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Introduction: Prospective applicants utilize the internet to obtain information on fellowship programs they wish to apply to. The COVID-19 pandemic presented challenges to orthopaedic spine fellowship programs, among them the transition to communicating with prospective applicants largely through web-based and virtual platforms. The purpose of this study was to assess the content of information accessible to applicants on orthopaedic spine fellowship program websites during September and October 2020 of the COVID-19 pandemic. Method(s): Seventy-nine accredited fellowship programs were identified from the North American Spine Society Fellowship Program Directory and assessed based upon 18 criteria categorized as composites of three domains: program overview, application information, and education. Information was compiled, tabulated to visualize numerical differences between each program, and analyzed via descriptive statistics. Result(s): No program website mentioned virtual tours or interviews. All websites listed an address for the program location, 99% listed a phone number, and 96% a contact email address. Seventy-seven percent mentioned research requirements, 77% mentioned research outputs, nine percent mentioned call responsibilities, and three percent mentioned international opportunities. Twenty-three percent of programs mentioned meetings or courses, 43% mentioned case log numbers, 37% mentioned didactics, 20% mentioned journal clubs, 20% mentioned clinic duties, and 16% mentioned rotations. Conclusion(s): Spine fellowship programs did not appreciably amend content on their websites during the COVID-19 pandemic. This is consistent with findings from pre-COVID-19, where fellowship programs were also underutilizing website platforms and did not showcase sufficient information online that prospective applicants could potentially benefit from knowing about their program.
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This study focuses on the fear of failure (FF) in entrepreneurship and its effect on the entrepreneurial orientation (EO) as a strategic orientation in firms. There has been much research on EO as a predictor of organizations' performance since it is considered a manifestation of the entrepreneurial direction inside the organization. Yet, the research on the relationships between individual-level variables and EO itself still has room for contribution, especially the internal aspects related to the entrepreneur or the manager. Therefore, this research aims to explore FF in entrepreneurship and its inhibiting and motivating roles. In addition, given that the firm is the unit of analysis in this study, this research explained how an entrepreneur's FF affects the EO of the firm amidst the COVID-19 outbreak. The study administered a quantitative research design using a structured questionnaire. The results showed a positive influence of the entrepreneur's fear of failure on the firm's entrepreneurial orientation manifested in the firm's innovativeness dimension. However, the other two dimensions that contribute to the firm's EO representation (proactiveness & risk-taking) showed insignificant relationships with the entrepreneur's FF. © 2022, Academic Conferences and Publishing International Limited. All right reserved.
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Introduction The UK has been severely affected by the COVID-19 pandemic. The impact on the adult population has been disproportionately higher when compared to children with consequent challenges to organ donation and liver transplantation (LT). Across the three UK paediatric liver centres there has only been a very small number of patients who tested positive for COVID-19 and all made a speedy and full recovery. We report here the response during the pandemic across the 3 paediatric LT centres. Methods A series of nationally agreed policy changes affecting the liver procurement, listing and transplant process were agreed during regular meetings with LT centre directors and NHSE. Actions at a local and national level were agreed to protect and maintain the paediatric LT programmes. Data were collected from 27/03/20 until 26/11/20 and compared with same time period for the years 2016-19. Results During the study period, there was a significant reduction in the adult population in the mean number of weekly liver offers, donors and LTs compared to before the pandemic with signs of recovery between the 1st and 2nd UK lockdown periods (figure 1). More specifically the number of livers offered nationally was reduced from an average 30-40/week to only <10/week during the 1st wave in the March-April period. The number of children on the LT list during the study period across all 3 centres was 74 in total with 17 (23%) super-urgent and 57(77%) electives, which was comparable to previous years. Overall, 65-80 paediatric LTs are performed annually across the UK's 3 paediatric centres. From March-November 2020 there were 58(82%) elective and 13(18%) super urgent (acute liver failure & hepatoblastoma) paediatric LTs performed. Donor Brain Dead (DBD) and Donor Cardiac Dead (DCDC) LTs were 54(76%) and 3(4%), respectively. Living related LT (LRLT) programme was sustained comprising 20% of LTs performed. The number of paediatric LTs performed during the pandemic was comparable to those performed yearly since 2016. The number of LT per paediatric centre for King's College Hospital (KCH), Birmingham Children's Hospital (BCH) and Leeds Liver Unit were 40 (56%), 15(21%) and 16(23%), respectively with excellent outcome. A 15-year-old girl from KCH diagnosed with Wilson disease presented with liver failure and became COVID-19 positive whilst listed. She underwent LT soon after becoming COVID-19 negative. No perioperative mortality was reported with excellent outcome so far in all. Conclusion The current COVID-19 pandemic had a significant impact on the UK adult LT programme. The paediatric programme LT was preserved despite a decrease in organ offering and retrieval nationally plus limitations on adult intensive care resources at a regional level. Overall, paediatric LT outcome remained very good.
