Emergence of SARS-CoV-2: Insight in genomics to possible therapeutics

Rising of a new virus from city of Cathay, responsible for 2019 global pandemic is caused by SARS-CoV-2marked as a great threat for populations. The member (CoV-2) from vast family of Covid virus with single-stranded RNA spread to over 216 countries and billions of individuals died all around the globe. Regardless of all strict standard operating procedures, special care and therapies, SARS-CoV-2 mutating its genomic structure and leads to shutting the world. While different therapeutic approaches face problems due to the complexity in pathogenicity mechanism of CoV-2 and its variants. Mechanism of action, genome analysis, transmission, development of broad-spectrum antiviral medications and SARS-CoV-2 vaccines have been reported which are essential for future directions to control this pandemic. Here, in this review, these domains were discussed to highlight the genome structure pathophysiology, immune response, multiple diagnostic methods, and possible treatment strategies. This review deliberates the methodologies for creating practical vaccinations and treatment cocktail to manage this eruption. © 2023, The Running Line. All rights reserved.

INSIGHT OF PANDEMIC COVID-19: DEVELOPMENTS AND CHALLENGES

This review focuses on the characteristics of coronavirus disease-19 (COVID-19) including virus structure, ecoepidemiology and pathophysiology, signs and symptoms in infected people, and data on virus pathogenicity, severity, and survivability in COVID-19 infected patients. The emphasis is on immunological reactions, diagnosis, prophylactic methods, and the zoonotic significance of COVID-19. The authors feel that the review's contents will be valuable to epidemiologists, virologists, public health officials, diagnosticians, laboratory workers, environmentalists, and socioeconomic experts. It has information on the many types of coronavirus variants, the disease situation in Pakistan and the WHO criteria for COVID-19 prevention is given. Moreover, lessons learned from the COVID-19 pandemic are also outlined.

New-Onset Thyroid Eye Disease After COVID-19 Infection in Patient with Graves' Disease Post-Radioactive Iodine Treatment

Introduction: Coronavirus disease 2019 (COVID-19) has been associated with dysregulation of the immune system and abnormal thyroid function. The aim of this novel case report is to inform physicians of the possibility that COVID-19 infection may precipitate thyroid eye disease (TED) in patients with Graves' Disease (GD) even after treatment with radioactive iodine (RAI). Case Description: In this report, we describe a patient with GD treated with RAI who developed TED after COVID-19 infection. The patient was initially diagnosed with GD in 2018. A thyroid uptake scan (I-123) was consistent with GD with moderately elevated uptake. She was initially managed with methimazole and atenolol and was eventually treated with RAI (16.32 millicurie I-131) in February 2021. She had post-ablative hypothyroidism managed with levothyroxine. The patient contracted COVID-19 in January 2022. In February 2022, the patient started experiencing eye irritation, dryness, protrusion of eyes, eyelid swelling, and visual disturbances. Thyroid stimulating hormone (TSH) receptor auto-antibodies (7.33 IU/L, normal < /=1.00 IU/L) and thyroid stimulating immunoglobulin (4.30 IU/L, normal < /=1.00 IU/L) were elevated. TSH was normal (2.180 mIU/L, normal 0.270 - 4.200 mIU/L) on levothyroxine 125 mcg daily. She was later diagnosed with TED. Discussion(s): GD is an autoimmune thyroid disorder related to the presence of TSH receptor-stimulating antibodies and is often associated with ocular symptoms. Activation of an autoimmune response during COVID-19 infection, may induce onset or relapse of GD. A study using the national health insurance service database in South Korea noted an increase in the incidence of subacute thyroiditis in 2020 in association with the COVID-19 pandemic. TED is usually seen in patients with GD. Radioactive iodine is widely used in the treatment of GD and has been associated with development or worsening of TED. There are published cases of TED occurring in patients with GD after receiving COVID-19 vaccine. It is thought that the inflammatory syndrome induced by the adjuvants could induce molecular mimicry, which could trigger TED. In most cases this adverse effect was transient, lasting a few months after treatment. There have been case reports of TED occurring after 3 to 21 days of COVID-19 vaccination in patients with controlled GD. Symptoms improved in 4-8 months. Development of TED in patients with GD who have been treated with RAI typically occurs soon after RAI therapy. For TED to occur in a GD patient 11 months after receiving RAI therapy is unusual. COVID-19 infection appears to have been the trigger for this patient's eye disease. This is highly unusual and has not been published to our knowledge.Copyright © 2023

