Pharmacology Commons^™

The Successful Treatment Of Brevundimonas Diminuta Using Ceftriaxone, In A Patient On Continuous Ambulatory Peritoneal Dialysis: A Case Report And Literature Review, Sukrit Kanchanasurakit, Natnicha Woranithipokin, Piyakamol Teeranaew, Natthawee Kaewrattanapatthama, Chotirat Nakaranurack

The Thai Journal of Pharmaceutical Sciences

Brevundimonas diminuta (B. diminuta) is found in the health-care environment and in the community. At present, there are few reports of infections caused by this microorganism, especially in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). A 44-year-old woman undergoing CAPD was diagnosed with a B. diminuta infection. Ceftriaxone was given both intravenously and intraperitoneally. After treatment with ceftriaxone, the peritoneal dialysis fluid white cell count, neutrophil count, and symptoms improved. To the best of our knowledge, this is the first case report of a B. diminuta infection in a patient had undergoing CAPD in Thailand

Impact Of Clinical Pharmacist Intervention On Medication Adherence In Patients With Cardiovascular Disease, S. Lavanya, Netal Patel, Arnav Purani, Kajal Patel

The Thai Journal of Pharmaceutical Sciences

Background: Cardiovascular diseases (CVDs) are a category of heart and blood vessel disorders that include coronary disorders, cerebrovascular diseases, rheumatic pain, and other conditions. One of the major risk factors for CVDs is high blood pressure (BP). Furthermore, it is poorly managed due to a lack of understanding of hypertension, a lack of proper primary care, and a lack of follow-up. The patient education improves the patient’s response to the disease and its management and their quality of life. Objectives: The objectives of this study were to evaluate the effect of clinical pharmacist intervention by the provision of patient counseling, …

Development And Optimization Of Polyherbal Formulation For Antiurolithiatic Activity Using Box Behnken Statistical Design, Tejal Gandhi, Vaidehi Patel, Saloni Dalwadi, Vaishali Thakkar

The Thai Journal of Pharmaceutical Sciences

Background: The objective of the present investigation was to design and evaluate the antiurolithiatic activity of extract of Tribulus terrestris, Bryophyllum pinnatum, and Cyperus rotundus on ethylene glycol-induced urolithiasis in Wistar albino rats using Box Behnken Design. To induce urolithiasis, 0.75% w/v ethylene glycol was administered orally to the rats for 28 days. Cystone 750 mg/kg was selected as the reference standard as a preventive dose. On the 28th day, urine discharged in 24 h was collected and subjected for estimation of various biochemical parameters which were evaluated using urine, serum, and kidney homogenate. The kidneys were also sectioned and …

Antioxidant Status, Antihyperlipidemic Activity, And Serum Electrolyte Levels In Dexamethasone-Induced Oxidative Stress In Wistar Rats Treated With Vitamin E, Idara Asuquo Okon, Justin Atiang Beshel, Daniel Udofia Owu

The Thai Journal of Pharmaceutical Sciences

Objectives: Dexamethasone (Dex) is an anti-inflammatory drug with serious side effects. The aim of this study was to investigate, antioxidants status, antihyperlipidemic activity, and serum electrolyte levels of rats treated with Vitamin E in Dex-induced oxidative stress. Materials and Methods: Wistar rats of both sexes were assigned to four groups (n = 6). The control group was fed with standard rat feed and water, while Dex group received 30 μg/kg of Dex. Vitamin E group received 300 IU/kg of vitamin E, while Dex + Vitamin E group received 30 μg/kg of Dex and 300 IU/kg of vitamin E. After 14 …

Silymarin And Oral Cancer: A Review On Clinical And Analytical Reports, Ramya Jonnalagadda, C. Vinodhini

The Thai Journal of Pharmaceutical Sciences

Oral cancer is the sixth-largest kind globally of cancer and a major health issue in India as well and affects a large population that is very vulnerable to recurrences and a lower survival rate among all the other malignancies. Milk thistle is a phytochemical herb of interest that has been used as folk medicine since ancient times. Due to its potential benefits, the pharmaceutical industrial world is widely using silymarin (an active component of milk thistle) for commercial preparations. Knowing the quantity and identity of active components is of utmost importance. Therefore, robust, accurate, and precise analytical methods are needed …

