Market development strategy and process performance of knowledge-intensive SMEs in the epidemic era: a process-oriented perspective

PurposeThis study analyzes in-depth how knowledge-intensive small and medium-sized enterprises (SMEs) can achieve higher new product development (NPD) process performance in the epidemic era and examine the internal development mechanism of knowledge-intensive SMEs in the process of continuous digital transformation.Design/methodology/approachThis issue is tested with partial least squares on data collected via a survey conducted from November 2021 to February 2022. The sample comprises 487 knowledge-intensive SMEs operating in China.FindingsThe results indicate that one form of cross-functional ambidexterity, market development strategy (MDS), plays an important role in process performance from an inside-out financial perspective and an outside-in customer perspective. Simultaneously, product innovation efficiency (PIE) mediates the relationship between MDS and the above results. Big data analytics capabilities (BDACs) positively regulate the relationship between MDS and PIE.Research limitations/implicationsThe authors do not consider other contingency factors. Future research should introduce influential factors such as leadership and competitive intensity to further distinguish the effects of MDS on NPD process performance.Practical implicationsThe study findings offer suggestions to help knowledge-intensive SME managers better manage their NPD process by making better use of their limited resources in developing countries such as China.Originality/valueThis study is one of only a few to adopt a process-oriented perspective to specifically examine how one form of cross-functional ambidexterity, MDS, impacts knowledge-intensive SME process performance in the epidemic era. This study also extends the theoretical framework of cross-functional ambidexterity to BDAC research.

Two-year outcome of extracorporeal membrane oxygenation in COVID-19 related severe respiratory failure

Objectives: We sought to evaluate 2-year outcome of V-V ECMO support for COVID-19 related severe respiratory failure in our center. Method(s): Retrospective analysis of 41 consecutive patients (73% male, mean age 51.6+/-14.2 years, mean BMI 35.1+/-12.5 kg/m2) with critical hypoxemic and/or hypercapnic refractory respiratory failure (mean P/F ratio 67.9+/-14.3 mmHg, mean pCO2 77.6.0+/-185.7 mmHg, Murray Score 3.71+/-0.4) on V-V ECMO support from October 2020 to January 2022 Results: With mean support duration of 234.4+/-63.2 hours, 29 patients (70.7%) were successfully weaned off. Finally, 19 of them (46.3%) were discharged home with good neurological outcome (CPC 1,2). During followup, 30-day, 6-, 12-, and 24 -month survival rate was 61.3%, 46.2%, 41.9%, and 41,9% respectively. In survivor group shorter symptoms onset to respiratory failure time (4+/-4.7 vs. 7+/-6.7 days, p=0.04), higher P/F ration (86+/-41.5 vs. 65+/-37.5 mmHg, p=0.04) and norepinephrine support (0.03+/-0.06 vs. 0.09+/-0.12 ug/kg/min, p=0.04), and lower IL-6 level (12.3+/-7.5 vs. 25.9+/-8.8 ng/l, p=0.03) p=0.01) were analysed before cannulation. Mean in-ICU stay and in-hospital stay in survivors;groups reached 32.5+/-27.7 days and 42.6+/-35.8 days, respectively. All long-term survivors (17 patients) complained about slight functional health limitation only with normal 6MWT (542.6+/- 89.2 min), near to normal spirometry parameters (FEV/VC 87+/-7.4%, DLCO 63.1+/-13.7%, KCO 82.,1+/-19.4%) and minimal neurological disability (CPC 1-2) Conclusion(s): 2-year outcome of V-V ECMO support in COVID-19 severe respiratory failure is acceptable even in the scope of low-volume ECMO centre. Reported functional status of long-term survivors was good despite the complicated and prolonged in-hospital stay. (Table Presented).

THE RELATIONSHIP BETWEEN THE FUNCTIONALITY OF CHILDREN WITH DISABILITIES AND ITS EFFECTS ON PARENTS DURING THE COVID-19 PANDEMIC PROCESS.

