BACKGROUND Laparoscopic gastric greater curvature plication (LGGCP) is a new restrictive weight loss procedure. METHODS Between February 2011 and June 2012, 57 patients underwent LGGCP. Thirteen had it associated with a lap band and were excluded from the study. Data was collected through routine follow-up. Demographics, complications, and percentage of excess weight loss (% EWL) were determined. RESULTS Forty-four patients underwent LGGCP, 40 women and 4 men with a mean age of 40 years (range, 18-72), a mean body mass index of 38 kg/m(2) (range, 35-46). Comorbidities included 2 diabetes mellitus, 11 hypertension, 8 hyperlipidaemia, and 8 obstructive sleep apnea. The mean operative time was 106 min (range, 60-180) and mean duration of hospital stay was 18 h (range, 12-168). Operative complications included one subphrenic abscess, one gastrogastric hernia, and one acute respiratory distress syndrome. Thirty patients experienced strong restriction with nausea and vomiting for the first 10 days (79.5 %). Eleven patients (25.0 %) came back with intractable nausea and vomiting, and were hospitalized, or had their hospital stay prolonged. Four patients needed early reversal of gastric plication (9 %). There was no postoperative death. The mean postoperative % EWL was 30.6 % (n = 40), 57.0 % (n = 24), 50.7 % (n = 13) at 1, 6, and 12 months, respectively. CONCLUSIONS LGGCP yields an acceptable weight loss compared to other restrictive procedures, but with a higher readmission rate for postoperative nausea and vomiting, or even reversal of plication. We advocate more studies to evaluate safety and effectiveness.

This paper utilized a new novel framework, the Initialization, Distribution, Explanation, and Action (IDEA) model, for Instructional Health Risk and Crisis Communication (IHRCC) to investigate the effectiveness of the COVID-19 crisis communication (CC) in Cameroon. This contemporary research is empirical, qualitative, exploratory, and novel in the field of CC. Based on the findings, the COVID-19 CC in Cameroon could be ranked mediocre-fair. This is informed by an analysis of the IDEA elements in the framework that reveals that "Internalization" (messages on timeliness, compassion, and impact) was poor, "Distribution" (messages, guidance/protocols, and sources/distribution of messages) and "Explanation" (accuracy of messages, updated messages, and CC languages) were fair, and "Action" (instructional messages on infection control) considered as mediocre. This paper contributes to literature in the field, including concept development in health CC. The novel IDEA framework for IHRCC can enable health crisis managers gain context and better apply best practices to health CC. A structured recommendation on how this can be done has been proffered.

Objective: The purpose of this report is to describe actions by chiropractic entities during the early stages of the coronavirus disease 2019 (COVID-19) pandemic. Methods: Large entities that support chiropractic education or practice were invited to participate in this report. Leaders of various entities were emailed an invitation. A designee who was assigned by the leader provided a brief synopsis of actions the entity had taken in response to the COVID-19 pandemic. Only entities that responded are included in this report. Results: Five entities agreed to participate: The Council on Chiropractic Education, Association of Chiropractic Colleges, Federation of Chiropractic Licensing Boards, National Board of Chiropractic Examiners, and the National Chiropractic Mutual Insurance Company. Common themes included (1) recognizing the crisis and taking action, (2) establishing a safe working environment for staff so that services could continue, (3) delivering communications to stakeholders (chiropractic students, practitioners, licensing boards, and others) to guide decisions and direct actions, and (4) continuing to monitor the situation and respond as new information becomes available. Conclusion: These entities serve a large portion of the chiropractic profession. They have been quick to respond in a responsible, compassionate, and supportive manner to assist chiropractic licensing boards, practitioners, and students during the COVID-19 pandemic. These findings are encouraging as the chiropractic profession looks to the future as it navigates changes in education and the health care environment in the months and years ahead.

PURPOSE: Air pollutant exposure constitutes a serious risk factor for the emergence or aggravation of (existing) pulmonary disease. The impact of pre-intensive care ambient air pollutant exposure on the duration of artificial ventilation was, however, not yet established. METHODS: The medical records of 2003 patients, admitted to the intensive care unit (ICU) of the Antwerp University Hospital (Flanders, Belgium), who were artificially ventilated on ICU admission or within 48 h after admission, for the duration of at least 48 h, were analyzed. For each patients home address, daily air pollutant exposure [particulate matter with an aerodynamic diameter 2.5 m (PM(2.5)) and 10 m (PM(10)), nitrogen dioxide (NO(2)) and black carbon (BC)] up to 10 days prior to hospital admission was modeled using a high-resolution spatialCtemporal model. The association between duration of artificial ventilation and air pollution exposure during the last 10 days before ICU admission was assessed using distributed lag models with a negative binomial regression fit. RESULTS: Controlling for pre-specified confounders, an IQR increment in BC (1.2 g/m(3)) up to 10 days before admission was associated with an estimated cumulative increase of 12.4% in ventilation duration (95% CI 4.7C20.7). Significant associations were also observed for PM(2.5), PM(10) and NO(2), with cumulative estimates ranging from 7.8 to 8.0%. CONCLUSION: Short-term ambient air pollution exposure prior to ICU admission represents an unrecognized environmental risk factor for the duration of artificial ventilation in the ICU. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00134-020-05999-3) contains supplementary material, which is available to authorized users.