Edible Mushrooms: An Emerging Therapeutic Of Diabetes, Nilanjan Chakraborty, Anuron Banerjee, Sudeshna Nandi, Swagata Sarkar, Krishnendu Acharya

The Thai Journal of Pharmaceutical Sciences

Diabetes is the third most customary non-infectious disease occurring worldwide and leads to untimely disability and mortality. This metabolic disorder is characterized by impaired insulin secretions and high blood glucose levels. Among others, type 2 diabetes is the most common. Various chemical and biochemical hypoglycemic drugs are utilized to control and treat hyperglycemia but required further interventions to reduce their toxicity and side effects on the users. Edible mushrooms have been employed from ancient times to heal many diseases as it composed of anti-oxidant, alkaloids, fibers, triterpenoids, and other phytochemicals. The bioactive secondary metabolites of mushrooms can improve insulin resistance …

Determination Of Sugars And Amino Acids In Japanese Wine Using Core–Shell Liquid Chromatography Tandem Electrochemical Detection, Kana Yoshimura, Aiko Sano, Ryuichiro Suzuki, Shun-Ichi Mitomo, Yukiko Negishi, Toshiki Mutai, Florencio Arce Jr, Gerard Lee See, Takashi Tanikawa, Yutaka Inoue

The Thai Journal of Pharmaceutical Sciences

In this study, sugars (glucose, fructose, and sucrose) and amino acids in plum and yuzu wines were quantified with a new and simple method involving an electrochemical detector (ECD) and core–shell column (S-30/70 = Styrene/divinylbenzene – 5 tetramethyldiaminohexane). Analysis was conducted under the following conditions: A column temperature (40°C), flow rate (0.3 mL/min), injection volume (20 μL), and mobile phase (0.1 mol/L NaOH). Glucose, fructose, and sucrose had retention times of 14.68 min, 16.22 min, and 19.29 min, respectively, when measured using an ECD. When the sugar content was compared among the plum wines, plum wine A had the lowest …

Hemogram Results And Renal Function Before And After Administration Of Black Cumin Seed Oil In Healthy Volunteers, Titiek Hidayati, Akrom Akrom, Sagiran Sagiran, Indrayanti Indrayanti

The Thai Journal of Pharmaceutical Sciences

No abstract provided.

Formulation, Characterization, And Pharmacokinetic Study Of Methoteraxate-Quercetin Loaded Nanoparticles, Gyanesh Kumar Sahu, Harish Sharma, Swarnali Das Paul, Ajazuddin, Chanchal Deep Kaur

The Thai Journal of Pharmaceutical Sciences

Objectives: Methotrexate (MTX) is a biopharmaceutics classification system Class IV drug having potential cytotoxic action against cancer cells. However, short half-life and poor bioavailability have limited its application. The object of this work was to entrap MTX and an herbal bioenhancer in a nanoparticle system to improve its bioavailability. Methods: We prepared the nanoparticles (NPs) by emulsion solvent evaporation method with Eudragit RLPO (ERLPO) polymer. Results: The result revealed good in vitro properties with 110 to 228 nm particle size range. The percentage of drugs released from all the batches in 72 h was within the range of 82.71 to …

Preclinical Development Of Novel Chemotherapeutic Agent Ac1lpszg: Formulation Optimization, In Vitro Characterization, And In Vivo Pharmacokinetics, Ritu Gupta

Dissertations (2016-Present)

Preclinical development of novel chemotherapeutic agent AC1LPSZG, a mammalian target of rapamycin (mTOR) inhibitor, involved development of sensitive reverse-phase ultra-performance liquid chromatography (UPLC) and LC-MS/MS methods for quantification of AC1LPSZG in in vitro study samples and rat plasma, respectively. Pharmacokinetic studies were done in SD rats after intravenous injection of cosolvent formulations. The resulting pharmacokinetic parameters were analyzed using non-compartmental analysis (NCA) and two-compartmental modeling. Poly (D, L-lactic-co-glycolic acid) (PLGA) is most used biodegradable synthetic polymer for nano drug delivery due to its non-toxic and biodegradable nature, and tunable release properties. PLGA nanoparticles (NPs) were prepared by ‘nanoprecipitation’ technique using …

