[Comment] The place for remdesivir in COVID-19 treatment

alkiviadis.1961 shared this article with you from Inoreader [Comment] The place for remdesivir in COVID-19 treatment Via The Lancet Infectious Diseases Finding antivirals that reduce mortality from severe respiratory viral infections has proven challenging. Phase 3 trials of baloxavir and pimodivir for severe influenza were unsuccessful (NCT03684044 and NCT03376321). Lopinavir–ritonavir and hydroxychloroquine are not efficacious in treating COVID-19.1,2 Interim results from the WHO-led, open-label, randomised SOLIDARITY trial3 of patients with COVID-19 report that 301 (11·0%) of 2743 patients analysed who received remdesivir and 303 (11·2%) of 2708 patients analysed who received standard care died by day 28 (Kaplan-Meier rate ratio [RR] 0·95, 95% CI 0·81–1·11; p=0·50). View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Economic Evaluation of Suture Versus Clip Anastomosis in Arteriovenous Fistula Creation

alkiviadis.1961 shared this article with you from Inoreader Economic Evaluation of Suture Versus Clip Anastomosis in Arteriovenous Fistula Creation Via Journal of Vascular Surgery Techniques like the use of nonpenetrating vascular clips for arteriovenous fistula (AVF) anastomotic creation have been developed in an effort to reduce fistula-related complications. However, the outcome data for the use of clips remains equivocal, while cost evaluations to support their use have been largely theoretical. Therefore, this study aimed to determine both the clinical and cost outcomes of AVFs created with nonpenetrating vascular clips compared to continuous suture technique over a 10-year period at a single institution. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Professionals guidance about palliative medicine in chronic heart failure: a mixed-method study

alkiviadis.1961 shared this article with you from Inoreader Professionals guidance about palliative medicine in chronic heart failure: a mixed-method study Via Online First Introduction Healthcare professionals (HCPs) experience difficulties in timely recognising and directing palliative care (PC) needs of their patients with chronic heart failure (CHF). The aim of this study was to develop a comprehensive tool to enable HCPs in timely recognising and directing PC needs in CHF. Methods A four-stage mixed-method study was performed. Stage 1: identification of needs and questions of patients and families; stage 2: prioritisation and refinement of the needs and questions; stage 3a: t esting and online feedback on V.1; stage 3b: selecting and refining care recommendations; stage 4: testing and review of V.2. Iterative reviews followed each step in the development process to ensure a wide range of stakeholder input. In total, 16 patients, 12 family members and 54 HCPs participated. Results A comprehensive set of 13 PC needs was identified, redefined and tested. The resulting tool, called Identification of patients with HeARt failure with PC needs (I-HARP), contains an introduction prompt with open questions to start the conversation, 13 closed screening questions with additional in-depth questions, and recommendations on actions for identified needs. Conclusion I-HARP contains an evidence-based set of questions and palliative CHF care suggestions for HCPs in the Netherlands. The resulting tool, approved by HCPs, patients and family members, is a promising guidance for HCP to timely recognise and direct PC needs in CHF. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Hospital end-of-life care: families free-text notes

alkiviadis.1961 shared this article with you from Inoreader Hospital end-of-life care: families free-text notes Via Online First Background Palliative care strives to improve quality of life for patients with incurable diseases. This approach includes adequate support of the patients' loved ones. Consequently, loved ones have personal experiences of providing end-of-life care for their next. This is a resource for information and may help to investigate the loved ones' perspectives on need for improvements. Aim To identify further quality aspects considered important by loved ones to improve the quality of care at the end of life as an addition to quantitative results from the Care of the Dying Evaluation for the German-speaking area (CODE-GER) questionnaire. Design Within the validation study of the questionnaire 'Care of the Dying Evaluation' (CODETM) GER, loved ones were asked to comment (free text) in parallel on each item of the CODE-GER. These free-text notes were analysed with the qualitative content analysis method by Philipp Mayring. Setting/participants Loved ones of patients (n=237), who had died an expected death in two university hospitals (palliative and non-palliative care units) during the period from April 2016 to March 2017. Results 993 relevant paragraphs were extracted out of 1261 free-text notes. For loved ones, important aspects of quality of care are information/communication, respect of the patient's and/or loved one's will, involvement in decision-making at the end of life (patient's volition) and having the possibility to say goodbye. Conclusions It is imp ortant for loved ones to be taken seriously in their sorrows, to be informed, that the caregivers respect the patients' will and to be emotionally supported. Trial registration number This study was registered at the German Clinical Trials Register (DRKS00013916). View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Allocation of funding into blast injury-related research and blast traumatic brain injury between 2000 and 2019: analysis of global investments from public and philanthropic funders

