Post-acute COVID-19 outcomes including participant-reported long COVID: amubarvimab/romlusevimab versus placebo in the ACTIV-2 trial

BackgroundIt is unknown if early COVID-19 monoclonal antibody (mAb) therapy can reduce risk of Long COVID. The mAbs amubarvimab/romlusevimab were previously demonstrated to reduce risk of hospitalization/death by 79%. This study assessed the impact of amubarvimab/romlusevimab on late outcomes, including Long COVID.MethodsNon-hospitalized high-risk adults within 10 days of COVID-19 symptom onset enrolled in a randomized, double-blind, placebo-controlled phase 2/3 trial of amubarvimab/romlusevimab for COVID-19 treatment. Late symptoms, assessed using a participant-completed symptom diary, were a pre-specified exploratory endpoint. The primary outcome for this analysis was the composite of Long COVID by participant self-report (presence of COVID-19 symptoms as recorded in the diary at week 36) or hospitalization or death by week 36. Inverse probability weighting (IPW) was used to address incomplete outcome ascertainment, giving weighted risk ratios (wRR) comparing amubarvimab/romlusevimab to placebo.FindingsParticipants received amubarvimab/romlusevimab (n = 390) or placebo (n = 390) between January and July 2021. Median age was 49 years, 52% were female, 18% Black/African American, 49% Hispanic/Latino, and 9% COVID-19-vaccinated at entry. At week 36, 103 (13%) had incomplete outcome ascertainment, and 66 (17%) on amubarvimab/romlusevimab and 92 (24%) on placebo met the primary outcome (wRR = 0.70, 95% confidence interval (CI) 0.53-0.93). The difference was driven by fewer hospitalizations/deaths with amubarvimab/romlusevimab (4%) than placebo (13%). Among 652 participants with available diary responses, 53 (16%) on amubarvimab/romlusevimab and 44 (14%) on placebo reported presence of Long COVID.InterpretationAmubarvimab/romlusevimab treatment, while highly effective in preventing hospitalizations/deaths, did not reduce risk of Long COVID. Additional interventions are needed to prevent Long COVID.FundingNational Institute of Allergy and Infectious Diseases of the National Institutes of Health. Amubarvimab and romlusevimab supplied by Brii Biosciences

Physiological Effects of Ascaris Suum Intestinal Microflora on 5-Hydroxytryptamine Level and Binding Sites in the Intestinal Epithelial Cells

Serotonin (5-hydroxytryptamine, 5-HT) has been shown to activate carbohydrate metabolism in adult female Ascaris suum. Serotonin may be either absorbed directly from the environment or synthesized de novo from the absorbed L-tryptophan in adult female A. suum. The enzymes necessary for the synthesis of 5-HT have been identified in both intestine and muscle tissues. The serotonin absorbed from the environment is obtained either from the host's gastrointestinal contents or from the 5-HT producing bacteria in the intestine of A. suum. Numerous 5-HT producing bacteria were identified in the intestinal microflora. The physiological contributions of 5-HT producing bacteria to the 5-HT level, turnover and binding sites in the intestinal tissue of A. suum were investigated

Oxytocin ameliorates the immediate myocardial injury in heart transplant through down regulation of the neutrophil dependent myocardial apoptosis

