Design and Development of Toroidal Core Winding Machine with Digital Interface

The small size and inherent superior electrical characteristics of a toroid has made it the first choice for many Original Equipment Manufacturers (OEMs). However, the lack of knowledge regarding the toroidal coil winding equipment is still hampering the growth of toroid as the first choice for transformers, inductors and other electrical applications. Additionally, due to Covid-19 pandemic and lockdown situation, small scale companies are lacking skilled manpower for the high precision task of toroidal core winding and taping. Although the machine is readily available in the market, the cost is still very high. Toroidal core winding machine is an equipment used for the purpose of winding toroidal cores which is used in various electrical machines such as current transformers, power transformers, isolation transformers, inductors and chokes, auto transformers, etc. This project aims to develop a low-cost toroidal winding machine with a user-friendly digital interface for selection of winding parameters as per the user input. The winding machine developed in this project is efficient and reliable with high-speed performance and negligible error. © 2022 IEEE.

A systematic review on pharmacist-led pharmaceutical care optimization through virtual platforms

Objectives To display virtual pharmaceutical care programs implemented by pharmacists across the world. Accordingly, a search in PubMed, Scopus and Embase with keywords such as ''Pharmacist', 'Pharmaceutical care', 'Virtual platform' and its associated medical subject headings retrieved appropriate articles. The quality of each filtered article were assessed with the Critical Appraisal Skills Program checklist. Key findings A total of 2 14 841 articles were identified through database screening and 16 articles were extracted and finalized. Twelve papers presented different forms of electronic medical record-based virtual pharmacy systems that had significantly contributed to patient care;minimizing medication errors, rectifying adverse events, modifying drug administration patterns to reduce the fatality of drug-drug interaction and further promoting medication counselling. Nevertheless, few studies had social media platforms for providing clinical pharmacy services that depicted good patient satisfaction. Additionally, we were also able to portray community pharmacies that transformed themselves to provide better and easily accessible pharmaceutical care to their society. There are limited numbers of peer-reviewed articles on pharmacist-operated virtual systems. However, owing to the benefits imparted to patient safety and care by the virtual pharmacy in the era of pandemic, it is highly recommended that more pharmacy professionals contribute and implement such programs in their settings. Prospero Registration ID CRD42022307175.

Kaiser Permanent (Kp) Mid-Atlantic States (Mas) Experience with Covid Related Hospital Admissions in Adult Patients with Myositis

Background. Myositis is a group of rare systemic disease and may be treated with immunosuppressives which increase the risk for poor outcome with the COVID19 pandemic. Patients with this condition may have higher rates of admission to the hospital. Methods. KP is a health insurance plan and provides care to about 800 thousand people (including Medicare and Medicaid population) in Maryland, District of Columbia and Northern Virginia. As part of quality improvements, we randomly looked at 40 patients from our larger cohort with myositis who are diagnosed and followed by a board-certified rheumatologist. We noted hospitalizations and Covid infection from March 1, 2020 to December 31, 2021. Results. Of the 40 patients, 29 (72%) were female and 11 were male. 19 (47%) were Blacks, 18 whites (including 6 Latino), and 3 Asians. Age ranged from 25 to 80 years with a mean age of 59.6 years. 25 (62%) patients had Dermatomyositis, 14 had polymyositis and 1 was IBM. The mean age at diagnosis was 55.9 years (range 23-80 years). 12 (30%) had myositis specific antibodies (4 Jo-1, 4 Mi-2, 1 PL 7, 1 PL 12, 1 PL7 plus PL12, 1 TIF Gamma). 22 (55%) were negative. Six did not have antibody testing. During this time, 11 (27.5%) were admitted to the hospital, 2 patients tested positive for COVID 19. One tested positive in the hospital and was asymptomatic. The other person was admitted for symptomatic COVID 19 infection. Other reasons for admission were cardiac, pulmonary (noncovid 19 related), infections, Gastrointestinal issues (including GI bleeding). One admission was for accidental bleach ingestion, and one for psychiatric admission. Of these 40 patients, 38 (95%) patients have received the COVID vaccinations, one patient refused, and for one person we do not have any record of vaccination. Conclusion. The admission rates to the hospital do appear to be higher for this group of patients with myositis, as is generally postulated. However, the reasons for admission were largely related to reasons other than COVID 19 infection and were related to general medical conditions.

