Cancer is currently a leading cause of mortality in the globe, particularly in the COVID-19 era, due to not enough and not in time care and treatment as well as limited coverage of COVID-19 vaccination. This article briefly discusses the reopening of the “CANCER MOONSHOT” in the United States (US). It’s time for conduction of novel strategies such as the iRT-ABCDEFG and web-based programs for prevention and management of cancer, and further deepen cooperation between China and the US so as to combat cancer and save more lives. In conclusion, as a huge biomedical engineering, the reopening of “CANCER MOONSHOT” is a great task with a special significance and value in the field of cancer prevention and treatment in the COVID-19 era.

We examined associations between mild or asymptomatic prenatal SARS-CoV-2 infection and preterm live birth in a prospective cohort study. During August 2020–October 2021, pregnant persons were followed with systematic surveillance for RT-PCR or serologically-confirmed SARS-CoV-2 infection until pregnancy end. The association between prenatal SARS-CoV-2 infection and preterm birth was assessed using Cox proportional-hazards regression. Among 954 pregnant persons with a live birth, 185 (19%) had prenatal SARS-CoV-2 infection and 123 (13%) had preterm birth. The adjusted hazard ratio for the association between SARS-CoV-2 infection and preterm birth was 1.28 (95% confidence interval 0.82-1.99, p=0.28), although results did not reach statistical significance.

Background Globally, viral pathogens are the leading cause of acute respiratory infection in children under-five years. We aim to describe the epidemiology of viral respiratory pathogens in hospitalized children under-two years of age in Eastern Province of Sierra Leone, during the second year of the SARS-CoV-2 pandemic. Methods We conducted a prospective study of children hospitalized with respiratory symptoms between October 2020 and October 2021. We collected demographic and clinical characteristics and calculated each participant´s respiratory symptom severity. Nose and throat swabs were collected at enrollment. Total nucleic acid was purified and tested for multiple respiratory viruses. Statistical analysis was performed using R version 4.2.0 software. Results 502 children less than two-years of age were enrolled. 376 (75%) had at least one respiratory virus detected. The most common viruses isolated were HRV/EV (28.2%), RSV (19.5%) and PIV (13.1%). Influenza and SARS-CoV-2 were identified in only 9.2% and 3.9% of children, respectively. Viral co-detection was common. Human metapneumovirus and RSV had more than two-fold higher odds of requiring O2 therapy while hospitalized. Conclusion Viral pathogen prevalence was high (75%) in our study population. Despite this, 100% of children received antibiotics, underscoring a need to expand laboratory diagnostic capacity and to revisit clinical guidelines implementation in these children. Continuous surveillance and serologic studies among more diverse age groups, with greater geographic breadth, are needed in Sierra Leone to better characterize the long-term impact of COVID-19 on respiratory virus prevalence and to better characterize the seasonality of respiratory viruses in Sierra Leone.

Pregnant individuals are known to be at increased risk of worse outcomes from COVID-19 infection. Recent data suggests that they are also more likely to exhibit milder symptoms and have higher rates of asymptomatic infection. The health impacts of milder disease are less well-described but may include adverse perinatal outcomes. Serosurveillance can help describe accurately background rates of seropositivity in populations with high rates of asymptomatic infection. The seroprevalence of SARS-CoV-2 infection prior to vaccine availability was assessed in two large maternity centres. Of 437 pregnant individuals, seven were positive on initial screening, with one false positive identified on subsequent confirmatory testing. An overall seropositivity rate of 1.4% was found. No adverse pregnancy outcomes were identified. Confirmatory testing was performed with four commercial antibody-based assays and an in-house microneutralisation assay. Wantai SARS-CoV-2 receptor-binding-domain total antibody performed best, similar to previous reports. Serological surveillance can estimate infection rates not captured by acute PCR testing, and may assist with contact tracing, estimation of immunity rates and inform public health policy in at-risk groups. Evaluation of serological assays should be integrated into serosurveillance initiatives.

