bluuebunny/crossref_metadata_2025 huggingface dataset:
Corporate Branding Organisasi Sektor Publik: Studi pada Technology Business Incubation Center Puspiptek
Authors:   Pascasarjana Ilmu Komunikasi, Universitas Indonesia, Sugiono Shiddiq , Puspitasari Maria ,   Sekolah Kajian Stratejik dan Global, Universitas Indonesia
Published: January 2021

Abstract. Technology Business Incubation Center (TBIC) Puspiptek is a public sector organization that provides business incubation services to startup companies. Communicating the identity of the organization to stakeholders is one effort that can be done to build its own appeal compared to other organizations. This study aims to provide an overview and evaluate the TBIC Puspiptek corporate branding activities through alignment of the vision-culture-image (VCI) model. The method used in this research is descriptive analysis with a qualitative approach, while the research data were obtained through interviews with TBIC management and documentation studies. The results of the study mentioned that TBIC Puspiptek has tried to harmonize its goals, culture and image even though there are still gaps between these components. TBIC has sought to harmonize its identity through the provision of services that foster a spirit of technopreneurship, build a positive communication climate and build good budget management. As for the gaps that arise due to less intense communication with stakeholders, the culture of public sector organizations that are less suited to the private sector as well as the irrelevance of the competencies of incubator managers. The conclusion that can be drawn is that public sector organizations involved in business competition need to do corporate branding in order to have their own appeal compared to other organizations. This research also provides various implications, one of which is to transform the Puspiptek culture as a learning organization. Keywords: Corporate branding, public sector organizations, business incubator, identity, VCI model
EL INGRESO MÍNIMO VITAL EN HOGARES UNIPERSONALES.
Authors: Jimeno Jiménez Fernando M.
Published: January 2021

This document studies the application of the new minimum vital income in relation to people who live alone in single-person households, a phenomenon with increasing importance in Spain. It´s detected how the residency requirements are more rigorous than those foreseen for traditional coexistence units, appreciating difficulties in the accreditation of requirements (registration and residence) in the homeless or hidden gender abuse. Matters that must be addressed are analyzed, such as the homogeneity in the requirements for non-contributory disability or retirement pensions in relation to the minimum vital income, the role that the Autonomous Communities must assume, the expansion of the maximum period of resolution and notification of six months or the need to present an annual income statement.
TRABAJO DOMÉSTICO Y PROTECCIÓN SOCIAL FRENTE A CONTINGENCIAS DEL TRABAJO.
Authors: Romeral Hernández Josefa
Published: January 2021

The social protection of household employees related to work contingencies is created parallel to their integration into the General Regime as a Special Relation, with the aim of equating their rights to those of the common Labor Relation, without it having been completed so far. This work presents a review of the legal regime of protection related to these contingencies, highlighting the deficiencies pending to be addressed in order to achieve real equality and dignification of the profession, such as occupational health and safety and unemployment protection, among others.
EMPLEABILIDAD Y APRENDIZAJE PERMANENTE EN LA ECONOMÍA FORMAL E INFORMAL: UN ANÁLISIS DEL TRABAJO DEL FUTURO EN EL HIPERCAPITALISMO.
Authors: Noronha Nassif Elaine
Published: January 2021

Splitting of the Statement of the Centenary of the OIT on the “future of the Work” (2019), of the Recommendation 195 of the OIT on the Development of Human Resources (2004), of the Recommendation 204 on Transition of the informal work for the formal work (2015), of the Report on Women and Men in the Informal Economy (2018) and statistical used for this rule, this article analyses of critical form the relation between the formal and informal work of the point of view of the employability and of the permanent learning required at present in the skilled literature, to find the underlying profile of the “industrial army of reservation” that it needs capitalism in the future of the work of the fourth industrial revolution
LÍMITES AL DERECHO DE ASISTENCIA SANITARIA TRANSFRONTERIZA Y PRINCIPIO DE PROPORCIONALIDAD TRAS LA SENTENCIA DEL TJUE DE 23 DE SEPTIEMBRE DE 2020.
Authors: López Insua Belén
Published: January 2021

Health protection is one of the fundamental pillars of the European Union and of the process of social-democratic constitutionalism. The achievement of a Community health care system is now more than ever one of the great challenges for the European community. In spite of these objectives, the European Union has adopted a logic that relies more on an interventionist model than on simple coordination, rather than on a harmonised system for all Member States. Unfortunately, this particular cooperative pluralism has made each of the Community countries competent and responsible for the coordination rules laid down by the Union. In this sense, Directive 2011/24/EU is set as the reference standard to guarantee the right of all European citizens to receive safe and quality healthcare, both in the public sphere and in the private sphere of another Member State. The aim is to guarantee the freedom of movement and movement of persons without damaging health. Today, the right to health care is a fundamental social right of a primary nature, which is linked to the right to life and dignity.
Ponto de vista dos profissionais de Educação Física sobre o uso da máscara facial durante o exercício físico na pandemia da COVID-19
Authors: Ferreira Mariana da Silva , Farias Gildeene Silva , Barros Gerleison Ribeiro , Santos Sueyla Ferreira da Silva , Sousa Thiago Ferreira de
Published: January 2021