Purpose: The aim of this study was to investigate the relationship between the functionality of disabled children and its effects on parents during the Covid-19 pandemic. Method(s): A total of 168 people, including 84 disabled children and 84 mothers, were included in the study. The Pediatric Disability Assessment Inventory (PEDI) and Gross Motor Function Classification System (GMFCS) were used for children with disabilities. The Zarit Burden Scale (ZBS), Fatigue Severity Scale (FSS) and The Nordic Musculoskeletal Questionnaire (NMQ) were applied to the mothers to question musculoskeletal disorders. Result(s): There was no correlation between care burden score and PEDI, total score, self-care and mobility scores (p>0.05). A moderately negative (r=-0.306;p<0.01) significant linear relationship was found between care burden score and social function score. There was no significant linear relationship between the fatigue severity score and PEDI total score, self-care, mobility and social function scores (p>0.05). No correlation was found between care burden score and fatigue severity score (p>0.05). For the last 12 months, only the pain in the lumbar region of the parents prevented them from doing their usual work. It was determined that the most aching body parts of the parents who complained of musculoskeletal pain during the last 12 months were in the waist, neck, shoulder, back, and knee regions. Conclusion(s): As a result, no relationship was found between the functionality of disabled children and their parents' influences during the Covid-19 pandemic.Copyright © 2022 Turkish Physiotherapy Association. All rights reserved.

Breaking the exascale barrier for the electronic structure problem in ab-initio molecular dynamics

The non-orthogonal local submatrix method applied to electronic structure–based molecular dynamics simulations is shown to exceed 1.1 EFLOP/s in FP16/FP32-mixed floating-point arithmetic when using 4400 NVIDIA A100 GPUs of the Perlmutter system. This is enabled by a modification of the original method that pushes the sustained fraction of the peak performance to about 80%. Example calculations are performed for SARS-CoV-2 spike proteins with up to 83 million atoms. [ FROM AUTHOR] Copyright of International Journal of High Performance Computing Applications is the property of Sage Publications, Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Feedback on post COVID-19 rehabilitation.

The outbreak of Coronavirus Disease 19 (COVID-19) following the Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2) viral infection has placed particular pressure on occidental health systems, especially in terms of acute care resources and critical care skills. A number of affected patients subsequently required a rehabilitation process, due to multiple functional limitations, either as a result of an extended stay in intensive care or the consequences of the infection itself. The aim of this article is to report on the Geneva experience in post COVID19 rehabilitation, through 2 clinical vignettes, illustrating the heterogeneity of symptoms and deficits that may be encountered following this disease.Copyright © 2020 Editions Medecine et Hygiene. All rights reserved.

Long-term functional outcome of severe COVID19 pneumonia treated with venovenous extracorporeal membrane oxygenation support - learnings from a single centre

Objectives: Implementation of venovenous extracorporeal membrane oxygenation (VVECMO) allowed survival of patients with severe respiratory failure associated with SARS-CoV-2 infection. However, VVECMO treatment is usually associated with long ICU stays, prolonged sedation, and neuromuscular blockage days. Functional disability, due to delirium and acquired muscle weakness, is frequently an inevitable burden causing long term disability. This study aims to analyse main characteristics of patients under ECMO due to COVID-19 pneumonia, their outcomes and functional status six months after ICU discharge. Method(s): Retrospective review of a prospectively collected database in an ECMO referral centre. All patients receiving VVECMO for SARS-CoV-2 infection were included. Epidemiological and clinical data were reviewed. Functional status at 6 months after ICU discharge was assessed with modified Rankin Scale (mRS). Result(s): Ninety-three patients were included (29% female). Median age was 54+/-12 years, mean SOFA was 5.7+/-2.9, mean SAPS II was 35.6+/-13.6. Mean time from intubation to cannulation was 5+/-5.6 days in 91 patients;awake-ECMO was performed in 2 patients. Mean ECMO run duration was 33.1+/-30 days (longest ECMO run was 194 days). A period of awake-ECMO was performed on 36.5% of patients, during 16.4+/-21.2 days. ICU-acquired weakness was diagnosed on 64.5% of patients and delirium on 63.4%. Mortality was 24.7% (23 patients) with only 1 patient deceased in hospital after ICU discharge. At 6 months follow-up, all patients were still alive and most of them (65.1%) were independent on all daily activities (mRS <= 2). Conclusion(s): Patients with severe COVID-19 treated with VVECMO support had very good functional outcomes at six-month follow-up. Despite long ICU length-of-stay, high incidence of delirium and acquired muscle weakness, full recovery at six-month post-ICU discharge was achievable in most patients.

