Rational, aims, and objectives: To probe into the status of medication adherence in patients after PCI and its correlation with health literacy. Methods: A total of 260 patients after PCI in cardiology department of three hospitals in Zhengzhou, were investigated by two questionnaire, which are 8-item Morisky Medication Adherence Scale and Chronic Disease Health Literacy Scale. Results: The score of medication adherence was 5.21±2.04, the score of health literacy was 80.8±24.43; Multivariate linear regression analysis results showed that degree of education, the number of hospitalization, monthly income, course of diseases were the influencing factors of medication adherence, which could explain 61.2% of the total variation; The medication adherence in patients after PCI was positively correlated with health literacy. Conclusion: The higher levels of health literacy positively influenced medication adherence scores in patients after PCI. Nursing staff should assist the patients after PCI to establish self-health management awareness, in order to improve their medication adherence.
One of the leading trends in the modern tissue engineering is the development of new effective methods of decellularization aimed at the removal of cellular components from donor tissue reducing its immunogenicity and the risk of rejection. Supercritical CO2 (scCO2) extraction can significantly improve the outcome of decellularization, reduce contamination and time costs. The resulting products can serve as personalized tools for tissue-engineering therapy of various somatic pathologies. However, decellularization of complex 3D structures, such as the aortic root, requires optimization of the parameters, including preconditioning medium composition, type of co-solvent, values of pressure and temperature insight the scCO2 reactor, etc. In our work, using an ovine aortic root model, we performed a comparative analysis of the efficiency of decellularization using approaches based on various combinations of these parameters. The protocols were based on combinations of treatment in alkaline, ethanol or detergent solutions with scCO2 extraction at different modes. Based on a histological analysis, we have selected an optimal protocol for the decellularization of ovine aortic root employing preconditioning in a detergent solution. The positive effects of scCO2 on the decellularization extent, cytotoxicity and histoarchitecture of the tissue were demonstrated.
COVID-19 has now become a global epidemic, prevailing over 213 countries of the world including Pakistan. To date, there have been more than 12000 cases and above 220 deaths reported in Pakistan. The outbreak is caused by a β-coronavirus called SARS-CoV-2, similar in characteristics to the SARS and MERS-CoV. It shows symptoms like pneumonia and may lead to death. Despite lockdown and possible isolation system, it is spreading rapidly. Lack of precautionary measures, specific vaccine and delayed diagnosis may be the major reasons for its spread. Several researches on COVID-19 have described its various features to extend its knowledge in order to help the scientific world in preparation of vaccine. Current review aimed to cover all essential data such as clinical characteristics, pathology, detailed morphology and structure, antigenicity of COVID-19 virus, role of structural proteins in anti-viral drug development and possible treatments being used. This manuscript would be helpful to select the best possible treatment depending on the availability and condition of the patient. Moreover, further research is needed for assistance in designing a virus-specific drug or vaccine.
Macrolides and corticosteroid resistant have been reported in mycoplasma pneumoniae (MP) pneumonia (MPP). MP clearance is difficult even by sensitive antibiotics in severe MPP (SMPP). SMPP children might develop into airway remodeling even bronchiolitis/bronchitis obliterans. There is an urgent need to identify serum biomarkers indicating the progress of MPP and to discover new target drugs for the treatment of SMPP. In this study, we collected serum samples from general MPP (GMPP) and SMPP patients to perform proteomics profiling. Total 130 differentially expressed proteins with 61 up-regulated in GMPP and 69 up-regulated in SMPP were identified. Among these, FCGBP was one of the most altered protein with highest fold change. Biological enrichment analysis indicated an uncontrolled inflammation catastrophe in SMPP. In addition, complement, coagulation cascades, collagen-containing extracellular matrix and platelet degranulation pathway were enriched in both groups. KEGG analysis indicated an enriched platelet activation in SMPP. ELISA was then performed to verify the dynamic serum FCGBP expression level between other GMPP and SMPP patients. FCGBP level in SMPP was significantly higher than that in GMPP. FCGBP level in GMPP exhibited a decreased trend while SMPP showed the opposite trend during the disease course. Our study demonstrates the first proteomics characteristic of GMPP and SMPP and provides FCGBP as a new serum biomarker indicating the progress of SMPP. Further CMap analysis identified 25 drugs target for the treatment of SMPP. Among them, MTOR inhibitor, a macrolide compound and cell proliferation inhibitor, is the most promising drug targeting for the treatment of SMPP.
