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Increasing patient and therapeutic complexity have created both challenges and opportunities for heart failure care. Within this background, the coronavirus disease-2019 pandemic has disrupted care as usual, accelerating the need for transition from volume-based to value-based care, and demanding a rapid expansion of telehealth and remote care for heart failure. Patients, clinicians, health systems, and payors have by necessity become more invested in these issues. Herein we review recent changes in health care policy related to the movement from volume to value-based payment and from in-person to remote care delivery.

Crop water productivity is a key element of water and food security in the world and can be quantified by the water footprint (WF). Previous studies have looked at the spatially explicit distribution of crop WFs but little is known about the temporal dynamics. We develop a new global gridded crop model – AquaCrop-Earth@lternatives (ACEA) – that can simulate three consumptive WF components: green (WFg), blue from irrigation (WFbi), and blue from capillary rise (WFbc) at high temporal and spatial resolutions. The model is applied to analyse global maize production during 1986–2016 at 5 × 5 arc minute grid. Our results show that in 2012–2016, the global average unit WF of maize is 723.2 m3 t−1 y−1 (89.5 % WFg, 8.3 % WFbi, 2.2 % WFbc) with values varying greatly around the world. Regions characterised by high agricultural development generally show a small unit WF and its interannual variation, such as Western Europe and Northern America (WF 3 t−1 y−1, CV  2500 m3 t−1 y−1, CV > 40 %). Since 1986, the global unit WF of maize has reduced by 34.6 % mainly due to the historical decrease in yield gaps. However, due to the rapid expansion of rainfed and irrigated cropland, the global WF of maize production has increased by 48.8 % peaking at 762.9 × 109 m3 y−1 in 2016. As many regions still have a high potential in decreasing yield gaps, the unit WF of maize is likely to continue reducing, whereas the WF of maize production is likely to continue growing as humanity’s rising appetite can lead to further cropland expansion. The simulation of other crops with ACEA is necessary to assess the pressure of overall crop production on ecosystems and freshwater resources worldwide.

El COVID-19, conocido popularmente como coronavirus, ha sido uno de los fenómenos mediáticos más relevantes desde principios de 2020. Uno de los efectos más notorios de su rápida expansión en España fue la cancelación del Mobile World Congress (MWC). Se trata de un foro global que reúne anualmente a las principales empresas tecnológicas del mundo y se define, en materia de agenda empresarial, como uno de los principales eventos anuales del sector. Según las estimaciones realizadas por la empresa organizadora GSMA, la previsión de asistentes al evento, previo a los resultados conocidos, era de más de 100.000 personas, contando tanto los asistentes de las empresas participantes como el público en general. Pese a ello, el pasado 12 de febrero y refiriéndose a las sucesivas cancelaciones de las empresas patrocinadoras y participantes por motivos de salud pública, la organización del MWC decidió cancelar el evento. Se analizan en este trabajo 125 noticias de los dos principales periódicos económicos en España y a través de una metodología basada en el análisis del contenido se comprueba el impacto del Congreso objeto de este estudio. En el periodo estudiado se concluye que las noticias sobre el Congreso Mundial de Móviles no fueron tan relevantes para estos medios de comunicación como sí lo fueron los efectos del covid-19.

Understanding the relationship between a species and its habitats is important for both conservation of imperiled species and control of invasive species. For migratory species, we hypothesize that maintaining connectivity between segregated habitats is more important than improving the quality of each habitat. In the case of anadromous lampreys of conservation concern, we posit that restoring passage routes between spawning, rearing and feeding habitats will result in higher larval abundance upstream from barriers than efforts to improve quality of these freshwater habitats. To explore this hypothesis, we reviewed conservation actions for native anadromous lampreys in freshwater and found that: i) improving passage between habitats results in immediate and quantifiable increases in larval abundance, ii) anadromous lampreys are capable of existing in suboptimal habitats, and iii) small reservoirs of production drive rapid expansion when anadromous lampreys are released from passage constraints. Hence, maintaining habitat connectivity is clearly crucial for conservation of anadromous lampreys. There are fewer examples of improvements to freshwater habitat that increased larval lamprey abundance, perhaps because lampreys are rarely the focus of these efforts. However, habitat limitations such as stream de-watering, chemical pollution, and scour occur and will likely be exacerbated by climate change. Documenting habitat actions that reverse these problems may provide evidence for the merits of lamprey-specific habitat improvement. Our observations are relevant to sea lamprey control in the Great Lakes because barriers and chemical treatment are key instruments of population regulation, and can be strategically deployed to limit production.

