Optional Part Research Articles

Expansive shrubs: Expansion factors and ecological impacts in northern Ethiopia

Expansive native species have the same ecological and economic consequences as invasive alien species through the reduction of ecosystem goods and services. We assessed human disturbance and environmental factors that are contributing to the expansion of two expansive shrubs, Cadia purpurea and Tarchonanthus camphoratus in Desa’a dry Afromontane forest, northern Ethiopia. We also evaluated their expansion effect on plant species composition, diversity, structure, and regeneration, and herbaceous cover. The forest was stratified into “invaded” and “uninvaded” based on percentage coverage of the two shrubs. Vegetation data were collected from each stratum using 75 nested plots per strata of 20m × 20m, 5m × 5m, and 1m × 1m for adult tree/shrub, sapling, and seedling, respectively. Moreover, data on environmental and human disturbance variables were collected from the main plots. We found that higher cover of the expansive shrubs was related to both human disturbance and environmental variables while some were species-specific. Species richness and diversity of plant species decreased significantly with an increase in abundance of the expansive shrubs. However, evenness did not change significantly with an increase in the abundance of the expansive shrubs. The density, mean diameter, mean height, and mean basal area of the plants decreased significantly with an increase with the cover of the shrubs. The expansive shrubs had a significant negative impact on regeneration and herbaceous cover. This study shows a distinctive variation in floristic composition, diversity, and regeneration status between the invaded and uninvaded communities, which suggests the need to be counteracted by management measures. Converting the underutilized expansive species into use as part of the management option should be given urge attention before it loses its ecological resilience.

Developing a Web-Based Shared Decision-Making Tool for Fertility Preservation Among Reproductive-Age Women With Breast Cancer: An Action Research Approach.

BackgroundThe pregnancy rate after cancer treatment for female survivors is lower than that of the general population. Future infertility is a significant concern for patients with breast cancer and is associated with a poor quality of life. Reproductive-age patients with breast cancer have safe options when choosing a type of fertility preservation method to be applied. Better information and support resources aimed at women to support their decision making are needed.ObjectiveThe objective of this study was to develop a web-based shared decision-making tool for helping patients with breast cancer make decisions on fertility preservation.MethodsWe used the action research cycle of observing, reflecting, planning, and acting to develop a web-based shared decision-making tool. The following four phrases were applied: (1) observe and reflect—collect and analyze the decision-making experiences of patients and health care providers; (2) reflect and plan—apply the initial results to create a paper design and modify the content; (3) plan and act—brainstorm about the web pages and modify the content; (4) act and observe—evaluate the effectiveness and refine the website’s shared decision-making tool. Interviews, group meetings, and constant dialogue were conducted between the various participants at each step. Effectiveness was evaluated using the Preparation for Decision-Making scale.ResultsFive major parts were developed with the use of the action research approach. The Introduction (part 1) describes the severity of cancer treatment and infertility. Options (part 2) provides the knowledge of fertility preservation. The shared decision-making tool was designed as a step-by-step process (part 3) that involves the comparison of options, patient values, and preferences; their knowledge regarding infertility and options; and reaching a collective decision. Resources (part 4) provides information on the hospitals that provide such services, and References (part 5) lists all the literature cited in the website. The results show the web-based shared decision-making meets both patients’ and health providers’ needs and helps reproductive-age patients with breast cancer make decisions about fertility preservation.ConclusionsWe have created the first web-based shared decision-making tool for making fertility preservation decisions in Taiwan. We believe female patients of reproductive age will find the tool useful and its use will become widespread, which should increase patient autonomy and improve communication about fertility preservation with clinicians.Trial RegistrationClinicaltrials.gov NCT04602910; https://clinicaltrials.gov/ct2/show/NCT04602910

Impact investment in marine conservation

Marine Protected Areas (MPAs) are promising examples of Nature-Based Solutions that can protect diversity while delivering ecosystem services. However insufficient funding for effective management and expansion of MPAs remains a challenge and one that particularly affects developing countries. During the last ten years, a community of investors seeking positive social and environmental impacts alongside financial returns, have stepped in to help fill this marine conservation financing gap. An innovative collaborative management approach has been recently implemented in the Dominican Republic for one of the largest MPAs in the Caribbean. Blended finance solutions mixing catalytic, development and impact finance have been used to cover the up-front capital needs. MPA revenues are being generated for MPA management and investor returns, via a range of sustainable finance tools including fees paid by visitors. The solution offers interesting outcomes that uses catalytic and development finance to mobilise commercial impact finance into MPAs. From a Government point of view, the approach provides empirical evidence of how non-public funding can become part of the financing options for a country’s MPA network, reducing the financial burden on Public Budgets. Scalability of the approach seems limited by the number of MPAs with tangible business models.

