bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical and histology features as predictor of severity of mucormycosis in post-COVID-19 patients: An experience from a rural tertiary setting in Central India
Authors: Jain Kavita , Surana Akshay , Choudhary Tej Singh , Vaidya Sudhakar , Nandedkar Shirish , Purohit Manju
Published: February 2022

Background:

An upsurge in cases of rhinosinusitis with or without associated orbital and/or cerebral involvement by mucormycosis has been observed in post-COVID-19 patients. Our objective is to evaluate the clinical and histopathology features of these patients to determine the severity and develop a scoring on the extent on tissue invasion.

Method:

We prospectively enrolled and analyzed 95 post-COVID-19 patients who presented with the invasive mucormycosis of the head and neck region. Clinical and histology details were noted in predesigned forms. Various histology variables were graded from I to III to propose a scoring system for the severity of the disease.

Results:

Mucormycosis was common in males with a mean age of 46.8 ± 11 years. Facial pain was the most common presenting complaint and 77% of the patients were diabetic. Most cases (n = 59) showed a moderate degree of neutrophilic infiltrate with ⩾50% tissue necrosis and angioinvasion in three or more vessels with a fungal load of 2+/3+. Histology severity grade III was observed in patients who died from cerebral mucormycosis (n = 3) and septicemia (n = 2) and in patients who had undergone orbital exenteration (n = 6).

Conclusion:

The histopathology and severity score classification was directly correlated with the outcome of the patients. Further evaluation and a larger study will help to validate the proposed scoring for its clinical use in all forms and causes of mucormycosis.
Comparative study of six SARS-CoV-2 serology assays: Diagnostic performance and antibody dynamics in a cohort of hospitalized patients for moderate to critical COVID-19
Authors: Chamkhi Sameh , Dhaouadi Tarak , Sfar Imen , Mokni Salma , Jebri Alia , Mansouri Dhouha , Ghedira Salma , Ben Jemia Emna , Ben Boujemaa Samia , Houissa Mohamed , Aouina Hichem , Ben Abdallah Taïeb , Gorgi Yousr
Published: February 2022

Background

To overcome the COVID-19 pandemic, serology assays are needed to identify past and ongoing infections. In this context, we evaluated the diagnostic performance of 6 immunoassays on samples from hospitalized patients for moderate to critical COVID-19.

Methods

701 serum samples obtained from 443 COVID-19 patients (G1: 356 positive RT-PCR patients and G2: 87 negative RT-PCR cases) and 108 pre-pandemic sera from blood donors were tested with 6 commercial immunoassays: (1) Elecsys Anti-SARS-CoV-2, Roche (Nucleocapsid, N), (2) Elecsys Anti-SARS-CoV-2 S, Roche (Spike, S), (3) Vidas SARS-COV-2 IgM/IgG, BioMérieux (S), (4) SARS-CoV-2 IgG, Abbott (N), (5) Access SARS-CoV-2 IgG, Beckman Coulter (Receptor Binding Domain), and (6) Standard F COVID-19 IgM/IgG Combo FIA, SD Biosensor (N).

Results

Global sensitivities of the evaluated assays were as follows: (1) Roche anti-N = 74.5% [69.6–79.3], (2) Roche anti-S = 92.7% [84.7–100], (3) Vidas IgM = 74.9% [68.6–81.2], (4) Vidas IgG = 73.9% [67.6–80.1], (5) Abbott = 78.6% [63.4–93.8], (6) Beckman Coulter = 74.5% [62–86.9], (7) SD Biosensor IgM = 73.1% [61–85.1], and (8) SD Biosensor IgG = 76.9% [65.4–88.4]. Sensitivities increased gradually from week 1 to week 3 as follow: (1) Roche anti-N: 63.3%, 81% and 82.1%; (2) Vidas IgM: 68.2%, 83.2% and 85.9%; and (3) Vidas IgG: 66.7%, 79.1% and 86.6%. All immunoassays showed a specificity of 100%. Seropositivity was significantly associated with a higher frequency of critical COVID-19 (50.8% vs. 38.2%), p = 0.018, OR [95% CI] = 1.668 [1.09–2.553]. Inversely, death occurred more frequently in seronegative patients (28.7% vs. 13.6%), p=3.02 E-4, OR [95% CI] = 0.392 [0.233–0.658].

Conclusion

Evaluated serology assays exhibited good sensitivities and excellent specificities. Sensitivities increased gradually after symptoms onset. Even if seropositivity is more frequent in patients with critical COVID-19, it may predict a recovery outcome.
Client Satisfaction With Virtual Consultations During the COVID-19 Pandemic at an Occupational Health Physical Therapy Clinic
Authors: Chetty Laran
Published: February 2022

Background:

The purpose of this project was to determine whether clients were satisfied with their occupational health physical therapy virtual consultations and whether or not they would have preferred a face-to-face consultation instead of a virtual consultation.

Methods:

Clients were mailed an adapted 10-item Telehealth Satisfaction Scale (TeSS) and asked to complete and return it in a prepaid envelope. Clients who returned the TeSS were then contacted by telephone and asked whether they would have preferred a face-to-face consultation instead of a virtual consultation.

Findings:

Overall, clients expressed a high degree of satisfaction with their virtual occupational health physical therapy consultation (96.9%). Most clients (82.1%) stated they would have chosen virtual consultations if given the choice.