O objetivo do estudo foi analisar a opinião dos profissionais de Educação Física (PEF) sobre as recomendações do uso de máscara facial na prática de exercícios físicos (EF) ao ar livre durante a pandemia de COVID-19. Foi realizado um estudo transversal com 2.234 PEF do Brasil. Um formulário on-line foi enviado para os PEF com 12 perguntas sobre recomendações do uso de máscara facial na prática de EF ao ar livre. Foi realizado teste do χ2 de Pearson e χ2 para tendência linear para avaliar a associação entre as variáveis, adotando o nível de significância de 5%. Os resultados mostram que 73,4% dos PEF recomendam a prática de EF ao ar livre no cenário da pandemia da COVID-19. Sobre o uso de máscara facial durante o EF, a recomendação foi maior para o uso somente em locais com aglomerações de pessoas e impossibilidade de distanciamento social (48,2%). Uma proporção significativa de profissionais opinou que a utilização da máscara facial durante o EF ao ar livre pode ser prejudicial, tanto para o desempenho físico (50,6%), como à saúde dos praticantes (37,7%). Houve associação entre o maior grau de titulação acadêmica do PEF com a recomendação do uso de máscara facial em qualquer situação (p = 0,003). Concluímos que, apesar dos PEF recomendarem a prática de EF ao ar livre, a maioria recomenda a utilização da máscara facial apenas na impossibilidade de distanciamento social.
Private Sequential Learning
Authors: Tsitsiklis John N. , Xu Kuang , Xu Zhi
Published: January 2021

Can we learn privately and efficiently through sequential interactions? A private learning model is formulated to study an intrinsic tradeoff between privacy and query complexity in sequential learning. The formulation involves a learner who aims to learn a scalar value by sequentially querying an external database and receiving binary responses. In the meantime, an adversary observes the learner’s queries, although not the responses, and tries to infer from them the scalar value of interest. The objective of the learner is to obtain an accurate estimate of the scalar value using only a small number of queries while simultaneously protecting his or her privacy by making the scalar value provably difficult to learn for the adversary. The main results provide tight upper and lower bounds on the learner’s query complexity as a function of desired levels of privacy and estimation accuracy. The authors also construct explicit query strategies whose complexity is optimal up to an additive constant.
Gauging diffraction patterns: field of view and bandwidth estimation in lensless holography
Authors: Soulez Ferréol
Published: January 2021

The purpose of this work is to provide a theoretically grounded assessment on the field of view and bandwidth of a lensless holographic setup. Indeed, while previous works have presented results with super-resolution and field-of-view extrapolation, there are no well-established rules to determine them. We show that the theoretical field of view can be large with a spatial-frequency bandwidth only limited by the wavelength, leading to an unthinkable number of degrees of freedom. To keep a realistic field of view and bandwidth, we propose several practical bounds based on a few setup properties, namely, the noise level and spatiotemporal coherence of the source.
Broadband mirrors for surface plasmon polaritons using integrated high-contrast diffraction gratings
Authors: Bezus Evgeni A. , Doskolovich Leonid L.
Published: January 2021

We propose and numerically investigate integrated high-contrast gratings (HCGs) for surface plasmon polaritons (SPPs) propagating along metal-dielectric interfaces, which consist of periodically arranged silicon pillars located on the gold surface. We demonstrate that such on-chip HCGs can be used as broadband plasmonic mirrors, which have subwavelength footprint in the SPP propagation direction and mean reflectance exceeding 85% in a 200-nm-wide spectral range for both the cases of normal and oblique SPP incidence. In order to increase the HCG efficiency and design practically feasible structures, we utilize a parasitic scattering suppression technique based on the use of two-layer grating pillars. The presented results may find application in two-dimensional optical circuits for steering the SPP propagation.
Polygenic risk scores in cardiovascular risk prediction: A cohort study and modelling analyses
Authors: Sun Luanluan , Pennells Lisa , Kaptoge Stephen , Nelson Christopher P. , Ritchie Scott C. , Abraham Gad , Arnold Matthew , Bell Steven , Bolton Thomas , Burgess Stephen , Dudbridge Frank , Guo Qi , Sofianopoulou Eleni , Stevens David , Thompson John R. , Butterworth Adam S. , Wood Angela , Danesh John , Samani Nilesh J. , Inouye Michael , Di Angelantonio Emanuele
Published: January 2021

Background

Polygenic risk scores (PRSs) can stratify populations into cardiovascular disease (CVD) risk groups. We aimed to quantify the potential advantage of adding information on PRSs to conventional risk factors in the primary prevention of CVD.