The accurate determination of the spatial trends on the variability of the gene pool of a species is essential to elucidate the underlying demographic-evolutionary events and, ultimately, to unravel the microevolutionary history of the species or population under examination. In this work, we present a new software tool called GenoCline, which is essentially devised to assist in detecting genetic clines from allele and phenotypic frequency data, and even from genome-wide data. This program package allows identifying the geographic orientation of clinal genetic variation through a system of iterative rotation of a virtual coordinate axis. At the same time, GenoCline can also be used to carry out complementary statistical analyses aimed at clarifying the potential origin of the genetic clines found, among which stand out spatial autocorrelation, isolation by distance, centroid method, multidimensional scaling and Sammon projection. Among the main advantages of this software are those related to ease in data entry and potential interconnection with other programs. Data entry is user-friendly. Genetic frequencies and geographic coordinates can be easily entered in spreadsheet table formatting, while genome-wide data can be imported in Eigensoft format. Genetic frequencies can also be exported in a format compatible with other programs dealing with population genetics and evolutionary biology. All illustrations of results are saved in eps format so that there will be high quality and easily editable vectorial graphs available for the researcher. GenoCline is implemented in Java, so it can be used with different operating systems.
In their interesting paper published in the British Journal of Clinical Pharmacology, Mackey et al. present an analysis aiming at characterizing resonance (i.e., neutrophils oscillations) in young patients treated by cyclic chemotherapy . The authors used further Quantitative Systems Pharmacology (QSP) modeling applied to granulopoïesis to demonstrate that timing of chemotherapy could impact on the dynamics of neutrophils. Consequently, the authors suggest that model-informed scheduling could help limiting hematological toxicity, e.g. by delaying supportive G-CSF therapy. The issue of controlling drug-induced side effects, especially hematological toxicities with cytotoxics, is critical in many respects. Pancytopenia can be rapidly life-threatening, especially in frail patients. When they do not directly lead to toxic-death, such severe toxicities frequently oblige practitioners to postpone or discontinue chemotherapy or associated radiation therapy, thus affecting clinical outcome and survival eventually. In addition, severe neutropenia with sepsis require antibiotics which history of use is suspected now to compromise the efficacy of immune checkpoint inhibitors, probably because of disruption of gut microbiota . In addition, it is now acknowledged that prolonged lymphopenia can have deleterious effect as well, especially in the era of immunotherapy. For instance, high neutrophils-to-lymphocytes basal ratios have been repeatedly associated with poor response to immunotherapy because it could promote immune desert at the tumor level . Altogether, developing strategies to control or reduce the risk of drug-induced hematological toxicities is therefore a major concern in clinical oncology, especially because as stated by the authors, cytotoxics are still today the backbone of most treatments of solid tumors and hematological malignancies. Developing in silico approaches as decision-making tools to optimize anticancer therapies has been a rising trend for decades now in clinical oncology . Pharmacokinetically-guided regimen with Bayesian adaptive dosing procedures have been already proposed for several years to tailor the administration of a variety of cytotoxics and oral targeted therapies . However, implementing adaptive dosing strategies in routine clinical setting remains challenging. Real-life precision medicine requires indeed mathematical models that are kept simple enough to allow proper identification of their parameters. This is a prerequisite for being easily applied prospectively in actual patients next, and not to be used solely as part of retrospective in silico modeling. This calls for using primarily top-down approaches, such as compartmental analysis prior to developing pharmacokinetics/pharmacodynamics (PK/PD) models likely to help oncologists to determine the optimal dosing and scheduling of a given drug to a given patient. More intricate modeling and QSP approaches are appealing strategies which are unfortunately impaired by their intrinsic complexity, which has made them unfit for routine use at bedside so far (Figure 1). Conversely, phenomenological modeling could in many respects look like an over-simplistic, suboptimal strategy, often mocked as being black-boxes simply linking an output to a given input. In turn, such models are more likely to be actually used in real-life setting, not despite the fact that they are black-boxes simply linking an output to a given input, but precisely because they are black-boxes simply linking an output to a given input. For instance, the Friberg model, as cited by the authors, is a simplified representation of hematopoiesis, using a semi-mechanistic, compartmental description of the proliferation and dynamics of the maturation of