Interprofessional and intraprofessional collaboration in crises situations in the intensive care unit regarding COVID-19 - a qualitative, retrospective analysis Abstract. Background: Interprofessional collaboration is elementary in the intensive care unit, a success factor in difficult patient situations and complex therapies. The COVID-19-pandemic challenged newly composed treatment teams, however, experience does not exist. Aim: We analyzed personal experiences and views on inter- and intraprofessional collaboration in intensive care units during the COVID-19-pandemic and identified influencing factors. Methods: We used a qualitative, retrospective study design, collected data from physicians, nurses in intensive care, anesthesia and surgery and physiotherapists during group discussions using the story / dialogue method. We analyzed the data according to Mayring's Qualitative content analysis. Results: We identified two main categories, each with three sub-categories: 1. Mastering a exceptional situation actively (Recognizing a common goal; Acting in solidarity; Getting to know each other in inter- / intraprofessional collaboration), 2. Having overcome the exceptional situation in retrospect (Maintaining personal contacts; Gaining new knowledge and perspectives; Taking what has been learned into the future). The participants rated the interprofessional and intraprofessional collaboration as good to very good. Conclusions: Factors promoting collaboration and positive experiences are to be incorporated into everyday work. The intraprofessional management team thereby defines common goals and values for the best possible patient care.

One of harm reduction's most salient features is its pragmatism. Harm reduction purports to distinguish itself from dominant prohibitionist and abstinence-based policy paradigms by being grounded in what is realistic, in contrast with the moralism or puritanism of prohibition and abstention. This is reflected in the meme "harm reduction works", popular both in institutional and grassroots settings. The idea that harm reduction is realistic and effective has meant different things among the main actors who seek to shape harm reduction policy. Drawing on scholarly literature about harm reduction, as well as examples from recent harm reduction advocacy efforts in relation to drug policy in Canada, this paper argues that harm reduction distinguishes itself through a unique "way of knowing". Grassroots harm reduction advocates, particularly as they argue through human rights frameworks, do more than simply make claims for the provision of particular services-like needle exchange, safe consumption sites, safe supply and the like-on the basis that these are realistic paths toward the health and well-being of people who use drugs. Rather, as they marshal lived experience in support of these policy changes through peer-driven initiatives in contexts of prohibition, they make particular claims about what constitute valid, methodologically rigorous evidence bases for action in contexts where policies to date have been driven by ideology and have developed in ways that have excluded and marginalized those most affected from policymaking. In doing so, they advocate for the centrality of people who use drugs not only in policy-making processes, but in evidence production itself.

Dengue virus, a positive-sense single-stranded RNA virus, continuously threatens human health. Although several criteria for evaluation of severe dengue have been recently established, the ability to prognose the risk of severe outcomes for dengue patients remains limited. Mutant spectra of RNA viruses, including single nucleotide variants (SNVs) and defective virus genomes (DVGs), contribute to viral virulence and growth. Here, we determine the potency of intrahost viral population in dengue patients with primary infection that progresses into severe dengue. A total of 65 dengue virus serotype 2 infected patients in primary infection including 17 severe cases were enrolled. We utilized deep sequencing to directly define the frequency of SNVs and detection times of DVGs in sera of dengue patients and analyzed their associations with severe dengue. Among the detected SNVs and DVGs, the frequencies of 9 SNVs and the detection time of 1 DVG exhibited statistically significant differences between patients with dengue fever and those with severe dengue. By utilizing the detected frequencies/times of the selected SNVs/DVG as features, the machine learning model showed high average with a value of area under the receiver operating characteristic curve (AUROC, 0.966 0.064). The elevation of the frequency of SNVs at E (nucleotide position 995 and 2216), NS2A (nucleotide position 4105), NS3 (nucleotide position 4536, 4606), and NS5 protein (nucleotide position 7643 and 10067) and the detection times of the selected DVG that had a deletion junction in the E protein region (nucleotide positions of the junction: between 969 and 1022) increased the possibility of dengue patients for severe dengue. In summary, we demonstrated the detected frequencies/times of SNVs/DVG in dengue patients associated with severe disease and successfully utilized them to discriminate severe patients using machine learning algorithm. The identified SNVs and DVGs that are associated with severe dengue will expand our understanding of intrahost viral population in dengue pathogenesis.