During the ongoing global pandemic of coronavirus disease 2019 (COVID-19), the benefit of treating patients with cancer must be weighed against the COVID-19 infection risks to patients, staff and society. Prostate cancer is one of the most common cancers among men and raises particular interest during the pandemic as recent reports show that the TMPRSS2 (and other serine proteases), which facilitate the entry, replication and budding of the virion from a cell, can be inhibited using androgen deprivation therapy. Nevertheless, patients with metastatic prostate cancer commonly receive chemotherapy which may compromise their immune system. This paper aims to address the current status of the COVID-19 in patients with cancer overall and suggests an optimal approach to patients with metastatic prostate cancer.

Determining the microbiologic etiology of enteric infection remains an elusive goal. Conventional approaches, including culture, microscopy, and antigen-based tests have significant limitations such as limit of detection and the need for multiple procedures. Molecular diagnostics, especially PCR based tests, are rapidly changing research and practice in infectious diseases. Diarrheal disease, with its broad range of potential infectious etiologies, is well suited for multiplex molecular testing. This review highlights examples of currently employed molecular tests, as well as ways in which these tests can be applied in the future. The absence of a gold standard for the microbiologic cause of diarrhea means that the clinical significance of detected organisms may not always be clear. Conventional wisdom is that there should be one main pathogen causing diarrhea, however our thinking is challenged by increased detection of mixed infections. Thus, the successful incorporation of molecular diagnostics for diarrheal disease into practice will require both a careful understanding of the technical aspects and research to define their clinical utility.

Introduction: To date, issues related to the protection of medical workers from COVID-19 infection, including immunological protection, are of particular interest. The aim of the study was to assess the risk of a new coronavirus infection depending on the initial immune status and occupational group during a 150-day follow-up. Materials and Methods: The study of immune response to the SARS-CoV-2 virus was carried out in the frame of the large-scale program ruled by the state body responsible for the epidemiological surveillance. From the regional sample, medical workers (301 people) without a previous history of the new coronavirus infection at the time of biosampling (June 2020) were selected. The comparison group included 52 workers and was formed from engineering and technical personnel not employed in medical institutions. Within 150 days from the blood sampling, cases of the new coronavirus infection were monitored based on the patient's inclusion in the Federal Register of COVID-19 patients. To estimate the adjusted hazard ratios, Cox proportional hazards models was applied. Results and Conclusions: In 150-day follow-up it was revealed that the probability of remaining healthy by the end of the follow-up was the lowest among doctors from medical and preventive institutions (MPI) that did not serve as temporary hospitals: HR 2,33 [95% CI 0,95;5,70], which may be due to both insufficient anti-epidemic measures and the peculiarities of the immune response and approaches for its evaluation. The risk of COVID-19 in seronegative individuals was higher, but without statistical significance.

Purpose: A strategic response to crisis research is a critical and growing area of study in management and business literature. Consequently, the sudden rise of COVID-19, that has a substantial adverse impact on the global economy in a relatively short period of time, brings into sharp focus on the possible and most effective types of strategic responses adopted by firms. In this context, this study aims to shed light on the types of strategic responses adopted by firms and the possible outcomes. Design/methodology/approach: To contribute to the advancement of knowledge around strategic responses in general for business, this study conducted a keyword bibliometric analysis reviewing 66 articles from highly ranked journals according to ABS list of journals published between the period 2006C2020 and synthesize the existing research on strategic responses. Findings: This research enabled the identification of the novel typology of strategic responses to the crisis, such as revived stakeholders relationships, revived pricing mechanisms and revived organizational compliance, and their outcomes. Additionally, the analysis established many research areas for scholars who will deal with this topic in the future. Originality/value: The literature review contributes to the management and business literature by providing a novel and comprehensive classification of crisis responses and synthesizing all new knowledge gained within a new conceptual framework. ? 2021, Emerald Publishing Limited.

