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Fulltext A Review on COVID-19 Mediated Impacts and Risk Mitigation Strategies for Dental Health Professionals

Sharma S, Parolia A, Kanagasingam S

Eur J Dent, 2020 Dec;14(S 01):S159-S164.
PMID: 33167046 DOI: 10.1055/s-0040-1718240

In the light of coronavirus disease 2019 (COVID-19), dentistry is facing unprecedented challenges. The closure of clinics has impacted dental health professionals (DHPs) not only financially but also psychologically. In this review, these consequences are discussed in detail to highlight the challenges that DHPs are facing thus far, in both developing and developed nations. Compromised mental health among DHPs is an important area that requires attention during this difficult period. Although, in previous pandemics, dentists have not worked on the frontline, the article discusses how their wide range of skillsets can be leveraged if another wave of COVID-19 pandemic appears. Finally, guidelines to reopen clinics and patient management have been discussed in detail that could serve as a quick reference guide for DHPs.

Matched MeSH terms: Attention
Ethical aspects in the use of radiation in medicine: update from ICRP Task Group 109

Bochud F, Cantone MC, Applegate K, Coffey M, Damilakis J, Del Rosario Perez M, et al.

Ann ICRP, 2020 Dec;49(1_suppl):143-153.
PMID: 32777956 DOI: 10.1177/0146645320929630

Whereas scientific evidence is the basis for recommendations and guidance on radiological protection, professional ethics is critically important and should always guide professional behaviour. The International Commission on Radiological Protection (ICRP) established Task Group 109 to advise medical professionals, patients, families, carers, the public, and authorities about the ethical aspects of radiological protection of patients in the diagnostic and therapeutic use of radiation in medicine. Occupational exposures and research-related exposures are not within the scope of this task group. Task Group 109 will produce a report that will be available to the different interested parties for consultation before publication. Presently, the report is at the stage of a working document that has benefitted from an international workshop organised on the topic by the World Health Organization. It presents the history of ethics in medicine in ICRP, and explains why this subject is important, and the benefits it can bring to the standard biomedical ethics. As risk is an essential part in decision-making and communication, a summary is included on what is known about the dose-effect relationship, with emphasis on the associated uncertainties. Once this theoretical framework has been presented, the report becomes resolutely more practical. First, it proposes an evaluation method to analyse specific situations from an ethical point of view. This method allows stakeholders to review a set of six ethical values and provides hints on how they could be balanced. Next, various situations (e.g. pregnancy, elderly, paediatric, end of life) are considered in two steps: first within a realistic, ethically challenging scenario on which the evaluation method is applied; and second within a more general context. Scenarios are presented and discussed with attention to specific patient circumstances, and on how and which reflections on ethical values can be of help in the decision-making process. Finally, two important related aspects are considered: how should we communicate with patients, family, and other stakeholders; and how should we incorporate ethics into the education and training of medical professionals?

Matched MeSH terms: Attention
Geospatial Insights for Retail Recommendation Using Similarity Measures

Ting CY, Ho CC, Yee HJ

Big Data, 2020 12;8(6):519-527.
PMID: 33347366 DOI: 10.1089/big.2020.0028

Recommending a retail business given a particular location of interest is nontrivial. Such a recommendation process requires careful study of demographics, trade area characteristics, sales performance, traffic, and environmental features. It is not only human effort taxing but often introduces inconsistency due to subjectivity in expert opinions. The process becomes more challenging when no sales data can be used to make a recommendation. As an attempt to overcome the challenges, this study used the machine learning approach that utilizes similarity measures to perform the recommendation. However, two challenges required careful attention when using the machine learning approach: (1) how to prepare a feature set that can commonly represent different types of retail business and (2) which similarity measure approach produces optimal recommendation accuracy? The data sets used in this study consist of points of interest, population, property, job type, and education level. Empirical studies were conducted to investigate (1) the overall accuracy of proposed similarity measure approaches to the retail business recommendation, and (2) whether the proposed approaches have a bias toward certain retail categories. In summary, the findings suggested that the proposed similarity-based techniques elicited an accuracy of above 70% and demonstrated higher accuracy when the recommendation was made within a set of similar retail businesses.

