Awareness and preparedness of healthcare workers against the first wave of the COVID-19 pandemic: A cross-sectional survey across 57 countries.

BACKGROUND: Since the COVID-19 pandemic began, there have been concerns related to the preparedness of healthcare workers (HCWs). This study aimed to describe the level of awareness and preparedness of hospital HCWs at the time of the first wave. METHODS: This multinational, multicenter, cross-sectional survey was conducted among hospital HCWs from February to May 2020. We used a hierarchical logistic regression multivariate analysis to adjust the influence of variables based on awareness and preparedness. We then used association rule mining to identify relationships between HCW confidence in handling suspected COVID-19 patients and prior COVID-19 case-management training. RESULTS: We surveyed 24,653 HCWs from 371 hospitals across 57 countries and received 17,302 responses from 70.2% HCWs overall. The median COVID-19 preparedness score was 11.0 (interquartile range [IQR] = 6.0-14.0) and the median awareness score was 29.6 (IQR = 26.6-32.6). HCWs at COVID-19 designated facilities with previous outbreak experience, or HCWs who were trained for dealing with the SARS-CoV-2 outbreak, had significantly higher levels of preparedness and awareness (p<0.001). Association rule mining suggests that nurses and doctors who had a 'great-extent-of-confidence' in handling suspected COVID-19 patients had participated in COVID-19 training courses. Male participants (mean difference = 0.34; 95% CI = 0.22, 0.46; p<0.001) and nurses (mean difference = 0.67; 95% CI = 0.53, 0.81; p<0.001) had higher preparedness scores compared to women participants and doctors. INTERPRETATION: There was an unsurprising high level of awareness and preparedness among HCWs who participated in COVID-19 training courses. However, disparity existed along the lines of gender and type of HCW. It is unknown whether the difference in COVID-19 preparedness that we detected early in the pandemic may have translated into disproportionate SARS-CoV-2 burden of disease by gender or HCW type

Safety and efficacy of fluoxetine on functional outcome after acute stroke (AFFINITY): a randomised, double-blind, placebo-controlled trial

Background Trials of fluoxetine for recovery after stroke report conflicting results. The Assessment oF FluoxetINe In sTroke recoverY (AFFINITY) trial aimed to show if daily oral fluoxetine for 6 months after stroke improves functional outcome in an ethnically diverse population. Methods AFFINITY was a randomised, parallel-group, double-blind, placebo-controlled trial done in 43 hospital stroke units in Australia (n=29), New Zealand (four), and Vietnam (ten). Eligible patients were adults (aged ≥18 years) with a clinical diagnosis of acute stroke in the previous 2–15 days, brain imaging consistent with ischaemic or haemorrhagic stroke, and a persisting neurological deficit that produced a modified Rankin Scale (mRS) score of 1 or more. Patients were randomly assigned 1:1 via a web-based system using a minimisation algorithm to once daily, oral fluoxetine 20 mg capsules or matching placebo for 6 months. Patients, carers, investigators, and outcome assessors were masked to the treatment allocation. The primary outcome was functional status, measured by the mRS, at 6 months. The primary analysis was an ordinal logistic regression of the mRS at 6 months, adjusted for minimisation variables. Primary and safety analyses were done according to the patient's treatment allocation. The trial is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12611000774921. Findings Between Jan 11, 2013, and June 30, 2019, 1280 patients were recruited in Australia (n=532), New Zealand (n=42), and Vietnam (n=706), of whom 642 were randomly assigned to fluoxetine and 638 were randomly assigned to placebo. Mean duration of trial treatment was 167 days (SD 48·1). At 6 months, mRS data were available in 624 (97%) patients in the fluoxetine group and 632 (99%) in the placebo group. The distribution of mRS categories was similar in the fluoxetine and placebo groups (adjusted common odds ratio 0·94, 95% CI 0·76–1·15; p=0·53). Compared with patients in the placebo group, patients in the fluoxetine group had more falls (20 [3%] vs seven [1%]; p=0·018), bone fractures (19 [3%] vs six [1%]; p=0·014), and epileptic seizures (ten [2%] vs two [<1%]; p=0·038) at 6 months. Interpretation Oral fluoxetine 20 mg daily for 6 months after acute stroke did not improve functional outcome and increased the risk of falls, bone fractures, and epileptic seizures. These results do not support the use of fluoxetine to improve functional outcome after stroke

Innovative Integration of Butina Clustering with Ensemble Learning Techniques for the Refined Pharmacophore Modeling of Apelin Receptor Agonists: A High-Impact Computational Approach

3D pharmacophore models describe the ligand’s chemical interactions in their bioactive conformation. They offer a simple but sophisticated approach to decipher the chemically encoded ligand information, making them a valuable tool in Drug Design. Our research summarized the key studies for applying 3D pharmacophore models in virtual screening for APJ receptor agonists. Recent advances in clustering algorithms and ensemble methods have enabled classical pharmacophore modeling to evolve into more flexible and knowledge-driven techniques. Butina clustering categorizes molecules based on their structural similarity (indicated by the Tanimoto coefficient) to create a structurally diverse training dataset. The ensemble learning method combines various individual pharmacophore models into a set of pharmacophore models for pharmacophore space optimization in virtual screening. This approach was evaluated on Apelin datasets and afforded good screening performance, as proven by receiver operating characteristic, enrichment factor, Güner-Henry score, and F-measure. Although one of the high-scoring models achieved statistically superior results in each dataset, the ensemble learning method including Voting and Stacking method balanced the shortcomings of each model and passed with close performance measures