A wave of SARS-CoV-2 infection speedily emerged in Shanghai, China, since late February 2022. Paxlovid is a therapeutic hybrid of different compounds and a novel SARS-CoV-2 protease inhibitor by blocking an enzyme required for viral protein synthesis. It could reduce the risk of hospitalization or death by 89% as well as being benefit for immunocompromised and severe COVID-19 patients. Our registry study indicated that the days of viral elimination and inflammation factors, such as IL-6, IL-10 and interferon-α levels could be lowered by paxlovid. Days of viral elimination may be associated with fasting blood glucose, NK cells count, interferon-α levels. Lipids profiles should be monitored before and after treatment of paxlovid, especially for those who have uncontrolled lipid disorder.

Several biomarkers have been evaluated as predictors of severity or in directing the treatment of COVID-19, however there are no conclusive results with prediction of the pathobiology of the infection. In this study, we evaluated serum levels of cytokines, chemokines, and cell growth factors in association with the pathobiology of mild to moderate SARS-CoV-2 infection. Those markers may act as immuno-inflammatory biomarkers in adults with mild to moderate flu syndrome who sought care at health units. Serum levels of SARS-CoV-2 infected patients (n=113) and flu symptoms individuals negative for SARS-CoV-2 (n=58), tested by the RT-qPCR test - nasal swab were compared to healthy controls (n=53). Participants who were symptomatic but negative for SARS-CoV-2 were tested for Influenza A/B and Respiratory Syncytial Virus (RSV). Results showed that the pro-inflammatory cytokines IL-1β, MCP-3, TNF-α and G-CSF were increased in symptomatic patients and the cytokines IL-6 and IL-10 were associated with patients positive for SARS-CoV-2 when compared to healthy controls. Symptoms associated with COVID-19 were fever, anosmia, ageusia and myalgia. For patients without SARS-CoV-2 infection their major symptom was sore throat. Five percent (4/83) of SARS-CoV-2 negative patients were positive for RSV. The pathobiology of mild to moderate SARS-CoV-2 infection was associated with increasing pro-inflammatory cytokines and also a pleiotropic IL-6 and anti-inflammatory IL-10 cytokines compared to healthy controls.

The emergence of SARS-CoV-2 Omicron variant has led to a complete reconfiguration of the therapeutic landscape, with most monoclonal antibodies having lost any neutralization activity. We report here a case series of 75 immunocompromised patients infected by the Omicron variant who benefited of convalescent plasma. At baseline, 49 (68%) of the participants had a WHO score of 5 and 23 (32%) a WHO score of 6. At day 28 the case fatality was 24%. We observed no significant difference in the clinical outcome between patients with hematological malignancies, solid organ transplantation or auto-immune diseases. These promising results require controlled studies.

Changes in Conception Rates, Not in Pregnancy-Related Behavior, Likely Caused Decline in Pre-Term Births in Developed Countries During the First Year of the COVID-19 Pandemic 11* Corresponding author: Peter Fallesen, peter.fallesen@sofi.su.se, Swedish Institute for Social Research, Stockholm University, Stockholm 106 91, Sweden.Peter Fallesen, PhDSwedish Institute for Social Research, Stockholm University, Stockholm 106 91, Sweden ROCKWOOL Foundation, Ny Kongensgade 6, 1472 Copenhagen C, DenmarkMoritz Oberndorfer, DSc  Institute of Social Medicine, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15/1. Stock, A-1090, Vienna, Austria; MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, Glasgow, G3 7HR, UK  Population Research Unit, University of Helsinki, Unioninkatu 35 (P.O. Box 18). 00014 University of Helsinki, Finland  

Cutaneous vasculitis after COVID-19 vaccination in a 41-year-old maleMehran Pournazari1, Shirin Assar1, Faraneh Farsad2, Dena Mohamadzadeh11Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran2 Research Centre of Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Saliva specimens offer practical advantages over serum specimens for studying SARS-CoV-2 immunity following natural infections or vaccination. Salivary anti-spike (S)-protein immunoglobulin G (IgG) antibody titers are quantifiable by ELISA with high sensitivity and specificity and robustly correlated with serum titers. Our longitudinal prospective study enrolled participants who received two-dose regimen vaccination with either mRNA-1273 or BNT162b2 vaccines, and salivary anti-S-protein IgG titers were measured at intervals for its duration. Subsequently, participants received homologous mRNA-1273 (n=28) and BNT162b2 (n=29) booster vaccines and enrolled in the booster study. Participants performed self-collection of saliva specimens with the OraSure ® device at predetermined time intervals for each cohort. Salivary anti-S-protein IgG titers varied between participants following the second dose; titers waned from their peak 9 to 150-fold in the mRNA-1273 cohort and 7 to 105-fold in the BNT162b2 cohort. The booster dose elicited a 2 to 238-fold increase in the mRNA-1273 cohort and a 20 to 255-fold increase in the BNT162b2 cohort from the lowest titer. These results replicate the antibody waning and recall trends following second and third doses reported in larger studies using serum specimens, supporting the use of non-invasive saliva specimens to monitor antibody titers during future epidemics or vaccination campaigns.

