ABSTRACT
Blended library services are reinforced by academic librarians to deal with the challenges that come from the changes caused by the pandemic. Transformation is reflected through information and communication technologies that are in constant development and available to users remotely. This study discusses the extent of usage and effectiveness of blended library services at the University of Baguio library by the students, faculty, nonteaching, and other library users. Blended library services covered online platforms, online resources, online circulation, online reference service, online information literacy (IL), and online want list form. This study used a descriptive research design to gather the information that will systematically describe the current status of the UB library online services. A survey questionnaire formatted in google form was employed to gather the needed information. The findings of the study reveal that the blended library services of the university have been utilized - much utilized by the users, specifically canvas LMS resources of online resources, online document delivery of online circulation and the library e-mail: library@e.ubaguio.edu of online reference service, other feature of blended library services have not been used to their full advantage. Furthermore, the blended library services are highly effective as assessed by the faculty, non-teaching staff, and other library users. Based on these findings, it is recommended that the Library strongly endorses additional databases and integration of these databases, library guides, and library services in the canvas LMS;regular posting of the blended services in the UB library social media account and platform for easier accessibility on the part library users;lastly, re-evaluate the way the development, manage and deliver marketing strategies of the blended services.
ABSTRACT
Background. It remains unclear if there is an association between COVID-19 and cryptococcosis. The purpose of this study was to compare demographic characteristics and outcomes of cryptococcosis between patients with COVID-19 to non-COVID-19 controls. Methods. Patients 18 years and older with cryptococcosis were identified from TriNetX, a global federated research network, and separated into two cohorts based on a diagnosis of COVID-19 within 3 months prior to the index diagnosis of cryptococcosis. The primary outcome was the percent mortality in each group. The secondary outcomes included the proportion of patients in each group who had underlying comorbidities, received immunosuppressive medications, or required hospitalization or ICU admission. Propensity score matching was performed to control for differences between groups based on demographics and comorbidities. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for outcomes, with p < 0.05 as the cut off for statistical significance. Results. A total of 6252 patients with cryptococcosis were included, of which 4.5% (n=283) had COVID-19 prior to diagnosis of cryptococcosis. Mortality was similar between patients with and without COVID-19 (13% vs 10%, p=0.075). Patients with cryptococcosis and previous COVID-19 were older (55.2 +/- 14.5 years vs 52 +/- 15.2 years, p=0.0005) and more likely to be non-Hispanic (73% vs 65%, p=0.0049). More patients with COVID-19 had a history of transplant (30% vs 13%, p < 0.0001), malignancy (37% vs 21%, p < 0.0001), and diabetes (35% vs 19%, p < 0.0001), but not HIV (29% vs 31%, p=0.5482). Prednisone and dexamethasone use were higher among patients with previous COVID-19 (32% vs 15%, p < 0.0001 and 17% vs 7%, p < 0.0001, respectively). Hospitalization rates were similar (54% vs 57%, p=0.278), but more patients with COVID-19 required ICU admission (19% vs 11%, p < 0.0001). In propensity score-matched analysis, patients with COVID-19 remained at higher odds of ICU admission (OR 1.85, 95% CI 1.15-2.97, p=0.010), but lower odds of hospitalization (OR 0.57, 95% CI 0.41-0.81, p=0.001). Conclusion. Patients with COVID-19 who developed cryptococcosis had higher rates of comorbidities, corticosteroid use, and ICU admission but did not experience higher mortality compared to non-COVID-19 controls.