Matched MeSH terms: Attention
Self-reported diabetes, hypertension and hypercholesterolemia among older persons in Malaysia

Ab Majid NL, Rodzlan Hasani WS, Mat Rifin H, Robert Lourdes TG, Jane Ling MY, Saminanthan TA, et al.

Geriatr Gerontol Int, 2020 Dec;20 Suppl 2:79-84.
PMID: 33370854 DOI: 10.1111/ggi.13968

AIM: The objective of this study is to determine the prevalence of self-reported diabetes, hypertension and hypercholesterolemia among older persons in Malaysia and their associated factors.
METHODS: The study used data from the National Health and Morbidity Survey in 2018. It was a cross-sectional study with two-staged stratified cluster sampling design. In total, 3977 adults aged ≥60 years were selected for this study. Respondents were interviewed face to face using a structured questionnaire. Self-reported diabetes, hypertension or hypercholesterolemia was defined as having ever been told they have these diseases by a medical doctor or paramedic. Data were analyzed using SPSS version 25. The multiple logistic regression model was used to examine the factors associated with the prevalence of self-reporting.
RESULTS: The prevalence of self-reported diabetes, hypertension and hypercholesterolemia among older persons in Malaysia were 27.7%, 51.1% and 41.8% respectively. Presence of other comorbidities and being obese showed higher odds for all three diseases. Indians, unemployed, inactive had higher odds for diabetes. Other Bumiputras, unemployed, non-smoker, obese and inactive had higher odds for hypertension. Non-smoker had higher odds for hypercholesterolemia.
CONCLUSIONS: Health promotion, vigilance, attention and services targeting on the associated factors should be strengthened for older persons in Malaysia to ensure healthy aging. Geriatr Gerontol Int 2020; 20: 79-84.

Matched MeSH terms: Attention
Caregivers' perceptions towards oral healthcare services for elders living in Malaysian nursing homes-A qualitative study

Letchumanan D, Mohamad Norpi N, Yusof ZYM, Razak IA, Abu Kasim NH, Abdullah NA, et al.

Gerodontology, 2020 Dec;37(4):332-341.
PMID: 32115787 DOI: 10.1111/ger.12466

OBJECTIVE: To assess the perceptions of caregivers towards oral healthcare services received by elders in Malaysian nursing homes and to identify challenges and suggestions for improvement.
BACKGROUND: Caregivers play an important role in the oral health care of elders in nursing homes.
METHODS: This study employed a qualitative approach using the nominal group technique (NGT) to obtain caregivers' feedback in nursing homes in Malaysia. Data were manually transcribed, summarised into keywords/key phrases, and ranked using weighted scores.
RESULTS: In total, 36 caregivers (21 from government and 15 from private nursing homes) participated in the NGT sessions. Overall, caregivers were satisfied with the low treatment cost, the quality of treatment, and the availability of dental visits to nursing homes. Caregivers were dissatisfied with the frequency of dental visits, long waiting times at government dental clinics, and inadequate denture hygiene education for elders in nursing homes. The challenges faced by caregivers were elders' poor oral health knowledge and attitude and lack of elders' trust of caregivers to look after their oral health. Suggestions for improvement were to increase the frequency of dental visits to nursing homes, provide oral health education to elders and caregivers, and give treatment priority to elders at dental clinics.
CONCLUSION: Despite being satisfied with the basic oral healthcare services received by elders in Malaysian nursing homes, caregivers raised some issues that required further attention. Suggestions for improvement include policy changes in nursing home dental visits and treatment priority for elders at government dental clinics.