Aim: It was aimed to evaluate the relationship between vaccine literacy and vaccine hesitancy in adults living in an industrial city. Method: The study was conducted with individuals working in a public institution between 15.02.2022 and 15.06.2022 as a descriptive cross-sectional design (n=435). The data were collected through Information Form, the COVID-19 Vaccine Literacy Scale and the Vaccine Hesitancy Scale in Pandemics, evaluated using the SPSS 21.0 program. The Declaration of Helsinki was complied with at all stages of the research. Ethical and institutional permission was approved. Results: The rate of the participants who had the COVID-19 vaccine was found to be 96.8%. The total mean score of the COVID-19 Vaccine Literacy Scale was found to be 2.71±.49 and the Vaccine Hesitancy in Pandemics Scale total mean score to be 27.94±5.19. The COVID-19 vaccine literacy level of the participants had a statistically significant effect on the vaccine hesitancy in pandemics. Conclusion: COVID-19 vaccine literacy was found to be moderate in the group examined, and it affected the level of vaccine hesitancy. It is crucial that the health personnel and social media resources preferred by the society as a source of information convey accurate and up-to-date information to individuals.

Objective: To study the safety and feasibility of virtual consultations in reproductive medicine. Design: This was a descriptive cross-sectional study involving subfertile patients attending a video consultation between September 2021 and August 2022 at St. Mary’s Hospital in Manchester, UK. Clinicians conducting virtual consultations during the same period responded to a parallel survey for healthcare professionals. Subjects: Subfertile patients attending a virtual consultation. Healthcare professionals conducting virtual consultations. Exposure: The survey link was offered in 4,932 consultations. A total of 577 (11.69%) patients responded and 510 completed the questionnaire (88.3%). Main Outcome Measures: Patient satisfaction measured as the percentage of patients preferring virtual to in person consultations. Results: The majority of the patients (475, 91.70%) had a positive experience with the video consultation and just under half of the patients (152, 48.65%) preferred a video consultation to an in person consultation due to cost and time savings. Most patients (375, 72.68%) felt safer and less exposed to COVID-19. When the risk of COVID-19 subsides, 242 patients (47%) would still prefer to attend video consultations, while 169 (32.82%) had no preference. Analysis of the responses from patients reporting a negative experience identified technical problems as a possible cause. The virtual consultations appeared to be suitable for patients with disabilities. The clinicians’ survey identified potential legal and ethical concerns. Conclusion: Virtual consultations are a safe and feasible alternative to in person consultations for subfertile patients. This large cross-sectional study revealed a high rate of patient satisfaction. Appropriate patient selection accounting for IT literacy, English language understanding and preference is crucial for successful virtual consultations. Further consideration should be given to ethical and legal challenges of virtual consultations.

As the Coronavirus Disease 2019 (COVID-19) outbreak spread, evidence has emerged that gender and race would bear a disproportionate impact on the morbimortality of COVID-19. Here, we conducted a retrospective observational study using the TabNet/DATASUS platform of the city of São Paulo. COVID-19 records from March 2020 thru December 2021 were included, and we evaluated the temporal trends of confirmed cases and case fatality rate by gender and ethnicity. Statistical analysis was performed using the R-software and the BioEstat-software, considering p<0.05 significant. From March/2020 to December/2021, 1,315,160 COVID-19 confirmed cases were recorded (57.1% females), and 2,973 deaths were due to COVID-19. Males presented higher median mortality (0.44% vs 0.23%; p<0.05) and ICU admission rates (0.34% vs 0.20%; p<0.05). Men were also associated with a higher risk of death (RR=1.28; p<0.05) and a higher chance of requiring ICU care (RR=1.29; p<0.05). The black ethnicity was associated with a higher risk of death (RR=1.19; p<0.05). White patients were more likely to require ICU admission (RR=1.13; p<0.05), whereas browns were associated with a protective effect (RR=0.86; p<0.05). Further, men presented a higher chance of death than women across the three major ethnic groups: whites (RR=1.33; p<0.05), blacks (RR=1.24; p<0.05), and browns (RR=1.35; p<0.05). In this study of COVID-19 in São Paulo, men were associated with worse outcomes, including in the three major ethnicities in the population. Blacks exhibited a higher risk of death, whites were more likely to require intensive care, and browns were at protection from ICU hospitalization.

