We value your privacy
What are the most important factors to considered when thinking about the cities of the future? What scholars to involve? Or, can we even leave some academic discipline behind and not include them in discussion?
This is just a teaser for an upcoming conference...
Theology in Rijeka and the Department of Philosophy of the Catholic Faculty of Theology at the University of Zagreb, the Department of Social and Human Sciences in Medicine at the Faculty of Medicine of the University of Rijeka, the Faculty of Health Studies of the University of Rijeka and Faculty of Theology at University Nicolaus Copernicus, Toruń (Poland) - organize an international symposium, titled „The City of Future: Anxiety of Expansion“, which will be held on November 13, 2020 (Friday) in the Theology Building (Rijeka, Omladinska 14).
One of the most important factors to ensure world peace is for city governments to prioritize good planning for the future, including conducting many scientific studies and investigations to determine short-term objectives and long-range goals.
There are two theories that are quite similar in nature, but different in substance, The theory of Mind and the theory of Mentaliz(S)ation, sorry, Im allergic to American spelling...pls dont kill me now :-) My understanding of them is this "Both of these concepts, mentalization and the theory of mind, describes processes that are metacognitive in their nature . Mentalization mainly concerns the reflection of affective or emotional mental states. In contrast however the, theory of mind focuses on things epistemic in nature such as beliefs, intentions and persuasions. My idea is that these two theories by them self are incomplete but combining elements of both, gives us a clearer understanding. Cognition and affect can't in my view be separated, they are both part of us as human beings and also a part of other animals. What are your thoughts? Am I wrong or right? I can stand criticism so bring it on...
Cognition and affect can't in my view be separated, they are both part of us as human beings and also a part of other animals. What are your thoughts? Am I wrong or right?
"Cognition and affect," you say, "can't … be separated." Well, of course, in the sense that "they are both part of us as human beings," we can't separate them in the sense of eliminating one or the other. We don't want to eliminate either.
But in conceptualization of the distinction, we do separate them. We are aware, for instance that "hot cognition" tends toward more impulsive turns and acts, while cooler, more dispassionate discourse, debate or discussion depend on self-restraint on the immediate flow of emotion. In consequence it can be taxing or frustrating to the initiates. But this kind of self-restraint is widely viewed as an intellectual, even a moral virtue --a cultivate ability and eventual disposition. It seems that both in theory and in practice, we do "separate" cognition and affect and consider them distinct. So, let that much be recognized and accepted.
On the other hand, it is clear that if we did not care about anything in the sense that no matter what happened we would have no emotional reaction, then we would have little motivation (little reason, one might say) to engage in complex cognition, debate, discussion or discourse. What this tells us is that cognition also has its underlying emotional tone and basis, which, in fact, is reflected in personal ideals dating from ancient times: the desirability of "tranquility," or say, "eudemon," Greek, and literally to be of "good spirit," and conventionally translated as "happiness."
Classically, I think it is clearly recognized that there are varieties of developed character among human beings which are strongly rational and discursive and yet quite passionate in devotion to ideas and ideals.
It is the moral duty of every citizen to follow the instructions given by Government. I am of the opinion that social distancing, staying at home, use of face when going out for very important work, proper washing of hands with soap and water, consuming immune boosting diet, and drinking hot water will be helpful to reduce the spread of this life threatening viral disease that has caused a great havoc in the world.
Under COVID-19, healthcare facilities requests a lot of sterilization to prevent hospital transmission of the disease. Bleach solution and many other disinfection agents may not be effective against such a large scale of usage.
Can ultraviolet light be used to inactivate the virus?
Can it be applied on whole room disinfection?
Can it be used on high turnover medical equipment sterilization? E.g. stethoscope.
Can it be used to inactivate infected donors' blood products or body fluids?
Actually, among standard commercial coils, the double cone coil offers high energy efficiency and balance between stimulated volume and superficial field strength. Direct TMS of targets at depths of approx 4 cm or more results in superficial stimulation strength that exceeds the upper limit in current rTMS safety guidelines. Approaching depths of approx 6 cm is almost certainly unsafe considering the excessive superficial stimulation strength and activated brain volume. Couple of effects might have seen with choice of shape/size/dimension/ material listed below.
Effect of coil shape/size
(1) ****Smaller coils have a focality advantage over larger coils; however, this advantage diminishes with increasing target depth. Smaller coils have the disadvantage of producing stronger field in the superficial cortex and requiring more energy.
(2) When the coil dimensions are large relative to the head size, the electric field decay in depth becomes linear, indicating that, at best, the electric field attenuation is directly proportional to the depth of the target.
(3) Ferromagnetic cores improve electrical efficiency for targeting superficial brain areas; however magnetic saturation reduces the effectiveness of the core for deeper targets, especially for highly focal coils. Distancing winding segments from the head, as in the H1 coil, increases the required stimulation energy.
Many studies and analyes we do require statistics to back up. However, many times the results run out to be statistically significant, yet when interpret it in the clinical context, it is too small to be significant.
This is rather frustrating. Any solution for solving this?
Is those very small interval unit scale more easily affected?
Can we change our analytics method to cope with the results?
Beyond statistical significance: clinical interpretation of rehabilitation research literature.
Recentrly, fungal infections cause an increase of morbidity and mortality in hospitalized patients and in immunocompromised persons. What are the most recent recommendations and guidelines for the control and prevention of nosocomial fungal infections.
The last two decades have shown an increase incidence of nosocomial fungalinfections in hospital environment.The important fungi that are implicated in nosocomial infections are Candida albicans, Non-Candida albicans, Aspergillus fumigatus and Non-Aspergillus fumigatus, Fusarium species and others. We have isolated several fungal pathogens from burn wounds of patients admitted in burn ward of the hospital. Certain measures, such as personal protective wear, proper hand hygiene, respiratory hygiene, thorough cleaning and disinfection, safe injection practice, avoidance of sharp needle and scalpel injury, and waste disposal besides prompt medical attention to skin injury, and appropriate treatment with anti-fungal drugs (fluconazole, itraconazole, Amphotericin B, posaconazole etc) can be effective to prevent nosocomial mycoses.
One see the following paper on nosocomial mycotic infections.
Alangaden GJ. Nosocomial Fungal Infections: Epidemiology, Infection Control, and Prevention. Infectious Disease Clinics of North America 2011;25:201-25.
The background of my question can be ranged as: ''Quantum tunneling'' can be used by enzymes to transfer electrons long distance what can be the reason behind protein quaternary architecture evolution to sustain. Also quantum tunelling may be the reason behind DNA mutation along changing the forms of nucleotides. The reason of efficiency of photosynthesis may be to protect quantum coherence. There are also works about sensation and quantum mechanics. Such as the difference of molecular vibrations probably being detected by the olfactroy recepters that makes us to feel different smells, a small number of points across the retina detects single photons and these are decoded by a specific retinal map that makes us identify what we see and entangled radical pair mechanism also help to some animal to navigate theirself.
Considering these, maybe merging quantum mechanics and evolution can fill many gaps.
