COVID-19 THERAPY: COMPARISON EFFECTIVITY BETWEEN REMDESIVIR AND FAVIPIRAVIR

Introduction: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS CoV-2) is the virus that causes Coronavirus Disease 2019 (COVID-19), a disease of global concern(1). Remdesivir and favipiravir are antiviral drugs that are considered COVID19 therapy, as described in Indonesia's 3rd COVID-19 Management Guidelines. They have a similar mechanism, specifically by inhibiting RNA dependent RNA polymerase of the virus (3). Several studies have reported that patients who were treated with these antivirals had a shorter hospital stays (4–6). However, the comparison of efficacy between remdesivir and favipiravir is still unknown.Methods: An observational analytic study was done using a retrospective cohort design. Eighty-eight medical records of COVID-19 patients between January 2021 to August 2021 are collected by consecutive sampling techniques, and this research was carried out at Gotong Royong Hospital Surabaya.Results: Based on the statistical analysis test, there was no clinical improvement difference found, neither patients received remdesivir nor favipiravir based on their clinical manifestations, such as ventilation support and chest X-ray, measured by WHO ordinal scale (p=0,486 ; p>0,05 on the first week and p=0,942 ; p>0,05 on the second week).Conclusions: Improved clinical manifestations were seen in the second week of therapy, either in patients who received remdesivir or favipiravir, but there was no significant effectivity difference between those drugs

Anglican clergy husbands securing middle-class gendered privilege through religion

Traditionally, clergy wives have been obliged to assist the Church in an unpaid capacity; such work has been feminised, associated with the assumed competencies of women (Denton 1962; Finch 1980, 1983; Murphy-Geiss 2011). Clergy husbands are a relatively recent phenomenon in the Church of England, emerging when women started to be ordained as deacons in 1987 and priests in 1994. Based on interviews with men whose wives were ordained as priests in the Church of England, this article will explore the dynamics of class and gender privilege. Most clergy husbands were middle class, defined through educational, occupational and cultural markers (Bourdieu 1984). The narratives highlighted how gender and class privilege was maintained and extended through the clergy spouse role. The interweaving dynamics of class and gender privilege secured preferential outcomes for participants; outcomes that were less evidenced in relation to working-class spouses. Using Bourdieu’s (1984) concepts of habitus, field and capital and Verter’s (2003) conceptualisation of spiritual capital, this article will highlight the complex ways in which gender and class advantage is perpetuated and sustained, using the Anglican parish as the analytical context, thereby emphasising the role religion plays in consolidating privilege

Twenty-four-hour time-use composition and cognitive function in older adults: cross-sectional findings of the ACTIVate study

IntroductionPhysical activity, sedentary behaviour and sleep are associated with cognitive function in older adults. However, these behaviours are not independent, but instead make up exclusive and exhaustive components of the 24-h day. Few studies have investigated associations between 24-h time-use composition and cognitive function in older adults. Of these, none have considered how the quality of sleep, or the context of physical activity and sedentary behaviour may impact these relationships. This study aims to understand how 24-h time-use composition is associated with cognitive function across a range of domains in healthy older adults, and whether the level of recreational physical activity, amount of television (TV) watching, or the quality of sleep impact these potential associations.Methods384 healthy older adults (age 65.5 ± 3.0 years, 68% female, 63% non-smokers, mean education = 16.5 ± 3.2 years) participated in this study across two Australian sites (Adelaide, n = 207; Newcastle, n = 177). Twenty-four-hour time-use composition was captured using triaxial accelerometry, measured continuously across 7 days. Total time spent watching TV per day was used to capture the context of sedentary behaviours, whilst total time spent in recreational physical activity was used to capture the context of physical activity (i.e., recreational accumulation of physical activity vs. other contexts). Sleep quality was measured using a single item extracted from the Pittsburgh Sleep Quality Index. Cognitive function was measured using a global cognition index (Addenbrooke’s Cognitive Examination III) and four cognitive domain composite scores (derived from five tests of the Cambridge Neuropsychological Test Automated Battery: Paired Associates Learning; One Touch Stockings of Cambridge; Multitasking; Reaction Time; Verbal Recognition Memory). Pairwise correlations were used to describe independent relationships between time use variables and cognitive outcomes. Then, compositional data analysis regression methods were used to quantify associations between cognition and 24-h time-use composition.ResultsAfter adjusting for covariates and false discovery rate there were no significant associations between time-use composition and global cognition, long-term memory, short-term memory, executive function, or processing speed outcomes, and no significant interactions between TV watching time, recreational physical activity engagement or sleep quality and time-use composition for any cognitive outcomes.DiscussionThe findings highlight the importance of considering all activities across the 24-h day against cognitive function in older adults. Future studies should consider investigating these relationships longitudinally to uncover temporal effects

