关键词： SOCIAL ENTERPRISES   EMPLOYMENT CENTERS   FINANCIAL ANALYSIS   PERFORMANCE   ECONOMY   ENTREPRENEURSHIP   ORGANIZATIONS   LEVERAGE   MISSION   MODELS  

摘要： The socio-labor inclusion of people with disabilities represents a substantial social challenge in European countries, particularly in Spain. Sheltered Workshops (SWs), a type of Work Integration Social Enterprise, are companies specifically designed to provide employment opportunities for individuals with disabilities, offering ongoing support throughout the integration process. SWs need to be profitable to sustain their social contributions. This study investigates the determinants of profitability for SWs in Spain, analyzing a sample of 1133 entities from 2010 to 2020. Using a static panel data model (random effects) and a dynamic panel data model (Generalized Method of Moments, GMM system), we estimate, among other factors, the impact of efficiency on profitability, with efficiency scores calculated via data envelopment analysis (DEA). Our findings reveal that the positive effect of operational efficiency outweighs the negative effect of social efficiency, resulting in a net positive impact of overall efficiency on profitability. The SWs were able to operate effectively to meet the needs of people with disabilities while achieving financial viability by combining social and economic goals. The study shows no significant differences in these effects when considering the legal status of the SWs (for-profit vs. non-profit). Additional factors influencing SW performance include size, low risk, and leverage, which have a positive impact, while age, liquidity, and tangibility generally have a negative and significant effect. During both the financial and COVID-19 crises, SWs experienced lower profitability; however, a positive and significant relationship between efficiency and profitability was observed during the COVID-19 crisis. The robustness of our results was confirmed through alternative measures of efficiency and performance and by addressing potential endogeneity issues. Understanding how financial and social factors influence profitability helps policymakers

关键词： COVID-19   Cardiovascular risk   Framingham Risk score   SCORE2-OP   LIFE-CVD  

摘要： BackgroundThe coronavirus disease 2019 (COVID-19) pandemic is associated with increases in morbidity and mortality worldwide. The mechanisms of how SARS-CoV-2 may cause cardiovascular (CV) complications are under investigation. The aim of the study was to assess the impact of the COVID-19 pandemic on CV *** are single-centre Bialystok PLUS (Poland) population-based and case-control studies. The survey was conducted between 2018 and 2022 on a sample of residents (n = 1507) of a large city in central Europe and patients 6-9 months post-COVID-19 infection (n = 126). The Systematic Coronary Risk Estimation 2 (SCORE2), the Systematic Coronary Risk Estimation 2-Older Persons (SCORE2-OP), the Cardiovascular Disease Framingham Heart Study and the LIFEtime-perspective model for individualizing CardioVascular Disease prevention strategies in apparently healthy people (LIFE-CVD) were used. Subsequently, the study populations were divided into CV risk classes according to the 2021 ESC Guidelines on cardiovascular disease prevention in clinical *** study population consisted of 4 groups: a general population examined before (I, n = 691) and during the COVID-19 pandemic (II, n = 816); a group of 126 patients post-COVID-19 infection (III); and a control group matched subjects chosen from the pre-COVID-19 pandemic (IV). Group II was characterized by lower blood pressure, low-density lipoprotein cholesterol (LDL-c) and high-density lipoprotein cholesterol (HDL-c) values than group I. Group III differed from the control group in terms of lower LDL-c level. There was no effect on CV risk in the general population, but in the population post-COVID-19 infection, CV risk was lower using FS-lipids, FS-BMI and LIFE-CVD 10-year risk scores compared to the prepandemic population. In all subgroups analysed, no statistically significant difference was found in the frequency of CV risk *** COVID-19 pandemic did not increase the CV risk calculated

关键词： acupuncture   long COVID   fatigue   depression   anxiety   headache   insomnia   cognitive impairment   TENSION-TYPE HEADACHE   NEEDLE ACUPUNCTURE   PRIMARY INSOMNIA   ELECTROACUPUNCTURE   MIGRAINE   EFFICACY   DEPRESSION   IMPROVES   FATIGUE  