During the coronavirus disease 2019 (COVID-19) pandemic, COVID-19 testing is crucial, as it enables early detection and halting the spread of infection throughout the community. Real-time reverse-transcriptase polymerase chain reaction (Real-time RT-PCR) testing is the predominant method for COVID-19 testing, and the cycle threshold value (Ct value) is used to determine COVID-19 positivity. There are many ongoing studies using Ct value, and the present study aims to examine time series distribution during the pandemic using Ct values at the national level and analyze the association with time-varying reproduction number (Rt) to discuss the utilization of laboratory-based COVID-19 test results. We used Real-time RT-PC results collected by Seegene Medical Foundation from the index case in Korea in February 2020 to January 2022 in Korea. The distribution of daily Ct value ( RdRp/S target) was examined, and it was compared with the daily count of newly diagnosed cases and Rt to determine the usability of Ct values. Moreover, time lag was applied to the daily count of newly diagnosed cases to analyze the association between Ct values and Rt. During the COVID-19 pandemic, Ct values declined in general, while viral load increased progressively. After Ct values dropped markedly, the number of newly diagnosed cases rose substantially, and the association analysis also confirmed that the daily count of newly diagnosed cases declined with increasing Ct values. The time series trend of the Ct values was also similar to that of Rt, a classic marker used as a predictor of the trends of the pandemic, and when compared to the actual count of newly diagnosed cases, Ct values can be used to predict new diagnoses earlier than Rt. The fact that the Ct values were more sensitive to a substantial rise of new COVID-19 cases than Rt was in the early days of the pandemic also support this. We examined the potential of Ct values as a predictor of new COVID-19 cases in real-time using nationally collected Ct value data. Further, we proposed the use of Ct values as an index reflecting the degree of viral load, so the findings of this study can be used as valuable evidence to support public health decisions for response and resource distribution.

Although Coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been controlled and prevented, mathematical modeling and analysis of transmission dynamics of COVID-19 still plays an essential role not only in the post COVID-19 era but also in the study of infectious diseases. This is an important foundation to propose effective strategies and measures for controlling diseases and projecting public health. This work is devoted to proposing and analyzing a new mathematical study for transmission dynamics of COVID-19. We first introduce a generalized SEIR epidemic model that use general nonlinear incidence rates to describe the “psychological” effect. After that, a rigorous mathematical analysis for the proposed COVID-19 model is performed. We establish the positivity and boundedness, calculate the basic reproduction number, determine possible (disease-free and endemic-disease) equilibrium points and investigate their asymptotic stability properties of the SEIR model. The obtained results improve and extend an SEIR model constructed in a recent work. For the purpose of numerical simulation, the Mickens’ methodology is applied to construct a dynamically consistent nonstandard finite difference (NSFD) model for the proposed SEIR epidemic model. The constructed NSFD scheme has the ability to provide reliable approximations that not only preserve the dynamical properties of the SEIR model for all the values of the step size but also are easy to be implemented. Finally, a set of illustrative numerical experiments is conducted to support the theoretical findings and to confirm advantages of the NSFD scheme over some well-known standard ones.