From the Document: Four months into the COVID-19 [coronavirus disease 2019] pandemic, the risk of illness and death has yet to dissipate in Washington, DC In fact, the number of people infected increases every day As of June 29, 2020, there have been 10,327 confirmed cases and 551 deaths To curb the spread of the virus, the mayor ordered people to stay at home and generally limit their contact with others But there's one place where social distancing and other practices known to contain COVID-19 simply cannot happen: the DC jail Jails are veritable petri dishes for COVID-19--and people incarcerated in them are not only some of the most vulnerable to contracting the virus, but they are often overlooked, too Hundreds of people are incarcerated in close proximity to each other, numerous staff enter and exit the facilities daily, and basic protective measures like hand sanitizer are prohibited as contraband COVID-19 (Disease);Epidemics;Public health

The 18th Brazilian Meeting on Organic Synthesis (18th BMOS) was planned to be held in Tiradentes, Brazil from October 2020. Due to the pandemic caused by the new coronavirus, the event was initially postponed until 2021 and will finally take place in late 2022. This Special Collection of The Chemical Record is organized together with Guest Editors ?ngelo de Ftima and Eufranio N. da Silva Jnior from Federal University of Minas Gerais and features contributions by present and previous participants of the conferene in the field of Organic Synthesis.

MOTIVATION Antimicrobial resistance (AMR) is one of the biggest global problems threatening human and animal health. Rapid and accurate AMR diagnostic methods are thus very urgently needed. However, traditional antimicrobial susceptibility testing (AST) is time-consuming, low throughput, and viable only for cultivable bacteria. Machine learning methods may pave the way for automated AMR prediction based on genomic data of the bacteria. However, comparing different machine learning methods for the prediction of AMR based on different encodings and whole-genome sequencing data without previously known knowledge remains to be done. RESULTS In the current study, we evaluated logistic regression (LR), support vector machine (SVM), random forest (RF), and convolutional neural network (CNN) for the prediction of AMR for the antibiotics ciprofloxacin (CIP), cefotaxime (CTX), ceftazidime (CTZ), and gentamicin (GEN). We could demonstrate that these models can effectively predict AMR with label encoding, one-hot encoding, and frequency matrix chaos game representation (FCGR encoding) on whole-genome sequencing data. We trained these models on a large AMR dataset and evaluated them on an independent public data set. Generally, RFs and CNNs perform better than LR and SVM with AUCs up to 0.96. Furthermore, we were able to identify mutations that are associated with AMR for each antibiotic. AVAILABILITY Source code in data preparation and model training are provided at GitHub website (https://github.com/YunxiaoRen/ML-iAMR). SUPPLEMENTARY INFORMATION Supplementary data are available at Bioinformatics online.

The coronavirus pandemic has turned school and university learning system from classroom-based to exclusively online all over the world. As this change is accompanied by a spike in demand of laptops, an excessive amount of obsolete devices will be witnessed in the near future. Laptops are the most valuable e-waste category containing a high content of numerous critical raw materials, thus their waste management is crucial. Considering the impact of the coronavirus pandemic on the laptop lifespan, the future quantities and pieces of obsolete laptops in Greece are estimated (2016-2040), as well as the critical raw materials (CRMs) and precious metals (PMs) embedded in them, to illustrate the potential of recovering useful resources, thus contributing to a circular economy. To this end, dynamic material flow analysis is adopted, lifespan distribution is evaluated and future sales are predicted by the logistic model utilizing a bounding analysis. Then the future End-of-Life (EoL) laptop quantities are estimated taking time-varying parameters into consideration such as penetration rate, population, laptop weight and lifespan. This study is a dynamic estimation that avoids using average values adopted from literature that are not country specific. The provided information is useful for implementing national plans, improving the management of the most valuable category, EoL laptops, enhancing resources efficiency and contributing to a circular economy. The coronavirus pandemic has a similar impact on laptop sales in other countries, affecting their future laptop waste as well.

The higher concentration of PM10 and PM2.5 in the lower atmosphere is severely harmful for human health and it also makes visibility diminution along with weather and climate modifications. The main objective is to find out the spatiotemporal variation and dispersal of PM10 and PM2.5 along with COVID-19 infection in the dusty city Kolkata. The consecutive two years PM10 and PM2.5 data of different stations have been obtained from State Pollution Control Board, Govt. of West Bengal. Forward trajectory analysis has been done through HYSPLIT (Hybrid Single Particle Lagrangian Integrated Trajectory) model to find the path and direction of air particles. The result showed that the various meteorological or environmental factors (such as temperature, relative humidity, wind, wind speed, pressure and gusty wind) and geographical location regulate the spatiotemporal variation of PM10 and PM2.5. These factors like high temperature with relative humidity and strong wind influence to disperse the particulate matters from north to south direction from city to outside during summer in Kolkata metropolitan city. During summer (both pre and lockdown years), the height of particles is extended up to 1000 m owing to active atmospheric ventilation whereas in winter it is confined within 100 m. The HYSPLIT model clearly specified that the particles dispersed from south, south-west to north and north east direction due to strong wind. The constant magnification of PM10 and PM2.5 in the lower atmosphere leads to greater frequency of COVID-19 infections and deaths. In Kolkata, the one of the crucial reasons of high infection and deaths (COVID-19) is co-morbidity of people.

