Gender, age and nationality differences in chronic kidney disease prevalence in the emirate of Abu Dhabi, UAE

AIM

We aimed to better understand the prevalence of chronic kidney disease in Abu Dhabi, UAE, where a very diverse ethnic population lives, each with their own risk profile.

METHODS

Data were analysed on all patients who were tested for serum creatinine in December 2019 for 4 years within our healthcare network. We analysed data for kidney disease by age, gender and nationality to study differences in prevalence and risk.

RESULTS

The entire cohort (EC) consisted 1 925 672 samples from 703 122 patients. 24% of patients had GFR < 90 mL/min/1.73 m2 (CKD2-5), 4% had more severe kidney dysfunction (CKD3-5) and 2% had UACR >3 mg/mmol and with GFR > 90 (CKD1). The long follow-up (LFU) group comprised 45.6% of patients who had eGFR on at least two occasions more than 90 days apart, and of these 19.5% had sustained eGFR <90, and 5.2% had CKD3-5. Males had lower eGFR than females in the EC (RR 1.68) and the LFU group (RR 1.76). Emirati Females had the lowest prevalence in the EC (2.9%) and expatriate females in the LFU (3.5%) groups. The relative risks of CKD in expatriate males were highest in the EC (2.14) and the LFU (2.39) groups. When we looked at the age distribution by nationality there were highly significant differences in some populations being highly represented at younger ages.

CONCLUSION

The prevalence of kidney disease in Abu Dhabi has a male predominance, with younger expatriates highly represented. A targeted strategy to identify those at high risk may identify early CKD to prevent progression to end-stage kidney disease.

The Influence of Joe Wicks on Physical Activity During the COVID-19 Pandemic: Thematic, Location, and Social Network Analysis of X Data

BACKGROUND

 Social media (SM) was essential in promoting physical activity during the COVID-19 pandemic, especially among people confined to their homes. Joe Wicks, a fitness coach, became particularly popular on SM during this time, posting daily workouts that millions of people worldwide followed.

OBJECTIVE

 This study aims to investigate the influence of Joe Wicks on SM and the impact of his content on physical activity levels among the public.

METHODS

 We used NodeXL Pro (Social Media Research Foundation) to collect data from X (formerly Twitter) over 54 days (March 23, 2020, to May 15, 2020), corresponding to the strictest lockdowns in the United Kingdom. We collected 290,649 posts, which we analyzed using social network analysis, thematic analysis, time-series analysis, and location analysis.

RESULTS

 We found that there was significant engagement with content generated by Wicks, including reposts, likes, and comments. The most common types of posts were those that contained images, videos, and text of young people (school-aged children) undertaking physical activity by watching content created by Joe Wicks and posts from schools encouraging pupils to engage with the content. Other shared posts included those that encouraged others to join the fitness classes run by Wicks and those that contained general commentary. We also found that Wicks' network of influence was extensive and complex. It contained numerous subcommunities and resembled a broadcast network shape. Other influencers added to engagement with Wicks via their networks. Our results show that influencers can create networks of influence that are exhibited in distinctive ways.

CONCLUSIONS

Our study found that Joe Wicks was a highly influential figure on SM during the COVID-19 pandemic and that his content positively impacted physical activity levels among the public. Our findings suggest that influencers can play an important role in promoting public health and that government officials should consider working with influencers to communicate health messages and promote healthy behaviors. Our study has broader implications beyond the status of fitness influencers. Recognizing the critical role of individuals such as Joe Wicks in terms of health capital should be a critical area of inquiry for governments, public health authorities, and policy makers and mirrors the growing interest in health capital as part of embodied and digital experiences in everyday life.

Traumatic bilateral neck of femur fracture in paediatric age: A case report and review of literature

Bilateral femoral neck fractures are rare, and only a few cases have been reported following major trauma in children. An 8-year-old male patient presented with pain both hips and inability to bear weight on his lower limbs, four days after he fell through a roof while playing. The anteroposterior pelvic radiograph showed a displaced transcervical fracture of the right femoral neck and an undisplaced transcervical fracture of the left femoral neck. Operative fixation of both hips with cannulated cancellous screws done on the 5th day of injury led to a successful outcome. This case is presented due to its rarity and successful outcome despite a late presentation.