Reducing the time to successful intravenous cannulation in anaesthetised children with poor vein visibility using a near-infrared device: A randomised multicentre trial.

During inhalational induction of anaesthesia for children, severe respiratory events can occur but can be rapidly treated once intravenous access is in place. Reducing the time to successful cannulation during inhalational induction for children with poor vein visibility would improve safety. To study the effectiveness of a near-infrared (NIR) vascular imaging device (Veinviewer) to facilitate intravenous cannulation. A prospective, multicentre, randomised, open clinical trial. The operating rooms of three paediatric hospitals in Paris, France, from 1 October 2012 to 31 March 2016. Children up to the age of 7 years, with poor vein visibility requiring general anaesthesia. Inhalational anaesthesia was initiated and intravenous cannulation was performed with the standard approach or with the Veinviewer Vision. The primary outcome was the time to successful intravenous cannulation. A secondary outcome was the proportion of successful first attempts. The mean time to successful intravenous cannulation was 200 (95% CI, 143 to 295) seconds in the Veinviewer and 252 (95% CI, 194 to 328) seconds for the control group: hazard ratio 1.28 (1.02 to 1.60) (P = 0.03). The adjusted hazard ratio for known predictive factors was 1.25 (0.99 to 1.56) (P = 0.06). Success at the first attempt was 64.6% (102/158) in the 'Veinviewer' group vs. 55.6% (85/153) in the 'control' group (P = 0.10). The Veinviewer has limited value in reducing the time to successful intravenous cannulation during inhalational anaesthesia for young children with poor vein visibility. However, there is a strong trend to reducing the delay in some cases and, given its absence of side effects, it could be part of a rescue option for a difficult venous-access strategy. NCT01685866 (http://www.clinicaltrials.gov).

TOURISM IN SCHOOL. THE SCHOOLCHILDREN ATTITUDE

The study of literary sources, as well as the analysis of the educational programs of public schools in different countries shows that tourism training is included in the school system in a number of countries. Currently, in the state educational documents of the Republic of Armenia, tourism training is included in the curriculum of the subject "Physical culture" in high school as an optional part. However, studies show that in practice it is not fully implemented, and there are many reasons for that. One of the reasons is that currently there is no scientific and methodological base for the organization and implementation of the tourism training program.

Diagnostic accuracy of Fever-PAIN and Centor criteria for bacterial throat infection in adults with sore throat: a secondary analysis of a randomised controlled trial.

BackgroundSore throat is a common and self-limiting condition. There remains ambiguity in stratifying patients to immediate, delayed, or no antibiotic prescriptions. The National Institute for Health and Care Excellence (NICE) recommends two clinical prediction rules (CPRs), FeverPAIN and Centor, to guide decision making.AimTo describe the diagnostic accuracy of CPRs in identifying streptococcal throat infections.Design & settingAdults presenting to UK primary care with sore throat, who did not require immediate antibiotics.MethodAs part of the Treatment Options without Antibiotics for Sore Throat (TOAST) trial, 565 participants, aged ≥18 years, were recruited on day of presentation to general practice. Physicians could opt to give delayed prescriptions. CPR scores were not part of the trial protocol but were calculated post hoc from baseline assessments. Diagnostic accuracy was calculated by comparing scores with throat swab cultures.ResultsIt was found that 81/502 (16.1%) patients had group A, C, or G streptococcus cultured on throat swab. Overall diagnostic accuracy of both CPRs was poor: area under receiver operating characteristics (ROC) curve 0.62 for Centor; and 0.59 for FeverPAIN. Post-test probability of a positive or negative test was 27.3% (95% confidence interval [CI] = 6.0% to 61.0%) and 84.1% (95% CI = 80.6% to 87.2%) for FeverPAIN ≥4; versus 25.7% (95% CI = 16.2% to 37.2%) and 85.5% (95% CI = 81.8% to 88.7%) for Centor ≥3. Higher CPR scores were associated with increased delayed antibiotic prescriptions (χ2 = 8.42, P = 0.004 for FeverPAIN ≥4; χ2 = 32.0, P<0.001 for Centor ≥3).ConclusionIn those who do not require immediate antibiotics in primary care, neither CPR provides a reliable way of diagnosing streptococcal throat infection. However, clinicians were more likely to give delayed prescriptions to those with higher scores.

