A conserved subunit vaccine designed against SARS-CoV-2 variants showed evidence in neutralizing the virus.

Novel coronavirus (SARS-CoV-2) leads to coronavirus disease 19 (COVID-19), declared as a pandemic that outbreaks within almost 225 countries worldwide. For the time being, numerous mutations have been reported that led to the generation of numerous variants spread more rapidly. This study aims to establish an efficient multi-epitope subunit vaccine that could elicit both T-cell and B-cell responses sufficient to recognize three confirmed surface proteins of the virus. The sequences of the viral surface proteins, e.g., an envelope protein (E), membrane glycoprotein (M), and S1 and S2 domain of spike surface glycoprotein (S), were analyzed by an immunoinformatic approach. Top immunogenic epitopes have been selected based on the assessment of the affinity with MHC class-I and MHC class-II, population coverage, along with conservancy among wild type and new variants of SARS-CoV-2 genomes. Molecular docking and molecular dynamic simulation suggest that the proposed top peptides have the potential to interact with the highest number of both the MHC class I and MHC class II. The epitopes were assembled by the appropriate linkers to form a multi-epitope vaccine. Epitopes used in the vaccine construct are conserved in all the variants evolved till now. This in silico-designed multi-epitope vaccine is highly immunogenic and induces levels of SARS-CoV2-neutralizing antibodies in mice, which is detected by inhibition of cytopathic effect in Vero cell monolayer. Further studies are required to improve its efficiency in the prevention of virus replication in lung tissue, in addition to safety validation as a step for human application to combat SARS-CoV-2 variants. KEY POINTS: • We discovered five T-cell epitopes from three surface proteins of SARS-CoV-2. • These are conserved in the wild-type virus and variants, e.g., beta, delta, and omicron. • The multi-epitope vaccine can induce IgG in mice that can neutralize the virus.

A randomized controlled trial of a group intervention for siblings of children with cancer: Changes in symptoms of anxiety in siblings and caregivers.

OBJECTIVE: This study assessed the effects of a group intervention-Siblings Coping Together (SibCT)-on siblings' and caregivers' anxiety symptoms compared to controls, and potential moderators. METHODS: Seventy healthy siblings of children on or off treatment (7-16 y old, 41 males) participated in a randomized controlled trial (RCT) with 2 arms/groups: SibCT (n = 41) and an attention control (CG) (n = 34). Both groups had eight 2-hour weekly sessions. EG followed SibCT's educational, social, and problem-solving activities. CG had planned games and crafts. Siblings and caregivers self-reported on anxiety symptoms at baseline, intervention end, and 3 months later. Multivariable mixed model analyses examined the intervention effect over time, and potential moderators (gender, on/off ill child's treatment). RESULTS: No main effects of group or time were found in sibling scores. A group × gender interaction (P < .05) indicated that in the intervention group female siblings reported less total anxiety symptoms than male siblings, with no significant gender differences in the control group. Caregivers' total anxiety symptoms declined over time (P < .02). A group × on/off treatment interaction in physiological/panic subscale (P < .03) indicated that when ill child was on treatment, caregivers of siblings in SibCT reported less anxiety compared with caregivers of CG. CONCLUSIONS: There was no clear SibCT intervention effect. SibCT may benefit female siblings, and caregivers whose ill child is on active treatment. Contextual factors (gender) seem to influence psychosocial intervention in this population.

A randomized control intervention trial to improve social skills and quality of life in pediatric brain tumor survivors.

BACKGROUND: To determine if a group social skills intervention program improves social competence and quality of life (QOL) in pediatric brain tumor survivors (PBTS). METHODS: We conducted a randomized control trial in which PBTS (8-16 years old, off therapy for over 3 months) were allocated to receive social skills training (eg, cooperation, assertion, using social cognitive problem solving strategies, role playing, games, and arts and crafts) in 8 weekly 2-hour sessions, or an attention placebo control (games and arts and crafts only). Outcomes were self-reported, proxy-reported (caregiver), and teacher-reported using the Social Skills Rating System (SSRS), to measure social competence, and the Pediatric Quality of Life (PedsQL4.0, generic) to measure QOL at baseline, after intervention, and at 6 months follow-up. At baseline, SSRS were stratified into low and high scores and included as a covariate in the analysis. RESULTS: Compared to controls (n = 48), PBTS in the intervention group (n = 43) reported significantly better total and empathy SSRS scores, with improvements persisting at follow-up. The PBTS in the intervention group who had low scores at baseline reported the greatest improvements. Proxy and teacher reports showed no intervention effect. CONCLUSIONS: Participating in group social skills intervention can improve self-reported social competence that persisted to follow up. The PBTS should be given the opportunity to participate in social skills groups to improve social competence.