Cardiac oxytocin (OT) is structurally identical to that found in the hypothalamus, which thereby indicates that cardiac OT is derived from the same gene and is an active form of OT. The abundance of OT and OT receptors in atrial myocytes shows that, directly and/or via the release of the cardiac hormone atrial natriuretic peptide, OT can regulate the force of cardiac contractions. Previous studies have demonstrated the role of OT in the myocardial inflammatory response. The mechanism by which OT elicits protective myocardial effects in the immediate post-transplantation period is not yet clear, and the role of the early phase inflammatory elements in this mechanism has not yet been studied. As a result, in this study, we have investigated the anti-inflammatory effects of OT on myocardial protection in the immediate post-transplantation period. Methods: Adult male Albino rats were grouped into: Sham, Control, and OT-treated groups. The control and treated groups sustained cervical heterotopic heart transplant. Myocardial injury was assessed by measuring: Plasma cardiac troponin I, myocardial proinflammatory cytokines, and histopathological assessment for score of injury, and degree of apoptosis. Myocardial myeloperoxidase, neutrophil infiltration, and neutrophil chemotactant agents, reactive oxygen species, and reactive nitrogen species formation all were measured in the myocardium after 3 hour of reperfusion to assess the neutrophil-dependant myocardial injury and the mechanism involved. Results: Oxytocin down-regulates the neutrophil chemotactant agents the KC/CXCL1 and MIP-2/CXCL2 which recruit less neutrophil into myocardium, this decrement in myocardial PMN infiltration is associated with less reactive oxygen species and reactive nitrogen species formation in the myocardium after 3 hours of global ischemia reperfusion. These oxytocin-induced down-regulation inflammatory and oxidative processes will end in less myocardial injury through impedance in the post-myocardial ischemia/reperfusion apoptotic process. Conclusion: Oxytocin ameliorates myocardial injury in heart transplant through down-regulation the myocardial inflammatory response, reactive oxygen species, and neutrophil-dependant myocardial apoptosis

Challenging Experiences of the Fathers of the Premature Infants Admitted in the Neonatal Intensive Care Unit (NICU)

Background: Birth of premature infants and their admission in the neonatal intensive care unit (NICU) are unexpected crises for the fathers. Therefore, raising the awareness of fathers regarding their experiences in such conditions could be helpful in the care of these neonates. The present study aimed to investigate the experiences of the fathers of the premature infants admitted in the NICU. Methods: This descriptive, explorative, qualitative study was conducted via purposive sampling, and 13 parents of the premature infants admitted in the NICUs of two hospitals in Isfahan, Iran, were enrolled. Semi-structural interviews were performed with the fathers of premature infants, and thematic analysis was used for data analysis. Results: Three main themes emerged in the study, including ‘emotions and responsibilities’, ‘information needs’, and ‘beliefs’. In terms of the emotions and responsibilities, fear and accountability were considered to be the major concerns among the fathers. With regard to information needs and beliefs, the need to obtain appropriate information and having faith in God and the infallible Imams were expressed by the fathers, respectively. Conclusion: Experiencing preterm birth and NICU admission are accompanied by stress and anxiety for the parents of the infants. Meanwhile, several factors could impair the ability of the fathers to cope with the crisis. Identifying and addressing the needs of the parents and providing the necessary training since the beginning of pregnancy could result in the effective management of NICU admission. In addition, proper facilities should be offered to support the fathers of preterm infants, such as parental leave

Use of Geogrids and Recycled Rubber in Railroad Infrastructure for Enhanced Performance

Railway tracks are conventionally built on compacted ballast and structural fill layers placed above the natural (subgrade) foundation. However, during train operations, track deteriorations occur progressively due to ballast degradation. The associated track deformation is usually accompanied by a reduction in both load bearing capacity and drainage, apart from imposing frequent track maintenance. Suitable ground improvement techniques involving plastic inclusions (e.g., geogrids) and energy absorbing materials (e.g., rubber products) to enhance the stability and longevity of tracks have become increasingly popular. This paper presents the outcomes from innovative research and development measures into the use of plastic and rubber elements in rail tracks undertaken at the University of Wollongong, Australia, over the past twenty years. The results obtained from laboratory tests, mathematical modelling and numerical modelling reveal that track performance can be improved significantly by using geogrid and energy absorbing rubber products (e.g., rubber crumbs, waste tire-cell and rubber mats). Test results show that the addition of rubber materials can efficiently improve the energy absorption of the structural layer and also reduce ballast breakage. Furthermore, by incorporating the work input parameters, the energy absorbing property of the newly developed synthetic capping layer is captured by correct modelling of dilatancy. In addition, the laboratory behavior of tire cells and geogrids has been validated by numerical modelling (i.e., Finite Element Modelling-FEM, Discrete Element-DEM), and a coupled DEM-FEM modelling approach is also introduced to simulate ballast deformation