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Introduction In April 2020 weekly teleconferences were established involving adult and paediatric representation from all 7 UK liver transplant (LT) centres and NHS England to discuss and maintain a national LT service during the COVID19 pandemic. Objective criteria to prioritise adult patients of high clinical urgency for prioritised access to LT were established. In lieu of such criteria for paediatric patients all three paediatric centres agreed to prioritise individual paediatric patients with chronic liver disease who were clinically deteriorating by consensus. A process to formally nationally prioritise clinically deteriorating paediatric patients was successfully introduced in October 2020. We report on the utilisation of the tier and outcome of these patients at a national level. Methods Patients from all 3 paediatric LT centres registered on the newly established national prioritised paediatric registration tier from October 2020-October 2021 were included. Demographic, clinical and laboratory data were collected and analysed. Results Since the introduction of the prioritization tier for children there were eight UK elective applications and all approved registrations. Mean age of patients registered was 5 years (range, 0-15). All patients were listed for LT prior to (Table Presented) prioritisation except patient 5 who was listed for liver-small bowel transplant before being prioritised for isolated LT. Indications for prioritization were hepatocellular carcinoma (1), acute decompensation due to portal hypertension (2), encephalopathy (3), sepsis (1), acute kidney injury (1). At time of prioritisation median values and range of alanine aminotransferase, albumin, total bilirubin, INR and platelets were 95 IU/ L (23-453), 25 g/L (16-39), 196 micromol/L (10-553), 1.6 (0.97-2.27) and 75 x109 (41-188), respectively. Median waiting time to transplant after prioritisation was 10 days (range, 3-37). All patients received a graft from a DBD donor and are all well at home. Median length of post-transplant ICU stay was 9 days (3-62) and total length of hospital stay was 56 days (27-85). Data on demographics and LT are listed on table 1. Conclusion The national paediatric prioritisation tier, introduced during the COVID19 pandemic, has been a pivotal initiative for the UK paediatric LT program, showcasing national collaboration. All patients underwent a LT successfully within a short time from prioritisation with 100% patient and graft survival. The intention is to maintain this prioritised paediatric tier following the pandemic.
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COVID-19 pandemic has led to an overwhelming healthcare system causing a delay in management of other infectious diseases such as tuberculosis. Rasmussen aneurysm (RA) appears in chronic cavitary tuberculosis. We report here, three cases of pulmonary tuberculosis complicated by RA admitted to Department 1 of Abderrahmane Mami hospital in Tunisia. Data were collected from June 2020 to September 2021. All patients presented with hemoptysis. Sputum was positive for the acid-fast bacilli. Computed tomographic pulmonary angiography showed RA. Only one patient underwent emergent glue embolization. These cases give an insight into the importance of timely therapeutic care for tuberculosis.