Matched MeSH terms: Attention
Exploring the temporal dynamics of inhibition of return using steady-state visual evoked potentials

Lim A, Janssen SMJ, Satel J

Cogn Affect Behav Neurosci, 2020 12;20(6):1349-1364.
PMID: 33236297 DOI: 10.3758/s13415-020-00846-w

Inhibition of return is characterized by delayed responses to previously attended locations when the interval between stimuli is long enough. The present study employed steady-state visual evoked potentials (SSVEPs) as a measure of attentional modulation to explore the nature and time course of input- and output-based inhibitory cueing mechanisms that each slow response times at previously stimulated locations under different experimental conditions. The neural effects of behavioral inhibition were examined by comparing post-cue SSVEPs between cued and uncued locations measured across two tasks that differed only in the response modality (saccadic or manual response to targets). Grand averages of SSVEP amplitudes for each condition showed a reduction in amplitude at cued locations in the window of 100-500 ms post-cue, revealing an early, short-term decrease in the responses of neurons that can be attributed to sensory adaptation, regardless of response modality. Because primary visual cortex has been found to be one of the major sources of SSVEP signals, the results suggest that the SSVEP modulations observed were caused by input-based inhibition that occurred in V1, or visual areas earlier than V1, as a consequence of reduced visual input activity at previously cued locations. No SSVEP modulations were observed in either response condition late in the cue-target interval, suggesting that neither late input- nor output-based IOR modulates SSVEPs. These findings provide further electrophysiological support for the theory of multiple mechanisms contributing to behavioral cueing effects.

Matched MeSH terms: Attention
Fulltext Numerical Prediction of Residual Stresses Distribution in Thin-Walled Press-Braked Stainless Steel Sections

Mutafi A, Yidris N, Koloor SSR, Petrů M

Materials (Basel), 2020 Nov 26;13(23).
PMID: 33256257 DOI: 10.3390/ma13235378

Stainless steels are increasingly used in construction today, especially in harsh environments, in which steel corrosion commonly occurs. Cold-formed stainless steel structures are currently increasing in popularity because of its efficiency in load-bearing capacity and its appealing architectural appearance. Cold-rolling and press-braking are the cold-working processes used in the forming of stainless steel sections. Press braking can produce large cross-sections from thin to thick-walled sections compared to cold-rolling. Cold-forming in press-braked sections significantly affect member behaviour and joints; therefore, they have attained great attention from many researchers to initiate investigations on those effects. This paper examines the behaviour of residual stress distribution of stainless steel press-braked sections by implementing three-dimensional finite element (3D-FE) technique. The study proposed a full finite element procedure to predict the residual stresses starting from coiling-uncoiling to press-braking. This work considered material anisotropy to examine its effect on the residual stress distribution. The technique adopted was compared with different finite element techniques in the literature. This study also provided a parametric study for three corner radius-to-thickness ratios looking at the through-thickness residual stress distribution of four stainless steels (i.e., ferritic, austenitic, duplex, lean duplex) in which have their own chemical composition. In conclusion, the comparison showed that the adopted technique provides a detailed prediction of residual stress distribution. The influence of geometrical aspects is more pronounced than the material properties. Neglecting the material anisotropy shows higher shifting in the neutral axis. The parametric study showed that all stainless steel types have the same stress through-thickness distribution. Moreover, R/t ratios' effect is insignificant in all transverse residual stress distributions, but a slight change to R/t ratios can affect the longitudinal residual stress distribution.

Matched MeSH terms: Attention
Fulltext The Development Impacts of COVID-19 at Home and Abroad: Politics and Implications of Government Action

Henson S, Kambhampati U, Mogues T, Olsen W, Prowse M, Ramos R, et al.

Eur J Dev Res, 2020 Nov 19.
PMID: 33230373 DOI: 10.1057/s41287-020-00334-4

What is COVID-19's impact on development? What lessons can be drawn from development studies regarding the effects of and recovery from COVID-19? The unprecedented scale and scope of government interventions carry implications at all levels: global, national, and local. In this introduction, our team of Editors underline the importance of systematic substantive study to further knowledge acquisition, and rigorous global-, national-, or context-specific evaluation to inform evidence-based policymaking. The 12 articles summarised here capture these values and sense of "high quality". In particular, despite early considerations in the first year of the pandemic, they illuminate the need for diverse responses beyond business-as-usual, attention to the multiplicity of impact of policies formulated, and progressive strategies to counteract the impacts of this disaster around the world. The path of future research is clear: studies need to consider and give voice to marginalised groups to counteract the short- and long-term impacts of the pandemic.