Tuberculosis chest X-ray detection using CNN-based hybrid segmentation and classification approach

Tuberculosis still significantly impacts the world's population, with more than 10 million people getting sick each year. Researchers have focused on developing computer-aided diagnosis (CAD) technology based on X-ray imaging to support the identification of tuberculosis, and deep learning is a popular and efficient method. However, deep learning-based CAD approaches usually ignore the relationship between the two vision tasks of specific region segmentation and classification. In this research, we introduced a novel TB-UNet, which is based on dilated fusion block (DF) and Attention block (AB) block for accurate segmentation of lungs regions and achieved the highest results in terms of Precision (0.9574), Recall (0.9512), and F1score (0.8988), IoU (0.8168) and Accuracy (0.9770). We also proposed TB-DenseNet which is based on five dual convolution blocks, DenseNet-169 layer, and a feature fusion block for the precise classification of tuberculosis images. The experiments have been performed on three chest X-ray (CXR) datasets, segmented images, and original images are fed to TB-DenseNet for better classification. Furthermore, the proposed method is tested against simultaneously three different diseases, such as Pneumonia, COVID-19, and Tuberculous. The highest results are achieved in terms of Precision (0.9567), Recall (0.9510), F1score (0.9538), and Accuracy (0.9510). The achieved results reflect that our proposed method produces the highest accuracy compared to the state-of-the-art methods. The source code is available at: https://github.com/ahmedeqbal/TB-DenseNet.Copyright © 2023 Elsevier Ltd

COVID-19 Stress and Burnout: An Investigation of Healthcare Providers

The outbreak of the contagion corona virus disease has engrossed worldwide attention. The nature of the disease and its spread has put excessive burden on service providers leading to burn out. In the face of health threats and work pressure during pandemic, the current study aimed to investigate the impact of COVID-19 stress on Burnout among health care providers. Following a convenient sampling technique, a sample of 153 healthcare providers with an age ranged from 24 to 60 years were assessed with COVID Stress Scale (Taylor, et al., 2020) and Maslach Burnout Inventory (MBI;Maslach et al., 1997). SPSS 21 was used for statistical analysis of data. Findings revealed that Sub-Scales of COVID stress collectively explained 48% of variance in predicting emotional exhaustion and 39% variance in producing depersonalization among healthcare providers. However, COVID stress negatively predicted personal accomplishment among healthcare providers. Moreover, t-test revealed that female healthcare providers showed higher level of COVID stress i.e. danger, socio-economic consequence, xenophobia and compulsive checking as compared to males while non-significant gender differences were observed for contamination and traumatic stress. The study also found a higher level of personal accomplishment among male healthcare providers whereas female healthcare providers demonstrated higher level of emotional exhaustion and depersonalization in comparison to male health care providers © 2022, Pakistan Journal of Psychological Research.All Rights Reserved.

Can trade credit rejuvenate Islamic banking?

This study proposes a renewal of the contemporary Islamic banking Murabaha financing model as it aggravates financial fragility with waning economic efficiency. We adapt the working capital framework of successful US companies like Amazon and Walmart and model an innovative Murabaha facility as trade credit within the real sector of the economy. We then test its robustness in a range of simulation tests. Our approach is novel and stands in contrast to the familiar financial sector fixed-income facilities, characteristic of Western economies, stealthily mimicked as mark-up (interest rate based) Murabaha by Islamic banks. We argue that this is neither appropriate nor effective for Islamic economies, making them fragile under monetary pressures in crises like the current coronavirus and energy ones. Our simulation results indicate that the trade credit Murabaha not only transforms debt into a risk-sharing one but also offers more competitive financing rates, reduces systemic risk, and improves financial stability. Furthermore, our results imply that the trade credit Murabaha can increase the efficiency of Islamic financial systems and make them more resilient to shocks. Consequently, this paper discusses the integration of our novel Murabaha within a recreated architecture of Universal Banking. As an implication, this should promote business activity and contribute to global growth. Finally, we recommend how to deploy our novel Murabaha based on trade credit (as opposed to the currently deployed fixed-income-mimicked Murabaha) to alleviate twin agency debt costs (risk shifting, underinvestment) and solve the ownership transfer problem of modern Islamic banking. © 2022, The Author(s).