The deployable bridge based on scissor structures is one of the effective methods to quickly restore traffic after natural and man-made disasters. Scissor structures have the advantages of high storage rate, lightweight, and convenient storage and transportation. However, when scissor structures are used as load-bearing structures, their stiffness and bearing capacity are low. In this study, a three-dimensional deployable bridge based on the cable-strengthened scissor structures was proposed. In addition to rapid expansion, steel cables were used to strengthen scissor structures to improve the stiffness and bearing capacity. Besides, the static loading comparative tests on cable-strengthened scissor structures and traditional scissor structures (cable-free scissor structures) were performed. The results show that the stiffness of the cable-free scissor structure is small, the bending moment of members is large, and the stress distribution is uneven. The stiffness of cable-strengthened scissor structure is significantly improved; the bending moment of members is significantly reduced; and the stress distribution in the member section is more uniform. It is proved that cables can be used to improve the stiffness and load-bearing capacity of scissor structures without affecting the deployability.

Tumours are surrounded by a host of noncancerous cells that fulfil both supportive and suppressive roles within the tumour microenvironment (TME). The drive to understand the biology behind each of these components has led to a rapid expansion in the number and use of 3D in vitro models, as researchers find ways to incorporate multiple cell types into physiomimetic configurations. The use and increasing complexity of these models does however demand many considerations. In this review we discuss approaches adopted to recapitulate complex tumour biology in tractable 3D models. We consider how these cell types can be sourced and combined and examine methods for the deconvolution of complex multicellular models into manageable and informative outputs.

Several severe acute respiratory syndrome coronavirus 2 variants of concern (VOCs) emerged in late 2020; lineage B.1.1.7 initially dominated globally. However, lineages B.1.351 and P.1 represent potentially greater risk for transmission and immune escape. In British Columbia, Canada, B.1.1.7 and B.1.351 were first identified in December 2020 and P.1 in February 2021. We combined quantitative PCR and whole-genome sequencing to assess relative contribution of VOCs in nearly 67,000 infections during the first 16 weeks of 2021 in British Columbia. B.1.1.7 accounted for 50% by week 8. P.1 accounted for

The rapid expansion of coronavirus SARS-CoV-2 has impacted various ethnic groups all over the world. The burden of infectious diseases including COVID-19 are generally reported to be higher for the Indigenous people. The historical knowledge have also suggested that the indigenous populations suffer more than the general populations in the pandemic. Recently, it has been reported that the indigenous groups of Brazil have been massively affected by COVID-19. Series of studies have shown that many of the indigenous communities reached at the verge of extinction due to this pandemic. Importantly, South Asia also has several indigenous and smaller communities, that are living in isolation. Till date, despite the two consecutive waves in India, there is no report on the impact of COVID-19 for indigenous tribes. Since smaller populations experiencing drift may have greater risk of such pandemic, we have analysed Runs of Homozygosity (ROH) among South Asian populations and identified several populations with longer homozygous segments. The longer runs of homozygosity at certain genomic regions may increases the susceptibility for COVID-19. Thus, we suggest extreme careful management of this pandemic among isolated populations of South Asia.

Histidine phosphorylation is an important and ubiquitous post-translational modification. Histidine undergoes phosphorylation on either of the nitrogens in its imidazole side chain, giving rise to 1- and 3- phosphohistidine (pHis) isomers, each having a phosphoramidate linkage that is labile at high temperatures and low pH, in contrast with stable phosphomonoester protein modifications. While all organisms routinely use pHis as an enzyme intermediate, prokaryotes, lower eukaryotes and plants also use it for signal transduction. However, research to uncover additional roles for pHis in higher eukaryotes is still at a nascent stage. Since the discovery of pHis in 1962, progress in this field has been relatively slow, in part due to a lack of the tools and techniques necessary to study this labile modification. However, in the past ten years the development of phosphoproteomic techniques to detect phosphohistidine (pHis), and methods to synthesize stable pHis analogues, which enabled the development of anti-phosphohistidine (pHis) antibodies, have accelerated our understanding. Recent studies that employed anti-pHis antibodies and other advanced techniques have contributed to a rapid expansion in our knowledge of histidine phosphorylation. In this review, we examine the varied roles of pHis-containing proteins from a chemical and structural perspective, and present an overview of recent developments in pHis proteomics and antibody development.

In the context of Netflix’s rapid expansion in European markets and its growing investments in original content, this article conducts a comparative case study analysis of Netflix offerings and investment strategies in four European Union countries: Belgium, Romania, Spain, and Sweden. A first aim of the article is to establish the extent to which offerings in these markets confirm or reshape the findings of transnational flow studies on the imbalance of content supply. A second aim is to analyze how these offerings reflect the platform’s investment strategies in the different markets. Although findings point to increased diversity in catalog composition, as well as growing investments in European works, Netflix also reconfirms and contributes to existing power imbalances between markets. US content dominates the four European catalogs, while investments in European original content considerably favor strong media markets over weaker ones.