Background: There has been a strong demand for N95 filtering facepiece respirators and surgical masks during respiratory infection pandemics, particularly for the frontline healthcare workers who are at risk of high exposure to biological hazards and for the patients seeking care who may be potentially transmitting the respiratory viruses through air. Respirators and masks are pivotal to meet the requirements of filtration efficiency and fitting characteristics for the users’ protection. Objective: The goals of this study were to systematically review the fit testing passing rates and identify the factors influencing the fitting characteristics. Methods Potentially relevant studies were identified using PubMed, Scopus, Web of Science, Science Direct, one scientific website (cdc.gov), and one scientific journal (ISRP.com) during the COVID-19 pandemic from February 5, 2020 to January 2, 2023. Meantime, the gray literature search was performed. Results: A number of studies conducted regarding the fit testing showed that low proportions of passing quantitative fit testing among the studied masks or respirators. Factors such brand, style, and gender were found to be influenced the respirator fit testing. Conclusion: This systematic review supports the importance of optimal fit testing for the healthcare workers with high-risk procedures. Manufacturers supply a variety of the mask/ respirator brands, models, styles, and sizes to ensure the expected respiratory protection for the end-users. The proper donning and doffing and reliable fit testing are other affective strategies for improving fitting. Some modifications / substitutions on components of fit testing procedures could be considered during pandemics of respiratory infections.

Aims: To improve the countermeasures of clinical trial institutions against major public health events such as COVID-19. Methods: A questionnaire was created to investigate the effects of the global static management policy against COVID-19 on clinical trials in Shanghai in 2022. And the convenience sampling combined with snowball sampling were adopted to interview clinical research coordinators (CRC) and clinical research associates(CRA) on the platform of SOJUMP as well as WeChat. Results: 156 valid questionnaires were collected, with an effective recovery rate of 93.98%. 98.07% of the respondents believed that the effects was severe. The extent of effects on different links of clinical trials was different (rank sum test P<0.01), being great on medication/follow-up (76.28% of significant effects), monitoring/audit (74.36%) and screening/admission (71.79%).The protocol deviations associated with out of visit window (experienced by 94.23% of respondents, during the static management policy), inspection (78.85%), medication (67.95%) and withdrawal (62.82%). And the interviewees reported 49.66% of the exclusion should blame the epidemic situation. The development of online-office or remote-ethics meetings alleviated the impact of lockdown policy on approval/ethics/contract and data cleaning/site closing. 90.98% of oral drugs could be sent by express delivery, but only 1.28% had the experience of online informed consent and remote inspection. Conclusions: We shall speed up the application of the intelligent clinical trial system and remote monitoring system, realize the transformation to a new model of patient-centered clinical trial, and improve the ability to cope with major public health events such as COVID-19.

1.1 Background Early in the SARS-CoV-2 pandemic, polymerase chain reaction (PCR) testing was reserved for symptomatic patients. However, many infections were asymptomatic or mildly symptomatic. Positive serologic antibody (Ab) testing is theorized to be a marker of prior infection, allowing for identification of true burden of disease and establishing links between outbreaks. 1.2 Objective Assess serologic testing in subjects after PCR testing and compare seropositivity rates of household vs. non-household close contacts. 1.3 Methods We identified subjects who were PCR-positive between March 2020 and May 2021. Index cases and close contacts then underwent serologic testing for IgG against SARS-CoV-2 nucleocapsid N-protein. 1.4 Results One-hundred-and-thirteen subjects underwent serologic testing with a sensitivity of 65.0%, specificity of 78.9%, positive predictive value of 92.9%, and negative predictive value of 34.9%. Index cases comprised 20.5% of subjects, and 73.9% were seropositive (p=0.01). Close contacts included 72% household contacts and 28% non-household contacts. One seropositive case had no prior PCR and four were PCR negative. No statistical difference existed in seropositivity between household and non-household contact (53.1% vs. 43.8%, p=0.4). 1.5 Conclusions Testing for IgG against SARS-CoV-2 N-protein may identify previously unrecognized infections in the community. Seropositivity rates of household vs. non-household contacts were not significantly different, and >50% of household contacts were seropositive.

We reported the first case of Guillain-Barré syndrome that is associated with COVID-19 and malaria coinfection. The current report demonstrates diagnostic challenge to identify GBS case in a country like Sudan that is endemic with several infectious diseases associated with developing GBS.

The volume of knowledge that the scientific community has compiled about SARS-CoV-2 and amyloid beta peptide is scarce, but it is growing every day. The interaction between the virus and the amyloid beta peptide is poorly understood and some data are unclear. The long-term consequences of SARS-CoV-2 infection on human health remain uncertain at this time. The present work provides a discussion about the association between the amyloid beta peptide and COVID-19.