Determinants of quality of life outcomes for survivors of pediatric brain tumors.

INTRODUCTION: To describe the quality of life (QOL) of pediatric brain tumor survivors (PBTSs) prospectively and to identify potential medical, personal and family contextual factors associated with QOL. METHODS: Ninety-one PBTSs (8-16 years) who were off treatment and attending a regular classroom participated. Self- and caregiver-proxy-reported on QOL at baseline, 2 and 8 months. At baseline, cognitive, executive function, attention and memory, medical and demographics information were attained. RESULTS: Significant improvements over time in PBTS's emotional QOL were self- and proxy-reported (P < 0.01) and global QOL proxy-reported (P = 0.04). Receiving cranial irradiation therapy (CIT) and poor behavioral regulation predicted poor global QOL scores reported by both informants (P < 0.017). Poor behavioral regulation also predicted poor self-reported school functioning, and poor proxy-reported emotional and social QOL (P < 0.037). Boys reported better emotional QOL (P = 0.029), and PBTSs over 11 years old were reported to have better emotion and school-related QOL. Finally, being non-White and having low income predicted poor self-reported global and emotional QOL (P = 0.041). CONCLUSIONS: Receiving CIT, having poor behavioral regulation, being a female, under 11 years old and coming from low-income, non-White families place PBTSs at risk for poor QOL.

Determinants of social competence in pediatric brain tumor survivors who participated in an intervention study.

PURPOSE: This prospective study describes disease/treatment, personal characteristics, and social/family contextual variables as risk and resilience factors that predict social competence in pediatric brain tumor survivors (PBTS). METHODS: Ninety-one PBTS (51% male, mean age 11.21 years, off-treatment, attending a regular classroom >50% of the time) participated. PBTS and their primary caregivers (proxy) completed the Social Skills Rating System (SSRS) to assess social competence at baseline, 2, and 8 months follow-up. At baseline, medical information (e.g., tumor type and location, cranial irradiation therapy (CIT)), personal characteristics (e.g., child's age and gender, intelligence, executive function, attention, and memory), and social/family factors (family income and ethnicity) were obtained. RESULTS: Using mixed model multivariable analyses with a longitudinal component, tumor type (medulloblastoma) (p < 0.01) and poor executive function, specifically, emotional control, were the best predictors of low total and assertion self-reported SSRS scores (p < 0.02). Receiving CIT was associated with low proxy-reported assertion (p = 0.035), and cooperation score (p = 0.02). Poor emotional control was associated with low proxy-reported total (p = 0.032), assertion (p = 0.023), and self-control scores (p = 0.007). Being non-White was associated with low proxy-reported total (p = 0.016), self-control (p = 0.040), responsibility (p = 0.035), and cooperation scores (p = 0.002). There were no significant changes over time. CONCLUSIONS: This study supports a multifactorial model of insult and non-insult factors (medical, personal, and social context) as determinants of social competence in PBTS. Data from both informants identify determinants of social competence. These factors need to be considered in future interventions to help children better improve their social competence.

Predictors of all-cause mortality in hospitalized COVID-19 patients taking corticosteroids: a multicenter retrospective cross-sectional study.

Despite the recommendations to avoid using corticosteroids systematically for hospitalized coronavirus disease of 2019 (COVID-19) patients, healthcare professionals used personalized treatments, including corticosteroids, as adjuncts to treat their patients due to their limited access to treatment options. This study aims to evaluate the use of corticosteroids among hospitalized COVID-19 patients with all-cause mortality as the primary outcome and to assess the predictors of all-cause mortality associated with the characteristics of the patients and the corticosteroid regimens adopted. Methods: A multicenter retrospective study was performed over three months targeting 422 COVID-19 patients from six hospitals in Lebanon. Data were collected from patients' medical charts retrospectively and covered a period of one year (September 2020-August 2021). Results: The study sample included 422 patients, predominantly males, with 59% of cases classified as severe or critical cases. Dexamethasone and methylprednisolone were the most used corticosteroids. Around 22% of the patients died during hospitalization. After adjusting for covariates, performing a polymerase chain reaction before admission increased the mortality rate by 424% compared to doing it at hospital admission (aHR 4.24, 95% CI 1.35-13.3), with 18.11 times higher mortality rate among critical cases (aHR 18.11, 95% CI 9.63-31.05). Exposure to side effects from corticosteroids increased the mortality rate by 514% compared to others (aHR 5.14, 95% CI 1.28-8.58). In particular, the mortality rate among patients having hyperglycemia dropped by 73% compared to others (aHR 0.27, 95% CI 0.06-0.98). Conclusion: Corticosteroids are frequently used in treating hospitalized COVID-19 patients. The all-cause mortality rate was higher among older and critical cases and lower among smokers and those treated for more than 7 days. Research exploring the safety and efficacy of corticosteroids is required to allow better in-hospital management of COVID-19 cases.