Methods and findings

Using data from UK Biobank on 306,654 individuals without a history of CVD and not on lipid-lowering treatments (mean age [SD]: 56.0 [8.0] years; females: 57%; median follow-up: 8.1 years), we calculated measures of risk discrimination and reclassification upon addition of PRSs to risk factors in a conventional risk prediction model (i.e., age, sex, systolic blood pressure, smoking status, history of diabetes, and total and high-density lipoprotein cholesterol). We then modelled the implications of initiating guideline-recommended statin therapy in a primary care setting using incidence rates from 2.1 million individuals from the Clinical Practice Research Datalink. The C-index, a measure of risk discrimination, was 0.710 (95% CI 0.703–0.717) for a CVD prediction model containing conventional risk predictors alone. Addition of information on PRSs increased the C-index by 0.012 (95% CI 0.009–0.015), and resulted in continuous net reclassification improvements of about 10% and 12% in cases and non-cases, respectively. If a PRS were assessed in the entire UK primary care population aged 40–75 years, assuming that statin therapy would be initiated in accordance with the UK National Institute for Health and Care Excellence guidelines (i.e., for persons with a predicted risk of ≥10% and for those with certain other risk factors, such as diabetes, irrespective of their 10-year predicted risk), then it could help prevent 1 additional CVD event for approximately every 5,750 individuals screened. By contrast, targeted assessment only among people at intermediate (i.e., 5% to <10%) 10-year CVD risk could help prevent 1 additional CVD event for approximately every 340 individuals screened. Such a targeted strategy could help prevent 7% more CVD events than conventional risk prediction alone. Potential gains afforded by assessment of PRSs on top of conventional risk factors would be about 1.5-fold greater than those provided by assessment of C-reactive protein, a plasma biomarker included in some risk prediction guidelines. Potential limitations of this study include its restriction to European ancestry participants and a lack of health economic evaluation.

Conclusions

Our results suggest that addition of PRSs to conventional risk factors can modestly enhance prediction of first-onset CVD and could translate into population health benefits if used at scale.
A metal artifact reduction method for small field of view CT imaging
Authors: Choi Seungwon , Moon Seunghyuk , Baek Jongduk
Published: January 2021

Several sinogram inpainting based metal artifact reduction (MAR) methods have been proposed to reduce metal artifact in CT imaging. The sinogram inpainting method treats metal trace regions as missing data and estimates the missing information. However, a general assumption with these methods is that data truncation does not occur and that all metal objects still reside within the field-of-view (FOV). These assumptions are usually violated when the FOV is smaller than the object. Thus, existing inpainting based MAR methods are not effective. In this paper, we propose a new MAR method to effectively reduce metal artifact in the presence of data truncation. The main principle of the proposed method involves using a newly synthesized sinogram instead of the originally measured sinogram. The initial reconstruction step involves obtaining a small FOV image with the truncation artifact removed. The final step is to conduct sinogram inpainting based MAR methods, i.e., linear and normalized MAR methods, on the synthesized sinogram from the previous step. The proposed method was verified for extended cardiac-torso simulations, clinical data, and experimental data, and its performance was quantitatively compared with those of previous methods (i.e., linear and normalized MAR methods directly applied to the originally measured sinogram data). The effectiveness of the proposed method was further demonstrated by reducing the residual metal artifact that were present in the reconstructed images obtained using the previous method.
Effects of maternal nutrient restriction during the periconceptional period on placental development in the mouse
Authors: Van Gronigen Case Gerialisa , Storey Kathryn M. , Parmeley Lauren E. , Schulz Laura C.
Published: January 2021

Maternal undernutrition has detrimental effects on fetal development and adult health. Total caloric restriction during early pregnancy followed by adequate nutrition for the remainder of gestation, is particularly linked to cardiovascular and metabolic disease risks during adulthood. The placenta is responsible for transport of nutrients from the maternal to fetal circulation, and the efficiency with which it does so can be adjusted to the maternal nutrient supply. There is evidence that placental adaptations to nutrient restriction in early pregnancy may be retained even when adequate nutrition is restored later in pregnancy, leading to a potential mismatch between placental efficiency and maternal nutrient supplies. However, in the mouse, 50% caloric restriction from days 1.5–11.5 of gestation, while temporarily altering placental structure and gene expression, had no significant effect on day 18.5. The periconceptional period, during which oocyte maturation, fertilization, and preimplantation development occur may be especially critical in creating lasting impact on the placenta. Here, mice were subjected to 50% caloric restriction from 3 weeks prior to pregnancy through d11.5, and then placental structure, the expression of key nutrient transporters, and global DNA methylation levels were examined at gestation d18.5. Prior exposure to caloric restriction increased maternal blood space area, but decreased expression of the key System A amino acid transporterSlc38a4at d18.5. Neither placental and fetal weights, nor placental DNA methylation levels were affected. Thus, total caloric restriction beginning in the periconceptional period does have a lasting impact on placental development in the mouse, but without changing placental efficiency.
Autophagy mediates grain yield and nitrogen stress resistance by modulating nitrogen remobilization in rice
Authors: Zhen Xiaoxi , Zheng Naimeng , Yu Jinlei , Bi Congyuan , Xu Fan
Published: January 2021