Innovative Strategies and Challenges for the Prevention of Pathological Anxiety in Children and Adolescents

The effects of pathological anxiety on public health have led to the realization that anxious children might experience significant limitations in their lives. Evidence-based cognitive-behavioral (CB) interventions are now being implemented in schools at a group level to combat anxiety.Childhood emotional health should be considered a national and global priority for an effective strategy promoting the prevention of mental health. The aim of this study is the description of novel data on the effectiveness of preventive interventions for anxious children, as well as the study of selective parameters that appear to affect treatment outcome.Furthermore, a brief review is cited regarding two empirically supported interventions, which include the Friends and Pyramid Club program and the Super Skills for Life program. Schools are considered suitable places for all types of prevention programs; they provide a familiar environment to a child, and by providing access to the prevention programs to many children, school programs could be the ideal way for anxious young individuals to practice and generalize their skills. Schools also offer an ideal space for collaboration between teachers and mental health professionals. Most programs have been effective in reducing anxiety, especially those based on the principles of CB, where the effects appear to be independent of the professional status of the leader (trained teacher or mental health professional). Friends and Pyramid Club interventions are well-established, multifaceted, and cost-effective programs, which include combinations of techniques (mostly behavioral activation, cognitive preparation, teaching social skills, and relaxation techniques). Super Skills for Life is a promising program, which also uses video feedback as a part of treatment. Prevention programs have been established as a vital part of the treatment options for specialists. Research related to childhood anxiety is increasing, while the perspectives for finding novel data seem promising for the upcoming years.In this context, several studies reveal the need for early, selective, intensive, persistent, multifaceted, and participatory interventions.

Глаголы физического контакта: модели управления и семантические сдвиги

Artykuł poświęcony jest korpusowym badaniom zmian semantycznych, które powstają przy wyrażaniu przez czasowniki kontaktu fizycznego, typu: całować, obejmować, gładzić walencji possesora (posiadacza) i części ciała. Reprezentują one różne modele rekcyjne : wyrażanie biernikiem walencji possesora przy fakultatywnym wyrażaniu części (całować ją (w usta), głaskać dziecko (po główce), walencji części formą biernika przy jednoczesnym wyrażaniu possesora przez zaimek dzierżawczy lub przez dopełniacz (całować jej ręce/ ręce żony), a także użycie formy celownika dla possesora, a biernika dla wyrażenia części (całować matce ręce, głaskać jej/ żonie plecy). Nasze ogólne spostrzeżenia uszczegóławiają wnioski z poprzednich prac z tego zakresu badań, wyjaśniają rozkład częstotliwości występowania omawianych konstrukcji z nazwami części ciała oraz preferowanych przez czasowniki syntaktycznych sposobów wyrażania semantycznych aktantów. Opisują także artystyczny efekt użycia omawianych wyrażeń w nietypowych konstrukcjach w tekstach literackich.&#x0D; АбстрактРабота посвящена корпусному исследованию семантических сдвигов, которые возникают при различном выражении валентности посессора и части у глаголов физического контакта целовать, обнимать, гладить и др. Они позволяют разные модели управления: выражение валентности посессора аккузативом при факультативном выражении части (целовать ее (в губы), гладить ребенка(по голове)), валентности части аккузативом при выражении валентности посессора притяжательным местоимением или генитивом (целовать ее руки, целовать руки жены), а также вынесение посессора в дативную конструкцию, с выражением части аккузативом (целовать ей руки, гладить ей спину). Наши общие наблюдения уточняют выводы предыдущих работ в этой области исследований, дают объяснение частотной дистрибуции названий частей тела по разным конструкциям, а также предпочтительным синтаксическим способам выражения семантических актантов у глаголов, описывают художественный эффект использования слов в несвойственных им конструкциях в литературных текстах.