Post COVID-19 changes in the structure and function of the thyroid in patients with autoimmune thyroiditis with hypothyroidism

COVID-19 is a severe immunosuppressive disease that can cause changes in the clinical course of autoimmune diseases. Autoimmune thyroiditis (AIT) is no exception. It is relevant to study the features of the clinical course of existing AIT in the post-COVID-19 period. The work aims to study the changes in the structure and function of the thyroid in patients with AIT with subclinical and manifest compensated hypothyroidism who had moderate COVID-19. A total of 123 patients aged 21-49 with AIT with subclinical hypothyroidism - 43 (group 1, 12 of whom had moderate COVID-19) and manifest hypothyroidism in the stage of medical compensation - 80 (group 2, 32 of whom had moderate COVID-19). The duration of AIT ranged from 4 to 13 years. In all cases, upon inclusion in the study and 2 and 6 months after it, changes in the structure of the thyroid gland were studied according to ultrasound data, as well as its functional capacity and the degree of compensation of hypothyroidism according to the thyroid-stimulating hormone indicator. In all patients with AIT, COVID-19 caused the progression of structural changes in the thyroid within one of two variants of the ultrasound picture of thyroiditis - hypoechoic heterogeneous or pseudo micronodular. The hormone-producing function also changed: in 7 out of 12 patients of group 1 of the main subgroup, hypothyroidism changed from subclinical to manifest hypothyroidism in the postoperative period, and in all patients of group 2 of the main subgroup, a further decrease in hormone synthesis was noted. In the post-COVID-19 period, patients with AIT undergo a progression of structural changes in the thyroid gland and a decrease in the synthesis of thyroid hormones.Copyright © 2023 The Authors.

Fruits as Boosters of the Immune System

Immunity is the major mechanism of host defence system against infectious and chronic diseases. The recent global concern of recent viral infection of SARS-CoV-19 has raised the demand of functional foods, nutraceuticals and fruits that can boost immunity. This will help in managing the overall physiological health and prevention of infectious and chronic diseases. Medicinal plants and fruits can help in boosting immunity through modulation of immune system and changing the types of immune response such as involvement of the induction, expression or amplification of the genes and proteins in inflammation and antioxidant system. The traditional medicine systems have used a wide variety of plants and fruits as supplement for immunomodulation including those for stimulation of immune system as well as immune compromisation deemed per se. Some of the plants that have been listed for immune boosting abilities included Curcuma longa, Withania somnifera, Phyllanthus emblica, Azadirachta indica, Panax ginseng, Rhododendron spiciferum, Caesalpinia bonducella, Tinospora cordifolia, Capparis zeylanica, Asparagus racemosus, Nelumbo nucifera, Arnica montana, Calendula officinalis, Echinacea purpurea and Euphorbia tirucalli. Reports indicate that a wide variety of phytochemicals like polysaccharide, alkaloids, flavonoids, terpenoids, lactones and glycoside have shown immunomodulatory properties under different pathophysiological conditions. Amongst the diverse chemical profile of plant extracts, polysaccharides are the water-soluble molecules that could activate immune responses when interacting directly with immune cells, while hydrophobic compounds like flavonoids such as quercetin and luteolin and terpenoids such as sesquiterpene lactones and curcumin showed potent immunomodulatory effects. Growing evidences suggest that phytochemicals from functional foods and fruits may be useful in maintaining the cytokine and chemokine balance, regulating oxidative status of cells, and targeting the specific cellular receptors as therapeutic targets. This chapter comprehensively enlists the plant resources with immune boosting abilities and explore their phytochemical characterization and molecular mechanism behind their protective effects. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2022.