Autophagy, a conserved cellular process in eukaryotes, has evolved to a sophisticated process to dispose of intracellular constituents and plays important roles in plant development, metabolism, and efficient nutrients remobilization under suboptimal nutrients conditions. Here, we show that OsATG8b, an AUTOPHAGY-RELATED8 (ATG8) gene in rice, was highly induced by nitrogen (N) starvation. Elevated expression of OsATG8b significantly increased ATG8 lipidation, autophagic flux, and grain yield in rice under both sufficient and deficient N conditions. Overexpressing of OsATG8b could greatly increase the activities of enzymes related to N metabolism. Intriguingly, the 15N-labeling assay further revealed that more N was remobilized to seeds in OsATG8b-overexpressing rice, which significantly increased the N remobilization efficiency (NRE), N harvest index, N utilization efficiency (NUE), and N uptake efficiency (NUpE). Conversely, the osatg8b knock-out mutants had the opposite results on these characters. The substantial transcriptional changes of the overexpressed transgenic lines indicated the presence of complex signaling to developmental, metabolic process, and hormone, etc. Excitingly, the transgenic rice under different backgrounds all similarly be boosted in yield and NUE with OsATG8b overexpression. This work provides an excellent candidate gene for improving N remobilization, utilization, and yield in crops simultaneously.
Precision long-read metagenomics sequencing for food safety by detection and assembly of Shiga toxin-producing Escherichia coli in irrigation water
Authors: Maguire Meghan , Kase Julie A. , Roberson Dwayne , Muruvanda Tim , Brown Eric W. , Allard Marc , Musser Steven M. , González-Escalona Narjol
Published: January 2021

Shiga toxin-producing Escherichia coli (STEC) contamination of agricultural water might be an important factor to recent foodborne illness and outbreaks involving leafy greens. Closed bacterial genomes from whole genome sequencing play an important role in source tracking. We aimed to determine the limits of detection and classification of STECs by qPCR and nanopore sequencing using 24 hour enriched irrigation water artificially contaminated with E. coli O157:H7 (EDL933). We determined the limit of STEC detection by qPCR to be 30 CFU/reaction, which is equivalent to 105 CFU/ml in the enrichment. By using Oxford Nanopore’s EPI2ME WIMP workflow and de novo assembly with Flye followed by taxon classification with a k-mer analysis software (Kraken2), E. coli O157:H7 could be detected at 103 CFU/ml (68 reads) and a complete fragmented E. coli O157:H7 metagenome-assembled genome (MAG) was obtained at 105−108 CFU/ml. Using a custom script to extract the E. coli reads, a completely closed MAG was obtained at 107−108 CFU/ml and a complete, fragmented MAG was obtained at 105−106 CFU/ml. In silico virulence detection for E. coli MAGs for 105−108 CFU/ml showed that the virulotype was indistinguishable from the spiked E. coli O157:H7 strain. We further identified the bacterial species in the un-spiked enrichment, including antimicrobial resistance genes, which could have important implications to food safety. We propose this workflow provides proof of concept for faster detection and complete genomic characterization of STECs from a complex microbial sample compared to current reporting protocols and could be applied to determine the limit of detection and assembly of other foodborne bacterial pathogens.
Quercetin as a potential treatment for COVID-19-induced acute kidney injury: Based on network pharmacology and molecular docking study
Authors: Gu Yue-Yu , Zhang Min , Cen Huan , Wu Yi-Fan , Lu Zhaoyu , Lu Fuhua , Liu Xu-Sheng , Lan Hui-Yao
Published: January 2021

Kidneys are one of the targets for SARS-CoV-2, it is reported that up to 36% of patients with SARS-CoV-2 infection would develop into acute kidney injury (AKI). AKI is associated with high mortality in the clinical setting and contributes to the transition of AKI to chronic kidney disease (CKD). Up to date, the underlying mechanisms are obscure and there is no effective and specific treatment for COVID-19-induced AKI. In the present study, we investigated the mechanisms and interactions between Quercetin and SARS-CoV-2 targets proteins by using network pharmacology and molecular docking. The renal protective effects of Quercetin on COVID-19-induced AKI may be associated with the blockade of the activation of inflammatory, cell apoptosis-related signaling pathways. Quercetin may also serve as SARS-CoV-2 inhibitor by binding with the active sites of SARS-CoV-2 main protease 3CL and ACE2, therefore suppressing the functions of the proteins to cut the viral life cycle. In conclusion, Quercetin may be a novel therapeutic agent for COVID-19-induced AKI. Inhibition of inflammatory, cell apoptosis-related signaling pathways may be the critical mechanisms by which Quercetin protects kidney from SARS-CoV-2 injury.
Breast self-examination practice and its determinants among women in Ethiopia: A systematic review and meta-analysis
Authors: Yeshitila Yordanos Gizachew , Kassa Getachew Mullu , Gebeyehu Selamawit , Memiah Peter , Desta Melaku
Published: January 2021

Background

The survival rate from breast cancer is lowest in African countries and the distribution of breast self-examination practice of and its determinants are not well investigated in Ethiopia. Therefore, this systematic review and meta-analysis was designed to determine the pooled prevalence of breast self-examination and its associated factors among women in Ethiopia.

Methods

Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed for this systematic review and meta-analysis. The databases used were; PUBMED, Cochrane Library, Google Scholar, CINAHL, African Journals Online, Dimensions and Summon per country online databases. Search terms used were; breast self-examination, breast cancer screening, early detection of breast cancer and Ethiopia. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for critical appraisal of studies. The meta-analysis was conducted using STATA 15 software. The pooled meta-analysis was computed to present the pooled prevalence and relative risks (RRs) of the determinate factors with 95% confidence intervals (CIs).