Artificial intelligence (AI) is the usage of scientific techniques to simulate human intellectual skills and to tackle complex medical issues involving complicated genetic defects such as cancer. The rapid expansion of AI in the past era has paved the way to optimum judgment-making by superior intellect, where the human brain is constrained to manage large information in a limited period. Cancer is a complicated ailment along with several genomic variants. AI-centred systems carry enormous potential in detecting these genomic alterations and abnormal protein communications at a very initial phase. The contemporary biomedical study is also dedicated to bringing AI expertise to hospitals securely and ethically. AI-centred support to diagnosticians and doctors can be the big surge ahead for the forecast of illness threat, identification, diagnosis, and therapies. The applications related to AI and Machine Learning (ML) in the identification of cancer and its therapy possess the potential to provide therapeutic support for quicker planning of a novel therapy for each person. Through the utilization of AI- based methods, scientists can work together in real-time and distribute their expertise digitally to possibly cure billions. In this review, the focus was on the study of linking biology with AI and describe how AI-centred support could assist oncologists in accurate therapy. It is essential to identify new biomarkers that inject drug defiance and discover medicinal goals to improve medication methods. The advent of the “next-generation sequencing” (NGS) programs resolves these challenges and has transformed the prospect of “Precision Oncology” (PO). NGS delivers numerous medical functions which are vital for hazard prediction, initial diagnosis of infection, “Sequence” identification and “Medical Imaging” (MI), precise diagnosis, “biomarker” detection, and recognition of medicinal goals for innovation in medicine. NGS creates a huge repository that requires specific “bioinformatics” sources to examine the information that is pertinent and medically important. The malignancy diagnostics and analytical forecast are improved with NGS and MI that provide superior quality images via AI technology. Irrespective of the advancements in technology, AI faces a few problems and constraints, and the clinical application of NGS continues to be authenticated. Through the steady progress of invention and expertise, the prospects of AI and PO look promising. The purpose of this review was to assess, evaluate, classify, and tackle the present developments in cancer diagnosis utilizing AI methods for breast, lung, liver, skin cancer, and leukaemia. The research emphasizes in what way cancer identification, the treatment procedure is aided by utilizing AI with supervised, unsupervised, and deep learning (DL) methods. Numerous AI methods were assessed on benchmark datasets with respect to “accuracy”, “sensitivity”, “specificity”, and “false-positive” (FP) metrics. Lastly, challenges along with future work were discussed.

Amidst the rapid expansion of education reform aimed at promoting educational equity, noticeably absent has been a focus on school counseling—a profession uniquely positioned to support students’ postsecondary, social emotional, and academic development. Despite research continually affirming the positive influence of counselors on students, uneven access to counseling support across US public schools, especially in urban areas, remains a reality today. Notably, high student-to-counselor ratios in schools that educate a large proportion of students of color and those living in low-income communities suggest that those students most in need of access to counseling support are the least likely to receive it. In this essay, we outline school counselors’ unique roles in supporting minoritized youth and draw on Bronfenbrenner’s (The ecology of human development: experiments in nature and design, Harvard University Press, Cambridge, 1979) ecological systems theory to consider the nested systems in which counselors work—systems which, we argue, place constraints on school counseling equity. This systems-level framing moves away from casting the limitations of our current student support model as an individual-level, personnel issue and instead conceptualizes it as an organizational one that must be remedied to ensure all students have equal access to critical counseling support.

The COVID-19 (coronavirus disease 2019) pandemic brought rapid expansion of pediatric telehealth to maintain patient access to care while decreasing COVID-19 community spread. We designed a retrospective, serial, cross-sectional study to investigate if telehealth implementation at an academic pediatric practice led to disparities in health care access. Significant differences were found in pre-COVID-19 versus during COVID-19 patient demographics. Patients seen during COVID-19 were more likely to be younger, White/Caucasian or Asian, English speaking, and have private insurance. They were less likely to be Black/African American or Latinx and request interpreters. Age was the only significant difference in patient demographics between in-person and telehealth visits during COVID-19. A multivariate regression showed older age as a significant positive predictor of having a video visit and public insurance as a significant negative predictor. Our study demonstrates telehealth disparities based on insurance existed at our clinic as did inequities in who was seen before versus during COVID-19.

Subsidence and accelerated sea level rise impact nesting area availability and flood probabilities of breeding islands for colonial nesting waterbirds. In 2017 and 2018, we monitored 855 nests of four species of colonial nesting waterbirds on Rabbit Island, LA, to determine factors affecting nest and chick success. Based on logistic exposure models of nests, tricolored herons had the greatest likelihood of survival to hatch (mean (95% confidence interval)) (77% (65.9–83.1%)), followed by brown pelicans (70% (59.9–98.5%)), roseate spoonbills (70% (38.9–83.8%)), and Forster’s terns (12% (10.7–12.2%)). Likelihood of survival to fledge was highest for tricolored herons (32% (12.8–40.7%)), followed by brown pelicans (28% (19.5–28.6%)), roseate spoonbills (47% (43.7–53.3%)), and Forster’s terns (0% (0.005–0.01%)). Nesting strategy and nest timing impacted survival rate; however, the effect depended on timing of inundation events as the timing of inundation events varied across years. Flooding was the primary cause of nest failure for most species. In 2003–2012, rapid expansion in brown pelican colony numbers and significant chick production occurred at Rabbit Island, but hydrologic records indicate no island inundation occurred during the breeding season from the beginning of the hydrologic record (2006) through 2011. Thus, our results contrast with those of previous studies conducted under different hydrologic conditions and demonstrate the challenges of short-term studies informing coastal restoration in a system that is influenced by multi-year to multi-decadal climatic cycles.

