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Showing papers by "University of Western Ontario published in 2020"


Journal ArticleDOI
TL;DR: Allocating Scarce Medical Resources for Covid-19 The Covd-19 pandemic has already stressed health care systems throughout the world, requiring rationing of medical equipment and care.
Abstract: Allocating Scarce Medical Resources for Covid-19 The Covid-19 pandemic has already stressed health care systems throughout the world, requiring rationing of medical equipment and care. The authors ...

2,286 citations


Journal ArticleDOI
TL;DR: This survey paper will help industrial users, data analysts, and researchers to better develop machine learning models by identifying the proper hyper-parameter configurations effectively and introducing several state-of-the-art optimization techniques.

739 citations


Journal ArticleDOI
24 Apr 2020-PLOS ONE
TL;DR: The method achieves 100% accurate classification of the COVID-19 virus sequences, and discovers the most relevant relationships among over 5000 viral genomes within a few minutes, ab initio, suggesting that this alignment-free whole-genome machine-learning approach can provide a reliable real-time option for taxonomic classification.
Abstract: The 2019 novel coronavirus (renamed SARS-CoV-2, and generally referred to as the COVID-19 virus) has spread to 184 countries with over 1.5 million confirmed cases. Such major viral outbreaks demand early elucidation of taxonomic classification and origin of the virus genomic sequence, for strategic planning, containment, and treatment. This paper identifies an intrinsic COVID-19 virus genomic signature and uses it together with a machine learning-based alignment-free approach for an ultra-fast, scalable, and highly accurate classification of whole COVID-19 virus genomes. The proposed method combines supervised machine learning with digital signal processing (MLDSP) for genome analyses, augmented by a decision tree approach to the machine learning component, and a Spearman’s rank correlation coefficient analysis for result validation. These tools are used to analyze a large dataset of over 5000 unique viral genomic sequences, totalling 61.8 million bp, including the 29 COVID-19 virus sequences available on January 27, 2020. Our results support a hypothesis of a bat origin and classify the COVID-19 virus as Sarbecovirus, within Betacoronavirus. Our method achieves 100% accurate classification of the COVID-19 virus sequences, and discovers the most relevant relationships among over 5000 viral genomes within a few minutes, ab initio, using raw DNA sequence data alone, and without any specialized biological knowledge, training, gene or genome annotations. This suggests that, for novel viral and pathogen genome sequences, this alignment-free whole-genome machine-learning approach can provide a reliable real-time option for taxonomic classification.

676 citations


Journal ArticleDOI
TL;DR: In this paper, the authors proposed a method to solve the problem of the problem: this paper ] of "uniformity" of the distribution of data points in the data set.
Abstract: Abstract

655 citations


Journal ArticleDOI
TL;DR: The current position of social media platforms in propagating vaccine hesitancy is discussed and next steps in how social media may be used to improve health literacy and foster public trust in vaccination are explored.
Abstract: Despite major advances in vaccination over the past century, resurgence of vaccine-preventable illnesses has led the World Health Organization to identify vaccine hesitancy as a major threat to global health. Vaccine hesitancy may be fueled by health information obtained from a variety of sources, including new media such as the Internet and social media platforms. As access to technology has improved, social media has attained global penetrance. In contrast to traditional media, social media allow individuals to rapidly create and share content globally without editorial oversight. Users may self-select content streams, contributing to ideological isolation. As such, there are considerable public health concerns raised by anti-vaccination messaging on such platforms and the consequent potential for downstream vaccine hesitancy, including the compromise of public confidence in future vaccine development for novel pathogens, such as SARS-CoV-2 for the prevention of COVID-19. In this review, we discuss the current position of social media platforms in propagating vaccine hesitancy and explore next steps in how social media may be used to improve health literacy and foster public trust in vaccination.