Results

We identified 2,637 studies, of which, 40 articles (with 17,820 participants) were eligible for inclusion in the final meta-analysis. The pooled estimate of breast self-examination in Ethiopia was 36.72% (95% CI: 29.90, 43.53). The regional distribution breast self-examination ranged from 21.2% (95% CI: 4.49, 37.91) in Tigray to 61.5% (95% CI: 53.98, 69.02) in Gambela region. The lowest prevalence of breast self-examination was observed among the general population (20.43% (95% CI: 14.13, 26.72)). Women who had non-formal educational status (OR = 0.4 (95% CI: 0.21, 0.77)), family history of breast cancer (OR = 2.04 (95% CI: 1.23, 3.39)), good knowledge of breast self-examination (OR = 4.8 (95% CI: 3.03, 7.6)) and favorable attitude toward breast self-examination (OR = 2.75, (95% CI: 1.66, 4.55)) were significantly associated with practice of breast self-examination.

Conclusions

Only a third of women in Ethiopia practiced breast examination despite WHO guidelines advocating for this practice among all women of reproductive age. Intervention programs should address the factors that are associated with breast self-examination. Population specific programs are needed to promote breast self-examination.
Assessing the efficacy of tablet-based simulations for learning pseudo-surgical instrumentation
Authors: Kryklywy James H. , Roach Victoria A. , Todd Rebecca M.
Published: January 2021

Nurses and surgeons must identify and handle specialized instruments with high temporal and spatial precision. It is crucial that they are trained effectively. Traditional training methods include supervised practices and text-based study, which may expose patients to undue risk during practice procedures and lack motor/haptic training respectively. Tablet-based simulations have been proposed to mediate some of these limitations. We implemented a learning task that simulates surgical instrumentation nomenclature encountered by novice perioperative nurses. Learning was assessed following training in three distinct conditions: tablet-based simulations, text-based study, and real-world practice. Immediately following a 30-minute training period, instrument identification was performed with comparable accuracy and response times following tablet-based versus text-based training, with both being inferior to real-world practice. Following a week without practice, response times were equivalent between real-world and tablet-based practice. While tablet-based training does not achieve equivalent results in instrument identification accuracy as real-world practice, more practice repetitions in simulated environments may help reduce performance decline. This project has established a technological framework to assess how we can implement simulated educational environments in a maximally beneficial manner.
Psychological therapies for adolescents with borderline personality disorder (BPD) or BPD features—A systematic review of randomized clinical trials with meta-analysis and Trial Sequential Analysis
Authors: Jørgensen Mie Sedoc , Storebø Ole Jakob , Stoffers-Winterling Jutta M. , Faltinsen Erlend , Todorovac Adnan , Simonsen Erik
Published: January 2021

Objectives

To review the effectiveness of psychological therapies for adolescents with borderline personality disorder (BPD) or BPD features.

Methods

We included randomized clinical trials on psychological therapies for adolescents with BPD and BPD features. Data were extracted and assessed for quality according to Cochrane guidelines, and summarized as mean difference (MD) with 95% confidence intervals (CI) for continuous data and as Odds ratios (OR) with 95% CI for dichotomous data. Risk of bias was assessed using Cochrane’s risk of bias tool for each domain. When possible, we pooled trials into meta-analyses, and used Trial Sequential Analysis (TSA) to control for random errors. Quality of the evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE).

Results

10 trials on adolescents with BPD or BPD features were included. All trials were considered at high risk of bias, and the quality of the evidence was rated as “very low”. We did TSA on the primary outcome and found that the required information size was reached. The risk of random error was thus discarded.

Conclusion

Only 10 trials have been conducted on adolescents with BPD or BPD features. Of these only few showed superior outcomes of the experimental intervention compared to the control intervention. No adverse effects of the interventions were mentioned. Attrition rates varied from 15–75% in experimental interventions. The overall quality was very low due to high risk of bias, imprecision and inconsistency, which limits the confidence in effect estimates. Due to the high risk of bias, high attrition rates and underpowered studies in this area, it is difficult to derive any conclusions on the efficacy of psychological therapies for BPD in adolescence. There is a need for more high quality trials with larger samples to identify effective psychological therapies for this specific age group with BPD or BPD features.
Utility of teleconsultation in accessing eye care in a developing country during COVID-19 pandemic
Authors: Mansoor Hassan , Khan Saad Alam , Afghani Tayyab , Assir Muhammad Zaman , Ali Mahmood , Khan Wajid Ali
Published: January 2021

Objective

To evaluate the utility of teleconsultation in the provision of eye care services during the COVID-19 lockdown. Disparities in the consultation burden of sub-specialities and socio-demographic differences in teleconsultation utilization were also assessed.

Methods

Al-Shifa Trust Eye Hospital Rawalpindi began audio and video teleconsultation using broadband telecommunication services during the lockdown. Patients’ and consultations’ data gathered during the first three weeks after the commencement of this programme were compared with data from the four weeks prior to lockdown. The weekly consultation ratio and overall consultation burden of sub-specialities were measured. Chi-Square tests of association determined the relationship between different variables (socioeconomic status and consultation characteristics) and consultation modality (on-site vs online).