A threefold approach including quantum chemical, molecular docking and molecular dynamic studies to explore the natural compounds from Centaurea jacea as the potential inhibitors for COVID-19.

In the current report, we studied the possible inhibitors of COVID-19 from bioactive constituents of Centaurea jacea using a threefold approach consisting of quantum chemical, molecular docking and molecular dynamic techniques. Centaurea jacea is a perennial herb often used in folk medicines of dermatological complaints and fever. Moreover, anticancer, antioxidant, antibacterial and antiviral properties of its bioactive compounds are also reported. The Mpro (Main proteases) was docked with different compounds of Centaurea jacea through molecular docking. All the studied compounds including apigenin, axillarin, Centaureidin, Cirsiliol, Eupatorin and Isokaempferide, show suitable binding affinities to the binding site of SARS-CoV-2 main protease with their binding energies -6.7 kcal/mol, -7.4 kcal/mol, -7.0 kcal/mol, -5.8 kcal/mol, -6.2 kcal/mol and -6.8 kcal/mol, respectively. Among all studied compounds, axillarin was found to have maximum inhibitor efficiency followed by Centaureidin, Isokaempferide, Apigenin, Eupatorin and Cirsiliol. Our results suggested that axillarin binds with the most crucial catalytic residues CYS145 and HIS41 of the Mpro, moreover axillarin shows 5 hydrogen bond interactions and 5 hydrophobic interactions with various residues of Mpro. Furthermore, the molecular dynamic calculations over 60 ns (6×106 femtosecond) time scale also shown significant insights into the binding effects of axillarin with Mpro of SARS-CoV-2 by imitating protein like aqueous environment. From molecular dynamic calculations, the RMSD and RMSF computations indicate the stability and dynamics of the best docked complex in aqueous environment. The ADME properties and toxicity prediction analysis of axillarin also recommended it as safe drug candidate. Further, in vivo and in vitro investigations are essential to ensure the anti SARS-CoV-2 activity of all bioactive compounds particularly axillarin to encourage preventive use of Centaurea jacea against COVID-19 infections.

Nexuses between Solumedrol and Dexamethasone in Moderate to Severe Covid Disease

Introduction: Covid 19 is a disease caused by a virus belonging to SARS Co V2 family of viruses. It primarily effects the lungs resulting in inflammation and pneumonia. Objective(s): The main objective of the study is to compare the outcomes and efficacy of solumedrol and dexamethasone in moderate to severe COVID disease. Material(s) and Method(s): This cross sectional study was conducted in Central Park Medical College and Teaching Hospital, Lahore and the duration of this study was from August 2021 to March 2022. The data was collected from 100 COVID-19 patients diagnosed with moderate to severe condition of the diseases. The data was collected through non-probability consecutive sampling technique. Result(s): The data was collected from 100 patients of moderate to severe COVID-19 condition. There were 35 patients in group I and 65 patients' group II. The mean age for dexamethasone (group II) was 55.41 +/- 10.4 years and solumedrol (group I) was 56.86 +/- 9.3 years. Conclusion(s): It is concluded that both drugs dexamethasone and solumedrol are effective in improving clinical and biochemical parameters of moderate to severe covid 19 disease. Copyright © 2022 Lahore Medical And Dental College. All rights reserved.