摘要： Importance: Acupuncture has been used to treat neurological and neuropsychiatric symptoms in China and other parts of the world. These symptoms, such as fatigue, headache, cognitive impairment, anxiety, depression, and insomnia, are common in people experiencing long COVID. Objective: This study aims to explore the feasibility of acupuncture in the treatment of neurological and neuropsychiatric symptoms in long COVID patients. Data Sources: A systematic search was conducted in four English and four Chinese databases from inception to 23 June 2023. Literature selection and data extraction were conducted by two pairs of independent reviewers. Study Selection: Randomized controlled trials (RCTs) that explored the effect of acupuncture on fatigue, depression, anxiety, cognitive abnormalities, headache, and insomnia were included. Data Extraction and Synthesis: RCTs that explored the effect of acupuncture on fatigue, depression, anxiety, cognitive abnormalities, headache, and insomnia were included. A meta-analysis was performed using R software. Heterogeneity was measured using I-2. Subgroup analyses were performed focusing on the duration of treatment and acupuncture modalities. The systematic review protocol was registered on PROSPERO (registration number: CRD42022354940). Main outcomes and measures: Widely adopted clinical outcome scales included the Fatigue Scale for assessing fatigue, the Hamilton Depression Rating Scale for evaluating depression, the Mini-Mental State Examination for assessing cognitive impairment, the Visual Analog Scale for headache severity, and the Pittsburgh Sleep Quality Index for measuring insomnia. Results: A total of 110 RCTs were included in the systematic review and meta-analysis. Overall, acupuncture was found to improve the scores of the Fatigue Scale (vs. medication: mean differences (MD): -2.27, P < 0.01; vs. sham acupuncture: MD: -3.36, P < 0.01), the Hamilton Depression Rating Scale (vs. medication: MD: -1.62, 95%, P < 0.01; vs. s

关键词： HIV/AIDS   HEALTH  

摘要： Background The coronavirus Disease 2019 (COVID-19) pandemic has brought about unique challenges in healthcare and nutrition, particularly for people living with HIV (PLHIV). Understanding their dietary patterns and nutritional status is crucial for developing targeted interventions and improving health outcomes. Therefore, this study assessed the dietary diversity and nutritional status of PLHIV during the COVID-19 *** We adopted a facility-based cross-sectional study design to enroll 220 PLHIV from two hospitals in the Central Region of Ghana. Dietary intakes were assessed using 24-hour recall. Anthropometric and body composition data were collected with a stadiometer and a body composition monitor. Dietary diversity was evaluated using the FAO's Individual Dietary Diversity Score (IDDS). Data analysis was conducted with SPSS version 20. Significance level was set p-value less than *** A significant proportion (33.2%) of PLHIV had low dietary diversity, with the majority (55.5%) categorized as needing dietary improvement. Approximately 2 out of every 10 of the participants were identified as underweight. Participants aged 40 to 59 years were more likely to exhibit higher dietary diversity (adjusted odds ratio (AOR) = 1.966, 95% Confidence Interval (CI): 1.045-4.987). Participants who consumed meals at least three times daily were more likely to have a high IDDS (AOR = 1.641, 95% CI: 1.221, 8.879). Employed participants (public sector and private sector) were also more likely to have a high IDDS compared to unemployed participants (AOR = 1.448, 95% CI: 1.028-3.042; AOR = 1.165, 95% CI: 1.030-9.329, respectively). Factors associated with undernutrition included being female (AOR = 1.829, 95% CI: 1.294, 3.872) and first-line antiretroviral therapy ART (AOR = 1.683, 95% CI: 1.282-2.424).Conclusion The study emphasizes the need for nutritional interventions for PLHIV, particularly during crises. It advocates for a policy collaboration to address food in

关键词： generalized anxiety disorder   mental health   medical student   Middle East   medical education   MENTAL-HEALTH PROBLEMS   STUDENTS   DEPRESSION   CONSEQUENCES   ASSOCIATION   DISTRESS   ILLNESS   STRESS  