Results

In total, 17507 on-site consultations (4377/week) were conducted compared to 1431 teleconsultations (477/week), which maintained 10.89% of the weekly pre-lockdown eye care services. The post-lockdown teleconsultation programme saw a relatively higher percentage of service utility among female (47.09% vs 44.71%), younger-age (31.33±19.45 vs 41.25±23.32 years) and higher-socioeconomic-status (32.21% vs 0.30%) patients compared to pre-lockdown on-site consultations. The most common indication for teleconsultation was red-eye (16.70%). While cornea and glaucoma clinics maintained most of the pre-lockdown services (30.42% and 29% respectively), the highest dropout was seen in optometric and vitreoretinal services supporting only 5.54% and 8.28% of pre-lockdown services, respectively.

Conclusion

Digital initiatives could partially maintain eye care services during the lockdown. Focused strategies to improve teleconsultation utilization are required during the pandemic and beyond.
Evaluation of a ‘serious game’ on nursing student knowledge and uptake of influenza vaccination
Authors: Mitchell Gary , Leonard Laurence , Carter Gillian , Santin Olinda , Brown Wilson Christine
Published: January 2021

Background

Influenza is a serious global healthcare issue that is associated with between 290,000 to 650,000 deaths annually. The aim of this study is to evaluate the effect of a ‘serious game’ about influenza, on nursing student attitude, knowledge and uptake of the influenza vaccination.

Methods

1306 undergraduate nursing students were invited, via email, to play an online game about influenza between September 2018 and March 2019. 430 nursing students accessed the game and completed an 8-item questionnaire measuring their attitudes to influenza between September 2018 and March 2019. In April 2019, 356 nursing students from this sample completed a follow-up 2-item questionnaire about their uptake of the influenza vaccination. A larger separate 40-item knowledge questionnaire was completed by a year one cohort of 124 nursing students in August 2018 prior to receiving access to the game and then after access to the game had ended, in April 2019. This sample was selected to determine the extent to which the game improved knowledge about influenza amongst a homogenous group.

Results

In the year preceding this study, 36.7% of the sample received an influenza vaccination. This increased to 47.8% after accessing to the game. Nursing students reported perceived improvements in their knowledge, intention to get the vaccination and intention to recommend the vaccination to their patients after playing the game. Nursing students who completed the 40-item pre- and post-knowledge questionnaire scored an average of 68.6% before receiving access to the game and 85.2% after. Using Paired T-Tests statistical analysis, it was determined that this 16.6% increase was highly statistically significant (P < 0.001).

Conclusions

The research highlights that the influenza game can improve knowledge and intention to become vaccinated. This study suggests that improvement in influenza knowledge is likely to encourage more nursing students to receive the influenza vaccination.
The critical role of infection prevention overlooked in Ethiopia, only one-half of health-care workers had safe practice: A systematic review and meta-analysis
Authors: Sahiledengle Biniyam , Tekalegn Yohannes , Woldeyohannes Demelash
Published: January 2021

Background

Effective infection prevention and control measures, such as proper hand hygiene, the use of personal protective equipment, instrument processing, and safe injection practicein the healthcare facilitiesare essential elements of patient safety and lead to optimal patient outcomes. In Ethiopia, findings regarding infection prevention practices among healthcare workers have been highly variable and uncertain. This systematic review and meta-analysis estimates the pooled prevalence of safe infection prevention practices and summarizesthe associated factors among healthcare workers in Ethiopia.

Methods

PubMed, Science Direct, Google Scholar, and the Cochran library were systematically searched. We included all observational studies reporting the prevalence of safe infection prevention practices among healthcare workers in Ethiopia. Two authors independently extracted all necessary data using a standardized data extraction format. Qualitative and quantitative analyseswere employed. The Cochran Q test statistics and I2 tests were used to assess the heterogeneity of the studies. A random-effects meta-analysis model was used to estimate the pooled prevalence of safe infection prevention practice.

Results

Of the 187 articles identified through our search, 10 studies fulfilled the inclusion criteria and were included in the meta-analysis. The pooled prevalence of safe infection prevention practice in Ethiopia was 52.2% (95%CI: 40.9–63.4). The highest prevalence of safe practice was observed in Addis Ababa (capital city) 66.2% (95%CI: 60.6–71.8), followed by Amhara region 54.6% (95%CI: 51.1–58.1), and then Oromia region 48.5% (95%CI: 24.2–72.8), and the least safe practices were reported from South Nation Nationalities and People (SNNP) and Tigray regions with a pooled prevalence of 39.4% (95%CI: 13.9–64.8). In our qualitative syntheses, the odds of safe infection prevention practice were higher among healthcare workers who had good knowledge and a positive attitude towards infection prevention. Also, healthcare workers working in facilities with continuous running water supply, having infection prevention guideline, and those received training were significantly associated withhigher odds of safe infection prevention practice.

Conclusions

Infection prevention practices in Ethiopia was poor, with only half of the healthcare workers reporting safe practices. Further, the study found out that there were regional and professional variations in the prevalence of safe infection prevention practices. Therefore, the need to step-up efforts to intensify the current national infection prevention and patient safety initiative as key policy direction is strongly recommended, along with more attempts to increase healthcare worker’s adherence towards infection prevention guidelines.
High-risk chest radiographic features associated with COVID-19 disease severity
Authors: Ong Sean Wei Xiang , Hui Terrence Chi Hong , Lee Yeong Shyan , Haja Mohideen Salahudeen Mohamed , Young Barnaby Edward , Tan Cher Heng , Lye David Chien
Published: January 2021

Objectives

High-risk CXR features in COVID-19 are not clearly defined. We aimed to identify CXR features that correlate with severe COVID-19.

