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Smoking and comorbidities are associated with COVID-19 severity and mortality in 565 patients treated in Turkey: a retrospective observational study
OBJECTIVE: We aimed to explore the prevalence of smoking rates and comorbidities and evaluate the relationship between them and disease severity and mortality in inpatients with COVID-19. METHODS: COVID-19 patients were divided into the following groups: clinic group, intensive care unit (ICU) group, survivors, and non-survivors. Non-COVID-19 patients were included as a control group. The groups were compared. RESULTS: There was no difference between patients with and without COVID-19 in terms of smoking, asthma, diabetes, dementia, coronary artery disease (CAD), hypertension, chronic renal failure and arrhythmia (p>0.05). Older age (Odds ratio (OR), 1.061; 95% confidence interval (CI): 1.041-1.082; p< 0.0001), chronic obstructive pulmonary disease (COPD) (OR, 2.775; 95% CI: 1.128-6.829; p=0.026) and CAD (OR, 2.696; 95% CI: 1.216-5.974; p=0.015) were significantly associated with ICU admission. Current smoking (OR, 5.101; 95% CI: 2.382-10.927; p<0.0001) and former smoking (OR, 3.789; 95% CI: 1.845-7.780; p<0.0001) were risk factors for ICU admission. Older age (OR; 1.082; 95% CI: 1.056-1.109; p<0.0001), COPD (OR, 3.213; 95% CI: 1.224-8.431; p=0.018), CAD (OR, 6.252; 95% CI: 2.171-18.004; p=0.001) and congestive heart failure (CHF) (OR, 5.917; 95% CI 1.069-32.258; p=0.042), were significantly associated with mortality. Current smoking (OR, 13.014; 95% CI: 5.058-33.480; p<0.0001) and former smoking (OR, 6.507; 95% CI 2.731-15.501; p<0.0001) were also risk factors for mortality. CONCLUSION: Smoking, older age, COPD, and CAD were risk factors for ICU admission and mortality in patients with COVID-19. CHF was not a risk factor for ICU admission; however, it was a risk factor for mortality.
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The impact of the COVID-19 pandemic on the field of pediatric rheumatology
The purpose of this review is to discuss the clinical management of children with pediatric rheumatic disease (PRD) during the Coronavirus disease of 2019 (COVID-19) pandemic, as well as the unique role of the pediatric rheumatologist during a time of emerging post-COVID inflammatory sequelae including, multisystem inflammatory syndrome in children (MIS-C). RECENT FINDINGS: To date, there has been little evidence to suggest that children with PRD, including those on immunomodulatory therapies, are at increased risk for severe COVID-19. Clinical guidance statements have been created to support clinical providers in providing care to children with PRD during the COVID-19 pandemic. Pediatric rheumatologists have also been called upon to assist in the identification and management of post-COVID sequelae, including the rapidly emerging inflammatory illness, MIS-C. SUMMARY: The COVID-19 era has been defined by a rapid expansion in scientific knowledge and a time of extraordinary local and worldwide collaboration, both within the pediatric rheumatology community, as well as across multiple disciplines. Through collective efforts, we have learned that children with PRD, including those on immunomodulatory therapies, are not at increased risk for severe COVID-19. Pediatric rheumatologists have also worked alongside other disciplines to develop guidance for the management of MIS-C, with the majority of patients experiencing excellent clinical outcomes.
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Cost-effectiveness of postmastectomy hypofractionated radiation therapy vs conventional fractionated radiation therapy for high-risk breast cancer
BACKGROUND: The phase 3 NCT00793962 trial demonstrated that postmastectomy hypofractionated radiation therapy (HFRT) was noninferior to conventional fractionated radiation therapy (CFRT) in patients with high-risk breast cancer. This study assessed the cost-effectiveness of postmastectomy HFRT vs CFRT based on the NCT00793962 trial. METHODS: A Markov model was adopted to synthesize the medical costs and health benefits of patients with high-risk breast cancer based on data from the NCT00793962 trial. Main outcomes were discounted lifetime costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER). We employed a time-dependent horizon from Chinese, French and USA payer perspectives. Model robustness was evaluated with one-way and probabilistic sensitivity analyses. RESULTS: Patients receiving CFRT versus HFRT gained an incremental 0.0163 QALYs, 0.0118 QALYs and 0.0028 QALYs; meanwhile an incremental cost of $2351.92, $4978.34 and $8812.70 from Chinese, French and USA payer perspectives, respectively. Thus CFRT versus HFRT yielded an ICER of $144,281.47, $420,636.10 and $3,187,955.76 per QALY from Chinese, French and USA payer perspectives, respectively. HFRT could maintain a trend of >50% probabilities of cost-effectiveness below a willingness-to-pay (WTP) of $178,882.00 in China, while HFRT was dominant relative to CFRT, regardless of the WTP values in France and the USA. Sensitivity analyses indicated that the ICERs were most sensitive to the parameters of overall survival after radiotherapy. CONCLUSIONS: Postmastectomy HFRT could be used as a cost-effective substitute for CFRT in patients with high-risk breast cancer and should be considered in appropriately selected patients.
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Skin Tests in The Work-Up of Cutaneous Adverse Drug Reactions: A Review and Update.
Skin tests, including patch tests (PTs), prick tests and intradermal tests (IDTs), are useful to identify the culprit(s) of a cutaneous adverse drug reaction (CADR), and to determine (a) safer alternative drug(s). PTs have a low sensitivity but are valuable to investigate maculopapular exanthema (MPE), as well as severe CADR, including toxic epidermal necrolysis (TEN), Stevens-Johnson syndrome (SJS), and (especially) acute generalized exanthematous pustulosis (AGEP) and drug rash with eosinophilia and systemic symptoms (DRESS). To ensure their specificity at least 10 controls should be performed. Prick tests are mainly used in the evaluation of immediate-type hypersensitivity, and can be performed with all drugs, except opiates. IDTs can be used to explore immediate and delayed-type hypersensitivity, if an injectable form of the drug exists. Except for SJS/TEN, IDTs should be performed by injecting 0.02 mL of the drug. We here provide a practical up-to-date review on the use of these skin tests in the work-up of CADRs. Numerous negative controls for drug PTs, prick tests and IDTs, as well as criteria for the immediate and delayed positivity of the latter, are included. It should be emphasized that a negative result never excludes the potential responsibility of a drug in a CADR. This article is protected by copyright. All rights reserved.
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Minimally invasive treatment of lateral epicondylitis.
Lateral epicondylitis (LE), also known as tennis elbow, is the most common cause of elbow pain in adults, with approximately 1-3% of the general population being afflicted. Although the condition is usually self-limiting, pain can be a major hindrance, limiting daily activity and the work capacity of patients. As a result, many treatment options have become available with the aim to shorten the duration of the disease and increase the quality of life. Steroid injections, NSAIDs, topical creams, platelet-rich plasma, physical therapy, and kinesiotaping are considered conservative treatments, while surgical options are last-resort treatments reserved for refractory LE. In this review, we will provide a brief summary of LE and focus on addressing conservative and minimally invasive interventional options for the treatment of LE.
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Design and synthesis of some imidazole derivatives: Theoretical evaluation of interaction with a coronavirus (HCoV-NL63)
Some compounds have been developed for the treatment of Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) using different protocols; however, some methods use different reagents which are dangerous and require special conditions. the objective of this investigation was to synthesize some imidazole derivatives from 2-methyl-5-nitroimidazole using some reactions such as etherification, reduction, and a hydroxy-keto derivative formation. In addition, the theoretical activity of imidazole derivatives (compounds 2, 3 and 5-8) was evaluated in a docking model using hydroxylchloroquine and favipiravir as controls. The results showed that 1) compounds 3 and 5 have a higher affinity by 5ewp protein surface compared with hydroxylchloroquine, favipiravir, 2 and 6-8. In conclusion, compounds 3 and 5 could inhibit the biological activity of coronavirus.
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Affordability of Heathy, Equitable and More Sustainable Diets in Low-Income Households in Brisbane before and during the COVID-19 Pandemic
The COVID-19 pandemic has increased food insecurity worldwide, yet there has been limited assessment of shifts in the cost and affordability of healthy, equitable and sustainable diets. This study explores the impact of the COVID-19 pandemic and income supplements provided by the Australian government on diet cost and affordability for low-income households in an Australian urban area. The Healthy Diets ASAP method protocol was applied to assess the cost and cost differential of current and recommended diets before (in 2019) and during the COVID-19 pandemic (late 2020) for households with a minimum-wage and welfare-only disposable household income, by area of socioeconomic disadvantage, in Greater Brisbane, Queensland, Australia. Data were collected between August and October, 2020, from 78 food outlets and compared with data collected in the same locations between May and October, 2019, in an earlier study. The price of most healthy food groups increased significantly during the pandemic—with the exception of vegetables and legumes, which decreased. Conversely, the price of discretionary foods and drinks did not increase during the pandemic. The cost of the current and recommended diets significantly increased throughout this period, but the latter continued to be less expensive than the former. Due to income supplements provided between May and September 2020, the affordability of the recommended diet improved greatly, by 27% and 42%, for households with minimum-wage and welfare-only disposable household income, respectively. This improvement in the affordability of the recommended diet highlights the need to permanently increase welfare support for low-income families to ensure food security.
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Digital Divide and Social Dilemma of Privacy Preservation
While digital divide studies primarily focused on access to information and communications technology (ICT) in the past, its influence on other associated dimensions such as privacy is becoming critical with a far-reaching impact on the people and society. For example, the various levels of government legislation and compliance on information privacy worldwide have created a new era of digital divide in the privacy preservation domain. In this article, the concept"digital privacy divide (DPD)"is introduced to describe the perceived gap in the privacy preservation of individuals based on the geopolitical location of different countries. To better understand the DPD phenomenon, we created an online questionnaire and collected answers from more than 700 respondents from four different countries (the United States, Germany, Bangladesh, and India) who come from two distinct cultural orientations as per Hofstede's individualist vs. collectivist society. However, our results revealed some interesting findings. DPD does not depend on Hofstede's cultural orientation of the countries. For example, individuals residing in Germany and Bangladesh share similar privacy concerns, while there is a significant similarity among individuals residing in the United States and India. Moreover, while most respondents acknowledge the importance of privacy legislation to protect their digital privacy, they do not mind their governments to allow domestic companies and organizations collecting personal data on individuals residing outside their countries, if there are economic, employment, and crime prevention benefits. These results suggest a social dilemma in the perceived privacy preservation, which could be dependent on many other contextual factors beyond government legislation and countries' cultural orientation.
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Lilly to test baricitinib against COVID-19
Eli Lilly and Company and the US National Institute of Allergy and Infectious Diseases will study baricitinib, a Lilly rheumatoid arthritis drug, as a potential treatment for people with COVID-19 It’s thought that baricitinib’s anti-inflammatory effect could help reduce the cytokine storm that COVID-19 can trigger in patients Ruxolitinib, a cancer treatment from Novartis and Regeneron, is also being tested for its potential to dampen the cytokine storm
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Percutaneous radiofrequency ablation of a small renal mass complicated by appendiceal perforation.
Percutaneous radiofrequency ablation (RFA) has gained wide acceptance as nephron-sparing therapy for small renal masses in select patients. Generally, it is a safe procedure with minor morbidity and acceptable short-term oncologic outcome. However, as a result of the close proximity of vital structures, such as the bowel, ureter, and large vessels, to the ablative field, complications regarding these structures may occur. This is the first article describing appendiceal perforation as a complication of computed tomography-guided RFA despite hydrodissection. When performing this innovative and promising procedure one should be aware of the possibility of particular minor and even major complications.
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Overcoming the Impact of COVID-19 on Surgical Mentorship: A Scoping Review of Long-distance Mentorship in Surgery
BACKGROUND: Mentorship in the surgical field has been increasingly recognized as a crucial component of career success. Distance mentorship models may be utilized to overcome geographic limitations, increase mentorship access, and strengthen mentoring relationships in surgery. OBJECTIVE: This review aimed to identify the scope of literature on distance mentoring in surgery, the range of its application, its effectiveness, and any gaps in the literature that should be addressed in order to enhance mentorship in the surgical field. DESIGN: A comprehensive PubMed review was performed in January 2021 on distance mentorship of students, trainees, and surgeons in the surgical field. Reviews, replies, and non-English articles were excluded. Data was extracted regarding publication year, author's country, specialty, subjects, aim of mentorship model, and efficacy. RESULTS: 134 total studies met inclusion and exclusion criteria. Most studies were published in 2020, written by authors in the United States, from general surgery, and featured an expert surgeon paired with a more junior fully trained surgeon. In all, 93.3% of studies utilized distance mentorship to enhance surgical skill through telementoring and only 4.5% were focused on mentorship to enhance careers through professional development. The remaining studies utilized distance mentorship models to increase surgical research (0.7%) and clinical knowledge (1.5%). CONCLUSION: The results of this review suggest successful implementation of distance mentoring in surgery through telementoring, but a lack of professionally aimed distance mentorship programs. Amidst COVID-19, distance mentorship is particularly important because of decreased face-to-face opportunity. Future studies in the surgical field should investigate distance mentoring as a means of increasing mentorship for professional development.
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Age-Dependent Serotype-Associated Case-Fatality Rate in Invasive Pneumococcal Disease in the Autonomous Community of Madrid between 2007 and 2020
The aim of this study was to investigate the serotype-associated fatality rate in cases of invasive pneumococcal disease (IPD) in the Spanish region of Madrid between 2007 and 2020. Serotyping was performed by Pneumotest Latex and the Quellung reaction using commercial antisera. Case-fatality rate was estimated as the ratio between the number of deaths at hospital discharge and the number of cases attributable to each serotype. To evaluate the association measures, the odds ratios with a 95% confidence interval were calculated. Twenty five pneumococcal serotypes were associated to mortality and comprised 87.8% of the total number of isolates characterized. Serotypes 8, 3, 19A, 1, 7F, 22F, 12F, and 11A were the most prevalent (≥3% each). Serotypes 31, 11A, and 19F were significantly associated to high case-fatality rates (>20% each). The lower significantly associated case-fatality rate (<10% each) was found in serotypes 5, 1, 12B, 7F, 12F, 8, 33, and 10A. The serotypes with higher mortality levels (≥0.04 per 100,000 population) were 11A (fatality 24.0%), 3 (fatality 18.7%), 19A (fatality 12.5%), and 8 (fatality 7.2%). Serotype 3 was worrisome because it is associated with important fatality levels combined with very high incidence and mortality rates. Serotype 11A also showed a high fatality with marked incidence and mortality levels. Some few frequent serotypes as 31, 19F, and 15A despite its high fatality had low levels of mortality. By contrast other serotypes as 8 showing low fatality had high mortality ranges because it shows a wide extended distribution. Finally, common serotypes, such as 1 and 5, presented small mortality length, due to their low case-fatality rates.
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Application of Graph Based Features in Computer Aided Diagnosis for Histopathological Image Classification of Gastric Cancer
The gold standard for gastric cancer detection is gastric histopathological image analysis, but there are certain drawbacks in the existing histopathological detection and diagnosis. In this paper, based on the study of computer aided diagnosis system, graph based features are applied to gastric cancer histopathology microscopic image analysis, and a classifier is used to classify gastric cancer cells from benign cells. Firstly, image segmentation is performed, and after finding the region, cell nuclei are extracted using the k-means method, the minimum spanning tree (MST) is drawn, and graph based features of the MST are extracted. The graph based features are then put into the classifier for classification. In this study, different segmentation methods are compared in the tissue segmentation stage, among which are Level-Set, Otsu thresholding, watershed, SegNet, U-Net and Trans-U-Net segmentation; Graph based features, Red, Green, Blue features, Grey-Level Co-occurrence Matrix features, Histograms of Oriented Gradient features and Local Binary Patterns features are compared in the feature extraction stage; Radial Basis Function (RBF) Support Vector Machine (SVM), Linear SVM, Artificial Neural Network, Random Forests, k-NearestNeighbor, VGG16, and Inception-V3 are compared in the classifier stage. It is found that using U-Net to segment tissue areas, then extracting graph based features, and finally using RBF SVM classifier gives the optimal results with 94.29%.
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Kardiale Zelltherapie – „lost in translation?“
Cardiac cell therapy covers more than two decades of tumultuous history. In this period of time, the perception of the heart as an organ consisting of a fixed number of terminally differentiated cardiomyocytes fundamentally changed. Suddenly, the myocardium was (or is) considered to be regenerative by intrinsic progenitor cells, inducible proliferation, and in particular by exogenic transplanted cells. While the clinical translation of real cardiomyocytes obtained by cellular reprogramming has progressed only slowly, a multitude of clinical studies were carried out with cell products of somatic origin. This was mostly based on assumptions and experimentally acquired data with respect to the plasticity of adult precursor cells that, in retrospect, lacked validity. Accordingly, on closer inspection the results of the clinical studies were not convincing but they were nevertheless often presented and viewed in a very optimistic light. Today, cardiac cell therapy with cells of a somatic origin is considered to have failed. Recapitulating the stages of this era can help recognize and avoid such undesirable developments in the future.