Outcome Comparison Between Tocilizumab and Pulse Solumedrol in Severe Covid Disease Among Resource Depleted Areas

Introduction: Pandemic coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 coronavirus has recently emerged. Objective(s): The main objective of the study is to find the outcome comparison between tocilizumab and pulse solumedrol in severe COVID disease among resource depleted areas. Material(s) and Method(s): This cross sectional study was conducted in Central Park Medical College and Teaching Hospital, Lahore and the duration of this study was from August 2021 to March 2022. The data was collected through non-probability consecutive sampling technique. The data was collected into two groups. Men and non-pregnant women over 18 years old COVID diagnosis confirmed by real time polymerase chain reaction (RT-PCR) Pao2 / FIO2 <200 Laboratory: high sensitivity C reactive protein> 5 mg / L;lactic dehydrogenase (LDH) > 245 U / l;Ferritin> 300;D-dimer> 1500;Interleukin-6> 7.0 pg / ml were included. Result(s): The data was collected from 300 patients, 150 in each group. There were 72.9% male aged 41-60 years 45.8% were female with a mean age of 55.4 +/- 10.6 years. Diabetes and hypertension was the most common comorbidity in selected patients. Tocilizumab group had more number of males (P = 0.017), with higher incidence of coronary artery disease (CAD, P = 0.008). Conclusion(s): It is concluded that Tocilizumab decreased the propensity of severe COVID-19 patients to require invasive mechanical ventilation when compared to high-dose solumedrol pulse, especially in those with severe ARDS, but this did not translate to improved 30-day survival in them. Copyright © 2022 Lahore Medical And Dental College. All rights reserved.

Emergency Remote Learning: Developing an Understanding about Online Learning Features and Students' Feelings

In mid spring 2020, an unprecedented Covid-19 induced switch of learning mode, from face-to-face instruction to online learning, disrupted not only teachers, but also students, both cognitively and emotionally. This study seeks to understand how students felt about their capabilities to succeed in the online learning environment (OLE) and which online learning features (OLF), offered to them by their instructors, positively, negatively, or neutrally impacted their learning. Three research questions guided this study: (1) What online learning features did students perceive as contributing positively, negatively, or neutrally to their learning and how were these perceived contributions related to students' demographics?;(2) How did students feel about their capabilities to succeed in the OLE?;and (3) How did students' feelings change during their online learning experiences and how did these changes relate to students' gender, academic performance, and prior online experience? An online survey was designed and face-validated to solicit information about students' perceptions about online learning features and feelings about their capabilities to succeed in the OLE. The 13-item survey consisted of 10 multiple-choice/multiple-answer and 3 open-ended questions. One thousand two hundred and thirty-seven (N = 1237) students taking 27 different courses, from 6 different institutions participated in the study. Presentation of the qualitative analyses of open-ended survey responses is outside the scope of this paper. Findings suggest that the three most frequent OLFs provided to students were electronic homework submission, recorded video lectures, and electronic exams. While video lectures, homework electronics submission, and downloadable documents or files were reported to be the top three OLFs that contributed positively to students' learning, poor internet performance, online exams, and projects were the top three OLFs that were reported to have contributed negatively to student learning. Changes in students' feelings during the online learning experience were also reported.

A REVIEW ON ASPECTS OF CURRENT PHARMACOTHERAPIES FOR COVID-19

: The novel coronavirus has infected over 609,848,852 individuals throughout the world with a total death of over 6.5 million since its outbreak in December 2019. Since then many therapeutic options have been approached and tested in clinical trials as well to find a potential cure or preventive therapy for the COVID-19 disease. This review summarizes the potential therapeutic options currently available for the treatment of COVID-19 including lopinavir-ritonavir, Hydroxychloroquine, Remdesivir, Ribavirin, dexamethasone, interferon, antibodies, Tocilizumab, Azithromycin, Piperacillin-tazobactam, Moxifloxacin, Ivermectin, Nitazoxanide, Baricitinib, and Arbidol. This study briefly discusses the clinical trials and encompasses the dosage, efficacy, adverse drug reactions, and possible mechanism of action of the potential treatment candidate where applicable. The growing number of reported cases posits an exigent need for a suitable therapy for the prevention and cure of this disease. Therefore, the study aims to provide vital information on each drug to highlight the latest scientific research that could be helpful for better prevention/treatment of COVID-19 disease.