Factors Affecting the Adoption of Artificial Intelligence-Enabled Virtual Assistants for Leukemia Self-Management.

AIM AND PURPOSE: The purpose of this study is to analyze the various influencing factors affecting the adoption of artificial intelligence (AI)-enabled virtual assistants (VAs) for self-management of leukemia. METHODS: A cross-sectional survey design is adopted in this study. The questionnaire included eight factors (performance expectancy, effort expectancy, social influence, facilitating conditions, behavioral intention, trust, perceived privacy risk, and personal innovativeness) affecting the acceptance of AI-enabled virtual assistants. A total of 397 leukemia patients participated in the online survey. RESULTS: Performance expectancy (µ = 3.14), effort expectancy (µ = 3.05), and personal innovativeness (µ = 3.14) were identified to be the major influencing factors of AI adoption. Statistically significant differences (p < .05) were observed between the gender-based and age groups of the participants in relation to the various factors. In addition, perceived privacy risks were negatively correlated with all other factors. CONCLUSION: Although there are negative factors such as privacy risks and ethical issues in AI adoption, perceived effectiveness and ease of use among individuals are leading to greater adoption of AI-enabled VAs.

Safety and immunogenicity evaluation of inactivated whole-virus-SARS-COV-2 as emerging vaccine development in Egypt.

BACKGROUND: Current worldwide pandemic coronavirus disease 2019 (COVID-19) with high numbers of mortality rates and huge economic problems require an urgent demand for safe and effective vaccine development. Inactivated SARS-CoV2 vaccine with alum. Hydroxide can play an important role in reducing the impacts of the COVID-19 pandemic. In this study, vaccine efficacy was evaluated through the detection of the neutralizing antibodies that protect mice from challenge with SARS-CoV 2 3 weeks after the second dose. We conclude that the vaccine described here has safety and desirable properties, and our data support further development and plans for clinical trials. METHODS: Characterized SARS-COV-2 strain, severe acute respiratory syndrome coronavirus 2 isolates (SARS-CoV-2/human/EGY/Egy-SERVAC/2020) with accession numbers; MT981440; MT981439; MT981441; MT974071; MT974069; and MW250352 at GenBank were isolated from Egyptian patients SARS-CoV-2-positive. Development of inactivated vaccine was carried out in a BSL-3 facilities and the immunogenicity was determined in mice at two doses (55 and 100 µg per dose). RESULTS: The distinct cytopathic effect induced by SARS-COV-2 propagation on Vero cell monolayers and the viral particles were identified as Coronaviridae by transmission electron microscopy and RT-PCR on infected cells cultures. Immunogenicity of the developed vaccine indicated the high antigen-binding and neutralizing antibody titers, regardless of the dose concentration, with excellent safety profiles and no deaths or clinical symptoms in mice groups. The efficacy of the inactivated vaccine formulation was tested by the wild virus challenge of the vaccinated mice and viral replication detection in lung tissues. CONCLUSIONS: Vaccinated mice recorded complete protection from challenge infection via inhibition of SARS-COV-2 replication in the lung tissues of mice following virus challenge, regardless of the level of serum neutralizing antibodies. This finding will support future trials for the evaluation of an applicable SARS-CoV-2 vaccine candidate.