Integration of the Butina algorithm and ensemble learning strategies for the advancement of a pharmacophore ligand-based model : an in silico investigation of apelin agonists

Introduction: 3D pharmacophore models describe the ligand's chemical interactions in their bioactive conformation. They offer a simple but sophisticated approach to decipher the chemically encoded ligand information, making them a valuable tool in drug design. Methods: Our research summarized the key studies for applying 3D pharmacophore models in virtual screening for 6,944 compounds of APJ receptor agonists. Recent advances in clustering algorithms and ensemble methods have enabled classical pharmacophore modeling to evolve into more flexible and knowledge-driven techniques. Butina clustering categorizes molecules based on their structural similarity (indicated by the Tanimoto coefficient) to create a structurally diverse training dataset. The learning method combines various individual pharmacophore models into a set of pharmacophore models for pharmacophore space optimization in virtual screening. Results: This approach was evaluated on Apelin datasets and afforded good screening performance, as proven by Receiver Operating Characteristic (AUC score of 0.994 ± 0.007), enrichment factor of (EF1% of 50.07 ± 0.211), Güner-Henry score of 0.956 ± 0.015, and F-measure of 0.911 ± 0.031. Discussion: Although one of the high-scoring models achieved statistically superior results in each dataset (AUC of 0.82; an EF1% of 19.466; GH of 0.131 and F1-score of 0.071), the ensemble learning method including voting and stacking method balanced the shortcomings of each model and passed with close performance measures

Gold Nanoparticles Modified a Multimode Clad-Free Fiber for Ultrasensitive Detection of Bovine Serum Albumin

Gold nanoparticles (Au NPs) were almost chosen as the first option for biological and biosensor applications due to their enhancement and their outstanding properties. The combining of optical fiber with localized surface plasmon resonance (LSPR) for forming a biosensor is widely used in diagnosis. In this work, we report a fiber optical biosensor based on LSPR of Au NPs for the detection of bovine serum albumin (BSA) protein. BSA was functionalized on Au NPs immobilized fiber optic sensing head (length of 1 cm) via methanesulfonic acid (MSA) by carboxylic binding. It is the binding between the analytes with the surface-modified Au NPs that caused refractive index changes in the sensing medium led to changes in optical power at the output of the sensor. The detection limit of the LSPR fiber biosensor was found to be 0.18 ng/mL for the BSA detection with the low coefficient of variation (CV) at under 1%. We have demonstrated the effectiveness of combining multimode fiber with Au NPs to generate the biosensor as the label-free sensor that can be a feasible tool for highly sensitive, rapid response time, stable, and miniaturized point-of-care analytical systems

Optimize temporal configuration for motor imagery-based multiclass performance and its relationship with subject-specific frequency

Enhancing the performance of motor imagery-based Brain-Computer Interfaces (BCI) has been a significant goal in the BCI field. To achieve such a goal, several typical and promising techniques have been implemented, such as developing intelligent algorithms, combining features from different domains, extracting subject-specific parameters, and so forth. Previous studies performing temporal segmentation often ended up with a large number of features and placed a burden on computational cost, which poses a disadvantage to online analysis. This study proposes a novel approach to utilizing short-window segments to find an optimal combination of time segments and feature extractors. Electroencephalogram data from four datasets (BCI Competition IV dataset 2a, 2b and two self-acquired datasets) were segmented into four types of the time window and had features extracted by Common Spatial Pattern and its variants, and lastly classified by Linear Discriminant Analysis. The result shows that the combination of the “2-s with 1-s overlapping” segment and Filter Bank Common Spatial Pattern yields overall accuracy of 2–6.5% (p-value <0.05), higher than other methods in comparison. In addition, the study finds that there is a negative correlation (r = −0.38) between the number of subject-specific frequency bands and the performance (p-value <0.0001). The results demonstrate that the narrower and more focus frequency range chosen, the more accurate the model can achieve. Our results indicate that the “2-s with 1-s overlapping” segment would be an ideal candidate for online BCI analysis, and the response of selected frequency bands could be an informative indicator to evaluate BCI performance

The natural history and transmission potential of asymptomatic severe acute respiratory syndrome coronavirus 2 infection

Background Little is known about the natural history of asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Methods We conducted a prospective study at a quarantine center for coronavirus disease 2019 in Ho Chi Minh City, Vietnam. We enrolled quarantined people with reverse-transcription polymerase chain reaction (RT-PCR)–confirmed SARS-CoV-2 infection, collecting clinical data, travel and contact history, and saliva at enrollment and daily nasopharyngeal/throat swabs (NTSs) for RT-PCR testing. We compared the natural history and transmission potential of asymptomatic and symptomatic individuals. Results Between 10 March and 4 April 2020, 14 000 quarantined people were tested for SARS-CoV-2; 49 were positive. Of these, 30 participated in the study: 13 (43%) never had symptoms and 17 (57%) were symptomatic. Seventeen (57%) participants imported cases. Compared with symptomatic individuals, asymptomatic people were less likely to have detectable SARS-CoV-2 in NTS collected at enrollment (8/13 [62%] vs 17/17 [100%]; P = .02). SARS-CoV-2 RNA was detected in 20 of 27 (74%) available saliva samples (7 of 11 [64%] in the asymptomatic group and 13 of 16 [81%] in the symptomatic group; P = .56). Analysis of RT-PCR positivity probability showed that asymptomatic participants had faster viral clearance than symptomatic participants (P  Conclusions Asymptomatic SARS-CoV-2 infection is common and can be detected by analysis of saliva or NTSs. The NTS viral loads fall faster in asymptomatic individuals, but these individuals appear able to transmit the virus to others