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Rescuing Low Frequency Variants within Intra-Host Viral Populations directly from Oxford Nanopore sequencing data
Infectious disease monitoring on Oxford Nanopore Technologies (ONT) platforms offers rapid turnaround times and low cost, exemplified by well over a half of million ONT SARS-COV-2 datasets. Tracking low frequency intra-host variants has provided important insights with respect to elucidating within host viral population dynamics and transmission. However, given the higher error rate of ONT, accurate identification of intra-host variants with low allele frequencies remains an open challenge with no viable solutions available. In response to this need, we present Variabel, a novel approach and first method designed for rescuing low frequency intra-host variants from ONT data alone. We evaluated Variabel on both within patient and across patient paired Illumina and ONT datasets; our results show that Variabel can accurately identify low frequency variants below 0.5 allele frequency, outperforming existing state-of-the-art ONT variant callers for this task. Variabel is open-source and available for download at: www.gitlab.com/treangenlab/variabel.
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Three-dimensional tumor cell cultures employed in virotherapy research
Oncolytic virotherapy constitutes an upcoming alternative treatment option for a broad spectrum of cancer entities. However, despite great research efforts, there is still only a single US Food and Drug Administration/European Medicines Agency-approved oncolytic virus available for clinical use. One reason for that is the gap between promising preclinical data and limited clinical success. Since oncolytic viruses are biological agents, they might require more realistic in vitro tumor models than common monolayer tumor cell cultures to provide meaningful predictive preclinical evaluation results. For more realistic invitro tumor models, three-dimensional tumor cell-culture systems can be employed in preclinical virotherapy research. This review provides an overview of spheroid and hydrogel tumor cell cultures, organotypic tumor-tissue slices, organotypic raft cultures, and tumor organoids utilized in the context of oncolytic virotherapy. Furthermore, we also discuss advantages, disadvantages, techniques, and difficulties of these three-dimensional tumor cell-culture systems when applied specifically in virotherapy research.
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Laboratory Comparison of Low-Cost Particulate Matter Sensors to Measure Transient Events of Pollution
Airborne particulate matter (PM) exposure has been identified as a key environmental risk factor, associated especially with diseases of the respiratory and cardiovascular system and with almost 9 million premature deaths per year. Low-cost optical sensors for PM measurement are desirable for monitoring exposure closer to the personal level and particularly suited for developing spatiotemporally dense city sensor networks. However, questions remain over the accuracy and reliability of the data they produce, particularly regarding the influence of environmental parameters such as humidity and temperature, and with varying PM sources and concentration profiles. In this study, eight units each of five different models of commercially available low-cost optical PM sensors (40 individual sensors in total) were tested under controlled laboratory conditions, against higher-grade instruments for: lower limit of detection, response time, responses to sharp pollution spikes lasting <1 [Formula: see text] , and the impact of differing humidity and PM source. All sensors detected the spikes generated with a varied range of performances depending on the model and presenting different sensitivity mainly to sources of pollution and to size distributions with a lesser impact of humidity. The sensitivity to particle size distribution indicates that the sensors may provide additional information to PM mass concentrations. It is concluded that improved performance in field monitoring campaigns, including tracking sources of pollution, could be achieved by using a combination of some of the different models to take advantage of the additional information made available by their differential response.
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Chronic Cognitive Impairment in AQP4+ NMOSD With Improvement in Cognition on Eculizumab: A Report of Two Cases
Cognitive impairment may be associated with aquaporin-4 antibody positive (AQP4+) NMOSD, particularly where there is prominent cerebral, corpus callosum, or thalamic involvement. It is unclear to what extent this phenomenon may be treatable after months to years. We describe two cases of AQP4+ NMOSD with cognitive impairment persisting over more than 6 months, where cognition improved after eculizumab was initiated. In the first case, a 51-year-old woman presented with a 2-month history of cognitive decline and ataxia, and diffuse involvement of the corpus callosum on MRI. AQP4 antibody testing returned positive. Cognitive impairment persisted on therapy with mycophenolate, then rituximab. She was switched to eculizumab from rituximab 18 months after disease onset because of breakthrough optic neuritis; memory and cognitive function improved on eculizumab. In the second case, a 26-year-old woman initially presented with visual, auditory and tactile hallucinations, and impairment in activities of daily living, and was given a diagnosis of schizophrenia. Nine months later she was hospitalized for increasing confusion. MRI showed leukoencephalopathy and diffuse involvement of the corpus callosum with multiple enhancing callosal lesions. AQP4 antibody testing was positive and CSF testing for other antibodies of autoimmune encephalitis was negative. She had some improvement in cognition with high dose corticosteroids but remained significantly impaired. On follow-up, her repeat MRI showed a small new right inferomedial frontal enhancing lesion although she did not complain of any new cognitive issues, her MOCA score was 21/30, and she was started on eculizumab. Two months after eculizumab initiation she and her family reported cognitive improvement and MOCA score was 25/30. Common features of these two cases included extensive callosal involvement and an element of ongoing gadolinium enhancement on MRI. Our experience suggests the possibility that cognitive impairment may be amenable to immunotherapy in certain cases of NMOSD.
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Factores relacionados con efectos adversos psiquiátricos en personal de salud durante la pandemia de COVID-19 en Ecuador
Introducción: Desde la aparición de la enfermedad por el nuevo coronavirus de 2019 (COVID-19), el mundo se enfrentó a una pandemia con consecuencias a todo nivel. En muchos países los sistemas de salud se han visto colapsados y el personal de salud ha tenido que enfrentarse a esta crisis en primera línea. Los efectos adversos sobre la salud mental del personal sanitario han sido ampliamente reportados. La presente investigación se enfoca en identificar los principales factores asociados con efectos adversos psicológicos. Métodos: Estudio descriptivo, transversal, basado en encuestas, aplicando los test PHQ-9, GAD-7, ISI y EIE-R a personal de salud de Ecuador durante la pandemia de COVID-19. Resultados: Participaron 1.028 personas, distribuidas en: 557 médicos (54,18%), 349 enfermeras (33,94%), 29 laboratoristas (2,82%), 27 paramédicos (2,62%), 52 psicólogos (5,05%) y 14 terapeutas respiratorios (1,36%), de 16 de las 24 provincias de Ecuador. El 27,3% tenía síntomas de depresión; el 39,2%, síntomas de ansiedad; el 16,3%, insomnio y el 43,8%, síntomas de TEPT; los 4 tipos de síntomas iban de moderados a graves. Los factores asociados más relevantes fueron: trabajar en Guayas (la provincia más afectada) (OR = 2,18 para síntomas depresivos y OR = 2,59 para síntomas de TEPT); ser médico posgradista (OR = 1,52 para síntomas depresivos y OR = 1,57 para insomnio), percepción de no contar con el equipo de protección adecuado (OR = 1,71 para síntomas de depresión y OR = 1,57 para síntomas de ansiedad) y ser mujer (OR = 1,39 para ansiedad). Conclusiones: El personal de salud puede tener una afección mental importante que puede requerir intervención médica psiquiátrica y psicológica. Los principales factores asociados se relacionan sobre todo con vivir y trabajar en ciudades con mayor número de casos y las características del trabajo, como ser médico posgradista, así como la percepción propia de seguridad. Se requiere realizar más estudios según evolucione la pandemia. Introduction: Since the emergence of the novel coronavirus disease (COVID-19), the world has faced a pandemic with consequences at all levels. In many countries, the health systems collapsed and healthcare professionals had to be on the front line of this crisis. The adverse effects on the mental health of healthcare professionals have been widely reported. This research focuses on identifying the main factors associated with adverse psychological outcomes. Methods: Descriptive, cross-sectional study based on surveys, applying the PHQ-9, GAD-7, ISI and EIE-R tests to healthcare professionals from Ecuador during the COVID-19 pandemic. Results: 1,028 participants, distributed in: 557 physicians (54.18%), 349 nurses (33.94%), 29 laboratory workers (2.82%), 27 paramedics (2.62%), 52 psychologists (5.05%) and 14 respiratory therapists (1.36%), from 16 of the 24 provinces of Ecuador. Of these, 27.3% presented symptoms of depression, 39.2% anxiety symptoms, 16.3% insomnia and 43.8% symptoms of PTSD, with the 4 types of symptoms ranging from moderate to severe. The most relevant associated factors were: working in Guayas (the most affected province) (OR = 2.18 for depressive symptoms and OR = 2.59 for PTSD symptoms); being a postgraduate doctor (OR = 1.52 for depressive symptoms and OR = 1.57 for insomnia), perception of not having the proper protective equipment (OR = 1.71 for symptoms of depression and OR = 1.57 for symptoms of anxiety) and being a woman (OR = 1.39 for anxiety). Conclusions: Healthcare professionals can suffer a significant mental condition that may require psychiatric and psychological intervention. The main associated factors are primarily related to living and working in cities with a higher number of cases and the characteristics of the job, such as being a postgraduate doctor, as well as the perception of security. The main risk factors are primarily related to geographical distribution and job characteristics, such as being a resident physician and self-perception of safety. Further studies are required as the pandemic evolves.
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Bottom-up solutions in a time of crisis: the case of Covid-19 in South Korea
Innovation systems have seen diverse actors attempting to tame the Covid-19 crisis, under varying degrees of government direction Largely neglected in scholarly and public attention, however, are ?bottom-up? solutions arising from the periphery of innovation systems Drawing on inductive case research on a fringe doctor who invented the idea of the drive-through testing system, and two university student teams that developed coronavirus applications, this study examines how peripheral actors generate innovative, bottom-up solutions at speed in a time of crisis Our findings reveal that, in a crisis situation, bottom-up solutions transpire on the basis of three innovation drivers: (a) peripheral status, expediting the commence of innovation activities;(b) interdisciplinary collaboration, enabling access to a greater spectrum of knowledge and perspectives;and (c) prior knowledge, prescribing the direction of solution generation We also identify that system intermediaries support the innovation activities of peripheral actors, thereby helping bottom-up solutions to become more customer facing Such functions of intermediaries include demand articulation, technical assistance, and promulgation of generated solutions Our findings offer theoretical implications for the literature on innovation in a time of crisis and practical implications for governments and organizations preparing themselves for the potential second wave of coronavirus emergencies, or even a completely new form of future crisis
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Coagulation phenotypes in sepsis and effects of recombinant human thrombomodulin: an analysis of three multicentre observational studies
BACKGROUND: A recent randomised trial showed that recombinant thrombomodulin did not benefit patients who had sepsis with coagulopathy and organ dysfunction. Several recent studies suggested presence of clinical phenotypes in patients with sepsis and heterogenous treatment effects across different sepsis phenotypes. We examined the latent phenotypes of sepsis with coagulopathy and the associations between thrombomodulin treatment and the 28-day and in-hospital mortality for each phenotype. METHODS: This was a secondary analysis of multicentre registries containing data on patients (aged ≥ 16 years) who were admitted to intensive care units for severe sepsis or septic shock in Japan. Three multicentre registries were divided into derivation (two registries) and validation (one registry) cohorts. Phenotypes were derived using k-means with coagulation markers, platelet counts, prothrombin time/international normalised ratios, fibrinogen, fibrinogen/fibrin-degradation-products (FDP), D-dimer, and antithrombin activities. Associations between thrombomodulin treatment and survival outcomes (28-day and in-hospital mortality) were assessed in the derived clusters using a generalised estimating equation. RESULTS: Four sepsis phenotypes were derived from 3694 patients in the derivation cohort. Cluster dA (n = 323) had severe coagulopathy with high FDP and D-dimer levels, severe organ dysfunction, and high mortality. Cluster dB had severe disease with moderate coagulopathy. Clusters dC and dD had moderate and mild disease with and without coagulopathy, respectively. Thrombomodulin was associated with a lower 28-day (adjusted risk difference [RD]: − 17.8% [95% CI − 28.7 to − 6.9%]) and in-hospital (adjusted RD: − 17.7% [95% CI − 27.6 to − 7.8%]) mortality only in cluster dA. Sepsis phenotypes were similar in the validation cohort, and thrombomodulin treatment was also associated with lower 28-day (RD: − 24.9% [95% CI − 49.1 to − 0.7%]) and in-hospital mortality (RD: − 30.9% [95% CI − 55.3 to − 6.6%]). CONCLUSIONS: We identified four coagulation marker-based sepsis phenotypes. The treatment effects of thrombomodulin varied across sepsis phenotypes. This finding will facilitate future trials of thrombomodulin, in which a sepsis phenotype with high FDP and D-dimer can be targeted. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13054-021-03541-5.
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Intubation among emergency department and hospitalized patients with COVID-19: A retrospective analysis of 18,467 patients
INTRODUCTION: As of December 18, 2020, there have been nearly 17 million cases of COVID-19 in the United States. Early studies reported intubation rates between 12.2-29.2% with varying criteria between sites and as the pandemic has progressed. With the rapid spread of infection and increased use of ventilators, triage of patients based on factors such as their past medical history can help guide resource allocation. This retrospective study examined a large multi-center cohort of patients with COVID-19 infection to identify risk factors associated with intubation. METHODS: Adult patients with an emergency department or inpatient encounter from December 1, 2019 to June 30, 2020 with COVID-19 were included in the Cerner COVID-19 dataset, which was extracted from 62 hospital systems throughout the United States. Only patients with at least two previous visits in the past 5 years were included. ICD-10 diagnosis codes, demographic data, and discharge status were collected and classified based on intubation status. Logistic regression model identified independently associated risk factors for intubation. RESULTS:18,467 patients with confirmed SARS-CoV-2 infection were identified, with 5,525 seen only in the ED and 12,942 hospitalized. The mean age was 54.3 ± 20.5 years, the mean body mass index (BMI) was 30.42 ± 11.72, 8,397 (45.6%) patients were male, and 938 (7.2%) were intubated. 1,829 (14.1%) patients died in the hospital and 4,185 (22.7%) had a non-routine discharge, which encompasses home health care, short-term hospital, other facility including intermediate care and skilled nursing home. Using multivariate logistic regression, patients who were intubated were more likely to present with stroke, pneumonia, acute kidney injury, septic shock, respiratory failure, cardiac arrest, and encephalopathy. From patient demographics and past medical history, male sex (p=0.011), age &gt; 35 (p=0.035 for 35-49 years old;p&lt;0.001 for &gt;50 years old), BMI &gt; 30 (p=0.013 for BMI 30-40;p=0.004 for BMI &gt;40), and previous respiratory failure (p=0.014) were independently associated with intubation. CONCLUSIONS: Among patients with COVID-19, male sex, increased age, BMI &gt; 30, and previous respiratory failure were independently associated with the risk for intubation. Intubated patients were also more likely to present with stroke, pneumonia, acute kidney injury, septic shock, respiratory failure, cardiac arrest, and encephalopathy. Clinicians should be aware of these independent risk factors for intubation to facilitate resource allocation and minimize the possibility of unanticipated crash intubations.
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Mapping Cancer in Africa: A Comprehensive and Comparable Characterization of 34 Cancer Types Using Estimates From GLOBOCAN 2020
OBJECTIVE: Cancer incidence and mortality rates in Africa are increasing, yet their geographic distribution and determinants are incompletely characterized. The present study aims to establish the spatial epidemiology of cancer burden in Africa and delineate the association between cancer burden and the country-level socioeconomic status. The study also examines the forecasts of the cancer burden for 2040 and evaluates infrastructure availability across all African countries. METHODS: The estimates of age, sex, and country-specific incidence and mortality of 34 neoplasms in 54 African countries, were procured from GLOBOCAN 2020. Mortality-to-incidence ratio (MIR) was employed as a proxy indicator of 5-year survival rates, and the socioeconomic development of each country was measured using its human development index (HDI). We regressed age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and MIR on HDI using linear regression model to determine the relationship between cancer burden and HDI. Maps were generated for each cancer group for each country in Africa. The data about the cancer infrastructure of African countries were extracted from the WHO Cancer Country Profiles. RESULTS: In Africa, an estimated 1.1 million new cases [95% uncertainty intervals (UIs) 1.0 – 1.3 million] and 711,429 [611,604 – 827,547] deaths occurred due to neoplasms in 2020. The ASIR was estimated to be 132.1/100,000, varying from 78.4/100,000 (Niger) to 212.5/100,000 (La Réunion) in 2020. The ASMR was 88.8/100,000 in Africa, ranging from 56.6/100,000 in the Republic of the Congo to 139.4/100,000 in Zimbabwe. The MIR of all cancer combined was 0.64 in Africa, varying from 0.49 in Mauritius to 0.78 in The Gambia. HDI had a significant negative correlation with MIR of all cancer groups combined and main cancer groups (prostate, breast, cervical and colorectal). HDI explained 75% of the variation in overall 5-year cancer survival (MIR). By 2040, the burden of all neoplasms combined is forecasted to increase to 2.1 million new cases and 1.4 million deaths in Africa. CONCLUSION: High cancer mortality rates in Africa demand a holistic approach toward cancer control and management, including, but not limited to, boosting cancer awareness, adopting primary and secondary prevention, mitigating risk factors, improving cancer infrastructure and timely treatment.