A Review Of Covid-19 In Relation To Metabolic Syndrome: Obesity, Hypertension, Diabetes, And Dyslipidemia, Elias Makhoul, Joseph L. Aklinski, Jesse Miller, Cara Leonard, Sean Backer, Payal Kahar, Mayur S. Parmar, Deepesh Khanna

HPD Articles

Although severe cases and mortality of coronavirus disease 2019 (COVID-19) are proportionally infrequent, these cases are strongly linked to patients with conditions of metabolic syndrome (obesity, hypertension, diabetes, and dyslipidemia). However, the pathophysiology of COVID-19 in relation to metabolic syndrome is not well understood. Thus, the goal of this secondary literature review was to examine the relationship between severe acute respiratory syndrome (SARS-CoV-2) infection and the individual conditions of metabolic syndrome. The objective of this secondary literature review was achieved by examining primary studies, case studies, and other secondary studies, to obtain a comprehensive perspective of theories and observations of …

Identifying Novel Pharmacogenetic Markers For Cancer Treatments: Exploiting Cancers Deficient In The Nucleotide Pool Sanitizing Hydrolases Nudt15 And Nudt18, Jacob Chandler Massey

Theses and Dissertations

The NUDIX hydrolases are a super family of enzymes with purported enzymatic activities of nucleotide hydrolases. The activity of the founding member, NUDT1 (also known as MTH1) is established to be a nucleotide hydrolase for d-8-oxoGTP, which is a mutagenic precursor if incorporated into DNA. Therefore, its activity serves to sanitize the nucleotide pool of mutagenic precursors. While known to be highly conserved among all organisms, the enzymatic and biological functions for nearly all the family members remain largely unexplored and unknown. Substrates of family members have been found to include canonical (deoxy)nucleotide triphosphates, oxidized (deoxy)nucleotide triphosphates, and non-nucleoside polyphosphates. …

Toxicity Assessment Of The Crude Ethanolic Pod Extract Of Swartzia Madagascariensis Desv. In Rats, Adelina A. Mwakalila, Saada M. Mbepera, Shaabani A. Mshamu, Amina Msonga, Washa B. Washa

Tanzania Journal of Science

This study assessed toxicity of the crude ethanolic pod extracts of Swartzia madagascariensis Desv in Wistar rats. Forty (40) Wistar rats aged 8–10 weeks were orally administered with crude extracts from pods of S. madagascariensis. Chemical analysis of serum and histopathology of liver and kidney from test animals were performed to determine the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and creatinine in serum. In addition, serum albumin levels were also determined. The levels of ALT, AST and creatinine were found to be high in groups treated with crude extracts compared to the control group, suggesting some damage in …

Corrigendum To “The Impact Of The Rare Disease And Orphan Drug Act In Taiwan” [J Food Drug Anal 29 (2021) 717-725]

Journal of Food and Drug Analysis

No abstract provided.

The Study Of Distribution Of Ingested Terbinafine On Skin With Ambient Ionization Tandem Mass Spectrometry, Yi-Tzu Cho, Hung Su, Ching-Ying Wu, Jingyueh Jeng, Chi-Wei Lee, Deng‐Chyang Wu, Tiao-Lai Huang, Jentaie Shiea

Journal of Food and Drug Analysis

We aim to develop an efficient and non-invasive strategy for monitoring of drugs and their metabolites via human skin. Probe sampling was combined with thermal desorption-electrospray ionization tandem mass spectrometry (TD-ESI/MS/MS) to characterize trace terbinafine, which was secreted on patient’s skin after ingesting terbinafine tablets. The terbinafine ion signals were directly detected in the samples collected from different skin regions and the signals were monitored for 8 weeks. The detection and location of terbinafine via the skin suggest that the methods are useful in rapidly and noninvasively collecting the molecular information of the ingested drug on skin for pharmacokinetic studies.

Chemiluminescence Of Lucigenin-Tetracycline And Itsapplication For Sensitive Determination Of Procyanidin, Shuai Quan, Kaixiang Ji, Fangshuo Liu, Tesfaye Hailemariam Barkae, Mohamed Ibrahim Halawa, Saima Hanif, Baohua Lou, Jianping Li, Guobao Xu

Journal of Food and Drug Analysis

Tetracycline was reported to trigger intense lucigenin chemiluminescence (CL). Based on its significant quenching to lucigenin-tetracycline CL, procyanidin was detected. The mechanism of the lucigenin-tetracycline CL and its quenching by procyanidin were proposed. Under the optimum conditions, the calibration curve is linear in the range of 10-1000 nM for procyanidin with a detection limit of 4.4 nM. The RSD for nine replicate determinations of procyanidin was less than 1.7%. Moreover, this method was satisfactorily applied to the determination of procyanidin in human urine samples and health food capsule of grape seed.

