A rapid review of challenges and opportunities related to diversity and inclusion as experienced by early and mid-career academics in the medicine, dentistry and health sciences fields.

BACKGROUND: Early- and mid-career academics in medicine, dentistry and health sciences are integral to research, education and advancement of clinical professions, yet experience significant illbeing, high attrition and limited advancement opportunities. OBJECTIVES: Identify and synthesise published research investigating challenges and opportunities related to diversity and inclusion, as experienced by early and mid-career academics employed in medicine, dentistry and health sciences disciplines. DESIGN: Rapid review. DATA SOURCES: OVID Medline, Embase, APA PsycInfo, CINAHL and Scopus. METHODS: We systematically searched for peer reviewed published articles within the last five years, investigating challenges and opportunities related to diversity and inclusion, as experienced by early and mid-career academics employed in medicine, dentistry and health sciences. We screened and appraised articles, then extracted and synthesised data. RESULTS: Database searches identified 1162 articles, 11 met inclusion criteria. Studies varied in quality, primarily reporting concepts encompassed by professional identity. There were limited findings relating to social identity, with sexual orientation and disability being a particularly notable absence, and few findings relating to inclusion. Job insecurity, limited opportunities for advancement or professional development, and a sense of being undervalued in the workplace were evident for these academics. CONCLUSIONS: Our review identified overlap between academic models of wellbeing and key opportunities to foster inclusion. Challenges to professional identity such as job insecurity can contribute to development of illbeing. Future interventions to improve wellbeing in academia for early- and mid-career academics in these fields should consider addressing their social and professional identity, and foster their inclusion within the academic community. REGISTRATION: Open Science Framework ( https://doi.org/10.17605/OSF.IO/SA4HX ).

A PHASE 1B STUDY OF ZOTATIFIN FOR THE TREATMENT OF MILD TO MODERATE COVID (PROpel)

Background: Zotatifin (eFT226) is a potent and selective inhibitor of eukaryotic initiation factor 4A (eIF4A), a host RNA helicase required for SARS-CoV-2 replication. In vitro, zotatifin demonstrates broad spectrum antiviral activity against all human coronaviruses tested. Zotatifin has physicochemical and pharmacokinetic (PK) properties suitable for convenient, single subcutaneous (sc) injection. This study assessed the safety, antiviral activity, and PK of zotatifin in non-hospitalized patients (pts) with mild/moderate COVID. Method(s): PROPEL is a randomized, placebo-controlled, double-blind study in non-hospitalized pts with mild/moderate COVID. At randomization, pts must have had a SARS-CoV-2 positive test within 7 days and at least 1 COVID symptom. Pts were randomized (3:1) to zotatifin or placebo sc in 3 cohorts of 12 pts each. Cohort 1, 2 and 3 received a single dose (SD) of zotatifin of 0.01. 0.02 and 0.035 mg/kg or matching placebo. Safety (adverse event (AE) and laboratory tests), antiviral activity (mid-turbinate nasal swabs and saliva), and plasma PK were collected over 30 days. The primary endpoint was safety;key secondary endpoints included SARS-CoV-2 viral load (VL) and PK. The study was not powered for statistical inferential testing. Result(s): 36 pts were enrolled across all three cohorts and completed a 30-day follow up. Data is currently available for pts in cohorts 1 and 2, 18 and 6 of whom received zotatifin and placebo, respectively. Baseline characteristics were comparable between groups. The most common AE was erythema at injection site in cohort 1 (44%) and cohort 2 (89%), vs. 0% in the zotatifin and pooled placebo groups, respectively. Other AE frequencies were comparable between zotatifin and placebo and no serious AEs were reported. The concentrationtime profile of zotatifin from cohorts 1 and 2 following sc administration was similar to that reported previously following IV administration, demonstrated a terminal elimination half-life (t1/2) of ~ 4 days, high steady-state volume of distribution (Vss) of 31 L/kg, and low plasma clearance (Cl) of 3.9 mL/min/kg. A faster time to viral RNA undetectability was observed with zotatifin vs. placebo (see Fig 1. Not statistically significant). Conclusion(s): Zotatifin was safe, well tolerated and demonstrated a trend in clinical antiviral activity in patients with mild to moderate COVID which supports further clinical development. Zotatifin sc route of administration supports a point of care treatment for COVID.