Conclusion/Application to Practice:

The cumulative feedback from clients suggested that the benefits of virtual consultations can be sustained post COVID-19 pandemic as clients have accepted and adapted to this new approach within the occupational health physical therapy clinic.
SARS-COV-2 Screening of Health Care Workers in Brunei Darussalam
Authors: Trivedi Ashish , Fontelera Maria , Lai Alice
Published: February 2022

Background:

Health care workers (HCWs) are at high risk of COVID-19 infection; therefore, screening is recommended for early detection and management to break the chain of transmission. Globally, multiple strategies have been utilized for the screening of HCWs. This article reports and evaluates an active surveillance and screening strategy for severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) among HCWs following work or nonwork exposures in Brunei Darussalam to prevent health care–associated COVID-19 transmission.

Methods:

In March 2020, the Ministry of Health through the Occupational Health Division adopted an active screening strategy for symptomatic and asymptomatic HCWs, which involved symptom screening, risk assessment, SARS-COV-2 testing, and management following work/nonwork exposure and recent overseas travel, and those with influenza-like illness (ILI) symptoms. Screening frequency was based on the HCWs’ symptoms and exposure, with the intent to evaluate all possible sources of exposure.

Findings:

As of December 31, 2020, 821 HCWs were screened, of which 632 (77%) had ILI symptoms and 14 (1.7%) had high-risk occupational exposure. Reverse transcription polymerase chain reaction (RT-PCR) swab testing was carried out on 577 (70.3%) HCWs, with the highest proportion of swabs done on doctors (85.1%; p < .01) due to their workplace exposure (34.3%) and overseas travel (38.7%).

Conclusion:

By July 2021, Brunei Darussalam had recorded zero cases of COVID-19 among HCWs from occupational exposure. Our strategy of active screening for SARS-COV-2 RT-PCR testing since early in the outbreak has proven to be successful, in combination with infection control practices and public health measures, in the prevention of occupational transmission, thereby facilitating early return to work for HCWs with low-risk exposure and without symptoms.
Intensive Care Unit Nurses’ Lived Experiences of Psychological Stress and Trauma Caring for COVID-19 Patients
Authors: Levi Paula , Moss Jacqueline
Published: February 2022

Background:

Intensive care unit (ICU) nurses are enduring unprecedented burden caring for COVID-19 patients. Few studies have reported types of work-related events that lead to occupational stress and post-traumatic stress disorder (PTSD).

Methods:

ICU nurses were recruited at an academic health science center to explore their experiences of caring for COVID-19 patients. Participants were interviewed for 1 hour using open-ended questions. Symptoms of PTSD were assessed using the PTSD Checklist, job satisfaction with a Likert-type scale, and intention to leave their job with a “yes or no” question. Semi-structured interviews were transcribed and analyzed using NVivo software; quantitative data were analyzed using frequencies and means with R 4.0.5.

Findings:

The ICU nurse sample comprised nine females and one male, all Caucasian, with a mean age of 26.6 years. Analysis of interview transcripts revealed six recurring themes: Change in Practice, Emotion, Patient’s Family, Isolation, Job Satisfaction, and Public Reaction. Quantitative findings revealed 7 of 10 met diagnostic criteria for PTSD. Most participants (7/10) were “somewhat satisfied” with their job. Five of 10 considered leaving their job in the last 6 months.

Conclusion/Implications for Practice:

Understanding the impact stressful pandemic-related patient care has on ICU nurses provides evidence that new policies are needed. Furthermore, qualitative findings provide insight into the best design and deployment of interventions to reduce stress and prevent development of PTSD. More research is needed to understand long-term effects of PTSD and to evaluate strategies to prevent PTSD during stressful emergency surges in intensive care.
Cleft Sign and Bone Marrow Edema of the Pubic Symphysis Are Associated With Sports and Bony Morphology in Patients With Femoroacetabular Impingement and Labral Tears
Authors: Nakayama Keisuke , Utsunomiya Hajime , Murata Yoichi , Takada Shinichiro , Tsukamoto Manabu , Sakai Akinori , Uchida Soshi
Published: February 2022

Background:

The cleft sign (CS) and bone marrow edema (BME) are considered magnetic resonance imaging (MRI) findings signifying a pubic pathology, which is associated with groin pain; however, their relationship with bony morphology related to femoroacetabular impingement (FAI) has not been established.

Purpose:

To investigate the prevalence of CS and BME in symptomatic patients with acetabular labral tears and assess their possible association with bone morphology and sport-specific activities.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

This study enrolled 418 patients (469 hips) undergoing hip arthroscopic surgery for labral tears. Also included were patients with labral tears in the setting of either hip dysplasia or borderline hip dysplasia who were undergoing endoscopic shelf acetabuloplasty combined with hip arthroscopic labral repair, cam osteoplasty, and capsular plication. All patients were screened for superior CS (SCS), inferior CS (ICS), and BME of the ipsilateral side of the pubis using 3-T MRI. We measured the following angles: lateral center edge (LCE), Sharp, Tönnis, vertical-central-anterior, and alpha. Then, we evaluated the relationship between patient characteristics and abnormal findings on MRI scans (preoperatively vs 1 year postoperatively).

