The authors describe the methodological strategies used to effectively recruit a diverse sample of nurses in a qualitative study. Adequate representation of diverse populations is necessary to advance science and health equity. A multimodal research approach (research team composition, flyers, social media, and purposive sampling) was used. When undertaking research with underrepresented groups, recruitment efforts should begin in the early phases of study planning with research team development that can assist in employing multiple recruitment strategies accordingly.

The coronavirus disease (COVID-19) pandemic has been a source of disruption, unexpected illness, stress, and adversity for people, worldwide. As the reality of the COVID-19 pandemic unfolded in early 2020, many healthcare organizations found themselves in the midst of their Magnet appraisals-just short of the 3rd appraisal phase, the Site Visit Phase. In response, the Magnet Recognition Program devised strategies to maintain the integrity of the appraisal process, despite the turbulence associated with the unexpected changes that healthcare organizations were confronting while contending with the impact of COVID-19. In this month's Magnet Perspectives column, we explore how the virtual site visit has provided healthcare organizations with the opportunity to complete this phase of their appraisal process while addressing the safety and well-being of the organization's staff as well as that of the Magnet appraisers.

BACKGROUND: Publications regarding the 100 top-cited articles in a given discipline are common, but studies reporting the association between article topics and their citations are lacking. Whether or not reviews and original articles have a higher impact factor than case reports is a point for verification in this study. In addition, article topics that can be used for predicting citations have not been analyzed. Thus, this study aims to: (1).. provide a visualization dashboard for the 100 top-cited articles related to article types and (2).. inspect major medical subject headings (i.e., MeSH terms in PubMed) to help predict citations. METHODS: We searched PubMed Central and downloaded 100 top-cited abstracts in the journal Medicine (Baltimore) since 2011. Four article types and 7 topic categories (denoted by MeSH terms) were extracted from abstracts. Contributors to these 100 top-cited articles were analyzed. Social network analysis and Sankey diagram analysis were performed to identify influential article types and topic categories. MeSH terms were applied to predict the number of article citations. We then examined the prediction power with the correlation coefficients between MeSH weights and article citations. RESULTS: The citation counts for the 100 articles ranged from 24 to 127, with an average of 39.1 citations. The most frequent article types were journal articles (82%) and comparative studies (10%), and the most frequent topics were epidemiology (48%) and blood and immunology (36%). The most productive countries were the United States (24%) and China (23%). The most cited article (PDID = 27258521) with a count of 135 was written by Dr Shang from Shandong Provincial Hospital Affiliated to Shandong University (China) in 2016. MeSH terms were evident in the prediction power of the number of article citations (correlation coefficients = 0.49, t = 5.62). CONCLUSION: The breakthrough was made by developing dashboards showing the overall concept of the 100 top-cited articles using the Sankey diagram. MeSH terms can be used for predicting article citations. Analyzing the 100 top-cited articles could help future academic pursuits and applications in other academic disciplines.

Objectives: We aimed to explore the frequencies of nasal symptoms in patients with COVID-19, including loss of smell and taste, as well as their presentation as the first symptom of the disease and their association with the severity of COVID-19. Methods: In this retrospective study, 1,206 laboratory-confirmed COVID-19 patients were included and followed-up by telephone call one month after discharged from Tongji Hospital, Wuhan. Demographic data, laboratory values, comorbidities, symptoms, and numerical rating scale scores (0-10) of nasal symptoms were extracted from the hospital medical records, and confirmed or reevaluated by the telephone follow-up. Results: From COVID-19 patients (N = 1,172) completing follow-up, 199 (17%) subjects had severe COVID-19 and 342 (29.2%) reported nasal symptoms. The most common nasal symptom was loss of taste (20.6%, median score = 6), while 11.4% had loss of smell (median score = 5). The incidence of nasal symptom including loss of smell and loss of taste as the first onset symptom was <1% in COVID-19 patients. Loss of smell or taste scores showed no correlation with the scores of other nasal symptoms. Loss of taste scores, but not loss of smell scores, were significantly increased in severe vs. non-severe COVID-19 patients. Interleukin (IL)-6 and lactose dehydrogenase (LDH) serum levels positively correlated with loss of taste scores. About 80% of COVID-19 patients recovered from smell and taste dysfunction in 2 weeks. Conclusion: In the Wuhan COVID-19 cohort, only 1 out of 10 hospital admitted patients had loss of smell while 1 out 5 reported loss of taste which was associated to severity of COVID-19. Most patients recovered smell and taste dysfunctions in 2 weeks.