Matched MeSH terms: Attention
Fulltext Screw Migration into Colon after Anterior Cervical Plating - An Unusual Complication: A Case Report

Sath S

Malays Orthop J, 2020 Nov;14(3):184-187.
PMID: 33403084 DOI: 10.5704/MOJ.2011.031

Complications in the form of esophageal injury, tracheal injury, injury to carotids, implant failure, loosening of screws, etc do occur after anterior cervical surgeries. Although intra-operative esophageal injuries are as such rare, there have been few reports of delayed esophageal perforation as well after anterior cervical surgeries. We report a very rare case of migration of missing screw from anterior cervical plate after anterior cervical corpectomy and plating, which had ultimately migrated down to colon and had to be removed via colonoscopy. Along with removal of migrated screw from colon, revision of failed anterior cervical surgery was done wherein plate and screws were removed with mesh cage left in-situ as it was snug-fit while pharyngeophageal perforation was explored and was found to be spontaneously healing, with addition of posterior Bohlman's interspinous wiring for added stability. Migration of screw from the anterior cervical plate into the colon although very rare, should be always kept in mind and its potentially serious complications. We also conclude that particular attention should be given to elderly people with poor bony quality who have high chances of implant failure, along with attention to proper cage size, screw position and proper locking of the screw to further lessen the chances of implant failure.

Matched MeSH terms: Attention
Hungarian layer: A novel interpretable neural layer for paraphrase identification

Xiao H

Neural Netw, 2020 Nov;131:172-184.
PMID: 32801109 DOI: 10.1016/j.neunet.2020.07.024

Paraphrase identification serves as an important topic in natural language processing while sequence alignment and matching underlie the principle of this task. Traditional alignment methods take advantage of attention mechanism. Attention mechanism, i.e. weighting technique, could pick out the most similar/dissimilar parts, but is weak in modeling the aligned unmatched parts, which are the crucial evidence to identify paraphrases. In this paper, we empower neural architecture with Hungarian algorithm to extract the aligned unmatched parts. Specifically, first, our model applies BiLSTM/BERT to encode the input sentences into hidden representations. Then, Hungarian layer leverages the hidden representations to extract the aligned unmatched parts. Last, we apply cosine similarity to metric the aligned unmatched parts for a final discrimination. Extensive experiments show that our model outperforms other baselines, substantially and significantly.

Matched MeSH terms: Attention
Fulltext Smart and Climate-Smart Agricultural Trends as Core Aspects of Smart Village Functions

Adesipo A, Fadeyi O, Kuca K, Krejcar O, Maresova P, Selamat A, et al.

Sensors (Basel), 2020 Oct 22;20(21).
PMID: 33105622 DOI: 10.3390/s20215977

Attention has shifted to the development of villages in Europe and other parts of the world with the goal of combating rural-urban migration, and moving toward self-sufficiency in rural areas. This situation has birthed the smart village idea. Smart village initiatives such as those of the European Union is motivating global efforts aimed at improving the live and livelihood of rural dwellers. These initiatives are focused on improving agricultural productivity, among other things, since most of the food we eat are grown in rural areas around the world. Nevertheless, a major challenge faced by proponents of the smart village concept is how to provide a framework for the development of the term, so that this development is tailored towards sustainability. The current work examines the level of progress of climate smart agriculture, and tries to borrow from its ideals, to develop a framework for smart village development. Given the advances in technology, agricultural development that encompasses reduction of farming losses, optimization of agricultural processes for increased yield, as well as prevention, monitoring, and early detection of plant and animal diseases, has now embraced varieties of smart sensor technologies. The implication is that the studies and results generated around the concept of climate smart agriculture can be adopted in planning of villages, and transforming them into smart villages. Hence, we argue that for effective development of the smart village framework, smart agricultural techniques must be prioritized, viz-a-viz other developmental practicalities.

Matched MeSH terms: Attention
The potential role of nanoyttria in alleviating oxidative stress biomarkers: Implications for Alzheimer's disease therapy

Tang KS

Life Sci, 2020 Oct 15;259:118287.
PMID: 32814066 DOI: 10.1016/j.lfs.2020.118287

Alzheimer's disease (AD) is a fatal neurodegenerative disease that requires immediate attention. Oxidative stress that leads to the generation of reactive oxygen species is a contributing factor to the disease progression by promoting synthesis and deposition of amyloid-β, the main hallmark protein in AD. It has been previously demonstrated that nanoyttria possesses antioxidant properties and can alleviate cellular oxidative injury in various toxicity and disease models. This review proposed that nanoyttria could be used for the treatment of AD. In this paper, the evidence on the antioxidant potential of nanoyttria is presented and its prospects on AD therapy are discussed.