The paper presents the incorporation of in silico missenses and studies the effect of missenses to understand its effect on the Ligand-Protein interactions, of COVID-19 protein. In silico protein-ligand interaction, studies are being used to understand and investigate the drug-likeness of various molecules. 19 novel COVID-19 proteins are designed by inducing in silico missenses by mutating N691 amino acid residue in 7bv2 protein, the only residue forming H-bond with the ligand molecule in the parent protein. The work illustrates the effects of in silico-induced mutation on various interactions such as H-Bond, VDW, π-alkyl interactions, and changes in the number and type of surrounding amino acid residues. The results have suggested a common pattern of behavior on mutation with T, V, W, and Y. Further, it is observed that the number and type of amino acid residues increase on mutation, suggesting future possibilities to understand the effect of natural mutation on the binding of a ligand molecule with the protein.

This study is to explore the advantages and obstacles of implementing Theory of Constraints (TOC), Lean and Six Sigma in Indian manufacturing organizations. The research also elaborates on the challenges of implementing TOC, Lean and Six Sigma in manufacturing organizations in India, along with the changes in the culture that are required for providing a proper climate to ensure success in a long-term manner. The methodology used in this study is a descriptive study, which explores and looks for the factors that influence the impulse or motivation to implement TOC, Lean and Six Sigma in Indian manufacturing organizations and factors that inhibit the implementation of TOC, Lean and Six Sigma. To achieve this goal of integrated TOC, Lean and Six Sigma, a significant review of the existing literature of the subject area has been done to prepare a framework with the help of statistics in view of the critical success factors. This research is a flow and arranged a type of survey of organizations that is conducted using MS-Excel and SPSS 25.0. The number of participants selected using a purposive sampling method in this study was 227 TOC, Lean and Six Sigma experts and owners or CEOs of manufacturing organizations in India. TOC, Lean and Six Sigma be used for facilitating the improvement processes in manufacturing operations, quality improvements and productivity. As some obstacles exist in implementing the integrated TOC, Lean and Six Sigma approach, the improvement processes and outcomes of change in the culture are noteworthy and worthwhile. The implementation of TOC, Lean and Six Sigma has also some constraints, including cost limitations, skill limitations, limited facilities and other such limitations. The implementation of TOC, Lean and Six Sigma during and after COVID-19 pandemic is not yet a matter of urgency or priority, and hence, cannot yet be applied.

Purpose To describe utilization patterns, characteristics of users and prescriber responsibility of the new oral antiviral medication, molnupiravir, indicated for mild-to-moderate COVID-19. Methods Using nationwide registries, we identified all Danish adults who filled a prescription for molnupiravir from December 16 th, 2021, to August 31 st, 2022. We described weekly incidence rates and patient characteristics over time, prescriber responsibility as well as time between molnupiravir initiation and a positive SARs-CoV-2 test. Patient characteristics were compared to an untreated SARS-CoV-2 positive cohort. Results By August 31 st, 2022, 5,847 individuals had filled a prescription for molnupiravir. The incidence rate gradually increased to 2,000 weekly prescriptions per 100,000 RT-PCR SARS-CoV-2 positives. Users of molnupiravir were most often men (55% vs. 45% women). The majority (81%) had a positive RT-PCR SARS-CoV-2 test and few (2.9%) redeemed molnupiravir outside the recommended window of 5 days from the positive test result. Compared to an untreated SARS-CoV-2 positive cohort, users of molnupiravir had a median age of 74 years vs. 44 years, a higher proportion resided in a nursing home (12% vs. 1.1%) and had a higher number of comorbidities (median of 3 vs. 0); most commonly hypertension (38%), chronic lung disease (35%), diabetes (20%) and mood disorders (20%). General practitioners were the primary prescribers of molnupiravir (91%). Conclusions Molnupiravir was mainly prescribed by general practitioners to RT-PCR SARS-CoV-2 positive individuals who had a potentially increased risk of severe COVID-19. Though some off-label prescribing occurred, our study indicates a high level of adherence to contemporary guidelines.

Due to submission process, there is no abstract or subheadings.