The novel coronavirus disease-2019 (COVID-19) was declared a pandemic by the World Health Organization on March 11, 2020. We discuss a less common presentation of COVID-19 in a patient where the use of telemedicine technology prevented the exposure of the healthcare team in an academic general pediatrics clinic. A medically complex 20-year-old male presented via virtual visit for unilateral eye redness and discharge. He received topical ophthalmic antibiotics for presumed acute bacterial conjunctivitis and was counseled on return precautions. Three days later, the patient developed shortness of breath, fever to 102.6F, and chest pain. COVID-19 testing returned positive. Conjunctivitis is a presenting symptom in 32% of COVID-19 cases. Current evidence suggests that these patients may transmit their illness at the time of presentation. Using telehealth, we avoided exposure to a COVID-19-positive patient who would not have met criteria for testing or droplet precautions. Telehealth allows providers to triage patients, identifying those who need to be seen in person, thereby minimizing exposure. Transitioning toward virtual practice, particularly during a pandemic, prepares for the possibility of healthcare workers being quarantined but still able to provide care and minimizes exposure to asymptomatic patients or those with atypical symptoms.

The most severe clinical manifestations of the Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), are due to an unbalanced immune response and a pro-thrombotic hemostatic disturbance, with arterial hypertension or diabetes as acknowledged risk factors. While waiting for a specific treatment, the clinical management of hospitalized patients is still a matter of debate, and the effectiveness of treatments to manage clinical manifestations and comorbidities has been questioned. In this study, we aim to assess the impact of the clinical management of arterial hypertension, inflammation and thrombosis on the survival of COVID-19 patients. The Spanish cohorts included in this observational retrospective study are from HM Hospitales (2035 patients) and from Hospital Universitario Central de Asturias (72 patients). Kaplan Meier survival curves, Cox regression and propensity score matching analyses were employed, considering demographic variables, comorbidities and treatment arms (when opportune) as covariates. The management of arterial hypertension with angiotensin-converting enzyme 2 (ACE2) inhibitors or angiotensin receptor blockers is not detrimental, as was initially reported, and neither was the use of non-steroidal anti-inflammatory drugs (NSAIDs). On the contrary, our analysis shows that the use on itself of corticosteroids is not beneficial. Importantly, the management of COVID-19 patients with low molecular weight heparin (LMWH) as an anticoagulant significantly improves the survival of hospitalized patients. These results delineate the current treatment options under debate, supporting the effectiveness of thrombosis prophylaxis on COVID-19 patients as a first-line treatment without the need for compromising the treatment of comorbidities, while suggesting cautiousness when administering corticosteroids.

BACKGROUND: There is emerging evidence that patients with Latent Tuberculosis Infection(LTBI) and Tuberculosis(TB) disease have an increased risk of the SARS-CoV-2 infection and predisposition towards developing severe COVID-19 pneumonia. In this study we attempted to estimate the number of TB patients infected with SARS-CoV-2 and have severe disease during the COVID-19 epidemic in Delhi, India. METHODS: Susceptible-Exposed-Infectious-Recovered (SEIR) model was used to estimate the number of COVID-19 cases in Delhi. Assuming the prevalence of TB in Delhi to be 0.55%, 53% of SARS-CoV2 infected TB cases to present with severe disease we estimated the number of SARS-CoV2 infected TB cases and the number of severe patients. The modelling used estimated R0 for two scenarios, without any intervention and with public health interventions. RESULTS: We observed that the peak of SARS-CoV-2-TB co-infected patients would occur on the 94th day in absence of public health interventions and on 138th day in presence of interventions. There could be 20,880 SARS-CoV-2 infected TB cases on peak day of epidemic when interventions are implemented and 27,968 cases in the absence of intervention. Among them, there could be 14,823 patients with severe disease when no interventions are implemented and 11,066 patients with severe disease in the presence of intervention. CONCLUSION: The importance of primary prevention measures needs to be emphasized especially in TB patients. The TB treatment centres and hospitals needs to be prepared for early diagnosis and management of severe COVID-19 in TB patients.