ABSTRACT
Background: Ibrutinib (IBR) is an oral covalent Bruton tyrosine kinase inhibitor (BTKi), licensed for treatment of relapsed or refractory mantle cell lymphoma (MCL). Under NHS interim Covid-19 agreements in England, IBR with or without rituximab (R) was approved for the frontline treatment for MCL patients (pts) as a safer alternative to conventional immunochemotherapy. Although recent phase 2 studies have reported high response rates in low-risk patients for this combination in the frontline setting, randomised phase 3 and real-world data are currently lacking. Aims: To describe the real-world response rates (overall response rate (ORR), complete response (CR) rate) and toxicity profile of IBR +/-R in adult patients with previously untreated MCL. Methods: Following institutional approval, adults commencing IBR +/-R for untreated MCL under interim Covid-19 arrangements were prospectively identified by contributing centres. Hospital records were interrogated for demographic, pathology, response, toxicity and survival data. ORR/CR were assessed per local investigator according to the Lugano criteria using CT and/or PET-CT. Results: Data were available for 66 pts (72.7% male, median age 71 years, range 41-89). Baseline demographic and clinical features are summarised in Table 1. 23/66 pts (34.8%) had high-risk disease (defined as presence of TP53 mutation/deletion, blastoid or pleomorphic variant MCL, or Ki67%/MiB-1 ≥30%). IBR starting dose was 560mg in 56/62 pts (90%) and was given with R in 22/64 pts (34%). At a median follow up of 8.7 months (m) (range 0-18.6), pts had received a median of 7 cycles of IBR. 19/60 pts (32%) required a dose reduction or delay in IBR treatment. New atrial fibrillation and grade ≥3 any-cause toxicity occurred in 3/59 pts (5.8%) and 8/57 (14.0%) respectively. For the whole population and high-risk pts only, ORR was 74.4% and 64.7% respectively (p=0.2379), with a median time to response of 3.8m, coinciding with the first response assessment scan. Seven pts (16.7%), of whom 2 had highrisk disease, attained CR at a median of 6.0m. ORR for pts receiving vs not receiving R were 84.2% and 66.7% respectively (p=0.1904). IBR was discontinued in 20/61 pts (32.8%) at a median time to discontinuation of 4.1m, due to progressive disease (PD, 19.7%), toxicity (4.9%), death (3.3%;1 pt each of Covid-19 and E. coli infection), pt choice (3.3%) and other unspecified reasons (1.6%). 15/66 pts (22.7%) overall and 7/23 (30.4%) with high-risk disease progressed on IBR at a median time to PD of 4.0m. No pts underwent autologous stem cell transplantation consolidation during the study period. 12/57 pts (21.1%) received second line treatment (R-chemotherapy n=7, Nordic MCL protocol n=2, VR-CAP n=2, pirtobrutinib n=1). Response to second line treatment was CR in 4/11 pts, PD in 7/11. Of the 2 Nordic-treated patients, 1 had CR after cycle 2 and 1 PD. Fourteen pts (21.2%) died during the follow up period, due to MCL (n=11), Covid-19 (n=2) and congestive cardiac failure (n=1). Overall survival was lower for patients with high-risk disease (HR 0.55, p=0.038). Image: Summary/Conclusion: In this real-world UK cohort of pts receiving first-line IBR +/-R for MCL, including older and high-risk pts, we report high ORR rates in a similar range to the phase II Geltamo IMCL-2015 study of combination IBR-R in an exclusively low-risk population. Documented CR rates were lower, possibly reflecting a low usage of rituximab in the Covid-19 pandemic as well as CT assessment of response. Treatment was generally well tolerated, with low rates of toxicityrelated treatment discontinuation. The study is ongoing.
ABSTRACT
Frequent and accessible testing is a critical tool to contain the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). To develop low-cost rapid tests, many researchers have used reverse transcription loop-mediated isothermal amplification (RT-LAMP) with fluorescent readout. Fluorescent LAMP-based assays can be performed using cost-effective, portable, isothermal instruments that are simpler to use and more rugged than polymerase chain reaction (PCR) instruments. However, false-positive results due to nonspecific priming and amplification have been reported for a number of LAMP-based assays. In this report, we implemented a RT-LAMP assay for SARS-CoV-2 on a portable isothermal fluorimeter and a traditional thermocycler;nonspecific amplification was not observed using the thermocycler but did occur frequently with the isothermal fluorimeter. We explored 4 strategies to optimize the SARS-CoV-2 RT-LAMP assay for use with an isothermal fluorimeter and found that overlaying the reaction with mineral oil and including the enzyme Tte UvrD helicase in the reaction eliminated the problem. We anticipate these results and strategies will be relevant for use with a wide range of portable isothermal instruments.