BackgroundCoronavirus Disease 19 (Covid-19) had previously been thought to affect mainly respiratory organs Recent studies had shown that this disease might impact another organ as well, including the liver Coronavirus has recently been found to be able to bind angiotensin-converting enzyme 2 (ACE2) on cholangiocytes, Leading to cell dysfunction and inflammatory response leading to liver injury Previous studies had shown that abnormal liver function can be detected in 14% to 53% of Covid-19 cases and was related to increased risk of mortality We aim to evaluate liver enzyme abnormality in Covid-19 patients and its association with disease outcome MethodsWe conducted a retrospective analysis of all confirmed Covid-19 cases from hospitals of Siloam Hospital Group in Indonesia from 6 March until 15 July 2020 Data with unavailable liver enzyme were excluded ResultsWe collected data from 266 patients with positive rt-PCR for Covid-19 A total of 81 patients (30 5%) had elevated liver enzyme on admission, with abnormal liver enzyme was defined as serum Alanine Aminotransferase (ALT) value &gt;35 IU/L Median ALT was 19 IU/L in the normal ALT group and 52 IU/L in the elevated ALT group Patients in both groups had similar characteristics in age (median 44 vs 47-year-old) and sex distribution (male percentage 69 1% vs 46 5%) The total mortality rate from all patient was 8 3% Risk of mortality was higher in patients with elevated ALT on admission compared to those with normal ALT (11 1% vs 7 0%, OR: 1 65, 95% CI: 0 67C4 04, p: 0 266) but this increase is not statistically significant Patients with elevated ALT also had a statistically significant higher risk of Intensive Care Unit admission (21 0% vs 8 6%, OR: 2 81, 95% CI: 1 34C5 88, p&lt;0 01) The average length of stay was similar between both groups (median 11 days vs 11 days, p: 0 612) ConclusionsElevated liver enzyme on admission could be found in a significant proportion of Covid-19 patients and was associated with non-statistically significant increased risk of mortality

BACKGROUND: Small observational studies have suggested that statin users have a lower risk of dying with COVID\19. We tested this hypothesis in a large, population\based cohort of adults in 2 of Canadas most populous provinces: Ontario and Alberta. METHODS AND RESULTS: We examined reverse transcriptaseCpolymerase chain reaction swab positivity rates for SARS\CoV\2 in adults using statins compared with nonusers. In patients with SARS\CoV\2 infection, we compared 30\day risk of all\cause emergency department visit, hospitalization, intensive care unit admission, or death in statin users versus nonusers, adjusting for baseline differences in demographics, clinical comorbidities, and prior health care use, as well as propensity for statin use. Between January and June 2020, 2.4% of 226 142 tested individuals aged 18 to 65 years, 2.7% of 88 387 people aged 66 to 75 years, and 4.1% of 154 950 people older than 75 years had a positive reverse transcriptaseCpolymerase chain reaction swab for SARS\CoV\2. Compared with 353 878 nonusers, the 115 871 statin users were more likely to test positive for SARS\CoV\2 (3.6% versus 2.8%, P<0.001), but this difference was not significant after adjustment for baseline differences and propensity for statin use in each age stratum (adjusted odds ratio 1.00 [95% CI, 0.88C1.14], 1.00 [0.91C1.09], and 1.06 [0.82C1.38], respectively). In individuals younger than 75 years with SARS\CoV\2 infection, statin users were more likely to visit an emergency department, be hospitalized, be admitted to the intensive care unit, or to die of any cause within 30 days of their positive swab result than nonusers, but none of these associations were significant after multivariable adjustment. In individuals older than 75 years with SARS\CoV\2, statin users were more likely to visit an emergency department (28.2% versus 17.9%, adjusted odds ratio 1.41 [1.23C1.61]) or be hospitalized (32.7% versus 21.9%, adjusted odds ratio 1.19 [1.05C1.36]), but were less likely to die (26.9% versus 31.3%, adjusted odds ratio 0.76 [0.67C0.86]) of any cause within 30 days of their positive swab result than nonusers. CONCLUSIONS: Compared with statin nonusers, patients taking statins exhibit the same risk of testing positive for SARS\CoV\2 and those younger than 75 years exhibit similar outcomes within 30 days of a positive test. Patients older than 75 years with a positive SARS\CoV\2 test and who were taking statins had more emergency department visits and hospitalizations, but exhibited lower 30\day all\cause mortality risk.