Purpose: The potential benefits of ICT integration in learning in schools have been extensively discussed in the academic literature worldwide. In recent years globally, there has been rapid expansion in integration of ICT in primary school education. Countries has further put in place many initiatives to enhance the same. Integration of Information and Communication Technology (ICT) is a critical factor in ensuring improved quality education. Despite the many benefits that are known to be brought by integrating ICT in teaching and learning, studies have shown that integration remains low especially in primary schools. The general objective of the study was to establish the influence of information communication technology on child education Methodology: The paper used a desk study review methodology where relevant empirical literature was reviewed to identify main themes and to extract knowledge gaps. Findings: The study found out that the influence of ICTs in learning cannot be dealt with in isolation. For technology to be effective, it must be availed to learners at the right time and place. There is need to be effective, it must be availed to learner’s proximity; that is in classrooms or supposed learning environment Recommendations: The study recommends that school management should focus on increasing their ICTs infrastructure by provision of computers, building computer laboratories and encouraging public-private partnership so as to help in internet connectivity and provision of basic infrastructure. Capacity building is an important initiative that helps in ensuring that the benefits that accrue from use of technology in education are maximized. Additionally, students should be provided with technical assistance to use ICTs in teaching and learning

Container on Barge (COB) facilitates intermodal transportation by transporting shipping containers on barge tows. COB has seen rapid expansion globally over the past 20 years, providing a cost-efficient, environmentally friendly, and congestion-reducing mode of container transportation. European countries have led COB transportation in both study and application over the past two decades. However, increasing interest is observed in both the USA and Asia. In this literature review and comparative analysis, 135 COB-focused peer-reviewed articles are reviewed and analyzed to systematically describe the development and current status of COB transportation research. The relevant literature is analyzed to reveal publication rates and titles, geographical regions of interest, research questions, applied methodologies, advantages of COB transportation, and key success factors. The aim of our effort is to provide information on various aspects of COB development among different regions in the world and to summarize the existing literature to support and guide future COB development.

Light Detection and Ranging (LiDAR) technology is playing a major role in different applications. Indeed, the possibility of exploiting either 3D geometric features and radiometric information makes LiDAR suitable for a wide range of practical domains. LiDAR proved also being quite flexible in terms of platforms where it can be implemented for the acquisition, spanning from airborne sensors up to car-based and hand-held instruments. Due to the rapid expansion of research concerning LiDAR intensity, the ISPRS WG III/5 launched in 2017 an initiative aimed at providing free access to LiDAR data acquired by modern multispectral ALS sensors as well as MLS data. The two datasets, MLS Data Set 1 – (“Sun Prairie”), and Multispectral LiDAR Data Set 2 – (“Tobermory”), were provided by Teledyne Optech Company (Canada) and were made freely available to researchers upon request. This paper is presenting the first results of this initiative in terms of applications, application domains and topics tackled by applicants. The relevance of this data set is also evaluated through a bibliometric analysis considering both Scopus and Web of Science indexed databases to analyse the main directions where the scientific research, the technical development and the application interest is moving to.

The rapid expansion of cities has tremendously increased the storm water volume, which frequently causes local flooding. Conventional drainage systems are often unable to sustain these run-off volu...

Vascular Ehlers–Danlos syndrome (vEDS) causes fatal vascular complications due to vascular fragility. However, invasive therapeutic procedures are generally avoided except in emergencies. We report a case of vEDS presenting with rapid expansion of a hepatic arterial aneurysm successfully treated using prophylactic endovascular therapy. A 43-year-old woman with vEDS confirmed by genetic testing was hospitalized for a symptomatic hepatic arterial aneurysm that expanded rapidly within a week. Prophylactic coil embolization was then successfully performed. Although the general applicability of this approach cannot be determined, prophylactic endovascular therapy can clearly be an option for arterial aneurysms at high risk of rupture.

The development of pharmaceutical companies, which is an important part of the national economy and industry, is closely related to people’s livelihood issues. With the era of big data, this paper uses the two-stage DEA and Malmquist method to evaluate the efficiency of listed Chinese pharmaceutical companies. From a static and dynamic perspective, it analyses the total factor productivity index, pure efficiency change index, scale efficiency index, and so on. The results show that government subsidies have not had a positive impact on most Chinese pharmaceutical companies, and for films, diseconomies of scale caused by rapid expansion should be avoided.

