Key considerations and common adverse events for HIV-positive patients with cancer treated with immune checkpoint inhibitors

HIV-infected patients are more susceptible to cancer due to their immune-compromised condition and HIV infection. Chronic inflammation and immune dysregulation are the main causes of cancer development in these patients. Because of lymphopenia and an immune-compromised condition, most HIV-infected patients with cancer were not considered for cytotoxic therapies, such as chemotherapy and radiotherapy. Immune checkpoint inhibitors (ICIs) have become a game-changer in many cancer types. However, not enough prospective data is available regarding the use of ICIs in HIV-infected patients with cancer. Retrospective data from case reports/series showed that ICIs are safe in HIV-infected patients with cancer.

Evaluation of COVID-19 Restrictions on Distance Runners' Training Habits Using Wearable Trackers

The COVID-19 pandemic caused widespread disruption to many individuals' lifestyles. Social distancing restrictions implemented during this global pandemic may bring potential impact on physical activity habits of the general population. However, running is one of the most popular forms of physical activity worldwide and one in which it could be maintained even during most COVID-19 restrictions. We aimed to determine the impact of COVID-19 restrictions on runners' training habits through analyzing the training records obtained from their GPS enabled wearable trackers. Retrospective and prospective data were collected from an online database (https://wetrac.ucalgary.ca). Runners' training habits, including frequency, intensity and duration of training, weekly mileage and running locations were analyzed and compared 9 months before and after the start of COVID-19 restrictions in March 2020. We found that runners ran 3 km per week more (p = 0.05, Cohen's d = 0.12) after the start of COVID-19 restrictions, and added 0.3 training sessions per week (p = 0.03, Cohen's d = 0.14). Moreover, runners ran an additional 0.4 sessions outdoors (p < 0.01, Cohen's d = 0.21) but there was no significant change in the intensity or duration of training sessions. Our findings suggested that runners adopted slightly different training regimen as a result of COVID-19 restrictions. Our results described the collective changes, irrespective of differences in response measures adopted by various countries or cities during the COVID-19 pandemic.

Simultaneous Descriptors of Research Design

Many students are not aware that research design can be simultaneously described in many different ways; for example, a drug trial may be described as being prospective, longitudinal, randomized, double-blind, and placebo-controlled, all at the same time. This article provides examples to explain how studies can be simultaneously prospective and cross-sectional, prospective and longitudinal, retrospective and cross-sectional, and retrospective and longitudinal. The term prospective indicates that the study data are newly collected, whereas the term retrospective indicates that the study data already exist in records and merely need to be extracted for study. The term cross-sectional indicates that the study subjects are studied on a single occasion; that is, at a single point in time. The term longitudinal indicates that the study subjects are followed up and that there is almost always more than one time point at which the subjects are assessed. This article also describes unusual designs, such as cross-sectional randomized controlled trials and retrospective studies with prospective data ascertainment.

Validation of a Novel Smartphone-Based Electronic Data Capture System Following Surgical Fixation of Distal Radial Fractures

Background: Large prospective institutional data provide the opportunity to conduct level II and III studies using robust methodologies and adequately powered sample-sizes, while circumventing limitations of retrospective databases. We aimed to validate a prospective data collection tool, the Orthopaedic Minimal Data Set Episode of Care (OME), implemented at a tertiary North American health care system for distal radial fracture (DRF) open reduction and internal fixation (ORIF). Methods: The first 100 DRF ORIFs performed after OME inception (February 2015) were selected for this validation study. A blinded review of the operative notes and charts was performed, and extracted data of 75 perioperative DRF ORIF procedure variables were compared with OME collected data for agreement. Outcomes included completion rates and agreement measures in OME versus electronic medical record (EMR)-based control datasets. Data counts were evaluated using raw percentages and McNemar tests. Cohen (κ) and concordance correlation coefficient analyzed categorical and numerical variable agreement, respectively. Results: Overall, OME demonstrated superior completion and agreement parameters versus EMR-based retrospective review. Nine data points (12.0%) demonstrated significantly higher completion rates within the OME dataset ( P < .05, each), and 88% (66/75) of captured variables demonstrated similar completion rates. Up to 80.0% (60/75) of variables either demonstrated an agreement proportion of ≥0.90 or were solely reported in the OME. Of 33 variables eligible for agreement analyses, 36.4% (12/33) demonstrated almost perfect agreement (κ > 0.80), and 63.6% (21/33) exhibited almost perfect or substantial agreement (κ > 0.60). Conclusions: The OME is a valid and accurate prospective data collection tool for DRF ORIF that is reliably able to match or supersede traditional retrospective chart review. Future investigations could use this tool for large-scale analyses investigating peri/intraoperative DRF ORIF variables.