Methods

All confirmed COVID-19 patients admitted within the study period were screened. Those with suboptimal baseline CXR were excluded. CXRs were reviewed by three independent radiologists and opacities recorded according to zones and laterality. The primary endpoint was defined as hypoxia requiring supplemental oxygen, and CXR features were assessed for association with this endpoint to identify high-risk features. These features were then used to define criteria for a high-risk CXR, and clinical features and outcomes of patients with and without baseline high-risk CXR were compared using logistic regression analysis.

Results

109 patients were included. In the initial analysis of 40 patients (36.7%) with abnormal baseline CXR, presence of bilateral opacities, multifocal opacities, or any upper or middle zone opacity were associated with supplemental oxygen requirement. Of the entire cohort, 29 patients (26.6%) had a baseline CXR with at least one of these features. Having a high-risk baseline CXR was significantly associated with requiring supplemental oxygen in univariate (odds ratio 14.0, 95% confidence interval 3.90–55.60) and multivariate (adjusted odds ratio 8.38, 95% CI 2.43–28.97, P = 0.001) analyses.

Conclusion

We identified several high-risk CXR features that are significantly associated with severe illness. The association of upper or middle zone opacities with severe illness has not been previously emphasized. Recognition of these specific high-risk CXR features is important to prioritize limited healthcare resources for sicker patients.
Clinical and radiological findings of adult hospitalized patients with community-acquired pneumonia from SARS-CoV-2 and endemic human coronaviruses
Authors: Baek Moon Seong , Cha Min Jae , Kim Min-Chul , Chung Jin-Won , Kim Won-Young , Choi Hyewon , Choi Seong-Ho
Published: January 2021

Endemic human coronaviruses (HCoVs) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are members of the family Coronaviridae. Comparing the findings of the infections caused by these viruses would help reveal the novel characteristics of SARS-CoV-2 and provide insight into the unique pathogenesis of SARS-CoV-2 infection. This study aimed to compare the clinical and radiological characteristics of SARS-CoV-2 and endemic HCoVs infection in adult hospitalized patients with community-acquired pneumonia (CAP). This study was performed at a university-affiliated tertiary hospital in the Republic of Korea, between January 1, 2015, and July 31, 2020. A total of 109 consecutive patients who were over 18 years of age with confirmed SARS-CoV-2 and endemic HCoVs were enrolled. Finally, 19 patients with SARS-CoV-2 CAP were compared to 40 patients with endemic HCoV CAP. Flu-like symptoms such as cough, sore throat, headache, myalgia, and prolonged fever were more common in SARS-CoV-2 CAP, whereas clinical findings suggestive of bacterial pneumonia such as dyspnea, leukocytosis with left shift, and increased C-reactive protein were more common in endemic HCoV CAP. Bilateral peripherally distributed ground-glass opacities (GGOs) were typical radiologic findings in SARS-CoV-2 CAP, whereas mixed patterns of GGOs, consolidations, micronodules, and pleural effusion were observed in endemic HCoV CAP. Coinfection was not observed in patients with SARS-CoV-2 CAP, but was observed in more than half of the patients with endemic HCoV CAP. There were distinctive differences in the clinical and radiologic findings between SARS-CoV-2 and endemic HCoV CAP. Further investigations are required to elucidate the mechanism underlying this difference. Follow-up observations are needed to determine if the presentation of SARS-CoV-2 CAP changes with repeated infection.
Emergency response for evaluating SARS-CoV-2 immune status, seroprevalence and convalescent plasma in Argentina
Authors: Ojeda Diego S. , Gonzalez Lopez Ledesma María Mora , Pallarés Horacio M. , Costa Navarro Guadalupe S. , Sanchez Lautaro , Perazzi Beatriz , Villordo Sergio M. , Alvarez Diego E. ,   BioBanco Working Group, Echavarria Marcela , Oguntuyo Kasopefoluwa Y. , Stevens Christian S. , Lee Benhur , Carradori Jorge , Caramelo Julio J. , Yanovsky Marcelo J. , Gamarnik Andrea V.
Published: January 2021