Dear James Des Lauriers , Quantum biology is a new emerging topic in recent years, I do advice you to watch ''The Secrets Of Quantum Physics: Let There Be Life'', an instructive documentary presented by Prof. Dr. Jim Al-Khalili and please read his and his colleague's recent related publications such as:
The Article Processing Charge (APC) is 1400 CHF (Swiss Francs) per accepted paper. However, the fees will be fully waived (as it is an invitation to contribute) if I can submit the paper by the end of June 2020.
If anyone have a collaboration idea, please send me a message.
Hello, we can work on neuroimaging analysis using ML/DL, I am specialized in neuroscience and you can contribute to the ML/DL application. If you are interested, email me at email@example.com. Thanks.
I am stuck at the following problem: I need to determine if there is a significant difference in Length of stay (LOS) in two groups: decendents and survivors, in different age groups. Can somebody help me with this? In a similar article I found they did use kruskal wallis to calculate this. Somebody some ideas to solve this in stata?
The two independent variables (age group: 3 levels; and type of case: 2 levels) could be evaluated in a two-way anova design. If there is any concern about conformance to normality and/or homogeneity assumptions, then exact/resampling/bootstrap estimation may be used to derive the significance tests. These are increasingly available within or as adjuncts to many statistical software packages and libraries (e.g., R, SPSS, SAS).
Here's a couple of links that you may find helpful in this regard:
You all are well aware that COVID-19 has disrupted every aspect of our lives including K12 and higher education sectors. Keeping in view the WHO recommendations, nations are enforcing social distancing in all fields including primary, secondary, higher secondary and university education. If we think positively, then this culprit COVID-19 is a blessing in disguise as the people are now taking care of personal hygiene, cleanliness of their surroundings and trying their best to improve their immunity. Besides educational institutions are reaching to the students.
During the past three months, the schools and universities around the globe have extended their outreach from a confined classroom to the students` bedrooms. Now the students can learn with more flexibility without wasting their times in travelling to their respective schools. The online mode of education has proven fruitful as it has lead to reduce institutional expenses which they had been spending on building & maintenance of infrastructure, electricity, furniture, multimedia and computing equipment. There is likelihood that tuition fee may be reduced with time if the situation prolongs (god forbid).
Apart from the above facts, I personally believe that online mode of education can not replace laboratory and clinical training of students who are pursuing their undergraduate studies in medicine, dentistry, engineering and such other technical fields.
What do you think? Will this batch of undergraduate students who are learning through online media i.e. LMS, Zoom, Webax etc, be able to acquire the professional competencies required in their respective fields. If the answer is no, then how can we utilize online platforms to ensure delivery of the quality education and achievement of course and program learning outcomes?
Consider the following voluntary scheme. There would be some eligibility requirements that would be consistent with the principles of health promotion. Only certain target groups would qualify.
You sign up and for walking 10,000 steps per day, you get a certain amount of money deposited directly to your cell phone. In principle, and in theory, what is wrong with this? In practice, people could cheat and so on but with the development of new technologies, it would be much more difficult to cheat so this disadvantage can be minimized. The funds for this scheme could come from a public-private partnership.
Ethics be damned. Let's do it. (Fiat money is funny money anyway so whatever is done with such money cannot be deemed ethical or unethical.)
i would count every running step twice, oh my!, i would be so rich!!! i can even imagine New York Step Exchange (NYSE) where people could meet to sell and buy walking and running steps: i would be a daily trader: i would run early in the morning and then i would wait patiently . . . i would sell my steps in tranches during the afternoon rush-hour.
In the absence of acquired immunity and/or effective vaccine against viral infection, breaking the chain of infection becomes the only option. Moreover some individuals possess innate resistance to some infections. This group of individuals will be protected even without acquired immunity and help to protected others through Herd immunity.
I am interested in how people and cultures view practitioners and supporters of Nutraceuticals. For generations, food or plant based substances have been used as a treatment for disease. The pharmaceutical industry has replaced grandma remedies. Charlatans have given the herbal drug industry a bad name. True believers of herbal cures though have also stretched the public's faith with cures for baldness to cancer and now to Covid-19.
Thank you for your valuable insight as a participant in the industry. I am torn, I want some of the folk medicine, herbal cures to be recognized as valuable, but I do not want to see them priced out of the poor's reach. They tend to be the average consumer.
It obvious that use of expired medicines where there are alternatives is unacceptable. There are, however, situations where the only available alternative medical product (medicine) used for life-threatening disease condition is expired and left with bare hands. What do healthcare professionals do on this situation, especially in this covid-19 pandemic where procurement is a challenge? Based on the risks-benefits assessment - the risk of leaving a patient without alternative and using expired medicine to save the patient and its associated risks - if they clinicians are going to use the product, what strategies they should follow to avoid medico-legal issues and transparency with consumers.
Many products have an extended shelf life. Most people would use an expired EPI pen in an emergency situation if that was all that was available. On 05 Feb 2020, Medscape published an interesting article by Douglas Paauw, MD, "Are Drug Expiration Dates a Myth?" https://www.medscape.com/viewarticle/924683_1
You can find a centralized database of genomes on https://www.gisaid.org/ . To access them, you have to register and it can take some time to actually obtain the info. Nevertheless, you can see the authors of the publications and contact them directly.
FDA has issued guidance to provide recommendations to health care providers and investigators on the administration and study of investigational convalescent plasma collected from individuals who have recovered from COVID-19 (COVID-19 convalescent plasma) during the public health emergency.
The guidance provides recommendations on the following:
pathways for use of investigational COVID-19 convalescent plasma
collection of COVID-19 convalescent plasma, including donor eligibility and donor qualifications
Because COVID-19 convalescent plasma has not yet been approved for use by FDA, it is regulated as an investigational product. A health care provider must participate in one of the pathways described below. FDA does not collect COVID-19 convalescent plasma or provide COVID-19 convalescent plasma. Health care providers or acute care facilities should instead obtain COVID-19 convalescent plasma from an FDA-registered blood establishment.
I was working for a project. The computational part is done. Now it's time to write a paper. But I am procrastinating much and actually I am not sure how to start or where to start.Which part should I write first? How can I accelerate the process.
I write from the very beginning (;-/)... It is necessary to write a work plan and gradually insert finished pieces or its fragments into it. Then see what necessary parts are missing and add these. Everything is simple.
After several passes, the skeleton (plan) is overgrown with meat (text). Sometimes I enter some thought (just a line or phrase) or data into this raw text as these arise in head.
Sometimes in the process of work it turns out that the original plan was not very good, then new (first empty) paragraphs are added to the text, and something disappears. Gradually, the article arises. The most important thing is to reread it, it is better to pause before the last viewing (several days or even weeks) in order to be able to look at the text with a “fresh look”. This is not the only way. I know a person who writes linearly - from beginning to end, as a silkworm draws a thread from itself. But I can’t do this - it’s easier for me to construct text from logical "cubes".
There was a proposal of a researcher who asked me to write down a paper which will more or less extend the poster (link bellow) published at ICCB 2016 in Prague. This all happened by an accident. I did not like to come at a conference without some presentation. Hence, I did quickly put the ideas that are resonating in my head for years on that poster to allow other researchers to benefit from it. Surprisingly, this poster is getting a great deal of attention. Therefore, I am thinking about to write down a review (prescription) how to design sel-organizing and emergennt systems with a rich example aparatus. If you like the idea then wisit the poster and let there a comment about it (bellow the poster).