We characterized exposures and demographics of Middle East respiratory syndrome coronavirus cases reported to the Saudi Arabia Ministry of Health during July 1COctober 31, 2017, and June 1CSeptember 16, 2018. Molecular characterization of available specimens showed that circulating viruses during these periods continued to cluster within lineage 5.

BACKGROUND: This study aims to compare the outcomes of COVID-19-positive disease in patients with a history of cancer to those without. METHODS: We retrospectively collected clinical data and outcomes of COVID-19 positive cancer patients treated consecutively in five North London hospitals (cohort A). Outcomes recorded included time interval between most recent anti-cancer treatment and admission, severe outcome [a composite endpoint of intensive care unit (ITU) admission, ventilation and/or death] and mortality. Outcomes were compared with consecutively admitted COVID-19 positive patients, without a history of cancer (cohort B), treated at the primary centre during the same time period (1 MarchC30 April 2020). Patients were matched for age, gender and comorbidity. RESULTS: The median age in both cohorts was 74 years, with 67% male, and comprised of 30 patients with cancer, and 90 without (1:3 ratio). For cohort B, 579 patients without a history of cancer and consecutively admitted were screened from the primary London hospital, 105 were COVID-19 positive and 90 were matched and included. Excluding cancer, both cohorts had a median of two comorbidities. The odds ratio (OR) for mortality, comparing patients with cancer to those without, was 1.05 [95% confidence interval (CI) 0.4C2.5], and severe outcome (OR 0.89, 95% CI 0.4C2.0) suggesting no increased risk of death or a severe outcome in patients with cancer. Cancer patients who received systemic treatment within 28 days had an OR for mortality of 4.05 (95% CI 0.68C23.95), p = 0.12. On presentation anaemia, hypokalaemia, hypoalbuminaemia and hypoproteinaemia were identified predominantly in cohort A. Median duration of admission was 8 days for cancer patients and 7 days for non-cancer. CONCLUSION: A diagnosis of cancer does not appear to increase the risk of death or a severe outcome in COVID-19 patients with cancer compared with those without cancer. If a second spike of virus strikes, rational decision making is required to ensure optimal cancer care.

OBJECTIVE The purpose of this study was to evaluate the efficacy of MDCT in the differentiation of diseases involving giant gastric folds and to identify the features most useful for predicting the presence of malignant gastric disease. MATERIALS AND METHODS Blinded reviewers retrospectively analyzed 16-MDCT scans of 64 patients who had endoscopic findings of giant gastric folds. Thirty of these patients had histopathologic results showing scirrhous carcinoma; 15, large B-cell lymphoma; 14, acute gastric mucosal lesions; and five, Mntrier disease. Unenhanced transparent volume-rendered images were assessed to determine the morphologic features of the whole stomach. Contrast-enhanced images were used to analyze wall thickness, stratification, enhancement pattern, and perigastric conditions. We used the Cramer phi-prime correlation coefficient to calculate the overall diagnostic accuracy of MDCT in several gastric disorders. Scatterplot analysis was used for overall diagnostic score, and analysis of the receiver operator characteristic curves of the neighboring two diseases was used to locate the cutoff values for best diagnostic accuracy. We used exact logistic regression to identify which MDCT image features were most predictive of the presence of malignant gastric disease. RESULTS The gastric wall was found to be significantly thicker in large B-cell lymphoma than in other disorders (p < 0.001). The overall diagnostic accuracy of MDCT in the four diseases was 100%. Loss of wall stratification was deemed the best MDCT predictor of the presence of malignancy. CONCLUSION MDCT may be a reliable means of noninvasive diagnosis in the care of patients with endoscopically detected giant gastric folds and may be useful for differentiating benign from malignant disease.