Hip disease in Mucopolysaccharidoses and Mucolipidoses: A review of mechanisms, interventions and future perspectives.

The hips are frequently involved in inheritable diseases which affect the bones. The clinical and radiological presentation of these diseases may be very similar to common hip disorders as developmental dysplasia of the hip, osteoarthritis and avascular necrosis, so the diagnosis may be easily overlooked and treatment may be suboptimal. Mucopolysaccharidosis (MPS) and Mucolipidosis (ML II and III) are lysosomal storage disorders with multisystemic involvement. Characteristic skeletal abnormalities, known as dysostosis multiplex, are common in MPS and ML and originate from intra-lysosomal storage of glycosaminoglycans in cells of the cartilage, bones and ligaments. The hip joint is severely affected in MPS and ML. Hip pathology results in limitations in mobility and pain from young age, and negatively affects quality of life. In order to better understand the underlying process that causes hip disease in MPS and ML, this review first describes the normal physiological (embryonic) hip joint development, including the interplay between the acetabulum and the femoral head. In the second part the factors contributing to altered hip morphology and function in MPS and ML are discussed, such as abnormal development of the pelvic- and femoral bones (which results in altered biomechanical forces) and inflammation. In the last part of this review therapeutic options and future perspectives are addressed.

Characterizing Tractability of Simple Well-Designed Pattern Trees with Projection

We study the complexity of evaluating well-designed pattern trees, a query language extending conjunctive queries with the possibility to define parts of the query to be optional. This possibility of optional parts is important for obtaining meaningful results over incomplete data sources as it is common in semantic web settings. Recently, a structural characterization of the classes of well-designed pattern trees that can be evaluated in polynomial time was shown. However, projection—a central feature of many query languages—was not considered in this study. We work towards closing this gap by giving a characterization of all tractable classes of simple well-designed pattern trees with projection (under some common complexity theoretic assumptions). Since well-designed pattern trees correspond to the fragment of well-designed {AND, OPTIONAL}-SPARQL queries this gives a complete description of the tractable classes of queries with projections in this fragment that can be characterized by the underlying graph structures of the queries. For non-simple pattern trees the tractability criteria for simple pattern trees do not capture all tractable classes. We thus extend the characterization for the non-simple case in order to capture some additional tractable cases.

Greening the Browns: A Bio-Based Land Use Framework for Analysing the Potential of Urban Brownfields in an Urban Circular Economy

The Circular Economy (CE) is expected to accelerate the use of resources with bio-based origin. Cities have an important role in such an economy, not only as main consumers but also because vegetation provides numerous ecosystem services essential for the well-being of urban dwellers. Urban lands are, however, heavily burdened with both past and present activities and ongoing urbanization. Retrofitting obsolete and potentially contaminated brownfields provides an opportunity to engage with bio-based land uses within the city. At the same time, plants are an important part of Gentle Remediation Options (GROs), a more sustainable alternative for managing contamination risks and restoring soil health. This paper (1) provides a tentative selection of Urban Greenspaces (UGSs) relevant for brownfields, and a compilation of ecosystem services provided by the selected UGSs, and (2) presents a framework covering the 14 selected bio-based land uses on brownfields, including GRO interventions over time. This framework provides three practical tools: the conceptualization of linkages between GROs and prospective UGS uses, a scatter diagram for the realization of 14 UGS opportunities on brownfields, and a decision matrix to analyze the requirements for UGS realization on brownfields.