Functional movement disorders during the COVID-19 pandemic

Functional movement disorders (FMDs) are a heterogenous group of movement abnormalities that greatly affect the quality of life of patients. They usually manifest as a result of underlying psychological or psychiatric illnesses without any known structural or neurochemical diseases. Various neurological disorders such as encephalitis, stroke, demyelination, seizures, and neuropathy have been reported by otherwise healthy individuals during the ongoing coronavirus disease 2019 (COVID-19) pandemic. Here, we describe the case of a 27-year-old woman who presented to our outpatient department with episodes of deviation of angle of mouth with variability and distractibility. Following thorough clinical evaluation and appropriate investigation, the underlying etiology was identified as FMD secondary to the restrictions imposed during the COVID-19 pandemic to contain the transmission of the virus. The lockdown, isolation, financial strain, and other pandemic-related issues are stressors that may contribute to psychogenic disorders in people.Copyright © 2021 Annals of Movement Disorders Published by Wolters Kluwer - Medknow.

Imbalanced brain connectome: A possible link behind functional somatic disorders, multiple chemical sensitivity, and long COVID patients

Background: Functional Somatic Disorders (FSDs) are characterized by persistent physical symptoms that cannot be explained by other somatic or psychiatric conditions. Multiple Chemical Sensitivity (MCS) is a non-allergic FSD characterized by odour intolerance and various somatic symptoms being attributed to the influence of toxic environmental chemicals in low, usually harmless doses. The pathophysiology of FSDs are still not clear. Smell and taste complaints were also among the notable symptoms characterizing the covid epidemic and the latest evidence suggests overlaps between long COVID and FSDs. Method(s): The study includes advanced analysis of MRI-derived functional and structural connectomes acquired on a 3 T MR scanner. Furthermore, it includes questionnaires and paraclinical tests, e.g. the Sniffin' Stick olfactory test, Mini-Mental State Examination, and Sino-Nasal Outcome test 22. The pilot part of the project included 6 MCS patients who were compared with 6 matched healthy participants. Later follow-up included analysis of 8 multiorgan FSD and 4 post-COVID patients. Result(s): The MCS group showed important brain structural connectivity differences in 34 tracts. Notably, for MCS patients, the olfactory cortex (especially in the right hemisphere) showed decreased connectivity with regions in the emotional system. Conclusion(s): We plan to extend these findings with whole-brain modelling of the functional connectivity in the patient groups. Long-term this could be used as a 'fingerprint' which could help with diagnosis and treatment monitoring in FSDs as well as with new diagnoses such as long-COVID.Copyright © 2023

Physical effects of Covid-19 in patients with diabetes 1 year after hospitalisation in the UK: PHOSP-Covid study

Aim: To investigate the impact of Covid-19 on daily activity, maximal physical performance, and clinical frailty of people living with diabetes (any type) 1-year post-hospitalisation for Covid-19 in the UK. Method(s): This study is part of PHOSP-Covid, a multicentre long-term cohort study that recruited adults (>=18 years) who were discharged from one of the 83 NHS hospitals across the four UK nations following a clinical diagnosis of Covid-19 before March 31, 2021. We compared The Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue, Incremental shuttle walk test (ISWT) distance (m), and clinical frailty (Rockwood frailty level), 5-month and 1-year after discharge in patients with and without diabetes. Result(s): Out of 2545 individuals (538 (21%) with diabetes), the proportion of individuals who classified as either 'mildly frail' or 'moderately or higher frail severity' was higher in individuals with diabetes (month 5: diabetes 9.9%, no diabetes 4.7%;month 12: diabetes 8%, no diabetes 4.9%). ISWT distance in patients with diabetes were significantly lower at both follow-ups but this measure improved from 5-months to 1-year (290 [95% CI: 190-440] vs 370 [250-560] for diabetes and 340 [210-450] vs 420 [270-590] for those without, both p < 0.01). At both time points, people with diabetes reported higher levels of fatigue (36 [24-44] vs 39 [25-46] at 5-month (p = 0.03);37 [26-45] vs 40 [28-47] at 1-year visit (p < 0.01)). Conclusion(s): One year after hospitalisation long Covid is more observed in people with diabetes.