blood progenitors. Because of its simplicity, this top-down approach has allowed the Friberg model to be extensively used over the last 15 years, both by academics and pharmaceutical companies, to describe the myelosuppressive effects of a variety of cytotoxics . Countless phenomenological models have been derived from the Friberg model ever since. For instance, the Meille model is based upon a similar simplified and semi-mechanistic representation of hematopoiesis and granulopoiesis, which encapsulates additionally a PK/PD model describing effects of supportive G-CSF administration on blood cells progenitors . When further combined with another phenomenological model for antiproliferative efficacy, it was used next to build an original constraint-model determining the optimal dosing and scheduling of densified chemotherapy combo plus G-CSF support. Once calibrated with pre-defined acceptable levels of hematological toxicity and desired level of tumor shrinkage, this mathematical-driven regimen was finally tested prospectively in metastatic breast cancer patients and showed excellent performances such as prolonged overall survival in heavily pretreated patients with fully controlled hematological toxicities . Importantly, the prospective use of such a mathematical model was made possible thanks to a first identification step with few blood samples taken from patients when treatment starts, providing individual data on drugs PK profile and blood counts . This critical step allowed fine tuning of individual PK/PD model parameters in real-time, thus ensuring optimal, personalized dosing next. Transposing such model-driven regimen at bedside seems to be only achievable when the whole modeling strategy is primarily built upon the parsimony principle, so as to be able to identify next individual parameters from sparse, routine data collected from patients in a real-life setting. Of note, no in-depth understanding of biological mechanisms can be provided by such models – dosing and scheduling of anticancer agents and G-CSF are connected to efficacy and toxicity endpoints through phenomenological black-boxes, not multi-scales models providing biological explanations of the phenomenon. In contrast, QSP models, such as the ones developed by the Craig group in this BJCP issue, offer appealing mechanistic features, thus allowing a better understanding of all the underlying mechanisms at play to explain pharmacodynamic endpoints. The downside is that the Mackey model is complex. It is based indeed upon more than 30 parameters, a large number of them having been fixed from the literature and thus are dependent on the variability and possible biases of the experiments used for their identification . Furthermore, in contrast to standard approaches in pharmacometrics using nonlinear mixed-effects (NLME) modeling, inter-individual variability of the parameters is not quantified. The issue with such a large number of parameters is that the practical identifiability from sparse individual data collected at bedside is expected to be poor, resulting in a large uncertainty for quantitative model predictions in real-life practice.Nevertheless, the qualitative observation of the resonance effect in neutrophils time dynamics induced by the administration of periodic chemotherapies, highlighted by Mackey et al., should prompt modelers to include such pivotal phenomenon, including in their phenomenological representations of hematological toxicity. This new concept could be easily integrated and quantitatively tested in NLME models by means of inter-occasion variability (IOV) between administrations. Such IOV could allow to describe the resonance effect and improve model predictions. A covariate analysis could be performed to identify potential factors explaining the origin of this observation. Furthermore, as stated by the authors, to avoid this deleterious phenomenon and to reduce cytotoxic-induced hematological toxicities with subsequent negative impact on tumor immunity, it is an absolute prerequisite to optimize empirical chemotherapy regimens and G-CSF support administrations, based on robust PK/PD compartmental modeling.Altogether, the Mackay study highlights how the very way we use anticancer agents does matter, and how a same drug can have diametrically different pharmacodynamics effects, depending on its scheduling. In this respect, this work is an important contribution to the field of Precision Medicine in Oncology, by suggesting that there is much room left to improve standard use of canonical cytotoxics and thatin silico strategies could help to achieve a better way to administrate anticancer drugs. To transform this theoretical concept into a practical decision-making tool for oncologists, mathematicians and modelers must compose with the issue of parameters identifiability, and what kind of accessible individual data are actually made available in routine patients. As long as these issues are nor fixed, modeling will remain an elegant but theoretical field disconnected from bedside practice. To the ever-rising complexity of cancer biology and the amazing amount of knowledge regarding in-depth mechanisms of action of drugs (such as molecular signaling pathways, genetic and epigenetic regulations affecting targets or key-proteins involved in pharmacodynamics responses), the temptation to implement all this knowledge into super-models should be resisted. Indeed for a proper and rapid in silico -to-bedside transposition, we believe that in the era of Precision Medicine, the more complex is a phenomenon, the simpler should be the mathematical model describing it.Competing Interest: the authors declare noneFunding: none