Sulfur, Phosphorus and Metals in the Stoichiometric Estimation of Biomethane and Biohydrogen Yields

The estimation of biomethane or biohydrogen yield is used to evaluate energy recovery during the process of the anaerobic treatment of waste and wastewater. Mathematically calculated theoretical values can also be used in biomethane or biohydrogen potential tests as reference points to calculate which fraction of substrate is decomposed, when the substrate degradation stopped and when the sample’s self-digestion begins. This study suggests expanded forms of equations for anaerobic processes leading to either biomethane or biohydrogen. The traditional equations describing the conversion of a substrate with known carbon, hydrogen, oxygen and nitrogen composition were expanded to account for the composition of sulfur (for biohydrogen yields) and phosphorus (both biohydrogen and biomethane yields). As an optional part, one metal cation was also incorporated into the chemical formula of the evaluated wastewater composition in case the compound of biodegradable interest exists as a salt. The equations derived here can be useful for researchers estimating energy recovery based on the elemental analysis of samples, such as algal biomass harvested during harmful algal blooms (HABs). Examples of biomethane and biohydrogen yield estimations from sulfur- and phosphorus-containing compounds are also provided.

Conducting research in Radiation Oncology remotely during the COVID-19 pandemic: Coping with isolation

IntroductionWith the COVID-19 pandemic, individuals have been forced to follow strict social isolation guidelines. While crucial to control the pandemic, isolation might have a significant impact on productivity and mental health. Especially for researchers working in healthcare, the current situation is complex. We therefore carried out a survey amongst researchers in the field of radiation oncology to gain insights on the impact of social isolation and working from home and to guide future work. Materials and methodsAn online survey was conducted between March 27th and April 5th, 2020. The first part contained 14 questions intended to capture an overview of the specific aspects related to research while in isolation. The second (optional) part of the questionnaire was the validated Hospital Anxiety and Depression Scale (HADS), a self-reported measure used to assess levels of anxiety and depressive symptoms. ResultsFrom 543 survey participants, 48.8% reported to work full-time from home. The impact on perceived productivity, with 71.2% of participants feeling less productive, caused 58% of participants to feel some level of guilt.Compared to normative data, relatively high levels of anxiety and depressive symptoms were recorded for the 335 participants who filled out the HADS questionnaire. Group comparisons found the presence of a supportive institutional program as the sole factor of statistical significance in both anxiety and depressive symptom levels. People having to work full-time on location showed higher depressive symptom levels than those working from home. Anxiety scores were negatively correlated with the number of research years. ConclusionResults of the survey showed there is a non-negligible impact on both productivity and mental health. As the radiation oncology research community was forced to work from home during the COVID-19 pandemic, lessons can be learned to face future adverse situations but also to improve work-life balance in general.

A phase III, randomized, double-blind study of adjuvant cemiplimab versus placebo post-surgery and radiation therapy (RT) in patients (pts) with high-risk cutaneous squamous cell carcinoma (CSCC).

TPS10084 Background: CSCC is the second most common skin cancer. While the surgical cure rate for CSCC is &gt; 95%, a proportion of pts are considered to have high risk for recurrence as assessed by immune status, primary disease stage, extent of nodal involvement, presence of extracapsular extension, and prior treatment. Post-operative RT is recommended for pts with high-risk features, but relapse with locoregional recurrence or distant metastases may still occur. This study evaluates the efficacy of cemiplimab, a human anti‒PD-1 monoclonal antibody, as an adjuvant therapy for pts with CSCC with high-risk features, after surgery and RT. Methods: This randomized, placebo-controlled, double-blind, multicenter, Phase 3 study will evaluate cemiplimab as an adjuvant treatment for pts with high-risk CSCC, based on surgical and clinicopathologic findings, who have completed surgery and post-operative RT (NCT03969004). Immunocompromised pts were excluded. The trial will enrol 412 pts from about 100 sites in North America, Europe, and Asia-Pacific regions. Pts with at least one of the following high-risk features are eligible: a) nodal disease with extracapsular extension b) in-transit metastases c) T4 lesion d) perineural invasion, and e) recurrent CSCC with at least one other risk factor. In Part 1 (blinded), pts will be randomized 1:1 to receive cemiplimab 350 mg or placebo intravenously every 3 weeks (Q3W) for up to 48 weeks. In optional Part 2 (unblinded), pts in the placebo arm who experience disease recurrence or pts in the cemiplimab arm who experience disease recurrence ≥3 months after completion of 48-week treatment in Part 1 will be eligible to receive open-label cemiplimab 350 mg Q3W for up to 96 weeks. Key objectives are to compare disease-free survival (primary) as well as overall survival, freedom from locoregional relapse, and distant relapse (secondary) of adjuvant cemiplimab vs placebo in pts with high-risk CSCC. This study is currently open for enrollment. Clinical trial information: NCT03969004.