Financial Constraints and Their Impact on University Students of Different Nationalities in the United Arab Emirates

Financial constraints caused by the economic slowdown in 2020 and COVID-19 that followed, affecting the student motivation for academic achievements, are of strategic importance to the global higher education (HE) sectors. This study aims to examine the effects of financial constraints on the motivation and academic performance of students of different nationalities in the United Arab Emirates (UAE) during the pandemic. This study will help us recognize the challenges among students from different backgrounds and nationalities and develop remedial strategies with a global perspective. We used a Likert scale-based questionnaire to collect data on motivation level, and associated variables from a sample of 371 students enrolled in different colleges in the UAE. Statistical techniques such as t-test, F-test, and chi-square test were used to explore the relationship between the variables in the data. The findings of the study revealed that financial constraints during the pandemic did not significantly affect academic motivation, regardless of gender, nationality, and age. The participants expressed that they were prepared and aware of the sunk costs involved in education. However, as the financial impact of the pandemic extended beyond 2020, unemployment increased, and parents were less prepared to bear their children's education costs. This inevitably increased the responsibilities of the universities to provide financial support to deserving students. © 2023, Association for Social Studies Educa. All rights reserved.

Differential impact of COVID-19 on mental health and burnout.

BACKGROUND: There may be differential impact of the COVID-19 pandemic on mental health and burnout rates of healthcare professionals (HCPs) performing different roles. AIMS: To examine mental health and burnout rates, and possible drivers for any disparities between professional roles. METHODS: In this cohort study, online surveys were distributed to HCPs in July-September 2020 (baseline) and re-sent 4 months later (follow-up; December 2020) assessing for probable major depressive disorder (MDD), generalized anxiety disorder (GAD), insomnia, mental well-being and burnout (emotional exhaustion and depersonalization). Separate logistic regression models (at both phases) compared the risk of outcomes between roles: healthcare assistants (HCAs), nurses and midwives (nurses), allied health professionals (AHPs) and doctors (reference group). Separate linear regression models were also developed relating the change in scores to professional role. RESULTS: At baseline (n = 1537), nurses had a 1.9-fold and 2.5-fold increased risk of MDD and insomnia, respectively. AHPs had a 1.7-fold and 1.4-fold increased risk of MDD and emotional exhaustion, respectively. At follow-up (n = 736), the disproportionate risk between doctors and others worsened: nurses and HCAs were at 3.7-fold and 3.6-fold increased risk of insomnia, respectively. Nurses also had a significantly increased risk of MDD, GAD, poor mental well-being and burnout. Nurses also had significantly worsened anxiety, mental well-being and burnout scores over time, relative to doctors. CONCLUSIONS: Nurses and AHPs had excess risk of adverse mental health and burnout during the pandemic, and this difference worsened over time (in nurses especially). Our findings support adoption of targeted strategies accounting for different HCP roles.

Factors Affecting Employee Engagement in the Malaysian Private Sector during the COVID-19 Pandemic

Employee engagement is pivotal to the success of an organization. The literature has indicated that employee engagement is enhanced via strong leadership, improved work-life balance, increased training and development as well as employee recognition. As such, this study aimed to examine the effects of these factors on employee engagement, especially among the Malaysian private sector, during the COVID-19 pandemic. The results of this study would provide an impetus to the Malaysian private sector to enhance employee engagement with policies that focus on making employees at the workplace passionate and highly involved. The results of this study will also add value to the existing literature on employee engagement. A quantitative survey was conducted, with questionnaires distributed online. This study targeted both male and female employees aged between 20 years old and 60 years old working in Kuala Lumpur and Selangor, Malaysia. A total of 154 respondents answered the online questionnaire. The data collected were analyzed using SPSS Software to identify the reliability and linearity of these variables as well as the testing of the correlation, and multiple regression analysis. The findings of the study indicated that both leadership and training and development had significant positive relationships with employee engagement. The scientific novelty of the study can be found from the findings of this research whereby employees desire a leader during the difficult times who can help them be more engaged in their work, and employees require more training and development, which are job-related, especially as the private sector embraces the endemic stage of COVID-19. Implications of the research findings are presented in this study. © 2022, City University of Hong Kong Press. All rights reserved.