Diabetes Distress During COVID-19: Three Brief ‘Snapshot’ Surveys of Adults With Diabetes Calling the Australian National Diabetes Services Scheme Helpline

The aim of this study was to take ‘snapshots’ of how people with diabetes are feeling emotionally during the coronavirus disease 2019 (COVID-19) pandemic. Three ‘snapshot’ surveys were conducted during May 2020, August 2020 and April 2021, each over a two-week period. Adults (≥18 years) with diabetes calling the Australian Government’s National Diabetes Services Scheme Helpline (NDSS) were invited to participate. Those who accepted were asked three questions sourced/adapted from the Problem Areas in Diabetes scale. Responses were recorded on a 5-point scale (0=’not a problem’, 4=’serious problem’). Of interest were scores ≥2, indicating this was at least a ‘moderate problem’. The survey was administered by NDSS Helpline staff via telephone. Basic demographic and clinical data were collected. In total, 1,278 surveys were completed over the three ‘snapshots’ (1st N=449; 2nd N=414; 3rd N=415). Participants were aged (median[IQR]) 62[47,72] years, 56% were women, and 57% had type 2 diabetes. At the 3rd ‘snapshot’, 21% had received a COVID-19 vaccine. Our findings show that feeling at least moderately ‘burned out’ by the constant effort needed to manage diabetes is salient, and consistently experienced by adults with diabetes calling the NDSS Helpline at three timepoints during the coronavirus pandemic. Those who participated in the 3rd ‘snapshot’ survey were less likely to report that feeling ‘alone with their diabetes’ or ‘worrying about their diabetes because of the COVID-19 pandemic’ were moderate or serious problems for them. Except for younger adults, findings indicate that the easing of restrictions may mitigate some of the effects of the pandemic on diabetes-specific emotional problems, including feeling ‘burned out’, ‘alone’ with diabetes, and/or worried about diabetes due to COVID-19. Prospective data are needed to improve our understanding of the emotional impact of COVID-19 on people with diabetes and to inform when and how to target support for those who need it most.

SYNERGISM TEST OF DATE (PHOENIX DACTYLIFERA L.) AND RAW TEMPE ON ANTIOXIDANT ACTIVITY

Introduction: Dates and tempeh are foods that both contain antioxidant compounds. Antioxidant compounds such as flavonoids and isoflavones are known to be found in dates and tempeh. This study was conducted to see how much antioxidant activity contained in dates and tempeh and how the effect of dates and tempeh consumed simultaneously on the increase in total antioxidant activity. Method: This study uses a direct experimental design with prospective data collection. The selected samples were dates with the type of sukkari and tempeh wrapped in plastic. Data processing was carried out using a simple linear regression statistical method. Results: The DPPH test method with UV-Visible Spectrophotometry instrument showed the results of the % inhibition value of dates fruit of 39.99% and tempeh of 24.52%. Testing the synergistic effect using 7 treatments showed that the treatment with a ratio of 50:50 had a higher % inhibition value than the other treatments, which showed that consuming dates and tempeh in a ratio of 50:50 could provide a synergistic effect on antioxidant activity. Conclusion The results obtained indicate that both samples, both dates and tempeh have high antioxidant activity, consuming both simultaneously can increase antioxidant activity. So it can be concluded that there is an effect on the synergistic effect of antioxidant activity of dates and tempeh which are consumed simultaneously. It is recommended to conduct research on the antioxidant activity of dates and tempeh using other test methods, and further research on the formulation of the preparation or clinical trials using mice.

Litrature Review Trauma Vascular

Vascular traumatic is trauma to the blood vessels caused by blunt injuries such as a hard impact or penetrating injuries such as sharp object injuries, penetrating bullet shots. Massive haemorrhage is the main cause of vascular trauma, resulting in death. Therefore, prompt treatment is needed to avoid other complications or even death due to uncontrolled bleeding. Vascular surgeons are the key to trauma injury patients, by controlling bleeding and vascular reconstruction, using aspects of open and endovascular surgical techniques. Diagnostic protocols are needed to identify injuries and consider the best tactics for surgical treatment of vascular injuries. Accurate, non-invasive diagnostic imaging techniques are key to this strategy. The aim of this review is to determine the optimal diagnostic imaging in patients with suspected vascular injury in the anatomic region and the method of treatment with retrospective or prospective data collection which is preferable to CT angiography compared to other methods. CT angiography can be declared the gold standard for diagnosing vascular injury in patients.