KCNQ1 Antibodies for Immunotherapy of Long QT Syndrome Type 2

BackgroundPatients with long QT syndrome (LQTS) are predisposed to life-threatening arrhythmias. A delay in cardiac repolarization is characteristic of the disease. Pharmacotherapy, implantable cardioverter-defibrillators, and left cardiac sympathetic denervation are part of the current treatment options, but no targeted therapy for LQTS exists to date. Previous studies indicate that induced autoimmunity against the voltage-gated KCNQ1 K+ channels accelerates cardiac repolarization. ObjectivesHowever, a causative relationship between KCNQ1 antibodies and the observed electrophysiological effects has never been demonstrated, and thus presents the aim of this study. MethodsThe authors purified KCNQ1 antibodies and performed whole-cell patch clamp experiments as well as single-channel recordings on Chinese hamster ovary cells overexpressing IKs channels. The effect of purified KCNQ1 antibodies on human cardiomyocytes derived from induced pluripotent stem cells was then studied. ResultsThe study demonstrated that KCNQ1 antibodies underlie the previously observed increase in repolarizing IKs current. The antibodies shift the voltage dependence of activation and slow the deactivation of IKs. At the single-channel level, KCNQ1 antibodies increase the open time and probability of the channel. In models of LQTS type 2 (LQTS2) using human induced pluripotent stem cell-derived cardiomyocytes, KCNQ1 antibodies reverse the prolonged cardiac repolarization and abolish arrhythmic activities. ConclusionsHere, the authors provide the first direct evidence that KCNQ1 antibodies act as agonists on IKs channels. Moreover, KCNQ1 antibodies were able to restore alterations in cardiac repolarization and most importantly to suppress arrhythmias in LQTS2. KCNQ1 antibody therapy may thus present a novel promising therapeutic approach for LQTS2.

Kurdistan’s role in European energy security

The paper analyzes the Kurdistan Regional Government’s (KRG) natural resource strategies, such as how it deals with huge reserves of many trillion cubic feet of its natural gas as significant energy. Because natural gas belongs to the cleanest burning fossil fuels, with 30 percent less carbon than oil, it plays a role in the global fuel economy. As KRG transports its natural gas to international markets, like European countries, via Turkey it means they also participate in energy security as a new actor. Because the KRG is landlocked, strong factors may affect Kurdish natural gas strategies because KRG is surrounded by today’s partners and yesterday’s enemies politically and economically. Turkey, the neighbor of KRG, also buys its gas and has an influence on these strategies after the Ukraine crisis that pushed European countries to make a turn towards Caspian natural gas. Kurdistan is part of the best option for European energy security as it plans to diversify natural gas imports. While the KRG benefits from selling its natural gas directly to international markets, this will come with some struggles. Many of these obstacles can be classified into two types: internal and external obstacles, such as a conflict with the central government regarding how to share gas revenues. Others problems include Iranian neighbor interest on natural resources in Kurdistan and Russia that looks to Kurdish gas as its ally if Kurdistan joins the southern gas corridor pipeline.

Cardiogenic Shock Spectrum: Outcomes Utilizing VA ECMO with or without Axillary Impella 5.0: Single Center Experience

VA ECMO is often used as a rescue therapy for rapid hemodynamic stabilization due to acute refractory cardiogenic shock, while elective Impella 5.0 is often a planned strategy as part of a long-term heart failure surgical option. The objective of this study is to evaluate the differences in outcomes depending on which form of mechanical support was used. Retrospective review of all patients with an Impella 5.0 or VA ECMO between January 2018 to September 2019. A total of 138 patients were placed on either VA ECMO or Impella 5.0. Of these, 39 patients received an Impella, 116 patients were placed on VA ECMO, and 17 patients received an Impella with concurrent VA-ECMO (EC-Pella). Of the 22 Impella 5.0 only patients, survival to discharge was 90% (n= 20) of which 55% (n= 12) had durable LVAD, 27% (n= 6) heart transplant. Survival to discharge was 58% for VA ECMO patients (n= 57), and 53% in patients requiring EC-Pella (n= 9). Though the survival to discharge rate decreased for both VA ECMO and EC-Pella when compared to Impella 5.0 alone, the acuity of patients requiring ECMO support was considerably higher than patients on Impella 5.0 alone. VA ECMO is often utilized in patients in rapid hemodynamic decline and improves survival, however, the addition of Impella 5.0 did not significantly change the survival if there is no long term exit strategy.