Rationale, aims, and objectives An inefficient health system wastes scarce resources even if it makes considerable gains in accountability and equity. Such a system is expected to perform better. Therefore, it is vital to examine the current performance of health systems and their constituents as well as assess how to reach their full potential. The aim of this study was to evaluate the technical and economic efficiency of medical diagnostic laboratories in hospitals affiliated with Urmia Medical Sciences University (UMSU) in 2016. Methods In this descriptive-analytical study, the data of all diagnostic laboratories of the hospitals of UMSU were inputted into Frontier 4.1 software after taking the logarithm. Then, the technical and economic efficiency of the laboratories were obtained by estimating the production and cost function using the stochastic frontier analysis method, assuming input minimization for 2016. Results The average technical and economic efficiency of the diagnostic laboratories was obtained as 0.931±0.34 and 0.519±0.33, respectively. These laboratories must reduce their inputs and costs to achieve full efficiency without changing the amount of their output. Conclusion Although the average economic efficiency of the diagnostic laboratories of the studied hospitals was high, there is still an increase in the efficiency of these units given the cost of inputs at the time of allocating resources. In addition, it is possible to improve the technical efficiency of the clinical laboratories of hospitals affiliated with UMSU by 48.1% by applying the same level of inputs and without increasing the costs.
The forest people around the world through their indigenous knowledge contribute to the sustainable management of forests. This article argues that the Sheka people in southwestern Ethiopia by their ecological knowledge, values, and spiritual use could manage the Ororo tree (Ekebergia capensis). The Ororo tree (Ekebergia capensis) is one of the most important endemic tree species in the Sheka zone southwestern Ethiopia and, at the same time, one of the most endangered species. Data collected on the indigenous ecological knowledge of the Sheka people and how the Ororo tree could be managed and conserved through the DEDO culture documented and the spiritual connection between the Ororo trees and the Sheka people traditional belief system measured. The findings revealed that through their traditional forest-related knowledge, the Sheka people conserve and manage a single larger tree called Ororo. The Ororo tree is a special type of tree that has cultural and spiritual attachments that are presently non-existent. This unique forest conservation practice has been referred to as the DEDO culture. The culture of DEDO comes up with worshiping around the Ororo tree. Thus, the culture of DEDO played an important role in maintaining the conservation of the DEDO sacred tree (Ororo) and biodiversity therein. Over time, the DEDO sacred tree (Ororo) conservation culture has been decline, and various factors have contributed to the decline of this useful ecological knowledge.
Atopic dermatitis (AD) is the chronic relapsing inflammatory skin disorder that affects both in childhood and adulthood. Mounting evidence indicates that gut dysbiosis contributes to AD via the gut-skin axis. Constipation could result in alteration of the gut microflora. The clinical impact of constipation on AD has not been researched. Therefore, we aim to assess the risk of AD in constipated patients by the longitudinal nationwide population-based cohort study. We collected 87015 people with constipation and 87015 patients without constipation between 1999 and 2013 from the Longitudinal Health Insurance Database, which is the subset of Taiwanese National Health Insurance Research Database. Propensity score analysis was administrated to match age, gender, comorbidities, and medications at a ratio of 1:1. Multiple Cox regression analysis was utilized to evaluate the adjusted hazard ratio of AD. In addition, sensitivity tests and a stratified analysis were conducted. The incidence of AD was 4.7 per 1,000 person-years in the constipation group, which was higher than the rate of 2.2 per 1,000 person-years observed in the non-constipation group. After adjustment for age, gender, comorbidities, corticosteroids, and antihistamine, people with constipation had a 2.11-fold greater risk of AD compared to those without constipation (adjusted hazard ratio [aHR]: 2.11 (95% C.I. 1.98-2.24). In subgroup analyses, people aged 12-19 years had a 2.34-fold higher risk of AD in the constipation cohort (aHR; 95% CI, 1.84-2.98). Moreover, people with constipation had a higher likelihood of AD, regardless of gender, and with or without comorbidities, as well as the usage of corticosteroids, and antihistamines. Constipation is connected with a significantly risk factor of AD. Clinicians should be careful of the possibility of AD in people with constipation. Further study is warranted to investigate the possible pathological mechanisms of underlying this relationship.