651 citations


Journal ArticleDOI
30 Jul 2020-BMJ
TL;DR: Glucocorticoids probably reduce mortality and mechanical ventilation in patients with covid-19 compared with standard care and the effectiveness of most interventions is uncertain because most of the randomised controlled trials so far have been small and have important study limitations.
Abstract: Objective To compare the effects of treatments for coronavirus disease 2019 (covid-19). Design Living systematic review and network meta-analysis. Data sources WHO covid-19 database, a comprehensive multilingual source of global covid-19 literature, up to 1 March 2021 and six additional Chinese databases up to 20 February 2021. Studies identified as of 12 February 2021 were included in the analysis. Study selection Randomised clinical trials in which people with suspected, probable, or confirmed covid-19 were randomised to drug treatment or to standard care or placebo. Pairs of reviewers independently screened potentially eligible articles. Methods After duplicate data abstraction, a bayesian network meta-analysis was conducted. Risk of bias of the included studies was assessed using a modification of the Cochrane risk of bias 2.0 tool, and the certainty of the evidence using the grading of recommendations assessment, development, and evaluation (GRADE) approach. For each outcome, interventions were classified in groups from the most to the least beneficial or harmful following GRADE guidance. Results 196 trials enrolling 76 767 patients were included; 111 (56.6%) trials and 35 098 (45.72%) patients are new from the previous iteration; 113 (57.7%) trials evaluating treatments with at least 100 patients or 20 events met the threshold for inclusion in the analyses. Compared with standard care, corticosteroids probably reduce death (risk difference 20 fewer per 1000 patients, 95% credible interval 36 fewer to 3 fewer, moderate certainty), mechanical ventilation (25 fewer per 1000, 44 fewer to 1 fewer, moderate certainty), and increase the number of days free from mechanical ventilation (2.6 more, 0.3 more to 5.0 more, moderate certainty). Interleukin-6 inhibitors probably reduce mechanical ventilation (30 fewer per 1000, 46 fewer to 10 fewer, moderate certainty) and may reduce length of hospital stay (4.3 days fewer, 8.1 fewer to 0.5 fewer, low certainty), but whether or not they reduce mortality is uncertain (15 fewer per 1000, 30 fewer to 6 more, low certainty). Janus kinase inhibitors may reduce mortality (50 fewer per 1000, 84 fewer to no difference, low certainty), mechanical ventilation (46 fewer per 1000, 74 fewer to 5 fewer, low certainty), and duration of mechanical ventilation (3.8 days fewer, 7.5 fewer to 0.1 fewer, moderate certainty). The impact of remdesivir on mortality and most other outcomes is uncertain. The effects of ivermectin were rated as very low certainty for all critical outcomes, including mortality. In patients with non-severe disease, colchicine may reduce mortality (78 fewer per 1000, 110 fewer to 9 fewer, low certainty) and mechanical ventilation (57 fewer per 1000, 90 fewer to 3 more, low certainty). Azithromycin, hydroxychloroquine, lopinavir-ritonavir, and interferon-beta do not appear to reduce risk of death or have an effect on any other patient-important outcome. The certainty in effects for all other interventions was low or very low. Conclusion Corticosteroids and interleukin-6 inhibitors probably confer important benefits in patients with severe covid-19. Janus kinase inhibitors appear to have promising benefits, but certainty is low. Azithromycin, hydroxychloroquine, lopinavir-ritonavir, and interferon-beta do not appear to have any important benefits. Whether or not remdesivir, ivermectin, and other drugs confer any patient-important benefit remains uncertain. Systematic review registration This review was not registered. The protocol is publicly available in the supplementary material. Readers’ note This article is a living systematic review that will be updated to reflect emerging evidence. Updates may occur for up to two years from the date of original publication. This is the fourth version of the original article published on 30 July 2020 (BMJ 2020;370:m2980), and previous versions can be found as data supplements. When citing this paper please consider adding the version number and date of access for clarity.

