Aims: To establish if COVID-19 has worsened outcomes in patients with AO 31 A or B type hip fractures. Methods: Retrospective analysis of prospectively collected data was performed for a five-week period from 20 March 2020 and the same time period in 2019. The primary outcome was mortality at 30 days. Secondary outcomes were COVID-19 infection, perioperative pulmonary complications, time to theatre, type of anaesthesia, operation, grade of surgeon, fracture type, postoperative intensive care admission, venous thromboembolism, dislocation, infection rates, and length of stay. Results: In all, 76 patients with hip fractures were identified in each group. All patients had 30-day follow-up. There was no difference in age, sex, American Society of Anesthesiologists (ASA) classification or residence at time of injury. However, three in each group were not fit for surgery. No significant difference was found in 30-day mortality; ten patients (13%) in 2019 and 11 patients (14%) in 2020 (p = 0.341). In the 2020 cohort, ten patients tested positive for COVID-19, two (20%) of whom died. There was no significant increase in postoperative pulmonary complications. Median time to theatre was 20 hours (interquartile range (IQR) 16 to 25) in 2019 versus 23 hours (IQR 18 to 30) in 2020 (p = 0.130). Regional anaesthesia increased from 24 (33%) cases in 2019 to 46 (63%) cases in 2020, but ten (14%) required conversion to general anaesthesia. In both groups, 53 (70%) operations were done by trainees. Hemiarthroplasty for 31 B type fractures was the most common operation. No significant difference was found for intensive care admission or 30-day venous thromboembolism, dislocation or infection, or length of stay. Conclusion: Little information exists on mortality and complications after hip fracture during the COVID-19 pandemic. At the time of writing, no other study of outcomes in the UK has been published.Cite this article: Bone Joint Open 2020;1-7:415-419.

Two pathways are described for submission to FDA for clearance of a diagnostic device: a Premarket Application (PMA), which can lead to approval of a diagnostic device, and a Premarket Notification, which can lead to clearance. The latter is often called a 510(k), named for the statute providing for this path. Recent FDA clearance of molecular-based multiplex panels represents the beginning of a new era for the diagnosis of respiratory infections. The ability to test for multiple pathogens simultaneously, accompanied by the increasing availability of molecular-based assays for newly recognized respiratory pathogens will likely have a major impact on patient care, drug development, and public health epidemiology. We provide a general overview of how FDA evaluates new diagnostics for respiratory tract infections and the agencys expectations for sponsors developing new tests in this area.

In a prospective study, we sought to determine acceptability of linkage of administrative and clinical trial data among Canadian patients and Research Ethics Boards (REBs). The goal is to develop a more harmonized approach to data, with potential to improve clinical trial conduct through enhanced data quality collected at reduced cost and inconvenience for patients. On completion of the original LY.12 randomized clinical trial in lymphoma (NCT00078949), participants were invited to enrol in the Long-term Innovative Follow-up Extension (LIFE) component. Those consenting to do so provided comprehensive identifying information to facilitate linkage with their administrative data. We prospectively designed a global assessment of this innovative approach to clinical trial follow-up including rates of REB approval and patient consent. The pre-specified benchmark for patient acceptability was 80%. Of 16 REBs who reviewed the research protocol, 14 (89%) provided approval; two in Quebec declined due to small patient numbers. Of 140 patients invited to participate, 115 (82%, 95% CI 76 to 88%) from across 9 Canadian provinces provided consent and their full name, date of birth, health insurance number and postal code to facilitate linkage with their administrative data for long-term follow-up. Linkage of clinical trial and administrative data is feasible and acceptable. Further collaborative work including many stakeholders is required to develop an optimized secure approach to research. A more coordinated national approach to health data could facilitate more rapid testing and identification of new effective treatments across multiple jurisdictions and diseases from diabetes to COVID-19.