Hasta finales del 2019, el Covid-19 era un virus desconocido. Su aparición y rápida expansión sorprendió a la comunidad médica internacional. Más allá de la facilidad de contagio y su potencial gravedad, actualmente está causando mayor conmoción el creciente número de pacientes que después de ser dados de alta, recaen y en ocasiones fallecen. A esta fecha se han registrado seis casos de reinfección comprobada a nivel mundial. Es una cantidad mínima en el universo de personas infectadas. No obstante, ¿la inmunidad contra la reinfección es temporal?, ¿debemos preocuparnos mientras los mecanismos inmunológicos sean desconocidos en profundidad? A fin de encontrar respuesta a estos interrogantes, se planteó como objetivo analizar la recurrencia de infecciones de Covid-19. Para eso, entre los días 20 al 27 de octubre de 2020, y del 1 al 3 de marzo de 2021, se realizó una revisión bibliográfica a través del buscador Google en las bases de datos Pubmed/Medline, Scielo, Scopus, ScienceDirect, Google Scholar, sitios oficiales y especializados. Como criterios de inclusión se aplicaron los descriptores: Covid-19, inmunidad, reincidencia, reinfección, Covid-19 en Argentina. En el marco de la revisión, los principales hallazgos son: 1) las pruebas médico-científicas son insuficientes para afirmar que un paciente dado de alta tiene muchas posibilidades para reinfectarse con Covid-19; 2) la inmunidad contra la reinfección es temporal; y 3) ante la posibilidad de recurrencia y la falta de evidencia concluyente sobre la estabilidad inmunológica, la recomendación más acertada para cualquier ciudadano es mantener las medidas de prevención y bioseguridad.

Giant ascending aortic aneurysm (AscAA >10 cm) is an uncommon entity with a variable presentation. The size of the aneurysm, rapid expansion, and calcification are associated with an increased risk of rupture. Atherosclerosis is the most common etiology of aortic aneurysm in the elderly population. Multimodality imaging can be wisely used for diagnosis, risk stratification, and follow-up. We herein report a case of successfully repaired giant calcified AscAA with a maximum diameter of 10 cm. We also provide a brief discussion on the role of multimodality imaging.

The rapid expansion of the gene therapy pipeline in recent years offers significant potential to treat diseases with great unmet medical need. However, the unique nature of these therapies poses challenges to regulating them within traditional frameworks, even when developing in a single country. Various factors exacerbate the issues in commercializing products across regions, including the lack of established regulatory frameworks for developing gene therapy products in many jurisdictions. While some countries have established separate regulatory frameworks for advanced therapies/regenerative medicine products, differences exist between them. Recommended solutions to overcome these hurdles include fostering convergence among countries with separate regulatory frameworks for these products and utilizing reliance and recognition for countries without such frameworks. Additionally, regulators who choose to establish new dedicated frameworks for regulating gene therapies should consider the inclusion of key elements such as expedited regulatory pathways that offer early engagement with regulators, innovative clinical trial design, and adequate post-market confirmatory studies. Increasing the alignment of regulatory pathways across countries will be crucial to facilitating the development of, and access to, gene therapies on a global scale.

COVID-19 is an infectious disease caused by the SARS-CoV-2 virus. Its symptoms are similar to those of the common flu, including fever, cough, dyspnea, myalgia, and fatigue. Due to its rapid expansion globally, the World Health Organization (OMS) declared it a pandemic. The molecular test commonly used worldwide for direct detection of the virus is the RT-PCR test but it takes time to process and the materials used are scarce. In this work we propose: (a) The design and implementation of a deep neural network architecture for the detection of patients with COVID-19 using as input X-ray images of the chest; the architecture is made up of a feature extraction phase, that is, a pre-trained model VGG16 extracts the features of the image; then in the second phase, a multilayer neural network classifies into one of two particular classes (1: COVID, 0: NO COVID). (b) The implementation of a Web platform that allows interested people to use our architecture in a clear, simple and transparent way. The deep learning algorithm was implemented in Python with specific libraries for the design of neural networks, while the Web platform was implemented in PHP using the Laravel framework and MySQL database. We evaluate the performance of our proposal using the sensitivity, specificity and area under the curve (AUC) evaluation metrics, obtaining good results in very short computational times. Fil: Orozco, Carlos Ismael. Universidad Nacional de Salta. Facultad de Ciencias Exactas. Departamento de Informática; Argentina Fil: Xamena, Eduardo. Universidad Nacional de Salta. Facultad de Ciencias Exactas. Departamento de Informática; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Martinez, Cristian Alejandro. Universidad Nacional de Salta. Facultad de Ciencias Exactas. Departamento de Informática; Argentina Fil: Rodriguez, Diego Alejandro. Universidad Nacional de Salta. Facultad de Ciencias Exactas. Departamento de Informática; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina

The discovery of CRISPR has revolutionized the field of genome engineering, but the potential of this technology is far from reaching its limits. In this review, we explore the broad range of applications of CRISPR technology to highlight the rapid expansion of the field beyond gene editing alone. It has been demonstrated that CRISPR technology can control gene expression, spatiotemporally image the genome in vivo, and detect specific nucleic acid sequences for diagnostics. In addition, new technologies are under development to improve CRISPR quality controls for gene editing, thereby improving the reliability of these technologies for therapeutics and beyond. These are just some of the many CRISPR tools that have been developed in recent years, and the toolbox continues to diversify.