602 citations


Journal ArticleDOI
TL;DR: The potential challenges associated with managing cancer patients during the COVID‐19 infection pandemic will be addressed, with suggestions of some practical approaches.
Abstract: The outbreak of coronavirus disease 2019 (COVID-19) has rapidly spread globally since being identified as a public health emergency of major international concern and has now been declared a pandemic by the World Health Organization (WHO). In December 2019, an outbreak of atypical pneumonia, known as COVID-19, was identified in Wuhan, China. The newly identified zoonotic coronavirus, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is characterized by rapid human-to-human transmission. Many cancer patients frequently visit the hospital for treatment and disease surveillance. They may be immunocompromised due to the underlying malignancy or anticancer therapy and are at higher risk of developing infections. Several factors increase the risk of infection, and cancer patients commonly have multiple risk factors. Cancer patients appear to have an estimated twofold increased risk of contracting SARS-CoV-2 than the general population. With the WHO declaring the novel coronavirus outbreak a pandemic, there is an urgent need to address the impact of such a pandemic on cancer patients. This include changes to resource allocation, clinical care, and the consent process during a pandemic. Currently and due to limited data, there are no international guidelines to address the management of cancer patients in any infectious pandemic. In this review, the potential challenges associated with managing cancer patients during the COVID-19 infection pandemic will be addressed, with suggestions of some practical approaches. IMPLICATIONS FOR PRACTICE: The main management strategies for treating cancer patients during the COVID-19 epidemic include clear communication and education about hand hygiene, infection control measures, high-risk exposure, and the signs and symptoms of COVID-19. Consideration of risk and benefit for active intervention in the cancer population must be individualized. Postponing elective surgery or adjuvant chemotherapy for cancer patients with low risk of progression should be considered on a case-by-case basis. Minimizing outpatient visits can help to mitigate exposure and possible further transmission. Telemedicine may be used to support patients to minimize number of visits and risk of exposure. More research is needed to better understand SARS-CoV-2 virology and epidemiology.

499 citations


Journal ArticleDOI
TL;DR: Inhibition of IL‐6 may be a novel target for therapeutics for the management of dysregulated host responses in patients with Covid‐19 and high‐quality studies of intervention in this field are urgently required.
Abstract: Coronaviruses may activate dysregulated host immune responses. As exploratory studies have suggested that interleukin-6 (IL-6) levels are elevated in cases of complicated Covid-19, we undertook a systematic review and meta-analysis to assess the evidence in this field. We systematically searched MEDLINE and EMBASE for studies investigating the immunological response in Covid-19; additional grey literature searches were undertaken. Study selection and data abstraction was undertaken independently by two authors. Meta-analysis was undertaken using random effects models to compute ratios of means with 95% confidence intervals (95%CIs). Eight published studies and two preprints (n = 1798) were eligible for inclusion. Meta-analysis of mean IL-6 concentrations demonstrated 2.9-fold higher levels in patients with complicated Covid-19 compared with patients with noncomplicated disease (six studies; n = 1302; 95%CI, 1.17-7.19; I2 = 100%). Consistent results were found in sensitivity analyses exclusively restricted to studies comparing patients requiring ICU admission vs no ICU admission (two studies; n = 540; ratio of means = 3.24; 95%CI, 2.54-4.14; P < .001; I2 = 87%). Nine of ten studies were assessed to have at least moderate risk of bias. In patients with Covid-19, IL-6 levels are significantly elevated and associated with adverse clinical outcomes. Inhibition of IL-6 may be a novel target for therapeutics for the management of dysregulated host responses in patients with Covid-19 and high-quality studies of intervention in this field are urgently required.