Quantitation Of Mycophenolic Acid And Metabolites By Uplc-Ms/Ms In Renal Transplant Patients, Yun-Fen Huang, Ya-Ching Huang, Hsiao-Chen Ning, Chia-Ni Lin

Journal of Food and Drug Analysis

Mycophenolate mofetil (MMF) and enteric-coated mycophenolate sodium (EC-MPS), specific inhibitors of lymphocyte proliferation, are commonly used as adjuvant therapy with calcineurin inhibitor agents after kidney transplantation. After administration, MMF and EC-MPS are hydrolyzed to mycophenolic acid (MPA), the active form of the drug, which must be monitored due to its narrow therapeutic window, drug–drug interactions, and large intra-and inter-individual pharmacokinetic variability despite a fixed dose. Monitoring plasma MPA level is recommended to maintain the drug within the therapeutic window, optimize its efficacy, and minimize side effects. This study aims to develop a method for quantifying MPA and its major metabolites …

Camphorataimide B Suppresses The Metastasis Of Human Colorectal Cancer Cell By Inhibiting Smad/Fak/Akt Axis And Promoting Degradation Of Snail/Bmp4 Complex, Chi-Chou Huang, Chia-Hung Hung, Yi-Ju Lee, Tsui-Hwa Tseng, Yean-Jang Lee, Shao-Hsuan Kao, Chau-Jong Wang

Journal of Food and Drug Analysis

Camphorataimide B (CamB) has anticancer activities against several tumors. Here, we aimed to investigate the mechanism(s) by which CamB inhibits metastasis of colorectal cancer (CRC) cells. Low-dose CamB did not affect the cell viability and cell cycle progression of CRC cells, but significantly inhibited the metastatic potentials of CRC cells. Mechanically, CamB reduced the protein and mRNA expression of BMP4, and inhibited Smad and FAK/Src/Akt signaling. CamB also decreased Snail levels by promoting its degradation via proteasome and thereafter reduced Snail-mediated BMP4 transcription. Moreover, CamB considerably inhibited the in vivo metastasis of DLD-1 cells in xenograft mice.

Orally Delivered Perilla (Perilla Frutescens) Leaf Extract Effectively Inhibits Sars-Cov-2 Infection In A Syrian Hamster Model, Yuan-Fan Chin, Wen-Fan Tang, Yu-Hsiu Chang, Tein-Yao Chang, Wen-Chin Lin, Chia-Yi Lin, Chuen-Mi Yang, Hsueh-Ling Wu, Ping-Cheng Li, Jun-Ren Sun, Shu-Chen Hsu, Chia-Ying Lee, Hsuan-Ying Lu, Jia-Yu Chang, Jia-Rong Jheng, Cheng Cheung Chen, Jyh-Hwa Kau, Chih-Heng Huang, Cheng-Hsun Chiu, Yi-Jen Hung, Hui-Ping Tsai, Jim-Tong Horng

Journal of Food and Drug Analysis

On analyzing the results of cell-based assays, we have previously shown that perilla (Perilla frutescens) leaf extract (PLE), a food supplement and orally deliverable traditional Chinese medicine approved by the Taiwan Food and Drug Administration, effectively inhibits SARS-CoV-2 by directly targeting virions. PLE was also found to modulate virus-induced cytokine expression levels. In this study, we explored the anti-SARS-CoV-2 activity of PLE in a hamster model by examining viral loads and virus-induced immunopathology in lung tissues. Experimental animals were intranasally challenged with different SARS-CoV-2 doses. Jugular blood samples and lung tissue specimens were obtained in the acute disease stage (3−4 …

Assessing The Fate Of Fatty Acid Esters Of Hydroxy Fatty Acids, Diglycerides And Monoacetyldiacylglycerides In Grilled Ruminant Meats Marinated With Unfiltered Beer-Based Marinades, Charles F. Manful, Thu H. Pham, Evan Wheeler, Muhammad Nadeem, Oludoyin A. Adigun, Nicole Walsh, Raymond H. Thomas

