Associated Fungal Infections, Related to the Global Covid-19 Pandemic (Literature Review)

The 2019 coronavirus disease (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has swept the globe. Based on a retrospective analysis of SARS and influenza data from China and around the world, we suggest that fungal co-infections associated with global COVID-19 may be missed or misdiagnosed. Although there are few publications, patients with COVID-19, especially severely ill or immunocompromised patients, are more likely to develop invasive mycoses. Aspergillus and Candida infections in patients with COVID-19 will require early detection by comprehensive diagnostic intervention (histopathology, direct microscopy, culture, (Arabian: 2004, Tilavberdiev: 2016) -β-D-glucan, galactomannan, and PCR assays) to ensure effective treatment. We consider it appropriate to assess risk factors, types of invasive mycoses, strengths and weaknesses of diagnostic methods, clinical conditions, and the need for standard or individual treatment

How Has the COVID-19 Pandemic Affected Students’ Online Social Presence?

The coronavirus disease 2019 pandemic has affected higher education institutions worldwide as they had to switch from face-to-face to online teaching almost overnight. This abrupt change made a huge impact on teaching, learning, and particularly, student engagement. This paper focuses on online social presence as an element of student engagement, which represents how students feel under synchronous online teaching. A survey was conducted among 244 first-year students to evaluate the impact of online social interaction, online collaboration, online contact with staff, online engagement, and online active learning on online social presence. Structural equation modeling was used to test and evaluate these multivariate relationships. Our study illustrates that all variables have a significant positive relationship with online social presence. In particular, online social interaction and online collaboration show a more powerful relationship with student online social presence. Thus, digital technologies should be adopted in a way that encourages students to actively interact with their peers

The Vehicle Routing Problem with Profits and Consistency Constraints

This paper models and solves a new transportation problem of practical importance; the Consistent Vehicle Routing Problem with Pro fits. There are two sets of customers, the frequent customers that are mandatory to service and the non-frequent potential customers with known and estimated profit s respectively, both having known demands and service requirements over a planning horizon of multiple days. The objective is to determine the vehicle routes that maximize the net profit, while satisfying vehicle capacity, route duration and consistency constraints. A new mathematical model is proposed that captures the pro fit collecting nature, as well as other features of the problem. For addressing this computationally challenging problem, an Adaptive Tabu Search has been developed, utilizing both short- and long-term memory structures to guide the search process. The proposed metaheuristic algorithm is evaluated on existing, as well as newly generated benchmark problem instances. Our computational experiments demonstrate the effectiveness of our algorithm, as it matches the optimal solutions obtained for small-scale instances and performs well on large-scale instances. Lastly, the trade-off between the acquired pro fits and consistent customer service is examined and various managerial insights are derived

Acceptability and feasibility of an isometric resistance exercise program for abdominal cancer surgery: An embedded qualitative study

Although it is recognized in the early stages of cancer recovery that changes in lifestyle including increases in physical activity improves physical function, there are no clear findings whether low versus moderate intensity activity or home or gym exercise offer optimal benefit. Isometric-resistance exercises can be carried out with very little equipment and space and can be performed while patients are bed-bound in hospital or at home. This embedded qualitative study, based in an English hospital trust providing specialist cancer care, was undertaken as a component of a feasibility trial to evaluate the acceptability and feasibility of an isometric-resistance exercise program and explore the suitability of functional assessments by drawing from the experiences of abdominal cancer patients following surgery. Telephone interviews were undertaken with 7 participants in the intervention group, and 8 interviews with the usual care group (n¼ 15). The gender composition consisted of 11 females and 4 males. Participants’ ages ranged from 27 to 84 (M¼ 60.07, SD ¼ 15.40). Interviews were conducted between August 2017 and May 2018, with audio files digitally recorded and data coded using thematic framework analysis. Our results show that blinding to intervention or usual care was a challenge, participants felt the intervention was safe and suitable aided by the assistance of a research nurse, yet, found the self-completion questionnaire tools hard to complete. Our study provides an insight of trial processes, participants’ adherence and completion of exercise interventions, and informs the design and conduct of larger RCTs based on the experiences of abdominal cancer surgery patients

Investigations of an increased incidence of non-Aspergillus invasive mould infections in an onco-haematology unit.

Invasive mould infections are life-threatening complications in patients with haematologic cancer and chemotherapy-induced neutropenia. While invasive aspergillosis represents the main cause of invasive mould infections, non-Aspergillus mould infections, such as mucormycosis, are increasingly reported. Consequently, their local epidemiology should be closely monitored. The aim of this study was to investigate the causes of an increased incidence of non-Aspergillus mould infections in the onco-haematology unit of a Swiss tertiary care hospital. All cases of proven and probable invasive mould infections were retrospectively identified via a local registry for the period 2007-2021 and their incidence was calculated per 10,000 patient-days per year. The relative proportion of invasive aspergillosis and non-Aspergillus mould infections was assessed. Factors that may affect invasive mould infections' incidence, such as antifungal drug consumption, environmental contamination and changes in diagnostic approaches, were investigated. A significant increase of the incidence of non-Aspergillus mould infections (mainly mucormycosis) was observed from 2017 onwards (Mann and Kendall test p = 0.0053), peaking in 2020 (8.62 episodes per 10,000 patient-days). The incidence of invasive aspergillosis remained stable across the period of observation. The proportion of non-Aspergillus mould infections increased significantly from 2017 (33% vs 16.8% for the periods 2017-2021 and 2007-2016, respectively, p = 0.02). Building projects on the hospital site were identified as possible contributors of this increase in non-Aspergillus mould infections. However, novel diagnostic procedures may have improved their detection. We report a significant increase in non-Aspergillus mould infections, and mainly in mucormycosis infections, since 2017. There seems to be a multifactorial origin to this increase. Epidemiological trends of invasive mould infections should be carefully monitored in onco-haematology units in order to implement potential corrective measures

Conidiobolus pachyzygosporus invasive pulmonary infection in a patient with acute myeloid leukemia: case report and review of the literature.