Results:

An overall 397 hips were included: 200 in men and 197 in women (mean ± SD age, 35.3 ± 16.0 years). There were hips in 214 athletes (53.9%) and hips in 183 nonathletes (46.1%). MRI findings revealed SCS, ICS, and BME in 18 (4.5%), 13 (3.3%), and 34 hips (8.6%), respectively. Abnormal MRI findings at the pubis were seen more often in athletes than nonathletes (23.8% vs 3.3%), and contact sports athletes had the most frequent abnormalities. There was no SCS in patients with an LCE angle <22°. SCS was more frequently seen in those who had an alpha angle ≥71°. More than 60% of abnormal findings at the pubis diminished after arthroscopic surgery that included FAI correction and labral repair.

Conclusion:

In patients with labral tears, CS and BME were seen more frequently in athletes versus nonathletes, especially contact athletes with FAI-related bony abnormalities. More than 60% of abnormal MRI pubis findings resolved after arthroscopic treatment of FAI.
Relationship Between Livelihood Capitals and Livelihood Strategies of Dalit
Authors: Giri Yam Nath
Published: February 2022

The Dalits of Nepal are living with a lack of opportunities, and the high-level poverty within Dalit communities shows that capabilities or livelihood of Dalits have not been adequately increased in quantity and quality. In the absence of capabilities, they have been adopting unsecured livelihood strategies. In this context, this study aims to find out the relationship between livelihood capitals and livelihood strategies adopted by the Dalit communities of Kusma municipality, Parbat, Nepal. The study was based on survey research design, and 390 respondents were selected by using stratified random sampling method. The relationship between the livelihood strategies and livelihood capitals are found positive, statistically significant and of moderate level strength with livelihood strategies. Access to capitals determine the livelihood strategies of the Dalit community. However, there is no rule and degree of relationship between the livelihood capitals and livelihood strategies. Likely, the agency and structure of the society dominate the capabilities of the Dalit households. Therefore, even though they have good knowledge, skills, income and physical capital, they are not well supported to choose livelihood strategies. Similarly, livelihood strategies do not contribute to livelihood outcomes as well.
Narayana Guru and the Formation of Political Society in Kerala: Anti-Caste Revolt, Religion and the Untouchables
Authors: Cybil K. V.
Published: February 2022

This article is an attempt to examine the salient features of a lower caste revolt began in Kerala in the nineteenth century. It was led by Narayana Guru (1854–1928), a spiritual leader with a distinctive urge to break free from the rules of pollution demarcated by Brahmins in the practice of knowledge. I argue that in the wake of this movement, a strong assertion of community was represented by the Ezhava, a caste which suffered pollution in Hinduism. The defining characteristic of this community today is that of a class—the OBC. In the existing lacunae of non-governmental categories to define the nature of this community, and the philosophy of Advaita remaining an impediment rather than an empowerment to expand the central notions of his thought, I argue that the transition from caste to community represented by Narayana Guru can no longer be situated in the discourse either of Sanskritization or of subalternity, but of the use of technologies of deification.
Media Influences on Caste-based Untouchability Practices in India
Authors: Archana  , Singh Pushpendra
Published: February 2022

This study is an attempt to record the extent of untouchability practices prevalent in India as well as to examine the role of the media such as TV, newspaper and radio, as a source of communication which has brought about shift in the practice of caste-based untouchability. For addressing the above-mentioned issues, the study has used the data of India Human Development Survey-II conducted in 2011–2012 by the University of Maryland and the National Council of Applied Economic Research, New Delhi. The findings of the study reveal that 27% of households practise untouchability in contemporary India. However, the households watching TV (25.6%) practise less untouchability than those reading newspapers (26.1%) and listening to the radio (29.6%). The culturally disadvantaged groups are excluded from the decision-making process of the media that communicates the untouchability practices with society. Hence, it is visible from the findings that the role of media is beyond the expectation related to controlling the caste-based untouchability practices.
How the Absence of Caste in Curriculum Aids the Presence of Caste in Pedagogy
Authors: Kain Damni
Published: February 2022

While caste has been invisibilized in the Indian curriculum, it is practised strongly in a pedagogical sense which maintains hierarchy in higher education. There exists a mutually reinforced relationship of absence (of caste in curriculum) and presence (of caste in pedagogy). The current study aims at assessing inclusivity in academic curriculum and pedagogy with regards to the question of caste in papers related to gender/women’s rights/feminism at the University of Delhi. The curriculum of gender-related papers provided by six departments at the University of Delhi for undergraduate students is assessed. Along with textual analysis, in depth phenomenological interviews were conducted with 20 respondents coming from diverse caste backgrounds. Professors and students who either taught or studied any paper related to gender/women’s rights at undergraduate level of the University of Delhi were interviewed. The results of the study highlight several mutually reinforcing relations between ‘caste-less curriculum’, ‘sacred teacher’ and methods of evaluation, which can be seen as an explanation of how invisibilization of caste in curriculum aids caste as a pedagogical practice.
Understanding Social Exclusion of the Low-caste Muslims in Kashmir
Authors: Shah Hafsa Sayeed
Published: February 2022

This paper attempts to establish the prevalence of the caste system among Muslims in Kashmir. This has been achieved by pointing to aspects like endogamy, ghettoization as well as hereditary passing of ‘menial’ jobs among the ‘low caste’ groups. Further, these findings have been substantiated by the fieldwork done over three months. The essential premise borrowed here to understand caste in Kashmir is that of social exclusion, which the low-caste groups face.