Today, the whole world is facing a biggest challenge in the form of coronavirus. The spread of COVID has caused health concerns worldwide. Considering this, there is an increase in the global efforts for the development of the COVID. The widespread provision of the vaccine is the major requirement in achieving the immunity against coronavirus. For this purpose, the public sentiments towards the vaccine campaign must be analysed. With the help of social media services, people are freely sharing their feelings and sentiments through posts, reviews or tweets. In this research, we have used advanced artificial intelligence methods for analysing the public sentiments towards vaccine campaigns. For this purpose, we used twitter data freely available on the Kaggle website and performed basic preprocessing steps. We used natural language processing (NLP) techniques such as TextBlob() and word cloud in order to find the polarity of the tweets to categorize them in seven different classes and find the most frequent keywords respectively. We used BERT model for sentimental analysis to understand the people's mental state by studying their opinion and behaviour towards vaccines. Hence, the artificial intelligence based social network analysis must be considered for performing and analyzing the public sentiments towards any trending topic, pandemic or any other worldwide or local issue. Such methods can help to develop the trust of people towards vaccine campaigns timely and help to provide the proper administration of vaccines at large scale. ? 2021 IEEE.

This paper explores dying in English prisons. Whilst often conflated, death and dying are conceptually different. While there is increased attention given to the investigation of deaths in custody, and the impact of prison deaths on healthcare staff and custodial staff, little attention has been paid to the experience of dying people themselves. Post-death investigations tell us little about dying experiences of the dying. This paper reviewed the literature on dying in English prisons and highlights this clear gap in knowledge. Four types of dying will be discussed in this paper: (1) suicide, (2) dying in older age, (3) deaths post-release, and (4) COVID-19 deaths. The importance of providing good end-of-life care and palliative care in prison is acknowledged in the literature, but this only shows awareness of the needs of a particular part of the prison population. To understand the complexities and nuances of dying in prison, all voices need to be included in research, otherwise what is left post-death of a person who died in prison is a Fatal Incidence Report. More empirical research is needed to illuminate the diversity of prison deaths and the lived reality of those dying behind locked doors. ? 2021 by the author. Licensee MDPI, Basel, Switzerland.

BACKGROUND: Martial arts training has shown positive impacts on balance and physiological measurements. Further investigation of the contents and feasibility of an effective therapeutic assessment of martial arts is needed in older adults, mainly for future applications and real-world implementation. METHODS: Sixteen older adults (8 male, 8 female, age 59C90 years), with or without chronic conditions, participated in a preliminary study using 5-weeks of karate training and a triple baseline control procedure. Group and single subject data analyses were conducted for dynamic balance, Timed Up and Go (TUG), hand grip, ankle plantarflexion force, and spinal cord excitability (via the soleus H-reflex) pre- and post-training. RESULTS: On average, participants completed a total of 2437 steps, 1762 turns, 3585 stance changes, 2047 punches, 2757 blocks, and 1253 strikes. Karate training improved dynamic balance performance such that the group average time was reduced (time to target (?13.6%, p = 0.020) and time to center (?8.3%, p = 0.010)). TUG was unchanged when considering the entire group (p = 0.779), but six participants displayed significant changes. Left handgrip (7.9%, p = 0.037), and plantarflexion force in the right (28.8%, p = 0.045) and left leg (13.3%, p = 0.024) increased for the group. Spinal cord excitability remained unchanged in group data analysis but 5 individuals had modulated H(max)/M(max) ratios. CONCLUSION: 5-weeks of karate training delivered in a fashion to mimic generally accessible community-level programs improved balance and strength in older adults. Whole-body movement embodied in karate training enhanced neuromuscular function and postural control. We met the overriding goal of this preliminary study to emphasize and assess feasibility and safety for the generalizability of martial arts interventions to real-world communities to impact health outcomes. Further quantitative work should explore threshold dose and development of martial arts training interventions as potential exercise is medicine functional fitness for older adults.