We report the emergency development and application of a robust serologic test to evaluate acute and convalescent antibody responses to SARS-CoV-2 in Argentina. The assays, COVIDAR IgG and IgM, which were produced and provided for free to health authorities, private and public health institutions and nursing homes, use a combination of a trimer stabilized spike protein and the receptor binding domain (RBD) in a single enzyme-linked immunosorbent assay (ELISA) plate. Over half million tests have already been distributed to detect and quantify antibodies for multiple purposes, including assessment of immune responses in hospitalized patients and large seroprevalence studies in neighborhoods, slums and health care workers, which resulted in a powerful tool for asymptomatic detection and policy making in the country. Analysis of antibody levels and longitudinal studies of symptomatic and asymptomatic SARS-CoV-2 infections in over one thousand patient samples provided insightful information about IgM and IgG seroconversion time and kinetics, and IgM waning profiles. At least 35% of patients showed seroconversion within 7 days, and 95% within 45 days of symptoms onset, with simultaneous or close sequential IgM and IgG detection. Longitudinal studies of asymptomatic cases showed a wide range of antibody responses with median levels below those observed in symptomatic patients. Regarding convalescent plasma applications, a protocol was standardized for the assessment of end point IgG antibody titers with COVIDAR with more than 500 plasma donors. The protocol showed a positive correlation with neutralizing antibody titers, and was used for clinical trials and therapies across the country. Using this protocol, about 80% of convalescent donor plasmas were potentially suitable for therapies. Here, we demonstrate the importance of providing a robust and specific serologic assay for generating new information about antibody kinetics in infected individuals and mitigation policies to cope with pandemic needs.
Carbomer-based adjuvant elicits CD8 T-cell immunity by inducing a distinct metabolic state in cross-presenting dendritic cells
Authors: Lee Woojong , Kingstad-Bakke Brock , Paulson Brett , Larsen Autumn , Overmyer Katherine , Marinaik Chandranaik B. , Dulli Kelly , Toy Randall , Vogel Gabriela , Mueller Katherine P. , Tweed Kelsey , Walsh Alex J. , Russell Jason , Saha Krishanu , Reyes Leticia , Skala Melissa C. , Sauer John-Demian , Shayakhmetov Dmitry M. , Coon Joshua , Roy Krishnendu , Suresh M.
Published: January 2021

There is a critical need for adjuvants that can safely elicit potent and durable T cell-based immunity to intracellular pathogens. Here, we report that parenteral vaccination with a carbomer-based adjuvant, Adjuplex (ADJ), stimulated robust CD8 T-cell responses to subunit antigens and afforded effective immunity against respiratory challenge with a virus and a systemic intracellular bacterial infection. Studies to understand the metabolic and molecular basis for ADJ’s effect on antigen cross-presentation by dendritic cells (DCs) revealed several unique and distinctive mechanisms. ADJ-stimulated DCs produced IL-1β and IL-18, suggestive of inflammasome activation, butin vivoactivation of CD8 T cells was unaffected in caspase 1-deficient mice. Cross-presentation induced by TLR agonists requires a critical switch to anabolic metabolism, but ADJ enhanced cross presentation without this metabolic switch in DCs. Instead, ADJ induced in DCs, an unique metabolic state, typified by dampened oxidative phosphorylation and basal levels of glycolysis. In the absence of increased glycolytic flux, ADJ modulated multiple steps in the cytosolic pathway of cross-presentation by enabling accumulation of degraded antigen, reducing endosomal acidity and promoting antigen localization to early endosomes. Further, by increasing ROS production and lipid peroxidation, ADJ promoted antigen escape from endosomes to the cytosol for degradation by proteasomes into peptides for MHC I loading by TAP-dependent pathways. Furthermore, we found that induction of lipid bodies (LBs) and alterations in LB composition mediated by ADJ were also critical for DC cross-presentation. Collectively, our model challenges the prevailing metabolic paradigm by suggesting that DCs can perform effective DC cross-presentation, independent of glycolysis to induce robust T cell-dependent protective immunity to intracellular pathogens. These findings have strong implications in the rational development of safe and effective immune adjuvants to potentiate robust T-cell based immunity.
Orthopoxvirus K3 orthologs show virus- and host-specific inhibition of the antiviral protein kinase PKR
Authors: Park Chorong , Peng Chen , Rahman M. Julhasur , Haller Sherry L. , Tazi Loubna , Brennan Greg , Rothenburg Stefan
Published: January 2021

The antiviral protein kinase R (PKR) is an important host restriction factor, which poxviruses must overcome to productively infect host cells. To inhibit PKR, many poxviruses encode a pseudosubstrate mimic of the alpha subunit of eukaryotic translation initiation factor 2 (eIF2), designated K3 in vaccinia virus. Although the interaction between PKR and eIF2α is highly conserved, some K3 orthologs from host-restricted poxviruses were previously shown to inhibit PKR in a species-specific manner. To better define this host range function, we compared the sensitivity of PKR from 17 mammals to inhibition by K3 orthologs from closely related orthopoxviruses, a genus with a generally broader host range. The K3 orthologs showed species-specific inhibition of PKR and exhibited three distinct inhibition profiles. In some cases, PKR from closely related species showed dramatic differences in their sensitivity to K3 orthologs. Vaccinia virus expressing the camelpox virus K3 ortholog replicated more than three orders of magnitude better in human and sheep cells than a virus expressing vaccinia virus K3, but both viruses replicated comparably well in cow cells. Strikingly, in site-directed mutagenesis experiments between the variola virus and camelpox virus K3 orthologs, we found that different amino acid combinations were necessary to mediate improved or diminished inhibition of PKR derived from different host species. Because there is likely a limited number of possible variations in PKR that affect K3-interactions but still maintain PKR/eIF2α interactions, it is possible that by chance PKR from some potential new hosts may be susceptible to K3-mediated inhibition from a virus it has never previously encountered. We conclude that neither the sensitivity of host proteins to virus inhibition nor the effectiveness of viral immune antagonists can be inferred from their phylogenetic relatedness but must be experimentally determined.