Social exclusion, in the context of this study, can be understood as a process that places certain caste groups in a disadvantaged position. This especially stems from being kept out of the larger social networks, in addition to not being able to access employment and education. It is also rooted in the overlapping layers of socio-cultural and economic deprivation. Poverty, in terms of material depravity, is starkly reinforced by such a socio-cultural identity of being a low-caste person employed in a ‘menial’ job. The objective of this paper, as such, is to theorize social exclusion faced by low-caste groups in Kashmir through a capability framework.

This paper also investigates the importance of relational deprivation which leads to the capability failure and hence poverty, as well as the dynamics of caste-class interaction in the similar framework of social exclusion.
B. R. Ambedkar: The Messiah and Emancipator of Indian Women
Authors: Ghosal Debjani
Published: February 2022

Dr Bhimrao Ramji Ambedkar was not only the father of the Indian Constitution or a vociferous critique of caste and untouchability but he was also a staunch supporter of women’s rights, their upliftment and emancipation. He strongly criticized the ancient lawgiver Manu and the Manusmrirti or Manav Dharma Shastra for showing contempt towards women and degrading them as slaves who are devoid of intellect. Manu denied women the right to chant Vedas, the right to education and the right to property. Ambedkar requested Indian women not to abide by the Manusmriti and to openly defy the laws of Manu. In order to ensure gender equality and the emancipation and progress of Indian women, he incorporated several articles in the Indian Constitution. As the first law minister of independent India, he introduced the Hindu Code Bill to safeguard the rights of Hindu women. It was due to his tireless efforts that the Constitution of independent India today incorporates several legislations to ensure the protection of women.
A Conceptual Framework for Investigating and Mitigating Machine-Learning Measurement Bias (MLMB) in Psychological Assessment
Authors: Tay Louis , Woo Sang Eun , Hickman Louis , Booth Brandon M. , D’Mello Sidney
Published: February 2022

Given significant concerns about fairness and bias in the use of artificial intelligence (AI) and machine learning (ML) for psychological assessment, we provide a conceptual framework for investigating and mitigating machine-learning measurement bias (MLMB) from a psychometric perspective. MLMB is defined as differential functioning of the trained ML model between subgroups. MLMB manifests empirically when a trained ML model produces different predicted score levels for different subgroups (e.g., race, gender) despite them having the same ground-truth levels for the underlying construct of interest (e.g., personality) and/or when the model yields differential predictive accuracies across the subgroups. Because the development of ML models involves both data and algorithms, both biased data and algorithm-training bias are potential sources of MLMB. Data bias can occur in the form of nonequivalence between subgroups in the ground truth, platform-based construct, behavioral expression, and/or feature computing. Algorithm-training bias can occur when algorithms are developed with nonequivalence in the relation between extracted features and ground truth (i.e., algorithm features are differentially used, weighted, or transformed between subgroups). We explain how these potential sources of bias may manifest during ML model development and share initial ideas for mitigating them, including recognizing that new statistical and algorithmic procedures need to be developed. We also discuss how this framework clarifies MLMB but does not reduce the complexity of the issue.
New Coronavirus Variants are Creating More Challenges to Global Healthcare System: A Brief Report on the Current Knowledge
Authors: Islam Salsabil , Islam Towhidul , Islam Md. Rabiul
Published: February 2022

The coronavirus is naturally mutating over time and producing new variants. Some of them are more contagious and destructive than previous strains. Also, some variants are capable of therapeutic escaping. Earlier SARS-CoV-2 variants proved that some are supercritical, and newly mutated strains are creating new challenges to the global healthcare systems. Here we aimed to evaluate different coronavirus variants and associated challenges for healthcare systems. We searched for information online and on the PubMed, Scopus, and Embase databases. We found the wild-type virus is more sensitive for neutralization and more controllable than newer variants. The Delta and Omicron variants are more highly transmissible than Alpha, Beta, and Gamma variants. Also, few strains are resistant to neutralization. Therefore, there is a chance of reinfection among the vaccinated population. The transmissibility and resistance of the recently identified Omicron variant is still unclear. The Delta variant is the most dangerous among all variants due to its high transmissibility, disease severity, and mortality rate. For poor and developing countries, oxygen supply, medication, vaccination, and device supply are challenging during epidemic waves. Slowing down the transmission, mass vaccination, vaccine redesign, re-compiling action plans, and following safety guidelines can be effective solutions to the new challenges.
Comparative investigation of the influence of stone-dust particles and bagasse fiber on the mechanical and physical properties of reinforced recycled high-density polyethylene bio-composites
Authors: Oladele Isiaka Oluwole , Aliu Simbiat Olawunmi , Taiwo Anuoluwapo Samuel , Agbeboh Newton Itua
Published: February 2022

One of the main purposes of this research is to control environmental pollution and mitigate the impact of ignorantly discarded waste plastics in the environment through recycling of such plastics and using them to develop innovative composite materials. The present work investigates the influence of stone-dust particles and bagasse fiber on the mechanical and physical properties of reinforced recycled high-density polyethylene bio-composites. The bagasse fiber was first treated with 0.5 m NaOH solution at a temperature of 50°C for 2 h in order to improve the surface morphology and also modified the mechanical properties of the fiber. Likewise, the stone-dust particles were analyzed by using a standard sieve shaker to obtain particle sizes of 75 μm. Both reinforcements were used for composite development through the compression molding technique and the samples were subjected to mechanical and physical properties tests in accordance with standards. Analysis of the results revealed that flexural, hardness, wear, and hydrophobicity of the developed bio-composites were improved by stone-dust particles. The flexural strength at peak and modulus were enhanced by 88% and 92%, respectively. Also, it was discovered that, tensile, impact and thermal conductivity properties of the bio-composites were improved by bagasse fiber. The ultimate tensile strength and Young’s modulus were enhanced by 43% and 34%, respectively. Hence, the blend of these by-products showed that they are potential bio-materials for the development of bio-composites.
Clinical Evaluation of the Hip With Focus on Assessment of Hip Instability
Authors: Turner Elizabeth H. G. , Watchmaker Lauren E. , Spiker Andrea M.
Published: February 2022