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Unsupervised cross-user adaptation in taste sensation recognition based on surface electromyography with conformal prediction and domain regularized component analysis
Human taste sensation can be qualitatively described with surface electromyography. However, the pattern recognition models trained on one subject (the source domain) do not generalize well on other subjects (the target domain). To improve the generalizability and transferability of taste sensation models developed with sEMG data, two methods were innovatively applied in this study: domain regularized component analysis (DRCA) and conformal prediction with shrunken centroids (CPSC). The effectiveness of these two methods was investigated independently in an unlabeled data augmentation process with the unlabeled data from the target domain, and the same cross-user adaptation pipeline were conducted on six subjects. The results show that DRCA improved the classification accuracy on six subjects (p<0.05), compared with the baseline models trained only with the source domain data;, while CPSC did not guarantee the accuracy improvement. Furthermore, the combination of DRCA and CPSC presented statistically significant improvement (p<0.05) in classification accuracy on six subjects. The proposed strategy combining DRCA and CPSC showed its effectiveness in addressing the cross-user data distribution drift in sEMG-based taste sensation recognition application. It also shows the potential in more cross-user adaptation applications.
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Transitioning from In Person to Online Human Anatomy: Student Perspectives from the COVID-19 Pandemic.
INTRODUCTION & OBJECTIVE In March 2020, medical schools around the country had to quickly transition from in person cadaveric anatomy curricula to an online distance learning format due to the COVID-19 pandemic. This posed a challenge for students who had acclimated to learning anatomy inside the laboratory for the majority of their first year of medical school. The purpose of this study was to assess student perceptions of the abrupt transition from in person anatomy dissections and practical exams to an exclusively online format. MATERIALS AND METHODS An anonymous survey was distributed to medical students from the Class of 2023 at the Medical College of Georgia at Augusta University (n=191) in February 2021. The survey assessed student perceptions of the impact of COVID-19 shutdowns on their medical education. In total, 45 responses were recorded, and survey data was analyzed using SPSS software. Nonparametric methods were used due to the ordinal nature of the Likert scale responses. A Wilcoxon signed rank test was performed. In addition, focus groups were conducted with 11 medical students who had completed the survey. RESULTS A majority of respondents (82.55%) stated that their learning and understanding of anatomy was worse after cancellation of in person anatomy lab dissections. In contrast, understanding of didactic lecture material was split, with 37.5% stating that online lectures had no impact on their learning and understanding of the material, 31.25% stating understanding was worse, and 25% stating it was better following transition to online-only lectures. The results from the Wilcoxon signed rank test of Likert scale responses indicated that students perceived impact of cancelling in person anatomy lab as significantly worse compared to the impact of cancelling in person lectures (p<0.001). Focus group responses echoed this theme, with the loss of 3-dimensional visual and tactile learning in laboratory cited most frequently by participants as a challenge with the transition to online anatomy. CONCLUSION Medical student respondents in the class of 2023 perceived online anatomy as inferior to in person laboratory sessions after the COVID-19 shut-down in March 2020. The transition from in person to online anatomy was more impactful on student understanding of material than the transition from in person to online didactic lectures. Of note, the students surveyed had completed the majority of their anatomy curriculum in person prior to the transition online. SIGNIFICANCE/IMPLICATION The medical school shutdowns that occurred in March 2020 due to the COVID-19 pandemic highlighted the importance of in person interaction with cadaveric specimens in anatomy education, especially in the context of how students were initially exposed to content. When possible, consideration should be given to learning approaches that students are familiar with and how changes to the curriculum will impact them.
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COVID-19 and postural tachycardia syndrome: a case series
BACKGROUND: Postural tachycardia syndrome (PTS) is a novel identified sequela of COVID-19 infection. This observational study describes clinical presentation, testing, and treatment response in seven patients diagnosed with PTS following COVID-19 infection. CASE SUMMARY: A total of seven active patients (three collegiate athletes, one recreational athlete, two registered nurses, one hospitality employee), age 24 ± 6 years, and six females were followed for a mean of 152 ± 105 days after contracting COVID-19. Tilt table was performed to establish the diagnosis. The most common presenting symptoms were palpitations (7/7), dyspnoea (6/7), and gastrointestinal complaints (5/7). One patient required hospitalization for symptom management. The mean latency of PTS onset following COVID-19 was 21 ± 15 days. Electrocardiograms (ECGs) demonstrated sinus rhythm in all patients, one with resting sinus tachycardia. Echocardiogram demonstrated normal systolic and diastolic left ventricular function in all patients. On tilt table testing, baseline heart rate (HR) was 72 ± 12 with maximum HR reaching 136 ± 13. Six of seven patients failed to respond to supportive therapy alone, and two patients failed medical management with ivabradine, midodrine, and/or metoprolol. Of three severely symptomatic patients, two demonstrated some degree of clinical recovery with intravenous immunoglobulin (IVIG). DISCUSSION: This novel case series describes the development of PTS in the context of COVID-19 infection. Severity of symptoms and response to treatment was heterogeneous. Interestingly, patients were poorly responsive to traditional PTS treatments, but IVIG showed potential as a possible therapeutic strategy for refractory PTS in two patients, particularly following COVID-19 infection.
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A look at the first quarantined community in the United States: Response of religious communal organizations and implications for public health during the COVID-19 pandemic
The current study examined anxiety and distress among members of the first community to be quarantined in the United States due to the COVID-19 pandemic. In addition to being historically significant, the current sample was unusual in that those quarantined were all members of a Modern Orthodox Jewish community and were connected via religious institutions at which exposure may have occurred. We sought to explore the community and religious factors unique to this sample, as they relate to the psychological and public health impact of quarantine. Community organizations were trusted more than any other source of COVID 19-related information, including federal, state, and other government agencies, including the CDC, WHO and media news sources. This was supported qualitatively with open-ended responses in which participants described the range of supports organized by community organizations. These included tangible needs (i.e. food delivery), social support, virtual religious services, and dissemination of COVID-19 related information. The overall levels of distress and anxiety were elevated and directly associated with what was reported to be largely inadequate and inconsistent health related information received from local departments of health. In addition, the majority of participants felt that perception of or concern about future stigma related to a COVID-19 diagnosis or association of COVID-19 with the Jewish community was high and also significantly predicted distress and anxiety. The current study demonstrates the ways in which religious institutions can play a vital role in promoting the well-being of their constituents. During this unprecedented pandemic, public health authorities have an opportunity to form partnerships with religious institutions in the common interests of promoting health, relaying accurate information and supporting the psychosocial needs of community members, as well as protecting communities against stigma and discrimination.
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Situation of the R&D Sector in Poland in the Face of the Current Crisis
How has the current crisis caused by the COVID-19 pandemic affected R&D and innovation in Poland? Numerous international studies conducted after the Great Depression in 2008-2010 show a strong procyclicality of investments in R&D and innovation in companies: investments rise during the economic upturn and fall sharply during the crisis. This procyclicality is driven within firms both by internal financial resources and by differences in market incentives to innovate. It seems likely that the COVID-19 crisis caused financial weakness for many actors, having the most significant impact on the willingness or ability of smaller firms to support R&D and innovation. However, where firms are able to sustain these investments, evidence from the crisis a decade ago suggests that they will be more likely to survive, grow more strongly, and have higher profitability. Based on the analysis of the literature and macroeconomic data, this paper presents several recommendations that, if implemented by R&D actors, could help increase the efficiency of operations, even in times of crisis. © 2021 Kinga Karpińska, published by Sciendo.
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Optic neuritis following SARS-CoV-2 infection
The most common neurologic symptoms in COVID-19 are headache, anosmia, and dysgeusia. Optic neuritis is an unusual manifestation of SARS-CoV-2 infection. We report a case of a patient who initially consulted for vision loss in the absence of respiratory symptoms. She was diagnosed with optic neuritis following SARS-CoV-2 infection. Delay in diagnosis of neuro-ophthalmic manifestations of COVID-19 may lead to irreversible optic atrophy. A mechanism in which viral antigens would induce an immune response against self-proteins, or direct SARS Cov-2 infection of the central nervous system, may be involved in optic nerve injury.
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Global thrombosis test for assessing thrombotic status and efficacy of antithrombotic diet and other conditions
Because of the high mortality from myocardial infarction and stroke, there is a great demand for finding novel methods of diagnosis, prevention and treatment of these diseases. Most of the current tests measure important determinants of thrombosis such as platelet function, coagulation and fibrinolysis in isolation; therefore, a global test measuring the actual thrombotic status would be more useful in clinical conditions. We obtained considerable experience by using the global thrombosis test, which determines the actual thrombotic status by taking into account the measured platelet reactivity, coagulation and fibrinolytic activities. In animal experiments, we found significant correlation between the ex vivo global thrombosis test measurements and the in vivo thrombotic status. The published evidence for the benefit of an antithrombotic diet with regular physical exercise is also described.
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A scoping research literature review to explore bereavement humor
The death of a loved one is extremely impactful. Although much of the focus now on helping people who are experiencing bereavement grief is oriented to distinguishing complicated from non-complicated grief for early pharmaceutical or psychiatric treatment, lay bereavement support comprises a more common and thus highly important but often unrecognized consideration. A wide variety of lay bereavement programs with diverse components have come to exist. This scoping research literature review focused on bereavement humor, one possible component. Humor has long been recognized as an important social attribute. Researchers have found humor is important for lifting the spirits of ill people and for aiding healing or recovery. However, humor does not appear to have been recognized as a technique that could benefit mourners. A multi-database search revealed only 11 English-language research articles have been published in the last 25 years that focused in whole or in part on bereavement humour. Although minimal evidence exists, these studies indicate bereaved people often use humor and for a number of reasons. Unfortunately, no investigations revealed when and why bereavement humor may be inappropriate or unhelpful. Additional research, multi-cultural investigations in particular, are needed to establish humor as a safe and effective bereavement support technique to apply or to use. Bereavement humor could potentially be used more often to support grieving people and bereaved people should perhaps be encouraged to use humor in their daily lives.
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Latent trajectories of symptom change during cognitive-behavior therapy predict post-treatment worsening of symptoms: a preliminary examination among outpatients with bulimia-spectrum eating disorders
PURPOSE: Up to 44% of individuals with bulimia nervosa (BN) experience worsening of symptoms after cognitive behavior therapy (CBT). Identifying risk for post-treatment worsening of symptoms using latent trajectories of change in eating disorder (ED) symptoms during treatment could allow for personalization of treatment to improve long-term outcomes METHODS: Participants (N = 56) with BN-spectrum EDs received 16 sessions of CBT and completed digital self-monitoring of eating episodes and ED behaviors. The Eating Disorder Examination was used to measured ED symptoms at post-treatment and 3-month follow-up. Latent growth mixture modeling of digital self-monitoring data identified latent growth classes. Kruskal–Wallis H tests examined effect of trajectory of change in ED symptoms on post-treatment to follow-up symptom change. RESULTS: Multi-class models of change in binge eating, compensatory behaviors, and regular eating improved fit over one-class models. Individuals with high frequency-rapid response in binge eating (H(1) = 10.68, p =0 .001, η(2) = 0.24) had greater recurrence of compensatory behaviors compared to individuals with low frequency-static response. Individuals with static change in regular eating exhibited greater recurrence of binge eating than individuals with moderate response (H(1) = 8.99, p = 0.003, η(2) = 0.20). CONCLUSION: Trajectories of change in ED symptoms predict post-treatment worsening of symptoms. Personalized treatment approaches should be evaluated among individuals at risk of poor long-term outcomes. LEVEL OF EVIDENCE: IV, evidence obtained from multiple time series. TRIAL REGISTRATION: ClinicalTrials.gov registration number NCT03673540, registration date: September 17, 2018. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40519-021-01348-5.
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Performance of the Innova SARS-CoV-2 antigen rapid lateral flow test in the Liverpool asymptomatic testing pilot: population based cohort study
OBJECTIVE: To assess the performance of the SARS-CoV-2 antigen rapid lateral flow test (LFT) versus polymerase chain reaction testing in the asymptomatic general population attending testing centres. DESIGN: Observational cohort study. SETTING: Community LFT pilot at covid-19 testing sites in Liverpool, UK. PARTICIPANTS: 5869 asymptomatic adults (≥18 years) voluntarily attending one of 48 testing sites during 6-29 November 2020. INTERVENTIONS: Participants were tested using both an Innova LFT and a quantitative reverse-transcriptase polymerase chain reaction (RT-qPCR) test based on supervised self-administered swabbing at testing sites. MAIN OUTCOME MEASURES: Sensitivity, specificity, and predictive values of LFT compared with RT-qPCR in an epidemic steady state of covid-19 among adults with no classic symptoms of the disease. RESULTS: Of 5869 test results, 22 (0.4%) LFT results and 343 (5.8%) RT-qPCR results were void (that is, when the control line fails to appear within 30 minutes). Excluding the void results, the LFT versus RT-qPCR showed a sensitivity of 40.0% (95% confidence interval 28.5% to 52.4%; 28/70), specificity of 99.9% (99.8% to 99.99%; 5431/5434), positive predictive value of 90.3% (74.2% to 98.0%; 28/31), and negative predictive value of 99.2% (99.0% to 99.4%; 5431/5473). When the void samples were assumed to be negative, a sensitivity was observed for LFT of 37.8% (26.8% to 49.9%; 28/74), specificity of 99.6% (99.4% to 99.8%; 5431/5452), positive predictive value of 84.8% (68.1% to 94.9%; 28/33), and negative predictive value of 93.4% (92.7% to 94.0%; 5431/5814). The sensitivity in participants with an RT-qPCR cycle threshold (Ct) of <18.3 (approximate viral loads >10(6) RNA copies/mL) was 90.9% (58.7% to 99.8%; 10/11), a Ct of <24.4 (>10(4) RNA copies/mL) was 69.4% (51.9% to 83.7%; 25/36), and a Ct of >24.4 (<10(4) RNA copies/mL) was 9.7% (1.9% to 23.7%; 3/34). LFT is likely to detect at least three fifths and at most 998 in every 1000 people with a positive RT-qPCR test result with high viral load. CONCLUSIONS: The Innova LFT can be useful for identifying infections among adults who report no symptoms of covid-19, particularly those with high viral load who are more likely to infect others. The number of asymptomatic adults with lower Ct (indicating higher viral load) missed by LFT, although small, should be considered when using single LFT in high consequence settings. Clear and accurate communication with the public about how to interpret test results is important, given the chance of missing some cases, even at high viral loads. Further research is needed to understand how infectiousness is reflected in the viral antigen shedding detected by LFT versus the viral loads approximated by RT-qPCR.
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Towards an open and effective dialogue on complementary medicine in oncology: protocol of patient participatory study ‘COMMON’
INTRODUCTION: Approximately half of patients with cancer use some form of complementary medicine alongside conventional cancer treatment. The topic of complementary medicine often remains undiscussed in consultations between patients with cancer and their healthcare providers. This results in increased risks for adverse or interaction effects and decreased access to the benefits of evidence-based complementary medicine for patients with cancer. This paper describes the design of patient participatory study titled ‘COMMON’ that aims to explore and enhance open and effective communication about complementary medicine in oncology. The study is carried out in collaboration with 12 (former) patients with breast cancer as coresearchers. METHODS AND ANALYSIS: The study complies with the six steps of the intervention mapping framework. Three non-academic hospitals recruit participants (patients with cancer, oncology healthcare providers and managers) for interviews about the organisation, experiences and needs regarding complementary medicine. To assess communication about complementary medicine, recorded oncology consultations are analysed. For an overview of evidence-based complementary medicine available to patients with cancer, a review of reviews is conducted on the evidence on cancer patient-reported outcomes of complementary medicine frequently used by patients with cancer, supplemented with an online search and survey among organisations and persons providing complementary medicine to patients with cancer. Together, these steps generate input for the development of a toolbox that supports an open and effective discussion on complementary medicine in oncology. In a pilot study, acceptability and usability of the toolbox are assessed among patients with cancer and oncology healthcare providers. Dissemination of the toolbox is covered by the commitment of stakeholder parties. ETHICS AND DISSEMINATION: The Medical Ethics Committee Arnhem-Nijmegen declared the study was exempted from formal approval under the Dutch Medical Research Involving Human Subjects Act. The results will be disseminated through open-access, peer-reviewed publications, stakeholder-reporting and presentations at relevant conferences.
