Towards the Betterment of Workers’ Quarters Within Construction Site in Light of Covid-19 Pandemic : Case Study of Workers’ Quarters in Kuching City South, Sarawak

Covid-19 pandemic has been the cause of the most significant global revolution in recent times. The attack from an invisible enemy had caught the world unprepared since its first reported outbreak from Wuhan, China, in 2019. As a result, challenges arising from that of unimaginable proportions soon followed suit, and the world felt the impact of those challenges on so many levels. Most of the economy’s industries had been greatly affected, with the construction industry being one of the hardest hit. Sarawak’s construction industry is not spared either, as several construc-tion site clusters resulting from workers’ quarters popped up from the circle. The scenario creates awareness of the importance of improving the quality of workers’ quarters. The Sarawak State Government, through its Ministry of Public Health, Housing and Local Government, had formulated a guideline for Local Authorities on the temporary permit application for workers’ quarters’ building within construc-tion sites. The response of the permit is studied using a qualitative approach through a case study of workers’ quarters within construction sites in the jurisdiction of Kuching City South as the primary research method. The study is mainly based on observation and literature review and discusses the permit implementation response among the construction industry players. The findings from this paper conclude that the implementation of the permit could be observed further to capture a greater level of compliance and accountability to improve the quality of workers’ quarters for occupational safety and the general health of labourers

Enhanced Determination of Streptococcus pneumoniae Serotypes Associated with Invasive Disease in Laos by Using a Real-Time Polymerase Chain Reaction Serotyping Assay with Cerebrospinal Fluid

A prospective hospital-based study was undertaken to define the incidence of invasive pneumococcal disease (IPD) and circulating serotypes in Laos. Of 10,799 patients with hemocultures and 353 patients with cerebrospinal fluid samples, 0.21% and 5.4%, respectively, were positive for Streptococcus pneumoniae, giving a total of 35 IPD patients. We developed a real-time polymerase chain reaction to detect serotypes represented in the 13-valent pneumococcal vaccine. A blinded evaluation comparing serotype as defined by the Quellung reaction versus the polymerase chain reaction demonstrated 100% concordance. The most frequent serotype (n = 33 patients) was 1 (n = 6), followed by serotypes 5, 6A/B/C, 14, and 23F. Serotypes represented in the 7-valent polysaccharide-protein conjugate vaccine (PCV-7) infected 39% of patients, with 73% coverage for the PCV-10 and PCV-13 vaccines. Although the sample size is small, these data suggest that the PCV-7 vaccine may have relatively low efficacy in Laos. Further studies are urgently needed to guide pneumococcal vaccine policy in Laos

Erratum to: Methods for evaluating medical tests and biomarkers

[This corrects the article DOI: 10.1186/s41512-016-0001-y.]

Evidence synthesis to inform model-based cost-effectiveness evaluations of diagnostic tests: a methodological systematic review of health technology assessments

Background: Evaluations of diagnostic tests are challenging because of the indirect nature of their impact on patient outcomes. Model-based health economic evaluations of tests allow different types of evidence from various sources to be incorporated and enable cost-effectiveness estimates to be made beyond the duration of available study data. To parameterize a health-economic model fully, all the ways a test impacts on patient health must be quantified, including but not limited to diagnostic test accuracy. Methods: We assessed all UK NIHR HTA reports published May 2009-July 2015. Reports were included if they evaluated a diagnostic test, included a model-based health economic evaluation and included a systematic review and meta-analysis of test accuracy. From each eligible report we extracted information on the following topics: 1) what evidence aside from test accuracy was searched for and synthesised, 2) which methods were used to synthesise test accuracy evidence and how did the results inform the economic model, 3) how/whether threshold effects were explored, 4) how the potential dependency between multiple tests in a pathway was accounted for, and 5) for evaluations of tests targeted at the primary care setting, how evidence from differing healthcare settings was incorporated. Results: The bivariate or HSROC model was implemented in 20/22 reports that met all inclusion criteria. Test accuracy data for health economic modelling was obtained from meta-analyses completely in four reports, partially in fourteen reports and not at all in four reports. Only 2/7 reports that used a quantitative test gave clear threshold recommendations. All 22 reports explored the effect of uncertainty in accuracy parameters but most of those that used multiple tests did not allow for dependence between test results. 7/22 tests were potentially suitable for primary care but the majority found limited evidence on test accuracy in primary care settings. Conclusions: The uptake of appropriate meta-analysis methods for synthesising evidence on diagnostic test accuracy in UK NIHR HTAs has improved in recent years. Future research should focus on other evidence requirements for cost-effectiveness assessment, threshold effects for quantitative tests and the impact of multiple diagnostic tests

Erratum to: Methods for evaluating medical tests and biomarkers

[This corrects the article DOI: 10.1186/s41512-016-0001-y.]