Expression of a protease-resistant insulin-like growth factor-binding protein-4 inhibits tumour growth in a murine model of breast cancer

BACKGROUND: Insulin-like growth factor 1 (IGF1) promotes breast cancer and disease progression. Bioavailability of IGF1 is modulated by IGF-binding proteins (IGFBPs). IGFBP4 inhibits IGF1 activity but cleavage by pregnancy-associated plasma protein-A (PAPP-A) protease releases active IGF1. METHODS: Expression of IGF pathway components and PAPP-A was assessed by western blot or RT-PCR. IGFBP4 (dBP4) resistant to PAPP-A cleavage, but retaining IGF-binding capacity, was used to block IGF activity in vivo. 4T1.2 mouse mammary adenocarcinoma cells transfected with empty vector, vector expressing wild-type IGFBP4 or vector expressing dBP4 were implanted in the mammary fat pad of BALB/c mice and tumour growth was assessed. Tumour angiogenesis and endothelial cell apoptosis were assessed by immunohistochemistry. RESULTS: 4T1.2 cells expressed the IGF1R receptor and IGFBP4. PAPP-A was expressed within mammary tumours but not by 4T1.2 cells. Proliferation and vascular endothelial growth factor (VEGF) production by 4T1.2 cells was increased by IGF1(E3R) (recombinant IGF1 resistant to binding by IGFBPs) but not by wild-type IGF1. IGF1-stimulated microvascular endothelial cell proliferation was blocked by recombinant IGFBP4. 4T1.2 tumours expressing dBP4 grew significantly more slowly than controls or tumours expressing wild-type IGFBP4. Inhibition of tumour growth by dBP4 was accompanied by the increased endothelial cell apoptosis. CONCLUSION: Protease-resistant IGFBP4 blocks IGF activity, tumour growth and angiogenesis

Characterising activity and diet compositions for dementia prevention: protocol for the ACTIVate prospective longitudinal cohort study

Introduction Approximately 40% of late-life dementia may be prevented by addressing modifiable risk factors, including physical activity and diet. Yet, it is currently unknown how multiple lifestyle factors interact to influence cognition. The ACTIVate Study aims to (1) explore associations between 24-hour time-use and diet compositions with changes in cognition and brain function; and (2) identify duration of time-use behaviours and the dietary compositions to optimise cognition and brain function.Methods and analysis This 3-year prospective longitudinal cohort study will recruit 448 adults aged 60-70 years across Adelaide and Newcastle, Australia. Time-use data will be collected through wrist-worn activity monitors and the Multimedia Activity Recall for Children and Adults. Dietary intake will be assessed using the Australian Eating Survey food frequency questionnaire. The primary outcome will be cognitive function, assessed using the Addenbrooke's Cognitive Examination-III. Secondary outcomes include structural and functional brain measures using MRI, cerebral arterial pulse measured with diffuse optical tomography, neuroplasticity using simultaneous transcranial magnetic stimulation and electroencephalography, and electrophysiological markers of cognitive control using event-related potential and time frequency analyses. Compositional data analysis, testing for interactions between time point and compositions, will assess longitudinal associations between dependent (cognition, brain function) and independent (time-use and diet compositions) variables. Conclusions The ACTIVate Study will be the first to examine associations between time-use and diet compositions, cognition and brain function. Our findings will inform new avenues for multidomain interventions that may more effectively account for the co-dependence between activity and diet behaviours for dementia prevention. Ethics and dissemination Ethics approval has been obtained from the University of South Australia's Human Research Ethics committee (202639). Findings will be disseminated through peer-reviewed manuscripts, conference presentations, targeted media releases and community engagement events. Trial registration number >Australia New Zealand Clinical Trials Registry (ACTRN12619001659190).Ashleigh E Smith, Alexandra T Wade, Timothy Olds, Dorothea Dumuid, Michael J Breakspear, Kate Laver ... et al