Blessed be the ties that bind: Mid-councils' impact on organizational identity and membership identification in the presbyterian church (USA) during COVID-19

This constructivist grounded theory study examined practices of shaping and maintaining organizational identity and membership identification at the Mid-council level of the Presbyterian Church (USA), resulting in a model that portrays how the global pandemic generated an inflection point for leadership. Studying denominational judicatories offered a unique perspective on the impact of physical distancing on efforts to establish and maintain organizational identity and membership identification. The COVID-19 pandemic offered an opportunity to discern how leadership facilitated the communication of organizational identity and the fostering of membership identification by paying specific attention to the use of symbols during this time when communal gatherings, meetings, and traditional rituals were made impossible.After providing an overview of the study, including the study's purpose and research questions, I provide an examination of current literature in the areas of organizational identity, organizational identification, and the use of symbols in organizational culture with an emphasis on the use of rituals. Twelve different Presbyteries were researched using interviews, observations, document analysis, and focus groups as data collection methods. These mid-councils were selected to reflect equal numbers of small, medium, and large presbyteries (based on overall membership) from various parts of the country. The data acquired from these sources formed the basis for a theory that explains how the COVID-19 pandemic generated an inflection point for strengthening and weakening organizational identity for different presbyteries (i.e., mid-councils) and how underlying factors helped to determine their subsequent trajectories. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Circulating mid-regional proadrenomedullin is a predictor of mortality in patients with COVID-19: a systematic review and meta-analysis.

BACKGROUND: Although there is increasing understanding of the changes in the laboratory parameters of Coronavirus disease 2019 (COVID-19), the correlation between circulating Mid-regional Proadrenomedullin (MR-proADM) and mortality of patients with COVID-19 is not fully understood. In this study, we conducted a systematic review and meta-analysis to evaluate the prognostic value of MR-proADM in patients with COVID-19. METHODS: The PubMed, Embase, Web of Science, Cochrane Library, Wanfang, SinoMed and Chinese National Knowledge Infrastructure (CNKI) databases were searched from 1 January 2020 to 20 March 2022 for relevant literature. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) was used to assess quality bias, STATA was employed to pool the effect size by a random effects model, and potential publication bias and sensitivity analyses were performed. RESULTS: 14 studies comprising 1822 patients with COVID-19 met the inclusion criteria, there were 1145 (62.8%) males and 677 (31.2%) females, and the mean age was 63.8 ± 16.1 years. The concentration of MR-proADM was compared between the survivors and non-survivors in 9 studies and the difference was significant (P < 0.01), I2 = 46%. The combined sensitivity was 0.86 [0.73-0.92], and the combined specificity was 0.78 [0.68-0.86]. We drew the summary receiver operating characteristic (SROC) curve and calculated the area under curve (AUC) = 0.90 [0.87-0.92]. An increase of 1 nmol/L of MR-proADM was independently associated with a more than threefold increase in mortality (odds ratio (OR) 3.03, 95% confidence interval (CI) 2.26-4.06, I2 = 0.0%, P = 0.633). The predictive value of MR-proADM for mortality was better than many other biomarkers. CONCLUSION: MR-proADM had a very good predictive value for the poor prognosis of COVID-19 patients. Increased levels of MR-proADM were independently associated with mortality in COVID-19 patients and may allow a better risk stratification.

The role of the mid-level bureaucracy in the COVID-19 pandemic

This article explores the effects of the COVID-19 pandemic on the performance of mid-level bureaucracy. This qualitative and exploratory investigation adopted the research strategy of a case study of the bureaucracy responsible for the social assistance policy of the city of Belo Horizonte, Brazil, in 2020. The research was conducted through bibliographic and documentary research and semi-structured interviews and questionnaires. The bureaucracy's perception of the changes in the intra-organizational dimensions of public administration caused by the pandemic was captured. It was possible to notice that the crisis affected the work system, the decision-making processes, the interactions with other actors, and the skills required for the performance of the functions of these government actors. The research showed that how the mid-level bureaucracy acted helps to understand the functioning of the service and the resilience of public policy in the context of crisis.