Matched MeSH terms: Attention
Hydroxychloroquine and Chloroquine in Prophylaxis and Treatment of COVID-19: What Is Known?

Shankar PR, Palaian S, Gulam SM

J Pharm Bioallied Sci, 2020 10 06;13(1):4-10.
PMID: 34084043 DOI: 10.4103/jpbs.JPBS_404_20

The corona virus disease-19 (COVID-19) pandemic has affected the entire world causing huge economic losses and considerable morbidity and mortality. Considering the explosive growth of the pandemic repurposing existing medicines may be cost-effective and may be approved for use in COVID-19 faster. Researchers and medical practitioners worldwide have explored the use of chloroquine and hydroxychloroquine, in few occasions combined with the macrolide antibiotic azithromycin, for COVID-19 treatment. These two drugs are economic and easily available, and hence gained attention as a potential option for COVID-19 management. As per the available evidence, the outcomes of treatments with these medications are conflicting from both the efficacy and safety (predominantly cardiac related) perspectives. Currently, multiple studies are underway to test the safety and efficacy of these medications and more results are expected in the near future. The retina, the endocrine system (with risk of hypoglycemia), the musculoskeletal system, the hematological system, and the neurological system may also be affected. The use of these drugs is contraindicated in patients with arrhythmias, known hypersensitivity, and in patients on amiodarone. In addition to the published literature, personal communication with doctors treating COVID-19 patients seems to suggest the drugs may be effective in reducing symptoms and hastening clinical recovery. The literature evidence is still equivocal and further results are awaited. There has been recent controversy including retraction of articles published in prestigious journals about these medicines. Their low cost, long history of use, and easy availability are positive factors with regard to use of these drugs in COVID-19.

Matched MeSH terms: Attention
Fulltext Carbon Nanotubes (CNTs)-Reinforced Magnesium-Based Matrix Composites: A Comprehensive Review

Abazari S, Shamsipur A, Bakhsheshi-Rad HR, Ismail AF, Sharif S, Razzaghi M, et al.

Materials (Basel), 2020 Oct 04;13(19).
PMID: 33020427 DOI: 10.3390/ma13194421

In recent years considerable attention has been attracted to magnesium because of its light weight, high specific strength, and ease of recycling. Because of the growing demand for lightweight materials in aerospace, medical and automotive industries, magnesium-based metal matrix nanocomposites (MMNCs) reinforced with ceramic nanometer-sized particles, graphene nanoplatelets (GNPs) or carbon nanotubes (CNTs) were developed. CNTs have excellent material characteristics like low density, high tensile strength, high ratio of surface-to-volume, and high thermal conductivity that makes them attractive to use as reinforcements to fabricate high-performance, and high-strength metal-matrix composites (MMCs). Reinforcing magnesium (Mg) using small amounts of CNTs can improve the mechanical and physical properties in the fabricated lightweight and high-performance nanocomposite. Nevertheless, the incorporation of CNTs into a Mg-based matrix faces some challenges, and a uniform distribution is dependent on the parameters of the fabricating process. The characteristics of a CNTs reinforced composite are related to the uniform distribution, weight percent, and length of the CNTs, as well as the interfacial bonding and alignment between CNTs reinforcement and the Mg-based matrix. In this review article, the recent findings in the fabricating methods, characterization of the composite's properties, and application of Mg-based composites reinforced with CNTs are studied. These include the strategies of fabricating CNT-reinforced Mg-based composites, mechanical responses, and corrosion behaviors. The present review aims to investigate and conclude the most relevant studies conducted in the field of Mg/CNTs composites. Strategies to conquer complicated challenges are suggested and potential fields of Mg/CNTs composites as upcoming structural material regarding functional requirements in aerospace, medical and automotive industries are particularly presented.