With the wish to reduce aerosol generation and the shorter time to anaesthetic readiness, this article discusses why rapid sequence spinal anaesthesia could be used in preference to general anaesthesia, for the benefit of both patients and staff during the COVID-19 pandemic.

BACKGROUND: Intra-dialytic hypotension (IDH) is the most common serious adverse event in paediatric haemodialysis (HD). Repeated IDH results in chronic multi-organ damage and increased mortality. At the Hospital for Sick Children, Toronto, retrospective data from all in-centre HD sessions revealed frequently occurring IDH events (16.5 5.6% of HD sessions per week). Based on literature review and clinical expertise, fluid volume management was selected as a potential modifiable risk factor to decrease IDH. Root causes identified as contributing to IDH were incorporated into a Paediatric haemodialysis fluid volume management (PedHDfluid) program using the Model for Improvement methodology including rapid cycles of change. METHODS: Multiple measures were evaluated including (i) Outcome: IDH events per number of HD sessions per week; (ii) Process: number of changes to estimated dry weight per number of HD sessions per week; (iii) Balancing: time spent on dry weight meeting per week. Data was analysed using statistical process control charts. We aimed to decrease IDH in our dialysis unit to < 10% of HD sessions per week over a 6-month period by implementing a PedHDfluid program, including a multifaceted dry weight assessment protocol, multidisciplinary meetings and electronic health records Dry Weight Evaluation flow sheet/synopsis. RESULTS: The project resulted in a decline in IDH events from 16.5 5.6% to 8.8 3.3% of HD sessions per week. More frequent dry weight changes and increased awareness of fluid removal goals were noted. CONCLUSIONS: A multidisciplinary approach including regular assessment, guidelines and systematic discussion, with an embedded electronic health record assessment and data gathering tool may sustainably reduce IDH events. GRAPHICAL ABSTRACT: A higher resolution version of the Graphical abstract is available as Supplementary information [Image: see text] SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00467-021-05298-z.

Lockdowns, social distancing, and COVID safe hygiene practices have rendered the usual face-to-face course delivery options all but impossible for many higher education institutions worldwide. A forced transition to online learning has been the only viable option for preventing a wholesale closure of many institutions. The aim of this study is to identify the role of educational technologies in the transition from face-to-face to online teaching and learning activities during the COVID-19 pandemic. This paper identified five challenges to transitioning to online education experienced by higher education institutions: synchronous/asynchronous learning tool integration, access to technology, faculty and student online competence, academic dishonesty, and privacy and confidentiality. From the studies examined in this literature review, strategies for successful online implementation were also noted. These included: providing e-learning training support for faculty and students, fostering online learning communities, and expanding traditional face-to-face course delivery to incorporate more elements of blended learning. A Technology Enhanced Learning Hub that encapsulates the learning process within a modality-neutral learning space is presented as a suggested framework for delivering higher education programs in this challenging environment.

Background: The COVID-19 pandemic has impacted spine care around the globe. Much uncertainty remains regarding the immediate and long-term future of spine care and education in this COVID-19 era. Study design: Cross-sectional, international study of spine surgeons. Methods: A multi-dimensional survey was distributed to spine surgeons around the world. A total of 73 questions were asked regarding demographics, COVID-19 observations, personal impact, effect on education, adoption of telemedicine, and anticipated challenges moving forward. Multivariate analysis was performed to assess factors related to likelihood of future conference attendance, future online education, and changes in surgical indications. Results: A total of 902 spine surgeons from seven global regions completed the survey. Respondents reported a mean level of overall concern of 3.7 on a scale of one to five. 84.0% reported a decrease in clinical duties, and 67.0% reported a loss in personal income. The 82.5% reported being interested in continuing a high level of online education moving forward. Respondents who personally knew someone who tested positive for COVID-19 were more likely to be unwilling to attend a medical conference 1 year from now (OR: 0.61, 95% CI: [0.39, 0.95], P =.029). The 20.0% reported they plan to pursue an increased degree of nonoperative measures prior to surgery 1 year from now, and respondents with a spouse at home (OR: 3.55, 95% CI: [1.14, 11.08], P =.029) or who spend a large percentage of their time teaching (OR: 1.45, 95% CI: [1.02, 2.07], P =.040) were more likely to adopt this practice. Conclusions: The COVID-19 pandemic has had an adverse effect on surgeon teaching, clinical volume, and personal income. In the future, surgeons with family and those personally affected by COVID-19 may be more willing to alter surgical indications and change education and conference plans. Anticipating these changes may help the spine community appropriately plan for future challenges.