The whole project is meant as a service to the community of biological and medical researchers who would like to know more but have no time to study mathematics and programming in depth.
Emergence phenomena is a kind of phenomena observed in a lot kind of systems (from arts to philosophy, biology, physics and so on). Emergence theory is the formal approach to study those phenomena. It is a very exiting area!
Actually, as you probably know, there are different levels of emergence. You may have weakemergence, strong emergence or even some intermediary relations. The kind of emergence phenomena you are considering are of weak type, which are typically related with complex systems (as maybe you were keeping in mind when you said (...) understand the dynamics of organizations' emergent properties that are virtually impossible to resolve by using any other mathematical tool (...).
I note, however, that a system A which weak emerge from a system B can a priori strongly emerges from a system C which itself strongly emerges from B (there is no contradiction because the emergence relation is not transitive in the general setup). This means that one can try to understand weak emergence relations (and therefore those complex systems) indirectly by looking at strong emerge relations.
With this in our minds, a natural question is the following:
existence problem for strong emergence. Given two systems A and B, can we find some strong emergence relation between them?
At present I'm very interested in studying this problem for physical systems, but a priori the methods could be generalized to other kind of systems. I've a recent work on the subject:
As we know that, every country will take a standard time to the approved patent of medicine, however in this pandemic situation, this will continue in the same process? Should we not consider the situational gravity for the greater good of humanity?
Considering the seriousness of the current COVID-19, the agency authorized to issue patent, is advised to give patent to drug as early as possible so that the drug can be used to treat the COVID-19 patients.Early patenting of drug will certainly help to save the life of patients.
Conozco algunos centros comunitarios que trabajan con este tipo de medicina, y considero que parte de la sabiduría en ciencias de la salud parte de como se tratan las enfermedades actualmente en las comunidades de los pueblos nativos.
Si, la mejor forma que tienes para desarrollarlo es siguiendo procedimientos acercados a los desarrollos farmacéuticos. Trabajar con ensayos clínicos a fin de testear la eficacia y seguridad de los insumos tradicionales
We can start with writing a review or research paper if there are data about the following topics: *Transmission modes of COVID-19 virus through environmental media, including air, water, soil, surfaces/interfaces, among others.
*Detection of COVID-19 virus in environmental media, such as air, surfaces, water, sewage water, among others.
Lack of concern and care for others. GED is a big word and encompasses many dimensions which is not easy to measure. Like all latent variable and concepts we need to test for validity and reliability before we can be sure of what we are measuring.
In the age of Covid19, is there a basic conflict between science and superstition in the discipline of medical knowledge? Are there some simple, sensible, robust and reasonable ways to distinguish a scientific statement (or fact) from a superstitious statement?
To stay focused, the topic will concentrate on science versus superstition in the scientific discipline of medicine. We will try our very best to stay focused and not stray off track. it is very easy to wander off message and be all over the map. i will try to summarize the key conclusions from time to time.
In the age of the Corona Virus, there are so many statements out there. The statements may not be scientific. But if they are not scientific, are they false? Are they fake? Are they simply statements based on superstition.
What should we do if people believe in statements that are not based on science? Should we be polite and tolerate their beliefs?
As long as people do not harm others, then from society’s point of view, the fact that people hold non-scientific hypotheses is probably benign. However, the trouble starts when the same people act these beliefs, and then cause harm to others. The question arises: what should society do in this case?
Based on the discussion, there are two assumptions and four categories.
Assumption1: Beliefs cannot be justified or unjustified.
Assumption2: hypotheses can be disproven
Scientific hypotheses that are based on justified facts in natural causation. Or scientific hypotheses have not been disproven (I prefer the negative formulation because we may never be able to prove anything but we are unable to disprove it.)
Since science cannot give a definitive answer, there are many competing answers that merit our attention, and we may not be able to select among them.
Non-scientific hypotheses are unjustified facts that may be “proven” in the future with better evidence and facts.
Pseudo-scientific hypotheses: not sure where these fit in?
Superstitions are unjustified beliefs in supernatural causation.
Joseph Tham, thanks for a thought provoking question. I think we should tolerate and respect beliefs and ideas that are not considered scientific. Our intolerance of such beliefs and ideas could be the result of a lack of understanding of the science behind them. We should therefore subject them to rigorous testing using the scientific method. A practical example is the fact that the World Health Organization has not dismissed out of hand the herbal remedy from Madagascar that is claimed to prevent illness from COVID-19. Instead the remedy is going to be tested using established scientific principles. The null hypothesis can then be rejected or accepted. This is how Indigenous Knowledge Systems contribute to scientific advancement.
Typically, WEIRD people have Western-influenced education. They are comfortable in international languages and have non-traditional values. Usually, they are young, hardworking, urban professionals with living and working experiences abroad.
It is not easy for someone from outside the culture and education to integrate into the society, what more to offer advice to policy makers. This happened even to East Asian countries where the influencial policy makers are home grown.
Your excellent questions might be complemented by several additional ones: who is behind the epidemiologists? Who is financing them? Which are the real interests of the research funders? These questions are not related to conspiracy theories but to the Covid-19 reality. Cui bono the lockdowns? Who is paying for the side-effects due to lockdowns? What about those people who could not be operated on time and lost their lives because their operations were cancelled? Nobody is counting the collateral victims. Why? We know by heart Covid-19 statistics. Pandemic is the omnipresent topic everywhere. What about the vital questions of humanity? Have they just disappeared?
I agree with Japneet Kaur. The problem in the cilia of olfactory sensory neurons. The myofibrilar myopathy is a genetic disease that associated with the primary ciliary dyskinesia. The primary ciliary dyskinesia resulted in defective cilia and olfactory receptors.
Attached, please find the article describing both myofibrilar myopathy and primary ciliary dyskinesia.
Ventilators are helpful in palliative medical care for some COVID-19 patients, but not all; therefore, ventilators should be made readily available even though only a fraction of patients will need them.
I am conducting a research project to see whether demographic/patient factors can predict patients who are likely to suffer a post-operative death (Categorical outcome Y/N).
I have conducted univariate regression procedure using SPSS Firths regression as I have a small sample size with the dependant variable being a sparse event. This has given me 3-4 variables with P<0.10.
DO I now proceed to perform a multi-logistic regression? If so, do I run Firths regression with all of these variables selected as co-variates or do I perform a more traditional multi-nominal regression model instead?
Any help would be appreciated as I can't find any guidance on this issue.
In order to graphically categorizing data, SPSS software does not have enough accuracy in graphical classification because it performs the classification operation with a linear criterion, not a point. Therefore, the results of the outcome from group classification are not accurate enough. This software is very suitable for statistical analysis.
Other software such as NTSYS-pc, PAST, PC-ord, CANOCO, TWINSPAN, Mathlab and etc are recommended for this.
COVID-19 has pull people apart from each other. Social distancing is the main way to prevent spreading of infection. Tele-medicine, once used for rural area remote healthcare model, is the emerging new way of practice under COVID-19.