Nanoparticle assembly is a complex and versatile method of generating new materials, capable of using thousands of different combinations of particle size, shape, composition, and ligand chemistry to generate a library of unique structures. Here, a history of particle self-assembly as a strategy for materials discovery is presented, focusing on key advances in both synthesis and measurement of emergent properties to describe the current state of the field. Several key challenges for further advancement of nanoparticle assembly are also outlined, establishing a roadmap of critical research areas to enable the next generation of nanoparticle-based materials synthesis.

OBJECTIVES This study tested the effect of Epimedium-derived phytoestrogen (PE) on preventing steroid-associated osteonecrosis (ON) in rabbit model. METHODS Thirty 28-week-old male New-Zealand white rabbits were divided into control group (CON; n=14) and PE group (PE; n=16; 5 mg/kg body weight/day) after receiving an established inductive protocol for inducing steroid-associated ON. Before and after inductive protocol, Dynamic-MRI was employed on bilateral femora for local intra-osseous perfusion, blood samples were examined for coagulation, fibrinolysis and lipid-transportation, and marrow samples were quantified for adipogenesis-gene mRNA expression. Six weeks later, bilateral femora were dissected for Micro-CT-based micro-angiography, and then ON lesion, intravascular thrombosis and extravascular fat-cell-size were examined histopathologically. RESULTS The incidence of ON in the PE group (31%) was significantly lower than that in the CON group (93%). Compared to the CON group, local intra-osseous perfusion was maintained in the PE group. Blocked trunk vessels were seldom found in micro-angiography of the PE-treated rabbits. Thrombosis incidence and fat-cell-size were both significantly lower in the PE group than those in the CON group. During the early period after induction, indicator of coagulation, fibrinolysis, lipid-transportation and adipogenesis-gene expression were found with significantly changing pattern in the PE group compared to the CON group. CONCLUSION PE was able to exert beneficial effect on preventing steroid-associated ON in rabbits with inhibition of both thrombosis and lipid deposition.

BACKGROUND: Efforts to define research Common Data Elements try to harmonize data collection across clinical studies. OBJECTIVE: Our goal was to analyze the quality and usability of data dictionaries of HIV studies. METHODS: For the clinical domain of HIV, we searched data sharing platforms and acquired a set of 18 HIV related studies from which we analyzed 26 328 data elements. We identified existing standards for creating a data dictionary and reviewed their use. To facilitate aggregation across studies, we defined three types of data dictionary (data element, forms, and permissible values) and created a simple information model for each type. RESULTS: An average study had 427 data elements (ranging from 46 elements to 9 945 elements). In terms of data type, 48.6% of data elements were string, 47.8% were numeric, 3.0% were date and 0.6% were date-time. No study in our sample explicitly declared a data element as a categorical variable and rather considered them either strings or numeric. Only for 61% of studies were we able to obtain permissible values. The majority of studies used CSV files to share a data dictionary while 22% of the studies used a non-computable, PDF format. All studies grouped their data elements. The average number of groups or forms per study was 24 (ranging between 2 and 124 groups/forms). An accurate and well formatted data dictionary facilitates error-free secondary analysis and can help with data de-identification. CONCLUSION: We saw features of data dictionaries that made them difficult to use and understand. This included multiple data dictionary files or non-machine-readable documents, data elements included in data but not in the dictionary or missing data types or descriptions. Building on experience with aggregating data elements across a large set of studies, we created a set of recommendations (called CONSIDER statement) that can guide optimal data sharing of future studies.

Documentation and evidence analysis are major components in forensic investigation; hence two-dimensional (2D) photographs along with three-dimensional (3D) models and data are used to accomplish this task. Data generated through 3D scanning and photogrammetry are generally visualised on a computer screen. However, spatial details are lost on the visualisation of 3D data on 2D computer screens. Virtual reality (VR) is an immersive technology that allows a user to visualise 3D information by immersing oneself into the scene. In forensics, VR was particularly introduced for the visualising and plotting distances of crime scenes; however, this technology has wider applications in the field of forensics and for court presentation. This short communication outlines the concept of VR and its potential in the field of forensics.