Journal of Food and Drug Analysis

Ruminant meats contain functional lipids including fatty acid esters of hydroxy fatty acids (FAHFA), diglycerides (DG), monoacetyldiglycerides (MAcDG) and medium chain triglycerides (McTG) whose consumption in the normal diet can confer benefits for consumer health. However, very little is known concerning how meat processing techniques such as marination and grilling affect the quantity and quality of these functional lipids in ruminant meats. We used ultra high-performance liquid chromatography coupled to high resolution accurate mass tandem mass spectrometry (UHPLC-HRAM-MS/MS) to show how grilling following marination with either India or Wheat ale unfiltered beer-based marinades affected the quantity and quality of these …

Exosomal Proteomics In Kidney Disease: From Technical Approaches To Clinical Applications, Ageng Brahmadhi, Yung-Kun Chuang, San-Yuan Wang, Chih-Chin Kao, I-Lin Tsai

Journal of Food and Drug Analysis

Exosomes are small extracellular vesicles (sEVs) secreted from cells and have a general diameter ranging from 30~150 nm. It was reported that exosomes have essential roles in intercellular communication and can be targeted as biomarkers of disease or as therapeutic agents. Among the different techniques used for exosome investigation, the mass spectrometry-based proteomics approach has accelerated the unraveling of the molecular composition of exosomes and has contributed to improved knowledge of molecular processes in various diseases. In this review, we focused on proteomics-based studies of exosomes and clinical applications in kidney diseases. A general introduction of exosomes, isolation and characterization …

Differential Scanning Calorimetry For Authentication Of Edible Fats And Oils - What Can We Learn From The Past To Face The Current Challenges?, Mahbuba Islam, Liliana Bełkowska, Piotr Konieczny, Emilia Fornal, Jolanta Tomaszewska-Gras

Journal of Food and Drug Analysis

Fats and oils authentication has become an important issue recently, due to the growing interest in consumption of cold-pressed oils. Therefore, it is becoming more and more difficult to maintain official control over the growing assortment of new cold-pressed oils. Authenticity of plant oils is also an important issue for religious or cultural reasons.This review article focuses on the application of differential scanning calorimetry (DSC) in the field of assessing authenticity of various fats and oils (e.g. olive oil, palm oil, confectionery fats, butter). Extra virgin olive oil (EVOO) is the most comprehensively tested oil by means of the DSC …

Trends And Applications Of Food Protein-Origin Hydrolysates And Bioactive Peptides, Yi-Hsieng Samuel Wu, Yi-Chen Chen

Journal of Food and Drug Analysis

It was reported that protein hydrolysates or derived peptides have more functionalities than their parent protein. Most functional protein hydrolysates or peptides are identified from various food products, including plant, fish, and land-animal protein sources. Within a few decades, the application of food protein-origin functional hydrolysates or peptides could be divided into two main categories according to their applied intentions: 1) preservatives and bioactive packing materials; 2) nutraceutical ingredients. According to the literature, the applications of food protein-origin functional hydrolysates or peptides on food preservative and nutraceutical ingredients have attracted much attention. However, the approach method should be changed. Multi-activities, …

Crude Extract Of Desmodium Gangeticum Process Anticancer Activity Via Arresting Cell Cycle In G1 And Modulating Cell Cycle-Related Protein Expression In A549 Human Lung Carcinoma Cells, Yuh-Fung Chen, Yi-Hsien Lu, Huei-Yann Tsai

BioMedicine

Background: Desmodium gangeticum (L.)DC., which belongs to the Leguminosae family, has been used in Taiwan and other subtropical countries as an external medicine to remove blood stasis, activate blood circulation, and reduce inflammation. It has been reported to have antioxidant effects and improve inflammatory responses in rats stimulated by pro-inflammatory agents and induced gastric ulcers in experimental animals over the past few decades. This plant has also been used to treat parasitic infections, but there are no reports regarding its effects on lung cancer. Therefore, this study attempted to investigate its water crude extract (in abbreviation DG) on lung …

Sex-Specific Effects Of Chaperone And Glial Defenses On Experimental Lewy Body Disease, Tarun Bhatia

Electronic Theses and Dissertations

Lewy body disorders are a group of neurodegenerative conditions characterized by the pathological misfolding and aggregation of the abundant protein, α-synuclein. The most common Lewy body disorders are Parkinson’s disease and dementia with Lewy bodies. Apart from ageing, male sex is a major risk factor for Lewy body disorders, as men are at ~1.5-fold higher risk for these diseases than women. Yet, preclinical studies on Lewy body disorders rarely examine sex as a biological variable, and the mechanisms underlying sex-skewedness in disease risk remain undetermined.