487 citations


Journal ArticleDOI
TL;DR: The authors found that adolescents are concerned about the COVID-19 crisis and are particularly worried about schooling and peer relationships, while more time connecting to friends virtually during the pandemic was associated with greater depression, but family time and schoolwork was related to less depression.
Abstract: We are facing an unprecedented time during the COVID-19 pandemic. Measures have been taken to reduce the spread of the virus, including school closures and widespread lockdowns. Physical isolation combined with economic instability, fear of infection, and uncertainty for the future has had a profound impact on global mental health. For adolescents, the effects of this stress may be heightened due to important developmental characteristics. Canadian adolescents (n = 1,054; M age= 16.68, SD = 0.78) completed online surveys and responded to questions on stress surrounding the COVID-19 crisis, feelings of loneliness and depression, as well as time spent with family, virtually with friends, doing schoolwork, using social media, and engaging in physical activity. Results showed that adolescents are very concerned about the COVID-19 crisis and are particularly worried about schooling and peer relationships. COVID-19 stress was related to more loneliness and more depression, especially for adolescents who spend more time on social media. Beyond COVID-19 stress, more time connecting to friends virtually during the pandemic was related to greater depression, but family time and schoolwork was related to less depression. For adolescents with depressive symptoms, it may be important to monitor the supportiveness of online relationships. Results show promising avenues to stave off loneliness, as time with family, time connecting to friends, as well as physical activity were related to lower loneliness, beyond COVID-19 stress. These results shed light on the implications of the COVID-19 pandemic for adolescents and document possible pathways to ameliorate negative effects.

481 citations


Journal ArticleDOI
TL;DR: Among patients with severe ANCA-associated vasculitis, the use of plasma exchange did not reduce the incidence of death or ESKD, and a reduced-dose regimen of glucocorticoids was noninferior to a standard- dose regimen with respect to death orESKD.
Abstract: Background More effective and safer treatments are needed for antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis. Methods We conducted a randomized trial with a 2-by-2 factor...

402 citations


Journal ArticleDOI
Michael D. Hill1, Mayank Goyal1, Bijoy K Menon1, Raul G. Nogueira2  +773 moreInstitutions (39)
TL;DR: Nerinetide did not improve the proportion of patients achieving good clinical outcomes after endovascular thrombectomy compared with patients receiving placebo, and this trial is registered with ClinicalTrials.gov, NCT02930018.

Journal ArticleDOI
TL;DR: Preliminary evidence is provided that adolescent substance use, including that which occurs face to face with peers, thereby putting adolescents at risk for contracting COVID-19, may be of particular concern during the pandemic.

Journal ArticleDOI
TL;DR: A number of pressing issues were identified by this review, including defining the true incidence of VTE in COVID patients, developing algorithms to identify those susceptible to develop thrombotic complications and severe disease, determining the role of biomarkers and/or scoring systems to stratify patients' risk, and designing adequate and feasible diagnostic protocols for PE.

Journal ArticleDOI
TL;DR: In this paper, the authors present a framework for the performance analysis of transmission scheduling with the QoS support along with the issues involved in short data packet transmission in the mMTC scenario and provide a detailed overview of the existing and emerging solutions toward addressing RAN congestion problem.
Abstract: The ever-increasing number of resource-constrained machine-type communication (MTC) devices is leading to the critical challenge of fulfilling diverse communication requirements in dynamic and ultra-dense wireless environments. Among different application scenarios that the upcoming 5G and beyond cellular networks are expected to support, such as enhanced mobile broadband (eMBB), massive machine type communications (mMTCs), and ultra-reliable and low latency communications (URLLCs), the mMTC brings the unique technical challenge of supporting a huge number of MTC devices in cellular networks, which is the main focus of this paper. The related challenges include quality of service (QoS) provisioning, handling highly dynamic and sporadic MTC traffic, huge signalling overhead, and radio access network (RAN) congestion. In this regard, this paper aims to identify and analyze the involved technical issues, to review recent advances, to highlight potential solutions and to propose new research directions. First, starting with an overview of mMTC features and QoS provisioning issues, we present the key enablers for mMTC in cellular networks. Along with the highlights on the inefficiency of the legacy random access (RA) procedure in the mMTC scenario, we then present the key features and channel access mechanisms in the emerging cellular IoT standards, namely, LTE-M and narrowband IoT (NB-IoT). Subsequently, we present a framework for the performance analysis of transmission scheduling with the QoS support along with the issues involved in short data packet transmission. Next, we provide a detailed overview of the existing and emerging solutions toward addressing RAN congestion problem, and then identify potential advantages, challenges, and use cases for the applications of emerging machine learning (ML) techniques in ultra-dense cellular networks. Out of several ML techniques, we focus on the application of low-complexity $Q$ -learning approach in the mMTC scenario along with the recent advances toward enhancing its learning performance and convergence. Finally, we discuss some open research challenges and promising future research directions.