The effects of unilateral concentric isokinetic training on muscle cross-sectional area

The purposes of this study were to (1) determine the effect of concentric isokinetic training on the cross-sectional area (CSA) of selected extensor and flexor muscles of the forearm and leg, (2) examine the potential for preferential hypertrophy of individual muscles within a muscle group, (3) identify the location (proximal, middle, or distal) of hypertrophy within an individual muscle, and (4) determine the effect of unilateral concentric isokinetic training on muscular strength and hypertrophy in the contralateral limb. Thirteen male college students (X $\pm$ SD age = 25.08 $\pm$ 6.13) volunteered to perform six sets of ten repetitions of forearm and leg extension and flexion of the non-dominant extremities three days per week for eight weeks, using a Cybex II isokinetic dynamometer. Pre-training and post-training peak torque and muscle CSA measurements for both the dominant and non-dominant extremities were determined utilizing a Cybex II isokinetic dynamometer and magnetic resonance imaging (MRI) scanner, respectively. The results of repeated measures ANOVA analyses indicated significant (p $\u3c$ 0.01) hypertrophy in all trained muscle groups as well as preferential hypertrophy of individual muscles and at specific locations within the semitendinosus and biceps femoris muscles. The only muscle that demonstrated hypertrophy on the contralateral side was the semitendinosus at the proximal level. In addition, significant (p $\u3c$ 0.01) increases in peak torque occurred for all movements on the trained side and only leg flexion on the contralateral side

Comparative Effectiveness of Ceftriaxone plus Metronidazole versus Anti-Pseudomonal Antibiotics for Perforated Appendicitis in Children.

Background: Appendicitis is the most common pediatric surgical emergency and one of the most common indications for antibiotic use in hospitalized children. The antibiotic choice differs widely across children's hospitals, and the optimal regimen for perforated appendicitis remains unclear. Methods: We conducted a retrospective cohort study comparing initial antibiotic regimens for perforated appendicitis at a large tertiary-care children's hospital. Children hospitalized between January 2011 and March 2015 who underwent surgery for perforated appendicitis were identified by ICD-9 codes with confirmation by chart review. Patients were excluded if they had been admitted 6548 hours prior to diagnosis, had a history of appendicitis, received inotropic agents, were immunocompromised, or were given an antibiotic regimen other than ceftriaxone plus metronidazole (CTX/MTZ) or an anti-pseudomonal drug (cefepime, piperacillin/tazobactam, ciprofloxacin, imipenem, or meropenem) within the first two days after diagnosis. The primary outcome of interest was post-operative complications, defined as development of an incisional infection or abscess within six weeks of hospital discharge. Results: Of the 353 children who met the inclusion criteria, 252 (71%) received CTX/MTZ and the others received an anti-pseudomonal regimen. A post-operative complication occurred in 37 (14.7%) of the CTX/MTZ group versus 18 (17.8%) of the anti-pseudomonal group. Antibiotic-related complications occurred in 4.4% of children on CTX/MTZ and 6.9% of children on anti-pseudomonal antibiotics (p = 0.32). In a multivariable logistic regression model adjusting for sex, age, ethnicity, and duration of symptoms prior to presentation, the adjusted odds ratio for post-operative complications in children receiving anti-pseudomonal antibiotics was 1.25 (95% confidence interval 0.66-2.40). Conclusion: Post-operative complication rates did not differ for children treated with CTX/MTZ versus a broader-spectrum regimen

Epidemiology, clinical characteristics, and Outcomes of 4546 Adult Admissions to High-Dependency and ICUs in Kenya: A multicenter registry-based observational study.

OBJECTIVES: To describe clinical, management, and outcome features of critically ill patients admitted to ICUs and high-dependency units (HDUs) in Kenya. DESIGN: Prospective registry-based observational study. SETTING: Three HDUs and eight ICUs in Kenya. PATIENTS: Consecutive adult patients admitted between January 2021 and June 2022. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Data were entered in a cloudbased platform using a common data model. Study endpoints included casemix variables, management features, and patient-centered outcomes. Patients with COVID-19 were reported separately. Of the 3892 of 4546 patients without COVID-19, 2445 patients (62.8%) were from HDUs, and 1447 patients (37.2%) were from ICUs. Patients had a median age of 53 years (interquartile range [IQR] 38–68), with HDU patients being older but with a lower severity (Acute Physiology and Chronic Health Evaluation II 6 [3–9] in HDUs vs. 12 [7–17] in ICUs; p \u3c 0.001). One in four patients was postoperative with 604 (63.4%) receiving emergency surgery. Readmission rate was 4.8%. Hypertension and diabetes were prevalent comorbidities, with a 4.0% HIV/AIDS rate. Invasive mechanical ventilation was applied in 3.4% in HDUs versus 47.6% in ICUs (p \u3c 0.001), with a duration of 7 days (IQR 3–21). There was a similar use of renal replacement therapy (4.0% vs. 4.7%; p \u3c 0.001). Vasopressor use was infrequent while half of patients received antibiotics. Average length of stay was 2 days (IQR 1–5). Crude HDU mortality rate was 6.5% in HDUs versus 30.5% in the ICUs (p \u3c 0.001). Of the 654 COVID-19 admissions, most were admitted in ICUs (72.3%) with a 33.2% mortality. CONCLUSIONS: We provide the first multicenter observational cohort study from an African ICU National Registry. Distinct management features and outcomes characterize HDU from ICU patients