This paper reviews the tools available to assess outcomes of treatment in irritable bowel syndrome, especially the effect on pain. It critically considers their development, relevance and reliability. Its conclusion is that there are few tools which meet the criteria necessary to place confidence in their validity as appropriate measures of patient outcomes.
Therapeutic monoclonal antibodies and related products have steadily grown to become the dominant product class within the biopharmaceutical market. Production of antibodies requires special precautions to ensure safety and efficacy of the product. In particular, minimizing antibody product heterogeneity is crucial as drug substance variants may impair the activity, efficacy, safety and pharmacokinetic properties of an antibody, consequently resulting in the failure of a product in pre-clinical and clinical development. This review will cover the manufacturing and formulation challenges and advances of therapeutic monoclonal antibodies, with a focus on improved processes to minimize variants and ensure batch-to-batch consistency. Processes put in place by regulatory agencies such as Quality-by-Design (QbD) and current Good Manufacturing Practices (cGMP) will be reviewed, and how their implementation has aided drug development in pharmaceutical companies. Advances in formulation and considerations on the intended use of a therapeutic antibody, including route of administration and patient compliance, will be discussed.
Rationale, aims and objectives: Joint contractures are common complications among elderly residents in long-term care facilities, causing activity limitations and participation restrictions and affecting quality of life (QOL). The aim of this study is to examine the psychometric properties of the Chinese version of the PaArticular Scales in joint contractures population. Methods: A cross-sectional study design. A sample of elderly residents aged over 64 years with joint contractures in one important joint who have lived at a facility for more than 6 months in twelve long-term care facilities in Taiwan (n = 243). The Chinese version of the PaArticular Scales of joint contractures was generated through 5 stages: translation, review, back-translation, a panel of specialists, and a pretest. Test-retest reliability, internal consistency reliability, construct validity, and criterion validity were evaluated, and the results were compared with those for the WHOQOL-BREF and WHODAS 2.0-36 items. Criterion validity was assessed using correlation coefficients to examine changes in the activity limitations and participation restrictions subdomain and predict QOL. Results: The Activities and Participation subscales had excellent internal consistency (Cronbach’s α coefficient = .975; SD = 17.34). The correlation coefficients between the PaArticular Scales and the WHODAS 2.0-36 items (r = .770, p < .001) and WHOQOL-BREF were significant and highly correlated (r = -.553, p < .001). Conclusions: The underlying theoretical model of the Chinese version of the PaArticular Scales functions well in Taiwan, and the Chinese version has acceptable levels of reliability and validity.
HPAI is endemic across parts of Indonesia, but the mechanisms of viral persistence in the poultry production system have not been well investigated. This mixed methods research conducted in Purbalingga District, Java characterised poultry populations and trade and contact networks and performed risk-based sampling for the active detection of HPAI virus in live bird markets, collector yards, backyard poultry, nomadic ducks and commercial farms. Approximately 60% of households kept birds, about half of which contributed towards household income. Traders tended to use multiple collector yards and live bird markets, and poultry might be presented at multiple markets before sale. Only the commercial farm sector implemented biosecurity practices and vaccination. Samples were screened for avian influenza virus (AIV) and positive samples were tested for the H5 and H9 sub-types. H5 virus was detected in all enterprise types, although there were few positive results in commercial farms, the backyard sector and nomadic duck flocks. The highest numbers of AIV, H5 and H9 viruses were found in the live bird markets and collector yards. The odds of detection of H5 in live bird markets and collector yards were similar; however, these were 3½ to 4 times higher than in backyard birds and nomadic ducks and 25 to 30 times higher than in commercial poultry. This suggests that transmission of infection in backyard poultry and duck production was likely to be driven more strongly by the value chain than by direct or indirect contacts at source. We could not determine whether the value chain concentrates or amplifies virus along its length, or whether AIV persists and actively circulates in live bird markets and collector yards. H5 and H9 viruses were detected year-round and were co-circulating in the different enterprise types, although no inference can be drawn regarding interactions between these HPAI and LPAI viruses.