Background:

Hip instability is a challenging clinical diagnosis, which often overlaps with the presentation of hip impingement and/or hip dysplasia. Many factors contribute to hip instability, including acetabular undercoverage, femoroacetabular-impingement-induced instability, and soft tissue laxity. It can cause significant pain and disability, either as a primary pathology or as a complication of surgery and if untreated can ultimately lead to early osteoarthritis.

Indications:

Hip dysplasia is often diagnosed with an anterior-posterior pelvic radiograph. The literature has supported a normal lateral center edge angle (LCEA) as ≥25°, borderline dysplasia an LCEA of 18° to 25°, and an LCEA <18° as true dysplasia, though some authors will diagnose borderline dysplasia as an LCEA of 20° to 25° and true dysplasia as an LCEA <20°. In addition, there are many radiographic measurements that have been described to aid in the diagnosis of hip instability beyond LCEA, including the acetabular inclination (or Tönnis angle), the femoro-epiphyseal acetabular roof (FEAR) index, and the cliff sign.

Technique Description:

Hip instability can be present even in the absence of radiographic findings, and many with insufficient coverage of the femoral head do not meet the radiographic definition of dysplasia. For this reason, it is important to have an understanding of the clinical assessment that may aid in the diagnosis of hip instability. Here, we present our preferred technique for clinical examination of the hip, focusing on the assessment of hip instability.

Results:

While no one maneuver is sufficient to diagnose hip instability, incorporation of multiple examinations in conjunction with radiographs can help to properly diagnose the presence of hip instability.

Discussion/Conclusion:

Hip instability is a challenging clinical diagnosis, and many examination maneuvers have been described to assess for hip instability. In this technical note, we describe our preferred technique for clinical examination of the hip, focusing on the assessment of hip instability.
The Effects of the Activity of Making Jewelry From Beads on the Anxiety Levels of Children With Cancer: A Randomised Controlled Study
Authors: Günay Ulviye , Sarman Abdullah , Salman Uygar , Yılmaz Aydan Selen
Published: February 2022

Background: Children hospitalized for cancer treatment are known to experience high levels of anxiety. This study aimed to examine the effects of making jewelry from beads on the state and trait anxiety levels of children with cancer. Methods: This parallel group, randomized controlled trial was conducted on 62 children aged 7–18 who were being treated for cancer. The children were selected using the random sampling method. The jewelry-making sessions with the children in the intervention group were held twice a week for four weeks. Data were analysed using the chi-square test, the Student's t-test, the independent samples t-test and linear regression. Results: The state anxiety levels of the children in the intervention group decreased both in the first week and the fourth week after making jewelry. The difference in the average post-test scores between the two groups was found to be significant ( p < .05). The fourth week average trait anxiety score of the children in the intervention group decreased ( M  =  33.2) in comparison to the average score of the control group ( M  =  36.5). The difference between the two groups was found to be significant ( p < .001). Discussion: This study found that the activity of making jewelry from beads was effective in reducing the state and trait anxiety levels of children with cancer.
Digital Technologies in Built Environment Projects: Review and Future Directions
Authors: Papadonikolaki Eleni , Krystallis Ilias , Morgan Bethan
Published: February 2022

Through a systematic literature review we explore how digital technologies reshape and catalyze digital innovations in the built environment—a highly project-based setting. We analyzed circa 3,000 titles, further narrowed down to 87 articles. We synthesized an original framework for data analysis. The article presents implications for the deployment of digital technologies on three levels: individuals, organizations, and projects. Whereas most of these studies examined the impact of digital innovation in projects, recommendations focused on organizations, suggesting future directions for performance measurement, developing capabilities of firms to manage changes in dynamic environments and interorganizational settings.
Analysis of racial and ethnic disparities in multiple myeloma US FDA drug approval trials
Authors: Kanapuru Bindu , Fernandes Laura L. , Fashoyin-Aje Lola A. , Baines Andrea C. , Bhatnagar Vishal , Ershler Rachel , Gwise Thomas , Kluetz Paul , Pazdur Richard , Pulte Elizabeth , Shen Yuan-Li , Gormley Nicole
Published: February 2022