With the rapid expansion of the RMB exchange rate’s floating range, the effects of the RMB exchange rate and global commodity price changes on China’s stock prices are likely to increase. This study uses both auto regressive distributed lag (ARDL) and nonlinear ARDL (NARDL) approaches to explore the symmetric and asymmetric effects of the RMB exchange rate and global commodity prices on China’s stock prices. Our findings show that without considering the critical variable of global commodity prices, there is no cointegration relationship between the RMB exchange rate and China’s stock prices, and the coefficient of the RMB exchange rate is not statistically significant. However, when we introduce global commodity prices into the NARDL model, the result shows that the RMB exchange rate has a negative effect on China’s stock prices, that there indeed exists a long-run cointegration relationship among the RMB exchange rate, global commodity prices, and stock prices in the NARDL model, and that global commodity price changes have an asymmetric effect on China’s stock prices in the long run. Specifically, China’s stock prices are more sensitive to increases than decreases in global commodity prices. Thus, increases in global commodity prices cause China’s stock prices to decline sharply. In contrast, the same magnitude of decline in global commodity prices induces a smaller increase in China’s stock prices.

The past decade has seen a rapid expansion of non-human forensic genetics coinciding with the development of 2nd and 3rd generation DNA sequencing technologies. Nanopore sequencing is one such technology that offers massively parallel sequencing at a fraction of the capital cost of other sequencing platforms. The application of nanopore sequencing to species identification has already been widely demonstrated in biomonitoring studies and has significant potential for non-human forensic casework, particularly in the area of wildlife forensics. This review examines nanopore sequencing technology and assesses its potential applications, advantages and drawbacks for use in non-human forensics, alongside other next-generation sequencing platforms and as a possible replacement to Sanger sequencing. We assess the specific challenges of sequence error rate and the standardisation of consensus sequence production, before discussing recent progress in the validation of nanopore sequencing for use in forensic casework. We conclude that nanopore sequencing may be able to play a considerable role in the future of non-human forensic genetics, especially for applications to wildlife law enforcement within emerging forensic laboratories.

Introduction: Covid-19 is a viral epidemic disease that causes serious health problems and death worldwide. The rapid expansion of Covid-19 infection led to the disruption of healthcare services and radical re-organisation of healthcare resources due to the healthcare workers' infection. Aim: This clinical study investigated the effects of Covid-19 infection on emergency and elective cases in our general surgery clinic. Material and methods: We retrospectively analysed the clinical data of 195 patients who underwent elective (Group Elective) and emergency (Group Emergency) surgery during the Covid-19 incubation period in the Bakirkoy Dr. Sadi Konuk Training and Research Hospital between March 11 - May 18, 2020. Demographic features, symptoms, surgical diagnoses, surgical methods, complications, duration of surgery, length of hospital stay and mortality, the status of Covid-19 of all patients were recorded. Results: 195 patients, including emergency and elective surgery cases, were operated on (104 and 91, respectively). The incidence of Covid-19 infection was 5.49% in patients scheduled for elective surgery and 4.8% in patients operated urgently, and all developed in the postoperative period. Two patients with emergency surgery died of respiratory failure, their mean age was 51 years. Two of 104 emergency-operated patients were positive from Covid-19 (1.92%) at the time of admission. Eighteen medical staff and nurses got Covid-19 infections. Conclusions: Due to the rapid spread of Covid-19 infection, early precautions must be taken in surgical clinics to guarantee the safety of patients all healthcare providers, and personnel.

COVID-19 spurred rapid expansion of pharmacy-based point-of-care testing (POCT). This growth was aided, in part, by federal guidance that removed state-level regulatory uncertainty surrounding the ability of pharmacists to administer, interpret, and act on the results of tests. Surveys suggest there is considerable confusion about the legality of these services by state regulators. To ensure the sustainability of POCT services over time, states should consider adopting a standard of care approach to regulation, allowing a flexible framework for practice innovation and expansion over time.

The COVID-19 pandemic, caused by the infectious agent SARS-CoV-2, has claimed the life of thousands of people around the world following its rapid expansion from Wuhan, China, in early January 2020. Since then, multiple groups worldwide have attempted to describe predictive models for adverse clinical outcomes in patients affected by this disease. Within laboratory findings, the first Chinese cohorts described an inverse relationship between the absolute lymphocyte count and disease severity, and about 80% of severe patients exhibited lymphopenia. However, there are discrepancies regarding the predictive value of this clinical manifestation, as well as in the pathophysiological mechanisms involved. Here, we review current evidence regarding lymphopenia in patients with COVID-19, and the potential utility of this hematological finding as a disease biomarker.