Here, we developed a sex-stratified model of Lewy body disorders by exposing primary neurons harvested …

Mathematical Model Of Triple-Negative Breast Cancer In Response To Combination Chemotherapies, Angelica Davenport, Yun Lu, Carlos Gallegos, Adriana Massicano, Katherine Heinzman, Patrick Song, Anna Sorace, Nick Cogan

Biology and Medicine Through Mathematics Conference

No abstract provided.

Clarifying Drug Reaction Terminology: Insights From Deaf College Students Allergic To Penicillin, Andrew Makarewicz

Undergraduate University Honors Capstones

Penicillin is considered to be the most frequently reported drug allergy, with roughly 10% of the U.S. population reporting an allergy (Lee, 2020; Sakoulas et al., 2019). However, current research suggests that more than 90% of people who report a penicillin allergy are actually not truly allergic (Blumenthal et al., 2015; Pongdee & Li, 2018). Confusion about side effects and allergic responses is a common way for penicillin allergies to be falsely reported (Stone et al., 2020). The Deaf community may experience this confusion at a higher rate due to health literacy barriers that likely hinder their learning and understanding …

Hyperbranched Polyester-Based Drug Delivery System For The Optical Imaging And Treatment Of Cancer, Truptiben Patel

Electronic Theses & Dissertations

Hyperbranched polymers are well known to be a promising new class of drug delivery system for biomedical application. In this research, a novel hyperbranched polyester polymer was synthesized by following melt polymerization technique utilizing our proprietary A₂B monomer, triethylene glycol and diethylenetriaminepentaacetic acid (DTPA). This polymerization process was catalyzed by p-toluene sulfonic acid and was monitored by analyzing the polymer sample in regular time intervals. The final polymer was purified using the solvent precipitation method and characterized using MALDI-TOF, NMR, and GPC, DSC, TGA, FT-IR. The solvent diffusion method was used to formulate polymeric nanoparticle and doxorubicin drug …

Pharmacometabolomics Profiling Of Preterm Infants Validates Patterns Of Metabolism Associated With Response To Dexamethasone Treatment For Bronchopulmonary Dysplasia, Bradley C. Stockard

Research Days

Background: Bronchopulmonary dysplasia (BPD) is one of the most common health complications of premature birth. Corticosteroids are commonly used for treatment of BPD, but their use is challenging due to variability in treatment response.

Objectives/Goal: Previous pharmacometabolomics study has established patterns of metabolite levels with response to dexamethasone. We obtained additional patient samples for metabolomics analysis to find associations between the metabolome and dexamethasone response in a validation cohort.

Methods/Design: 14 infants provided 15 plasma and 12 urine samples. The measure of treatment response was the calculated change in respiratory severity score (deltaRSS) from pre-to-post treatment. Each metabolite was assessed …

The Racial Divide: A Follow Up Study On Racial Disparity Amongst Covid-19 Survivors In An Urban Community, Christopher Millet, Emily Racoosin, Spandana Narvaneni, George Horani, Sherif Roman, Alisa Farokhian, Arslan Chaudhry, Sohail Chaudhry, Yezin Shamoon, Humberto Jimenez, Patrick Michael, Jin Suh

Journal of Community Hospital Internal Medicine Perspectives

Background Studies have shown that COVID-19 has had a disproportionate effect on minority groups in both the clinical and social settings in America. We conducted a follow up study on patients previously diagnosed with COVID-19 one year ago in an urban community in New Jersey. The purpose of the study was to evaluate the socioeconomic impact of COVID-19 as well as assess for receptiveness towards COVID-19 vaccination amongst various ethnic groups.

Methods This was a prospective cohort study consisting of patients who had recovered from COVID-19 one year prior. The patients included in the study had a confirmed COVID-19 diagnosis …