Social media ambassadors and collaboration with OncoAlert: a European Network of Young Gynae Oncologists study of comparative Twitter analysis of #ESGO2021 and #ESGO2022

OBJECTIVE

The primary objective was to reveal the impact of social media ambassadors and the collaboration between the European Society of Gynaecological Oncology (ESGO) and the OncoAlert Network on Twitter during the ESGO 2022 Congress by comparing it with the ESGO 2021 Congress. We also aimed to share our experience on how to organize a social media ambassador program and evaluate the potential benefits for the society and the ambassadors.

METHODS

We defined the impact as promoting the congress, sharing the knowledge, change in follower count, and change in tweet, retweet, and reply counts. We used the Academic Track Twitter Application Programming Interface to retrieve data from ESGO 2021 and ESGO 2022. We used the keywords of ESGO2021 and ESGO2022 to retrieve data for each of the conferences. The time range in our study captured interactions from before, during, and after conferences. We collected the ambassadors', ESGO's, and the European Network of Young Gynae Oncologists' (ENYGO's) follower data on Twitter from November 2021 to November 2022 for comparative analysis.

RESULTS

There was a 7.23-fold increase in the use of the official congress hashtag in 2022 compared with 2021. Compared with #ESGO2021 data, the main interventions of the Social Media Ambassadors and OncoAlert partnership determined 7.79-, 17.36-, 5.50-, 10.58-, and 8.50-fold increases with #ESGO2022 data in the mentions, mentions in retweet, tweet, retweet, and replies, respectively. Similarly, all other most commonly used hashtags in the top 10 list indicated a range from 2.56- to 7.00-fold increase. Compared to the ESGO 2021 congress month, ESGO and the majority (83.3%, n=5) of ambassadors gained more followers during ESGO 2022 congress month.

CONCLUSIONS

An official social media ambassadors program and collaboration with influential accounts in the field of interest are beneficial for congress-related engagement on a social media platform (Twitter). Individuals participating in the program can also benefit from gaining higher visibility among specific audience.

Analysis of exhaled breath to identify critically ill patients with ventilator-associated pneumonia

Ventilator-associated pneumonia commonly occurs in critically ill patients. Clinical suspicion results in overuse of antibiotics, which in turn promotes antimicrobial resistance. Detection of volatile organic compounds in the exhaled breath of critically ill patients might allow earlier detection of pneumonia and avoid unnecessary antibiotic prescription. We report a proof of concept study for non-invasive diagnosis of ventilator-associated pneumonia in intensive care (the BRAVo study). Mechanically ventilated critically ill patients commenced on antibiotics for clinical suspicion of ventilator-associated pneumonia were recruited within the first 24 h of treatment. Paired exhaled breath and respiratory tract samples were collected. Exhaled breath was captured on sorbent tubes and then analysed using thermal desorption gas chromatography-mass spectrometry to detect volatile organic compounds. Microbiological culture of a pathogenic bacteria in respiratory tract samples provided confirmation of ventilator-associated pneumonia. Univariable and multivariable analyses of volatile organic compounds were performed to identify potential biomarkers for a 'rule-out' test. Ninety-six participants were enrolled in the trial, with exhaled breath available from 92. Of all compounds tested, the four highest performing candidate biomarkers were benzene, cyclohexanone, pentanol and undecanal with area under the receiver operating characteristic curve ranging from 0.67 to 0.77 and negative predictive values from 85% to 88%. Identified volatile organic compounds in the exhaled breath of mechanically ventilated critically ill patients show promise as a useful non-invasive 'rule-out' test for ventilator-associated pneumonia.

Analysing Twitter's Role in Combating the Magnetic Vaccine Conspiracy Theory Using Social Network Analysis

BACKGROUND

The popularity of the magnetic vaccine conspiracy theory, and others of a similar nature, creates challenges to promoting vaccines and disseminating accurate health information.