Breast cancer survival rates have markedly improved. Consequently, survivorship issues have received increased attention. One common sequela of treatment is chemotherapy-induced cognitive impairment (CICI). CICI causes a range of impairments that can have a significant negative impact on quality of life. Knowledge of the prevalence of this condition is required to inform survivorship plans, and ensure adequate resource allocation and support is available for sufferers. Objective To estimate the prevalence of cognitive impairment following chemotherapy treatment for breast cancer. Methods Medline, Scopus, CINAHL and PSYCHInfo were searched for eligible studies which included prevalence data on CICI, as ascertained though the use of self-report, or neuropsychological tests. Methodological quality of included studies was assessed. Findings were synthesised narratively, with meta-analyses being used to calculate pooled prevalence when impairment was assessed by neuropsychological tests. Results and discussion The review included 52 studies. Time-points considered ranged from the chemotherapy treatment period to greater than 10 years after treatment cessation. Summary prevalence figures (across time-points) using self-report, short cognitive screening tools and neuropsychological test batteries were 44%, 16% and 21-34% respectively (very low GRADE evidence). Conclusion Synthesised findings demonstrate that 1 in 3 breast cancer survivors may have clinically significant cognitive impairment. Prevalence is higher when self-report based on patient experience is considered. This review highlights a number of study design issues that may have contributed to the low certainty rating of the evidence. Future studies should take a more consistent approach to the criteria used to assess impairment. Larger studies are urgently needed.

Among different approaches to control the COVID-19 disease, there is clear interest to develop inhibitors which block the virus interaction with the host cells and through this simple mechanism could facilitate developing medication In this report, interaction of the virus SARS- CoV-2 spike protein S1 binding site with potential antiviral peptide ligands is analysed computationally The peptides are derived from the binding domain of the angiotensinconverting enzyme 2, which is the receptor site for this virus These calculations reveal that although shortening of these peptides from the N terminus and C terminus reduces their docking energy on the S1 binding site, there is still a number of peptides which effectively bind to the binding site on the SARS CoV2 spike protein S1, and thus can be used as leads for further optimization of the inhibitory effect Finally, this may open new perspectives for working out treatments against the virus infection (English) [ABSTRACT FROM AUTHOR] Arendusfaasis olevate erinevate COVID-19 raviv?imaluste hulgas eristub selge huvi inhibiitorite v?ljattamise vastu, mis blokeerivad viiruse tungimist peremeesrakku ja h?lbustavad selle lihtsa mehhanismi kaudu haiguse ravi Sellest ideest l?htudes on k?esolevas ts uuritud SARS-CoV-2 teravikvalgul S1 asuva sidumistsentri omadusi, sest selle kaudu seostub see viirus raku pinnal asuva retseptorvalguga ACE2, millele j?rgneb viiruse RNA tungimine peremeesrakku Uuringuks vajalikud peptiidid (200 hendit) konstrueeriti ACE2 struktuurist l?htudes ja nende jaoks arvutati dokkimise energia, mis kirjeldab nende seostumist viiruse teravikvalguga S1 Need arvutused n?itavad, et juba uuritud peptiidide hulgas esineb mitmeid hendeid, mis efektiivselt seonduvad teravikvalguga ja seega takistavad viiruse seondumist rakuga Saadud andmetest l?htudes on v?imalik j?tkata uurimistd peptiidide sidumise efektiivsuse edasiseks suurendamiseks, pidades silmas viirusinfektsioonivastaste ravimite loomise perspektiivi (Estonian) [ABSTRACT FROM AUTHOR] Copyright of Proceedings of the Estonian Academy of Sciences is the property of Teaduste Akadeemia Kirjastus and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission However, users may print, download, or email articles for individual use This abstract may be abridged No warranty is given about the accuracy of the copy Users should refer to the original published version of the material for the full abstract (Copyright applies to all Abstracts )

Cities are currently struggling with increasingly limited land availability and rising land prices in urban areas In this regard, proper land management can control land prices and optimize space to be effective, efficient and sustainable This paper presents the results of research in Sungai Selan, a small city of Central Bangka Regency It focuses on the forms of land management by determining the community and stakeholder readiness in a Land Cooperative Institution to implement a Detail Urban Spatial Plan (RDTRK), especially concerning land consolidation We conducted this study during the Covid-19 pandemic and, therefore, research methods were adapted to suit the prevailing conditions by uploading expert priority choices online The experts involved were those considered the main stakeholders of RDTRK implementation, such as representatives from the local government agencies, members of the Local Council of People Representative (DPRD), and selected members of cooperatives dealing with land and spatial issues The results show that stakeholders are in general ready to establish land cooperatives and incorporate into RDTRK implementation with certain conditions ? 2020 by the authors Licensee MDPI, Basel, Switzerland