African Americans (AAs) have a higher incidence of multiple myeloma (MM) than White patients. Mortality is also higher in AAs compared with White patients. AAs more commonly have immunoglobulin H translocations t(11;14) and t(14;16) compared with White patients. We sought to characterize the demographic representation in MM clinical trials and evaluate outcomes based on race and ethnicity. We conducted a pooled analysis of all trials submitted to the US Food and Drug Administration (FDA) to support approval of a MM therapeutic between 2006 and 2019. Demographic characteristics were analyzed descriptively. An age-adjusted stratified Cox regression model was used to evaluate the relationship between time-to-event outcomes and race and ethnicity. Nineteen global trials comprising 10 157 patients were pooled. White, Asian, and Black patients comprised 84%, 7%, and 4% of the dataset, respectively; Hispanic patients comprised 4%. The age-adjusted overall survival hazard ratio (HR) for Black compared with White patients was 0.89 (95% confidence interval [CI], 0.75-1.05). The age-adjusted HR for US Black vs US White patients was 0.82 (95% CI, 0.66-1.02). For rest-of-world (RoW) Black vs RoW White patients, the HR was 1.31 (95% CI, 0.97-1.77). Black and Hispanic patients were underrepresented in the trials supporting FDA approval of MM drugs. Black patients were primarily enrolled in the United States. Outcomes in US patients were more favorable compared with those in patients in the RoW. Given the higher incidence of MM in AAs and the different disease characteristics, efforts should be made to improve representation of AAs in MM clinical trials.
Assessing cough symptom severity in refractory or unexplained chronic cough: findings from patient focus groups and an international expert panel
Authors: Kum Elena , Guyatt Gordon H. , Munoz Caroline , Beaudin Suzanne , Li Shelly-Anne , Abdulqawi Rayid , Badri Huda , Boulet Louis-Philippe , Chen Ruchong , Dicpinigaitis Peter , Dupont Lieven , Field Stephen K. , French Cynthia L. , Gibson Peter G. , Irwin Richard S. , Marsden Paul , McGarvey Lorcan , Smith Jaclyn A. , Song Woo-Jung , O'Byrne Paul M. , Satia Imran
Published: February 2022

Background

Cough symptom severity represents an important subjective end-point to assess the impact of therapies for patients with refractory or unexplained chronic cough (RCC/UCC). As existing instruments assessing the severity of cough are neither widely available nor tested for measurement properties, we aim to develop a new patient-reported outcome measure addressing cough severity.

Objective

The aim of this study was to establish items and domains that would inform development of a new cough severity instrument.

Methods

Three focus groups involving 16 adult patients with RCC/UCC provided data that we analysed using directed content analysis. Discussions led to consensus among an international panel of 15 experts on candidate items and domains to assess cough severity.

Results

The patient focus group provided 48 unique items arranged under broad domains of urge-to-cough sensations and cough symptom. Feedback from expert panel members confirmed the appropriateness of items and domains, and provided an additional subdomain related to cough triggers. The final conceptual framework comprised 51 items in the following domains: urge-to-cough sensations (subdomains: frequency and intensity) and cough symptom (subdomains: triggers, control, frequency, fit/bout duration, intensity, quality and associated features/sequelae).

Conclusions

Consensus findings from patients and international experts established domains of urge-to-cough and cough symptom with associated subdomains and relevant items. The results support item generation and content validity for a novel patient-reported outcome measure for use in health research and clinical practice.
Spatio-temporal variation of bacterioplankton community structure in the Pearl River: impacts of artificial fishery habitat and physicochemical factors
Authors: Bi Sheng , Lai Han , Guo Dingli , Liu Xuange , Wang Gongpei , Chen Xiaoli , Liu Shuang , Yi Huadong , Su Yuqin , Li Guifeng
Published: February 2022

Background

Artificial fishery habitat has been widely used in fishery resource protection and water habitat restoration. Although the bacterioplankton plays an important ecological role in fisheries ecosystems, the effect of artificial fishery habitat on bacterioplankton is not clear. In this study, high-throughput sequencing based on the 16S rRNA gene was carried out to study the characteristics of bacterioplankton community structure in artificial fishery habitat and to determine the principal environmental factors that shaped the composition, structure and function of bacterioplankton communities in an unfed aquaculture system.

Results

The results indicated that the most dominant phyla were Proteobacteria (Alphaproteobacteria and Gammaproteobacteria), Actinobacteria, Cyanobacteria, and Bacteroidetes, which accounted for 28.61%, 28.37%, 19.79%, and 10.25% of the total abundance, respectively. The factors that cause the differences in bacterioplankton community were mainly manifested in three aspects, including the diversity of the community, the role of artificial fishery habitat, and the change of environmental factors. The alpha diversity analysis showed that the diversity and richness index of the bacterioplankton communities were the highest in summer, which indicated that the seasonal variation characteristics had a great influence on it. The CCA analysis identified that the dissolved oxygen, temperature, and ammonium salt were the dominant environmental factors in an unfed aquaculture system. The LEfSe analysis founded 37 indicator species in artificial structure areas (AS group), only 9 kinds existing in the control areas of the open-water group (CW group). Meanwhile, the KEGG function prediction analysis showed that the genes which were related to metabolism in group AS were significantly enhanced.

Conclusions

This study can provide reference value for the effect of artificial habitat on bacterioplankton community and provide fundamental information for the follow-up study of ecological benefits of artificial fishery habitat. It may be contributed to apply artificial fishery habitat in more rivers.
Yoghurt consumption is associated with changes in the composition of the human gut microbiome and metabolome
Authors: Le Roy Caroline Ivanne , Kurilshikov Alexander , Leeming Emily R. , Visconti Alessia , Bowyer Ruth C. E. , Menni Cristina , Falchi Mario , Koutnikova Hana , Veiga Patrick , Zhernakova Alexandra , Derrien Muriel , Spector Tim D.
Published: February 2022

Background

Yoghurt contains live bacteria that could contribute via modulation of the gut microbiota to its reported beneficial effects such as reduced body weight gain and lower incidence of type 2 diabetes. To date, the association between yoghurt consumption and the composition of the gut microbiota is underexplored. Here we used clinical variables, metabolomics, 16S rRNA and shotgun metagenomic sequencing data collected on over 1000 predominantly female UK twins to define the link between the gut microbiota and yoghurt-associated health benefits.