摘要： Introduction Mental health among medical students is an area that has been increasingly garnering world-wide attention. Yet, despite this increased attention, research related to anxiety disorders in Saudi Arabia remain limited. This study aims to address this gap by assessing the prevalence of generalized anxiety disorder (GAD) as well as explore its association with students' sociodemographic factors and academic performance among medical students in a Saudi Arabian institute that has a diverse, multicultural student *** The study takes place in a unique educational environment: a privately funded institute in Riyadh, the capital of Saudi Arabia, with 32% of its student body comprising international students from over 40 countries, during the COVID-19 pandemic. The study deploys the use of a survey that was sent to the students at this institute via their institutional emails. A survey containing 33 items assessing demographics, GAD using GAD-7 questionnaire, stress-relief measures, online learning experience during the pandemic, mental disorders, anxiety associated with the pandemic, two open-ended questions, and one item assessing sleep *** The results of the survey showed that a significant majority of the responders' scores in the GAD-7 assessment were in the range of moderate to severe anxiety. The results also suggest that low cGPA and the first academic years are significantly associated with higher GAD-7 scores. Students found severe time constraints, difficult educational content, and lack of psychological support to be major sources of stress. Furthermore, students suggested providing an in-house psychologist, personalized feedback, and guidance on study tactics as methods to reduce *** These findings, among others, suggest a need for further studies and research in this field to uncover broader patterns and inform targeted mental health support strategies.

关键词： broncho-alveolar lavage   computed tomography   Covid-19   intensive care unit   outcome   MIDDLE LOBE SYNDROME  

摘要： Broncho-alveolar lavage (BAL) is indicated in cases of uncertain diagnosis but high suspicion of Sars-Cov-2 infection allowing to collect material for microbiological culture to define the presence of coinfection or super-infection. This prospective study investigated the correlation between chest computed tomography (CT) findings, Covid-19 Reporting and Data System score, and clinical outcomes in Coronavirus disease 2019 (Covid-19) patients who underwent BAL with the aim of predicting outcomes such as lung coinfection, respiratory failure, and hospitalization length based on chest CT abnormalities. Study population included 34 patients (range 38-90 years old; 20 males, 14 females) with a positive nucleic acid amplification test for Covid-19 infection, suitable BAL examination, and good quality chest CT scan in the absence of lung cancer history. Pulmonary coinfections were found in 20.6% of patients, predominantly caused by bacteria. Specific correlations were found between right middle lobe involvement and pulmonary co-infections. Severe lung injury (PaO2/FiO2 ratio of 100-200) was associated with substantial involvement of right middle, right upper, and left lower lobes. No significant correlation was found between chest CT findings and inflammatory markers (C-reactive protein, procalcitonin) or hospitalization length of stay. Specific chest CT patterns, especially in right middle lobe, could serve as indicators for the presence of co-infections and disease severity in noncritically ill Covid-19 patients, aiding clinicians in timely interventions and personalized treatment strategies.

关键词： COVID-19   Multimodality   Feature fusion   Deep convolutional neural networks   Vision transformers  

摘要： PurposeCOVID-19 continues to spread, and cause increasing deaths. Physicians diagnose COVID-19 using not only real-time polymerase chain reaction but also the computed tomography (CT) and chest x-ray (CXR) modalities, depending on the stage of infection. However, with so many patients and so few doctors, it has become difficult to keep abreast of the disease. Deep learning models have been developed in order to assist in this respect, and vision transformers are currently state-of-the-art methods, but most techniques currently focus only on one modality (CXR).Design/methodology/approachThis work aims to leverage the benefits of both CT and CXR to improve COVID-19 diagnosis. This paper studies the differences between using convolutional MobileNetV2, ViT DeiT and Swin Transformer models when training from scratch and pretraining on the MedNIST medical dataset rather than the ImageNet dataset of natural images. The comparison is made by reporting six performance metrics, the Scott-Knott Effect Size Difference, Wilcoxon statistical test and the Borda Count method. We also use the Grad-CAM algorithm to study the model's interpretability. Finally, the model's robustness is tested by evaluating it on Gaussian noised *** pretrained MobileNetV2 was the best model in terms of performance, the best model in terms of performance, interpretability, and robustness to noise is the trained from scratch Swin Transformer using the CXR (accuracy = 93.21 per cent) and CT (accuracy = 94.14 per cent) ***/valueModels compared are pretrained on MedNIST and leverage both the CT and CXR modalities.