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Cardiac ECM: Its Epigenetic Regulation and Role in Heart Development and Repair
The extracellular matrix (ECM) is the non-cellular component in the cardiac microenvironment, and serves essential structural and regulatory roles in establishing and maintaining tissue architecture and cellular function. The patterns of molecular and biochemical ECM alterations in developing and adult hearts depend on the underlying injury type. In addition to exploring how the ECM regulates heart structure and function in heart development and repair, this review conducts an inclusive discussion of recent developments in the role, function, and epigenetic guidelines of the ECM. Moreover, it contributes to the development of new therapeutics for cardiovascular disease.
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Integrin Activation Enables Sensitive Detection of Functional CD4+ and CD8+ T Cells: Application to Characterize SARS-CoV-2 Immunity
We have previously shown that conformational change in the ß2-integrin is a very early activation marker that can be detected with fluorescent multimers of its ligand intercellular adhesion molecule (ICAM)-1 for rapid assessment of antigen-specific CD8+ T cells. In this study, we describe a modified protocol of this assay for sensitive detection of functional antigen-specific CD4+ T cells using a monoclonal antibody (clone m24 Ab) specific for the open, high-affinity conformation of the ß2-integrin. The kinetics of ß2-integrin activation was different on CD4+ and CD8+ T cells (several hours vs. few minutes, respectively); however, m24 Ab readily stained both cell types 4-6 h after antigen stimulation. With this protocol, we were able to monitor ex vivo effector and memory CD4+ and CD8+ T cells specific for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), cytomegalovirus (CMV), Epstein-Barr virus (EBV), and hepatitis B virus (HBV) in whole blood or cryopreserved peripheral blood mononuclear cells (PBMCs) of infected or vaccinated individuals. By costaining ß2-integrin with m24 and CD154 Abs, we assessed extremely low frequencies of polyfunctional CD4+ T cell responses. The novel assay used in this study allows very sensitive and simultaneous screening of both CD4+ and CD8+ T cell reactivities, with versatile applicability in clinical and vaccination studies.
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Thermal spread of vessel-sealing devices evaluated in a clinically relevant in vitro model.
INTRODUCTION Bipolar vessel-sealing devices (VSDs) have advantages in urological surgeries (less hemorrhage, shorter operating time). However, these instruments can cause thermal injuries, which can result in neural damage and necrosis. The objectives of this study were to establish a reproducible in vitro model for standardized assessment of electrosurgical devices and to evaluate whether optimized placement of surgical instruments can reduce the thermal spread. METHODS We evaluated thermal spread of two VSDs in vitro using thin bovine muscle strips. Thermal injury was measured using an infrared camera, temperature probes and histology. The recordings were made with the VSD alone and with a rectangular clamp next to the VSD. RESULTS Both instruments showed a significant temperature spread of 2.5 mm lateral to the VSD. The placement of a metal clamp next to the VSD significantly reduced the temperature spread. Histological examinations were able to underline these findings. CONCLUSIONS In this study we describe a straightforward clinically relevant in vitro model for the evaluation of future electrosurgical instruments. We demonstrated that the thermal spread of VSD could be further reduced by optimized placement of an additional surgical instrument. Our results could help surgeons protect sensitive structures like nerves in the vicinity of the VSD.
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Past, present, and future barriers to digital transformation in manufacturing: A review
Research in digital transformation (DT) is burgeoning Meanwhile, the COVID-19 pandemic has not only influenced both day-to-day functions of firms dramatically, but also their efforts to become more digitally mature In this review paper, we discuss the barriers to DT before, during, and what may well continue after the COVID-19 pandemic and offer a new strategy discipline—Strategic Doing—that may be useful to manufacturing firms in achieving successful DT We discuss the divergent definitions and drivers of DT diving deep into the barriers for manufacturing firms to mature digitally We briefly describe digital readiness and current efforts of DT in manufacturing while describing the impact of COVID-19 on DT initiatives We conclude by describing Strategic Doing and suggesting new paths for research in this area
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Secretive Jasons to offer advice on how to reopen academic labs shut by pandemic
A group of prominent academic scientists that has been advising the U S government on security matters since the Cold War is conducting a quick-turnaround, pro bono study of a new threat to national security—the impact of COVID-19 on academic research And this time it’s personal
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Clinical Utility of Emergency Capsule Endoscopy for Diagnosing the Source and Nature of Ongoing Overt Obscure Gastrointestinal Bleeding.
Background and Aims In patients with ongoing overt obscure gastrointestinal bleeding (OGIB), prompt detection of the bleeding source is crucial to treatment success. However, there is no consensus on the optimal timing of diagnostic capsule endoscopy (CE). We investigated the clinical utility of emergency CE for detecting the source of ongoing overt OGIB. Methods We retrospectively evaluated 146 consecutive patients who, between February 2009 and July 2018, underwent emergency CE at Hiroshima University Hospital to detect the source of ongoing overt OGIB. Patients with a bleeding source located outside the small bowel were excluded. The remaining 127 patients were stratified according to the timing of CE relative to the onset of bleeding: patients in group A (n = 15, 12 men; mean age: 75 years; age range: 62-83 years) underwent CE within 48 hours of bleeding onset, whereas patients in group B (n = 112, 73 men; mean age: 65 years; age range: 17-88 years) underwent CE at >48 hours after bleeding onset. All patients underwent double-balloon endoscopy, and the final diagnosis was compared against the CE findings. Results The CE lesion detection rate was significantly higher in group A (12/15 patients, 80%) than in group B (53/112 patients, 47%) (p = 0.0174). There was no significant difference between the two groups regarding the patients' background characteristics. Vascular lesions were the most frequent finding in both groups. The diagnostic concordance rate between emergency CE and double-balloon endoscopy was 100% in group A and 92.9% in group B. Rebleeding after endoscopic treatment was confirmed in only one patient in group B. Conclusions Emergency CE represents a useful diagnostic modality in patients with ongoing overt OGIB, potentially improving detection rates and reducing rebleeding risk.
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Future Path Toward TB Vaccine Development: Boosting BCG or Re-educating by a New Subunit Vaccine
Tuberculosis (TB), an infectious disease caused by Mycobacterium tuberculosis (Mtb), kills 5,000 people per day globally. Rapid development and spread of various multi drug-resistant strains of Mtb emphasize that an effective vaccine is still the most cost-effectives and efficient way of controlling and eradicating TB. Bacillus Calmette-Guerin (BCG), the only licensed TB vaccine, still remains the most widely administered human vaccine, but is inefficient in protecting from pulmonary TB in adults. The protective immunity afforded by BCG is thought to wane with time and considered to last only through adolescent years. Heterologous boosting of BCG-primed immune responses using a subunit vaccine represents a promising vaccination approach to promote strong cellular responses against Mtb. In our earlier studies, we discovered lipopeptides of ESAT-6 antigen with strong potential as a subunit vaccine candidate. Here, we have investigated that potential as a booster to BCG vaccine in both a pre-exposure preventive vaccine and a post-exposure therapeutic vaccine setting. Surprisingly, our results demonstrated that boosting BCG with subunit vaccine shortly before Mtb challenge did not improve the BCG-primed immunity, whereas the subunit vaccine boost after Mtb challenge markedly improved the quantity and quality of effector T cell responses and significantly reduced Mtb load in lungs, liver and spleen in mice. These studies suggest that ESAT-6 lipopeptide-based subunit vaccine was ineffective in overcoming the apparent immunomodulation induced by BCG vaccine in Mtb uninfected mice, but upon infection, the subunit vaccine is effective in re-educating the protective immunity against Mtb infection. These important results have significant implications in the design and investigation of effective vaccine strategies and immunotherapeutic approaches for individuals who have been pre-immunized with BCG vaccine but still get infected with Mtb.
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UV-C light completely blocks highly contagious Delta SARS-CoV-2 aerosol transmission in hamsters
Behavioral and medical control measures are not effective in containing the spread of SARS-CoV-2. Here we report on the effectiveness of a preemptive environmental strategy using UV-C light to prevent airborne transmission of the virus in a hamster model and show that UV-C exposure completely prevents airborne transmission between individuals
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Long-Term Monitoring of Amphibian Populations of a National Park in Northern Spain Reveals Negative Persisting Effects of Ranavirus, but Not Batrachochytrium dendrobatidis
Amphibians are the most highly threatened vertebrates, and emerging pathogens are a serious threat to their conservation. Amphibian chytrid fungi and the viruses of the Ranavirus genus are causing disease outbreaks worldwide, including in protected areas such as National Parks. However, we lack information about their effect over amphibian populations in the long-term, and sometimes these mortality episodes are considered as transient events without serious consequences over longer time-spans. Here, we relate the occurrence of both pathogens with the population trends of 24 amphibian populations at 15 sites across a national Park in northern Spain over a 14-year period. Just one out 24 populations presents a positive population trend being free of both pathogens, while seven populations exposed to one or two pathogens experienced strong declines during the study period. The rest of the study populations (16) remain stable, and these tend to be of species that are not susceptible to the pathogen present or are free of pathogens. Our study is consistent with infectious diseases playing an important role in dictating amphibian population trends and emphasizes the need to adopt measures to control these pathogens in nature. We highlight that sites housing species carrying Ranavirus seems to have experienced more severe population-level effects compared to those with the amphibian chytrid fungus, and that ranaviruses could be just as, or more important, other more high-profile amphibian emerging pathogens.
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Spreading of COVID-19 in Italy as the spreading of a wave packet
We find that the spreading of the COVID-19 pandemic in Italy can be described as the propagation of a wave packet in a dispersive medium where the effect of lockdown is simulated by the dispersion relation of the medium. We start expanding a previous statistical analysis based on the official data provided by the Italian Civil Protection during 100 days, from March 2nd to June 9th. As the total number of people infected with the virus is uncertain, we have considered the trend of ICU patients and the sum of hospitalized patients and the deceased. Both the corresponding curves are well approximated by the same function depending on four free parameters. The model allows to predict the short-term behavior of the pandemic and to estimate the benefits due to lockdown measures.
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New York State and the Nation: Trends in Firearm Purchases and Firearm Violence During the COVID-19 Pandemic.
BACKGROUND The impacts of social stressors on violence during the coronavirus disease 2019 (COVID-19) pandemic are unknown. We hypothesized that firearm purchases and violence would increase surrounding the pandemic. This study determined the impact of COVID-19 and shelter-in-place (SIP) orders on firearm purchases and incidents in the United States (US) and New York State (NYS). METHODS Scatterplots reflected trends in firearm purchases, incidents, and deaths over a 16-month period (January 2019 to April 2020). Bivariate comparisons of SIP and non-SIP jurisdictions before and after SIP (February 2020 vs. April 2020) and April 2020 vs. April 2019 were performed with the Mann-Whitney U test. RESULTS The incidence of COVID-19 in the US increased between February and April 2020 from 24 to 1 067 660 and in NYS from 0 to 304 372. When comparing February to March to April in the US, firearm purchases increased 33.6% then decreased 22.0%, whereas firearm incidents increased 12.2% then again increased by 3.6% and firearm deaths increased 23.8% then decreased in April by 3.8%. In NYS, comparing February to March to April 2020, firearm purchases increased 87.6% then decreased 54.8%, firearm incidents increased 110.1% then decreased 30.8%, and firearm deaths increased 57.1% then again increased by 6.1%. In both SIP and non-SIP jurisdictions, April 2020 firearm purchases, incidents, deaths, and injuries were similar to April 2019 and February 2020 (all P = NS). DISCUSSION Coronavirus disease 2019-related stressors may have triggered an increase in firearm purchases nationally and within NYS in March 2020. Firearm incidents also increased in NYS. SIP orders had no effect on firearm purchases and firearm violence.
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Chinese Society of Anesthesiology expert consensus on anesthetic management of cardiac surgical patients with suspected or confirmed Coronavirus disease 2019
The outbreak of a new coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) in China in December 2019 has brought serious challenges to disease prevention and public health. Patients with severe coronavirus disease 2019 (COVID-19) who undergo cardiovascular surgery necessitate extremely high demands from anesthesia personnel, and face high risks of mortality and morbidity. Based on the current understanding of COVID-19 and the clinical characteristics of cardiovascular surgical patients, the authors provide anesthesia management guidelines for cardiovascular surgery along with the prevention and control of COVID-19.
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COMPARISON OF RADIOFREQUENCY ABLATION AND CURETTAGE IN OSTEOID OSTEOMA IN CHILDREN.
Objective Osteoid osteoma, which is observed in the adolescent and young adult population as benign bone tumors, appears as a single nidus with a diameter < 2 cm and is treated with open surgery. However, technological advances in medicine have made it possible to apply less invasive procedures in surgery. Methods Between 2006-2014, 24 patients < 18 years of age were treated for osteoid osteoma. Patient demographic data, surgical data, complications, and recurrences were noted. Results Twenty-four patients (mean age, 11 [2-18] years) were treated and followed up for a mean 3.58 (range, 1-9) years. Mean patient age in the curettage group was 12.1 (range, 3-18) years. Mean operation length was 69.5 (range, 60-120) minutes. Mean hospital stay was 1.3 (range, 0-2) days. Mean patient age in the radiofrequency ablation (RFA) group was 10.7 (range, 2-17) years. Five patients were female and 8 were male. Mean operation length was 49.6 (range, 20-90) minutes. Mean hospital stay was 0.3 (range, 0-1) days. Mean follow-up time was 1.76 (range, 1-4) years. Mean operation length, hospital stay, and follow-up were significantly shorter in the RFA group. Conclusions Considering reduced costs due to shorter hospitalization periods and the ability to reach anatomically difficult locations, percutaneous procedures are likely to replace the conventional open approach. Level of evidence: II, retrospective study.
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COVID-19 and energy: Influence mechanisms and research methodologies
Considering the important role of energy in modern society, it is imperative to study the current situation and future development of energy under the influence of COVID-19. This paper identifies the current research hotspots, proposes future research directions accordingly, and summarizes the methodologies via a bibliometric analysis. Five research hotspots include COVID-19 and the changes of energy consumption, COVID-19 and the fluctuation of the energy market, COVID-19 and the development of renewable energy, COVID-19 and climate impacts caused by energy consumption, and COVID-19 and the energy policy. According to the influence mechanism of COVID-19 on each hotspot, the pandemic has exerted short-term influencs on energy consumption, energy price, and air pollution. Meanwhile, the pandemic could have a far-reaching impact on the renewable energy sector, climate, and energy policy. In addition, the main methodologies are reviewed, which indicate that regression analysis and scenario analysis are commonly used as the quantitative and qualitative methods, respectively. Moreover, given the nonlinear relations between the pandemic and energy, an artificial neural networks model is used to enhance the prediction efficiency of energy demand and price. Finally, policy implications for obtaining clean, low-carbon, safe, and efficient energy in the context of COVID-19 are proposed.
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Cytotoxic T-Cell-Based Vaccine against SARS-CoV-2: A Hybrid Immunoinformatic Approach
This paper presents an alternative vaccination platform that provides long-term cellular immune protection mediated by cytotoxic T-cells. The immune response via cellular immunity creates superior resistance to viral mutations, which are currently the greatest threat to the global vaccination campaign. Furthermore, we also propose a safer, more facile, and physiologically appropriate immunization method using either intranasal or oral administration. The underlying technology is an adaptation of synthetic long peptides (SLPs) previously used in cancer immunotherapy. The overall quality of the SLP constructs was validated using in silico methods. SLPs comprising HLA class I and class II epitopes were designed to stimulate antigen cross-presentation and canonical class II presentation by dendritic cells. The desired effect is a cytotoxic T cell-mediated prompt and specific immune response against the virus-infected epithelia and a rapid and robust virus clearance. Epitopes isolated from COVID-19 convalescent patients were screened for HLA class I and class II binding (NetMHCpan and NetMHCIIpan) and highest HLA population coverage (IEDB Population Coverage). 15 class I and 4 class II epitopes were identified and used for this SLP design. The constructs were characterized based on their toxicity (ToxinPred), allergenicity (AllerCatPro), immunogenicity (VaxiJen 2.0), and physico-chemical parameters (ProtParam). Based on in silico predictions, out of 60 possible SLPs, 36 candidate structures presented a high probability to be immunogenic, non-allergenic, non-toxic, and stable. 3D peptide folding followed by 3D structure validation (PROCHECK) and molecular docking studies (HADDOCK 2.4) with Toll-like receptors 2 and 4 provided positive results, suggestive for favorable antigen presentation and immune stimulation.