alkiviadis.1961 shared this article with you from Inoreader Allocation of funding into blast injury-related research and blast traumatic brain injury between 2000 and 2019: analysis of global investments from public and philanthropic funders Via Journal of the Royal Army Medical Corps Online First Introduction There is little systematic tracking or detailed analysis of investments in research and development for blast injury to support decision-making around research future funding. Methods This study examined global investments into blast injury-related research from public and philanthropic funders across 2000–2019. Research databases were searched using keywords, and open data were extracted from funder websites. Data collected included study title, abstract, award amount, funder and year. Indi vidual awards were categorised to compare amounts invested into different blast injuries, the scientific approaches taken and analysis of research investment into blast traumatic brain injury (TBI). Results A total of 806 awards were identified into blast injury-related research globally, equating to US$902.1 million (m, £565.9m GBP). There was a general increase in year-on-year investment between 2003 and 2009 followed by a consistent decline in annual funding since 2010. Pre-clinical research received $671.3 m (74.4%) of investment. Brain-related injury research received $427.7 m (47.4%), orthopaedic injury $138.6 m (15.4%), eye injury $63.7 m (7.0%) and ear injury $60.5m (6.7%). Blast TBI research received a total investment of $384.3 m, representing 42.6% of all blast injury-related research. The U.S. Department of Defense funded $719.3 m (80%). Conclusions Investment data suggest that blast TBI research has received greater funding than other blast injury health area s. The funding pattern observed can be seen as reactive, driven by the response to the War on Terror, the rising profile of blast TBI and congressionally mandated research. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Evaluation of glucose-6-phosphate dehydrogenase (G6PD) status in US military and VA patients with COVID-19 infection

alkiviadis.1961 shared this article with you from Inoreader Evaluation of glucose-6-phosphate dehydrogenase (G6PD) status in US military and VA patients with COVID-19 infection Via Journal of the Royal Army Medical Corps Online First View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Release of Mafia-crime prisoners during the COVID-19 epidemic: imbalance between detainees health and public safety

alkiviadis.1961 shared this article with you from Inoreader Release of Mafia-crime prisoners during the COVID-19 epidemic: imbalance between detainees health and public safety Via Journal of the Royal Army Medical Corps Online First View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Accidental sulfur mustard exposure from explosive ordnance in a UK military service person

alkiviadis.1961 shared this article with you from Inoreader Accidental sulfur mustard exposure from explosive ordnance in a UK military service person Via Journal of the Royal Army Medical Corps Online First Chemical warfare presents a continuing threat to military personnel as a result of both direct hostile action and the indirect exposure to chemical weapons that remain as a legacy from previous conflicts. This paper will discuss the presentation and medical management of an indirect exposure to sulfur mustard in a UK military service person. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Unusual presentations of cutaneous larva migrans in British military personnel

alkiviadis.1961 shared this article with you from Inoreader Unusual presentations of cutaneous larva migrans in British military personnel Via Journal of the Royal Army Medical Corps Online First Cutaneous larva migrans (CLM) is one of numerous skin diseases that occur in British military personnel on deployments to the tropics and sub-tropics. It is typically managed by military primary healthcare services, but diagnostic uncertainty or unavailability of anti-helminthic medication may prompt referral to UK Role 4 healthcare services. Cases of CLM seen at the UK Role 4 Military Infectious Diseases & Tropical Medicine Service from 2005 to 2020 were identified and their case notes were reviewed to identify learning and discussion points. There were 12 cases identified, of which five came from Brunei and three were from Belize. Causes for referral were due to diagnostic uncertainty (58%) and the unavailability of anti-helminthic medication (42%). Several cases had CLM in an unusual distribution due to specific military activities performed in endemic areas. Telemedicine was very useful in making some of the diagnoses in theatre and avoiding the need for medical evacuation. Military personnel may have unusual presentations of CLM due their unique military activities. In areas that are endemic for CLM, clinicians should maintain high clinical suspicion for CLM, carry appropriate anti-helminthic medications and consider screening cases of CLM and their colleagues for other infections with similar aetiology (eg, human hookworm infection and strongyloidiasis). View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sex-Related Differences in Anxious-Depressive and Defensive Behavior in Wistar Rats