关键词： antiviral treatment   COVID-19   Omicron   remdesivir   MORTALITY  

摘要： Although real-world studies have found that remdesivir is effective in preventing poor prognosis, more information is needed on the optimal timing of remdesivir administration in high-risk coronavirus disease 2019 (COVID-19) patients in the Omicron era. From February 2022 to January 2023, a single-center retrospective study was performed in Korea. We compared the clinical characteristics and treatment outcomes between early (remdesivir treatment within 0-3 days from symptom onset) and late (>= 4 days from symptom onset) treatment groups of patients who received remdesivir monotherapy. Of 284 patients, 225 were classified into the early treatment group and 59 were classified into the late treatment group. The early treatment group had a lower rate of 28-day progression to severe disease than the late treatment group (1.4% vs 7.4%, P = .03). Delaying remdesivir treatment >= 4 days from symptom onset (adjusted odds ratio [aOR], 6.17; 95% CI, 1.18-32.44; P = .03) and Charlson comorbidity index >= 3 (aOR, 9.62; 95% CI, 1.65-56.10; P = .01) were independent risk factors for 28-day progression to severe disease. Our results suggest that early administration of remdesivir could be associated with better prognosis in COVID-19 patients with the Omicron variant, and within 3 days from symptom onset seems to be the appropriate timing.

关键词： Innovation   Resilience   Universities   Institutions   Education   KNOWLEDGE MANAGEMENT   FRAMEWORK   SIZE   OWNERSHIP   HISTORY   AGE  

摘要： PurposeResilience has been emphasised by researchers as a probable framework for overcoming challenging circumstances and fostering organisational innovation. Universities have had to shift to a blended learning system which includes online learning. Prior scholars have studied resilience as a reactive aspect which focuses on organisation's ability to bounce back from a downfall. This study aims to establish the antecedent role of resilience capacity which is a proactive ability to preparedly respond to a downfall. Design/methodology/approachThe research adopts an explanatory study design to establish the hypothesised antecedent role of organisational resilience capacity in enhancing organisational innovation. Drawing a sample from Ugandan Universities, hierarchical regression was used to test the role of organisational resilience capacity on organisational innovation. The study also tested the influence of organisational characteristics of ownership, age and size on innovation. FindingsThe study findings show that the three dimensions of organisational resilience capacity (cognitive capacity, behavioural preparedness and contextual capacity) significantly enhance organisational innovation. The findings further reveal that ownership has a significant effect on innovation. The results show that organisational size and age do not influence innovation. Practical implicationsThe study's conclusions help contemporary managers decide how to set up numerous strategic initiatives to activate organisational resilience towards innovation. To deal with disruption, organisations should use dependable innovation systems and best practices in a robust and adaptable way. Organisational managers ought to integrate the doctrines of resilience into various organisational activities such as training and development and simulation activities, so that organisational managers learn resilience skills to deal with environmental changes. Originality/valueThis research shows how the three di

关键词： Pattern of thyroid dysfunction   COVID pneumonia   Outcome  

摘要： BackgroundSince the onset of the COVID-19 pandemic, multiple studies have reported a bidirectional between COVID-19 and dysfunction of the thyroid gland. These studies have identified various forms of thyroid dysfunction that have been found to affect the severity and outcome of COVID-19 infection. However, the data from these studies have been inconsistent and conflicting. Our objective was to assess the prevalence of various types of thyroid dysfunction among moderate to severe cases of COVID-19 pneumonia. In addition, the study aimed to evaluate the outcome of thyroid dysfunction after recovery from COVID-19 *** and methodsIn this observational prospective study data on the clinical features of individuals with moderate to severe COVID-19 pneumonia who were admitted to Zagazig University isolation hospitals from April to December 2022 and their laboratory results were gathered and examined. Thyroid function tests, including TSH, FT3, and FT4, were conducted for all patients upon admission. Follow-up testing was performed on patients who initially had aberrant thyroid lab results 90 days after recovering from COVID-19 *** study comprised a total of 136 patients who had moderate (44.1%) to severe (55.9%) COVID-19 infection. Sick euthyroid syndrome was the most prevalent form of thyroid dysfunction, accounting for 58.7% of patients with thyroid disorders on admission. After 90 days of post-COVID-19 examination, thyroid dysfunction recovery was observed in 61% of cases. A statistically significant correlation was noted between the severity of COVID-19 and the levels of TSH, free T3, and the ratio of free T3 to T4. A large percentage of patients who showed complete recovery had sick euthyroid syndrome. All patients diagnosed with primary hypothyroidism maintained their hypothyroidism condition, whereas those with hyperthyroidism showed complete ***-19 patients may experience several patterns of thyroid dysfunction, i