Journal ArticleDOI
TL;DR: A series of design parameters including sulfur loading, electrolyte thickness, discharge capacity, discharge voltage, and cathode sulfur content are systematically analyzed to study their influence on the gravimetric and volumetric energy densities of SSLSB pouch cells.
Abstract: Solid-state lithium–sulfur batteries (SSLSBs) with high energy densities and high safety have been considered among the most promising energy storage devices to meet the demanding market requirements for electric vehicles. However, critical challenges such as lithium polysulfide shuttling effects, mismatched interfaces, Li dendrite growth, and the gap between fundamental research and practical applications still hinder the commercialization of SSLSBs. This review aims to combine the fundamental and engineering perspectives to seek rational design parameters for practical SSLSBs. The working principles, constituent components, and practical challenges of SSLSBs are reviewed. Recent progress and approaches to understand the interfacial challenges via advanced characterization techniques and density functional theory (DFT) calculations are summarized and discussed. A series of design parameters including sulfur loading, electrolyte thickness, discharge capacity, discharge voltage, and cathode sulfur content are systematically analyzed to study their influence on the gravimetric and volumetric energy densities of SSLSB pouch cells. The advantages and disadvantages of recently reported SSLSBs are discussed, and potential strategies are provided to address the shortcomings. Finally, potential future directions and prospects in SSLSB engineering are examined.

Journal ArticleDOI
TL;DR: The addition of LET to a single-bundle hamstring tendon autograft ACLR in young patients at high risk of failure results in a statistically significant, clinically relevant reduction in graft rupture and persistent rotatory laxity at 2 years after surgery.
Abstract: Background:Persistent anterolateral rotatory laxity after anterior cruciate ligament (ACL) reconstruction (ACLR) has been correlated with poor clinical outcomes and graft failure.Hypothesis:We hypo...

Journal ArticleDOI
Doreen M. Rabi1, Kerry McBrien1, Ruth Sapir-Pichhadze2, Meranda Nakhla2, Sofia B. Ahmed3, Sandra M. Dumanski3, Sonia Butalia4, Alexander A. Leung1, Kevin C. Harris5, Lyne Cloutier6, Kelly B. Zarnke1, Marcel Ruzicka7, Swapnil Hiremath8, Ross D. Feldman9, Sheldon W. Tobe10, Tavis S. Campbell1, Simon L. Bacon11, Kara Nerenberg1, George K. Dresser12, Anne Fournier13, Ellen Burgess1, Patrice Lindsay14, Simon W. Rabkin5, Ally P.H. Prebtani15, Steven A. Grover16, George Honos17, Jeffrey E. Alfonsi12, JoAnne Arcand18, François Audibert17, Geneviève Benoit13, Jesse Bittman5, Peter Bolli15, Anne-Marie Côté19, Janis M. Dionne5, Andrew C. Don-Wauchope15, Cedric Edwards7, Tabassum Firoz20, Jonathan Y. Gabor, Richard E. Gilbert21, Jean Grégoire22, Steven E. Gryn12, Milan Gupta15, Fady Hannah-Shmouni23, Robert A. Hegele12, Robert J. Herman1, Michael D. Hill1, Jonathan G. Howlett1, Gregory L. Hundemer7, Charlotte Jones5, Janusz Kaczorowski17, Nadia A. Khan5, Laura M. Kuyper5, Maxime Lamarre-Cliche17, Kim L. Lavoie24, Lawrence A. Leiter25, Richard Lewanczuk26, Alexander G. Logan27, Laura A. Magee28, Birinder K. Mangat5, Philip A. McFarlane25, Donna McLean29, André Michaud19, Alain Milot30, Gordon W. Moe25, S. Brian Penner31, Andrew L. Pipe7, Alexandre Y Poppe17, Evelyne Rey17, Michael Roerecke32, Ernesto L. Schiffrin16, Peter Selby32, Mike Sharma33, Ashkan Shoamanesh33, Praveena Sivapalan34, Raymond R. Townsend35, Karen Tran5, Luc Trudeau16, Ross T. Tsuyuki26, Michel Vallée36, Vincent Woo31, Alan Bell25, Stella S. Daskalopoulou2 
TL;DR: The 2020 guidelines include new guidance on themanagement of resistant hypertension and the management of hypertension in women planning pregnancy.

