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Introduction: Hepatitis C virus (HCV) infection is common in patients with end-stage renal disease. We investigated the safety and efficacy of ombitasvir (OBV)/paritaprevir (PTV)/ritonavir (r) ± dasabuvir (DSV) ± ribavirin (RBV) in 2 phase 3, open-label, multicenter studies in patients with stage 4 or 5 chronic kidney disease (CKD). Methods: RUBY-I, Cohort 2 enrolled treatment-naïve or -experienced patients with HCV genotype (GT) 1a or 1b infection, with or without cirrhosis. Patients received 12 weeks (24 weeks for GT1a patients with cirrhosis) of OBV/PTV/r + DSV; all GT1a patients received RBV. RUBY-II enrolled treatment-naïve patients with GT1a or GT4 infection without cirrhosis. All patients received 12 weeks of RBV-free treatment: OBV/PTV/r + DSV for GT1a-infected patients; OBV/PTV/r for GT4-infected patients. The primary endpoint was sustained virologic response at posttreatment week 12 (SVR12). Results: RUBY-I, Cohort 2 and RUBY-II enrolled 66 patients, including 50 (76%) on dialysis; 15 (23%) had compensated cirrhosis. Overall, the SVR12 rate was 95% (63/66); 1 patient had virologic failure. There were 3 discontinuations due to adverse events. Seventy-three percent (27/37) of patients receiving RBV had adverse events leading to RBV dose modification. The RBV-free RUBY-II study had no hemoglobin-associated adverse events. Conclusion: Treatment with OBV/PTV/r ± DSV ± RBV was well tolerated and patients with HCV GT1 or 4 infection and stage 4 or 5 CKD had high SVR12 rates, including patients with compensated cirrhosis and/or prior treatment experience. Keywords: chronic kidney disease, NS5A inhibitor, NS3/4A protease inhibitor, renal disease, RUBY

In the presented synthetic work, a series of novel substituted 1, 4-Dihydropyridine derivatives (DHPs) have been prepared by the reaction of substituted aromatic aldehydes, ethyl acetoacetate, and ammonium acetate in the presence of a heterogeneous catalyst silica sulfuric acid at ambient temperature via expeditious, mild, inexpensive and one pot Hantszch multicomponent synthetic methodology. Various benefits of this approach are simple work-up; short reaction times at ambient reaction temperature, excellent yields, green solvent system, no by-products and purification of products without chromatographic separation. The catalyst was easily recovered by simple filtration and reused up to five times without washing with any solvent and without major loss in its activity. All the synthesized compounds were characterized by IR, 1H NMR, 13C NMR and LC-Mass spectroscopic techniques. Molecular modelling of the synthesized novel compounds with respect to Lipinski rule of five, drug likeness, toxicity profiles, drug score and other physico-chemical properties are described and compared with market available generic drugs. Theoretical screenings data suggested that the reported compounds possessed a broad range of lipophilic character, no toxicity risks and similar bioactivity scores as relative with standard drugs used for comparison.

Millions of people all over the world are affected by disability arising out of accident, disease, or congenital. This is a crucial health issue for mankind and needs structured treatment and rehabilitation plans. Prevalence and management capacity of disability have wide cross-cultural and geographical variations. Despite the lack of specific data there are reasons to believe that third-world countries have more disabilities and fewer resources and capacity for rehabilitation. So, there is a strong relationship between poverty and disability. Marginalized populations, disadvantaged or at-risk populations such as women, older people, and people who are poor are inappropriately affected by disability. Children from poverty-stricken families, indigenous populations, and ethnic minority groups are significantly at higher risk of experiencing disability. There is a higher prevalence of disability in lower-income countries than in higher-income countries. Poor people from lowerincome countries are usually involved in high-risk jobs which make them vulnerable to injury and disability. Because of exaggerated life stress, poor health status, and poor living conditions due to poverty, people at low resource outset are more vulnerable to disease and disability. Of inadequate support from affluent persons as well as from the government, they spend their last savings to meet the treatment costs and get poorer. They are also common victims of road traffic accidents when they travel on risky roads and vehicles. There are many other shreds of evidence for a link between disability and poverty in low and middle-income countries and there is an urgent need for further research and policy action to break the cycle. This review article intends to find out the relationship between poverty and disability and reveals how poverty influences suffering disability and vice versa. [ABSTRACT FROM AUTHOR]