The number of COVID-19 (Coronavirus Disease of 2019) cases in Jordan is rising rapidly. A serious threat to the healthcare system appears on the horizon. Our study aims to evaluate preparedness of Jordanian frontline doctors to the worsening scenario. It has a questionnaire-based cross-sectional structure. The questionnaire was designed to evaluate preparedness according to knowledge about virus transmission and protective measures, adherence to protection guidelines, and psychological impacts affecting doctors. Institutional factors affecting doctors readiness like adopting approach protocols and making protection equipment available were investigated; 308 doctors from different healthcare facilities participated (response rate: 53.9%). Approximately 25% of doctors (n = 77) previously took care of COVID-19 patients, and 173 (56.2%) have institutional COVID-19 approach protocols. Only 57 doctors (18.5%) reported all PPE (Personal Protective Equipment) available. The self-reported score of preparedness to deal with COVID-19 patients was 4.9 2.4. Doctors having institutional protocols for dealing with COVID-19 cases and those with sustained availability of PPE reported higher scores of preparedness (5.5 2.3 and 6.2 2.1 with p < 0.001, respectively). Correlations with knowledge score, adherence to PPE score, and psychological impacts were investigated. The study revealed multiple challenges and insufficiencies that can affect frontline doctors preparedness. Policy makers are urged to take these findings into consideration and to act promptly.

Two-way active avoidance (TWAA) acquisition constitutes a particular case of approach -avoidance conflict for laboratory rodents. The present article reviews behavioural, psychopharmacological and neuroanatomical evidence accumulated along more than fifty years that provides strong support to the contention that anxiety is critical in the transition from CS (conditioned stimulus)-induced freezing to escape/avoidance responses during the initial stages of TWAA acquisition. Thus, anxiolytic drugs of different types accelerate avoidance acquisition, anxiogenic drugs impair it, and avoidance during these initial acquisition stages is negatively associated with other typical measures of anxiety. In addition behavioural and developmental treatments that reduce or increase anxiety/stress respectively facilitate or impair TWAA acquisition. Finally, evidence for the regulation of TWAA acquisition by septo-hippocampal and amygdala-related mechanisms is discussed. Collectively, the reviewed evidence gives support to the initial acquisition of TWAA as a paradigm with considerable predictive and (in particular) construct validity as an approach-avoidance conflict-based rodent anxiety model.

Since the start of the Coronavirus disease 2019 (COVID-19) governments and health authorities across the world have find it very difficult in controlling infections. Digital technologies such as artificial intelligence (AI), big data, cloud computing, blockchain and 5G have effectively improved the efficiency of efforts in epidemic monitoring, virus tracking, prevention, control and treatment. Surveillance to halt COVID-19 has raised privacy concerns, as many governments are willing to overlook privacy implications to save lives. The purpose of this paper is to conduct a focused Systematic Literature Review (SLR), to explore the potential benefits and implications of using digital technologies such as AI, big data and cloud to track COVID-19 amongst people in different societies. The aim is to highlight the risks of security and privacy to personal data when using technology to track COVID-19 in societies and identify ways to govern these risks. The paper uses the SLR approach to examine 40 articles published during 2020, ultimately down selecting to the most relevant 24 studies. In this SLR approach we adopted the following steps; formulated the problem, searched the literature, gathered information from studies, evaluated the quality of studies, analysed and integrated the outcomes of studies while concluding by interpreting the evidence and presenting the results. Papers were classified into different categories such as technology use, impact on society and governance. The study highlighted the challenge for government to balance the need of what is good for public health versus individual privacy and freedoms. The findings revealed that although the use of technology help governments and health agencies reduce the spread of the COVID-19 virus, government surveillance to halt has sparked privacy concerns. We suggest some requirements for government policy to be ethical and capable of commanding the trust of the public and present some research questions for future research.

Detection of SASR-CoV-2 plays a significant role in reducing the transmission of COVID-19. Antigen swab test is widely used for screening due to its low processing time and cost, while RT-PCR is used in patient monitoring since it is quite expensive. Although the antigen swab test is more affordable than the RT-PCR, it only generates a discrete result: positive or negative. Thus, it cannot be used for patient monitoring. A method using antigen-antibody binding and surface plasmon resonance (SPR) principle was developed in this research to create an affordable, instant, and quantified SARS-CoV-2 detection method. In this study, modified scFv is tested as a potential bioreceptor since it is easier to be expressed than the whole antibody. The results show that the scFv with the best potential was harvested from the periplasm of E. coli and purified. It has a maximum response at 8.02 RU, LOD at 8.34 ng/mL, linearity at 1.38 in the range of 25-200 ng/mL, and a determination coefficient at 92 percent.