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Background. Currently, the management of SARS-CoV-2 varies with no definitive clinical guidelines, as scientific evidence across the globe differs in therapeutic options. This study intends to provide some clarity to the insufficient data based on the role of monotherapy with tocilizumab (TCZ) and combination therapy with remdesivir (RDV) and TCZ among patients in El Paso, Texas. Methods. 154 SARS-CoV-2-positive patients from four different hospitals in El Paso, Texas, were screened, with 113 eligible for this longitudinal comparative observational study (2/1/2020-10/31/2020). Group 1 (80 patients) were given TCZ within the first 24 hours of hospitalization, followed by methylprednisolone for 72 hours, and Group 2 (33 patients) received TCZ as detailed in the single therapy group, plus RDV within the first 24 hours. Mann Whitney U test assessed Median differences in laboratory biomarkers and Bivariate Logistic Regression assessed the odds of risk. An observation is said to be statistically significant if P-value is ≤ 0.05. Results. A statistically significant increased median IL-6 values were noted among those given only TCZ compared to those that received TCZ plus RDV (511.33 vs. 199.0) with a P-value (0.007). Patients in Group 1 had statistically significant lower odds for ventilation use than Group 2 (OR=0.34, 95%CI=0.12-0.95, p=0.034), although no statistically significant difference in mortality outcomes was observed across groups (OR=0.43, 95%CI:0.13-1.39, p=0.269). Table 1. Laboratory biomarkers and treatment groups (Mann Whitney U test) Table 2. Clinical outcomes and treatment groups using the Bivariate Logistic regression (OR) Conclusion. This study population is unique as it reflects a predominantly Hispanic demographic population in El Paso with different genetics, background characteristics, and predisposition to diabetes, and obesity than the rest of the United States (US). We concluded that the use of TCZ in SARS-CoV-2 positive patients in El Paso, with or without RDV, reported no mortality benefit. However, some minimal/non-use of ventilation benefit was observed in Group 1. Our study design is considered the first of its kind using TCZ and RDV in a longitudinal comparative observational study. Nonetheless, a randomized controlled trial study is recommended to ultimately determine the combination role of TCZ and RDV among this highly vulnerable group of patients.
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The novel coronavirus pandemic (COVID-19) caused by SARS-CoV-2 has affected more than 53 million individuals worldwide. Currently, there is a dire need to develop or find potential drugs that can treat SARS-CoV-2 infection. One of the standard methods to accelerate drug discovery and development in pandemics is to screen currently available medications against the critical therapeutic targets to find potential therapeutic agents. The literature has pointed out the 3CLpro and RdRp proteins as the most important proteins involved in viral replications. In the present study, we used an in-silico modeling approach to examine the affinity of six tyrosine kinases inhibitors (TKIs), Imatinib, Ponatinib, Nilotinib, Gefitinib, Erlotinib, and Dasatinibagainst the 3CLpro and RdRp by calculating the energy balance. The six tested TKIs had more than-7 Kcal/mol energy balance values for both viral target proteins. Nilotinib and Ponatinib showed the highest affinity for 3CLpro (-8.32,-8.16, respectively) while Dasatinib, Ponatinib, and Imatinib presented the strongest binding toRdRp(-14.50,-10.57,-9.46, respectively). Based on these findings, we recommend future evaluations of TKIs for SARs-CoV-2 infection in-vitro and further testing in clinical trials. © 2021 by the authors.
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Introduction: Online education has grown a lot in recent months in our country during the global health crisis (COVID19). It has been widely used at all levels and fields of education ranging from elementary school to graduate and postgraduate studies. Aim: To evaluate this teaching method compared to classical face-to-face teaching by referring to the learner’s point of view Methods: It was a prospective and descriptive cross-sectional study targeting residents in medical imaging (all levels approximately 200 people) It was based on an online questionnaire sent to all residents after attending synchronous online teaching sessions at the College of Medical Imaging and Nuclear Medicine. The assessment was done by the learners using a 5 points Likert scale. Results: Ninety-seven residents answered the questionnaire. Sixty percent of our learners were satisfied with this new way of teaching. 73% of the students found the logistical means suitable for this course. The main advantages noted by our residents were accessibility to sessions from any location and the ability to replay lessons later. The weaknesses put forward were the lack of interaction with the teacher compared to face-to-face teaching and the occurrence of technical problems which could sometimes hamper the smooth running of the sessions. Conclusion: Our study allowed us to get feedback from our learners on this teaching. The multiplication of learning means, in particular a hybrid education should be considered to overcome the shortcomings of exclusive online teaching.