Current Treatment Options Available for COVID-19 : A Review

The World Health Organization (WHO) introduced the term 2019 novel corona virus to refer to a corona virus that affected the lower respiratory tract of patients with pneumonia in Wuhan, China. The official name of the 2019 novel corona virus is corona virus disease (COVID-19), announced by WHO. The total reported cases of COVID-19 as of 15th June, 2020 are 79,95,877 and 4,35,598 reported deaths. Non-availability of vaccines and medicines for its treatment is really threatening to the world right now. All chloroquine and Hydroxychloroquine, antibacterial therapy like azithromycin and doxycycline, antiviral therapy like lopinavir/ritonavir and remdesivir, convalescent plasma therapy, zinc, vaccines and Tocilizumab are part of possible management options and none is officially approved for the treatment. Current review of various articles by searching on PubMed is initiated with intention of creating meaningful information regarding all possible management that is available or will be available in near future of COVID-19.

The use of CAM products, practices, and practitioners by long-term endometrial cancer survivors in Australia.

The use of complementary and alternative medicines (CAM) has been reported to be frequent and increasing in the general population and among cancer survivors. Very few studies have investigated the use of CAM among long-term endometrial cancer survivors. To address this gap in evidence, this qualitative study aimed to understand the use of CAM and factors motivating the use among long-term survivors of endometrial cancer. Semi-structured qualitative interviews were conducted with 17 women diagnosed with endometrial cancer 7-10years previously, to understand their CAM use and its impact on their wellbeing. Thematic analysis was performed by two researchers to extract the most relevant quotes related to CAM products, practices, and practitioners. All 17 women interviewed used some type of CAM practices, practitioners, or products, specifically 94% concentrated on their diet, 88% focused on their exercise, 59% used a CAM product, 53% visited a CAM practitioner, and 18% used a CAM psychological approach. The main motivators for CAM use included to reduce physical and psychological symptoms, and to stop or reduce medications. Women reported a lack of lifestyle advice from their traditional medical healthcare team which they therefore tried to obtain from other sources. Our findings suggest CAM practices, practitioners, or products form an important part of women's healthcare options and are commonly used by long-term endometrial cancer survivors. Our data can be of importance to health care professionals and hospitals, as it reflects an unfulfilled need among cancer survivors that does not currently appear to be met by their traditional healthcare team.

Whole-body MRI within a surveillance program for carriers with clinically actionable germline TP53 variants - the Swedish constitutional TP53 study SWEP53

BackgroundThe current guidelines in Sweden regarding individuals with a clinically actionable (i.e. pathogenic or likely pathogenic) germline TP53 variant recommend patients to take part of the national Swedish P53 Study (SWEP53).MethodsThe study comprises a patient registry (mandatory for all participants) and three optional parts: a biobank, a surveillance program and a psychosocial evaluation of the surveillance. All known adult eligible carriers regardless of age are offered to take part of the surveillance program offering MRI yearly of the whole-body, breast, and brain as well as breast ultrasound. A special surveillance program is offered for individuals 15–18 years old with a 50% risk of being a mutation carrier or with a verified TP53 variation, includes ultrasound of the abdomen and urine corticosteroid profiles. Clinically motivated further examinations are performed upon need. The national inclusion is performed through the six clinical genetic units in Sweden at Umeå, Uppsala, Stockholm, Gothenburg, Linköping and Lund, and the surveillance is mainly performed through the oncology clinics.ResultsTo date, a total of 41 adults and 11 children have been included in the study.ConclusionsThe SWEP53 is the first structured national surveillance program including radiological and clinical routines for TP53 mutation carriers in the Scandinavian setting. The aim of this publication is to present and describe the ongoing Swedish surveillance study to encourage the initiation of similar studies and to contribute to the knowledge of adequate clinical handling of these cancer prone families.Trial registrationTrial registration number: ISRCTN13103571, retrospectively registered on 14/10/2019.