In recent years, Digital Technologies (DTs) are becoming an inseparable part of human lives. Thus, many scholars have conducted research to develop new tools and applications. Processing information, usually in the form of binary code, is the main task in DTs, which is happening through many devices, including computers, smartphones, robots, and applications. Surprisingly, the role of DTs has been highlighted in people's life due to the COVID-19 pandemic. There are several different challenges to implement and intervene in DTs during the COVID-19 outbreak; therefore, the present study extended a new fuzzy approach under Hesitant Fuzzy Set (HFS) approach using Stepwise Weight Assessment Ratio Analysis (SWARA) and Weighted Aggregated Sum Product Assessment (WASPAS) method to evaluate and rank the critical challenges of DTs intervention to control the COVID-19 outbreak. In this regard, a comprehensive survey using literature and in-depth interviews have been carried out to identify the challenges under the SWOT (Strengths, Weaknesses, Opportunities, Threats) framework. Moreover, the SWARA procedure is applied to analyze and assess the challenges to DTs intervention during the COVID-19 outbreak, and the WASPAS approach is utilized to rank the DTs under hesitant fuzzy sets. Further, to demonstrate the efficacy and practicability of the developed framework, an illustrative case study has been analyzed. The results of this study found that Health Information Systems (HIS) was ranked as the first factor among other factors followed by a lack of digital knowledge, digital stratification, economic interventions, lack of reliable data, and cost inefficiency In conclusion, to confirm the steadiness and strength of the proposed framework, the obtained outputs are compared with other methods.

Sustainable development is a concern and a challenge of modern societies, either in developing and developed countries. Good governance is crucial to managing efficiently all kind of resources, including natural resources, for the well-being of current and future generations. Digital transformation can be a key driver of changes in governments if they want to enhance transparency, accountability and efficiency. E-government facilitates integrated policies and public services to promote sustainable and inclusive economic growth, social development and environmental protection. E-government contributes to efficient resource management, and so can help to improve namely natural resource usage in the present to avoid damage to their usage in the future. The aim of this study is to analyse the impact of e-government on sustainable development. Using a logit model, for a sample of 103 countries in the period 2003C2018, the results suggest that e-government development is a positive determinant for a country to attain sustainable development, proxied by adjusted net savings, that embraces a countrys economic, social and environmental development. This study provides evidence that e-government increases the probability to attain sustainable development mostly in developing and transition economies. The results also suggest that economic growth and gross national income per capita are significant positive influences in sustainable development in the whole sample and that countries with lower age dependency and natural resource rents are more likely to have sustainable development. Developing e-government allows promoting sustainable development, particularly in developing and in transition economies.

Stressful life events predict changes in brain structure and increases in psychopathology, but not everyone is equally affected by life stress. The learned helplessness theory posits that perceiving life stressors as uncontrollable leads to depression. Evidence supports this theory for youth, but the impact of perceived control diverges based on stressor type: perceived lack of control over dependent (self-generated) stressors is associated with greater depression symptoms when controlling for the frequency of stress exposure, but perceived control over independent (non-self-generated) stressors is not. However, it is unknown how perceived control over these stressor types is associated with brain structure. We tested whether perceived lack of control over dependent and independent life stressors, controlling for stressor exposure, is associated with gray matter (GM) in a priori regions of interest (ROIs; mPFC, hippocampus, amygdala) and across the cortex in a sample of 108 adolescents and emerging adults ages 14-22. There were no associations across the full sample between perceived control over either stressor type and GM in the ROIs. However, less perceived control over dependent stressors was associated with greater amygdala gray matter volume in female youth and greater medial prefrontal cortex thickness in male youth. Furthermore, whole-cortex analyses revealed less perceived control over dependent stressors was associated with greater GM thickness in cortical regions involved in cognitive and emotional regulation. Thus, appraisals of control have distinct associations with brain morphology while controlling for stressor frequency, highlighting the importance of differentiating between these aspects of the stress experience in future research.

With the deepening of economic integration, it is important to study the spillover effect of macroeconomic uncertainty among regions along with social network knowledge. Based on microblog users' network connection, this paper analyzes the network factors that affect the uncertain spillover effect between regions by using ERGM. It is found that there are three peaks of uncertainty spillover effect in China, corresponding to the financial crisis in 2008, the post financial crisis in 2010 and COVID-19 in early 2020. As an effective transmission mode and a reflection of inter provincial relations, close social relationships are crucial in the study of uncertainty spillover effects. Relatively developed provinces have higher spillover effect, while relatively underdeveloped provinces are usually the recipients of uncertainty in the network. In particular, the impact of inter provincial social network on uncertainty spillover is statistically more significant than that of GDP, population, transportation and other node attributes.