alkiviadis.1961 shared this article with you from Inoreader Sex-Related Differences in Anxious-Depressive and Defensive Behavior in Wistar Rats Via Latest Results for Neuroscience and Behavioral Physiology Sex-related differences in the behavior of animals in aversive situations were identified by comparing male and female Wistar rats in tests for anxiety, depression-like behavior, assessments of the dynamics of the acquisition and extinction of a classical defensive reflex and a passive avoidance reflex, and also acquisition of an active avoidance reflex. In tests for anxiety, females differed from males in having lower levels of anxiety and greater movement and exploratory activity. In the Porsolt test, females showed less extensive signs of depression-like behavior. After stress, the blood corticosterone content in females was greater than that in males. Females showed higher pain sensitivity. Conditioned reflex fear in the passive avoidance reflex was greater in males than females; ther e was no difference in animals of different sexes in the classical defensive reflex. Extinction of conditioned reflex fear in these two types of reflex occurred more quickly in females than males. Acquisition of the active avoidance reflex was easier in females than males. It is suggested that females are more inclined to the active defensive strategy and to overestimate danger, while males, conversely, prefer passive defensive responses. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Microelectrophysiological Studies of the Ratio of Excitatory to Inhibitory Synaptic Processes in the Corticonigral Projection in a Model of Parkinson’s

alkiviadis.1961 shared this article with you from Inoreader Microelectrophysiological Studies of the Ratio of Excitatory to Inhibitory Synaptic Processes in the Corticonigral Projection in a Model of Parkinson's Via Latest Results for Neuroscience and Behavioral Physiology Experiments on 23 white male rats (250 g) analyzed the spike activity of individual neurons in the substantia nigra pars compacta (SNc, 242 neurons, n = 11) and substantia nigra pars reticulata (SNr, 289 neurons, n = 12) during high-frequency stimulation of the primary motor cortex (M1)in normal animals and in animals with a rotenone model of Parkinson's disease (BP). SNc neurons in the model of PD showed a complete absence of depressor effects induced by stimulation, though tetanic potentiation was accompanied by posttetanic potentiation and depression at levels 1.65 and 2.02 times greater than in normal animals. In SNr neurons in normal animals, tetanic potentiation, accompanied by post-tetanic potentiation and depression, was 2.37 times greater than tetanic depressi on, while in the model of PD the levels of both depressor and excitatory activity induced by stimulation were below normal. Spike activity frequency in SNc and SNr neurons preceding and accompanying stimulation was significantly greater than normal in the model of PD. This is evidence for excitotoxicity accompanying neurodegenerative damage, which is completed by neuron apoptosis and death. In SNr neurons, both depressor and excitatory reactions accompanying stimulation were markedly dominant over those in SNc neurons, which is evidence for more extensive cortical projections to the SNr. Furthermore, SNc neurons demonstrated greater susceptibility to pathological changes due to poststimulus depressor effects than SNr neurons, with formation of more marked excitatory effects, which is evidence of a greater involvement of the SNc in PD. In the model of PD, lacking stimulation-induced depressor effects and more marked excitatory effects in SNc neurons, SNr neurons retained their depres sor reactions and relatively decreased excitatory reactions, which is evidence of a lower level of susceptibility of SNr neurons to excitotoxicity, extreme increases in the excitability of surviving neurons compensating for the lack of excitation of dead cells. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Acoustic and Perceptual Features of the Emotional Speech of Adolescents Aged 14–16 Years

alkiviadis.1961 shared this article with you from Inoreader Acoustic and Perceptual Features of the Emotional Speech of Adolescents Aged 14–16 Years Via Latest Results for Neuroscience and Behavioral Physiology The goal of the study was to describe perceptual and acoustic characteristics of emotional spontaneous speech of adolescents aged 14–16 years. 18 adolescents aged 14–16 years (9 boys and 9 girls, three people in each age) were participants. Perceptual analysis of speech of children by adults (70 Russian speakers and 70 speakers of other languages) was conducted to define the emotional state via voice and speech characteristics. Instrumental and linguistic analysis was used to determine acoustic features and linguistic information on which listeners rely while recognizing the adolescents' state. It was shown that listeners had difficulty in recognizing the emotional state of adolescents, but Russian-speaking listeners recognized the emotional state better (26% of phrases recognized w ith probability 0.75–1.0) than speakers of other languages. Adults recognized comfort better than discomfort, Russian listeners better than foreigners. Russian listeners are likely to rely on acoustic and linguistic information, speakers of other languages – on acoustic features of adolescents' speech. Phrases uttered in comfort are characterized by a wider pitch range vs. phrases uttered in the neutral state. It was revealed that the phrases of girls uttered in comfort have significantly higher average pitch values vs. discomfort. There were no significant differences between boys and girls in acoustic characteristics of emotional speech. Phrase duration and pitch range values can be included in automatic recognition systems of the speaker's emotional state via speech as additional informative features. The paper discusses the specificity of emotion manifestation in adolescents and the possibility of further use of the results. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.