The role of gender inclusive leadership during the COVID-19 pandemic to support vulnerable populations in conflict settings.

The real heroines in the fight against COVID-19 are women'.1 Significant attention has been given to women political leaders in highincome settings, where it has been reported that women have led several countries' effective national responses to COVID-19.2 However, little attention has been given to the role of women as leaders and decision makers in conflict settings. In conflict settings, COVID-19 is a multidimensional and existential crisis for many: a pandemic colliding with poor governance, insecurity, instability, other disease outbreaks (eg, cholera), disintegrated health and education systems, and food insecurity.3 These have dire consequences for vulnerable populations in conflict settings, including women and girls.4 Pandemics are a gendered vulnerability, with their socioeconomic impact disproportionately higher among women. 5 6 In this article, we argue that cultivating and harnessing the advancements of women's leadership globally and implementing a gender inclusive lens in pandemic preparedness and responses by including the experiences and voices of women in conflict settings is paramount. This will in turn create effective leadership models, as well as improving women and girls' access to adequate healthcare in conflict settings

Formulation and Evaluation of Instant Dissolving Film of a Poorly Soluble Drug Cilnidipine

The chemical formula in question is classified as a calcium antagonist, which includes cilnidipine (also known as dihydropyridine) as one of its component parts. This is accomplished through a process known as L-type calcium channel blockage, which prevents calcium from entering the capillaries and so accomplishes the desired effect. The consequence of this is a decrease in blood pressure. Intravenous administration of the medicine results in a higher level of bioavailability compared to oral administration of the drug in tablet form. This is due to the diminished solubility of the substance in water. Propylene glycol and PEG 400 were combined to create a polymer that lacked stickiness and hardness. The drug's solubility and release are greatly enhanced when inclusion complexes are made using cyclodextrin. Research on PEG 400 and propylene glycol drug release in vitro examined a number of independent factors, including pH, thickness, weight uniformity, percent drug content, folding endurance, disintegration time, and percent drug

Global seasonal influenza mortality estimates:a comparison of three different approaches

Prior to updating global influenza-associated mortality estimates, the World Health Organization convened a consultation in July 2017 to understand differences in methodology and implications for results of 3 influenza mortality projects from the US Centers for Disease Control and Prevention (CDC), the Netherlands Institute for Health Service Research’s Global Pandemic Mortality Project II (GLaMOR), and the Institute for Health Metrics and Evaluation (IHME). The expert panel reviewed estimates and discussed differences in data sources, analysis, and modeling assumptions. We performed a comparison analysis of the estimates. Influenza-associated respiratory death counts were comparable between CDC and GLaMOR; the IHME estimate was considerably lower. The greatest country-specific influenza-associated fold differences in mortality rate between CDC and IHME estimates and between GLaMOR and IHME estimates were among countries in Southeast Asia and the Eastern Mediterranean region. The data envelope used for the calculation was one of the major differences (CDC and GLaMOR: all respiratory deaths; IHME: lower-respiratory infection deaths). With the assumption that there is only one cause of death for each death, IHME estimates a fraction of the full influenza-associated respiratory mortality that is measured by the other 2 groups. Wide variability of parameters was observed. Continued coordination between groups could assist with better understanding of methodological differences and new approaches to estimating influenza deaths globally

Sustained remission of symptoms and improved health-related quality of life in patients with cryopyrin-associated periodic syndrome treated with canakinumab: results of a double-blind placebo-controlled randomized withdrawal study

Abstract Introduction To assess the effect of canakinumab, a fully human anti-interleukin-1β antibody, on symptoms and health-related quality of life (HRQoL) in patients with cryopyrin-associated periodic syndrome (CAPS). Methods In this 48-week, phase 3 study, patients with CAPS received canakinumab 150 mg subcutaneously at 8-week intervals. All patients (n = 35) received canakinumab during weeks 1 through 8; weeks 9 through 24 constituted a double-blind placebo-controlled withdrawal phase, and weeks 24 through 48 constituted an open-label phase in which all patients received canakinumab. Patient and physician assessments of symptoms, levels of inflammatory markers, and HRQoL were performed. Results Rapid symptom remission was achieved, with 89% of patients having no or minimal disease activity on day 8. Responses were sustained in patients receiving 8-weekly canakinumab. Responses were lost during the placebo-controlled phase in the placebo group and were regained on resuming canakinumab therapy in the open-label phase. Clinical responses were accompanied by decreases in serum levels of C-reactive protein, serum amyloid A protein, and interleukin-6. HRQoL scores at baseline were considerably below those of the general population. Improvements in all 36-item Short-Form Health Survey (SF-36) domain scores were evident by day 8. Scores approached or exceeded those of the general U.S. population by week 8 and remained stable during canakinumab therapy. Improvements in bodily pain and role-physical were particularly marked, increasing by more than 25 points from baseline to week 8. Therapy was generally well tolerated. Conclusions Canakinumab, 150 mg, 8-weekly, induced rapid and sustained remission of symptoms in patients with CAPS, accompanied by substantial improvements in HRQoL. Trial registration Clintrials.gov NCT0046598

Support for UNRWA's survival

The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) provides life-saving humanitarian aid for 5·4 million Palestine refugees now entering their eighth decade of statelessness and conflict. About a third of Palestine refugees still live in 58 recognised camps. UNRWA operates 702 schools and 144 health centres, some of which are affected by the ongoing humanitarian disasters in Syria and the Gaza Strip. It has dramatically reduced the prevalence of infectious diseases, mortality, and illiteracy. Its social services include rebuilding infrastructure and homes that have been destroyed by conflict and providing cash assistance and micro-finance loans for Palestinians whose rights are curtailed and who are denied the right of return to their homeland

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy