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In this randomized trial involving 438 hospitalized patients with severe Covid-19 pneumonia, the use of the monoclonal antibody tocilizumab did not result in significantly better clinical status or lower mortality than placebo at 28 days.

Purpose The proliferation of the coronavirus disease (COVID-19) has threatened the service industry, especially the restaurant sector, requiring innovative ways to help restaurants overcome this challenge. Thus, based on the stimulus–organism–response (SOR) model, the purpose of this study is to examine the role of customers' perception of a restaurant's innovativeness (CPRI) in brand evangelism by mediating customer engagement (CE). Additionally, this study examines the moderating role of customer openness to experience. Design/methodology/approach A Web-based survey collected the primary data from 483 Egyptian customers. The data were analysed using the partial least squares structural equation modelling method based on WarpPLS.7 software. Findings According to the findings, CPRI, which acts as a stimulus in the SOR model, positively affects CE (organism) and brand evangelism (response). CE positively affects restaurant evangelism. Additionally, CE mediates the relationship between CPRI and evangelism. Openness to experience moderates the relationship between CPRI, engagement and brand evangelism. Research limitations/implications This study addresses the gaps in understanding CE and brand evangelism within the context of restaurant innovation. This study assesses restaurant innovativeness scales of developing economies in multiple dimensions. Egyptian restaurant marketing managers should innovate products, services, experiences, and promotions to increase consumer engagement and feedback through technology. Originality/value This study investigates how Egyptian restaurants engage with and evangelise customers through innovation. This is one of the few studies that examine brand evangelism in a restaurant setting from the perspective of the SOR theory. Additionally, this study analyses CE as a mediator and openness to experience as a moderator.

The city of Abou Zenimah in South Sinai is one of the Red Sea coastal cities at risk of water scarcity and food shortage due to seawater intrusion and limited rainfall. The proposed project of a WEF Nexus system aims to create a stable source of water for consumption, agriculture, and industrial needs while also implementing sustainable agriculture and aquaculture for the growth of vegetables and fish as a source of food, mitigating the risks associated with climate variations and unstable crop calendars. The system utilizes Forward Osmosis desalination to produce 250,000 m3/year of fresh water, Aquaponics and Aeroponics for crop and fish growth, and Evaporation Ponds for salt extraction. The integration of renewable energy through Photovoltaics, meeting a daily demand of 6.39 MWh, ensures that the emissions are minimized for the sustainable operations of the project. The project is anticipated to have positive environmental, economic, and social impacts for the community of Abou Zenimah and other cities in South Sinai. The feasibility study of the project highlights the importance of commercializing the products from the project to have a feasible pay-back period estimated at 5 years. Through creating resource security and employment opportunities, this project shall create resilience for the residents at risk of political upheavals and uncertain conditions.

Abstract Background Respiratory syncytial virus (RSV) is the most important viral cause of severe respiratory illness in young children and lacks a vaccine. RSV cold-passage/stabilized 2 (RSVcps2) is a modification of a previously evaluated vaccine candidate in which 2 major attenuating mutations have been stabilized against deattenuation. Methods RSV-seronegative 6–24-month-old children received an intranasal dose of 105.3 plaque-forming units (PFU) of RSVcps2 (n = 34) or placebo (n = 16) (International Maternal Pediatric Adolescent AIDS Clinical Trials protocol P1114 and companion protocol CIR285). RSV serum neutralizing antibody titers before and 56 days after vaccination, vaccine virus infectivity (defined as vaccine virus shedding detectable in nasal wash and/or a ≥4-fold rise in serum antibodies), reactogenicity, and genetic stability were assessed. During the following RSV transmission season, participants were monitored for respiratory illness, with serum antibody titers measured before and after the season. Results A total of 85% of vaccinees were infected with RSVcps2 (median peak titer, 0.5 log10 PFU/mL by culture and 2.9 log10 copies/mL by polymerase chain reaction analysis); 77% shed vaccine virus, and 59% developed a ≥4-fold rise in RSV-serum neutralizing antibody titers. Respiratory tract and/or febrile illness occurred at the same rate (50%) in the vaccine and placebo groups. Deattenuation was not detected at either of 2 stabilized mutation sites. Conclusions RSVcps2 was well tolerated and moderately immunogenic and had increased genetic stability in 6–24-month-old RSV-seronegative children. Clinical Trials Registration NCT01852266 and NCT01968083. The live respiratory syncytial virus (RSV) vaccine RSVcps2, containing virus with stabilized temperature-sensitivity attenuation mutations, was well tolerated, moderately immunogenic, and genetically stable in RSV-seronegative 6–24-month-old children. This virus and its stabilized mutations are suitable for use in further vaccine development.

Clozapine (CLZ); an atypical antipsychotic drug, is well known to have a significant role in managing schizophrenic patients with substance use disorder (SUD). Unfortunately, many patients are deprived of CLZ benefits due to its limited prescription. This is based upon concerns regarding the critical side effects of CLZ in case of overdosing especially, with the lack of accessible therapeutic drug monitoring (TDM) tools. In this contribution, a simple, accurate and sensitive electrochemical method is proposed for CLZ assay in human saliva. Unlike previously reported methods for TDM of CLZ that depends on invasive matrices as plasma and urine, this method employs electrochemical approaches in exploring human saliva as a patient-friendly alternative for assessing CLZ. The proposed method employs differential pulse voltammetry (DPV) with a sensitive and selective Ag-doped ZnO nanoparticles based carbon paste electrode (CPE). The adopted electrochemical sensor has not been previously reported for CLZ determination, despite it offers enhanced sensitivity together with simple synthesis. The synthesized nanoparticles were characterized through Fourier-transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDX). The developed sensor was optimized and validated as per FDA guidelines of bioanalytical methods. The linear range in saliva was 0.31–3.67 µmol/L and the lower limit of quantitation (LLOQ) was 0.31 µmol/L. The high reliability and applicability of the suggested method has strong potential to be integrated in a point-of-care testing (POCT) device to introduce more accessible TDM that enables smooth TDM of CLZ. Therefore, it opens pathways for broader and safe use of CLZ. Graphical abstract

As a GABA-β receptor agonist, the central muscle relaxant Baclofen (BAC) has a potential of abuse. Unfortunately, the sense of wellbeing and pleasure is obtained at very high BAC doses. This is associated with many life-threating or even fatal cases due to neurological and respiratory failures. Moreover, having narrow therapeutic index makes BAC a high-risk drug. This is potentiated in case of long-treatment regimen or off-label use in smoking and alcohol cessation protocols. Until now, there is no rapid diagnostic test available for BAC screening. Therefore; It is quite difficult to routinely monitor cases on BAC regimen. On the other hand, smartphone-based colorimetric point of care testing (POCT) is displacing conventional analytical approaches in the detection and assay of abused drugs as well as therapeutic drug monitoring. It offers on-site, rapid, easy, affordable and interpretable analysis. Incorporating smartphone as a portable device facilitates its application, especially in remote areas and low-income countries. For the first time, the current work presents a smartphone-based colorimetric POCT for BAC analysis in urine without interference from urine matrix. It depends on BAC reaction with naphthoquinone sulfonate (NQS) in highly alkaline aqueous medium. The developed color was captured in a customized photo box using smartphone camera. Then, intensity of the blue channel was measured by a software application “Color Analyzer”. All parameters were optimized with respect to the colorimetric reaction, photographing and smartphone-based analysis. All parameters were successfully investigated according to FDA guidelines for bioanalytical method validation. Also, all POCT criteria were considered as per WHO requirements. This method could determine BAC, linearly, from 0.02 to 0.21 mmol L−1 in urine. Moreover, LLOQ was lower than the expected BAC therapeutic concentrations in urine. The proposed method proved high reliability and suitability to analyze BAC in urine. This strongly recommends its routine application in screening BAC abusers and BAC therapeutic monitoring.