Journal ArticleDOI
TL;DR: An overview of halide solid-state electrolytes (SSEs) including their development, structure, ionic conductivity, chemical stability, and current limitations is presented in this article.
Abstract: Halide solid-state electrolytes (SSEs) with high room-temperature ionic conductivity (>10−3 S cm−1), wide electrochemical windows, and good compatibility toward oxide cathode materials have achieved impressive progress and attracted significant attention for application in all-solid-state lithium batteries (ASSLBs). This review presents an overview of halide SSEs, including their development, structure, ionic conductivity, chemical stability, and current limitations. Firstly, we give a brief overview of the historical development of halide-based SSEs, followed by an introduction to the different types of halide SSEs. From a practical point of view, the synthesis methods, especially scalable liquid-phase synthesis, are intensively discussed. Then, the associated stability issues involving basic structure stability, air/humidity stability, and electrochemical stability (electrolyte/SSE interface and electrochemical stability window) are also discussed in detail. Comprehensive coverage and thorough understanding of the properties of halide SSEs are provided and it is expected to help guide the development of future SSEs towards ASSLBs for energy storage applications.

Journal ArticleDOI
TL;DR: In this article, the authors proposed a new strategy for PEO-based high-voltage all-solid-state lithium batteries (ASSLBs) development by changing the unstable terminal groups.
Abstract: Due to higher energy density, high-voltage all-solid-state lithium batteries (ASSLBs) have attracted increasing attention. However, they require solid-state electrolytes (SSEs) with wide electrochemical stability windows (ESW, typically >4.2 V) and high-stability against the Li anode. Nevertheless, poly(ethylene oxide) (PEO), the most widely used solid polymer electrolyte (SPE), can’t tolerate a high-voltage over 4 V. Whether the main chain (–C–O–C–) or the terminal hydroxide group (–OH) is the limiting factor for the narrow ESW remains unknown. Herein, poly(ethylene glycol) (PEG) and poly(ethylene glycol)dimethyl ether (PEGDME) with different terminal groups are selected to answer this question. The results show that the reactive terminal –OH group is the limiting factor towards applicability against high voltage and the Li anode. Replacing –OH with more stable –OCH3 can significantly extend the ESW from 4.05 to 4.3 V, while improving the Li-anode compatibility as well (Li–Li symmetric cells stably run for 2500 h at 0.2 mA cm−2). Its practical application is further proved by developing PEGDME-based ASSLB pouch cells. The 0.53 mA cm−2 Li–LiFePO4 and 0.47 mA h cm−2 Li–LiNi0.5Mn0.3Co0.2O2 cells demonstrated high capacity retention of 97% and 90% after 210 cycles and 110 cycles, respectively. This work offers a new strategy for PEO-based high-voltage ASSLB development by changing the unstable terminal groups.

Journal ArticleDOI
TL;DR: The 2.5 release of Hyphy includes a completely re-engineered computational core and analysis library that introduces new classes of evolutionary models and statistical tests, delivers substantial performance and stability enhancements, improves usability, streamlines end-to-end analysis workflows, makes it easier to develop custom analyses, and is mostly backwards compatible with previous HyPhy releases.
Abstract: HYpothesis testing using PHYlogenies (HyPhy) is a scriptable, open-source package for fitting a broad range of evolutionary models to multiple sequence alignments, and for conducting subsequent parameter estimation and hypothesis testing, primarily in the maximum likelihood statistical framework. It has become a popular choice for characterizing various aspects of the evolutionary process: natural selection, evolutionary rates, recombination, and coevolution. The 2.5 release (available from www.hyphy.org) includes a completely re-engineered computational core and analysis library that introduces new classes of evolutionary models and statistical tests, delivers substantial performance and stability enhancements, improves usability, streamlines end-to-end analysis workflows, makes it easier to develop custom analyses, and is mostly backward compatible with previous HyPhy releases.