Virtual REU Program: Engineering Education Research

This paper describes a National Science Foundation-funded Research Experiences for Undergraduates (REU) Site program conducted through virtual working environment. Due to the Covid-19 pandemic, REU 2021 activities were conducted online through Canvas and Zoom communication platforms. The major aim of this program is to provide undergraduate students with experiences in engineering education research (i.e., education research in the context of engineering). This paper provides an overview of the program, and briefly describes the virtual working environment, and students' research experiences during the 10-week program. A total of 11 undergraduate students, seven graduate mentors, and seven faculty mentors have actively participated in the program. The program is conducted in two phases: Phases 1 (i.e., Weeks 1-2) and 2 (i.e., Weeks 3-10). Phase 1 consists of preparatory and foundational work that is delivered to participants and will allow them to begin Phase 2 with some educational research foundation already established. The results of the project evaluation show that the program has made a positive impact on increasing education research skills and communication skills of the participating REU students. The participating REU students reported that the research projects they worked on increased their motivation and confidence for continuing to engage in engineering education research. Four participants (i.e., 36.4% of the total participants) suggested that, if available, they would prefer face-to-face over a virtual REU program. Another four participants (i.e., 36.4%) felt that both face-to-face and virtual would offer the same quality of research experiences, and 3 participants (i.e., 27.2% of the total participants) voiced their preference of virtual over face-to-face REU program. © American Society for Engineering Education, 2022.

QUALITY IMPROVEMENT STUDIES ARE FEASIBLE IN AUSTERE PERIODS OF RESOURCE ALLOCATION SUCH AS THE COVID-19 PANDEMIC: IMPLEMENTATION OF A NOVEL AGGRESSIVE POSTOPERATIVE AMBULATION PROTOCOL

Purpose/Background: Quality improvement (QI) and enhanced recovery after surgery (ERAS) protocols are effective in reducing length of stay and complications after colorectal surgery. The COVID-19 pandemic's strain on hospital personnel and resources called into question the feasibility of implementation of QI studies. Hypothesis/Aim: We aimed to successfully implement of a novel, structured postoperative ambulation protocol in colorectal surgery patients and determine its effect on patient outcomes in a time of strained personnel. Methods/Interventions: This prospective non-randomized study included all patient who underwent elective inpatient abdominal colorectal procedures at a single quaternary care center. All patients were already undergoing a standard ERAS protocol at baseline. A structured, aggressive postoperative ambulation protocol was developed. An erasable poster (Figure) was placed in patient rooms which allowed the nursing staff and patient to track progress towards specific ambulation goals. The protocol measured specific metrics such as out-of-bed to chair and the number and extent of daily ambulation relative to postoperative day. The protocol was initiated on post-operative day 0, and increased in duration and distance daily. Nursing staff was educated on the protocol prior to initiation and a standard process was created to outline the documentation requirements. The primary outcome measured was hospital length of stay. Secondary outcomes were return of bowel function, 30-day postoperative DVT/PE rate, and 30-day readmission rate. A change in these outcomes metrics over time compared to historical controls was noted. Results/Outcome(s): The protocol was implemented in February 2020, with improvements in outcomes beginning in July 2020 following extensive re-education for nursing staff. Adherence to the post-operative ambulation regimen increased from 36% at baseline to 75%. This was associated with an improvement in postoperative return of bowel function (2.13 days vs 1.44 days), post-operative length of stay (6.36 days vs 3.33 days), postop VTE/PE rates (1.64% vs 0%) and readmission rate (6.56% vs 0%) over a period of 12 months. Limitations: The outcomes of this study may have been influenced by other uncontrolled measures during the COVID crisis but most if not all led to decreased personnel and resources making success of such a project difficult. A standard ERAS protocol was in place with good compliance (>95%) for over 2 years prior to the initiation of this study. Conclusions/Discussion: A novel, structured, aggressive early postoperative ambulation protocol is feasible during times of strained personnel resources such as the COVID-19 pandemic, and leads to improvement in postoperative outcomes such as postoperative length of hospital stay, return of bowel function, VTE/PE rates, and postoperative ambulation without an increase in the readmission rate.

