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Background: This study evaluated the clinical outcomes of patients with severe COVID-19 pneumonia treated with remdesivir plus standard corticosteroid treatment (SCT) or with remdesivir plus high-dose corticosteroid pulse therapy (HDCPT)., Methods: One hundred and two patients with severe COVID-19 pneumonia and respiratory failure were included. The patients were divided into two cohorts. The first comprised patients who received remdesivir and SCT, consisting of 6 mg dexamethasone daily for up to 10 days or until hospital discharge. The second included patients who received remdesivir and HDCPT, composed of 250 mg iv of methylprednisolone for three days, followed by a slow reduction in the dose of steroids. The severity of hypoxemia was assessed using the SaO2/FiO2 peripheral oxygen saturation index., Results: 55 received remdesivir plus HDCPT, and 47 received remdesivir plus SCT. Mortality at 30 days was significantly lower among patients who received remdesivir plus HDCPT (4/55) than among those who did not (15/47). In patients who received remdesivir plus HDCPT, 7.3% required invasive mechanical ventilation and admission to the ICU and 36.4% non-invasive ventilation versus 29.8% and 61.7%, respectively, among those treated with remdesivir plus SCT. Remdesivir plus HDCPT induced a significantly faster improvement in the SaO2/FiO2 index., Conclusion: Early combination treatment with remdesivir plus HDCPT reduced in-hospital mortality and the need for admission to the ICU. Furthermore, it improved the SaO2/FiO2 index faster in patients with severe COVID-19 pneumonia.

Background: The complex unfolding of the US opioid epidemic in the last 20 years has been the subject of a large body of medical and pharmacological research, and it has sparked a multidisciplinary discussion on how to implement interventions and policies to effectively control its impact on public health., Objective: This study leverages Reddit, a social media platform, as the primary data source to investigate the opioid crisis. We aimed to find a large cohort of Reddit users interested in discussing the use of opioids, trace the temporal evolution of their interest, and extensively characterize patterns of the nonmedical consumption of opioids, with a focus on routes of administration and drug tampering., Methods: We used a semiautomatic information retrieval algorithm to identify subreddits discussing nonmedical opioid consumption and developed a methodology based on word embedding to find alternative colloquial and nonmedical terms referring to opioid substances, routes of administration, and drug-tampering methods. We modeled the preferences of adoption of substances and routes of administration, estimating their prevalence and temporal unfolding. Ultimately, through the evaluation of odds ratios based on co-mentions, we measured the strength of association between opioid substances, routes of administration, and drug tampering., Results: We identified 32 subreddits discussing nonmedical opioid usage from 2014 to 2018 and observed the evolution of interest among over 86,000 Reddit users potentially involved in firsthand opioid usage. We learned the language model of opioid consumption and provided alternative vocabularies for opioid substances, routes of administration, and drug tampering. A data-driven taxonomy of nonmedical routes of administration was proposed. We modeled the temporal evolution of interest in opioid consumption by ranking the popularity of the adoption of opioid substances and routes of administration, observing relevant trends, such as the surge in synthetic opioids like fentanyl and an increasing interest in rectal administration. In addition, we measured the strength of association between drug tampering, routes of administration, and substance consumption, finding evidence of understudied abusive behaviors, like chewing fentanyl patches and dissolving buprenorphine sublingually., Conclusions: This work investigated some important consumption-related aspects of the opioid epidemic using Reddit data. We believe that our approach may provide a novel perspective for a more comprehensive understanding of nonmedical abuse of opioids substances and inform the prevention, treatment, and control of the public health effects., (©Duilio Balsamo, Paolo Bajardi, Alberto Salomone, Rossano Schifanella. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 04.01.2021.)

Energy harvesting sensor systems typically incorporate energy buffers (e.g., rechargeable batteries and supercapacitors) to accommodate fluctuations in supply. However, the presence of these elements limits the miniaturization of devices. In recent years, researchers have proposed a new paradigm, transient computing, where systems operate directly from the energy harvesting source and allow computation to span across power cycles, without adding energy buffers. Various transient computing approaches have addressed the challenge of power intermittency by retaining the processor's state using non-volatile memory. However, no generic approach has yet been proposed to retain the state of peripherals external to the processing element. This paper proposes RESTOP, flexible middleware which retains the state of multiple external peripherals that are connected to a computing element (i.e., a microcontroller) through protocols such as SPI or I 2 C. RESTOP acts as an interface between the main application and the peripheral, which keeps a record, at run-time, of the transmitted data in order to restore peripheral configuration after a power interruption. RESTOP is practically implemented and validated using three digitally interfaced peripherals, successfully restoring their configuration after power interruptions, imposing a maximum time overhead of 15% when configuring a peripheral. However, this represents an overhead of only 0.82% during complete execution of our typical sensing application, which is substantially lower than existing approaches., Competing Interests: The authors declare no conflict of interest.

PURPOSE: Only early detection of non-symptomatic patients is able to arrest the diffusion of the non-symptomatic HCV infection and lead to prompt treatment. Our aim was to attempt to correlate the presence of perihepatic lymph nodes and hepatitis C infection and to assess whether ultrasonography can have a role to promote specific investigations for pre-clinical diagnosis of virus C infection. METHOD: We performed a controlled study on a cohort of 7974 subjects from a town of 27000 inhabitants on the eastern coast of Sicily. Serologic hepatitis A, B and C markers, alanine aminotransferase levels and abdominal ultrasound examination according to size and number of peri-hepatic lymph nodes were performed on blind basis. RESULTS: One or more pathological lymph nodes were present in 684/7974 subjects. Haematochemical tests revealed the presence of anti-HCV positivity in 528/684 subjects with pathological lymph nodes and in 8/7290 subjects without pathological lymph nodes, there being a significant difference (P<0.0001) between the two groups. CONCLUSION: Our results confirm the association between perihepatic lymph nodes and virus C infection. Correct diagnostic assessment of this datum could lead not only to early diagnosis by specific blood test for HCV and consequent prompt aimed treatment, but could pave the way for efficacious territorial prevention and detection of an elevated percentage of likely non-symptomatic carriers.

This paper describes a case of drug-induced hepatitis that onset in a patient who was hospitalised in our department after administration of calcium heparin. The rarity of the case was shown not only by the very short time elapsed between cause (drug administration) and effect (bio-humoral changes detected), but also by the histology results of the liver biopsy. This latter confirmed that mechanisms of idiosyncrasy, which may cause liver cell necrosis, can occur after administration of any drug.

In Part Two of the paper a model for curriculum development is proposed which derives from the teaching experience of the authors. This is intended to provide a methodological and conceptual framework for studying the problem of human consciousness and action in relation to health in a way that is consistent with both the values and purposes of student-centered learning and the claims of critical theory. It is suggested that such a critical curriculum of health is needed in order to ensure that the 'knowledgeable doer' Project 2000 aims to produce is indeed a qualitatively different kind of professional nurse practitioner.

This paper examines the potential for developing a more critical and reflexive curriculum around the sociology of health in nurse education. In Part One a review of the literature on Project 2000 to date suggests that insufficient attention has been paid to the scope for linking methodological and epistemological issues. it is argued that the status of 'andragogy' as a strategy of teaching and learning is ill-defined and that the nature of sociological theory in nurse education remains too crude and dichotomous to produce the 'knowledgeable doer', a qualitatively different kind of professional nurse practitioner.