Role of decentralised governance in implementing the National AIDS Control Programme in Kerala.

SETTING: In alignment with the UN Sustainable Development Goals (SDGs), Kerala State in India aims to end the HIV/AIDS epidemic, using its strong background in local governance to implement the National AIDS Control Programme (NACP). OBJECTIVE: To examine the role of local governments in the implementation of NACP in tune with SDGs. DESIGN: We conducted a state-wide exploratory study using document reviews, key informant and in-depth interviews, which were analysed thematically. RESULTS: Four overarching themes that emerged were 1) preparation for programme implementation, 2) positive impact of local government involvement, 3) convergence with other organisations, and 4) barriers to implementation. Local government commitment to implementing the programme was evidenced by their adoption of the HIV/AIDS policy, facilitative interdepartmental coordination and local innovations. Interventions focused on improving awareness about the disease and treatment, and social, financial and rehabilitative support, which were extended even during the COVID-19 pandemic. Fund shortages and poor visibility of the beneficiaries due to preference for anonymity were challenges to achieving the expected outcomes. CONCLUSION: The NACP is ably supported by local governments in its designated domains of interventions, prevention, treatment, and care and support. The programme can achieve its target to end the AIDS epidemic by overcoming the stigma factor, which still prevents potential beneficiaries from accessing care.

CONTEXTE: En accord avec les Objectifs de développement durable (SDG) des Nations unies, l'État du Kérala en Inde a pour objectif de mettre fin à l'épidémie de VIH/SIDA en s'appuyant sur sa forte expérience de gouvernance locale en matière de mise en œuvre du Programme national de lutte contre le SIDA (NACP). OBJECTIF: Examiner le rôle des gouvernements locaux dans la mise en œuvre du NACP, en accord avec les SDG. MÉTHODES: Nous avons réalisé une étude exploratoire à l'échelle de l'État, par le biais d'analyses documentaires, d'entretiens avec des informateurs clés et d'entretiens approfondis, qui ont ensuite été analysés de manière thématique. RÉSULTATS: Quatre thèmes centraux ont été identifiés : 1) préparation de la mise en place du programme, 2) impact positif de l'implication des gouvernements locaux, 3) convergence avec d'autres organisations, et 4) obstacles à la mise en œuvre. L'engagement des gouvernements locaux à mettre en œuvre le programme se manifestait par l'adoption de la politique de lutte contre le VIH/SIDA, par une coordination interdépartementale facilitée et par des innovations locales. Les interventions portaient sur l'amélioration de la sensibilisation au VIH/SIDA et à son traitement, ainsi qu'aux systèmes de soutien social, financier et de réadaptation disponibles ; ces interventions ont même été maintenues pendant la pandémie de COVID-19. Le manque de financements et la mauvaise visibilité des bénéficiaires en raison d'une volonté d'anonymat représentaient autant d'obstacles empêchant d'atteindre les résultats escomptés. CONCLUSION: Les gouvernements locaux apportent leur soutien efficace au NACP dans les domaines d'intervention qui lui ont été assignés (prévention, traitement, soins et soutien). Le programme peut atteindre son objectif d'éradication de l'épidémie de SIDA s'il parvient à lutter contre la stigmatisation associée à la maladie, qui empêche encore d'éventuels bénéficiaires d'accéder aux soins.

Combatting emerging infectious diseases from Nipah to COVID-19 in Kerala, India.

BACKGROUND: The state of Kerala, India, has experienced several unprecedented events in the past few years. The current study was an attempt to explore perceptions of stakeholders on how the decentralised system helped during the Nipah virus (NiV) outbreaks and COVID-19 pandemic in Kerala. METHODS: This study used a qualitative descriptive approach built on the advocacy paradigm. The stakeholders who were involved in decision-making and the representatives of local self-government who had real-time experience and had handled the challenges were identified using purposive sampling. Seven key informant interviews (KIIs) and nine in-depth interviews (IDIs) were conducted. RESULTS: Findings indicate that decentralisation had enabled the state to effectively deal with the outbreaks and the pandemic. The survey revealed four major themes: decision-making, engagement level, people-centric action, and difficulties. Two to four categories have emerged for each theme. CONCLUSION: The study results highlight the importance of human resources and service delivery as balancing factors during public health emergencies in any developing nation with limited resources. Given that very few nations have the healthcare infrastructure and resources necessary to cater to the healthcare needs of the whole population, decentralisation should be reinforced.