Relationship of "Tooth Condition” with Mobility and Cognitive Function of Residents in Special Elderly Nursing Homes Practicing Functional Recovery Care, Case-control Study

The world continues to struggle with the COVID-19 pandemic, and there is concern over the increase in the needs of older people for nursing care. In this study, the relationships of the "tooth condition” with mobility and cognitive function were investigated in 1,000 residents of 14 special elderly nursing homes. In those using well-fitting dentures, the percentage of those capable of independent indoor mobility was highest at 21.6%, and the percentages of those able to communicate (66.2%), understand routines (47.5%), state their own age (36.2%), remember recent events (45.0%), state their own name (85.7%), understand seasons (43.7%), and understand places (46.4%) were significantly higher than in those in other "tooth conditions”. This study clarified the relationships of the "tooth condition” with mobility and cognitive function, and maintaining an adequate "tooth condition” was suggested to contribute to the prevention of a condition requiring long-term nursing care. © 2023 Asian Society of Human Services.

"Not in the Same Boat": Navigating towards academic literacy teaching during the COVID-19 crisis

This chapter describes the experience of academic literacy teachers in their adaptation of face-to-face teaching activities to the remote mode in a university in Colombia. Students in these courses face various challenges associated with their contexts and their home areas for studying - the physical conditions, quality of internet connections, and sometimes lack of electricity. Alongside these challenges, they lack literacy skills to face the demands posed by the learning tasks they encounter in their courses. The change to remote emergency teaching due to the COVID-19 crisis represented a threat for this vulnerable population as their academic literacy teachers were not used to navigating technology-mediated environments. After intensive professional development provided by the Teaching Excellence Center, faculty designed strategies to match teachers and students' access and familiarity to technology. Teaching tasks and delivery were modified as well. Feedback from faculty recognized the complexity and difficulty of such transformations, as well as its potential for opportunities. Students were positive about the experience and recognized the role teachers played in making this transition possible. Conclusions suggest that having a unified pedagogy helped them navigate the crisis regardless of their technological or literacy needs. © Springer Nature Switzerland AG 2021. All rights reserved.

The Effect of FOXP3+Regulatory T Cells on Infectious and Inflammatory Diseases

CD4+CD25+FOXP3+regulatory T cells (Tregs) contribute to the maintenance of immune homeostasis and tolerance in the body. The expression levels and functional stability of FOXP3 control the function and plasticity of Tregs. Tregs critically impact infectious diseases, especially by regulating the threshold of immune responses to pathogenic microorganisms. The functional regulatory mechanism and cell-specific surface markers of Tregs in different tissues and inflammatory microenvironments have been investigated in depth, which can provide novel ideas and strategies for immunotherapies targeting infectious diseases.Copyright © 2021. All rights reserved.

Effect of knowledge, social and religious factors effecting the intention of Muslims in Pakistan to receive COVID-19 vaccination: mediating role of attitude towards COVID-19 vaccination