Results

According to food frequency questionnaires (FFQ), 73% of subjects consumed yoghurt. Consumers presented a healthier diet pattern (healthy eating index: beta = 2.17 ± 0.34; P = 2.72x10−10) and improved metabolic health characterised by reduced visceral fat (beta = −28.18 ± 11.71 g; P = 0.01). According to 16S rRNA gene analyses and whole shotgun metagenomic sequencing approach consistent taxonomic variations were observed with yoghurt consumption. More specifically, we identified higher abundance of species used as yoghurt starters Streptococcus thermophilus (beta = 0.41 ± 0.051; P = 6.14x10−12) and sometimes added Bifidobacterium animalis subsp. lactis (beta = 0.30 ± 0.052; P = 1.49x10−8) in the gut of yoghurt consumers. Replication in 1103 volunteers from the LifeLines-DEEP cohort confirmed the increase of S. thermophilus among yoghurt consumers. Using food records collected the day prior to faecal sampling we showed than an increase in these two yoghurt bacteria could be transient. Metabolomics analysis revealed that B. animalis subsp. lactis was associated with 13 faecal metabolites including a 3-hydroxyoctanoic acid, known to be involved in the regulation of gut inflammation.

Conclusions

Yoghurt consumption is associated with reduced visceral fat mass and changes in gut microbiome including transient increase of yoghurt-contained species (i.e. S. thermophilus and B. lactis).
Development and multi-center clinical trials of an up-converting phosphor technology-based point-of-care (UPT-POCT) assay for rapid COVID-19 diagnosis and prediction of protective effects
Authors: Zhang Pingping , Li Baisheng , Wang Yao , Min Wei , Wang Xiaohui , Zhou Yugui , Li Zhencui , Zhao Yong , Zhang Huan , Jiang Min , Zheng Huanying , Yang Chao , Zhang Wei , Zuo Le , Gao Qi , Yang Zhengrong , Li Yanzhao , Feng Tiejian , Lin Changqing , Hu Qinghua , Song Tie , Yang Ruifu
Published: February 2022

Background

Quantitative point-of-care testing assay for detecting antibodies is critical to COVID-19 control. In this study, we established an up-conversion phosphor technology-based point-of-care testing (UPT-POCT), a lateral flow assay, for rapid COVID-19 diagnosis, as well as prediction of seral neutralizing antibody (NAb) activity and protective effects.

Methods

UPT-POCT was developed targeting total antibodies against the receptor-binding domain (RBD) of SARS-CoV-2 spike protein. Using ELISA as a contrast method, we evaluated the quantitation accuracy with NAb and serum samples. Cutoff for serum samples was determined through 70 healthy and 140 COVID-19 patients. We evaluated the cross-reactions with antibodies against other viruses. Then, we performed multi-center clinical trials of UPT-POCT, including 782 patients with 387 clinically confirmed COVID-19 cases. Furthermore, RBD-specific antibody levels were detected using UPT-POCT and microneutralization assay for samples from both patients and vaccinees. Specifically, the antibodies of recovered patients with recurrent positive (RP) reverse transcriptase-polymerase chain reaction test results were discussed.

Results

The ratios of signal intensities between the test and control bands on the lateral flow strip, namely, T/C ratios, was defined as the results of UPT-POCT. T/C ratios had excellent correlations with concentrations of NAb, as well as OD values of ELISA for serum samples. The sensitivity and specificity of UPT-POCT were 89.15% and 99.75% for 782 cases in seven hospitals in China, respectively. We evaluated RBD-specific antibodies for 528 seral samples from 213 recovered and 99 RP COVID-19 patients, along with 35 seral samples from inactivated SARS-CoV-2 vaccinees, and we discovered that the total RBD-specific antibody level indicated by T/C ratios of UPT-POCT was significantly related to the NAb titers in both COVID-19 patients (r = 0.9404, n = 527; ρ = 0.6836, n = 528) and the vaccinees (r = 0.9063, ρ = 0.7642, n = 35), and it was highly relevant to the protection rate against RP (r = 0.9886, n = 312).

Conclusion

This study reveals that the UPT-POCT for quantitative detection of total RBD-specific antibody could be employed as a surrogate method for rapid COVID-19 diagnosis and prediction of protective effects.
“One-step” approach versus “Step-up” approach minimally invasive treatment for infected pancreatic necrosis: a study protocol for a single-center, prospective, randomized controlled trial
Authors: Zheng Zhi , Lu Jiongdi , Cao Feng , Ding Yixuan , Guo Yulin , Mei Wentong , Qu Yuanxu , Liu Shuang , Sun Haichen , Cui Yeqing , Li Ang , Li Fei
Published: February 2022

Background

Currently, the minimally invasive “Step-up” surgical strategy is still the main treatment for infected pancreatic necrosis (IPN). However, indiscriminate implementation of the “Step-up” strategy can lead to increased numbers of operations and prolonged hospital stay. The “Step-up” approach is not appropriate for some patients due to unavailabilty of a safe puncture path. Therefore, we developed the “One-step” surgical approach to treat IPN, which is safety. However, there is still a lack of comparison of the short and long-term efficacy between the “One-step” and “Step-up” approach. Consequently, we are conducting this clinical trial to provide a reference for IPN treatment.