OBJECTIVE To report experience with negative pressure wound therapy (NPWT) in 45 consecutive dogs admitted with extensive cutaneous wounds and to determine if NPWT is feasible in veterinary hospital practice. STUDY DESIGN Prospective descriptive study. ANIMALS Dogs (n = 45). METHODS Collected data were organized into 6 categories: patient data, wound data, NPWT data, adjunctive treatments, complications, and final outcome. RESULTS Wounds (53 in 45 dogs) were largely traumatic in origin, and distributed fairly evenly to the trunk, proximal and distal aspects of the limbs. Most wounds (34 dogs, 76%) had no granulation tissue and were treated a mean of 4.2 days after wounding, whereas 11 dogs had granulating wounds that were initially treated a mean of 87 days after wounding. Median NPWT use was 3 days with a mean hospitalization of 7.8 days. Most wounds (33; 62%) were closed surgically after NPWT and were healed by 14 days. The other 18 wounds healed (mean, 21 days) by second intention after hospital discharge. Overall, 96% of the wounds healed; 2 dogs died before definitive closure could be attempted. CONCLUSION NPWT is applicable to a wide variety of canine wounds, is well tolerated, allows for several days between dressing changes, and can used to optimize the wound bed for surgical closure or second intention healing.

As the largest adult generation in the U S , millennials will have an outsized impact on the future of health care Here are some ways to make primary care more appealing to all patients, including the first group raised with the internet

BACKGROUND: In this study, we performed molecular characterization of SARS-CoV-2 strains in Hiroshima and its mutation pattern between the first and second waves of the outbreak. METHOD: A total of 55 nasal swab samples from the first wave in Hiroshima and 13 from the second wave were examined quantitatively by RT-qPCR and qualitatively by nested PCR using specific primers. Four samples from each wave underwent next-generation sequencing and phylogenetic tree analysis including controls and all sequences retrieved in Japan from GISAID and GenBank. Subsequently, mutations were examined. RESULTS: Viral load ranged 7.85 10(1)?1.42 10(8) copies/ml. Of 68 samples, one was Asian type-O, 65 were European type-GR, and 2 were undetectable. Phylogenetic tree analysis indicated that Japan was infected with various Asian strains (L, S, V, O) from January through April. By second week of March, European strains (G, GH, GR) had appeared, and GR strains became predominant after mid-March. The first case in Hiroshima was classified as Asian strain O, and the rest were GR strains. Then, second wave of GR strains appeared independently with 11C15 base mutations. Comparing the first- and second-wave GR strains, mutation rate was 1.17C1.36 10(?3) base substitutions per site per year; in addition, amino acid changes occurred at S1361P and P3371S in ORF1a, A314V in ORF1b, and P151L in N. All seven GR strains were D614G variants with R202K and G203R mutations in N. A single-nucleotide insertion in ORF8 that causes a defect in ORF8 protein was found in one isolate (S66) from the second wave. CONCLUSION: Our findings reveal the evolutionary hierarchy of SARS-CoV-2 in Japan. The predominant D614G variants and a new form of ORF8 deletion in Hiroshima provide the clue for role of viral factor in local outbreaks of SARS-CoV-2.

Face au COVID\19, les autorits nationales ont adopt des mesures de nature et de porte varies, avec des effets notables sur les marchs du travail, notamment pour certains groupes. Les auteurs utilisent les enqutes sur la population active de sept pays revenu intermdiaire ou lev pour observer les transitions professionnelles au premier semestre de 2020 et comparer la situation avec la mme priode de 2019. Ils concluent que la volatilit est plus faible dans les pays qui ont choisi de soutenir les revenus en subventionnant les salaires plut?t que par d'autres moyens, mais que la pandmie a creus les ingalits partout.