Different specialties have different practicing needs, what difficulties do you encounter on applying tele-medicine under COVID-19 in your specialty? Will tele-medicine totally uproot the usual face-to-face room consultation of medical practitioners? And becoming the new service model?
What is your view?
Virtually Perfect? Telemedicine for Covid-19
Covid-19 and Health Care’s Digital Revolution
Telemedicine in the Era of COVID-19
The Journal of Allergy and Clinical Immunology: In Practice
Keep Calm and Log On: Telemedicine for COVID-19 Pandemic Response.
‘Healing at a distance’—telemedicine and COVID-19
Public Money & Management
The Role of Telehealth in Reducing the Mental Health Burden from COVID-19
The World Health Organization (WHO) defines traditional medicine as "the sum total of the knowledge, skills, and practices based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness". But some people believe traditional medicine is contrasted with scientific medicine.
What is your opinion? Can we use traditional medicine for treatment of COVID19? If your answer is yes, how do you want to do it?
Metal corpus of the ship (moisture, condensation, mold, lower temperature). Creates confined space.
Cold air currents when the ship is moving. Some cabins have a terrace. Other passangers use the common outside viewing decks.
Vibrations from the ship's engine disturb, days on end, the normal liquid environment (intracellular, extracellular) within which cells live, function, reproduce. The vestibular apparatus suffers as well.
Cleanliness - dubious. Could use the toilet brush to clean also the toilet seat and the sink with (as in many hotels around the world). Apparently, nothing wrong with that. :O
Lack of adequate ventilation (probably, the air conditioning system is linked between rooms at the same level).
Fresh water purity (absent - onboard water desalination; when were the filters last changed?).
Bacteria and viruses jump from sea water onto skin, in nose and throat via water droplets in the air. When humid, one inhales deeper. Boy, is this not helpful!
Toilets and shower waste water outlets connected - water pressure differential due to movement of the ship (esp. side to side). Splashes in the bathroom.
Rats, cockroaches, ants (need no introduction).
Goodness! What a long list, is not it?
Could be even longer.
Mitsubishi Heavy Industries should have some idea as to how long...
The gender gap: I do have to attend my child needs, specially related with the remote school activities plus cooking and cleaning the house. All these activities at the same time oh having a full time job as an specialist in higher education. Trying to get focus and reading for a while is such a goal!
The summary of the bloomberg article spells it out. Herd immunity with its unfortunate 'collateral damage' as no one has any immunity to this novel pathogen, and secondly, immunization, which is still a long way off. Thus, prevention is better than cure, but there is no cure, except the above, besides for all the supportive treatment provided.
A famine of food does not necessarily mean that there is a shortage of food; it is the inaccessibility of food. Is it the same with the Covid19, in the sense that there is inaccessibility to medical resources?
Treatment and management of cholera are best accomplished by the administration of copious amounts of intravenous or oral fluids to replace fluids lost from the severe diarrhea. The administration of antimicrobial agent can be shorten the duration of diarrhea and thereby reduce fluid losses. However, resistance to tetracycline and doxycycline has been reported. Therefore administration of additional antimicrobials such as azithromycin and ciprofloxacin may be necessary.
Less than five months after the world first learnt about the new coronavirus causing fatal pneumonia in Wuhan, China, there are more than 90 vaccines for the virus at various stages of development, with more announced each week. At least six are already being tested for safety in people.
Now, developers, funders and other stakeholders are laying the groundwork for their biggest challenge yet: determining which vaccines actually work.
This typically involves giving thousands or tens of thousands of people a vaccine or placebo and seeing, over months or even years, whether there is a difference between the two groups in how many people get infected in the course of their daily lives, as well as checking that no safety issues emerge.
But in this pandemic, scientists will have to accelerate and streamline that process. A vaccine may be the only way to generate immunity to the virus across a population: despite the millions of coronavirus cases worldwide, some preliminary studies suggest that only a small fraction of people in even hard-hit regions have been infected with SARS-CoV-2, and their immunity is unclear.
This month, the World Health Organization (WHO) in Geneva, Switzerland, sketched out plans for a clinical trial that will test numerous vaccines in a single study. Some developers and funders have plans for their own efficacy trials. But key questions remain, such as which vaccines will be tested first — or at all — and how their effectiveness will be measured and compared.
“It’s going to require a level of coordination that has never really happened before, and a time frame that’s never really been even imagined,” says Mark Feinberg, president and chief executive of the International AIDS Vaccine Initiative (IAVI) in New York City. “You can’t take 200 vaccines into efficacy trials,” says Seth Berkley, chief executive of Gavi, the Vaccine Alliance in Geneva, which funds immunizations in low and middle-income countries.
The WHO’s proposed Solidarity Vaccine Trial seeks to speed development with an adaptive design. This allows vaccines to be added to the trial on an ongoing basis. Participants will be enrolled continuously, and vaccines that don’t seem to be working can be dropped from testing.
The WHO still needs to hammer out details, such as how a vaccine’s efficacy will be measured, says Marie-Paule Kieny, research director at the French National Institute of Health and Medical Research in Paris. But she thinks its overall approach makes sense. “One of the challenges is prioritization — which vaccine should you test first,” she says.
The WHO has established an expert panel to prioritize vaccines for inclusion in its trial, but it is unlikely to be the only organization seeking to do this. “Some strategic alignment and coordination in this effort is going to be critically important or otherwise it'll become very chaotic,” says Feinberg. But the WHO plan “by itself may not be sufficient,” he adds.
The US National Institutes of Health (NIH) in Bethesda, Maryland, this month unveiled a partnership with more than a dozen companies that aims to coordinate the development of drugs and vaccines for coronavirus. And the Coalition of Epidemic Preparedness (CEPI), a global foundation that funds vaccine development, is supporting 9 different vaccines. The non-profit hopes to raise US$2 billion to pay for efficacy trials, manufacturing and other costs, says Melanie Saville, the organization’s director of vaccine research and development.
Criteria for prioritizing vaccines for efficacy could include its production capacity and the immune response generated in early human trials and animal studies, says Kieny, as well as regulators’ experience with the specific type of vaccine. Some of the kinds of vaccine being developed, such as RNA vaccines, have not been widely tested in people or used in a vaccine that has won regulatory approval.
A vaccine developed at the Jenner Institute at the University of Oxford, UK, is currently undergoing early-phase trials. “There’s a reasonable chance that we’ll be able to pick up the efficacy of the vaccine over the next couple of months,” Andrew Pollard, an infectious disease researcher at Oxford leading the trial, said at an online press briefing.
A small number of developers with plans and funding to get their vaccine approved and scale up production will likely call the shots with regard to how efficacy trials are done, says Rip Ballou, a program leader at IAVI. “Doing a phase III trial to show efficacy is meaningless if it's not coupled to a plan to actually licence and deliver under some regulatory authority,” he says. “There's only a handful of players that will be able to meet that very high bar. Because otherwise, it's a publication. It's not a vaccine.”
A fair shot
Another challenge will be determining how the different vaccines compare to one another. WHO’s proposal for an efficacy trial could allow the performance of different vaccines to be directly compared, but Kieny thinks that some developers may be unwilling to accept this because it could hurt a vaccine’s commercial prospects.