In response to the ongoing coronavirus disease 2019 (COVID-19) pandemic, an online laboratory surveillance system was established to monitor severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) real-time reverse transcription-PCR (rRT-PCR) testing capacities and results. SARS-CoV-2 rRT-PCR testing data were collected from 97 clinical laboratories, including 84 medical institutions and 13 independent clinical laboratories in Korea. We assessed the testing capacities to utilize SARS-CoV-2 rRT-PCR based on surveillance data obtained from February 7th to June 4th, 2020 and evaluated positive result characteristics according to the reagents used and sample types. A total of 1,890,319 SARS-CoV-2 rRT-PCR testing were performed, 2.3% of which were positive. Strong correlations were observed between the envelope (E) gene and RNA-dependent RNA polymerase (RdRp)/nucleocapsid (N) genes threshold cycle (Ct) values for each reagent. No statistically significant differences in gene Ct values were observed between the paired upper and lower respiratory tract samples, except in the N gene for nasopharyngeal swab and sputum samples. Our study showed that clinical laboratories in Korea have rapidly expanded their testing capacities in response to the COVID-19 outbreak, with a peak daily capacity of 34,193 tests. Rapid expansion in testing capacity is a critical component of the national response to the ongoing pandemic.

Background: The rapid expansion of corona virus (COVID-19) pandemic and inability in most countries to control it in finding out an effective treatment or vaccine to prevent it, resulted in worldwide recourse to committing people to remain at home for a long time, which had many negative effects on individuals in all aspects of health. Aim of the study was to evaluate effects of home confinement during COVID-19 outbreak on the physical, social and psychosocial status of children and adolescents. A descriptive cross sectional design was used in carrying out the present study; the data were collected from a convenient sample of 183 children and adolescents' survey, which distributed electronically. The survey targeted the preparatory, secondary schools and university students send online via Egypt and Saudi Arabia portals. A structured questionnaire that consists of personal characteristics of the studied sample; plus effects of home confinement on physical activity; social and psychological status children and adolescent. The results revealed that studied subjects suffered from negative effects on physical, social and psychological status as result of home confinement. This study concluded that home confinement due to COVID-19 which has negative effect on physical status, social relations and worsening in the psychological behaviors of children and adolescents. Therefore, this study recommended to design educational interventions for children and adolescent to enable them to cope and adjust with emergency health hazards.

In the past 2 decades, there has been a rapid expansion of clinical studies investigating the safety and efficacy of biological treatment methods for a wide range of diseases. These biological treatment methods increasingly are used in clinical practice based on limited available evidence. This article provides an overview of evidence on biological treatment methods for foot and ankle pathologies, including ankle osteoarthritis, osteochondral lesions of the talus, and Achilles tendinopathy.

While telemedicine has been utilized with more frequency over the past two decades, there remained significant barriers to its broad implementation. The COVID-19 global pandemic served as a stimulus for rapid expansion and implementation of telemedicine services across medical institutions worldwide in order to maximize patient care delivery, minimize exposure risk among healthcare providers and patients alike, and avoid overcrowding of patient care facilities. In this experience report, we highlight the teledermatology initiatives executed by the Dermatology Service at Memorial Sloan Kettering Cancer Center in New York City, with particular emphasis on image ingestion and potential for future automation and improvement.

Purpose of the research. The article analyzes the general state of the modern domestic pharmaceutical nomenclature system in order to identify the transformation processes taking place in it, determine the directions of development, and in particular the place and role of traditional Latin special terminology in it. Research methods are induction, deduction, descriptive, contextual-interpretive and component analysis methods. Scientific novelty. Considering the fact that such an analysis has not been carried out in Ukraine, this work will be useful for the specialists' understanding of the existing terminological problems and their further elimination. Conclusions. Despite the rapid expansion of the sphere of English language functioning, Latin traditionally remains the basis of international scientific terminology and specialized nomenclature codes, especially in medical and related branches of people’s activity. The fundamental study of the Latin language and the foundations of terminology is the key to professional terminological literacy of the future specialists – medical doctors and pharmacists.

Earlier, 13 haplotype groups defined by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genome sequence variations were identified in 2790 sequences available in March 2020. Also, 23403A>G that causes p. Asp614Gly in the spike protein and is one of the defining variations of the haplotype group H1, was becoming increasingly prevalent. As a follow-up, 74922 SARS-CoV-2 sequences retrieved from individuals infected in June 1 to November 15 were analyzed. Consistent with the reports on 23403A>G, H1 haplotype frequency increased world-wide; among August to November sequences, only 0.3% were associated with non-H1 haplotypes. This finding prompted assessment of H1 sub-haplotypes among the sequences of the later stage of the coronavirus disease 2019 pandemic. The distribution of the sub-haplotypes differed in different regions, but 98.4% of the sequences were associated with five H1 sub-haplotypes. One of these had not been previously observed and had emerged in Europe by June 2020. The most important finding of the present study is identification of this new sub-haplotype (H1r) and finding evidence that suggest it may have a high potential for expansion. Its frequency had reached 10%-90% in various countries/territories of Europe by the end of September. The new sub-haplotype is defined by seven sequence variations, one of which causes Ala222Val in the spike protein.