Laboratory examination of ballast deformation and degradation under impact loads with synthetic inclusions

© 2020 Elsevier Ltd This paper presents a laboratory study on alleviating the deformation and degradation (breakage) of ballast subjected to impact loads using geogrids and rubber mats. A series of drop hammer impact tests are carried out to determine how well the geogrid, under-ballast mat (UBM) or under-sleeper pad (USP) can attenuate impact loads and mitigate ballast degradation. Geogrids to be placed at different locations in a ballast assembly, in combination either with a UBM or a USP are tested. Laboratory test results prove that the inclusion of rubber mats and geogrids decrease the dynamic impact loads transferred to the ballast aggregates and subsequently decrease the degradation (breakage) and deformation of ballast. The tensile strength of geogrids and subgrade stiffness are found to considerably influence the performance of geogrid-reinforced ballast under impact loading conditions. The measured impact forces and accelerations of ballast with and without an artificial inclusion show that rubber mats definitely reduce track vibration (acceleration) and the subsequent deformation and breakage of ballast. These inclusions will not only increase safety and passenger comfort they will also lead to more economical and efficient track designs

Laboratory examination of ballast deformation and degradation under impact loads with synthetic inclusions

© 2020 Elsevier Ltd This paper presents a laboratory study on alleviating the deformation and degradation (breakage) of ballast subjected to impact loads using geogrids and rubber mats. A series of drop hammer impact tests are carried out to determine how well the geogrid, under-ballast mat (UBM) or under-sleeper pad (USP) can attenuate impact loads and mitigate ballast degradation. Geogrids to be placed at different locations in a ballast assembly, in combination either with a UBM or a USP are tested. Laboratory test results prove that the inclusion of rubber mats and geogrids decrease the dynamic impact loads transferred to the ballast aggregates and subsequently decrease the degradation (breakage) and deformation of ballast. The tensile strength of geogrids and subgrade stiffness are found to considerably influence the performance of geogrid-reinforced ballast under impact loading conditions. The measured impact forces and accelerations of ballast with and without an artificial inclusion show that rubber mats definitely reduce track vibration (acceleration) and the subsequent deformation and breakage of ballast. These inclusions will not only increase safety and passenger comfort they will also lead to more economical and efficient track designs

Use of geogrids and recycled rubber in railroad infrastructure for enhanced performance

© 2019 by the authors. Licensee MDPI, Basel, Switzerland. Railway tracks are conventionally built on compacted ballast and structural fill layers placed above the natural (subgrade) foundation. However, during train operations, track deteriorations occur progressively due to ballast degradation. The associated track deformation is usually accompanied by a reduction in both load bearing capacity and drainage, apart from imposing frequent track maintenance. Suitable ground improvement techniques involving plastic inclusions (e.g., geogrids) and energy absorbing materials (e.g., rubber products) to enhance the stability and longevity of tracks have become increasingly popular. This paper presents the outcomes from innovative research and development measures into the use of plastic and rubber elements in rail tracks undertaken at the University of Wollongong, Australia, over the past twenty years. The results obtained from laboratory tests, mathematical modelling and numerical modelling reveal that track performance can be improved significantly by using geogrid and energy absorbing rubber products (e.g., rubber crumbs, waste tire-cell and rubber mats). Test results show that the addition of rubber materials can efficiently improve the energy absorption of the structural layer and also reduce ballast breakage. Furthermore, by incorporating the work input parameters, the energy absorbing property of the newly developed synthetic capping layer is captured by correct modelling of dilatancy. In addition, the laboratory behavior of tire cells and geogrids has been validated by numerical modelling (i.e., Finite Element Modelling-FEM, Discrete Element—DEM), and a coupled DEM-FEM modelling approach is also introduced to simulate ballast deformation