Swati Gupta, IAVI’s Vice President and Head of Emerging Infectious Diseases and Scientific Strategy, says vaccine developers will want to understand how key decisions are made before committing to trials that involve comparisons with other vaccines, to make sure their vaccines have “a fair shot at being able to show its efficacy”.
But it is essential to be able to compare different vaccines, even if it requires vaccines developers to set aside their short-term interests, says Charlie Weller, vaccine lead at the Wellcome Trust biomedical charity in London. “They work under commercial business models. That's not going to work for the situation we're in now," she says.
Expected global demand for a coronavirus vaccine could make developers more willing to cooperate. “We need more than one vaccine,” says Kieney. “Monopoly is always very bad, and none of the vaccines may have enough production capacity.”
One factor that could encourage such cooperation is the shifting geography of the pandemic. “China would have been a great place in Wuhan to have done efficacy trials two months ago,” says Berkley. “Italy would have would have been a great place to do it a month ago.” As a result, developers have incentive to join initiatives such as the WHO’s or the NIH’s, because of their access to clinical trial infrastructure around the world that could bring vaccines to where there are coronavirus cases. “We need to be nimble,” adds Gupta.
While most experts see large trials as a necessity to ensure that coronavirus vaccines are safe and effective, some developers are examining alternatives.
One option is to look for signs that a vaccine works in early-stage trials involving hundreds of participants, and then seek permission from regulators to deploy the vaccine under ‘emergency use’ rules in high-risk groups, such as health-care workers, who are more likely to be infected with the coronavirus. Regulators such as the US Food and Drug Administration can grant emergency use, while additional data is collected to license a vaccine.
Cansino Biologics in Tianjin, China, which is developing a vaccine comprised of a chemically inactivated form of SARS-CoV-2 virus, will consider this approach, according to a company spokesman. Johnson and Johnson said in a press release that its vaccine could be ready for emergency use in early 2021.
No vaccine has ever been deployed under emergency-use provisions, says Katherine O'Brien, who heads WHO's immunizations, vaccines, and biologicals department. If coronavirus vaccines follow that path, regulators will seek extra reassurance that a vaccine is safe. “There is no compromise that can be made on the safety issues,” O’Brien adds.
Momentum is building for an even more radical proposal to determine which vaccines work: intentionally infecting young, healthy volunteers, negating the need to wait for trial participants to become infected naturally. These ‘human challenge’ studies are already used to study infectious diseases such as malaria and dengue, and some researchers say they should be considered to speed the development of coronavirus vaccines.
Berkley says challenge trials could be used to rapidly determine which vaccines advance to large-scale trials. But he thinks they may be too risky without either an effective drug or a genetic test to identify the rare young individuals who are likely to develop severe disease. “Until you have a recognised treatment, I think that's a pretty tough story,” he says.
Academic journals publish original articles and higher level of evidence like review as their basis of survival. However, most journals also allow the manuscript type of "Letter to the editor" for readers in the field to reply previously published articles or on special events and issues like those once in a lifetime e.g. COVID-19.
As a researcher or author, do you think it is worth writing such a manuscript type?
Can you resubmit such "Letter" to another journal I'd being rejected?
Will you expect any citations from such "Letter"?
Will such "Letter" be externally peer-reviewed?
Is an underlying relationship with the editor an advantage of writing such "Letter"?
What do the editor expect you to write before accept your "Letter"?
Will "Letter" increase your h-index number?
There is no source of information on the acceptance rate of such articles.
Do you have any experience on the acceptance rate of such?
If such "Letter" is rejected, how will you handle the hard work with great effort paid?
How to write a letter to the editor that the editor will want to publish.
The virus is primarily spread between people during close contact, often via small droplets produced by coughing, sneezing, or talking. While these droplets are produced when breathing out, they usually fall to the ground or onto surfaces rather than remain in the air over long distances.People may also become infected by touching a contaminated surface and then touching their eyes, nose, or mouth. The virus can survive on surfaces for up to 72 hours. It is most contagious during the first three days after the onset of symptoms, although spread may be possible before symptoms appear and in later stages of the disease.
by vaccination and finding the gens for the spike protein on the surface of corona virus and put them into a harmless virus to make a vaccine .. such technique if success, the pandemic virus will surely ended up .. but unfortunately .. it takes time
Dear all, english is becoming a universal language. At the present time it is considered as the only tool of communication between nations. Historical reasons are behind, but for sure those english native speaking countries are the leaders in R&D, which attracted the other countries to send their young Scholars to have such expeience to use once they return back to their mother land. My Regards
I am searching for journal whose impact factor is at least 1 and that do not have article processing fee for publication. I am looking for journal related to medicine or diabetes/endocrinology. Thank you.
Joseph Tham how are you? i would like to answer that yes, but the role of this COVID 10 pandemia during the last 4 months showed that not, underline because according with the human kind`s history: health, education, and human peace progress never being something really important for political leaders in opposite way the budget for supporting war in all sense always being the main aim of the rich countries developing or even poor countries.
We know very little about COVID-19 at this moment and its effects on the developing and/or mature brain. In general viral infections can impair charnolophagy (CB autophagy) which is the basic molecular mechanism of intra-cellular detoxification (ICD) for normal function to remain healthy. By attacking the most sensitive neural progenitor cells in the brain, the virus can alter their pluripotency and induce charnolosome (CS) destabilization implicated in inflammasome (particularly NRLP-3) activation to induce hypercytokinemia and charnoptosis (CB apoptosis) implicated in pyroptosis, apoptosis, and necrosis of sensitive hippocampal and other CNS neurons by releasing Panx-1, Viroporine, and gasdermins to cause Charnoly Body Molecular Pathogenesis (CBMP) implicated in early morbidity and mortality through its general (Viral) lytic cycle.
For more details, you may please refer to my books " The Zika Virus Disease: Prevention and Cure" The Charnoly Body: A Novel Biomarker of Mitochondrial Bioenergetics" Fetal Alcohol Spectrum Disorder; and Nicotinism and Emerging Role of E-Cigarettes. I wish I could write more about it.
Dr. Ebada, It is all about Environmental Sanitation, our own Life-Style, Immunity, Mitochondrial Bio-energetics and intracellular detoxification through charnolophagy (CB autophagy), which is compromised by COVID-19 through CS destabilization to cause early morbidity and mortality by infecting the CNS. Thanks.
The image shows surgical and gynaecological instruments used by ancient Egyptians over 3000-5000 years BC. It explains how advanced medicine at that time, scalpels, forceps, curettes were known and what we use as surgical instruments date back to ancient Egyptians designs. The question is, do you have a history of medicine in your medical/health curricula? What are the objectives of this component? And how do you integrate this part to other elements in the curriculum?
COVID-19 is spreading around the world, and faeces were popular and agreed for the presence of viral RNA with different studies reported. Its presence mean that the gastrointestinal (GI) tract is one of the hosting organ for such coronavirus.
How are other parts of the GI tract system affected by this virus?
Clinical features of covid-19-related liver damage.
Under COVID_19, most evidence and data are on adults, but more and more paediatric cases with some mortality are ongoing.