Journal ArticleDOI
TL;DR: In this paper, single-atom Cu catalysts were dispersed on nitrogen-doped carbon by a nitrogen-coordination strategy, and the presence of nitrogen enabled good dispersion and attachment of atomic Cu species on carbon.
Abstract: We report single-atom Cu catalysts dispersed on nitrogen-doped carbon by a nitrogen-coordination strategy. The presence of nitrogen enabled good dispersion and attachment of atomic Cu species on th...


Journal ArticleDOI
TL;DR: Examination of several Machine Learning models for forecasting the mechanical properties of concrete, including artificial neural networks, support vector machine, decision trees, and evolutionary algorithms are examined.

Journal ArticleDOI
TL;DR: Interventions for hypertriglyceridaemia are discussed, including diet and lifestyle, established treatments such as fibrates and omega-3 fatty acid preparations and emerging therapies, including various biological agents.
Abstract: Hypertriglyceridaemia is a common clinical problem. Epidemiologic and genetic studies have established that triglyceride-rich lipoproteins (TRL) and their remnants as important contributors to ASCVD while severe hypertriglyceridaemia raises risk of pancreatitis. While low-density lipoprotein is the primary treatment target for lipid lowering therapy, secondary targets that reflect the contribution of TRL such as apoB and non-HDL-C are recommended in the current guidelines. Reduction of severely elevated triglycerides is important to avert or reduce the risk of pancreatitis. Here we discuss interventions for hypertriglyceridaemia, including diet and lifestyle, established treatments such as fibrates and omega-3 fatty acid preparations and emerging therapies, including various biological agents.

Journal ArticleDOI
TL;DR: Despite the seriousness of the health situation, this new drive to move to online learning provides the necessary opportunity to assess the future approach to curriculum design and delivery for the anatomical sciences.
Abstract: \"All hands on deck, we need to move everything online as quickly as possible\". This is the message that has been ringing out across universities worldwide over the last couple of months as the Covid-19 pandemic has taken hold. Anatomists have responded to this call enthusiastically and creatively, ensuring that their students have resources available to continue and support their learning as they are forced to study remotely and exercise social distancing and where necessary self-isolation. Despite the seriousness of the health situation, this new drive to move to online learning provides the necessary opportunity to assess our future approach to curriculum design and delivery for the anatomical sciences. This pause to reevaluate is necessary as online learning, offers up refreshing and pedagogically innovative approaches to facilitate learning. For many courses and programs however, it is not the long-term silver bullet solution to all learning provision and has consequences that must be considered.

