Public search interests related to COVID-19: Insights from Google Search Trends in Bangladesh

PURPOSE: Public response monitoring is critical to reducing COVID-19 infections and developing effective public health strategies. This study explored Google search trends to understand public responses to COVID-19 concerns in Bangladesh. METHODS & MATERIALS: We used country-level Google search trends data to examine the association between Google search terms related to COVID-19 deaths, face masks, and COVID-19 vaccines and the actual and one-week lagged actual COVID-19 death counts from February 2, 2020, to December 19, 2020, in Bangladesh. RESULTS: Search terms related to COVID-19 deaths, face masks, and COVID-19 vaccines increased and peaked during March and April, but then began declining gradually after June 2020. The mean relative search volume for face masks (35 points) was higher than for death information (8 points) and vaccines (16 points) throughout the study period, and searching for masks peaked (100 points) during the third week of March. Search interests for death information and face masks were negatively correlated with the actual and one-week lagged actual COVID-19 death counts. CONCLUSION: In response to declining trends in COVID-19-related google search terms, policymakers should strengthen ongoing risk communication and preventive information dissemination programs to control and prevent COVID-19 cases and deaths

Enhancing the selective extracellular location of a recombinant E. coli domain antibody by management of fermentation conditions

The preparation of a recombinant protein using Escherichia coli often involves a challenging primary recovery sequence. This is due to the inability to secrete the protein to the extracellular space without a significant degree of cell lysis. This results in the release of nucleic acids, leading to a high viscosity, difficulty to clarify, broth and also to contamination with cell materials such as lipopolysaccharides and host cell proteins. In this paper, we present different fermentation strategies to facilitate the recovery of a V H domain antibody (13.1 kDa) by directing it selectively to the extracellular space and changing the balance between domain antibody to nucleic acid release. The manipulation of the cell growth rate in order to increase the outer cell membrane permeability gave a small ~1.5-fold improvement in released domain antibody to nucleic acid ratio without overall loss of yield. The introduction during fermentation of release agents such as EDTA gave no improvement in the ratio of released domain antibody to nucleic acid and a loss of overall productivity. The use of polyethyleneimine (PEI) during fermentation was with the aim to (a) permeabilise the outer bacterial membrane to release selectively domain antibody and (b) remove selectively by precipitation nucleic acids released during cell lysis. This strategy resulted in up to ~4-fold increase in the ratio of domain antibody to soluble nucleic acid with no reduction in domain antibody overall titre. In addition, a reduction in host cell protein contamination was achieved and there was no increase in endotoxin levels. Similar results were demonstrated with a range of other antibody products prepared in E. coli

Bridging the Location Gap: Physician Perspectives of Physician-Pharmacist Collaboration in Patient Care (BRIDGE Phase II)

Background: To optimize patient outcomes, the patient-centred medical home model emphasizes comprehensive team-based care. Pharmacists are qualified to enhance appropriate medication use and help improve patient outcomes through provision of medication therapy management (MTM) services. To optimally provide MTM, pharmacists must effectively collaborate with physicians. This study explored factors that influence pharmacist-physician collaboration. Methods and Findings: A convenience sample of five physicians participated in semi-structured interviews and the resulting data were analyzed using qualitative methods. Transcripts of the interviews were independently coded for themes by two researchers. Five themes emerged: trustworthiness, role specification, relationship initiation, effects on practice, and professional awareness/expectations. Conclusions: Overall interviewees spoke positively about pharmacists; however, when discussing collaboration, they spoke almost exclusively about pharmacists within their clinic. Since most pharmacists practice outside of clinics, bridging the location gap is imperative for collaboration. In addition, physicians lacked an overall understanding of pharmacists’ training and clinical capacity. This may inhibit pharmacists from participating to their full professional capability within integrated healthcare teams. One approach to resolve this lack of physician understanding of pharmacists’ role and value may be to co-educate health professional students. Further research is needed to explore ways to improve interprofessional collaborative care

Evaluation of options for harvest of a recombinant E. coli fermentation producing a domain antibody using ultra scale-down techniques and pilot-scale verification

Ultra scale-down (USD) methods operating at the millilitre scale were used to characterise full-scale processing of E. coli fermentation broths autolysed to different extents for release of a domain antibody. The focus was on the primary clarification stages involving continuous centrifugation followed by depth filtration. The performance of this sequence was predicted by USD studies to decrease significantly with increased extents of cell lysis. The use of polyethyleneimine (PEI) reagent was studied to treat the lysed cell broth by precipitation of soluble contaminants such as DNA and flocculation of cell debris material. The USD studies were used to predict the impact of this treatment on the performance and here it was found that the fermentation could be run to maximum productivity using an acceptable clarification process (e.g a centrifugation stage operating at 0.11 L per m(2) equivalent gravity settling area per h followed by a resultant required depth filter area of 0.07 m(2) per L supernatant). A range of USD predictions was verified at the pilot scale for centrifugation followed by depth filtration. This article is protected by copyright. All rights reserved

Biological characterization of rabbit nucleus pulposus cells on a biphasic scaffold made of polycaprolactone and methacrylated gellan gum hydrogel