Let's gather all the paediatric related COVID-19 research here for referencing.
1) Yung CF, Kam K, Wong MS, et al. Environment and Personal Protective Equipment Tests for SARS-CoV-2 in the Isolation Room of an Infant With Infection. Ann Intern Med. 2020; [Epub ahead of print 1 April 2020]. doi: https://doi.org/10.7326/M20-0942
2) Brooks Samantha K, Smith Louise E, Webster Rebecca K, Weston Dale, Woodland Lisa, Hall Ian, Rubin G James. The impact of unplanned school closure on children’s social contact: rapid evidence review. Euro Surveill. 2020;25(13):pii=2000188. https://doi.org/10.2807/1560-7917.ES.2020.25.13.2000188
3) Dong L, Tian J, He S, et al. Possible Vertical Transmission of SARS-CoV-2 From an Infected Mother to Her Newborn. JAMA. Published online March 26, 2020. doi:10.1001/jama.2020.4621
4) Iqbal SN, Overcash R, Mokhtari N, Saeed H, Gold S, Auguste T, et al. An Uncomplicated Delivery in a Patient with Covid-19 in the United States. N Engl J Med. 2020 Apr 01.
5) Qiu H, Wu J, Hong L, Luo Y, Song Q, Chen D. Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID-19) in Zhejiang, China: an observational cohort study. Lancet Infect Dis. 2020 Mar 25.
6) Zeng H, Xu C, Fan J, et al. Antibodies in Infants Born to Mothers With COVID-19 Pneumonia. JAMA. Published online March 26, 2020. doi:10.1001/jama.2020.4861
7) Zeng L, Xia S, Yuan W, et al. Neonatal Early-Onset Infection With SARS-CoV-2 in 33 Neonates Born to Mothers With COVID-19 in Wuhan, China. JAMA Pediatr. Published online March 26, 2020. doi:10.1001/jamapediatrics.2020.0878
8) Chen D, Yang H, Cao Y, Cheng W, Duan T, Fan C, et al. Expert consensus for managing pregnant women and neonates born to mothers with suspected or confirmed novel coronavirus (COVID-19) infection. Int J Gynaecol Obstet. 2020 Mar 20.
I am interested in collaborating with any researcher working on modelling corona virus using fractional derivatives. If you are a researcher or you have a related project, please feel free to let me know if you need someone to collaborate with you on this research study. If you know someone else working on this research project, please share my collaboration interest with him.her. I would be very happy to collaborate on this research project with other researchers worldwide.
In my circle of friends there is a lively debate if corona is as dangerous as our media and governments is trying to portrait. Im one of those who doesn't believe Covid 19 is so much more dangerous to the general population than, lets say the flu. With that said I dont mean I would like to contract it, or any other illness. What is your take on the current situation? Is Covid 19 in your view something to be feared or do you like me view it as something that should not affect our lives and our economy to the extent it now has. How does your society handle the issue and what is your take? Best regards Henrik
Recently, I was conducted a quantitative analysis based on urban travel mode choices and national culture (Hofsede's culture dimensions)for 41 countries. The results showed that there are significant correlations, I presented several linear regression models which demonstrate travel mode choices can be predicted by culture dimensions. So I wondered if it can be related with evolution. The article is below:
Respiratory infections can be transmitted through droplets of different sizes: when the droplet particles are >5-10 μm in diameter they are referred to as respiratory droplets, and when then are <5μm in diameter, they are referred to as droplet nuclei. According to current evidence, COVID-19 virus is primarily transmitted between people through respiratory droplets and contact routes.2-7 In an analysis of 75,465 COVID-19 cases in China, airborne transmission was not reported.
Droplet transmission occurs when a person is in in close contact (within 1 m) with someone who has respiratory symptoms (e.g., coughing or sneezing) and is therefore at risk of having his/her mucosae (mouth and nose) or conjunctiva (eyes) exposed to potentially infective respiratory droplets. Transmission may also occur through fomites in the immediate environment around the infected person. Therefore, transmission of the COVID-19 virus can occur by direct contact with infected people and indirect contact with surfaces in the immediate environment or with objects used on the infected person (e.g., stethoscope or thermometer).
Airborne transmission is different from droplet transmission as it refers to the presence of microbes within droplet nuclei, which are generally considered to be particles <5μm in diameter, can remain in the air for long periods of time and be transmitted to others over distances greater than 1 m.
In the context of COVID-19, airborne transmission may be possible in specific circumstances and settings in which procedures or support treatments that generate aerosols are performed; i.e., endotracheal intubation, bronchoscopy, open suctioning, administration of nebulized treatment, manual ventilation before intubation, turning the patient to the prone position, disconnecting the patient from the ventilator, non-invasive positive-pressure ventilation, tracheostomy, and cardiopulmonary resuscitation.
There is some evidence that COVID-19 infection may lead to intestinal infection and be present in faeces. However, to date only one study has cultured the COVID-19 virus from a single stool specimen. There have been no reports of faecal−oral transmission of the COVID-19 virus to date.
Probiotics are live microorganisms that are intended to have health benefits when consumed or applied to the body. They can be found in yogurt and other fermented foods,dietary supplements, and beauty products.
In Hong Kong, currently popular legal physical (non-online) gambling would be horse-racing football and mark-six (a kind of lucky draw for numbers). Of course, there are many more different ones online.
However, the responsible organization (Hong Kong Jockey Club) closed down all the branches since COVID-19. There is a short period in between that it was re-opened, and many gamblers grasped the time to go in to refill or retrieval their accounts' money.
Unluckily, under social distancing rule, race course is banned for entry even for horse owners.
As a citizen, I can feel how broken hearts these horse racing gamblers are. And with time of few months, I feel that horse racing is falling out of colour.
Besides, football legends all over the world is closing as well. And bars for alcohol are all closed down by law too.
Of course, there is also Majong. Yet, shops providing these are also closed.
That's why I feel that people may shift their attention to others under COVID-19.
Dengue fever is a disease caused by a family of viruses transmitted by infected mosquitoes. It is an acute illness of sudden onset that usually follows a benign course with symptoms such as headache, fever, exhaustion, severe muscle and joint pain, swollen lymph nodes (lymphadenopathy), and rash.
A hospital-acquired infection (HAI), also known as a nosocomial infection, is an infection that is acquired in a hospital or other health care facility. To emphasize both hospital and nonhospital settings, it is sometimes instead called a health care–associated infection (HAI or HCAI).
Yes, an immune enhancer medicine naturally produced from plant combinations (herb
- to- herb) may likely prevent corona virus disease. This is because plants contain micronutrients and antioxidants that helps to boost the immune system and prevent the oxidation of free radicals in the body. COVID-19 is a
respiratory tract infectious disease (RTIs) caused by virus. Most medicinal plants have anti microbial and antivirus activity.
I would like to understand in what cases blood or some other biological liquid passes through implant or graft with some porous microstructure according the Darcy law (thanks to the pressure differences).
I have an idea to produce a research about blood permeability through various implants microstructure, but unfortunately it is harder than I thought to found some justification in literature that blood actually could pass through such microstructure due the Darcy law. Thus, I would be grateful for your help in this question - maybe you have some papers about it or some other helpful stuff.
