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Gynecologic cancer care has been affected by the COVID-19 pandemic. We studied the association of racial disparity and COVID infection in the care of patients with gynecologic cancers. To assess the association of racial disparity and COVID infection in gynecologic cancers the National Cancer Database (NCDB) was queried for the year 2020 for patients with histologically confirmed diagnosis of cervical, endometrial and ovarian cancers. Patients were divided into two cohorts based on COVID test result status and subsequently stratified based on race. Race/ethnicity was categorized as 1) non-Hispanic White (NHW), 2) non-Hispanic Black (NHB), and 3) Hispanic. Subjects with missing race/ethnicity information were excluded. Outcome variables were time from diagnosis to initiation of treatment (surgery, radiation therapy versus chemotherapy). Continuous and categorical variables were reported as median [interquartile range] and number [rate] and were compared using Mann-Whitney U test and Chi-Square test, respectively. Statistical software was used and the level of significance was set at 0.05. A total of 36,863 subjects with newly diagnosed gynecologic cancers in 2020 underwent had available COVID testing information (4,827 with cervical, 23,935 with endometrial, and 8,101 with ovarian cancer). 31,516 (85.5%), 4,735 (12.8%), and 612 (1.7%) of the population were NHW, NHB, and Hispanic, respectively. The overall rate of COVID infection was the highest in NHB (6.9%), followed by Hispanic (5.6%) and NHW (5.4%), p < 0.001. Patients with cervical cancer had the highest rate of COVID infection (7.3%), followed by ovarian (5.6%) and endometrial (5.2%), p < 0.001. Non-Hispanic Black women with cervical cancer had the highest rate of infection (8.6%). Median time from diagnosis to first surgical procedure was highest in COVID positive NHB subjects (52 [IQR 20-91] in NHB, 41 [IQR 12-67] in NHW, and 40 [IQR 9-58] in Hispanics, p = 0.02). Median time from diagnosis to first radiation treatment was also highest in COVID positive NHB subjects (83 [IQR 29-107] in NHB, 52 [IQR 17-67] in NHW, and 39 [IQR 9-51] in Hispanics, p = 0.04). There was not racial or ethnic disparity in time from diagnosis to the first systemic therapy. COVID pandemic has substantially impacted gynecologic cancer care in the United States and exacerbated existing healthcare disparities. Members of African American community with gynecologic cancers have been affected the most compared to other racial groups, both in terms of COVID infection rates and delays in receiving care. Further study is warranted to understand impact on long-term cancer related outcomes. [ABSTRACT FROM AUTHOR]

Background Detection and treatment of anal histologic high-grade squamous intraepithelial lesions (hHSIL) prevents anal cancer. However, anal hHSIL incidence among women with human immunodeficiency virus (HIV, WHIV) remains unknown. Performance of anal high-risk human papillomavirus ([hr]HPV), anal cytology (anal-cyt), and both for hHSIL detection longitudinally over 2 years also remains undetermined. Methods We determined 2-year incidence and cumulative risk estimates (2-y-CR) of anal hHSIL among WHIV using prevalence and incidence (per 100 person-years [py]) observations stratified by baseline hrHPV and/or anal-cyt results. Results In total, 229 WHIV with complete baseline data were included in the analysis; 114 women without prevalent anal hHSIL were followed with 2 annual evaluations. Median age was 51, 63% were Black, and 23% were Hispanic. Anal hrHPV or abnormal anal-cyt was associated with an increased risk of incident anal hHSIL at 2 years (18.9/100py [95% confidence interval {CI} 11.4–31.3] and 13.4/100py [95% CI 8.0–22.7], respectively) compared with no detection of anal HPV or negative cytology (2.8/100py [95% CI 1.1–7.4] and 4.2 [95% CI, 1.8–10.2]) The presence of anal hrHPV with abnormal cytology was associated with 2-y-CR of anal hHSIL of 65.6% (95% CI 55.4%–75%); negative hrHPV with negative cytology was associated with 2-y-CR of anal hHSIL of 9.2% (95% CI 7.0–16.0). Conclusions Detection of anal hrHPV or abnormal anal cytology are comparable predictors for 2-y-CR of anal hHSIL. The absence of anal hrHPV combined with negative cytology was predictive of a lower (but measurable) risk of developing anal hHSIL. These findings provide important data to inform anal cancer screening guidelines for WHIV. [ABSTRACT FROM AUTHOR]