Intervertebral disc (IVD) degeneration (IDD) is nowadays considered as the main physiological cause for low back pain (LBP). LBP is known to affect people of any age, having a world socioeconomic burden of 70 billion euros per year[1]. Current LBP treatments only treat the symptoms without solving the problem. So, finding new ways of treating IDD is finding new ways of reducing socioeconomic impact created by LBP. Tissue Engineering (TE) is an exponentially growing area due to its potential of finding patient-specific treatments in terms of immunological compatibility by using patient’s own cells. Though, it is time for TE to take a step towards an even more patient-specific way of treating diseases. Reverse Engineering (RE) appeared as a way to find how a system works without having its blueprints. RE combined with 3D printing can help researchers reproduce any kind of anatomical structure. So, by combining both TE and RE it is possible to develop not only a patient-specific treatment strategy in terms of immunological-compatibility but also in terms of structure. The IVDs, which are located on the spine, are composed by a hydrogel-like nucleus pulposus (NP) core that is contained vertically by cartilaginous end-plates, and horizontally by a fibrocartilage ring called annulus fibrosus (AF). The purpose of this study is to use Reverse and Tissue Engineering to develop custom-made implants for IVD regeneration. Rabbit spines were analyzed by micro-computerized tomography and were RE into a virtual 3D model which was then 3D printed with polycaprolactone, that has already shown, in the literature,a great potential as a material to develop AF scaffolds[2]. The solid scaffold was then filled with rabbit NP cell-laden methacrylated gellan gum (GG-MA) hydrogel. The GG-MA hydrogel has been shown great promise for NP regeneration, in vitro and in vivo[3]. This way, a fully patient-specific biphasic scaffold was produced which mimics the native IVD’s structure and biomechanics. 1. Whatley BR, Wen X. 2012; Intervertebral disc (IVD): Structure, degeneration, repair and regeneration.Materials Science and Engineering C32(2):61–77. 2. Lazebnik M, Singh M, Glatt P,et al. 2011; Biomimetic method for combining the nucleus pulposus and annulus fibrosus for intervertebral disc tissue engineering.Journal of Tissue Engineering and Regenerative Medicine5:e179–e187. 3. Silva-Correia J, Zavan B, Vindigni V,et al. 2013; Biocompatibility Evaluation of Ionic- and Photo-Crosslinked Methacrylated Gellan Gum Hydrogels: In vitro and In Vivo Study.Advanced Healthcare Materials2:568-575

Regeneration of the intervertebral disc

Degeneration of intervertebral disc (IVD) seems to be one of the main causes associated to lower back pain (LBP), one of the most common painful conditions that lead to work absenteeism, medical visits, and hospitalization in actual society [1,2]. This complex fibro-cartilaginous structure is composed by two structures, an outer multilayer fiber structure (annulus fibrosus, AF) and a gel-like inner core (nucleus pulposus, NP), which are sandwiched in part between two cartilage endplates (CEP) [1]. Existing conservative and surgical treatments for LBP are directed to pain relief and do not adequately restore disc structure and mechanical function [2]. In the last years, several studies have been focusing on the development of tissue engineering (TE) approaches aiming to substitute/regenerate the AF or NP, or both by developing an artificial disc that could be implanted in the body thus replacing the damaged disc [3]. TE strategies aiming to regenerate NP tissue often rely on the use of natural hydrogels, due to the number of advantages that these highly hydrated networks can offer. Nevertheless, several of the hydrogel systems developed still present numerous problems, such as variability of production, and inappropriate mechanical and degradation behaviour. Recently, our group has proposed the use of gellan gum (GG) and its derivatives, namely the ionic- and photo-crosslinked methacrylated gellan gum (GG-MA) hydrogels, as potential injectable scaffolds for IVD regeneration [4,5]. Work has been conducted regarding the improvement of GG mechanical properties either by chemically modifying the polymer (allowing to better control in situ gelation and hydrogel stability) [4] or by reinforcing it with biocompatible and biodegradable GG microparticles (enabling the control of degradation rate and cell distribution) [5]. Another strategy currently under investigation relies on the development of a biphasic scaffold that mimics the total disc by using a reverse engineering approach

White Matter Microstructural Damage on Diffusion Tensor Imaging in Cerebral Small Vessel Disease

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A study of National Health Service management of chronic osteoarthritis and low back pain

AIM: To describe treatment and referral patterns and National Health Service resource use in patients with chronic pain associated with low back pain or osteoarthritis, from a Primary Care perspective. BACKGROUND: Osteoarthritis and low back pain are the two commonest debilitating causes of chronic pain, with high health and social costs, and particularly important in primary care. Understanding current practice and resource use in their management will inform health service and educational requirements and the design and optimisation of future care. METHOD: Multi-centre, retrospective, descriptive study of adults (⩾18 years) with chronic pain arising from low back pain or osteoarthritis, identified through primary care records. Five general practices in Scotland, England (two), Northern Ireland and Wales. All patients with a diagnosis of low back pain or osteoarthritis made on or before 01/09/2006 who had received three or more prescriptions for pain medication were identified and a sub-sample randomly selected then consented to an in-depth review of their medical records (n=264). Data on management of chronic pain were collected retrospectively from patients’ records for three years from diagnosis (‘newly diagnosed’ patients) or for the most recent three years (‘established’ patients). FINDINGS: Patients received a wide variety of pain medications with no overall common prescribing pattern. GP visits represented the majority of the resource use and ‘newly diagnosed’ patients were significantly more likely to visit their GP for pain management than ‘established’ patients. Although ‘newly diagnosed’ patients had more referrals outside the GP practice, the number of visits to secondary care for pain management was similar for both groups. CONCLUSION: This retrospective study confirmed the complexity of managing these causes of chronic pain and the associated high resource use. It provides an in-depth picture of prescribing and referral patterns and of resource use

Interview Emile Roemer

Het zal niemand ontgaan zijn, het is crisis in Nederland. Er moet nodig hervormd worden en de burger weet veelal niet meer waar hij aan toe is. Terwijl de regering samen met de gedoogpartij bezuinigingen doorvoert die vergaande consequenties hebben voor grote groepen van de Nederlandse samenleving, zakken traditioneel grote partijen (het CDA en de PvdA) steeds verder weg in de peilingen. Een partij die het in de peilingen voor de wind gaat, is de SP. De redactie interviewde fractievoorzitter Emile Roemer