Idiopathic anomalous congenital band causing small intestinal obstruction in a 5-month-old dog

A 5-month-old, intact male, yellow Labrador retriever was presented with a 24-hour history of anorexia and vomiting. Abdominal imaging revealed the presence of a mechanical obstruction in the jejunum and peritoneal effusion. Cytologic evaluation and culture of the effusion prior to surgery identified a suppurative exudate with bacteria consistent with septic peritonitis and suspected to be related to the intestinal lesion. An exploratory laparotomy was performed, and a segment of jejunum was circumferentially severely constricted by an off-white, fibrous band of tissue. Resection and anastomosis of the strangulated segment of jejunum and excision of the constricting band provided resolution of the clinical signs. The dog made a complete recovery. Histologic evaluation revealed the band to be composed of fibrovascular and smooth muscle tissue, consistent with an idiopathic anomalous congenital band. No other gastrointestinal lesions were observed, either grossly at surgery or histologically in the resected segment of intestine. To our knowledge, a similar structure has not been reported in the veterinary literature.Copyright © 2022 Canadian Veterinary Medical Association. All rights reserved.

SYSTEM INTEGRATION FOR SMALL ENTERPRISES: SYSTEMATIC LITERATURE REVIEW

The impacts of COVID-19 are expected to shutter business performance globally. Though, very little early evidence on the impacts is recorded currently. Small business owners are expected to be hugely impacted compared to larger business counterparts. This is a result of limitations in financial capabilities, skills, and human resources. Small and Mid-size Enterprises (SMEs) play a crucial role in the resilience and sustainability of economic growth globally. An early-stage loss to business activity as a result of COVID-19 has significant implications for future economic inequality, income losses, and policy. This has triggered research into sustainability measures suitable for business maturity and to improve operational performance. Research is addressing issues ranging from developing a digital platform suitable for the collection of systems and automating its processes. This study complements publications that develop a technological and digital landscape by further expatiating on digital transformation issues and smart operational implementations in the context of SMEs. This study initiates by systematically identifying relevant contemporary publications on SME digitalization using the Scopus database. The documents are then reviewed by focusing on the crucial factors and current systems that influence the process of digital transformations for SMEs. The results facilitate sustainable business value and are crucial as a reference document that guides SMEs for future smart operational implementations. Copyright, American Society for Engineering Management, 2022.

Protein Energy Wasting and Clinical Outcomes of Children with Ckd2-5d- a Prospective Longitudinal Study

Introduction: Protein energy wasting (PEW) is an established entity in adults with CKD but is not well studied in children. The burden of PEW has been observed to be higher in Indian children with CKD compared to the chronic kidney disease in children (CKiD) cohort. The impact of PEW on outcomes needs to be addressed in these children with CKD. This prospective longitudinal study was undertaken in children with CKD 2-5D to assess the association of PEW with clinical outcomes of infection related hospital admissions (IRHA). Method(s): Children (age 2-18 years) with CKD 2-5D, from a tertiary care center were recruited for PEW assessment from January 2017 following ethical committee approval and informed consent. Children with evidence of infection in the last month and those on dialysis for less than a month were excluded. Demographic characteristics and clinical outcomes of hospital admissions were recorded till June 2022. Based on the CKiD study, PEW was diagnosed and categorized using 5 criteria: 1. Muscle mass (Mid arm muscle circumference);2. Body mass (body mass index);3. Biochemical parameters (serum cholesterol, serum albumin, serum transferrin, and C-reactive protein);4: Appetite and 5. Short stature. PEW was further categorized as mild (> 2 criteria), standard (> 3 criteria), and modified (> 3 criteria with short stature). Infections that needed hospitalization included viral hemorrhagic fever, COVID-19 infection, sepsis, urinary tract infection, lower respiratory tract infection, peritonitis, and catheter-related blood stream infection. Result(s): Among 136 children (45 on dialysis, mean age 122 + 46 months, 70% males) 72 (53%) had PEW. The proportions of those with mild, standard, and modified PEW were 8%, 13%, and 32% respectively. Over a mean follow-up of 38 + 21 months, 104 (76%) children required hospital admissions of which 69% were due to infections. Death was noted in 2%, and 12% got transplanted. The proportion of children needing hospital admissions was significantly higher in those with PEW compared to those without PEW (85% vs 66% respectively, p=0.011). IRHA was observed in 68% of children with PEW compared to 36% without PEW (p<0.001). The proportion of IRHA in those with dialysis with or without PEW ((87% vs 50%, p=0.001) was significantly higher compared to those with CKD 2-5 (54% vs 32%, p= 0.03). In the overall cohort, the proportion of IRHA was significantly higher with modified PEW compared to other PEW categories (p<0.001), [modified: 74.4%, standard: 58.0%, mild: 59%, no PEW: 36%]. On multivariable analysis, by adjusting for age, gender, etiology of CKD, and dialysis, the presence of PEW and dialysis status were independent factors associated with IRHA [Adjusted OR 3.58 (1.62,7.89), p=0.002] and [OR 3.29 (1.4,7.75), p=0.006, respectively]. Similarly, the presence of inflammation was independently associated with IRHA [OR 3.93 (1.49, 10.3), p=0.002]. Figure 1 shows the risk factors associated with IRHA based on PEW categories and inflammation status. [Formula presented] Conclusion(s): In children with CKD 2-5D, the presence of PEW and inflammation were significantly associated with IRHA. Children with modified PEW had nearly 5 times more risk of developing IRHA, reinforcing the importance of growth as a unique parameter of PEW in these children. No conflict of interestCopyright © 2023