Pomegranate peel, the waste product generated from pomegranate fruit, has prophylactic properties, such as antimicrobial, anti-malarial, and controls respiratory infections and influenza. Based on the previous literature and need of the hour, molecular docking was performed to evaluate the inhibitory effects of major pomegranate peel polyphenols against COVID-19. Among the 44 studied compounds, 37 polyphenols show interaction with the catalytic dyad of the Mpro protease and 18 polyphenols have a higher binding affinity than that of the Mpro protease inhibitor (N3), indicating their high probability of binding at ACE2: SARS-CoV-2 interface. Furthermore, several polyphenols studied in this work are found to have higher binding affinity as compared to those of hydroxychloroquine, lopinavir, nelfinavir, and curcumin, some of which have been earlier tested against COVID-19. Further, molecular dynamics simulations (200 ns) for Mpro-polyphenols including pelargonidin3-glucoside, quercetin3-O-rhamnoside, cyanidin3-glucoside and punicalin revealed highly stable complexes with less conformational fluctuations and similar degree of compactness. Estimation of total number of intermolecular hydrogen bonds and binding free energy confirmed the stability of these Mpro-polyphenol complexes over Mpro-curcumin complex. Based on the greater binding affinity of polyphenols of pomegranate peel towards Mpro as compared to that of curcumin, pomegranate peel may be considered in any herbal medicinal formulation or may be incorporated into daily diets for prevention of COVID-19.Communicated by Ramaswamy H. Sarma.

Intestinal failure secondary to short bowel syndrome is still a very serious condition. Treatment consists of parenteral nutrition to provide nutrients and maintain body weight. During the last decades, intestinal lengthening procedures have become more available. The goal of this review is to discuss the results of the literature on the most commonly performed intestinal lengthening procedures. RECENT FINDINGS: Longitudinal Intestinal Lengthening, Serial Transverse Enteroplasty (STEP), and Spiral Intestinal Lengthening and Tailoring (SILT) are currently the most frequently reported intestinal lengthening procedures. The most recent literature of these procedures is described with respect to indication, technical details, complications, short and long-term outcome, and PN independence. SUMMARY: On the basis of indication, surgical complexity, complications, and clinical success, we conclude that the STEP procedure is probably the best choice for most centers.

The risk of potential vertical transmission in SARS-CoV-2 infected pregnant women is currently a topic of debate. To explore the correlation between the two, we searched PubMed, Embase?, and Web of Science for studies on vertical transmission of COVID-19. The quality of the studies was evaluated by the Cochrane risk of bias tool. Detailed information of each included case including methods of delivery, protection measures for mothers and neonates at birth, types of specimens, inspection time, results of testing and feeding patterns was collected to assess the possibility of vertical transmission. The results showed that of the 390 neonates reported in 36 studies, 23 were infected with SARS-CoV-2 by potential vertical transmission. From the perspective of virology and pathology, Vertical transmission of SARS-CoV-2 was possible via uterus or breastmilk. Some reported potential vertically transmitted neonates could be attributed to horizontal transmission. It is extremely vital to fully elucidate the potential routes of transmission of SARS-CoV-2, implicating clinical practices to reduce the risk of not only horizontal transmission but also vertical transmission, thus protecting neonates from COVID-19 infection.

Social media platforms face rampant misinformation spread through multimedia posts shared in highly-personalized contexts [10, 11] Foundational qualitative research is necessary to ensure platforms' misinformation interventions are aligned with users' needs and understanding of information in their own contexts, across platforms In two studies, we combined in-depth interviews (n=15) with diary and co-design methods (n=23) to investigate how a mix of Americans exposed to misinformation during COVID-19 understand their information environments, including encounters with interventions such as Facebook fact-checking labels Analysis reveals a deep division in user attitudes about platform labeling interventions, perceived by 7/15 interview participants as biased and punitive As a result, we argue for the need to better research the unintended consequences of labeling interventions on factual beliefs and attitudes Alongside these findings, we discuss our methods as a model for continued independent qualitative research on cross-platform user experiences of misinformation in order to inform interventions ? 2021 ACM

INTRODUCTION: During the COVID-19 pandemic, the discipline of geriatrics at the Santa Casa de Sao Paulo School of Medical Sciences of S?o Paulo was adapted to a web-based learning environment due to social distancing measures. OBJECTIVE: To describe the full adaptation of the discipline of geriatrics to a web-based learning tool, of two activities that were developed including the current COVID-19 to illustrate some of the main concepts of geriatric medicine. METHODS: The course was fully adapted to the open-source course management system called MOODLE. The first activity was a COVID-19 clinical case discussion, whose main objective was to include COVID-19 in the content of our course, illustrating some of the main concepts of geriatrics. The second activity was a Comprehensive Geriatric Assessment (CGA) experience, done via videoconference, which also assessed the impact of social distancing measures on the health of older adults. RESULTS: A total of 43 medical students performed both activities, and 95% of the students considered the inclusion of the COVID-19 into the discipline of geriatrics useful, 88% approved the practical experience of CGA, and 84% felt that they contributed to the health of the interviewees after contact. CONCLUSION: Adapting our discipline to a web-based learning tool, while including the current COVID-19 in our course content and a practical experience of CGA via videoconference was possible and approved by students. The adoption of this initiative may not only be an academic strategy, but also a possible way to improve the quality of life of older people during the COVID-19 pandemic