Conidiobolus spp. (mainly C. coronatus) are the causal agents of rhino-facial conidiobolomycosis, a limited soft tissue infection, which is essentially observed in immunocompetent individuals from tropical areas. Rare cases of invasive conidiobolomycosis due to C. coronatus or other species (C.incongruus, C.lamprauges) have been reported in immunocompromised patients. We report here the first case of invasive pulmonary fungal infection due to Conidiobolus pachyzygosporus in a Swiss patient with onco-haematologic malignancy. A 71 year-old female was admitted in a Swiss hospital for induction chemotherapy of acute myeloid leukemia. A chest CT performed during the neutropenic phase identified three well-circumscribed lung lesions consistent with invasive fungal infection, along with a positive 1,3-beta-d-glucan assay in serum. A transbronchial biopsy of the lung lesions revealed large occasionally septate hyphae. A Conidiobolus spp. was detected by direct 18S rDNA in the tissue biopsy and subsequently identified at species level as C. pachyzygosporus by 28S rDNA sequencing. The infection was cured after isavuconazole therapy, recovery of the immune system and surgical resection of lung lesions. This is the first description of C. pachyzygosporus as human pathogen and second case report of invasive conidiobolomycosis from a European country

The impact generated by public and charity-funded research in the UK: A systematic literature review

Objective: To identify, synthesize and critically assess the empirical evidence of the impact generated by public and charity funded health research in the United Kingdom. Methods: We conducted a systematic literature review of the empirical evidence published in English in peer-reviewed journals between 2006 and 2017. Studies meeting the inclusion criteria were selected and their findings were analysed using the Payback Framework into five main categories: knowledge, benefits to future research and research use, benefits from informing policy and product development, health and health sector benefits and broader economic benefits. We assessed the studies for risk of selection, reporting and funding bias. Results: Thirteen studies met the inclusion criteria. The majority of the studies (10 out of 13) assessed impact at multiple domains including the main 5 key themes of the Payback Framework. All of them showed a positive impact of funded research on outcomes. Of those studies, one presented low risk of bias (8%), 6 studies were classified as presenting moderate risk of bias (46%) and 6 studies presented high risk of bias (46%). Conclusions: Empirical evidence on the impact of public and charity funded research is still limited and subject to funding and selection bias. More work is needed to establish the causal effects of funded research on academic outcomes, policy, practice and the broader economy

Effects of pre- and post-operative resistance exercise interventions on recovery of physical function in patients undergoing abdominal surgery for cancer: A systematic review of randomised controlled trials

Objective: To systematically review the effects of pre- and post-operative resistance exercise training on the recovery of physical function in patients undergoing abdominal surgery for cancer. Data sources: A systematic review of English articles using Medline, PEDro, Cinahl and The Cochrane Library electronic databases was undertaken. Eligibility criteria for selecting studies: Studies were included if they used a randomised, quasi-randomised, or controlled trial study design and compared the effects of a muscle-strengthening exercise intervention (+/- other therapy) with a comparative non-exercise group; involved adult participants (≥18 years) who had elected to undergo abdominal surgery for cancer; and used muscle strength, physical function, self-reported functional ability, range of motion and/or a performance-based test as an outcome measure. Results: Following screening of titles and abstracts of the 588 publications retrieved from the initial search, 24 studies met the inclusion criteria and were accessed for review of the full-text version of the article and 2 eligible met the inclusion criteria and were included in the review. One exercise programme was undertaken pre-operatively and the other post-operatively, until discharge from hospital. There were no differences between groups in either study. Conclusion: The only two studies designed to determine whether pre- or post-operative resistance muscle-strengthening exercise programmes improved or negatively affected physical function outcomes in patients undergoing abdominal surgery for cancer provide inconclusive results. The exercise interventions of the included studies were performed for 5 and 8 session respectively

Ontogenic changes in hematopoietic hierarchy determine pediatric specificity and disease phenotype in fusion oncogene-driven myeloid leukemia

Fusion oncogenes are prevalent in several pediatric cancers, yet little is known about the specific associations between age and phenotype. We observed that fusion oncogenes, such as ETO2–GLIS2, are associated with acute megakaryoblastic or other myeloid leukemia subtypes in an age-dependent manner. Analysis of a novel inducible transgenic mouse model showed that ETO2–GLIS2 expression in fetal hematopoietic stem cells induced rapid megakaryoblastic leukemia whereas expression in adult bone marrow hematopoietic stem cells resulted in a shift toward myeloid transformation with a strikingly delayed in vivo leukemogenic potential. Chromatin accessibility and single-cell transcriptome analyses indicate ontogeny-dependent intrinsic and ETO2–GLIS2-induced differences in the activities of key transcription factors, including ERG, SPI1, GATA1, and CEBPA. Importantly, switching off the fusion oncogene restored terminal differentiation of the leukemic blasts. Together, these data show that aggressiveness and phenotypes in pediatric acute myeloid leukemia result from an ontogeny-related differential susceptibility to transformation by fusion oncogenes. SIGNIFICANCE: This work demonstrates that the clinical phenotype of pediatric acute myeloid leukemia is determined by ontogeny-dependent susceptibility for transformation by oncogenic fusion genes. The phenotype is maintained by potentially reversible alteration of key transcription factors, indicating that targeting of the fusions may overcome the differentiation blockage and revert the leukemic state