Background and Aims: Perceived stress and mindfulness can impact medical decision-making in both patients and clinicians. The aim of this study was to conduct a cross-sectional evaluation of the relationships between stress, mindfulness, self-regulation, perceptions of treatment conversations, and decision-making preferences among clinicians. Also, perceptions of treatment conversations and decision-making preferences among patients with cancer were evaluated. Methodology: Survey instruments were developed for clinicians and patients incorporating previously published questions and validated instruments. Institutional review board approval was obtained. Patients, physicians, and advanced practice providers from a tertiary referral center were asked to complete surveys. Continuous variables were evaluated for normality and then bivariate relationships between variables were evaluated using χ 2 , Fisher's exact test, Cochran-Mantel-Haenszel (CMH) row mean scores differ statistic, or Kruskal-Wallis tests, where appropriate. Significance was defined at P < . 05. All tests were conducted using SAS v.9.4. Results: 77 patients and 86 clinicians (60.1% and 43% response rates, respectively) participated in the surveys. More clinicians who reported feeling “great/good” said they always/sometimes had enough time to spend with patients (66.1%) compared to those that hardly ever/never had enough time (26.3%), χ 2 (1, N = 75) = 6.62, P = .0101; CMH row mean scores differ statistic). Interestingly, 40.3% of patients preferred a paternalistic style of decision-making compared to 6.3% of clinicians, χ 2 (2, N = 146) = 27.46, P < .0001; χ 2 test. Higher levels of dispositional mindfulness (Mindful Attention Awareness Scale) were found among clinicians who reported they felt “great/good” (median = 4.5) as compared to those who reported that they were “definitely stressed/stressed out” (3.3), χ 2 (2, N = 80) = 10.32, P = .0057; Kruskal-Wallis test. Higher levels of emotional self-regulation (Emotional Regulation Questionnaire—Cognitive Reappraisal facet) were found among clinicians who reported they felt “great/good” (median = 31.0) compared to those who reported that they were “definitely stressed/stressed out” (20.0), χ 2 (2, N = 79) = 8.88, P = .0118; Kruskal-Wallis test. Conclusion: In order to have meaningful conversations about treatment planning, an understanding of mental well-being and its relationship to decision-making preferences is crucial for both oncology patients and clinicians. Our results show that for clinicians, lower perceived stress was associated with higher levels of mindfulness (experiencing the present moment), emotional self-regulation, and spending more time with patients. Larger prospective studies are needed to validate these findings.

Rifampicin, is an antibiotic used in the treatment of numerous types of bacterial infections, including tuberculosis, Mycobacterium avium complex, leprosy, and Legionnaires' disease. To explicate the binding interactions of Rifampicin with bovine serum albumin (BSA) at molecular level, in the presence of cationic, anionic, and neutral surfactants, it is urgent to investigate their interactions to accomplish its pharmacokinetic and pharmacodynamics gaps vital for advance development and improvement as a therapeutic drug. Thus, we have investigated the binding interaction of Rifampicin with BSA at physiological pH 7.4 in the presence and absence of surfactants Sodium dodecyl sulfate, Cetyltrimethylammonium bromide, and Tween 80. The multispectroscopic studies of Rifampicin with BSA as investigated by UV–visible, fluorescence, and circular dichroism spectroscopy shown a significant stabilization of BSA in the presence of surfactants; that can help in designing more competent drug formulations from a pharmaceutical point of view. [ABSTRACT FROM AUTHOR]

In order to construct a 3D rotor model, periodicity and Multiple Reference Frame (MRF) strategies were applied to address full Computational Fluid Dynamics (CFD) that incorporate the Reynolds-averaged Navier-Stokes (RANS) equations. A simulation model was run to examine the power of the wind turbines, both including and excluding the hub and tower. The purpose of this was to identify an approach that would decrease the computational time cost of wind turbine simulation. Firstly, a full-scale horizontal axis wind turbine simulation was carried out, and subsequently, comparisons were made with the results of the wind tunnel experiment utilizing the K-omega SST and Sparlat Allmaras viscosity models. The results were compared to determine the optimum model with the lowest simulation time and highest accuracy to the experimental results. Following this, the complete models' simulation was compared to the model excluding the hub and tower in order to check the disparity in the results of the two. Additionally, to ascertain the computational cost saving, the ratio of the two simulation times was established. The findings show that the two models produce results that correspond well to the experimental results, and that the power coefficient had a greater value for the complete model than the simple model. Furthermore, it was found that the power coefficient values of the full model have significantly higher levels of similarity to the experimental values. The Sparlat Allmaras and K-omega SST viscosity models returned error percentages of 0.52% and 12.6% respectively. For the partial model utilizing the same computer device, a 5.7% error rate was recorded, with a computational time saving of approximately 34%. [ABSTRACT FROM AUTHOR]