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Introduction: 2020 brought numerous challenges for burn survivors and their families. This project assessed the impact of two major global / national phenomena, specifically the impact of a) COVID-19 and b) local / community / national actions around racism and policing on child and youth burn survivors and their families. Methods: Our burn camp program moved to a virtual format for 2020. Campers (ages 8-18) and their caregivers / parents completed questionnaires about their year, rating and specifying the personal impacts of these phenomena. They rated how their year has been overall and selected 'what has helped you get through tough times'. 47 campers and 47 caregivers / parents participated. Results: Impact of COVID-19 The majority of youth rated the impact of COVID-19 as 'somewhat' to 'highly' (78%), while the majority of caregivers rated 'somewhat' (64%). Campers and caregivers identified the following impacts most often and to similar degrees: Online school/virtual learning, Friends/Social, Sports/Activities, Quarantine, Isolation, Worries, Quality time with family. Caregivers also highlighted: Getting creative at home and Uncertainties. Impact of local / community / national actions around racism and policing on you and your family The majority of campers and caregivers rated the impact as 'Somewhat', 'Very Little' or 'Not Impacted' (86%), although participants rating higher impact also provided moving personal experiences. What has helped you get through tough times this year Over 85% of campers and caregivers / parents rated their year overall as 'OK' or 'Pretty Good'. Campers and caregivers endorsed Family, Friends, Faith, and What I learned recovering from my burn injury as factors helping them get through tough times. Conclusions: Children, youth, and families who have experienced a burn injury report both negative and positive impacts from the global and national phenomena of COVID-19 and local / community / national actions around racism and policing. Not all youth and families are equally impacted. Family and friends were the greatest sources of support during tough times. One burn survivor family indicated that what they learned recovering from burn injury has helped them through this challenging year-'I have learned to just adapt and change because anything can happen at any point.' Most burn survivors and their families indicate the year has been 'OK' or 'pretty good'. Connection through burn camp provided the opportunity to share the impacts, but also the strengths and resiliencies in our burn community.
ABSTRACT
RATIONALE: Although lung cancer screening (LCS) uptake has increased to 5-16% nationally, screening initiation and adherence rates are threatened by the ongoing COVID-19 pandemic. Consistent with guidelines from a CHEST expert panel, our LCS program deferred new and annual low-dose CT (LDCT) screens during the pandemic's spring surge. Upon resuming screening, we pivoted to shared decision-making (SDM) via telemedicine. We characterized how these changes in screening implementation impacted our LCS volume and adherence. METHODS: We measured LCS patient- and LDCT scan-related volumes through our centralized program during pre-COVID (2019), deferral (March 18-May 18, 2020), and follow-up (May 18-November 18, 2020) to measure 3 outcomes: 1). Monthly volume of LDCTs in 2020 compared to 2019, 2). LDCT completion rate for SDM via telemedicine during the follow-up period, and 3). Adherence rates among patients due for LDCT during the deferral period and returned in the subsequent 6 months, compared to adherence among pre-COVID LCS patients. Adherence was defined as a subsequent CT within 11-18 months of a Lung-RADS 1 or 2 result, 4-8 months for Lung-RADS 3, and 2.5-4.5 months for Lung-RADS 4 patients recommended for 3-month follow-up. RESULTS: Monthly scan volume in our LCS program decreased during the COVID-19 first wave but increased following resumption of screening, and by August, the number of LDCTs exceeded 2019 (Figure). The number of patients screened between May-November 2020 and May-November 2019 was comparable (491 and 505 patients, respectively). However, the frequency of patients returning for follow-up was higher in 2020 compared with 2019 (62.1% vs. 46.3%). Following implementation of telemedicine, the screening completion rate decreased during May-November 2020, with 88.6% of patients (435/491) completing SDM but not LDCT, compared with 100% between May-November 2019. During the deferral period March-May 2020, 124 patients were due for a follow-up scan, and 54 (43.5%) received their scan within the study period. In comparison, 60.3% due for follow-up during the same period in 2019 completed their scan. CONCLUSIONS: Maintaining screening adherence has become a focus for many LCS programs. We observed that following the spring surge of the COVID-19 pandemic, the frequency of returning patients was greater than that of new patients initiating screening. Conducting SDM via telemedicine may introduce a barrier to LCS completion. Adherence rates decreased from 2019, with the lowest rates among Lung-RADS 3 patients due for a 6-month follow-up. Additional research should test LCS implementation strategies to improve adherence during the COVID-19 pandemic.