Thank You Mr Bayan for this valuable book: Bio-materials in Clinical Practice, Advances in Clinical Research and Medical Devices
Part I Material Classes
Part II Bio-material Properties and Characterization
Part III Clinical Applications
Part II includes the article: Computer Modeling of Stent Deployment in the Coronary Artery Coupled with Plaque Progression. It is very interesting Numerical solution but it does not present a valuable knowledge about blood flow through implants according to the Darcy law. It does not refer too Darcy law.
Stent deployment with plaque formation and progression for specific patient in coronary arteries is described considering blood flow in a hollow Arteries. Blood flow simulation is described by Navier-Stokes and continuity equations not by Darcy law.
In a paper deposited in BioRxiv entitled: "Susceptibility of ferrets, cats, dogs, and different domestic animals to SARS-coronavirus-2" the team from Harbin Vet Institute intentionally infected several species of animals including cats with SARS-CoV-2. The results showed that the virus was transmitted between the cats, but no sympthoms of COVID-19 were observed.
This result is interesting in terms of an observation made by a medic from Spain - Sabina Olex-Condor that from the 100 patients serious with COVID-19 that she examined there were no cat owners. She suggested as a hypothesis that due to cross-immunity (cats are a known reservoir of coronaviruses) cat owners have milder sympthoms of COVID-19.
I'm aware that the paper from Harbin Institute is a pilot study, has many possible dead ends and limitations. I'm also aware that this cross-immunity hypothesis suggested by Sabina need serious assement due to limited number (and problalbly non-representative set) of patients.
Do you think that this is possible in terms of knowledge of human immunology? If the above is met do any of you have access to indepth demografic (?) data of people infected with SARS-CoV-2 to check this hypothesis?
Disclaimer: not an expert in medicine or veterinary, I study plant genomics, this is pure scientific curiosity.
There are thousands of coronaviruses infecting mammals. Humans commonly are infected with four which cause common colds (229E, OC43, HKU1 and NL63) and we have also been infected by SARS-CoV (2003-2004 outbreak) and MERS-CoV (2013 and other small outbreaks), as well as this new (SARS-CoV-2 pandemic) strain. Cats and dogs, and bats and pigs and cattle and horses all have coronaviruses of various types infecting them too.
There is no evidence that other cat coronaviruses such as the Feline coronavirus UU21, or Feline infectious peritonitis virus, can infect humans or cause any cross-protection against SARS-CoV-2. These viruses are all very distantly related to each other, and so are the 4 human common cold coronavirses, so we would not expect any cross-protection at all. If that type of broadly cross-protective immunity was possible, then one human influenza vaccine would be good for all, and making a vaccine for HIV would be easy.
Many of us are doing ongoing prospective research, yet COVID-19 has paused our work for a while or even months because of the city shut-down. There is an unexpected huge increase in lost to follow-up in our research clinics.
How should we deal with these cases, and the associated data?
The selection bias caused by the lost to follow-up cannot be adjusted by study design, as it is started already. What methods can we use to adjust instead?
Can anyone simply explain how inverse probability-of-censoring weighted estimation technique work on this issue?
How to run it practically, e.g. by SPSS software? Or other higher level of statistical software is needed?
How about stratification-based methods or weighted methods? How are they working actually?
When not inside an infected cell or in the process of infecting a cell, viruses exist in the form of independent particles, or virions, consisting of: (i) the genetic material, i.e. long molecules of DNA or RNA that encode the structure of the proteins by which the virus acts; (ii) a protein coat, the capsid, which surrounds and protects the genetic material; and in some cases (iii) an outside envelope of lipids. The shapes of these virus particles range from simple helical and icosahedral forms to more complex structures. Most virus species have virions too small to be seen with an optical microscope, about one hundredth the size of most bacteria.
I am involved in a post graduate programme in medicine. I observed but in all modules where self-directed learning has been applied, students are not progressing as expected. My thinking was may be our transition was not well done. Any input well-appreciated.
Why is Self-Directed Learning the Better Approach?
With a variety of methods, for example, goal-based learning, that facilitate the self-directed approach as well as the ability to guide your own learning experience, self-directed learning already seems like the more appealing approach. Let’s delve a little deeper and consider some of the practical benefits of embarking upon a self-directed learning journey and, how this method not only impacts learners but, their organization as well.
The learner has complete control:
By choosing learning activities directly in line with their own interests/meet the needs of their end-goal, learners are more likely to engage with the content and therefore, take away beneficial points of interest to help better perform in their job role.
Rooted in the application of skills:
With SDL, learners are required to grasp the “how” and the “why” rather than the “what”. These acquired skills can then be utilized throughout their role for example, problem-solving, time management and communication skills.
Fosters a collaborative learning environment:
The social element of Curatr allows learners to interact with one another throughout their learning journeys. Subjects, problems and solutions can be debated by all learners and, ultimately, this encourages learners to learn from their colleagues and peers, creating a combined knowledge throughout an organization.
Meets individual learners needs:
SDL facilitates learning at one’s own pace. Relevance also increases because learners are motivated to learn from their own experiences while applying their newly-acquired knowledge to the job in hand.
A more convenient approach:
Through SDL, learners have the ability to learn whenever and wherever – for instance, listening to a podcast in the car, reading a short article on the train. Mobile versions help facilitate this possibility and, learning becomes much more manageable for learners to fit into the working week.
Overcoming the Pitfalls of SDL
Like with any learning approach, there are a few drawbacks to be mindful of when implementing the strategy into your organizations learning environment.
Loss of motivation:
With this approach, learners are now accountable for their own learning and, there is a risk that learners could lose motivation to continue. To overcome this, it offers the reflection feature that encourages learners to engage with their learning content, thinking back on what they have actually learned and the benefits of the learning material from a continuing professional development point of view.
With the developing stories of the spread of COVID-19 all around the world, which has been declared as a pandemic by WHO recently, I am wondering, in how much time this virus would vanish from the surface of the Earth? Is there any scientific study available for this?
I am conducting a research project to see whether demographic/patient factors can predict patients who are likely to suffer a post-operative death (Categorical outcome Y/N).
I have conducted univariate regression procedure using SPSS Firths regression as I have a small sample size with the dependant variable being a sparse event. This has given me 3-4 variables with P<0.10.
DO I now proceed to perform a multi-logistic regression? If so, do I run Firths regression with all of these variables selected as co-variates or do I perform a more traditional multi-nominal regression model instead?
Any help would be appreciated as I can't find any guidance on this issue.
You didn't indicate how small a number the less-observed outcome was for your data set. If it's 100 or more, I wouldn't worry at all about using ordinary logistic regression. If 50-80, then LR may be fine if you have only a modest number of IVs in your model. If it's, say, 10 or fewer, then you're better off sticking with Firth method or some adjustment thereto (see link below). There are other, penalty-added methods available; I just don't know how they might perform with your data.
It's possible that someone has done a simulation study that includes conditions that match well to your data set. If not, you could always try that, to be more confident about your ultimate choice.