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Demyelinating Disease of the Central Nervous System Concurrent With COVID-19
Neurological diseases related to coronavirus disease-2019 (COVID-19) are increasingly reported. We report here three cases that presented with subtle neurologic findings manifesting within a range of 15 days to four months after their COVID-19 diagnoses. Magnetic resonance imaging showed acute multifocal periventricular and subcortical demyelinating lesions. Some of the lesions showed contrast enhancement and diffusion restriction. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) PCR was found in the cerebrospinal fluid of just one patient. All patients received intravenous methylprednisolone therapy. In this report, we aim to discuss the aspects of possible COVID-19-related demyelination that support a diagnosis of multiple sclerosis (MS) or acute disseminated encephalomyelitis (ADEM).
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Providing pharmaceutical care during the COVID-19 pandemic: attitudes and experiences of home-treated patients in Jordan
OBJECTIVES: This study aims to explore home-treated COVID-19 patients’ experiences and perceptions of pharmaceutical care services offered during their sickness. METHODS: This is a cross-sectional online questionnaire study, where a 30-item questionnaire was texted via a link to COVID-19 patients who were tested positive previously. A list of anonymised numbers was obtained from different COVID-19 testing centres. The study received ethical approval from the Institutional Review Board at the King Abdulla University Hospital/Jordan University of Science and Technology. KEY FINDINGS: A total of 268 patients who were previously diagnosed with COVID-19 agreed to participate in this study. Only 22.9% of patients reported taking medications regularly. Almost one-third of respondents (28.7%) indicated that pharmacists were involved in prescribing medicine to patients. Almost half the respondents (49.6%) stated that they or their caregivers obtained information and advice about their medicine from the pharmacists. Only 54.9% of the respondents agreed/strongly agreed that pharmacists have enough scientific information to provide the necessary medical assistance to COVID-19 patients. Patients who work in the medical field, and who always get their medication from the same pharmacy, showed better perception towards pharmaceutical care services that might be provided to COVID-19 patients (P < 0.01). CONCLUSIONS: Pharmacists had an unsatisfactory contribution to the management of the disease in outpatient settings. Moreover, there was a poor perception of the pharmacists’ role including their knowledge, communication skills and counselling skills. Thus, it is essential to improve pharmacists’ knowledge and practices about infectious diseases.
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Functional Activities Detected in the Olfactory Bulb and Associated Olfactory Regions in the Human Brain Using T2-Prepared BOLD Functional MRI at 7T
Olfaction is a fundamental sense that plays a vital role in daily life in humans, and can be altered in neuropsychiatric and neurodegenerative diseases. Blood oxygenation level-dependent (BOLD) functional magnetic resonance imaging (fMRI) using conventional echo-planar-imaging (EPI) based sequences can be challenging in brain regions important for olfactory processing, such as the olfactory bulb (OB) and orbitofrontal cortex, mainly due to the signal dropout and distortion artifacts caused by large susceptibility effects from the sinonasal cavity and temporal bone. To date, few studies have demonstrated successful fMRI in the OB in humans. T2-prepared (T2prep) BOLD fMRI is an alternative approach developed especially for performing fMRI in regions affected by large susceptibility artifacts. The purpose of this technical study is to evaluate T2prep BOLD fMRI for olfactory functional experiments in humans. Olfactory fMRI scans were performed on 7T in 14 healthy participants. T2prep BOLD showed greater sensitivity than GRE EPI BOLD in the OB, orbitofrontal cortex and the temporal pole. Functional activation was detected using T2prep BOLD in the OB and associated olfactory regions. Habituation effects and a bi-phasic pattern of fMRI signal changes during olfactory stimulation were observed in all regions. Both positively and negatively activated regions were observed during olfactory stimulation. These signal characteristics are generally consistent with literature and showed a good intra-subject reproducibility comparable to previous human BOLD fMRI studies. In conclusion, the methodology demonstrated in this study holds promise for future olfactory fMRI studies in the OB and other brain regions that suffer from large susceptibility artifacts.
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Contribution of Nanotechnology in the Fight Against COVID-19
Coronavirus disease (COVID-19) is a respiratory infectious disease caused by a newly discovered virus strain, severe acute respiratory syndrome coronavirus-2 (SARS-Cov-2) This pandemic spread quickly across nations with a high mortality rate in immunocompromised patients This contagious disease posed a serious threat to health systems It impacted the continents of the earth in a way that could not have been predicted Therefore, many leading funding agencies announced the call for proposal to diagnosis and treatment of COVID-19 pandemic using advanced technology-based methods, including nanotechnology The researchers coming from the nanotechnology community can contribute their efforts to cope with COVID-19 As a community member of nanotechnology, we suggest some new research targets that can be designed and improved, optimized, and developed the existing/new materials in the sub-field of diagnostics and healthcare of nanotechnology The potential research targets to fight against COVID-19 includes Point-of-care diagnostics (POCD), surveillance and monitoring, novel therapeutics, vaccine development, research, and development, repurposing existing drugs with potential therapeutic applications, development of antiviral nanocoating/antimicrobial spray-based coating for PPE, magnetic nanoparticles and viral RNA and rapid detection kits
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Risk factor assessment and outcomes of intra procedural rupture of intracranial aneurysm during endovascular treatment: A race against time.
AIM Introduction: Intra-procedural rupture (IPR) of cerebral aneurysms is a serious complication of endovascular treatment (EVT) that is associated with high rate of mortality and poor outcomes. Therefore, it is important to identify the risk factors for aneurysmal IPR to improve patient outcomes. We evaluated the possible risk factors for aneurysmal IPR and discussed its management and outcomes for patients. MATERIAL AND METHODS Methods: A total of 106 patients with cerebral aneurysm who have undergone EVT were included in this study, with a mean follow-up period of 17.2 months. Risk factors for IPR, such as the aneurysm's location, size and morphology, etc. were evaluated, and the chi-squared test was used for statistical analysis. Clinical outcomes were assessed using the modified Rankin scale (mRS) at 15 months. RESULTS Results: Among all 106 patients who have undergone EVT, five (4.7%) had aneurysmal IPR as well as ruptured aneurysms with subarachnoid haemorrhage (SAH). Among those five patients, primary coiling was performed in three cases and balloon/stent-assisted coiling was performed in two cases, with complete occlusion of the aneurysmal sac achieved in four (4/5) patients. Clinical follow-up with the mRS scores of the patients revealed mortality in one patient (20%), favourable outcomes in three patients (60%) and unfavourable outcomes in one patient (20%). CONCLUSION Conclusion: Aneurysmal IPR is considered a rare but important complication of endovascular coiling that is associated with poor clinical outcomes. Several risk factors are significantly associated with IPR, such as small-sized aneurysm ( 3.5 mm), presence of bleb and parent vessel tortuosity. Acom location, irregular shape and past episode of SAH also increase the risk of IPR, but such association was found to be statistically insignificant in our study. Although IPR is considered a devastating complication, good clinical outcomes can be achieved with early detection and proper management using rapid aneurysmal coil packing and occlusion.
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Social Work Practice: Accounting for Double Injustices Experienced by Women Under the Confluence of Covid-19 Pandemic and Climate Change Impacts in Nyanga, Zimbabwe
In this paper, the researchers argue that the repercussions of the Coronavirus Disease 19 (COVID-19) pandemic are taking a toll on rural women, not as a new phenomenon, but as an amplifier for their historical calamities dovetailed by climate change. The declaration of COVID-19 as a global pandemic by the World Health Organisation ignited widespread pronouncements of national state of disasters in various countries around the globe including Zimbabwe. Subsequently, like other countries, Zimbabwe followed the precautionary measures outlined by the WHO and pronounced its national lockdown to curtail the transmission of the virus. This paper intends to demonstrate how convergence of the COVID-19 pandemic and climate change impacts serves as a double injustice for rural women in Nyanga communities, Zimbabwe. The study was qualitative in nature guided by the descriptive research design. Twenty participants comprising rural women and social workers were selected using purposive and convenience sampling techniques. Data were collected using focus group discussions and key informant interviews. The Thematic Content Analysis was followed to analyse the data from which the findings were derived. This study established that the COVID-19 pandemic is enhancing the catastrophic implications created by climate change on rural women whose food security systems are shattered, livelihood strategies maimed, caregiving roles burgeoning, and access to healthcare systems compromised. This daunting double impact is aggravated by gender inequalities, social exclusion and patriarchal dominance. The centrality of social justice to social work connotes that the profession has a tendentious responsibility to stand in the gap and liberate women from the jaws of these double catastrophes (climate change and COVID-19).
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Fear of COVID-19 in Romania: Validation of the Romanian Version of the Fear of COVID-19 Scale Using Graded Response Model Analysis
One of the basic emotions generated by the COVID-19 pandemic is the fear of contacting this disease. The main aim of this study was to examine the psychometric properties of the Romanian version of the Fear of COVID-19 Scale (FCV-19S), based on classical test theory and item response theory, namely, graded response model. The FCV-19S was translated into Romanian following a forward-backward translation procedure. The reliability and validity of the instrument were assessed in a sample of 809 adults (34.6% males; M(age) = 32.61; SD ±11.25; age range from 18 to 68 years). Results showed that the Romanian FCV-19S had very good internal consistency (Cronbach’s alpha = .88; McDonald’s omega = .89; composite reliability = .89). The confirmatory factor analysis for one-factor FCV-19S based on the maximum likelihood estimation method with Satorra-Bentler correction for non-normality proved that the model fitted well (CFI = .99, TLI = .97, RMSEA = .06, 90% CI [.05, .09], SRMR = .01). As for criterion-related validity, the fear of COVID-19 score correlated with depression (r = .25, p < .01), stress (r = .45, p < .01), resilience (r = − .22, p < .01) and happiness (r = −.33, p < .01). The heterotrait-monotrait criteria less than .85 certified the discriminant validity of the FCV-19S-RO. The GRM analysis highlighted robust psychometric properties of the scale and measurement invariance across gender. These findings emphasized validity for the use of Romanian version of FCV-19S and expanding the existing body of research on the fear of COVID-19. Overall, the current research contributes to the literature not only by validating the FCV-19S-RO but also by considering the positive psychology approach in the study of fear of COVID-19, emphasizing a negative relationship among resilience, happiness and fear in the context of the COVID-19 pandemic.
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Psychophysical evaluation of chemosensory functions 5 weeks after olfactory loss due to COVID-19: a prospective cohort study on 72 patients
PURPOSE: To evaluate the evolution of chemosensation via extended psychophysical testing in patients who suffered from sudden chemosensory loss due to coronavirus disease 2019 (COVID-19). Additionally, this study sought to determine whether odor threshold testing provided additional information on olfactory loss due to COVID-19 compared to the more common odor identification testing. METHODS: Prospective cohort study of patients with sudden chemosensory loss since February 2020 and confirmed COVID-19 infection via RT-PCR or serology testing. Olfactory function was tested extensively using the "Sniffin Sticks" test battery. In addition, we screened gustatory perception and nasal cooling sensations using psychophysical tests. RESULTS: Seventy-two patients completed the study. After a mean of 37 days, 37% of patients showed olfactory dysfunction, 7% were dysgeusic, and 48% showed signs of low sensitivity for cooling sensation. A longer duration of anosmia before smell improvement was correlated with lower olfactory function at 5 weeks. Odor threshold detection was more affected by COVID-19 compared to odor identification. CONCLUSION: Five weeks after developing sudden chemosensory loss due to COVID-19, a high proportion of patients were dysosmic and showed signs of low nasal cooling sensitivity, whereas most of them had normal taste function. SARS-CoV-2 affected mainly odor thresholds, possibly suggesting that the major cause of loss of smell lies at the level of the olfactory neuroepithelium, rather than in the central nervous system.
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Display of epitopes on the surface of tobacco mosaic virus: impact of charge and isoelectric point of the epitope on virus-host interactions
The biophysical properties of the tobacco mosaic tobamovirus (TMV) coat protein (CP) make it possible to display foreign peptides on the surface of TMV. The immunogenic epitopes G5-24 from the rabies virus (RV) glycoprotein, and 5B19 from murine hepatitis virus (MHV) S-glycoprotein were successfully displayed on the surface of TMV, and viruses accumulated to high levels in infected leaves of Nicotiana tabacum Xanthi-nn. The peptide RB19, which contains an arginine residue plus the 5B19 epitope fused to the CP (TMV-RB19), resulted in the induction of necrotic local lesions on inoculated leaves of N. tabacum Xanthi-nn and cell death of infected BY2 protoplasts. RNA dot blot assays confirmed that expression of the acidic and basic pathogenesis-related PR2 genes were induced in infected Xanthi-nn leaf tissue. TMV that carried epitope 31D from the RV nucleoprotein did not accumulate in inoculated tobacco leaves. Analysis of hybrid CPs predicted that the isoelectric points (pI):charge value was 5.31: − 2 for wild-type CP, 5.64: − 1 for CP-RB19, and 9.14: + 2 for CP-31D. When acidic amino acids were inserted in CP-RB19 and CP-31D to bring their pI:charge to near that of wild-type CP, the resulting viruses TMV-RB19E and TMV-4D:31D infected N. tabacum Xanthi-nn plants and BY2 protoplasts without causing cell death. These data show the importance of the pI of the epitope and its effects on the hybrid CP pI:charge value for successful epitope display as well as the lack of tolerance to positively charged epitopes on the surface of TMV.
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Risk assessment of COVID-19 epidemic resurgence in relation to SARS-CoV-2 variants and vaccination passes
The introduction of COVID-19 vaccination passes (VPs) by many countries coincided with the Delta variant fast becoming dominant across Europe. A thorough assessment of their impact on epidemic dynamics is still lacking. Here, we propose the VAP-SIRS model that considers possibly lower restrictions for the VP holders than for the rest of the population, imperfect vaccination effectiveness against infection, rates of (re-)vaccination and waning immunity, fraction of never-vaccinated, and the increased transmissibility of the Delta variant. Some predicted epidemic scenarios for realistic parameter values yield new COVID-19 infection waves within two years, and high daily case numbers in the endemic state, even without introducing VPs and granting more freedom to their holders. Still, suitable adaptive policies can avoid unfavorable outcomes. While VP holders could initially be allowed more freedom, the lack of full vaccine effectiveness and increased transmissibility will require accelerated (re-)vaccination, wide-spread immunity surveillance, and/or minimal long-term common restrictions.
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Keynote Speaker II Biomedical Engineering Research in the Social Network Analysis Era: Stance Classification for Analysis of Hoax Medical News in Social Media
Abstract Biomedical engineering research trend can be healthcare models with unobtrusive smart systems for monitoring vital signs and physical activity. Detecting infant facial cry because of inability to communicate pain, recognizing facial emotion to understand dysfunction mechanisms through micro expression or transform captured human expression with motion device into three-dimensional objects are some of the applied systems. Nowadays, collaborated with biomedical research, mining and analyzing social network can improve public and private health care sectors as well such as research health news shared on social media about pharmaceutical drugs, pandemics, or viral outbreaks. Due to the vast amount of shared news, there is an urgency to select and filter information to prevent the spread of hoax or fake news. We explored in depth some steps to classify hoaxes written as news articles. This discussion also encourages on how technologies of social network analysis could be used to make new kinds improvement in health care sectors. Then close with a description of limitless future possibilities of biomedical engineering research in social media.
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Cystic fibrosis improves COVID-19 survival and provides clues for treatment of SARS-CoV-2
Systemic pools of ATP are elevated in individuals homozygous for cystic fibrosis (CF) as evidenced by elevated blood and plasma ATP levels. This elevated ATP level seems to provide benefit in the presence of advanced solid tumors (Abraham et al., Nature Medicine 2(5):593–596, 1996). We published in this journal a paper showing that IV ATP can elevate the depleted ATP pools of advanced cancer patients up to levels found in CF patients with subsequent clinical, biochemical, and quality of life (QOL) improvements (Rapaport et al., Purinergic Signalling 11(2): 251–262, 2015). We hypothesize that the elevated ATP levels seen in CF patients may be benefiting CF patients in another way: by improving their survival after contracting COVID-19. We discuss here the reasoning behind this hypothesis and suggest how these findings might be applied clinically in the general population.
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Effects of COVID-19 pandemic on out-of-hospital cardiac arrests: A systematic review
INTRODUCTION: In addition to the directly attributed mortality, COVID-19 is also likely to increase mortality indirectly. In this systematic review, we investigate the direct and indirect effects of COVID-19 on out-of-hospital cardiac arrests. METHODS: We searched PubMed, BioMedCentral, Embase and the Cochrane Central Register of Controlled Trials for studies comparing out-of-hospital cardiac arrests occurring during the pandemic and a non-pandemic period. Risk of bias was assessed with the ROBINS-I tool. The primary endpoint was return of spontaneous circulation. Secondary endpoints were bystander-initiated cardiopulmonary resuscitation, survival to hospital discharge, and survival with favourable neurological outcome. RESULTS: We identified six studies. In two studies, rates of return of spontaneous circulation and survival to hospital discharge decreased significantly during the pandemic. Especially in Europe, bystander-witnessed cases, bystander-initiated cardiopulmonary resuscitation and resuscitation attempted by emergency medical services were reduced during the pandemic. Also, ambulance response times were significantly delayed across all studies and patients presenting with non-shockable rhythms increased in two studies. In 2020, 3.9-5.9% of tested patients were SARS-CoV-2 positive and 4.8-26% had suggestive symptoms (fever and cough or dyspnoea). CONCLUSIONS: Out-of-hospital cardiac arrests had worse short-term outcomes during the pandemic than a non-pandemic period suggesting direct effects of COVID-19 infection and indirect effects from lockdown and disruption of healthcare systems. Patients at high risk of deterioration should be identified outside the hospital to promptly initiate treatment and reduce fatalities. Study registration PROSPERO CRD42020195794.