ABSTRACT
Background: ARICA (AdheRence to Inhaled Corticosteroids in Asthma) is a comprehensive inhaled corticosteroid (ICS) adherence intervention designed to remediate each patient's unique reason for not taking their ICS as prescribed. Objective: The primary objective was to evaluate the feasibility and acceptability of implementing ARICA in a health system. Methods: 29 Black adults who self-reported ICS nonadherence, had uncontrolled persistent asthma, and a Duke Primary Care provider visit within the past 3 years were randomly assigned to intervention (N=15) or control (N=14) in a waitlist randomized controlled pilot trial. Participants were assigned to 1-3 ARICA components based on adherence barriers selected by participants;including, an asthma selfmanagement program, financial assistance referral program, and/or objective feedback on asthma control. All participants received weekly texts and emails dispelling asthma myths. Activities were delivered virtually due to COVID-19. Primary outcomes were feasibility (e.g., process outcomes) and acceptability (e.g., patient exit interviews) measured at 12 weeks. Secondary asthma (e.g., ACT) and adherence outcomes (e.g., DOSEnonadherence) were measured. Results: Most participants were female (N=27, 93%), nonsmokers (N=26, 70%), poorly controlled with ACT <15 (N=14, 48%), and mean age 49.8. Most (N=14, 93%) completed all assigned intervention components and reported mean 4.8 of 5 on Weiner feasibility, acceptability, and appropriateness of intervention. The intervention group had a greater and statistically significant improvement in ACT (Δ-3.5, CI 6.0,0.96) and Marks AQLQ (Δ 11.5, CI 5.5,17.4) when compared to changes in the control ACT (Δ-2.5, CI-5.2,0.05) and Marks AQLQ (Δ5.7, CI-1.3,12.8), respectively. The improvement in ACT in the intervention group was clinically significant. The intervention group also reported a greater and statistically significant decrease in degree of nonadherence (DOSE Δ 0.74, CI 0.2,1.3) than control (DOSE Δ 0.36, CI-0.04,0.75) and a greater decrease in the number of adherence barriers identified in the intervention group (Δ 2.1, CI 1.2,3.0) versus control group (Δ1.6, CI 0.3,3.0). The study was not powered to assess a statistically significant change between groups. Conclusion: The implementation of ARICA in a cohort of Black adults was feasibly deployed in a health system and acceptable to participants. There was a trend in improvement in asthma control and asthma quality of life and a decrease in nonadherence and barriers to adherence.
ABSTRACT
RATIONALE: During the COVID-19 pandemic's spring surge, many lung cancer screening (LCS) programs delayed scans. Upon resuming screening, programs pivoted to telemedicine for shared decision-making (SDM) to minimize COVID transmission risks. This can lead to a cascade of alterations in LCS implementation, exacerbating disparities in screening. We hypothesize these changes have altered the sociodemographic characteristics of our LCS population. METHODS: At our institution in Philadelphia, LCS was deferred beginning March 18, 2020. We analyzed data from patients living in Philadelphia undergoing LCS through our centralized program upon resumption of screening on May 18 and the subsequent 6 months. Patient-level sociodemographic characteristics were compared with a “Pre-COVID” cohort screened May-November 2019. Geospatial analysis was performed for neighborhood-level internet access among patients receiving SDM inperson vs. telemedicine. RESULTS: The 408 patients screened after program reopening had a mean age of 64.2±5.8 years, 246 patients (60.3%) were female, 204 (50.1%) were White and 196 (48.2%) were Black/African-American. Over half were current smokers (n=224, 54.9%), and 172 patients (42.2%) had COPD. Compared with the Pre-COVID cohort, the Post-reopening cohort had no statistically significant differences in age, sex, race, smoking status or intensity, BMI, COPD, personal or family history of lung cancer, or insurance status. Education was significantly different between the two groups, with the Post-reopening cohort comprised of a lower percentage of patients with <HS education (16.9% vs. 11.3%), a greater frequency of patients with a HS diploma (42.6% vs. 46.1%), and fewer patients with education beyond HS (39.2% vs. 35.2%) (p<0.001). There was no significant difference in mean PLCOm2012 lung cancer risk (6.5±5.6% vs. 6.4±5.7%) or frequency of positive screens (≥Lung-RADS 3;8.9% vs. 8.4%). After excluding follow-up patients, education remained the only significant difference between groups. Analysis of neighborhood-level household internet access revealed no difference in the number of patients from census tracts with the lowest availability of household internet. Among the 15 census tracts with the greatest loss of patients from Pre-COVID to Postreopening, only 26.7% were in the highest quartile of internet deficit. CONCLUSIONS: LCS disparities can include disproportionate underscreening of individuals who are Black/African-American, live in rural areas, or have low socioeconomic status. Despite significant changes to our LCS program's workflow, the only significant difference between our Pre-COVID and Post-reopening cohorts was education level. Future research should be directed toward developing strategies to support LCS-eligible patients with low levels of education in the era of telemedicine.