National approaches to managing cancer care: responses of countries in the MENA region to the COVID-19 pandemic.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic presents serious challenges to cancer care because of the associated risks from the infection itself and the disruption of care delivery. Therefore, many professional societies have published recommendations to help manage patients with cancer during the current pandemic. The objective of our study is to assess the national responses of Middle East North Africa (MENA) countries in terms of publishing relevant guidelines and analyse various components of these guidelines. METHODS: A survey based on the preliminary review of the literature regarding cancer care adaptations has been developed and then completed by a group of oncologists from the following Arab countries affected by the pandemic: Algeria, Egypt, Iraq, Jordan, Kuwait, Lebanon, Morocco, Oman, Saudi Arabia, Syria, Tunisia, United Arab Emirates and Yemen. The survey inquired about COVID-19 cases, national recommendations regarding general measures of COVID-19 prevention and patient care in oncology as well as their implementation about cancer care adaptations during the pandemic. RESULTS: Analysis of the COVID-19 pandemic-related guidelines revealed at least 30 specific recommendations that we categorised into seven essential components. All included countries had national guidelines except one country. Estimated full compliances with all specific category recommendations ranged from 30% to 69% and partial compliance ranged from 23% to 61%. CONCLUSION: There is a very good response and preparedness in the Arab Middle East and North Africa region surveyed. However, there are inconsistencies in the various components of the guidelines across the region, which reflects the evolving status of the pandemic in each country as well as the lack of clear evidence-based guidelines for many of the issues in question. There is a need for a clear framework on essential components that should be included in these guidelines to assure providing the best guidance to the oncology community.

Efficacy of inactivated velogenic Newcastle disease virus genotype VII vaccine in broiler chickens.

Newcastle disease (ND) causes severe economic losses in poultry production. Despite the intensive vaccination regimes of NDV in Egypt, many outbreaks are being reported. The present study focused on the preparation and evaluation of inactivated velogenic Newcastle disease virus vaccine (genotype VII) isolated from Egyptian broiler chicken during 2015-2016. Fifty-five tissue samples including trachea, lung, liver, proventriculus, intestine, and kidney collected from commercial broiler chickens were used for virus isolation in specific pathogen-free embryonated chicken eggs (ECE) and identified using RT-PCR and sequencing. The isolates were classified by sequencing as velogenic NDV genotype VIId containing F0 protein cleavage site motifs (112RRQKRF117). A selected isolate was served as a master seed for the preparation of inactivated NDV vaccine with or without Montanide ISA70 adjuvant and evaluated in SPF chicks. Nine NDV isolates were isolated on ECE and the highest infectivity titer of the virus was 7.50 log10 EID50 mL-1 by the 5th passage. Vaccinated chicks with NDV-Montanide ISA70 adjuvanted vaccine exhibited antibody titer of 5.20 log2 at the 3rd-week-post-vaccination (WPV) with the highest titer (8.90 log2 mL-1) at the 6th-WPV. Protective antibodies values were persisted to 12th WPV followed by a gradual decrease to the end of the experiment (16th weeks). Vaccination of chicks with inactivated NDV isolate without adjuvant failed to induce protective HI antibodies all over the experiment. Chickens vaccinated with the ISA70 adjuvant vaccine were passed homologous challenge tests with 100% protective efficiency, while the unadjuvanted vaccine could not provide any protective efficiency. In conclusion, the preparation of inactivated oil adjuvant vaccine from NDV field circulating strains was efficient in controlling the disease in Egypt.

Eliciting Help Without Pity: The Effect of Changing Media Images on Perceptions of Disability.

This study investigated whether newer, more positive disability charity images can elicit helping behavior without producing pity. One hundred sixty-one university undergraduate students were presented with 35 older (1960-1990) and newer (1991-2010) disability charity images and completed a questionnaire about each image. Results indicate that overall, identification with depicted individuals was low; positive attitudes and perceptions of capabilities were moderate to high. Newer images led to more positive responses, but no significant difference in willingness to help. Eliciting pity through negative depictions of disability appears not to be a necessary precondition for eliciting helping behavior toward people with disabilities.

The Emotional Experience and Perceived Changes in Siblings of Children With Cancer Reported During a Group Intervention.

PURPOSE/OBJECTIVES: To examine the experiences and perceived changes in siblings of children with cancer while participating in a group intervention program. 
. RESEARCH APPROACH: Repeated observations during group participation and content analysis. 
. SETTING: A tertiary pediatric health center in Ontario, Canada.
. PARTICIPANTS: Twenty-two siblings (aged 7-18 years) of children with cancer. 
. METHODOLOGIC APPROACH: Siblings participated in the Siblings Coping Together program, an eight-week group intervention designed for this population. Data consisted of materials completed by siblings (49 homework sheets, 33 pieces of artwork), and 31 logs recording events within group sessions. 
. FINDINGS: Three categories emerged from the data. CONCLUSIONS: These findings provide rich insight into siblings' own views of changes in themselves and within the family, as well as the perceived benefits of group participation. 
. INTERPRETATION: Methodologically, this study demonstrated that the inclusion of visual materials as data is a valid methodology for future research. Clinically, these findings can help nurses in their daily care of children with cancer and their families.