, Anti-Müllerian hormone (AMH) and thyroid stimulating hormone (TSH) values were found to be significantly different among CCI groups (all p≤ 0.01). At regression models, age at presentation and AMH emerged as independent predictors of CCI>1. Age at presentation <36 years (OR=1.742, 95% CI [1.284; 2.364]) and an AMH level <2.3 ng/ml (OR=1.864, 95% CI [1.29; 2.69]) were the most informative cutoff values for CCI >1. Conclusions: A younger age at presentation and lower AMH levels are significant predictors of decreased general health in women requiring clinical evaluation for fertility treatment. As observed for sperm parameters in men, AMH might serve as a proxy of women’s general health status. Key words: AMH, comorbidities, health, infertility
Constitutive androstane receptor promoted- hepatomegaly and liver regeneration is par...
Huichang BI
Yue Gao

Huichang BI

and 11 more

April 29, 2020
Background & Purpose: The constitutive androstane receptor (CAR) belongs to nuclear receptor superfamily. The administration of CAR agonist TCPOBOP to mice leads to hepatomegaly but the mechanism is unclear. Yes-associated protein (YAP) is a downstream factor of Hippo signaling pathway, which is a potent regulator of organ size and tissue homeostasis. This study examined the role of YAP in CAR-promoted hepatomegaly and liver regeneration. Experimental Approach: The effect of CAR on liver enlargement and liver regeneration was evaluated in wild-type (WT) mice, liver-specific YAP-deficient mice, and partial hepatectomy (PHx) mice. KI67 and CTNNB1 staining were performed to evaluate the proliferation response and hepatocytes size. The protein levels of YAP and its downstream targets were measured and Co-IP was conducted to explore the protein-protein interaction between CAR and YAP. Key Results: The results suggested TCPOBOP increases the liver/body weight ratio in WT mice and PHx mice. Hepatocytes enlargement occurred around the central vein area, while the number of KI67+ cells increased around portal vein area. The translocation of YAP was induced and its downstream targets were upregulated after CAR activation via TCPOBOP. Co-IP results revealed a potential protein-protein interaction between CAR and YAP. However, CAR-induced hepatomegaly was still observed in Yap-/- mice. Conclusion and Implications: CAR activation promotes hepatomegaly and liver regeneration in part by inducing nuclear translocation of YAP and interaction with YAP pathway, which provides new insights for understanding the physiological functions of CAR, and suggests the potential for manipulation of liver size.
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