Current levels of public acceptability of immunisation put at serious risk the effectiveness of any future anti-SARS-CoV-2 vaccination programs High levels of

Efficient vaccines are the main strategy to control the avian coronavirus (AvCoV), although several drawbacks related to traditional attenuated and inactivated vaccines have been reported. These counterpoints highlight the importance of developing new alternative vaccines against AvCoV, especially those able to induce long-lasting immune responses. This study evaluated and compared two inactivated vaccines formulated with AvCoV BR-I variants, one composed of chitosan nanoparticles (AvCoV-CS) and the second by Montanide oily adjuvant (AvCoV-O). Both developed vaccines were administered in a single dose or associated with the traditional Mass attenuated vaccine. The AvCoV-CS vaccine administered alone or associated with the Mass vaccine was able to induce strong humoral and cell-mediated immune (CMI) responses and complete protection against IBV virulent infection, wherein single administration was characterized by high IgA antibody levels in the mucosa, whereas when associated with the Mass vaccine, the serum IgG antibody was predominantly observed. On the other hand, single administration of the oily vaccine presented poor humoral and CMI responses and consequently incomplete protection against virulent challenge, but when associated with the Mass vaccine, immune responses were developed, and complete protection against infection was observed. Both of our experimental vaccines were able to induce full protection against virulent IBV challenge. A single dose of AvCoV-CS vaccine was sufficient to achieve complete protection, while AvCoV-O required a previous priming by a Mass strain to complete the protection.

The authors have requested that this preprint be withdrawn due to erroneous posting.

The ability to adapt and utilize emergency facilities is a critical element in responding to surges resulting from man-made and natural events. The current stresses on emergency services throughout the country find few adequately prepared to effectively absorb a sudden increase in patients along with some of the potential special requirements, such as quarantining of epidemic patients and mass decontamination. This article reviews major findings of the federally funded ER One project, a research initiative that has described a number of facility strategies, which should be considered in planning new emergency facilities. An early case study in the application of these principles at the recently completed Tampa General Hospital emergency service is provided, illustrating how, when integrated into the early planning and design, many of the ER One recommendations can be implemented at modest capital cost increases.

OBJECTIVES: Dental treatments are inherently associated with the appearance of potentially infective aerosols, blood and saliva splashes. The aim of the present study was to investigate the quantitative contamination of protective eyewear during different dental treatments and the efficacy of the subsequent disinfection. MATERIALS AND METHODS: Fifty-three standardized protective eyewear shields worn by students, dentists and dental assistants during different aerosol-producing dental treatment modalities (supragingival cleaning, subgingival periodontal instrumentation, trepanation and root canal treatment and carious cavity preparation; within all treatments, dental evacuation systems were used) were analysed, using common forensic techniques. For detection of blood contamination, luminol solution was applied onto the surface of safety shields. A special forensic test paper was used to visualize saliva contamination. Further analysis was conducted after standardized disinfection using the same techniques. Statistical analysis was performed using SPSS. RESULTS: Macroscopically detectable contamination was found on 60.4% of protective eyewear surfaces. A contamination with blood (median 330 pixels, equivalent to 0.3% of the total surface) was detected on all shields after dental treatment. Between various dental treatments, the contamination with blood tend to be statistically significant (p = 0.054). Highest amount of blood was observed after professional tooth cleaning (median 1,087 pixels). Significant differences of saliva contamination were detected between the different measurements (p < 0.001) with contamination only after dental treatment. Due to the low variance and right-skewed distribution for saliva contamination, no statistical analysis between different treatments could be performed. After disinfection, 0.02% blood contamination and no saliva contamination were detected. CONCLUSIONS: Disinfection is effective against blood and saliva contamination. Macroscopically, clean protective eyewear contains up to 12% surface contamination with blood. Based on the results, it may be concluded that protective eyewear is essential for each dental practitioner. CLINICAL RELEVANCE: As standard for infection prevention in the dental practice, disinfection of protective eyewear after each patient is necessary.

This article describes a rapid implementation research project with the Stockholm health care system to assist the system to respond to the COVID-19 pandemic. It uses this example to illustrate some ways in which implementation research and knowledge can contribute to improving service responses to the pandemic and its consequences as these evolve over the coming months. A sub-specialty of rapid implementation science is proposed to provide practical assistance and as one way to develop implementation research. PLAIN LANGUAGE ABSTRACT: This article describes a rapid implementation research project with the Stockholm health care system to assist the system to respond to the COVID-19 pandemic. It uses this example to illustrate some ways in which implementation research and knowledge can contribute to improving service responses to the pandemic and its consequences as these evolve over the coming months. A sub-specialty of rapid implementation science is proposed to provide practical assistance and as one way to develop implementation research.