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Simulation resources offer an opportunity to highlight aerosol dispersion within the operating room environment. We demonstrate our methodology with a supporting video that can offer operating room teams support in their practical understanding of aerosol exposure and the importance of personal protective equipment.

This study examined the relationship between reactions of the bereaved to conditions of the pandemic and severity of their grief and levels of impairment. A total of 831 American adults who lost a loved one to COVID-19 responded to validated measures of dysfunctional grief and functional impairment, as well as items assessing unique complications associated with the pandemic (e.g. resentment toward doctors, social isolation). In combination, circumstantial risk factors accounted for 59% of the variance in social impairment and fully 71% of the variance in pandemic grief, leading to the development of an inventory of Pandemic Grief Risk Factors (PGRF), which displayed a unified factor structure, high reliability and strong convergent validity. Implications for psychological screening and intervention for those bereaved by COVID-19 are briefly noted.

Deductive verification has been successful in verifying interesting properties of real-world programs. One notable gap is the limited support for floating-point reasoning. This is unfortunate, as floating-point arithmetic is particularly unintuitive to reason about due to rounding as well as the presence of the special values infinity and Not a Number (NaN). In this paper, we present the first floating-point support in a deductive verification tool for the Java programming language. Our support in the KeY verifier handles arithmetic via floating-point decision procedures inside SMT solvers and transcendental functions via axiomatization. We evaluate this integration on new benchmarks, and show that this approach is powerful enough to prove the absence of floating-point special valuesoften a prerequisite for further reasoning about numerical computationsas well as certain functional properties for realistic benchmarks.

The coronavirus disease 2019 (COVID-19) crisis confronted us, like many researchers worldwide, with an unforeseen challenge during the final stages of a randomized controlled trial involving ataxia patients. Institutional guidelines suddenly no longer allowed regular follow-up visits to take place, impeding the clinical evaluation of long-term outcomes. Here, we discuss the various scenarios that we considered in response to these imposed restrictions and share our experience of home video recording by dedicated, extensively instructed family members. Albeit somewhat unconventional at first glance, this last resort strategy enabled us to reliably assess the study's primary endpoint at the predefined point in time and hopefully encourages researchers in other ongoing ataxia trials to continue their activities. Remote assessments of ataxia severity may serve as a reasonable substitute in interventional trials beyond the current exceptional situation generated by the COVID-19 pandemic, but will require further investigation.

PURPOSE: This study was conducted to explain the psychological reactions of COVID\19 patients to the stress caused by the disease crisis from the perspective of the survivors. DESIGN AND METHODS: A phenomenological approach was adopted to the qualitative study of 14 COVID\19 survivors selected through purposive sampling. FINDINGS: Two themes extracted as the psychological reactions of the patients to the COVID\19\induced stress included self\moderating effect of stress and psychological maladaptation. PRACTICE IMPLICATIONS: The present findings appear effective in laying the foundations for performing interventions to improve constructive psychological reactions such as using self\moderating mechanisms of the COVID\19\induced stress and reducing or eliminating maladaptive psychological reactions such as depression, anger, self\blaming, and regret.

The rapid proliferation of coronavirus put public health in danger, and affected the global economy, while making the tourism industry suffer its worst recession. The imposition of strict restrictions on citizens free movement by the majority of the countries, as an effort to stop or slow down the new Covid-19 cases, has resulted in a rapid decline in the turnover of tourism businesses since April 2020. With the tourist transportation services demand facing an unprecedented decrease, the tourism industry has to deal with difficulties which can even push many businesses to collapse. The hospitality industry proved to be vulnerable as visitors were susceptible to risk and therefore sought safety. During the Covid-19 pandemic, hotels turned to social media to achieve timely and direct communication with their customers. This study aims to record and analyze the use of social media by the total of 5* hotels of Attica region during the coronavirus pandemic. A qualitative research was undertaken, and a social media posts analysis was conducted. The frequency, topic and purpose of the posts were detected and interpreted. The results show that hotels used social media to adopt a more humane attitude by sharing a sense of hope and care. Implications for actions and initiatives that need to be undertaken in the future are discussed. ? 2021, The Author(s), under exclusive license to Springer Nature Switzerland AG.