CONTEXTE: L'État du Kérala, Inde, a connu plusieurs évènements sans précèdent au cours des dernières années. Cette étude a cherché à analyser l'opinion des parties prenantes quant à l'aide apportée par le système décentralisé pendant les épidémies de virus Nipah (NiV) et la pandémie de COVID-19 au Kérala. MÉTHODES: Cette étude a eu recours à une méthode descriptive qualitative construite à partir du paradigme de mobilisation. Les parties prenantes impliquées dans la prise de décisions et les représentants des administrations locales autonomes, forts de leur expérience en temps réel et de leur expérience de gestion des défis, ont été identifiés par échantillonnage dirigé. Sept entretiens avec des informateurs clés (KII) et neuf entretiens approfondis (IDI) ont été réalisés. RÉSULTATS: Les résultats indiquent que la décentralisation a permis à l'État de gérer les épidémies et la pandémie de manière efficace. L'enquête a mis en évidence quatre thèmes majeurs : prise de décisions, niveau d'engagement, action centrée sur les personnes et difficultés. Chaque thème a pu être divisé en deux à quatre catégories. CONCLUSION: Les résultats de l'étude soulignent l'importance des ressources humaines et de la fourniture de services en tant que facteurs d'équilibre en période d'urgence de santé publique dans tous les pays en développement dotés de ressources limitées. Puisque très peu de pays disposent des infrastructures de santé et des ressources nécessaires pour répondre aux besoins sanitaires de l'ensemble de la population, la décentralisation devrait être renforcée.

Impact of COVID-19 on Guillain-Barre Syndrome in India: A Multicenter Ambispective Cohort Study.

Introduction/Aims: Studies conducted during the coronavirus disease 2019 (COVID-19) pandemic have reported varied data regarding the incidence of Guillain-Barre syndrome (GBS). The present study investigated demographic and clinical features, management, and outcomes of patients with GBS during a specified period of the COVID-19 pandemic, and compared these features to those of GBS in the previous year. Methods: A multicenter, ambispective cohort study including 26 centers across India was conducted. Data from a pre-COVID-19 period (March 1 to August 31, 2019) were collected retrospectively and collected ambispectively for a specified COVID-19 period (March 1 to August 31, 2020). The study was registered with the Clinical Trial Registry India (CTRI/2020/11/029143). Results: Data from 555 patients were included for analysis: pre-COVID-19 (n = 334) and COVID-19 (n = 221). Males were more commonly affected during both periods (male:female, 2:1). Gastroenteritis was the most frequent antecedent event in 2019 (17.4%), whereas fever was the most common event in 2020 (10.7%). Paraparesis (21.3% versus [vs.] 9.3%, P = 0.001) and sensory involvement (51.1% vs. 41.3%; P = 0.023) were more common during COVID-19 in 2020, whereas back pain (26.3% vs. 18.4%; P = 0.032) and bowel symptoms (20.7% vs. 13.7%; P = 0.024) were more frequent in the pre-COVID period. There was no difference in clinical outcomes between the two groups in terms of GBS disability score at discharge and 3 months after discharge. Independent predictors of disability in the pre-COVID period included areflexia/hyporeflexia, the requirementfor intubation, and time to bulbar weakness; in the COVID-19 period, independent predictors included time from onset to admission, intubation, and intubation requirement. The mortality rate was 2.3% during the entire study period (13/555 cases). Discussion: Results of this study revealed an overall reduction in the frequency of GBS during the pandemic. The lockdown likely reduced the risk for antecedent infections due to social distancing and improved hygiene, which may have resulted in the reduction of the frequency of GBS.

A Case of COVID-19 Presenting as Acute Liver Failure

Although children with COVID-19 make up a small proportion of patients and have milder symptoms than adults, liver damage is a well-documented side effect of COVID-19 infection. Most liver damage caused by COVID-19 is modest. In this report, a case of a 6-year-old child who was hospitalised to a paediatric intensive care unit (PICU) with COVID-19 manifested as acute liver failure is de-scribed. © 2022 Nawghare et al.