SYNTHESIS AND EVALUATION OF LO-FI LOW-LOAD HEARING AIDS MODULE WITH PIEZO FILM AND CONDUCTIVE POLYMER

We fabricated a capacitor-type actuator with laminated conductive polymer on both sides of the piezoelectric film and evaluated basic acoustic characteristics. This actuator is applied to our new 'Auditory AR (Augmented Reality) device' which enables users to hear both real and virtual sound information. We carried out measurements of those actuator-characteristics in a cylindrical frame with constant curvature, the same with our AR device. The AC (Alternating Current) amplification characteristics simply increase quasi-linearly within the audio band, and saturate at about 10 kHz, near the upper limit of audio frequency. We applied the autocorrelation analysis method to evaluate the verbal speech transmission efficiency, without human examinee, because of the global pandemic of the COVID-19, and successfully estimated the transmission clarity under the "Virus-free" circumstances. We developed a 'vector effective duration model' to evaluate users' verbal cognitive clarity, only with physical measurement without human subjects. In the low-frequency band below 1 kHz and in the ultra-high-frequency band above 10 kHz, beyond auditory bands, the frame-mounted actuator shows conspicuous attenuation. In the mid-frequency band between 1 kHz and 10 kHz, i.e., higher area of the audio band, selectively amplified frequency components are observed. This mid-frequency band primarily conveys the semantic content of spoken language. This area is the band for "whispering". Our actuator amplifies this "whispering band" in harmonic ways effectively and is suitable for a "Lo-Fi auditory module" that cuts off unnecessary low- and high-frequency bands;auditory organs are mostly exhausted with physical impacts conveyed by those low-frequency components, and they transmit more emotional information than verbal meanings. Users can use this module all day long without auditory fatigue. Renewals in hearing aids and welfare technologies are expected. © International Institute of Acoustics and Vibration (IIAV), 2022.

The clinical effectiveness and validity of home spirometry in children with cystic fibrosis