Women currently account for 27% of new human immunodeficiency virus (HIV) infections in the United States, the majority of which are acquired through heterosexual transmission. In the United States, black and Latino persons are disproportionately affected by the HIV epidemic, a disparity that is most dramatically present among HIV-infected women. Many of these women face significant discrimination as a result of race or ethnicity and sex, and they suffer disproportionately from poverty, low health literacy, and lack of access to high-quality HIV care. As a consequence, despite the availability of highly active antiretroviral therapy (HAART), women with HIV often have delayed entry into care and experience poor outcomes. This article reviews risk factors for HIV infection in women, barriers to engagement in care, and strategies to improve linkage to HIV-related medical and social care.

Abstract Background The safety and immunogenicity of live respiratory syncytial virus (RSV) candidate vaccine, LID/ΔM2-2/1030s, with deletion of RSV ribonucleic acid synthesis regulatory protein M2-2 and genetically stabilized temperature-sensitivity mutation 1030s in the RSV polymerase protein was evaluated in RSV-seronegative children. Methods Respiratory syncytial virus-seronegative children ages 6–24 months received 1 intranasal dose of 105 plaque-forming units (PFU) of LID/ΔM2-2/1030s (n = 21) or placebo (n = 11). The RSV serum antibodies, vaccine shedding, and reactogenicity were assessed. During the following RSV season, medically attended acute respiratory illness (MAARI) and pre- and postsurveillance serum antibody titers were monitored. Results Eighty-five percent of vaccinees shed LID/ΔM2-2/1030s vaccine (median peak nasal wash titers: 3.1 log10 PFU/mL by immunoplaque assay; 5.1 log10 copies/mL by reverse-transcription quantitative polymerase chain reaction) and had ≥4-fold rise in serum-neutralizing antibodies. Respiratory symptoms and fever were common (60% vaccinees and 27% placebo recipients). One vaccinee had grade 2 wheezing with rhinovirus but without concurrent LID/ΔM2-2/1030s shedding. Five of 19 vaccinees had ≥4-fold increases in antibody titers postsurveillance without RSV-MAARI, indicating anamnestic responses without significant illness after infection with community-acquired RSV. Conclusions LID/ΔM2-2/1030s had excellent infectivity without evidence of genetic instability, induced durable immunity, and primed for anamnestic antibody responses, making it an attractive candidate for further evaluation. Live respiratory syncytial virus (RSV) vaccine LID/∆M2-2/1030s attenuated by deletion of the RNA regulatory protein M2-2 and temperature-sensitivity mutation 1030s had excellent immunogenicity and genetic stability in RSV-seronegative 6- to 24-month-old children, making it an attractive candidate for further evaluation.

Abstract Background Live respiratory syncytial virus (RSV) candidate vaccine LIDΔM2-2 is attenuated by deletion of the RSV RNA regulatory protein M2-2, resulting in upregulated viral gene transcription and antigen expression but reduced RNA replication. Methods RSV-seronegative children ages 6–24 months received a single intranasal dose of 105 plaque forming units (PFU) of LIDΔM2-2 (n = 20) or placebo (n = 9) (NCT02237209, NCT02040831). RSV serum antibodies, vaccine infectivity, and reactogenicity were assessed. During the following RSV season, participants were monitored for respiratory illness and pre- and post-RSV season serum antibodies. Results Vaccine virus was shed by 95% of vaccinees (median peak titers of 3.8 log10 PFU/mL by quantitative culture and 6.3 log10 copies/mL by PCR); 90% had ≥4-fold rise in serum neutralizing antibodies. Respiratory symptoms and fever were common in vaccine (95%) and placebo (78%). One vaccinee had grade 2 rhonchi concurrent with vaccine shedding, rhinovirus, and enterovirus. Eight of 19 vaccinees versus 2 of 9 placebo recipients had substantially increased RSV antibody titers after the RSV season without medically attended RSV disease, indicating anamnestic vaccine responses to wild-type RSV without significant illness. Conclusion LIDΔM2-2 had excellent infectivity and immunogenicity, encouraging further study of vaccine candidates attenuated by M2-2 deletion. Clinical Trials Registration NCT02237209, NCT02040831. The live respiratory syncytial virus (RSV) vaccine LIDΔM2-2, attenuated by deletion of the RNA regulatory protein M2-2, had excellent infectivity and immunogenicity in RSV seronegative 6–24-month old children, encouraging further study of vaccine candidates attenuated by M2-2 deletion.