Emergence of Tele-rehabilitation during COVID-19: A Case Report of a Survivor with Multiple Co-morbidities

Coronavirus disease 2019 (COVID-19) survivors experience impaired pulmonary function, reduced muscle strength, and exercise intolerance affecting their activities of daily living. Literature has demonstrated a need for multi-disciplinary approach for their faster recovery. In a pandemic like situation where maintaining social distancing to reduce the risk of transmission had become a norm, telerehabilitation services came to a great rescue of both the patients and health-care providers. At present, there are not any established guidelines for rendering pulmonary rehabilitation through telerehabilitation (TR). Besides, it's effective implementation depends on numerous patient-centric factors such as age, hemodynamic stability, presence of comorbidities, availability of resources, and cognitive level of the patient. We hereby present the case of a 69-year-old female diagnosed with COVID-19 with prolonged hospital stay, having a history of multiple co-morbidities, focusing on the role of 12 weeks of TR in improving her functional outcomes.

Extracorporeal membrane oxygenation - A bridge to life in COVID-19 complicated pregnancy

The utility of extracorporeal membrane oxygenation (ECMO) has gained significant attention over the past 25 years. ECMO has revolutionized the management of patients with refractory cardiac and respiratory complications in critically ill patients. We herewith present a case of a 26-year-old pregnant female patient with coronavirus disease-2019 and refractory hypoxemia, who was managed successfully on ECMO.

Lockdown Without Loss? A Natural Experiment of Net Payoffs from COVID-19 Lockdowns

Lacking a federal policy to control the spread of COVID-19, state governors ordered lockdowns and mask mandates, at different times, generating a massive natural experiment. The authors exploit this natural experiment to address four issues: (1) Were lockdowns effective in reducing infections? (2) What were the costs to consumers? (3) Did lockdowns increase (signaling effect) or reduce (substitution effect) consumers' mask adoption? (4) Did governors' decisions depend on medical science or nonmedical drivers? Analyses via difference-in-differences and generalized synthetic control methods indicate that lockdowns causally reduced infections. Although lockdowns reduced infections by 480 per million consumers per day (equivalent to a reduction of 56%), they reduced customer satisfaction by 2.2%, consumer spending by 7.5%, and gross domestic product by 5.4% and significantly increased unemployment by 2% per average state by the end of the observation period. A counterfactual analysis shows that a nationwide lockdown on March 15, 2020, would have reduced total cases by 60%, whereas the absence of any state lockdowns would have resulted in five times more cases by April 30. The average cost of reducing the number of cases by one new infection was about $28,000 in lower gross domestic product.

Efficiency & Patient Satisfaction of Colorectal Telephone Consultation during the Covid-19 Pandemic

Aim: COVID-19 has necessitated a new approach to consult patients due to requirement for social distancing and avoiding unnecessary contact. This study aimed to assess the feasibility and patients' satisfaction of virtual clinic (VC) appointment compared to face-to- face (F2F) appointment. This study aimed to assess the feasibility and patients' satisfaction of virtual clinic (VC) appointment compared to face-to- face (F2F) appointment. Method(s): Patients referred under routine referral to the service between 09/10/2019 and 31/12/2019 and waiting for an appointment for more than one year were screened and allocated to VC or F2F according to set criteria based on symptoms and pathology. Demographic data, symptoms, pathology and waiting time were collected retrospectively. Structured telephone interviews were conducted to evaluate patients' satisfaction. Result(s): 559 patients were referred in the study period. Of this, 33.6% and 49.4% were triaged to attend a VC, or F2F clinic, respectively. Of the VC patients, 53.9% patients were discharged after an initial appointment, whereas 37.3% patients required a follow-up F2F appointment due to persistent symptoms or patient preference. Of the F2F patients, 82.8% were from the initial triage due to requirement for clinical examination or patients' preference. 90.5% of patients who underwent VC reported being either satisfied or very satisfied with their experience, in contrast to 86.0% of patients who underwent a F2F appointment (P < 0.05). Conclusion(s): VC appointments significantly reduced waiting times and only 1/3 of VC patients required a further F2F appointment. Patient were more satisfied with VC than an F2F appointment, and it may be a useful approach for service efficiency, particularly during ongoing COVID pandemic.