Introduction: During the COVID-19 pandemic, home spirometry became essential for continued monitoring of cystic fibrosis patients, however, the clinical effectiveness was unknown. Aim(s): The aims of this study were to assess the success rate of testing patients at home and to compare the home spirometry and lab spirometry results Methods: 147 home spirometry devices (Air Next, NuvoAir, USA) were given out to cystic fibrosis patients (M:F 67:80;mean age 11.8 [4.7 - 17.3]) who had previous experience of spirometry and deemed to be competent to perform spirometry at home. Patients were asked to perform 4 tests in the first month, then 1 test per month unless clinically requested. When Lab spirometry resumed, 28 (M:F 12:16;mean age 13.1 [8.0-17.0]) patients tested on NuvoAir within 5 days (mean 0.7 days (1.0)) of Lab spirometry (Vyntus Spiro, Vyaire Medical, USA). Correlation between spirometry indices were analysed using linear regression. Result(s): 142 patients (96.6%) successfully onboarded onto the NuvoAir platform. Between July 2020 and Jan 2022, 1854 tests were performed, with 1711 (92.3%) tests over-read to be valid. 54 patients (36.7%) performed >=15 tests requested. FEV1 (R2 = 0.93, p = <0.00), FVC (R2 = 0.91, p = <0.00), MMEF (R2 = 0.87, p = <0.00) and PEF (R2 = 0.88, p = <0.00) all showed significant correlation between Lab spirometry and Home spirometry. Conclusion(s): Our results show that home spirometry is well adopted by cystic fibrosis patients and they are able to perform valid loops on this device. Continual encouragement may be required to achieve good trend data. There is also close agreements between this home spirometry device and the gold standard of laboratory spirometry.

Procalcitonin and Adrenomedullin in Infectious Diseases

Calcitonin (CT) and adrenomedullin (ADM) are members of the CT family. Procalcitonin (PCT) is a prohormone of CT. Elevations in serum PCT and ADM levels are associated with severe sepsis and coronavirus disease 2019 (COVID-19). PCT enhances sepsis mortality and it binds to the CGRP receptor, which is a heterodimer of CT receptor-like receptor and receptor activity-modifying protein 1. The N-terminal truncated form of PCT, PCT3-116, is produced by the cleavage of PCT by dipeptidyl peptidase 4 (DPP-4) and is the main form of PCT in serum during sepsis, inducing microvascular permeability. Mid-regional pro-adrenomedullin (MR-proADM) is used instead of ADM as a biological indicator because ADM is rapidly degraded, and MR-proADM is released at the same rate as ADM. ADM reduces endothelial permeability and promotes endothelial stability. Endothelial dysfunction is responsible for multiple organ failure in sepsis and COVID-19 patients. Therefore, ADM may be an important molecule for improving the severity associated with sepsis and COVID-19. This review focuses on the current knowledge of PCT and ADM in sepsis and COVID-19.Copyright © 2023 by the authors.

Understanding the Capacities of Mid-Level Supervisors in Addressing Burnout Resulting from the COVID-19 Pandemic: An Interpretive Phenomenological Analysis

The purpose of this Interpretative Phenomenological Analysis study was to understand how mid-level professionals in student affairs experience their own capacity for and training experiences in minimizing burnout from stressors related to the COVID-19 pandemic at colleges and universities in New England. Herzberg's two factor theory of motivation served as the theoretical framework for this research study, as it described the how supervision can impact job satisfaction. Seven mid-level supervisors from New England colleges and universities participated in two semi-structured interviews. Findings from data analysis included: (a) mid-level supervisors are challenged with guiding staff through change where institutions of higher education struggle with adaptability;(b) supervisors understand empathy and constructive relationships as important supervisory capacities to minimize burnout;(c) while supervision can aid in minimizing burnout among direct reports, it may not individually address the pervasive and complex issue;and (d) supervisory capacity development in student affairs is experiential and lacking robust, formal training practices. This study illustrated how mid-level supervisors understood their abilities and limitations of reducing burnout within complex college and university environments. Recommendations from this study included implications for senior student affairs officers and human resources management including offering institutional specific, cohort-based supervisor training and development initiatives and improved supervisor onboarding processes. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Early childhood education and covid-19 pandemic: actions of middle-level bureaucrats in the Baixada Fluminense

The current article is a research clipping aimed at mapping actions associated with early childhood education that were taken by ten municipalities in Baixada Fluminense during the covid-19 pandemic, based on conversations with mid-level bureaucrats accounting for managing municipal education institutions. The adopted methodology comprised virtual meetings and questionnaire application. Remote teaching was adopted by these municipalities as temporary alternative to maintain the school year running, although there were many contradictions about the adopted pedagogical approach. This option has disregarded the fact that many children lived in social vulnerability contexts and that their families were concerned with material issues associated with subsistence, as well as with poor access to technological devices and services. Results have pointed towards disarticulation among federated entities, a fact that has hindered coordinators' actions. Thus, it is essential thinking about the place of these professionals in State's bureaucracy. © 2023,Revista Brasileira de Educacao.All Rights Reserved.