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Orofacial manifestations of SAPHO syndrome: a systematic review of case reports
SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) syndrome is a poorly known disease with cutaneous and osteo-articular manifestations requiring a multidisciplinary care. The aim of this study was to review the case reports that have described oral manifestations in patients suffering for this syndrome. A systematic review of case reports was performed on PubMed and Science Direct on January 2020 among all the articles dealing with the disease. In vitro, preclinical, and clinical studies have not been included to select only the case reports. Eighteen articles, published between 1999 and 2019, were included. All the patients presented mandibular osteomyelitis or sclerosis, associated with various other symptoms such as trismus, temporomandibular joint arthritis, or dysphagia. The data highlight the high variability in the disease's manifestations between people and also in the treatments applied. Knowing the orofacial signs of the SAPHO syndrome, the dental surgeon has a crucial role in the diagnosis procedure and must take place in the multidisciplinary medical team involved in the patient following. Some care adaptations are needed for oral interventions in these patients, depending on their treatments and their handicap.Key Points• Orofacial manifestations of SAPHO syndrome mainly occur on the mandible.• In cases of mandible sclerosis, decorticalization surgeries may be performed.• Oral care are encouraged, especially the preventive treatments to limit the necessity of surgeries.• The complexity in the management of patients suffering for a SAPHO syndrome concerns the oral manifestations, the patient general health and the treatments he has to take every day.
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Gambling treatment service providers’ views about contingency management: a thematic analysis
BACKGROUND: There is a need to improve retention and outcomes for treatment of problem gambling and gambling disorder. Contingency management (CM) is a behavioural intervention involving identification of target behaviours (such as attendance, abstinence, or steps towards recovery) and the provision of incentives (such as vouchers or credits towards the purchase of preferred items) contingent on objective evidence of these behaviours. Contingency management for abstinence and attendance in substance misuse treatment has a substantial evidence base but has not been widely adopted or extended to other addictive behaviours such as gambling. Potential barriers to the widespread adoption of CM may relate to practitioners’ perceptions about this form of incentive-based treatment. The present study sought to explore United Kingdom (UK) gambling treatment providers’ views of CM for treatment of problem gambling and gambling disorder. METHODS: We conducted semi-structured interviews with 30 treatment providers from across the UK working with people with gambling problems. Participants were provided with an explanation of CM, several hypothetical scenarios, and a structured questionnaire to facilitate discussion. Thematic analysis was used to interpret findings. RESULTS: Participants felt there could be a conflict between CM and their treatment philosophies, that CM was similar in some ways to gambling, and that the CM approach could be manipulated and reduce trust between client and therapist. Some participants were more supportive of implementing CM for specific treatment goals than others, such as for incentivising attendance over abstinence due to perceived difficulties in objectively verifying abstinence. Participants favoured providing credits accruing to services relevant to personal recovery rather than voucher-based incentives. CONCLUSIONS: UK gambling treatment providers are somewhat receptive to CM approaches for treatment of problem gambling and gambling disorder. Potential barriers and obstacles are readily addressable, and more research is needed on the efficacy and effectiveness of CM for gambling. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12954-022-00600-0.
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The impact of the COVID-19 pandemic on cancer deaths due to delays in diagnosis in England, UK: a national, population-based, modelling study
BACKGROUND: Since a national lockdown was introduced across the UK in March, 2020, in response to the COVID-19 pandemic, cancer screening has been suspended, routine diagnostic work deferred, and only urgent symptomatic cases prioritised for diagnostic intervention. In this study, we estimated the impact of delays in diagnosis on cancer survival outcomes in four major tumour types. METHODS: In this national population-based modelling study, we used linked English National Health Service (NHS) cancer registration and hospital administrative datasets for patients aged 15-84 years, diagnosed with breast, colorectal, and oesophageal cancer between Jan 1, 2010, and Dec 31, 2010, with follow-up data until Dec 31, 2014, and diagnosed with lung cancer between Jan 1, 2012, and Dec 31, 2012, with follow-up data until Dec 31, 2015. We use a routes-to-diagnosis framework to estimate the impact of diagnostic delays over a 12-month period from the commencement of physical distancing measures, on March 16, 2020, up to 1, 3, and 5 years after diagnosis. To model the subsequent impact of diagnostic delays on survival, we reallocated patients who were on screening and routine referral pathways to urgent and emergency pathways that are associated with more advanced stage of disease at diagnosis. We considered three reallocation scenarios representing the best to worst case scenarios and reflect actual changes in the diagnostic pathway being seen in the NHS, as of March 16, 2020, and estimated the impact on net survival at 1, 3, and 5 years after diagnosis to calculate the additional deaths that can be attributed to cancer, and the total years of life lost (YLLs) compared with pre-pandemic data. FINDINGS: We collected data for 32 583 patients with breast cancer, 24 975 with colorectal cancer, 6744 with oesophageal cancer, and 29 305 with lung cancer. Across the three different scenarios, compared with pre-pandemic figures, we estimate a 7·9-9·6% increase in the number of deaths due to breast cancer up to year 5 after diagnosis, corresponding to between 281 (95% CI 266-295) and 344 (329-358) additional deaths. For colorectal cancer, we estimate 1445 (1392-1591) to 1563 (1534-1592) additional deaths, a 15·3-16·6% increase; for lung cancer, 1235 (1220-1254) to 1372 (1343-1401) additional deaths, a 4·8-5·3% increase; and for oesophageal cancer, 330 (324-335) to 342 (336-348) additional deaths, 5·8-6·0% increase up to 5 years after diagnosis. For these four tumour types, these data correspond with 3291-3621 additional deaths across the scenarios within 5 years. The total additional YLLs across these cancers is estimated to be 59 204-63 229 years. INTERPRETATION: Substantial increases in the number of avoidable cancer deaths in England are to be expected as a result of diagnostic delays due to the COVID-19 pandemic in the UK. Urgent policy interventions are necessary, particularly the need to manage the backlog within routine diagnostic services to mitigate the expected impact of the COVID-19 pandemic on patients with cancer. FUNDING: UK Research and Innovation Economic and Social Research Council.
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Posterior Reversible Encephalopathy Syndrome: A Rare Complication in COVID-19
The coronavirus disease 2019 (COVID-19) has a broad spectrum of manifestations. Neurological complications are not uncommon in patients with COVID-19. We report the case of a middle-aged man who presented with a cough and fever. He had a decreased oxygen saturation and required supplementary oxygen therapy. During his stay, he developed an unexplained seizure. Computed tomography of the brain revealed vasogenic edema located posteriorly. Subsequently, magnetic resonance imaging demonstrated subcortical white-matter hyperdensities, in keeping with the diagnosis of posterior reversible encephalopathy syndrome, an exceedingly rare manifestation in COVID-19. This condition should be kept in mind when encountering unexplained neurological manifestations that developed in patients with COVID-19.
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Relationship between type of hand hygiene method and incidence of skin problems during Covid-19 pandemic in Ahvaz;Iran
Background: During the Coronavirus disease 2019 (COVID-19) outbreak, there was a increase in human activities in relation to hygiene, especially hand hygiene. The purpose of this study was to investigation the, hand hygiene among volunteers during the COVID-19 pandemic in Ahvaz, southwest Iran during 2020. Methods: : Data validation was performed using WHO criteria. A web-based prospective cross-sectional descriptive study which conducted during 2020 in Ahvaz city, southwest Iran. The data collection was based on completion of the volunteer questionnaire. In our study, WhatsApp software was used. Results: : The number of participants in our study were 1000 persons. Based on result this study, the mean ages (mean ± SD) participants were 32.84±10.74 years for women and 33.06±11.08 years for men. According finding this study, there was no relationship between age of participants and hand-skin’s health scores (p>0.05). Conclusions: : It was concluded that during the COVID-19 pandemic all the assessed hand hygiene behaviors of Iranian were improved, compared with those before, but hand hygiene education is still necessary.Therefore, the results of this study may be useful for health policymaker in order to cope with the emerging disease.
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Investigation of potential safety hazards during medical waste disposal in SARS-CoV-2 testing laboratory
This study aims to investigate the potential safety hazards and provide reference for improving the medical waste disposal procedure in SARS-CoV-2 testing laboratory. Our SARS-CoV-2 testing group detected the RNA residue on the surface of medical waste with Droplet Digital PCR, and held a meeting to discuss the risks in the laboratory medical waste disposal process. After effective autoclaving, SARS-CoV-2 contaminated on the surface of medical waste bags was killed, but the average concentration of viral RNA residues was still 0.85 copies/cm(2). It would not pose a health risk, but might contaminate the laboratory and affect the test results. When the sterilized medical waste bags were transferred directly by the operators without hand disinfection, re-contamination would happen, which might cause the virus to leak out of the laboratory. Furthermore, we found that sterilization effect monitoring and cooperation among operators were also very important. In summary, we investigated and analyzed the potential safety hazards during the medical waste disposal process in SARS-CoV-2 testing laboratory, and provided reasonable suggestions to ensure the safety of medical waste disposal.
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Generalizability of deep learning based fluence map prediction as an inverse planning approach
Deep learning-based fluence map prediction(DL-FMP) method has been reported in the literature, which generated fluence maps for desired dose by deep neural network(DNN)-based inverse mapping. We hypothesized that DL-FMP is similar to general fluence map optimization(FMO) because it's theoretically based on a general inverse mapping. We designed four experiments to validate the generalizability of DL-FMP to other types of plans apart from the training data, which contained only clinical head and neck(HN) full-arc VMAT plans. The first three experiments quantified the generalizability of DL-FMP to multiple anatomical sites, different delivery modalities, and various degree of modulation(DOM), respectively. The fourth experiment explored the generalizability and stability to infeasible dose inputs. Results of the first experiment manifested that DL-FMP can generalize to lung, liver, esophagus and prostate, with gamma passing rates (GPR) higher than 95%(2%/2mm). The second experiment showed that DL-FMP can generalize to partial-arc plans and predict partial-arc fluences. GPR(3mm/3%) ranged from 96% to 99%. DL-FMP cannot generate fluence maps in discrete beam angles for IMRT input. But the predicted dose still agreed with ground truth dose with 93% GPR(5%/5mm). The third experiment demonstrated that DL-FMP can generalize to various DOMs, with GPRs(3%/3mm) ranged in 94%-98%. Moreover, the DOM of predicted fluence maps correlated to the optimality of the input dose accordingly. The fourth experiment exemplified that DL-FMP can make stable predictions for infeasible dose input. In conclusion, we validated that DL-FMP can generalize to plans for multiple anatomical sites, plans of different delivery modalities and plans with various DOM. It can also make stable prediction for infeasible input.
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Motivation for COVID-19 Vaccination in Priority Occupational Groups: A Cross-Sectional Survey
Due to the limited availability of COVID-19 vaccines, occupational groups with priority access were identified prior to vaccination. The study aimed to analyze motives for vaccination in these occupational groups. Methods: Members of occupational groups, who were vaccinated at the vaccination center of University Hospital Olomouc before 30 April 2021, were asked to fill in an online questionnaire. Results: A total of 3224 completed questionnaires were obtained from 1332 healthcare workers, 1257 school employees, 363 social service workers, 210 security force members, and 62 critical infrastructure workers. The most frequent motive for vaccination was the effort to protect family members (76.2%), the effort to prevent the spread of COVID-19 in one’s profession (72.3%), followed by concerns about COVID-19 itself (49.1%) and exemptions from anti-epidemic measures (36.8%). Only for social services, the motive focused on one’s profession was mentioned more often (75.2%) than the motive focused on the family (71.1%). At the level of detailed profession-oriented motives, a collegial effort of security force members to protect co-workers and not to endanger the workplace was dominant. Conclusions: The effort to prevent the spread of COVID-19 in the professional environment is a strong motive for vaccination, and strongest among social service workers.
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Foreshadowing Change? Theories, Policies, and COVID-19
Abstract: The COVID-19 crisis determined a forceful change in European policy. Despite the theoretical dominance of the mainstream, metrics other than prices were used to decide how to deal with issues such as provisioning, subsidies, and the financial measures they required. This change, which involved both policy makers and the general public, undermined the dominant view that price-centered coordination of the economy constrains socially relevant decisions. It suggests that neoliberal dominance is not robust either in terms of policy priorities or in the way it affects people’s behavior. It also suggests that what a proper economic policy requires is an economic theory that does not merely describe the institutional status quo but foresees its possible change. © 2021, Journal of Economic Issues / Association for Evolutionary Economics.
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Early predictors and screening tool developing for severe patients with COVID-19
Background: Coronavirus disease 2019 (COVID-19) is a declared global pandemic, causing a lot of death. How to quickly screen risk population for severe patients is essential for decreasing the mortality. Methods: This retrospective study included all the 813 confirmed cases diagnosed with COVID-19 before March 2 nd , 2020 in a city of Hubei Province in China. Data of the COVID-19 patients including clinical and epidemiological features were collected through Chinese Disease Control and Prevention Information System. Predictors were selected by logistic regression, and then categoried to four different level risk factor. A screening tool for severe patient with COVID-19 was developed and tested by ROC curve. Results: Seven early predictors for severe patients with COVID-19 were selected, including chronic kidney disease ( OR =14.7), age above 60 ( OR =5.6), lymphocyte count less than <0.8 × 10 9 per L ( OR =2.5), Neutrophile to Lymphocyte Ratio larger than 4.7 ( OR =2.2), high fever with temperature ≥38.5℃ ( OR =2.2), male ( OR =2.2), cardiovascular related diseases ( OR =2.0). The Area Under the Curve of the screening tool developed by above seven predictors was 0.798 (95%CI: 0.747~0.849), and its best cut-off value is >4.5, with sensitivity 72.0% and specificity 75.3%. Conclusions: This newly developed screening tool can be a good choice for early prediction and alert for severe case especially in the condition of overload health service.
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Antiviral Activity of Vitamin D and COVID 19: Current Understanding
Innate and adaptive immune responses, which are intimately related to the evolution of many infectious diseases, are influenced by the biologically active form of vitamin D. From a mechanical perspective, there are several rationales to assume that vitamin D positively modifies host responses to SARS-CoV-2, either in the early infection or subsequent hyper-inflammatory stages of COVID-19. It has been long known that vitamin D metabolites induce antiviral effects through indirect and direct mechanisms via antimicrobial peptides, immune modulation, the interaction between major viral and cellular particles, initiation of apoptosis and autophagy, and diversity of hereditary and epigenetic aspects. The remarkable overlap between the deficiency of vitamin D and risk factors for severe COVID-19, including obesity, aging, and Black or Asian ethnicity, has motivated researchers to assume that supplementation of vitamin D can be promising as a preventive or treatment agent for COVID-19. Since the outset of the pandemic, researchers have integrated literature searches and cross-sectional statistical studies to appraise the vitamin D level impact of COVID-19, whereby nearly 30 observational studies have confirmed that the incidence, severity, and mortality of COVID-19 are inversely related to the serum 25OHD concentrations. Also, some recently announced clinical trials indicated that vitamin D supplementation has a positive effect on the severity of COVID-19;however, other studies, including clinical trials, have not supported that, especially if we take into account what was revealed in a recent clinical trial, i.e., airway diseases are related to the irregular metabolism of vitamin D increasing the potential of developing vitamin D deficiency due to pulmonary inflammation. Therefore, more dedicated studies are required without critical limitations to ascertain the actual effect of vitamin D in preventing and treating COVID-19, and if its effectiveness is proven, the effective dose must be determined. © 2021 Bentham Science Publishers. All rights reserved.