Flares after hydroxychloroquine reduction or discontinuation: results from the Systemic Lupus International Collaborating Clinics (SLICC) inception cohort

ObjectivesTo evaluate systemic lupus erythematosus (SLE) flares following hydroxychloroquine (HCQ) reduction or discontinuation versus HCQ maintenance.MethodsWe analysed prospective data from the Systemic Lupus International Collaborating Clinics (SLICC) cohort, enrolled from 33 sites within 15 months of SLE diagnosis and followed annually (1999–2019). We evaluated person-time contributed while on the initial HCQ dose (‘maintenance’), comparing this with person-time contributed after a first dose reduction, and after a first HCQ discontinuation. We estimated time to first flare, defined as either subsequent need for therapy augmentation, increase of ≥4 points in the SLE Disease Activity Index-2000, or hospitalisation for SLE. We estimated adjusted HRs (aHRs) with 95% CIs associated with reducing/discontinuing HCQ (vs maintenance). We also conducted separate multivariable hazard regressions in each HCQ subcohort to identify factors associated with flare.ResultsWe studied 1460 (90% female) patients initiating HCQ. aHRs for first SLE flare were 1.20 (95% CI 1.04 to 1.38) and 1.56 (95% CI 1.31 to 1.86) for the HCQ reduction and discontinuation groups, respectively, versus HCQ maintenance. Patients with low educational level were at particular risk of flaring after HCQ discontinuation (aHR 1.43, 95% CI 1.09 to 1.87). Prednisone use at time-zero was associated with over 1.5-fold increase in flare risk in all HCQ subcohorts.ConclusionsSLE flare risk was higher after HCQ taper/discontinuation versus HCQ maintenance. Decisions to maintain, reduce or stop HCQ may affect specific subgroups differently, including those on prednisone and/or with low education. Further study of special groups (eg, seniors) may be helpful.

Complement system component dysregulation is a distinctive feature of COVID-19 disease: a prospective and comparative analysis of patients admitted to the emergency department for suspected COVID-19 disease

The complement system (CS) plays a pivotal role in Coronavirus disease 2019 (COVID-19) pathophysiology. The objective of this study was to provide a comparative, prospective data analysis of CS components in an all-comers cohort and COVID-19 patients. Patients with suspected COVID-19 infection admitted to the Emergency department were grouped for definite diagnosis of COVID-19 and no COVID-19 accordingly. Clinical presentation, routine laboratory and von Willebrand factor (vWF) antigen as well as CS components 3, 4 and activated 5 (C5a) were assessed. Also, total complement activity via the classical pathway (CH50) was determined. Levels of calprotectin in serum were measured using an automated quantitative lateral flow assay. We included 80 patients in this prospective trial. Of those 19 (23.7%) were tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Patients with COVID-19 had higher levels of CS components 5a and 4 (54.79 [24.14–88.79] ng/ml vs. 35 [23.15–46.1] ng/ml; p = 0.0433 and 0.3772 [± 0.1056] g/L vs. 0.286 [0.2375–0.3748] g/L; p = 0.0168). COVID-19 patients had significantly higher levels of vWF antigen when compared to the control group (288.3 [± 80.26] % vs. 212 [151–320] %; p = 0.0469). There was a significant correlation between CS C3 and 5a with vWF antigen (rs = 0.5957 [p = 0.0131] and rs = 0.5015 [p = 0.042]) in COVID-19 patients. There was no difference in calprotectin plasma levels (4.786 [± 2.397] µg/ml vs. 4.233 [± 2.142] µg/ml; p = 0.4175) between both groups. This prospective data from a single centre all-comers cohort accentuates altered levels of CS components as a distinct feature of COVID-19 disease. Deregulation of CS component 3 and C5a are associated with increased vWF antigen possibly linking vascular damage to alternative CS activation in COVID-19.

Pre-pandemic Predictors of Loneliness in Adult Men During COVID-19

Loneliness is a major public health issue, with its prevalence rising during COVID-19 pandemic lockdowns and mandated “social distancing” practices. A 2020 global study (n = 46,054) found that, in comparison to women, men experienced the greatest levels of loneliness. Although research on predictors of loneliness during COVID-19 is increasing, little is known about the characteristics of men who may be particularly vulnerable. Studies using prospective data are needed to inform preventative measures to support men at risk of loneliness. The current study draws on rare longitudinal data from an Australian cohort of men in young to mid-adulthood (n = 283; aged M = 34.6, SD = 1.38 years) to examine 25 pre-pandemic psychosocial predictors of loneliness during COVID-19 social restrictions (March–September 2020). Adjusted linear regressions identified 22 pre-pandemic predictors of loneliness across a range of trait-based, relational, career/home and mental health variables. Given the extensive set of predictors, we then conducted penalized regression models (LASSO), a machine learning approach, allowing us to identify the best fitting multivariable set of predictors of loneliness during the pandemic. In these models, men's sense of pre-pandemic environmental mastery emerged as the strongest predictor of loneliness. Depression, neuroticism and social support also remained key predictors of pandemic loneliness (R2 = 26, including covariates). Our findings suggest that men's loneliness can be detected prospectively and under varying levels of social restriction, presenting possible targets for prevention efforts for those most vulnerable.