ELECTRICAL DISTRIBUTION: DEVELOPING A STRATEGIC PLAYBOOK FOR OPENING A NEW PROXIMITY EXPANSION LOCATION IN A DENSITY MARKET

Distributors' operational weaknesses and reliance on a few large customers became magnified during the 2019-2021 covid pandemic. In today's B2B marketplace post-pandemic, the distributor has new challenges to grow market share, meet "Amazon” expectations for B2B customers, and overcome the loss of market share to competitors. For a distributor to support the small to the mid-market customer, proximity locations are needed to bring inventory, counter showrooms (will-call), and knowledgeable associates closer to the customer in a brick-and-mortar location. This paper will present a model and playbook to evaluate the current geographic footprint to best serve the small to mid-market customers. Growth initiatives to grow organically thru geographic expansion into new, adjacent, and proximity markets are researched to identify objective market indicators and subjective variables that can be weighted to determine and rank for future proximity locations. Research from "like” industries, competitors, and interviews, helped to ten variables for ranking. The research includes interviews with experts in B2B business and analysis of over 800 competitor locations in the electrical distributor's footprint. Competitor locations were mapped to showcase areas of brick-and-mortar (expansion) opportunities, threats, and saturation. Data from an electrical distributor who opened two new test proximity locations during the project is used to determine post-Covid-19 customer behavior, evaluate financial analytics to refine Pro-forma, and outline for standardization for future expansion. The model and playbook can be used to drive data-driven decision-making and monetize efforts for pre-launch efforts of a proximity expansion location in a density market. Copyright, American Society for Engineering Management, 2022.

Breath analysis by ultra-sensitive broadband laser spectroscopy detects SARS-CoV-2 infection.

Rapid testing is essential to fighting pandemics such as coronavirus disease 2019 (COVID-19), the disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Exhaled human breath contains multiple volatile molecules providing powerful potential for non-invasive diagnosis of diverse medical conditions. We investigated breath detection of SARS-CoV-2 infection using cavity-enhanced direct frequency comb spectroscopy (CE-DFCS), a state-of-the-art laser spectroscopic technique capable of a real-time massive collection of broadband molecular absorption features at ro-vibrational quantum state resolution and at parts-per-trillion volume detection sensitivity. Using a total of 170 individual breath samples (83 positive and 87 negative with SARS-CoV-2 based on reverse transcription polymerase chain reaction tests), we report excellent discrimination capability for SARS-CoV-2 infection with an area under the receiver-operating-characteristics curve of 0.849(4). Our results support the development of CE-DFCS as an alternative, rapid, non-invasive test for COVID-19 and highlight its remarkable potential for optical diagnoses of diverse biological conditions and disease states.

Evaluation of a novel anterior nasal swab for the detection of SARS-CoV-2.

BACKGROUND: During the course of the COVID-19 pandemic, nasopharyngeal swabs, combined throat and nose swabs and saliva samples have been evaluated for SARS-CoV-2 detection using nucleic acid amplification tests (NAT). Literature on anterior nasal swabs is limited. We investigated a novel anterior nasal swab that has been designed to standardised self-collection, maximise sample uptake and improve user comfort. We used combined throat and nose swabs and neat saliva samples as the comparators. RESULTS: The overall positive percentage agreement between the Rhinoswab™ and the combined throat and nose swab was 95.2 % at day 2 post participant recruitment and 93.3 % on day 4 post participant recruitment. This was favourable to the positive percentage agreement with saliva at the same time points. CONCLUSION: In our study the Rhinoswab™ performed equally well in comparison to a combined throat and nose swab for the laboratory detection of SARS-CoV-2 using nucleic acid amplification techniques.

A novel capsule endoscopy for upper and mid-GI tract: the UMGI capsule.