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Dying in times of the coronavirus: An online survey among healthcare professionals about end-of-life care for patients dying with and without COVID-19 (the CO-LIVE study)
BACKGROUND: During the COVID-19 outbreak restricting measures may have affected the provision of good end-of-life care for patients with and without COVID-19. AIM: To describe characteristics of patients who died and the care they received, and to examine how patient characteristics, setting and visiting restrictions are related to provided care and evaluation of the dying process. DESIGN: An open observational online survey among healthcare professionals about their experience of end-of-life care that was provided to a patient with or without COVID-19 who died between March and July 2020. SETTING/PARTICIPANTS: Healthcare professionals (nurses, physicians and others) in the Netherlands from all settings: home (n = 163), hospital (n = 249), nursing home (n = 192), hospice (n = 89) or elsewhere (n = 68). RESULTS: Of patients reported on, 56% had COVID-19. Among these patients, 358 (84.4%) also had a serious chronic illness. Having COVID-19 was negatively, and having a serious chronic illness was positively associated with healthcare staff's favourable appreciation of end-of-life care. Often there had been visiting restrictions in the last 2 days of life (75.8%). This was negatively associated with appreciation of care at the end of life and the dying process. Finally, care at the end of life was less favourably appreciated in hospitals and especially nursing homes, and more favourably in home settings and especially hospices. CONCLUSIONS: Our study suggests that end-of-life care during the COVID-19 pandemic may be further optimised, especially in nursing homes and hospitals. Allowing at least some level of visits of relatives seems a key component.
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Migrant Workers and Human Rights: A Critical Study on India's COVID-19 Lockdown Policy
India was one of the leading countries to implement the initial lockdown to contain the COVID-19 pandemic, but still, the lockdown failed and within a few months, India joined the list of countries most affected by the coronavirus epidemic Why did this transpire? What were the reasons abaft this? Where did the Indian government miss? This manuscript endeavors to study the lacunae in the lockdown plans of the Indian Government and highlights the mistakes committed by the Government which caused the lockdown in India to fail and further exposed the domestic migrant laborers to unbearable difficulties The manuscript argues that the fundamental and economic rights bestowed upon the domestic migrant workers and other laborers under labor laws and the Indian constitution were breached extensively during the lockdown and that the state’s policies during the lockdown worsened the condition of the domestic migrant workers
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Endoscopic extended transsphenoidal resection of tuberculum sellae meningiomas: nuances of neurosurgical technique.
Over the past decade, advances in endoscopic microsurgical techniques have resulted in an increasingly aggressive endonasal approach to tumors of the midline skull base. Meningiomas of the tuberculum sellae are often closely associated with cerebrovascular structures, and their removal has traditionally required a transcranial approach. An endonasal approach offers many advantages, including early tumor devascularization and tumor debulking (without manipulation of the optic apparatus), direct access to the medial optic canal, and a minimal-access corridor. Although recent articles have focused on techniques for reaching and approaching the area of the pathology (how to get there), the authors of this report discuss the technical nuances of endoscopic microsurgery when the operator is already "there." They describe their 6-step technique for endoscopic skull base bone removal, tumor dissection/resection, and closure. They also augment their description with elaborate illustrations.
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Rape Survivors' Sorrow: Major Depressive Symptoms and Sexually Transmitted Infection Among Adolescent Girls, Southwest Ethiopia
PURPOSE: Rape is one of the sexual violence acts against women globally. Adolescent girls are vulnerable to this event and experience more severe and long-standing adverse effects. Thus, this study aimed to examine major depressive symptoms and associated factors and the level of sexually transmitted infection among female adolescents evaluated for rape cases at Jimma Medical Center. PATIENTS AND METHODS: Institutional-based cross-sectional study was conducted among adolescent girls assessed for rape cases in Jimma Medical Center. Data were collected using structured questionnaire and entered into Epi Data version 3.1 then exported to SPSS version 21.0 for analysis. Descriptive statistics and regression analyses were carried out. RESULTS: A total of 174 raped adolescent females took part in the study. Of the total participants, 155 (89.1%) of these individuals had major depressive symptoms (95 CI %, 84.5–93.7%), while 85 (48.9%) of them had an STI (95% CI, 41.1–56.9%). From logistic regression, place of residence (AOR 14.65, 95%, (p=0.002)), attending school currently (AOR 9.01, 95%, p=0.004), raped by hitting (AOR 17.67, 95%, p<0.001) and unwanted pregnancy (AOR 14.68, 95%, p=0.001) were the variables associated with major depression. CONCLUSION: This study indicates that adolescents were suffering from several encumbrances like major depressive symptoms, sexually transmitted diseases and unwanted pregnancy. It also indicated that place of residence, school attending, and unwanted pregnancy had an association with major depressive symptoms. Therefore, the need for a comprehensive approach while treating this vulnerable group is highly recommended.
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Comparative Evaluation of the Antimicrobial and Mucus Induction Properties of Selected Bacillus Strains against Enterotoxigenic Escherichia coli
Probiotics have been shown to bind to host receptors, which are important for pathogen adhesion and induce the host’s production of defence factors. They can activate the goblet-cell-derived production of mucins, a major component of the mucus layer and a physical barrier participating in limiting the proximity of microorganisms to the epithelial layer. In the last decade, Bacillus spp. strains have gained interest in human and animal health due to their tolerance and stability under gastrointestinal tract conditions. Moreover, Bacillus spp. strains can also produce various antimicrobial peptides that can support their use as commercial probiotic supplements and functional foods. The present study aimed to evaluate and determine the ability of selected Bacillus spp. strains to inhibit the growth of enterotoxigenic Escherichia coli (ETEC) F4 and to reduce binding of ETEC F4 to HT29-16E (mucus-secreting and goblet-like) human intestinal cells. Moreover, mucus production in the HT29 cells in the presence of the Bacillus spp. strains was quantified by ELISA. Bacillus spp. strains (CHCC 15076, CHCC 15516, CHCC 15541, and CHCC 16872) significantly inhibited the growth of ETEC F4. Moreover, the ability of the probiotic Bacillus spp. strains to stimulate mucin release was highly strain dependent. The treatment with Bacillus subtilis CHCC 15541 resulted in a significant increase of both MUC2 and MUC3 in HT29-16E cells. Therefore, this strain could be an up-and-coming candidate for developing commercial probiotic supplements to prevent infections caused by ETEC F4 and, potentially, other pathogens.
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RadioGraphics Update: Contrast-enhanced US Approach to the Diagnosis of Focal Liver Masses.
Editor's Note.-Articles in the RadioGraphics Update section provide current knowledge to supplement or update information found in full-length articles previously published in RadioGraphics. Authors of the previously published article provide a brief synopsis that emphasizes important new information such as technological advances, revised imaging protocols, new clinical guidelines involving imaging, or updated classification schemes. Articles in this section are published solely online and are linked to the original article.
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Simultaneous degradation of glucocorticoids and sterilization using bubbling corona discharge plasma based systems: a promising terminal water treatment facility for hospital wastewater
Glucocorticoids (GCs) have drawn great concern due to their widespread contamination in the environment and application in treating patients with COVID-19. Due to the lack of data about GC removal using advanced treatment processes, a novel paralleling and bubbling corona discharge reactor (PBCD) combined with iron-loaded activated-carbon fibre (Fe-ACF) was addressed in this study to degrade GCs represented by hydrocortisone (HC) and betamethasone (BT). The results showed that the PBCD-based system can degrade GCs effectively and can achieve effective sterilization. The removal rates of GCs were ranked as PBCD/Fe-ACF > PBCD/ACF > PBCD. The concentration of E. coli was reduced from 109 to 102 CFU/mL after 60 min of PBCD-based system treatment. The abundance of bacteria in actual hospital wastewater (HWW) was significantly reduced. Plasma changed the physical and chemical properties of ACF and Fe-ACF by etching axial grooves and enhancing stretching vibrations of surface functional groups, thus promoting adsorption and catalytic degradation. For GC degradation, the functional reactive species were identified as •OH, 1O2, and •O2 radicals. Possible degradation pathways for HC and BT were proposed, which mainly included defluorination, keto acid decarboxylation, demethylation, intramolecular cyclization, cleavage and ester hydrolysis, indicating a reduction in GC toxicity. Since GCs are widely used in patients with COVID-19 and their wastewater needs to be sterilized simultaneously, the intensive and electrically driven PBCD-based system is promising in GC pollution control and sterilization in terminal water treatment facilities.
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New-Onset Transient Global Amnesia: A Clinical Challenge in an Air Medical Transportation Pilot With a History of Coronavirus Disease 2019
A 43-year-old male Bell 214C helicopter pilot presented to the emergency ward with flu-like syndrome. His nasopharyngeal severe acute respiratory syndrome coronavirus 2 real-time polymerase chain reaction test was positive, and a chest computed tomographic scan confirmed coronavirus disease 2019 pneumonia. He was admitted, received treatment, was discharged, and returned to flying. During the mission debrief, copilots who had flown with him reported that he experienced episodes of in-flight dizziness and blacked out. They occurred briefly during the cruise and hovering flight, perhaps for a few seconds of disorientation and unconsciousness. Rapid identification of the copilot and control of the helicopter prevented any incident or accident. Afterward, he explained the sudden onset and unexpected brief periods of loss of consciousness after a headache. The flight safety office referred him to the aviation medical center for further investigations. The cardiovascular, neurologic, laboratory, and toxicologic assessments were inconclusive with the approach to sudden-onset transient loss of consciousness. The only abnormal finding was hippocampus lesions on brain magnetic resonance imaging (MRI). Because of the possible diagnosis of transient global amnesia, the aviation medical examiner suspended him from flight duties until complete recovery and the absence of any probable complications.
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COVID-19 among Nursing Staff: Settings and Regional Differences COVID-19 entre a equipe de enfermagem: Cenários e diferenças regionais
Background/Aims So far detailed insights into the nursing staff's COVID-19 symptoms, testing, and results are missing. Therefore, this study aimed to describe the setting and regional differences in the occurrence of COVID-19 among nursing staff, analysing symptoms, testing, and their respective results. Methods We used an online survey to conduct this cross-sectional study among Austrian nursing staff in different settings between May 12 and July 13, 2020. This article follows the STROBE statement. The survey includes demographic data, including age, professional qualification, e.g., nurse, nurse aid, and in which federal state and setting the participants work. In addition, we asked for COVID-19 symptoms and (result of the) testing. We used descriptive statistics as well as bivariate analysis to calculate the differences. Results Nearly every sixth nurse reported experiencing COVID-19 symptoms. We found statistically significant differences between the settings and the federal provinces for the reported COVID-19 symptoms, but not the test results. In total, 1.6% of the participating nurses were tested for COVID-19, of which all were positive for COVID-19. Conclusions In the future during a pandemic, health care staff should be comprehensively tested in all settings. Our results showed that shifting the perspectives from critical/acute settings to other settings, such as nursing homes, is needed.
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Religious marginality, covid-19, and redress of targeting and inequalities
This article interrogates whether we should consider ‘religious marginality’ as a qualifier much like the exploration of how gender, ethnicity, and class inequalities are explored when examining Covid-19-related vulnerabilities and their implications for building back better Drawing on a case study of Pakistan as well as evidence from India, Uganda, and Iraq, this article explores the accentuation of vulnerabilities in Pakistan and how different religious minorities experience the impact of the interplay of class, caste, ethnicity, and religious marginality The article argues that where religious minorities exist in contexts where the broader political and societal policy is one of religious ‘othering’ and where religious marginality intersects with socioeconomic exclusion, they experience particular forms of vulnerability associated directly or indirectly with Covid-19 consequences that are acute and dire in impact Building back better for religiously inclusive societies will require both broad-based as well as more specific redress of inequalities © 2021 The Authors IDS Bulletin © Institute of Development Studies
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The pandemic knocks on the occupational health's door
The pandemic caused by SARS-CoV-2 has tested our current National Occupational Safety and Health System. The pandemic, managed from the public health Administration sector, has directly affected the world of work. Therefore, the management of this contingency has demanded a joint and agile response from two areas, public health and occupational health, and has proved its indissoluble nature. This article analyzes the main activities carried out in the labor context to fight against COVID-19 in order to identify the best tools to integrate the measures defined by the competent public health authorities in the occupational safety and health management. Likewise, this article shows the vision of the main international organizations about the relationship between the pandemic and the safety and health at work.
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Early Detection of COVID-19 Epidemic Using Search Engine Query Data
Background: Early warnings of emerging infectious disease are crucial to prevent epidemics. However, in the early stage of the COVID-19 pandemic, traditional infectious disease surveillance failed to deliver a warning alert. The aim of this work is to develop search-engine-based surveillance methods for the early warning and prediction of COVID-19 outbreaks. Methods: By using more than 444 million Baidu search queries from China as training set, we collected 32 keywords from the Baidu Search Index that may related to COVID-19 outbreak from 18 December 2019 to 11 February 2020. The Beijing Xinfadi outbreak from 30 May 2020 to 30 July 2020 was used as independent test set. A multiple linear regression was applied to model the relationship between the daily query frequencies of keywords and the daily new cases. Findings: Our results show that 11 keywords in search queries were highly correlated to the daily numbers of confirmed cases (r =0.96, P <0.01). An abnormal initial peak (1.46 times the normal volume) in queries appeared on 31 December 2019, which could have served as an early warning signal for an outbreak. Of particular concern, on this day, the volume of the query “Wuhan Seafood Market” increased by over 240 times (from 10 to 2410), the volume of the query “Wuhan outbreak” increased by over 622 times (from 7 to 4359), and 17.5% of China’s query volume originated from Hubei Province, 51.15% of which was from Wuhan city. The quantitative model using four keywords (“Epidemic”, “Masks”, “Coronavirus” and “Clustered pneumonia”) successfully predicted the daily numbers of cases for the next two days, and detected an early signal during the Beijing Xinfadi outbreak (R2 =0.80). Interpretation: Our study demonstrates the ability of search engine query data to detect COVID-19 outbreaks, and suggests that abnormalities in query volume can serve as early warning signals.
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Uses and Resources of Technologies by Mathematics Students Prior to COVID-19
Digital competence in education includes, amongst other things, the ability to create and manage content and information, mastery of communication tools, and solving technological problems The access to information and communication technologies (ICT) for educational purposes could have affected the academic performance of mathematics students prior to COVID-19 The objectives were to (1) analyze family and economic factors that could influence the use of ICT for educational purposes, and (2) determine what attributes of Melilla’s mathematics students could explain an additional variation in the use of ICT for academic purposes before COVID-19 A total of 2018 students at secondary schools in Melilla were included in this cross-sectional study A validated questionnaire with 14 questions regarding ICT and its uses and resources in mathematics learning was administered to students Statistical analysis revealed that 63 81% of students used ICT to study mathematics and 36 19% did not Of this percentage, 30 22% failed mathematics and 68 43% reported that ICT does not help them improve their grades The use of ICT to study mathematics was influenced by students’ perceptions of its usefulness for their academic performance and learning We also found an association with educational level and time spent on the Internet
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Validating and optimizing the method for molecular detection and quantification of SARS-CoV-2 in wastewater
Wastewater surveillance of SARS-CoV-2 has become a promising tool to estimate population-level changes in community infections and the prevalence of COVID-19 disease. Although many studies have reported the detection and quantification of SARS-CoV-2 in wastewater, remarkable variation remains in the methodology. In this study, we validated a molecular testing method by concentrating viruses from wastewater using ultrafiltration and detecting SARS-CoV-2 using one-step RT-qPCR assay. The following parameters were optimized including sample storage condition, wastewater pH, RNA extraction and RT-qPCR assay by quantification of SARS-CoV-2 or spiked human coronavirus strain 229E (hCoV-229E). Wastewater samples stored at 4 °C after collection showed significantly enhanced detection of SARS-CoV-2 with approximately 2–3 PCR-cycle threshold (Ct) values less when compared to samples stored at −20 °C. Pre-adjustment of the wastewater pH to 9.6 to aid virus desorption followed by pH readjustment to neutral after solid removal significantly increased the recovery of spiked hCoV-229E. Of the five commercially available RNA isolation kits evaluated, the MagMAX-96 viral RNA isolation kit showed the best recovery of hCoV-229E (50.1 ± 20.1%). Compared with two-step RT-qPCR, one-step RT-qPCR improved sensitivity for SARS-CoV-2 detection. Salmon DNA was included for monitoring PCR inhibition and pepper mild mottle virus (PMMoV), a fecal indicator indigenous to wastewater, was used to normalize SARS-CoV-2 levels in wastewater. Our method for molecular detection of SARS-CoV-2 in wastewater provides a useful tool for public health surveillance of COVID-19.