PurposeThis study aims to empirically examine the knowledge, social and religious factors effecting the intention to receive COVID-19 vaccination while considering the mediating role of attitude towards COVID-19 vaccination. The research explores how the Islamic ideologies shape Muslims' knowledge, social and religious beliefs towards COVID-19 vaccination acceptance or refusal.Design/methodology/approachTheoretically, the study is based on the functional theory of attitudes. The model of the study is comprised of nine variables explaining the attitude and intention towards COVID-19 vaccination. Among nine variables, perceived Islamic religiosity, perceived behavioural control and Halal consciousness among Muslims are explained through the value-expressive function of attitude. Furthermore, the perceived risk of COVID-19, the perceived side effect of COVID-19 vaccination and the perceived efficacy of COVID-19 vaccination are considered in the model based on the utility function of attitude. Moreover, social influence for COVID vaccination, subjective norms and group conformity are ed from the social-adjustive function of attitude. This study used a quantitative survey research method to test the hypotheses. A total of 1,000 questionnaires were distributed to non-vaccinated Muslim respondents from five cities in Pakistan. The structural equation modelling (SEM) technique was used to test the relationship among the variables in the proposed model. The partial least square-SEM method explained the variances in the dependent variables. Moreover, to test the structure of data, different statistical tests, including exploratory factor analysis (EFA), factor loadings and average variance extracted, were used with the help of Statistical Package for the Social Sciences (SPSS) and analysis of a moment structures (AMOS) 23.0 version.FindingsResults for direct effect showed a significant negative effect of Islamic religiosity, perceived behavioural control, halal consciousness, perceived side effect of COVID-19 vaccination, social influence, subjective norm and group conformity on attitude towards COVID-19 vaccination. In contrast, insignificant results showed no relationship of perceived risk from COVID-19 infection and perceived efficacy of COVID-19 vaccination with attitude towards COVID-19 vaccination. Results for mediating effect showed the significant negative mediating effect of attitude towards COVID-19 vaccination between Islamic religiosity, perceived behavioural control, halal consciousness, perceived side effect, social influence, subjective norm, group conformity and intention to receive COVID-19 vaccination. While results showed the insignificant mediation of attitude towards COVID-19 between perceived risk from COVID-19 infection, perceived efficacy of COVID-19 vaccination and intention to receive COVID-19 vaccination.Research limitations/implicationsFurther studies are required to compare the attitude and intention among the temporary refusal group (those who will consider vaccination the future) and the permanent refusal group (those who will not consider vaccination the future). Comparing Muslim and non-Muslim groups can also explain differences in attitude and intention towards COVID-19 vaccination.Originality/valueThe area of acceptance and refusal of COVID-19 vaccination has been given limited attention in academic literature. Theoretically, this research has proposed a well-defined model to explain the attitude of Muslims towards COVID-19 vaccination. This model can helpf predict the attitude and intentions of Muslims towards vaccination or medicines. Moreover, this research is a unique contribution for the vaccination brands to consider the discussed factors before launching their brand in Muslim countries.

Mapping of functional areas in Spain based on mobile phone data during different phases of the COVID-19 pandemic

Mobility functional areas are tools based on human mobility that can be useful for spatial and transport planning in delicate situations such as the COVID-19 pandemic. In this work, we aim to map functional areas in Spain from four days corresponding to different phases of the disease. For that goal, mobile phone data provided by Spanish Statistical National Institute (INE) has been used due to its value and potential to provide constantly updated information of mobility at almost-real time. The methodology consists of a network analysis over an origin-destination matrix to obtain modularity values for 3214 population cells provided by the INE. These values were then used to cluster the cells into functional areas. The results show how different confinement and mobility restriction policies influence the amount, size and shape of the functional areas, and therefore, they affect access to services or jobs.

'Online therapy' to reduce caregiver's distress and to stimulate post-severe acquired brain injury motor and cognitive recovery: A Sicilian hospital experience in the COVID era.

INTRODUCTION: Severe acquired brain injury(SABI) often results in the deterioration of physical, cognitive and emotional functions in the patient and a significant caregiver's distress syndrome, which is now amplified by the social isolation, depression and financial difficulties related to the COVID-19 pandemic. The use of web-based online-therapy has been shown to be useful to overcome caregiver's distress syndrome and further stimulate cognitive-motor recovery of SABI-patients. Our study aimed to investigate whether a systematic online Skype-therapy(OLST) may be of support in favoring global cognitive and sensory-motor recovery in SABI-patients and reducing caregiver distress. METHODS: Twenty-five SABI-subjects in inpatient regimen were provided with intensive OLST with the caregiver for 12 weeks in addition to standard neurorehabilitation. Each subject and caregiver was evaluated before and after the treatment by administering an ad hoc battery. Furthermore, 18 of 27 patients were provided with EEG recording in resting state. RESULTS: We found a significant reduction in caregiver's anxiety (p<0.0001) and burden(p<0.0001). Patients showed significant improvement in trunk control (p<0.0001), functional independence (p = 0.005), functional (p = 0.01) and global communication (p = 0.004), cognitive functioning (p = 0.001), and behavioral responsiveness (p = 0.0004). The training yielded a significant connectivity change within the fronto-centro-parietal areas in the delta frequency band (p<0.0001) and the centro-parieto-occipital areas in the alpha range (p = 0.004). DISCUSSION: OLST may be a useful and complementary treatment to optimize global cognitive and functional recovery in SABI-subjects and reduce caregivers' concerns in the Covid-era. OLST can foster cognitive-motor recovery potentially by favoring the plasticity-dependent functional recovery. Therefore, OLST could be proposed as a tool allowing social conversations also in the hospital setting.