BACKGROUNDS AND AIMS: Complete and consecutive observation of the gastrointestinal (GI) tract continues to present challenges for current endoscopy systems. We developed a novel upper and mid gastrointestinal (UMGI) capsule endoscopy using the modified detachable string magnetically controlled capsule endoscopy (DS-MCE) and inspection method and aimed to assess the clinical application. METHODS: Patients were recruited to undergo UMGI capsule endoscopy followed by esophagogastroduodenoscopy. All capsule procedures in the upper gastrointestinal (UGI) tract were conducted under the control of magnet and string. The main outcome was technical success, and the secondary outcomes included visualization of the UMGI tract, examination time, diagnostic yield, compliance, and safety evaluation. RESULTS: Thirty patients were enrolled and all UMGI capsule procedures realized repeated observation of the esophagus and duodenum with detection rates of 100.0%, 80.0%, and 86.7% of Z-line, duodenal papilla, and reverse side of pylorus, respectively. String detachment was succeeded in 29 patients (96.7%) and the complete examination rate of UMGI tract was 95.45% (21/22). All UMGI capsule procedures were well tolerated with low discomfort score, and had a good diagnostic yield with per-lesion sensitivity of 96.2% in UGI diseases. No adverse events occurred. CONCLUSIONS: This new capsule endoscopy system provides an alternative screening modality for the UMGI tract, and might be indicated in cases of suspected upper and small bowel GI bleeding. Trial registration DS-MCE-UGI and SB, NCT04329468. Registered 27 March 2020, https://clinicaltrials.gov/ct2/results?cond=&term=NCT04329468 .

Sensitivity to treatment and score bands of the Infants and Toddlers Dermatology Quality of Life questionnaire.

Background: The Infants and Toddlers Dermatology Quality of Life (InToDermQoL) questionnaire is the first dermatology-specific proxy health related QoL instrument for children from birth to 4 years. Score meaning bands and the sensitivity to successful therapeutic intervention are important to interpret the clinical meaning of an instrument. Objective: The aim of the present study was to check the sensitivity to successful therapeutic intervention and establish score bands of the InToDermQoL questionnaire. Methods: Parents or grandparents of 424 children with skin diseases from Spain, Malta, Croatia, Romania, Greece, and Ukraine filled in national language versions of the InToDermQoL questionnaire. Disease severity of children with atopic dermatitis was assessed by SCORAD (Scoring atopic dermatitis). Cohen's d was used to assess the responsiveness of the instrument. Results: The mean total InToDermQoL scores significantly decreased after treatment. Severity grading of the SCORAD scores gave stratification of the InToDermQoL severity grades based on 95% confidence intervals. Scores below a calculated minimal important difference of 2 corresponded to no effect on patient's health related QoL. Limitations: Score banding may be slightly different across patient population and study context. Conclusion: All 3 age-specific versions of the InToDermQoL questionnaire showed sensitivity to treatment. Score bands for the InToDermQoL questionnaire have been established.

Preparing for the unexpected in a COVID-19 world: The teaching dilemmas of a mid-semester faculty change

Despite the perceived rarity of mid-semester faculty changes, there is a shortage of literature to guide administrators and faculty on best practices for handing the dilemmas associated with mid-semester faculty changes. This is particularly concerning given the uncertainty of situations like the COVID-19 global pandemic and recent research that finds that future extreme epidemics are likely to happen. This paper seeks to answer two questions (1) What can faculty and administrators do to prepare students who are experiencing a mid-semester faculty change, and (2) What procedures and processes are in place to assist the incoming faculty? Data were collected through a survey of students who had underwent a mid-semester faculty change and interviews with administrators who deal with personnel issues like this one. The data suggest faculty should first meet with students to assess their progress before jumping into an established lesson plan (the opposite of how faculty normally prepare to teach a class). Clear communication about expectations, organization of the course materials, and instructor flexibility was identified as keys to student success during a teaching disruption. These findings align with decades of research on teaching and learning. Administrators should create contingency plans that go beyond the personnel transaction and that help faculty quickly prepare for a transition that is student focused. More research is needed to identify the best administrative processes and procedures to assist faculty in a smooth transition when taking over a course mid-semester. © University of Deusto.

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.