Impact of covid-19 pandemic on routine immunization of children

Objective: To find the impact of Covid-19 pandemic on routine immunization of children. Methodology: This cross sectional study was done at the New City Teaching Hospitaland Divisional Head Quarter Teaching Hospital, Mirpur, Azad Kashmir from March to September 2021. Data about routine immunization of children from parents was collected by using predesigned questionnaire. All data were analysed using SPSS version 20. Results: The study included 1200 parents. We found that 80% parents had scheduled vaccination for their children, 18% had delayed vaccination while 2% missed vaccination during Covid – 19 pandemic. Major reason for delayed vaccination was fear of contracting Covid – 19 in 65% respondents. We found that 80% parents feared that their children have chance to get Covid – 19 infection, 78% responded that their children might transmit this infection while 74% reported that their children have chance to get hospitalized due to Covid-19. Majority of the respondent had positive attitude towards vaccination. Conclusion: Covid-19 pandemic had major impact on the timing of routine immunization of children in Pakistan. © 2022, Pakistan Medical Association. All rights reserved.

The impact of the vaccination and booster shots in containing the COVID-19 epidemic in Bahrain: A game theory approach

In this study, game theory is used to determine the effect of vaccination and booster shots in containing COVID-19 in Bahrain. The study is divided into three parts and in each part, the payoff matrix and the biometric is generated. The Nash equilibrium points are determined by marking the maximum value in the first entry of each column and the maximum value in the second entry of each row. The results show that the vaccination and the booster shots significantly reduce the number of infected individuals, the number of patients reaching the ICU, and the number of deaths due to COVID-19. © 2021 IEEE.

An ensemble learning based approach to autonomous COVID19 detection using transfer learning with the help of pre-trained Deep Neural Network models

An automated means for predicting the virus is of utmost importance to help the medical personnel to detect patients, prepare reports and produce results fast and impeccably so that people can get early treatment and prevent future transmissions. In this work, we proposed a COVID19 detection method using chest x-ray images by training and testing pre-trained deep neural network models, such as VGG19, InceptionV3, and Densenet201 individually, and got an accuracy of 96.9%, 95.2%, and 96.7% respectively. Then to bolster the performance of each model, we proposed an average weighted based ensemble approach and got an accuracy of 97.5%, which surpassed the performance of each separate model. © 2021 IEEE.

Non-Invasive Ventilation versus Invasive Mechanical Ventilation: Results from a Tertiary Care Hospital

Objective: To compare the patient outcome in severe COVID-19 pneumonia between the non-invasive ventilation and invasive mechanical ventilation. Study design: Prospective, observational study Study Setting and Duration: Department of Pulmonology, Bahawal Victoria Hospital, Bahawalpur from January 2021 to June 2021. Methodology: We analyzed 660 patients of severe covid pneumonia. Conscious proning was done in those requiring ≥ 21 L oxygen and oxygen saturation < 90%. We defined typical ARDS according to Berlin criteria. Atypical ARDS did not fulfill set criteria. We divided ARDS into 2 types i-e H and L type. We managed ARDS with either NIV, invasive mechanical ventilation or both. We used multiple regression analysis to predict ICU stay. Results: Out of 660 patients, 285 (43.18%) developed biPAP failure and were subsequently intubated. We observed 273 (41.4%) overall mortality, 175 (64.1%) in IMV and 98 (35.9%) in the NIV group (p<0.0001). invasive mechanical ventilation had statistically significant correlation with mortality and also predicted ICU stay. (p=< 0.001, OR 3.2, p=0.001). Conclusion: NIV therapy is superior to invasive mechanical ventilation in terms of ICU stay and outcome.