Telemedicine Evaluation of Hip Ailments.

Background During the coronavirus disease 2019 (COVID-19) pandemic, telemedicine has provided new means of patient care while still allowing for physical examination and history to be obtained. Hip ailments are a common musculoskeletal problem leading to limited function. Today, we lack a standardized telemedicine hip evaluation protocol. Aim The aim of this manuscript is to provide an efficient means of extracting relevant information while performing telemedicine examinations of the hip. Methods The authors have created a step-by-step evaluation guide for physicians to evaluate hip complaints, including inspection, palpation, range of motion, strength testing, functional assessment, gait analysis, and special testing, with images of each maneuver. Results  We have developed a table of evaluation questions and instructions and a glossary of images of each maneuver to facilitate hip examination via telemedicine. Conclusions This manuscript provides a structured template for performing a telehealth examination of hip ailments.

Feasibility of Virtually Delivering Functional Fitness Assessments and a Fitness Training Program in Community-Dwelling Older Adults.

The COVID-19 pandemic limited older adults' access to preventative and diagnostic services and negatively affected accessibility to age-appropriate exercise programs. The purpose of this study was to assess the feasibility of conducting guided virtual functional fitness assessments before and after participation in an 8-week virtual, live fitness program (Vivo) designed for older adults. It was hypothesized there would be no significant difference between in-person and virtual functional fitness assessments and function would improve following the program. Thirteen community-dwelling older adults were recruited, screened, and randomly assigned to in-person-first or virtual-first fitness assessment groups. Validated assessments were delivered using standardized scripts by trained researchers and included Short Physical Performance Battery (SPPB) balance, a 30 s Chair Stand Test, 8 Foot Up-and-Go Test, 30 s Arm Curl Test, and 2 min Step Test. The eight-week, twice-a-week live virtual fitness program involved cardiovascular, balance, agility, Dual-Task, and strength training. Results showed no significant differences between all but one assessment measures, and several measures improved following the eight-week program. Fidelity checks demonstrated the high fidelity of program delivery. These findings illustrate that virtual assessments can be a feasible method to measure functional fitness in community-dwelling older adults.

SARS-CoV-2 Omicron Specific Mutations Affecting Infectivity, Fusogenicity, and Partial TMPRSS2-Independency.

The COVID-19 pandemic resulted from the global spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Since its first appearance in 2019, new SARS-CoV-2 variants of concern (VOCs) have emerged frequently, changing the infection's dynamic. SARS-CoV-2 infects cells via two distinct entry routes; receptor-mediated endocytosis or membrane fusion, depending on the absence or presence of transmembrane serine protease 2 (TMPRSS2), respectively. In laboratory conditions, the Omicron SARS-CoV-2 strain inefficiently infects cells predominantly via endocytosis and is phenotypically characterized by decreased syncytia formation compared to the earlier Delta variant. Thus, it is important to characterize Omicron's unique mutations and their phenotypic manifestations. Here, by utilizing SARS-CoV-2 pseudovirions, we report that the specific Omicron Spike F375 residue decreases infectivity, and its conversion to the Delta S375 sequence significantly increases Omicron infectivity. Further, we identified that residue Y655 decreases Omicron's TMPRSS2 dependency and entry via membrane fusion. The Y655H, K764N, K856N and K969N Omicron revertant mutations, bearing the Delta variant sequence, increased the cytopathic effect of cell-cell fusion, suggesting these Omicron-specific residues reduced the severity of SARS-CoV-2. This study of the correlation of the mutational profile with the phenotypic outcome should sensitize our alertness towards emerging VOCs.