Abstract: Unlike most head and neck cancers, the presence of distant metastasis (DM) does not preclude curative intent treatment and surgical interventions are common in metastatic disease. DM has an adverse impact on survival and lends considerable morbidity to the patient. This research attempts to study the demographics, patterns of metastasis, and surgical interventions in this rare subgroup of patients with differentiated thyroid cancer (DTC). Materials and methods: Thirty two patients of DTC with radiologically or histopathologically or cytopathologically confirmed DM who underwent surgery at a tertiary care centre from August 2011 to December 2018 formed the study cohort of this retrospective study. Results: The study population comprised 59% females and had a median age of 55 (19- 79) years. Thorax was the most common site of metastasis, documented in 56% of patients, while 53% patients had bone metastases. Multiple DM were noted in 8 patients. All patients underwent total thyroidectomy or completion thyroidectomy with or without neck dissection. Surgery for metastatic sites was possible in 14 patients (44%) with debulking and spine fixation being the commonest surgical intervention for metastasis. Thyroidectomy, with or without neck dissection followed by radioactive iodine (RAI) ablation was used as the primary modality to treat DM in patients who did not undergo specific surgical treatment for distant metastases. The median dose of RAI received by patients was 400 (25 – 749) mCi, in one to four sessions (median- 2 sessions). Three patients received conventional chemotherapy, while four received Sorafenib. Conclusion: Metastasectomy in differentiated thyroid cancer with distant metastases is feasible in selected patients and surgical interventions are most commonly performed on the spine to prevent neurological complications. RAI ablation is universally administered in this subset of patients and in very high doses, often distributed in multiple sessions. The role of chemotherapy and tyrosine kinase inhibitor is still restricted to palliative settings and cost constraints remain a detriment to more widespread use.
Abstract: Objectives: Sudden deafness, also known as sudden sensorineural hearing loss (SSNHL), has numbers hypotheses about its etiology. One of them believes that changes in sex hormone levels may increase the risk of thrombosis and block the cochlear microcirculation, leading to the occurrence of SSNHL. Design: Women in different periods of physiological cycles, the levels of sex hormones in their body will change significantly, which had correlated to SSNHL. Participants: This study collected 435 female subjects who were admitted to the otolaryngology clinic of our hospital from July 2017 to November 2019. Setting: The participants were grouped by the menstrual cycle. Main outcome measures: The pure tone audiometry test results of the subjects were recorded and the differences among the groups were be analyzed. Results: 1. There was a significant difference in the average hearing threshold of subjects in different periods (F(3, 774)=8.773, P<0.001), and the average hearing threshold in follicular period (35.44 dBHL) was significantly lower than that in menstrual period (51.09 dBHL, P<0.001), luteal period (42.69 dBHL, P=0.036) and menopause (47.39 dBHL, P<0.001); 2. There was a correlation between the subjects at different periods and the severity of SSNHL (2 = 38.587, P <0.001), and the SSNHL severity was the slightest in the follicular period according to the mean rank value. 3. The analysis of SSNHL typing of subjects at different periods were variously (2 = 38.568, P < 0.001). Conclusions: The results of this study can explain the effect of sex hormone on SSNHL to a certain extent, and we will further explore the relationship between sex hormone levels and SSNHL, in order to provide more support for the diagnosis and treatment of SSNHL.
Background and Purpose: SARS-coV-2 pandemic continues to cause an unprecedented global destabilization. There is an urgent need to develop vaccines or identify molecules to treat severe cases and repurposing of drugs is the best approach at this hour. Thalidomide, despite having an infamous history has been successfully repurposed and tested for various disease conditions including inflammatory diseases and tumor. Few reports emphasize the use of thalidomide with a SARS-coV-2 pneumonia patient being successfully treated with thalidomide. Experimental Approach: A meta-analysis comparing the transcriptomes of SARS-coV-2 infected tissues with thalidomide and lenalidomide-induced transcriptomic changes in transformed lung, endothelial and hematopoietic models was performed. Key Results: Thalidomide and lenalidomide exhibited pleiotropic effects affecting a range of biological processes including inflammation, immune response, angiogenesis, MAPK signaling, NOD-like receptor signaling, TLR signaling, leukocyte differentiation and innate immunity, the processes which are aberrantly regulated in severe COVID-19 patients. In addition, we show the similarities between the expression profiles of SARS-coV-2 infected lung and systemic lupus erythematous. Conclusion and Implications: The present study recommends thalidomide analogs as a “better fit” to treat severe cases of novel viral infections, healing the damaged network by compensating the impairment caused by the Coronavirus disease-2019 (COVID-19).