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A Machine-Learning-Based Risk-Prediction Tool for HIV and Sexually Transmitted Infections Acquisition over the Next 12 Months
Background: More than one million people acquire sexually transmitted infections (STIs) every day globally. It is possible that predicting an individual’s future risk of HIV/STIs could contribute to behaviour change or improve testing. We developed a series of machine learning models and a subsequent risk-prediction tool for predicting the risk of HIV/STIs over the next 12 months. Methods: Our data included individuals who were re-tested at the clinic for HIV (65,043 consultations), syphilis (56,889 consultations), gonorrhoea (60,598 consultations), and chlamydia (63,529 consultations) after initial consultations at the largest public sexual health centre in Melbourne from 2 March 2015 to 31 December 2019. We used the receiver operating characteristic (AUC) curve to evaluate the model’s performance. The HIV/STI risk-prediction tool was delivered via a web application. Results: Our risk-prediction tool had an acceptable performance on the testing datasets for predicting HIV (AUC = 0.72), syphilis (AUC = 0.75), gonorrhoea (AUC = 0.73), and chlamydia (AUC = 0.67) acquisition. Conclusions: Using machine learning techniques, our risk-prediction tool has acceptable reliability in predicting HIV/STI acquisition over the next 12 months. This tool may be used on clinic websites or digital health platforms to form part of an intervention tool to increase testing or reduce future HIV/STI risk.
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Impact of COVID-19 pandemic on the pre-hospital evaluation and presentation of ischemic stroke at a non-urban comprehensive stroke center
Introduction: Many reports have described a decrease in the numbers of patients seeking medical attention for typical emergencies during the COVID-19 pandemic These reports primarily relate to urban areas with widespread community transmission The impact of COVID-19 on non-urban areas with minimal community transmission is less well understood Methods: Using a prospectively maintained pre-hospital quality improvement database, we reviewed our hospital EMS transports with a diagnosis of stroke from January to April 2019 (baseline) and January to April 2020 (pandemic) We compared the volume of patients, transport/presentation times, severity of presenting symptoms, and final diagnosis Results: In January, February, March, and April 2019 10, 11, 17 and 19 patients, respectively were transported in comparison to 19, 14, 10 and 8 during the same months in 2020 From January through April 2019 there was a 53% increase in transports, compared to a 42% decrease during the same months in 2020 The slopes of these trend lines are significantly different (3 30;95%CI 0 48 - 6 12 versus -3 70;95%CI -5 76 - -1 64, P = 0 001) There were no significant differences in demographics, comorbidities, symptom severity, or stroke discharge diagnoses between the two time periods However, the median interval from LKW to time of EMS dispatch was significantly longer in January to April 2020 (12 + 273 min) compared to the same time period of January through April in 2019 (7 + 115 min) Conclusion: Our data indicate not only a decrease in patient transport volumes but more alarmingly, significantly longer intervals to EMS activation for suspected stroke care These results suggest that even in a non-urban location without widespread community transmission patientswere delaying or avoiding care for severe illness such as stroke (Figure Presented)
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An iterative topic model filtering framework for short and noisy user-generated data: analyzing conspiracy theories on twitter
Conspiracy theories have seen a rise in popularity in recent years. Spreading quickly through social media, their disruptive effect can lead to a biased public view on policy decisions and events. We present a novel approach for LDA-pre-processing called Iterative Filtering to study such phenomena based on Twitter data. In combination with Hashtag Pooling as an additional pre-processing step, we are able to achieve a coherent framing of the discussion and topics of interest, despite of the inherent noisiness and sparseness of Twitter data. Our novel approach enables researchers to gain detailed insights into discourses of interest on Twitter, allowing them to identify tweets iteratively that are related to an investigated topic of interest. As an application, we study the dynamics of conspiracy-related topics on US Twitter during the last four months of 2020, which were dominated by the US-Presidential Elections and Covid-19. We monitor the public discourse in the USA with geo-spatial Twitter data to identify conspiracy-related contents by estimating Latent Dirichlet Allocation (LDA) Topic Models. We find that in this period, usual conspiracy-related topics played a marginal role in comparison with dominating topics, such as the US-Presidential Elections or the general discussions about Covid-19. The main conspiracy theories in this period were the ones linked to “Election Fraud” and the “Covid-19-hoax.” Conspiracy-related keywords tended to appear together with Trump-related words and words related to his presidential campaign.
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Creativity in the South Korean Workplace: Procedural Justice, Abusive Supervision, and Competence
Innovation is now a feature of daily life. In a rapidly changing market environment and amid fierce competition, organizations pursue survival and growth through innovation, and the key driver of innovation is the creativity of employees. Because the value of creativity has been emphasized, many organizations are looking for effective ways to encourage employees to be creative at work. From a resource perspective, creativity at work can be viewed as a high-intensity job demand, and organizations should encourage it by providing and managing employee resources. This study is an attempt to empirically investigate how competence and abusive supervision affect the relationship between procedural justice and creativity from the conservation of resources perspective. Findings from two-wave time-lagged survey data from 377 South Korean employees indicate that procedural justice increases creativity through the mediation of competence. Furthermore, abusive supervision has a negative moderating effect on the relationship between procedural justice and competence. The findings show that competence moderates the relationship between procedural justice and creativity and that the lower the level of abusive supervision, the greater the effect of procedural justice on competence and creativity.
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The Current Safety Regulation for Radiation Emergency Medicine in Korea
Radiation emergency medicine (REM) systems are operated around the world to provide specialized care for injured individuals who require immediate medical attention in accidents. This manuscript describes the current status of REM safety regulation in Korea and summarizes an assessment of the effects of this regulation. Responding to the requests of people for stronger safety regulations related to radiation exposure, a unique REM safety regulation for nuclear licensees, which is enforceable by laws, has been established and implemented. It is not found in other countries. It can provide a good example in practice for sustainable REM management including document reviews on medical response procedures and inspections of equipment and facilities. REM preparedness of nuclear or radiologic facilities has been improved with systematic implementation of processes contained in the regulation. In particular, the medical care system of licensees has become firmly coordinated in the REM network at the national level, which has enhanced their abilities by providing adequate medical personnel and facilities. This legal regulation service has contributed to preparing the actual medical emergency response for unexpected accidents and should ultimately secure the occupational safety for workers in radiation facilities.
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Spatial analysis of falls in an urban community of Hong Kong
BACKGROUND: Falls are an issue of great public health concern. This study focuses on outdoor falls within an urban community in Hong Kong. Urban environmental hazards are often place-specific and dependent upon the built features, landscape characteristics, and habitual activities. Therefore, falls must be examined with respect to local situations. RESULTS: This paper uses spatial analysis methods to map fall occurrences and examine possible environmental attributes of falls in an urban community of Hong Kong. The Nearest neighbour hierarchical (Nnh) and Standard Deviational Ellipse (SDE) techniques can offer additional insights about the circumstances and environmental factors that contribute to falls. The results affirm the multi-factorial nature of falls at specific locations and for selected groups of the population. CONCLUSION: The techniques to detect hot spots of falls yield meaningful results that enable the identification of high risk locations. The combined use of descriptive and spatial analyses can be beneficial to policy makers because different preventive measures can be devised based on the types of environmental risk factors identified. The analyses are also important preludes to establishing research hypotheses for more focused studies.
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Snapshot Models of Undocumented Immigration.
Accurately estimating the size of the undocumented immigrant population is a critical component of assessing the health and security risks of undocumented immigration to the United States. To provide one such estimate, we use data from the Mexican Migration Project (MMP), a study that includes samples of undocumented Mexican immigrants to the United States after their return to Mexico. Of particular interest are the departure and return dates of a sampled migrant's most recent sojourn in the United States, and the total number of such journeys undertaken by that migrant household, for these data enable the construction of data-driven undocumented immigration models. However, such data are subject to an extreme physical bias, for to be included in such a sample, a migrant must have returned to Mexico by the time of the survey, excluding those undocumented immigrants still in the United States. In our analysis, we account for this bias by jointly modeling trip timing and duration to produce the likelihood of observing the data in such a "snapshot" sample. Our analysis characterizes undocumented migration flows including single-visit migrants, repeat visitors, and "retirement" from circular migration. Starting with 1987, we apply our models to 30 annual random snapshot surveys of returned undocumented Mexican migrants accounting for undocumented Mexican migration from 1980 to 2016. Scaling to population quantities and supplementing our analysis of southern border crossings with estimates of visa overstays, we produce lower bounds on the total number of undocumented immigrants that are much larger than conventional estimates based on U.S.-based census-linked surveys, and broadly consistent with the more recent estimates reported by Fazel-Zarandi, Feinstein, and Kaplan.
Please summerize the given abstract to a title
COVID–19の第1波への対応に係るJAAM全国調査(JAAM Nationwide Survey on the response to the first wave of COVID–19 in Japan): ~第1部:医療機関はどのように診療体制を整えたか~(– Part I: How to set up a treatment system in each hospital –)
Aim: To clarify how the medical institutions overcame the first wave of coronavirus disease 2019 (COVID–19) in Japan and to discuss its impact on the medical labor force. Methods: We analyzed questionnaire data from the end of May 2020 from 180 hospitals (102,578 beds) certified by the Japanese Association for Acute Medicine. Results: Acute (emergency) medicine physicians treated severe COVID–19 patients in more than half of hospitals. Emergency medical teams consisted of acute medicine physicians and other specialists. Frontline acute care physicians were concerned about their risk of infection in 80% of hospitals, and experienced stress due to a lack of personal protective equipment. Twenty–six of the 143 hospitals that had a mental health check/consultation system in place indicated that there was a doctor who experienced mental health problems. Of the 37 hospitals without a system, only one hospital was aware of the presence of a doctor complaining of mental health problems. Conclusion: Acute care physicians and physicians in other departments experienced high levels of stress as they fought to arrange COVID–19 treatment teams and inpatient COVID–19 wards for infected patients. Medical materials and equipment may be sufficient for a second or third wave; however, active support is needed for the physical and mental care of medical staff. Mental health problems may be missed in facilities without mental check and consultation system.
Please summerize the given abstract to a title
The impact of the international crisis on the entrepreneurial intentions of refugees
Purpose: We investigate the entrepreneurial intentions of a population under crisis — namely, recent Syrian refugees in Jordan — and Jordanian citizens to start small businesses during the COVID-19 pandemic Design/methodology/approach: Using a structured two-part survey, data were collected through online self-reported questionnaires in which respondents subjectively reported self-perceptions The first part dealt with respondents’ characteristics and the second with their entrepreneurial intentions The survey took place in Jordan, sampling Jordanian citizens and Syrian refugees A nonprobability sampling technique was used to collect the data Findings: The results show that net desirability for self-employment, tolerance for risk and self-efficacy are related to entrepreneurial intentions We find significant differences between the Syrian refugees and the Jordanian citizens in terms of risk-taking and self-efficacy as determinants of engagement in entrepreneurial activities Originality/value: This study offers guidance to institutions working with refugees during times of crisis Implications are discussed © 2021, Emerald Publishing Limited
Please summerize the given abstract to a title
Depressive symptoms in the front-line non-medical workers during the COVID-19 outbreak in Wuhan
Background: The outbreak of Coronavirus Disease 2019 (COVID-19) has been raising global anxiety and fear to the real or perceived health threat from the virus. This study aimed to investigate the psychological impacts and depression in the front-line non-medical workers in Wuhan, the first and the worst hit place by COVID-19. Methods: A total of 191 front-line non-medical workers in Wuhan were recruited by online survey. The Positive and Negative Affect Schedule (PANAS), the Stress Reaction Questionnaire (SRQ) and the Patient Health Questionnaire-9 (PHQ) were used. The results showed that 50.3% (96) participants reported the clinically significant symptoms of depression. Results: Among them, 33.0% (63) participants were with mild depression, 10.5% (20) participants with moderate depression, 5.8% (11) with moderately severe depression, and 1% (2) with severe depression. Participants with depression tend to be post-90s (the generation born after 1990s), females, with increased levels of stress reactions, increased negative affects, but lower positive affects compared to these without depression. The stepwise logistic regression analysis revealed that post-90s (β = 0.908, P = 0.016), the emotional reaction (β = 0.122, P = 0.005) and physical reaction (β = 0.124, P = 0.020) in SQR were significant independent responsible for the development of depression. Conclusion: The findings of the present study suggest the targeted psychological intervention measures should be developed to improve the mental health of non-medical workers on the front-line of COVID-19 epidemic, especially the females and younger individuals.
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Risk perception and determinants in small- and medium-sized agri-food enterprises amidst the COVID-19 pandemic: Evidence from Egypt
AFRICAN DEVELOPMENT Abstract: The coronavirus disease-2019 (COVID-19) pandemic has disrupted many activities along agri-food supply chains in developing countries and posed unprecedented challenges in particular to small and medium agri-food enterprises (SMEs). Drawing on a survey of 166 Egyptian agri-food SMEs, this study investigates differences in- and determinants of COVID-19 business risk perception among these enterprises. The empirical results showed that risk perception was highly asymmetric across geographical regions. Enterprises with longer cash flow coverage periods and higher values of total assets perceived significantly lower risk levels, as cash and assets functioned as a buffer against the impact of COVID-19. The findings of the study imply that the “just-in-time” approach and the absence of a proactive and preventative stance to risk management reduced the resilience of agri-food SMEs to the risks presented by the pandemic. Generally, enterprises that operate both in domestic and export markets perceived lower COVID-19 risks. Finally, the main export destination to which the surveyed enterprises export was a significant determinant of their risk perception. These findings could be useful to managers of agri-food businesses in terms of better understanding of risks and promotion of risk management practices. More so, they can help design effective policy interventions to mitigate the impacts of the pandemic on Egyptian agri-food SMEs and build up their resilience to future pandemics and shocks
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The impact of mental health and stress concerns on relationship and sexuality amidst the COVID-19 lockdown
Background Since 23rd January 2020, the Chinese government has imposed restrictive measures including self-isolation, travel restrictions and lockdown of Wuhan city in order to prevent the incoming waves of COVID-19 outbreak in the country. However, the impact of mental health and stress concerns on relationship and sexuality amidst the COVID-19 lockdown was currently unclear. Aim The cross-sectional study was designed to determine the changes in health, relationship and sexuality among the Chinese couples who lived together amid the early stages of COVID-19 pandemic in China. Methods Participants of Chinese nationality aged ≥18 years were asked to complete a self-administered online questionnaire regarding sexuality behaviour and impact of event scale (IES) in March 2020. Non-random sampling was used for participant recruitment. Also assessed were sociodemographic data including sex, age, employment, region, sexual dysfunction, and whether participants tested positive for COVID-19. Outcomes IES score, frequency of sexual intercourse per week, quality of usual sex life, emotional bonding and duration of relationship were measured. Results A total of 1139 participants (i.e., 735 males and 404 females) were included in the study. Mean age and IES of participants was 33.6±9.5 years and 27.4±8.6, respectively. Being male was significantly associated with increased frequency of sexual intercourse amid the COVID-19 pandemic (P=0.012). Also, participants with an IES score &lt;26 were more likely to report that they had increased frequency of sexual intercourse per week (P&lt;0.001) and the COVID-19 pandemic had positively affected the quality of their usual sex lives (P&lt;0.001). On the other hand, participants with IES score ≥26 were more likely to report that the COVID-19 pandemic had positively affected their emotional bonding (P&lt;0.001). Clinical implications Frequency of sexual intercourse and quality of sex life in participants who experienced high stressful impact were more likely to be affected by the COVID-19 pandemic. Strengths and limitations This was one of the first studies to assess sexual behaviour during the COVID-19 pandemic in Chinese adults. Since participants were asked to self-report their sexual behaviour, this potentially introduced self-reporting and recall bias into our findings. Conclusions Our study reported that despite the moderate-to-severe stressful impact due to the COVID-19 pandemic, the majority reported no significant changes in the frequency of their sexual intercourse per week, quality of their usual sexual lives and emotional bonding.
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Lobectomy for Non-Small Cell Lung Cancer after Coronary Artery Bypass Grafting Surgery.
BACKGROUND The efficacy of video-assisted thoracoscopic surgery lobectomy in patients with previous coronary artery bypass grafting (CABG) surgery is controversial. OBJECTIVES To investigate whether skeletonized left internal mammary artery (LIMA) mobilization contributes to the development of severe adhesions, which will affect what type of lung surgery (open or closed procedure) will be required in the future. METHODS Eight patients (mean age 73.9 years) with previous CABG surgery using a LIMA to left anterior descending (LAD) graft underwent left-sided lobectomy for operable non-small cell lung carcinoma. RESULTS The lobectomy by thoracotomy rate was 62.5% (5 patients), generally in patients with tumors in the left upper lobe or in patients post-neoadjuvant chemotherapy, while the video-assisted thoracic surgery lobectomy rate was 37.5% (3 patients). Mean hospital stay was 8.3 days. There was no mortality or major morbidity, apart from six minor complications in four patients (50%) (air leak, atrial fibrillation, atelectasis, pneumonia). CONCLUSIONS Patients with operable non-small cell lung carcinoma following CABG surgery who need left upper lobe resection do not benefit from the video-assisted thoracoscopic surgery technique due to significant adhesions between the LIMA to LAD graft and the lung. The method of preserving a small portion of the lung on the LIMA to LAD graft may help during left upper lobe resections. Adhesions in the left pleural space after LIMA mobilization appear to minimally affect left lower lobe video-assisted thoracoscopic surgery.
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