Matched MeSH terms: Attention
Fulltext Salmonella-innovative targeting carrier: Loading with doxorubicin for cancer treatment

Rabea S, Alanazi FK, Ashour AE, Salem-Bekhit MM, Yassin AS, Moneib NA, et al.

Saudi Pharm J, 2020 Oct;28(10):1253-1262.
PMID: 33132719 DOI: 10.1016/j.jsps.2020.08.016

Cell- based targeted delivery is recently gain attention as a promising platform for delivery of anticancer drug in selective and efficient manner. As a new biotechnology platform, bacterial ghosts (BGs) have novel biomedical application as targeted drug delivery system (TDDS). In the current work, Salmonellas' BGs was utilized for the first time as hepatocellular cancer (HCC) in-vitro targeted delivery system. Successful BGs loading and accurate analysis of doxorubicin (DOX) were necessary steps for testing the applicability of DOX loaded BGs in targeting the liver cancer cells. Loading capacity was maximized to reach 27.5 µg/mg (27.5% encapsulation efficiency), by incubation of 10 mg BGs with 1 mg DOX at pH 9 in constant temperature (25 °C) for 10 min. In-vitro release study of DOX loaded BGs showed a sustained release (182 h) obeying Higuchi sustained kinetic release model. The death rate (tested by MTT assay) of HepG2 reached to 64.5% by using of 4 μg/ml, while it was about 51% using the same concentration of the free DOX (P value

Matched MeSH terms: Attention
Correction to: Suspended sediment load prediction using artificial neural network and ant lion optimization algorithm

Banadkooki FB, Ehteram M, Ahmed AN, Teo FY, Ebrahimi M, Fai CM, et al.

Environ Sci Pollut Res Int, 2020 Oct;27(30):38117-38119.
PMID: 32705552 DOI: 10.1007/s11356-020-10139-x

Following the publication of the article it has come to the authors' attention that the first panel of Fig. 11 has been repeated with the second panel of Fig. 11.

Matched MeSH terms: Attention
Fulltext A Survey on Underwater Wireless Sensor Networks: Requirements, Taxonomy, Recent Advances, and Open Research Challenges

Fattah S, Gani A, Ahmedy I, Idris MYI, Targio Hashem IA

Sensors (Basel), 2020 Sep 21;20(18).
PMID: 32967124 DOI: 10.3390/s20185393

The domain of underwater wireless sensor networks (UWSNs) had received a lot of attention recently due to its significant advanced capabilities in the ocean surveillance, marine monitoring and application deployment for detecting underwater targets. However, the literature have not compiled the state-of-the-art along its direction to discover the recent advancements which were fuelled by the underwater sensor technologies. Hence, this paper offers the newest analysis on the available evidences by reviewing studies in the past five years on various aspects that support network activities and applications in UWSN environments. This work was motivated by the need for robust and flexible solutions that can satisfy the requirements for the rapid development of the underwater wireless sensor networks. This paper identifies the key requirements for achieving essential services as well as common platforms for UWSN. It also contributes a taxonomy of the critical elements in UWSNs by devising a classification on architectural elements, communications, routing protocol and standards, security, and applications of UWSNs. Finally, the major challenges that remain open are presented as a guide for future research directions.

Matched MeSH terms: Attention
Evolution of adsorption process for manganese removal in water via agricultural waste adsorbents

Rudi NN, Muhamad MS, Te Chuan L, Alipal J, Omar S, Hamidon N, et al.

Heliyon, 2020 Sep;6(9):e05049.
PMID: 33033772 DOI: 10.1016/j.heliyon.2020.e05049

Manganese has recently been a topic of interest among researchers, particularly when 1,752 million tonnes of manganese are expected to be produced by the steel industry in 2020. Manganese discharges from industrial effluents have increased manganese contamination in water sources. Its concentrations of more than 0.2 mg/L in the water sources could have negative impacts on human health and the aquatic ecosystem. Thereby, the available water treatment processes face challenges in effectively removing manganese at low cost. In response to these challenges, adsorption has emerged as one of the most practical water treatment processes for manganese removal. In particular, agricultural waste adsorbents received a lot of attention owing to their low cost and high efficiency (99%) in the removal of manganese. Therefore, this paper reviews the removal of manganese by adsorption process using agricultural waste adsorbents. The factors affecting the adsorption process, the mechanisms, and the performances of the adsorbents are elucidated in detail.