INTRODUCTION: Distortion product otoacoustic emission (DPOAE) was measured to investigate the effect of mask use and type on oxygen saturation on cochlear function in health care professionals during the COVID-19 pandemic. MATERIAL AND METHODS: Group 1 participants wore surgical masks; Group 2 participants wore N95 masks. Distortion product otoacoustic emission and oxygen saturation were measured in both groups before and after mask use. RESULTS: Comparison of signal-to-noise ratio (SNR) values before and after surgical mask use in DPOAE measurements of group 1 revealed statistically significant difference in the right and left ears. Comparison of the SNR values in DPOAE measurements of group 2 before and after 8 hours of N95 mask use revealed statistically significant differences in the right ear at 988, 2963, 4444, and 8000 Hz and in the left ear at 8000 Hz. CONCLUSION: We found that prolonged mask use may affect the outer hair cells in the cochlea, causing deterioration in DPOAE values.

While Vietnam suffered economically due to COVID-19, the ruling Vietnam Communist Party burnished its image through its successful management of the crisis. This review examines the roots of the party's success and discusses why the party has nonetheless continued to stifle dissent. It also previews the 13th Party Congress. ? 2021 by The Regents of the University of California.

En Berkeley Inglaterra en1749 nace Edward Jenner, el hombre que cambio la historia de la medicina En 1796 ya siendo medico visitaba tambos y observaba con espiritu critico, las pustulas de las ordenadoras ocasionadas por la viruela vacuna En esa epoca morian anualmente en el mundo 9 millones de personas Jenner sabia por Lady Montagu (esposa del embajador ingles en Turquia) que alli inoculaban desde 1721 virus de lesiones de viruela humana Si bien algunos se inmunizaban, un gran numero moria En sus visitas a las ordenadoras, una de ellas le dijo que no tenia miedo a la viruela porque estaba protegida por la contaminacion vacuna A ella le pidio que permitiera inocular con material de sus pustulas a su hijo de 8 anos James Phipps, el nino tuvo fiebre leve que supero en dias

Color is the most potent stimulating factor affecting human vision, and the environmental color of an indoor space is a spatial component that affects the environmental stress level. As one of the methods of assessing the physiological response of the autonomic nervous system that influences stress, heart rate variability (HRV) has been utilized as a tool for measuring the users stress response in color environments. This study aims to identify the effects of the changes of hue, brightness, and saturation in environmental colors on the HRV of two groups with different stress levelsthe stress potential group (n = 15) and the healthy group (n = 12)based on their stress level indicated by the Psychosocial Well-being Index (PWI). The ln(LF), ln(HF), and RMSSD values collected during the subjects exposure to 12 environments colors of red and yellow with adjusted saturation and brightness, were statistically analyzed using t-test and two-way ANOVA. The results show that the HRV values in the two groups did not significantly vary in response to the changes in hue, brightness and saturation. The two groups stress factors distinguished according to the stress levels by the PWI scale affected the In(LF) parameter, which demonstrates that the PWI index can be utilized as a reliable scale for measuring stress levels. The ultra-short HRV measurement record and the use of a sole In(LF) parameter for stress assessment are regarded as the limitations of this study.

There is a high incidence of upper respiratory viral infections in the human population, with infection severity being unique to each individual. Upper respiratory viruses have been associated previously with secondary bacterial infection, however, several cross-sectional studies analyzed in the literature indicate that an inverse relationship can also occur. Pathobiont abundance and/or bacterial dysbiosis can impair epithelial integrity and predispose an individual to viral infection. In this review we describe common commensal microorganisms that have the capacity to reduce the abundance of pathobionts and maintain bacterial symbiosis in the upper respiratory tract and discuss the potential and limitations of localized probiotic formulations of commensal bacteria to reduce the incidence and severity of viral infections.