Acute myeloid leukemia (AML) is a heterogeneous group of diseases that poses an array of therapeutic challenges. For decades two chemotherapeutic agents, cytarabine and daunorubicin, remained the backbone of AML therapy protocols. However, since 2017 nine novel therapies have been approved for the management of AML. With the rapid expansion of therapeutic options, hematologists must adapt their practice to optimize the benefits of these novel therapy options and minimize treatment toxicity. Here, we discuss the novel therapies that have changed the standard of care in management of patients with AML. We summarize the pivotal clinical trials that lead to the approval of these agents, and ongoing trials evaluating additional potential indications. We discuss several promising therapy candidates and their corresponding clinical trials. We discuss therapeutic strategies to incorporate these therapies into practice and pose unanswered questions that have arisen along with the expansion of treatment options.

Three-dimensional (3D) printing is a method by which two-dimensional (2D) virtual data is converted to 3D objects by depositing various raw materials into successive layers. Even though the technology was invented almost 40 years ago, a rapid expansion in medical applications of 3D printing has only been observed in the last few years. 3D printing has been applied in almost every subspecialty of medicine for pre-surgical planning, production of patient-specific surgical devices, simulation, and training. While there are multiple review articles describing utilization of 3D printing in various disciplines, there is paucity of literature addressing applications of 3D printing in breast cancer management. Herein, we review the current applications of 3D printing in breast cancer management and discuss the potential impact on future practices.

Purpose of Review This review summarizes HIV care delivered via telemedicine before and during the COVID-19 pandemic and highlights areas of study to inform optimal usage of telemedicine in HIV clinical practice in the future. Recent Findings To address barriers to care created by the COVID-19 pandemic, regulatory agencies and payors waived longstanding restrictions, which enabled rapid expansion of telemedicine across the country. Preliminary data show that providers and persons with HIV (PWH) view telemedicine favorably. Some data suggest telemedicine has facilitated retention in care, but other studies have found increasing numbers of PWH lost to follow-up and worsened virologic suppression rates despite offering video and/or telephone visits. Summary The COVID-19 pandemic has exacerbated gaps in the HIV care continuum. To help mitigate the impact, most clinics have adopted new virtual care options and are now evaluating usage, impact, and concerns. Further research into the effects of telemedicine on HIV care and continued work towards universal access are needed.

In Ethiopia, the rapid expansion of the construction sector has resulted in the wastage of construction materials that negatively affect the environment, society, and the economy. The reason is inefficient waste management strategies practiced in construction projects. Hence, an adequate material waste management strategy is required. This study was an attempt to identify the key techniques that can help to minimize material wastage in building construction projects. Questionnaire surveys, interviews, and reviews of previous studies and related literature were employed in gathering the relevant data. Seventy of 85 questionnaires administered and distributed to contractors, consultants, and clients were returned. These data were analyzed using the relative importance index method. The results indicated that employing waste management officers for this purpose, using prefabricated or off-site production of components, appropriate on-site waste management, and incorporating a policy of material waste minimization plan were identified as key measures to minimize construction material wastes.

Adoptive cell transfer (ACT) with tumor-infiltrating lymphocytes (TILs) can generate durable clinical responses in patients with metastatic melanoma and ongoing trials are evaluating efficacy in other advanced solid tumors. The aim of this study was to develop methods for the expansion of tumor-reactive TIL from resected soft tissue sarcoma to a degree required for the ACT. From 2015 to 2018, 70 patients were consented to an institutional review board-approved protocol, and fresh surgical specimens were taken directly from the operating room to the laboratory. Fragments of the tumor (1 mm(3)) or fresh tumor digest were placed in culture for a period of 4 weeks. Successfully propagated TIL from these cultures were collected and analyzed by flow cytometry. TIL were cocultured with autologous tumor and function was assessed by measurement of interferon-γ in the supernatant by enzyme-linked immunosorbent assay. Initial TIL cultures were further expanded using a rapid expansion protocol. Nearly all specimens generated an initial TIL culture (91% fragment method, 100% digest method). The phenotype of the TIL indicated a predominant CD3(+) population after culture (43% fragment, 52% digest) and TIL were responsive to the autologous tumor (56% fragment, 40% digest). The cultured TIL expanded to a degree required for clinical use following rapid expansion protocol (median: 490-fold fragment, 403-fold digest). The data demonstrate the feasibility of TIL culture from fresh soft tissue sarcoma. The derived TIL have tumor-specific reactivity and can be expanded to clinically relevant numbers. An active ACT clinical trial using the methods described in this report is now approved for patients with metastatic soft tissue sarcoma.

The incidence of heart failure (HF) remains high and patients with HF are at risk for frequent hospitalisations. Remote monitoring technologies may provide early indications of HF decompensation and potentially allow for optimisation of therapy to prevent HF hospitalisations. The need for reliable remote monitoring technology has never been greater as the COVID-19 pandemic has led to the rapid expansion of a new mode of healthcare delivery: the virtual visit. With the convergence of remote monitoring technologies and reliable method of remote healthcare delivery, an understanding of the role of both in the management of patients with HF is critical. In this review, we outline the evidence on current remote monitoring technologies in patients with HF and highlight how these advances may benefit patients in the context of the current pandemic.