Journal ArticleDOI
TL;DR: RBV/rIFN therapy was commonly used in critically ill MERS patients but was not associated with reduction in 90-day mortality or in faster MERS-CoV RNA clearance.
Abstract: Background The objective of this study was to evaluate the effect of ribavirin and recombinant interferon (RBV/rIFN) therapy on the outcomes of critically ill patients with Middle East respiratory syndrome (MERS), accounting for time-varying confounders. Methods This is a retrospective cohort study of critically ill patients with laboratory-confirmed MERS from 14 hospitals in Saudi Arabia diagnosed between September 2012 and January 2018. We evaluated the association of RBV/rIFN with 90-day mortality and MERS coronavirus (MERS-CoV) RNA clearance using marginal structural modeling to account for baseline and time-varying confounders. Results Of 349 MERS patients, 144 (41.3%) patients received RBV/rIFN (RBV and/or rIFN-α2a, rIFN-α2b, or rIFN-β1a; none received rIFN-β1b). RBV/rIFN was initiated at a median of 2 days (Q1, Q3: 1, 3 days) from intensive care unit admission. Crude 90-day mortality was higher in patients with RBV/rIFN compared to no RBV/rIFN (106/144 [73.6%] vs 126/205 [61.5%]; P = .02]. After adjusting for baseline and time-varying confounders using a marginal structural model, RBV/rIFN was not associated with changes in 90-day mortality (adjusted odds ratio, 1.03 [95% confidence interval {CI}, .73-1.44]; P = .87) or with more rapid MERS-CoV RNA clearance (adjusted hazard ratio, 0.65 [95% CI, .30-1.44]; P = .29). Conclusions In this observational study, RBV/rIFN (RBV and/or rIFN-α2a, rIFN-α2b, or rIFN-β1a) therapy was commonly used in critically ill MERS patients but was not associated with reduction in 90-day mortality or in faster MERS-CoV RNA clearance.

Journal ArticleDOI
TL;DR: In this paper, a mixed conductive layer (MCL) consisting of electron-conductive nanoparticles embedded in an ionconductive network is introduced at the interface between the garnet SSE and the Li anode.
Abstract: Solid-state batteries (SSBs) with metallic lithium (Li) anodes and nonflammable solid-state electrolytes (SSEs) are viewed as the next-generation batteries because of their potential improvement in energy density and guarantee of safety. However, even though the high-density solid garnet SSE pellets exhibit high ionic conductivity, high transference number, and large shear modulus, the unexpectedly serious occurrence of dendrite propagation remains a problem. Herein, a mixed conductive layer (MCL) consisting of electron-conductive nanoparticles embedded in an ion-conductive network is introduced at the interface between the garnet SSE and the Li anode. Such MCL not only leads to the transition from lithiophobicity to lithiophilicity, but also homogenizes the electric-field distribution inside the MCL and relieves the electronic attacks to the garnet. As a result, the Li/MCL/garnet/MCL/Li cells show a critical current density as high as 1.2 mA cm−2 and stable cycling for over 1000 h at 0.1 mA cm−2. The LiCoO2/Li cells with the MCL-protected interface show excellent cycling and rate performance at room temperature. These results demonstrate a rational design for a stable garnet/Li interface and an effective strategy to enable Li metal anodes in SSBs.


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TL;DR: There was consensus that alongside traditional research, HAB scientists must set new courses of research and practices to deliver the conceptual and quantitative advances required to forecast future HAB trends.

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TL;DR: In this paper, the authors provide concrete information on the global lignin market and supply, and discuss its most explored applications - these being phenols and polyols due to their importance in short-and mid-terms lignIN market development.
Abstract: Lignin is an abundant renewable feedstock for bioenergy, chemicals and materials production. Numerous review papers have addressed lignin research; though, a limited focus has been given to lignin commercial initiatives and its market applications potential. However, this is an area of great importance, given the growth of commercial lignin production. For instance, expressed in the strategic directions taken by pulp mills with kraft lignin valorization as a primary pathway in their transformation to the biorefinery. This work aims to provide concrete information on the global lignin market and supply, and to discuss its most explored applications - these being phenols and polyols due to their importance in short- and mid-terms lignin market development. Over the years, lignosulfonates have dominated the market. However, kraft lignin production increased by 150% from 2014 to 2018, competing with lignosulfonates to some extent. Even with the increased kraft lignin precipitation, it should remain a bioenergy source for kraft mills in the short- and mid-terms, with only its surplus being directed to biochemicals and biomaterials. The most demonstrated market application of kraft lignin is the production of biophenol, with biopolyol as a prone application in the mid-term. In both cases, lignin modification to obtain uniform and reactive biochemicals could allow faster market penetration. Besides, phenol and polyol markets are expected to grow globally providing an opportunity for biopolymers. The main recommendations are related to scaling up technologies to achieve technical and economic optimization of lignin applications as well as collaborative research efforts connecting stakeholders in the value chain.