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Background: Acute kidney injury (AKI) is a complication that has been described among severely ill patients with COVID-19 and may be more common in those with underlying chronic kidney disease (CKD). Some patients with AKI require renal replacement therapy (RRT), including continuous RRT (CRRT). During the COVID-19 pandemic, some US areas experienced CRRT supply shortages. We sought to describe the percent of hospitalized COVID-19 patients who developed AKI or needed RRT to inform patient care and resource planning. Methods: We searched for studies in the literature and public health investigations that described CKD, AKI, and/or RRT in COVID-19 patients from January 2020 onward. Studies were excluded if no CKD, AKI, or RRT information was provided. We abstracted counts of hospitalized COVID-19 patients, including those admitted to intensive care units (ICU) who developed AKI, underwent RRT, and/or had CKD. Data were pooled across cohorts by geographic region with available data (US, China, or United Kingdom [UK]). We compared proportions using Chi-square tests. Results: A total of 311 studies were identified;23 studies (US n=11;China n=11;UK n=1) that described kidney disease and/or kidney-related outcomes in hospitalized COVID-19 patients were included. Underlying CKD prevalence was higher in US cohorts (10.3%) compared with China (2.5%) or UK (1.5%) (p< 0.0001). AKI was markedly higher among hospitalized (31.3% vs. 6.4%;p < 0 .001) and ICU patients (55.4% vs. 18.2%;p< 0.0001) in the US compared to China. The percent of ICU patients requiring RRT in the US (16.8%) was significantly different from that reported in China (12.5%) and the UK (23.9%) (p< 0.0001). Limitations include differences in CKD and RRT definitions across studies. Conclusion: AKI is a frequent outcome among US COVID-19 patients, affecting almost one third of hospitalized and more than half of ICU patients. AKI was reported more frequently in the US than China. The percent of ICU patients who received RRT was higher in the US and UK than in China. Understanding the occurrence of kidney-related outcomes among patients with COVID-19 including the impact of underlying CKD and regional practice variations is essential for healthcare systems to successfully plan for RRT needs during the pandemic.
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A major assumption for both leadership researchers and practitioners is that the relationship between leaders and followers is the pivotal concern for leadership. Viewing leadership through the lens of responsibility, however, changes the pivotal relationship substantially. The principal relationship concern becomes the relationship between leaders and their stakeholders. To better understand this relationship the article seeks to explore the question: Leadership for what purpose? The article offers an initial answer to this question by looking at the responsibilities of those who lead in the corporate world. In particular, we argue that leaders need to give primary attention to what they seek to achieve, why, for whom, and where. In this way the article seeks to (re)centre the concerns of leadership scholarship to address the challenges and responsibilities of those who seek to lead. The article offers an inter-disciplinary theory rooted in an inter-complementary perspective on capitalism, purpose and responsibility that enables organizational leaders to understand how the fiduciary duty of generating value for shareholders can be aligned with other stakeholder interests including employees, communities, societies, the environment and indeed humanity. This theory we describe as the ‘The theory of Good Dividends’. MAD statement: This article seeks to Make a Difference (MAD) through challenging how we consider leadership in order to address the perfect storm of societal challenges that threaten humanity. In the recent past, our most pressing challenge was Climate Change;but this has been overshadowed by Covid 19. And this too will be overshadowed by other more compelling challenges. Corporate leadership has the power and influence to address and tackle these challenges. The article argues that leadership scholars need to fundamentally shift our focus away from the leader-follower relationship that has traditionally dominated our field of inquiry to the leader-stakeholder relationship. © 2021 Informa UK Limited, trading as Taylor & Francis Group.