• Optimized design of new natural gas pyrolysis reactor using catalytic liquid metal. • Designed new methanol process using natural gas pyrolysis and CO2 utilization. • Negative cradle-to-gate CO 2 emissions are achievable with new process. • Low CO 2 emissions from supply chains of natural gas and captured CO 2 are critical. • Process is economically profitable if the carbon produced by pyrolysis is sold. Due to its abundance and relatively low cost, natural gas will continue to be a common feedstock for methanol production, at least in the near to medium term. The present work focuses on natural gas pyrolysis in a catalytic liquid metal bubble reactor, combined with CO 2 utilization, as an alternative to traditional steam reforming processes. The pyrolysis reactor consists of multiple vertical tubes filled with molten Cu 0.45 Bi 0.55 alloy and heated in the radiant zone of a fired heater. The reactor geometry and operating conditions are optimized by rigorously accounting for the coupling of bubble flow hydrodynamics with the catalytic and non-catalytic kinetics of methane pyrolysis in molten metals. Pyrolysis generates hydrogen and solid carbon, which rise first through the liquid metal and then through a layer of molten salt (e.g., NaBr) whose purpose is to minimize the loss of liquid metal entrained with the carbon. The carbon forms a recoverable layer above the salt, and the hydrogen reacts with captured CO 2 in a separate methanol synthesis reactor. The cradle-to-gate and cradle-to-grave CO 2 emissions are 0.074 and 1.45 t CO 2 -eq/t methanol, respectively, for median supply chain emissions of natural gas and captured CO 2. This is a lower carbon footprint than other practical pyrolysis and steam methane reforming processes. Negative cradle-to-gate CO 2 emissions are achievable if natural gas and captured CO 2 are sourced from supply chains with low emissions. The estimated carbon production cost of $0.27/kg is well below the recent market price of carbon black in the United States. The production cost of carbon is most sensitive to the fixed capital investment of the plant, the captured CO 2 cost, the natural gas and methanol costs, and the discount rate. [ABSTRACT FROM AUTHOR]

Introduction: 79% of the American and 87.2% of the Iranian pregnant women suffer from sleep disorders. Thesedisordersarethe result ofphysiological, hormonal, and physicalchangesoccurring in pregnancy due todifferent causes such as fetal Sex. This study aimed to evaluate the association of fetal sex and common complaints of pregnancy in pregnant women with sleep disorder. Materials and Methods: This is a cross-sectional study conducted on 972 pregnant women with sleep disorders referring to two selected health care centers in Makou affiliated to Urmia University of Medical Sciences during June-Oct 2012. Data collection tools included demographic characteristics and Pittsburgh Standard Sleep Quality. Sampling was done by convenient sampling. Pregnant women with sleep disorders (Based on the PSQI) were selected as the subjects then demographic characteristics and beck depression standard questionnaires was completed by women, and statistical methods used to analysis. Results: The results indicated that there were significant association (p≤0.05) between fetal sex to backache (r=0.129) and vomiting(r=0.204). Women with female fetus's more than male experienced backpain and vomiting. Other complaints were not significantly different. Conclusion: Fetal gender is independently associated with adverse pregnancy outcome. Although the added risk is relatively small, further investigation of the mechanisms underlying this association may contribute to our understanding of the pathophysiology of pregnancy complications such as sleep disorders. [ABSTRACT FROM AUTHOR]

Background. Dermatology residency programs are relatively diverse in their resident selection process. The authors investigated the importance of 25 dermatology residency selection criteria focusing on differences in program directors' (PDs') perception based on specific program demographics. Methods. This cross-sectional nationwide observational survey utilized a 41-itemquestionnaire that was developed by literature search, brainstorming sessions, and online expert reviews. The data were analyzed utilizing the reliability test, two-step clustering, and K-means methods as well as other methods. The main purpose of this study was to investigate the differences in PDs' perception regarding the importance of the selection criteria based on program demographics. Results. Ninety-five out of 114 PDs (83.3%) responded to the survey. The top five criteria for dermatology residency selection were interview, letters of recommendation, United States Medical Licensing Examination Step I scores, medical school transcripts, and clinical rotations. The following criteria were preferentially ranked based on different program characteristics: "advanced degrees," "interest in academics," "reputation of undergraduate and medical school," "prior unsuccessful attempts to match," and "number of publications."Conclusions. Our survey provides up-to-date factual data on dermatology PDs' perception in this regard. Dermatology residency programs may find the reported data useful in further optimizing their residency selection process. [ABSTRACT FROM AUTHOR]