Management & Complications of Airway in COVID-19 suspected & confirmed cases: a retrospective cohort epidemiological study in a tertiary care centre

Background: The outbreak of COVID-19 in Pakistan started from February 2020 and over the next few months it affected around a million people, leaving thousands dead in an already burdened healthcare infrastructure. Rising to the challenge of COVID 19 airway management, we adopted components of 'Consensus guidelines for managing airways in patients with COVID 19 to improve success of first pass intubation alongwith minimising risk of infection to self and others. Aim: To analyse the techniques of airway management and complications of suspected or confirmed COVID status at time of their airway management. Methodology: After ethical approval by the institutional review board, data is collected from the Hospital Information System (HIS) for cases fulfilling inclusion criteria, from April to September 2020 in a tertiary care cancer hospital, Pakistan. Results: In our centre, forty-five intubations were performed, 71% of these intubations were out of hours and 43% performed by consultants. It had a high 1st attempt success rate of 84.4%, using Videolaryngoscope (64.4%) and 55.6% confirmed use of capnography. In all cases (100%) PPE was available and used. Minimum number of personnel in room during intubation was kept to four to five in 55.6% of cases. Conclusion: Dedicated airway team used Personal Protective Equipment in all cases (100%) and restricted the number of personnel during the procedure. A high success rate of 1st attempt intubation, widely used videolaryngoscope, single agent induction and consultant intubators were salient features of our practice.

Patient perception on hand trauma management through a plastic surgery trauma clinic

Aim: We assessed patient perceptions of hand trauma management through a plastic surgery trauma clinic. We also assessed effects of educating patients about outcomes of their condition on their desire to have prompt surgery. Method: A prospective survey review was conducted at our plastic surgery trauma clinic. Patients included were those referred due to simple hand trauma. Any patients needing urgent admissions were excluded. An anonymous survey assessing patient perceptions before and after education about delay in surgery was distributed. Results: Of 100 patients, there were mixed expectations regarding trauma clinic;38% (n=38) expect an operation, 32% (n=32) expect no operation and 30% (n=30) expect either option. 90% (n=90) expect surgery within a week (50% n=50) or within a day (40% n=40);10% expect it (n=10) within a few weeks. After educating patients about no negative effects on their condition from surgical delay, 43% (n=17) fewer patients desired surgery within a day, and 8% (n=3) fewer patients desired surgery within a week. 190% (n=19) more patients were willing to have surgery within a few weeks. 79% (n=79) would rather come back at a guaranteed surgical slot than stay in hospital until a slot is available. 72% (n=72) considered knowledge about long-term outcomes associated with surgical delay to influence their decision more than anaesthetic type (12% n=12) and personal circumstances (16% n=16). Conclusions: If appropriate patients are assured that their condition will not be affected by surgical delay, fewer patients may stay in hospital with financial benefits of reduced bed occupancy and reduced covid risks.

A Survey-based qualitative study to characterize expectations of software developers from five stakeholders

Background. Studies on developer productivity and well-being find that the perceptions of productivity in a software team can be a socio-Technical problem. Intuitively, problems and challenges can be better handled by managing expectations in software teams. Aim. Our goal is to understand whether the expectations of software developers vary towards diverse stakeholders in software teams. Method. We surveyed 181 professional software developers to understand their expectations from five different stakeholders: (1) organizations, (2) managers, (3) peers, (4) new hires, and (5) government and educational institutions. The five stakeholders are determined by conducting semi-formal interviews of software developers. We ask open-ended survey questions and analyze the responses using open coding. Results. We observed 18 multi-faceted expectations types. While some expectations are more specific to a stakeholder, other expectations are cross-cutting. For example, developers expect work-benefits from their organizations, but expect the adoption of standard software engineering (SE) practices from their organizations, peers, and new hires. Conclusion. Out of the 18 categories, three categories are related to career growth. This observation supports previous research that happiness cannot be assured by simply offering more money or a promotion. Among the most number of responses, we find expectations from educational institutions to offer relevant teaching and from governments to improve job stability, which indicate the increasingly important roles of these organizations to help software developers. This observation can be especially true during the COVID-19 pandemic. © 2021 IEEE Computer Society. All rights reserved.