COVID-19 is affecting all kinds of human activities, research is not exempted. Many ongoing research studies are not paused because of COVID-19, patient recruitment cannot be continued, follow up visits are not stict to schedule, intervention procedures may be delayed, blood test monitor are postponed.
I would expect a higher loss to follow up rate during this period, which would affect the reliability of research. Even after COVID-19, will the recruited subjects have some difference than those recruited before?
I ruminated a consideration on this proposal for the last couple of days as Germany is in anticipation of the surge.
To be clear: This is also just a theoretical exercise and – if applied - would count as a desperate measure in the case of patients otherwise not being ventilated at all.
What if the mode of ventilation chosen would not be conventional BIPAP but APRV/inverse ratio PCV?
The control parameters correspond to conventional ventilator settings as follows: P-high (P-insp), P-low (PEEP), T-high (insp. Time), T-low (exp. time) and FiO2. Note that implementing this mode of ventilation with conventional BIPAP, which is possible in some devices, will in some setups require calculation of respiratory rate, which is 60/(Thigh+Tlow). The slightly different terminology as well as specific algorithms for implementation have been characterized and properly published by experts in the field – which I am NOT. There have been promising studies in ARDS which I will attach below.
If one assumes that for two (or more) patients the key treatment goal would be oxygenation with a more liberal approach to CO2 removal, it should be possible to choose P-high, FiO2 and to some degree T-low to achieve safe oxygenation margins for both patients.
This would still allow for some inhomogeneity in compliance between the patients as the lung is splinted to a rather high point in the P-V curve by P-high resulting in a high resting volume. This is the proposed “open-lung” aspect of this ventilation mode. Nevertheless, due to the sparse and brief passive pressure relief phases it is believed to go without higher frequency repeated expansion like in conventional PCV, resulting in less energy deposition into the tissue. The repeated overinflation/atelectasis due to inhomogeneos P-V dependencies had been my main concern when thinking about PCV in a shared circuit and a possible result of volutrauma/atelectotrauma in the patients.
In case of inhomogeneous severity between the patients/different disease progression the treatment goal could be set for the more severe patient accepting hyperoxia in the “more well” patient.
In terms of CO2 removal a “common ground” target for the patients could be set in wider range of acceptable values, opting for permissive hypercapnia.
As the passive release of the lung volume to exhalation in T-low will generate outflow which is cropped at a certain level of peak flow (by setting T-low) when conventionally setting up/adjusting this mode, it might be difficult to assess this control parameter for the individual patient in a shared circuit.
APRV does even allow for spontaneous breathing on P-high in weaning approaches which have been proposed as well.
If flow for the device serving two patients would be dialed high enough to compensate for potential maximum inspiratory peak flow generated by both patients in spontaneous breathing, it could be fathomable to even conduct weaning with two spontaneously breathing patients sharing the same circuit.
I write this as I feel we are all staring in a potential abyss, which might force us to make choices that neither of us ever wanted to make.
Hence, this is a THEORETICAL CONSIDERATION and not a recommendation. Also I do not take any legal responsibility if patient harm ensues. I hope everybody understands that.
Also probably someone already thought of this.
But I thought: Sharing is caring.
Take care and stay strong.
Cane RD, Peruzzi WT, Shapiro BA. Airway pressure release ventilation in
severe acute respiratory failure. Chest, Aug 1991: 100 (2); 460-3 Fergson
ND, et al. High-frequency oscillation in early acute respiratory distress
syndrome. New England Journal of Medicine 2013, 368 (9), 795-804 Frawley
PM, Habashi NM. Airway pressure release ventilation: theory and practice.
AACN Clinical Issues, 2001: 12 (2); 234-246 Garner W, Downs JB, Stock MC et
al. Airway pressure release ventilation (APRV). A human trial. Chest, Oct
1988: 94 (4); 779-81 Habashi NM. Other approaches to open-lung ventilation:
Airway pressure release ventilation. Crit Care Med 2005 Vol 33, No. 3
(suppl.) Maxwell RA, Green JM, Waldrop J et al. A randomized prospective
trial of airway pressure release ventilation and low tidal volume
ventilation in adult trauma patients with acute respiratory failure. The
Journal of Trauma, Injury, Infection and Critical Care, 2010: 69; 501-511
Modrykamien A, Chatburn RL, Ashton RW. Airway pressure release ventilation:
an alternative mode of mechanical ventilation in acute respiratory distress
syndrome. Cleveland Clinic Journal of Medicine, 2011: 78 (2); 101-110
Rasanen J, Cane RD, Downs JB et al. Airway pressure release ventilation
during acute lung injury: a prospective multicenter trial.
Critical Care Medicine, Oct 1991: 19 (10); 1234-41 Roy S, et al. Early
airway pressure release ventilation prevents ADRS – a novel preventative
approach to lung injury. Shock 2013, 39 (1), 28-38
Bickel (2009) describes those who remain robust under stress as resilient. Those who can rapidly adapt to change in times of stress are resilient. So, my question to you is, how are you? How are you coping? Are you thriving? Make sure you have seen this -> https://youtu.be/CCe5PaeAeew
Bickel, J. (2009). Faculty resilience and career development: Strategies for strengthening academic medicine. In Faculty Health in Academic Medicine (pp. 83-92). Humana Press.
Momordica charantia has a number of purported uses including cancer prevention, treatment of diabetes, fever, HIV and AIDS, and infections. While it has shown some potential clinical activity in laboratory experiments, "further studies are required to recommend its use".
Does anyone know in which species the grass allergen Phl p5 occurs? It was originally isolated from the grass species Phleum pratense so it must at least occur in that species. It stand to reason that it might also occur in other species of the genus Phleum. A few papers states that it is universal in many grasses, but with poor documentation.
Can anyone provide conclusive evidence and/or references in which the authors state in which species (or cultivars) the allergen occurs and/or have been isolated from? I welcome answers from all researchers along with special interest from expert knowledge primarily from plant ecology, aerobiology, immunology and other health professionals.
Being invited to be reviewer for a conference or to be speaker is tempting for most young scientists. Not being aware of this businessplan I unfortunately accepted to review abstracts for one of such conference. Googleing around I realised I am not alone and that there are also several people wondering whether they should attend a conference or not as they are unsure if the organisers are genuine or not.
There are lists of predatory journals (e.g. https://predatoryjournals.com/journals/) but I did not find a good or comprehensive list of predatory conferences. So lets discuss such invitations to get a sense for those that can be trusted:
I am facing a problem when I try to calculate the hr from two different survival curves, here is the problem: in the first plot the experimental group's curve is more close to the placebo group then the second plot, even if the first plot's hr is smaller than the second plot. I wonder what the possible reasons are. Can you guys help me to solve this problem? Thanks.
Oncology is a branch of medicine that deals with the prevention, diagnosis, and treatment of cancer. A medical professional who practices oncology is an oncologist. The name's etymological origin is the Greek word ὄγκος (óngkos), meaning 1. "burden, volume, mass" and 2. "barb", and the Greek word λόγος (logos), meaning "study".
Cancer survival has improved due to three main components: improved prevention efforts to reduce exposure to risk factors (e.g., tobacco smoking and alcohol consumption), improved screening of several cancers (allowing for earlier diagnosis), and improvements in treatment.