Background: Since December 2019, the world has been facing one of the most critical health threats of the last decades. In March 2021, the official number of deaths passed 2.6 million worldwide. Most countries have developed policies to control the disease. Nevertheless, countries have experienced different outcomes related to their various adapted policies. Complementing our first report, in this article, we report our findings of comparing the policies adopted to combat coronavirus disease 2019 (COVID-19) in Iran, with those from nine selected countries, including China, Japan, South Korea, Singapore, Germany, the United States, the United Kingdom, Spain, and Italy, to draw evidence-informed policy lessons. Methods: This is a qualitative study conducted based on document analysis related to COVID-19 policies in Iran and nine selected countries. Using a deductive approach, data were extracted and analyzed based on the components of the WHO Building Blocks Framework. Finally, we compared the Iranian policies with the nine selected countries. Results: Documents analysis revealed a spectrum of policies, which have led to a variety of outcomes. Based on our findings, three main strategies (widespread testing, comprehensive contact tracing, and timely measures) were the most effective directions to combat COVID-19. Conclusion: The experience of the first and second waves of COVID-19 showed that the risk of coronavirus is serious and will continue until a vaccine or decisive treatment is achieved. Therefore, countries are required to adopt appropriate and tailored policies to deal with this crisis effectively. Applying the experiences from the previous waves is essential for more efficient performance in the likely upcoming waves. INSET: 260. [ABSTRACT FROM AUTHOR]

Background Women living with human immunodeficiency virus (WLHIV) have disproportionately high rates of squamous cell carcinoma of the anus compared with the general population of women. Anal high-grade squamous intraepithelial lesions (HSILs) precede anal cancer, and accurate studies of HSIL prevalence among WLHIV in the United States are lacking. Methods The AIDS Malignancy Consortium 084 study was a multicenter national trial to evaluate the prevalence of and risk factors for anal HSIL in a US cohort. Eligible participants were WLHIV aged ≥18 years with no history of anal HSIL. Study participants had an examination including collection of cervical/vaginal and anal specimens, followed by high-resolution anoscopy with biopsy. Results We enrolled 256 women with evaluable anal pathology. The mean age was 49.4 years, 64% women were non-Hispanic black, 67% were former or current smokers, and 56% reported ever having anal sex with a man. The median CD4 T-cell count was 664 cells/μL. The prevalence of anal histologic HSIL (hHSIL) was 27% (95% confidence interval [CI], 22%–33%). There was a strong concordance (240/254) between local and consensus pathologists for hHSIL vs less than hHSIL (κ = 0.86 [95% CI,.79–.93]). Current CD4 count of ≤200 cells/μL was the strongest predictor of consensus anal hHSIL diagnosis (adjusted odds ratio [aOR], 10.34 [95% CI, 3.47–30.87]). History of anoreceptive intercourse was also associated with hHSIL (aOR, 2.44 [95% CI, 1.22–4.76]). Conclusions The prevalence of anal hHSIL in WLHIV in the United States was 27% in this study where all participants received high-resolution anoscopy and biopsy. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) has a devastating impact on global populations triggered by a highly infectious viral sickness, produced by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The third major cause of mortality in the United States, following heart disease and cancer in 2020, was undoubtedly COVID-19. The centers for disease control and prevention (CDC) and the world health organization (WHO) separately developed a categorization system for differentiating new strains of SARS-CoV-2 into variants of concern (VoCs) and variants of interest (VoIs) with the continuing development of various strains SARS-CoV-2. By December 2021, five of the SARS-CoV-2 VoCs were discovered from the onset of the pandemic depending on the latest epidemiologic report by the WHO: Alpha (B.1.1.7), Beta (B.1.351), Gamma (P.1), Delta (B.1.617.2), and Omicron (B.1.1.529). Mutations in the receptor-binding domain (RBD) and n-terminal domain (NTD) have been found throughout all five identified VoCs. All strains other than the delta mutant are often found with the N501Y mutation situated on the RBD, resulting in higher binding between the spike protein and angiotensin-converting enzyme 2 (ACE2) receptors, enhanced viral adhesion, and following the entrance to host cells. The introduction of these new strains of SRAS-CoV-2 is likely to overcome the remarkable achievements gained in restricting this viral disease to the point where it is presented with remarkable vaccine developments against COVID-19 and strong worldwide mass immunization initiatives. Throughout this literature review, the effectiveness of current COVID-19 vaccines for managing and prohibiting SARS-CoV-2 strains is thoroughly described. [Display omitted] • Equitable COVID-19 vaccine distribution serves as a strong barrier to the emergence of SARS-CoV-2 VoCs. • Administration of heterologous vaccines enhances cellular and humoral immunity against novel strains of SARS-CoV-2. • Novel combination therapies (oral antiviral compounds and vaccination) to combat COVID-19. [ABSTRACT FROM AUTHOR]