Differences in Outcomes Between High Dose and Low Dose Belatacept Conversion on Allograft Function in Kidney Transplant Patients

Background: Belatacept, a selective costimulation T cell blocker is used to avoid unwanted side effects from calcineurin inhibitors. Improved allograft function despite increased risk of early rejection and viral infection have been reported. Method(s): This is a single center retrospective study conducted at Mayo Clinic Arizona. We converted patients to the high dose belatacept (10mg/kg) if transplanted within 1 month and to the low dose (5mg/kg) after 1 month if they had significant side effects with calcineurin inhibitors or suboptimal allograft function with chronicity changes on biopsy findings. Tacrolimus dose was discontinued immediately in high dose conversion group but was overlapped and tapered down within 4 weeks in low dose conversion group. We included both deceased donor and living donor transplant recipients from 2013 to 2021. We compared the effect of high dose and low dose on the occurrence of rejection and infection at 1 year. Result(s): Total of 75 patients were switched to belatacept and 56 (74%) was converted to low dose and 17 (26%) were converted to high dose. No statistical difference found in recipient and donor characteristics between 2 groups (Fig 1). There was no statistical significance in allograft function, rejection rate and infection rate at 1 year (Fig 2). However, the ocurrence of COVID 19 infection was statistically significant in high dose conversion group. Conclusion(s): Allograft function was comparable at 12 months between 2 groups for those transplaned within 1 year. It is important to recognize the potential for overimmunosuppression when transitioning to belatacept.

Aging Population: Social and Economic Concerns and Complexities During COVID-19

In the wake of the pandemic, many lessons have been learnt, and different challenges have been incurred, leading to the creation of not only stress but also limiting the activities of old-age people. One of the most vulnerable sections of the society is the ‘aging population’. This theoretical chapter discusses the concerns and complexities affecting the aging population in the present pandemic (COVID-19) and how the concerns and complexities impact social and economic activities. The chapter also explores the stress variable. The chapter uses the current scenario and secondary sources to explore the research phenomenon in-depth. Recommendations to the policymakers are given at the end. © 2022 by IGI Global. All rights reserved.

Continuing Qualitative Data Collection During the COVID 19 Pandemic: Lessons Learnt from A Study Among Tribes in Manipur, India

COVID-19 pandemic has caused disruptions in carrying out research activities in the field. The established methods of data collection for both qualitative and quantitative research could not be implemented. Researchers worldwide adopted contactless data collection methods, including the use of mobile phones for research purposes. This paper presents the experiences of conducting interviews among tribal population using mobile phones in three villages of Manipur during the pandemic. The interviews proved to be successful and effective. Minor technical glitches were a challenge but were not significant to affect the quality of the data. During unprecedented times such as the current pandemic, conducting interviews via mobile phones could be a viable alternative to face-to-face interviews for collecting qualitative data from the communities. © The Authors retain.

Factors affecting consumer behaviour during the COVID-19 pandemic in Malaysia

Consumer behavior has changed during the Covid-19 pandemic in all spheres of life. In Malaysia, there was a surge in e-commerce, a preference to buy essential goods from trusted brands while being cautious with spending. During the pandemic, Malaysian consumers have been more careful about spending their money and where they spend their money. Based on the review of past literature, the study's goal was to examine the relationships of variables such as perceived severity, cyberchondria, self-efficacy, and self-isolation on consumer behavior during the Covid-19 pandemic in Malaysia. The aim of the study was also to highlight the implications of the study that will be beneficial to the Malaysian government, the consumer association, and retailers. The quantitative research method was used to conduct this study via online questionnaires. The target respondents were consumers from Selangor between the ages of 20 to 60, mainly those with jobs and who earned a monthly income. A total of 196 respondents answered the questionnaire. The reliability, linearity, normality, correlation, and multiple regression tests were conducted using SPSS. The study results revealed that only perceived severity and self-isolation had significant relationships with consumer behavior. The scientific novelty of the study was that both cyberchondria and self-efficacy were insignificant. These findings imply that both cyberchondria and self-efficacy do not affect the consumer behaviour of Malaysian during the pandemic. The implications of the research findings were discussed.