Methods

This is an ongoing, single-center, randomized controlled trial of patients with IPN. The total sample size required for the trial (May 2021–December 2023) is approximately 128 patients. Patients will be randomly assigned to either an experimental group (One-step) or a control group (Step-up) at a ratio of 1:1 using the block randomization method. We used the case report forms and electronic data capture systems to obtain demographic information, preoperative laboratory examination, auxiliary examination results, surgery data, postoperative recovery outcomes, and follow-up outcomes. The patients will be followed up for 2 years after surgery. The primary endpoint is a composite endpoint, consisting of mortality and severe complications. The secondary endpoints include the incidence of organ dysfunction, the number of surgical procedures, mortality (the incidence of death in hospital and deaths within 30 days of discharge), hospital stay, intensive care unit stay, hospitalization costs, perioperative inflammatory marker changes, and short-and long-term complications.

Discussion

Compared with the “Step-up,” the “One-step” minimally invasive surgery can significantly reduce the number of operations, reduce the length of hospital stay and hospitalization costs without increasing the incidence of composite endpoint events, and has better short- and long-term efficacy and safety. Additionally, there was no statistically significant difference in perioperative complications and mortality between “Step-up” and “One-step”. This study will assist with the formulation of an effective and scientific “One-step” minimally invasive treatment strategy for IPN, and an understanding of this technique will facilitate clinical decision-making for IPN.

Trial Registration ChiCTR2100044348. Trial status: Ongoing.
An ultra-rare case of immunoskeletal dysplasia with neurodevelopmental abnormalities in an Indian patient with homozygous c.953C > T variant in EXTL3 gene: a case report
Authors: Bajaj Shruti , Satoskar Purnima , Nair Aadhira , Sheth Frenny , Sheth Jayesh , Sheth Harsh
Published: February 2022

Background

Immunoskeletal dysplasia with neurodevelopmental abnormalities (ISDNA) is an ultra-rare genetic condition that belongs to the group of spondyloepimetaphyseal dysplasias. It is caused due to presence of biallelic variants in theEXTL3gene. The encoded exostosin like glycosyltransferase 3 (EXTL3) protein plays a key role in heparan sulfate synthesis. The skeletal and nervous systems are prominently affected in ISDNA with variability in immunological manifestations. Here, we report the 15thcase of ISDNA (third patient of an Indian ancestry) in the world, along with a review of literature.

Case presentation

A 15-month-old female child with clinical indications of global developmental delay, short stature, coarse facial features, and hypotonia was referred to our clinic. Spondyloepimetaphyseal dysplasias associated with extra-skeletal manifestations was suspected based on clinic-radiological correlation. Whole exome sequencing analysis revealed the presence of a homozygous known pathogenic variant c.953C > T (p. Pro318Leu) in exon 3 of theEXTL3gene, thereby confirming diagnosis of ISDNA.

Conclusion

We present an ultra-rare case of ISDNA- third patient of Indian ancestry and only the 15threported case in the literature. On review of all cases in the literature, we find that the affected individuals show abnormalities primarily in three systems namely- skeletal, nervous and immune system. Notably, patients harbouring the same variant inEXTL3gene show phenotypic variability especially with respect to presence or absence of immunological manifestations, suggesting a role of unknown modifiers. Hence, it is currently not possible to correlate the variant position in theEXTL3gene with disease severity.
Who gets vaccinated in a measles-rubella campaign in Nepal?: results from a post-campaign coverage survey
Authors: Danovaro-Holliday M. Carolina , Rhoda Dale A. , Lacoul Mona , Prier Mary L. , Gautam Jhalak Sharma , Pokhrel Tara Nath , Dixit Sameer Mani , Rajbhandari Rajesh Man , Bose Anindya Sekhar
Published: February 2022

Background

Following the 2015 earthquake, a measles-rubella (MR) supplementary immunization activity (SIA), in four phases, was implemented in Nepal in 2015–2016. A post-campaign coverage survey (PCCS) was then conducted in 2017 to assess SIA performance and explore factors that were associated with vaccine uptake.

Methods

A household survey using stratified multi-stage probability sampling was conducted to assess coverage for a MR dose in the 2015–2016 SIA in Nepal. Logistic regression was then used to identify factors related to vaccine uptake.

Results

Eleven thousand two hundred fifty-three households, with 4870 eligible children provided information on vaccination during the 2015–2016 MR SIA. Overall coverage of measles-rubella vaccine was 84.7% (95% CI: 82.0–87.0), but varied between 77.5% (95% CI: 72.0, 82.2) in phase-3, of 21 districts vaccinated in Feb-Mar 2016, to 97.7% (CI: 95.4, 98.9) in phase-4, of the last seven mountainous districts vaccinated in Mar-Apr 2016. Coverage in rural areas was higher at 85.6% (CI: 81.9, 88.8) than in urban areas at 79.0% (CI: 75.5, 82.1). Of the 4223 children whose caregivers knew about the SIA, 96.5% received the MR dose and of the 647 children whose caregivers had not heard about the campaign, only 1.8% received the MR dose.

Conclusions

The coverage in the 2015–2016 MR SIA in Nepal varied by geographical region with rural areas achieving higher coverage than urban areas. The single most important predictor of vaccination was the caregiver being informed in advance about the vaccination campaign. Enhanced efforts on social mobilization for vaccination have been used in Nepal since this survey, notably for the most recent 2020 MR campaign.