Matched MeSH terms: Attention
Fulltext Impact of COVID-19 on clinical trials and clinical research: A systematic review

Sathian B, Asim M, Banerjee I, Pizarro AB, Roy B, van Teijlingen ER, et al.

Nepal J Epidemiol, 2020 Sep;10(3):878-887.
PMID: 33042591 DOI: 10.3126/nje.v10i3.31622

Background: The World Health Organization has reported more than 31,186,000 confirmed cases of coronavirus disease-19 (COVID-19), including 962,343 deaths, worldwide as on September 21, 2020. The current COVID-19 pandemic is affecting clinical research activities in most parts of the world. The focus on developing a vaccine for SARS-CoV-2 and the treatment of COVID-19 is, in fact, disrupting many upcoming and/or ongoing clinical trials on other diseases around the globe. On March 18, 2020, the United States Food and Drug Administration (FDA) issued an updated guideline for the conduct of clinical trials during the current health emergency situation. The potential challenges, such as social distancing and quarantines, result in study participants' inaccessibility and trial personnel for in-person scheduled study visits and/or follow-up. Due to the sudden onset and wide-spread impact of COVID-19, its influence on the management of clinical trials and research necessitates urgent attention. Therefore, our systematic review of the literature aims to assess the impact of the COVID-19 pandemic on the conduction of clinical trials and research. The search for the relevant articles for review included the keywords "COVID-19" AND "clinical trial" in PubMed, MEDLINE, Embase, Google scholar and Google electronic databases. Key findings include: delaying subject enrollment and operational gaps in most ongoing clinical trials, which in turn has a negative impact on trial programmes and data integrity. Globally, most sites conducting clinical trials other than COVID-19 are experiencing a delay in timelines and a complete halt of operations in lieu of this pandemic, thus affecting clinical research outcomes.

Matched MeSH terms: Attention
Effects of dehydroepiandrosterone (DHEA) supplementation on the lipid profile: A systematic review and dose-response meta-analysis of randomized controlled trials

Qin Y, O Santos H, Khani V, Tan SC, Zhi Y

Nutr Metab Cardiovasc Dis, 2020 08 28;30(9):1465-1475.
PMID: 32675010 DOI: 10.1016/j.numecd.2020.05.015

BACKGROUND AND AIMS: Dehydroepiandrosterone (DHEA) supplementation has gained attention in individuals with adrenal insufficiency, and as a tool for increasing androgens and estrogens whereby is proposed to improve the accretion of muscle and bone mass. However, DHEA supplementation has demonstrated negative effects on the lipid profile and, thus, we aimed to analyze the body of evidence in this regard.
METHODS AND RESULTS: A systematic review and dose-response meta-analysis of randomized controlled trials (RCTs) was performed employing in Scopus, PubMed/Medline, Web of Science, Embase and Google Scholar, then including relevant articles that addressed the effects of DHEA supplementation on the lipid profile, up to February 2020. Combined findings were generated from 23 eligible articles. Hence, total cholesterol (TC) (weighted mean difference (WMD): -3.5 mg/dl, 95% confidence interval (CI): -8.5 to 1.6)), low-density lipoprotein-cholesterol (LDL-C) (WMD: 0.34 mg/dl, 95% CI: -3 to 3.7) and triglycerides (TG) levels (WMD: -2.85 mg/dl, 95% CI: -9.3 to 3.6) did not alter in DHEA group compared to the control, but HDL-C levels significantly reduced in DHEA group (WMD: -3.1 mg/dl, 95% CI: -4.9 to -1.3). In addition, a significant reduction in HDL-C values was observed in studies comprising women (WMD: -5.1 mg/dl, 95% CI: -7.2 to -3) but not in males (WMD: 0.13 mg/dl, 95% CI: -1.4 to 1.7).
CONCLUSIONS: Overall, supplementation with DHEA did not change circulating values of TC, LDL-C and TG, whereas it may decrease HDL-C levels. Further long-term RCTs are required to investigate the effects of DHEA particularly on major adverse cardiac events.

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