OBJECTIVE

Health conspiracy theories are gaining in popularity. The study's objective was to evaluate the Twitter social media network related to the magnetic vaccination conspiracy theory and to apply social capital theory to analyse the unique social structures of influential users. As a strategy for online public health surveillance, we employ social network analysis to identify the important opinion leaders sharing the conspiracy, the key websites, and the narratives.

METHODS

A total of 18,706 tweets were retrieved and analysed using social network analysis. Data were retrieved from June 01 to June 13 (2021) using the keyword 'vaccine magnetic'. Tweets were retrieved via a dedicated Twitter Application Programming Interface (API). More specifically, the Academic Track API was used, and the data were analysed using NodeXL Pro and Gephi.

RESULTS

There were a total of 22,762 connections between Twitter users within the dataset. The study found that the most influential user within the network consisted of a news account that was reporting on the conspiracy. There were also several other users that became influential such as an epidemiologist, a health economist, and a retired sports athlete who exerted their social capital within the network.

CONCLUSIONS

Our study finds that influential users were effective broadcasters against the conspiracy, and their reach extended beyond their own network of Twitter followers. We emphasise the need for trust in contact with influential users concerning health information, particularly in the context of widespread social uncertainty resulting from the pandemic, when public sentiment on social media may be unpredictable. The study highlights the potential of influential users to disrupt information flows of conspiracy theories due to their unique social capital.

CLINICALTRIAL

Analyzing Discussions Around Rural Health on Twitter During the COVID-19 Pandemic: Social Network Analysis of Twitter Data

Background

Individuals from rural areas are increasingly using social media as a means of communication, receiving information, or actively complaining of inequalities and injustices.

Objective

The aim of our study is to analyze conversations about rural health taking place on Twitter during a particular phase of the COVID-19 pandemic.

Methods

This study captured 57 days' worth of Twitter data related to rural health from June to August 2021, using English-language keywords. The study used social network analysis and natural language processing to analyze the data.

Results

It was found that Twitter served as a fruitful platform to raise awareness of problems faced by users living in rural areas. Overall, Twitter was used in rural areas to express complaints, debate, and share information.

Conclusions

Twitter could be leveraged as a powerful social listening tool for individuals and organizations that want to gain insight into popular narratives around rural health.

How to Use the Six-Step Digital Ethnography Framework to Develop Buyer Personas: The Case of Fan Fit

BACKGROUND

One of the key features of digital marketing is customer centricity, which can be applied to the domain of health. This is expressed through the ability to target specific customer segments with relevant content using appropriate channels and having data to track and understand each interaction. In order to do this, marketers create buyer personas based on a wide spectrum of quantitative and qualitative data. Digital ethnography is another established method for studying web-based communities. However, for practitioners, the complexity, rigor, and time associated with ethnographical work are sometimes out of reach.

OBJECTIVE

This paper responds to the gaps in the practically focused method of using social media for digital ethnography to develop buyer personas. This paper aims to demonstrate how digital ethnography can be used as a way to create and refine buyer personas.

METHODS

Using a case study of the Fan Fit smartphone app, which aimed to increase physical activity, a digital ethnography was applied to create a better understanding of customers and to create and refine buyer personas.

RESULTS

We propose two buyer personas, and we develop a 6-step digital ethnography framework designed for the development of buyer personas.

CONCLUSIONS

The key contribution of this work is the proposal of a 6-step digital ethnography framework designed for the development of buyer personas. We highlight that the 6-step digital ethnography could be a robust tool for practitioners and academicians to analyze digital communications for the process of creating and updating data-driven buyer personas to create deeper insights into digital and health marketing efforts.

Ecosystem Services: A Social and Semantic Network Analysis of Public Opinion on Twitter

Social media data reveal patterns of knowledge, attitudes, and behaviours of users on a range of topics. This study analysed 4398 tweets gathered between 17 January 2022 and 3 February 2022 related to ecosystem services, using the keyword and hashtag "ecosystem services". The Microsoft Excel plugin, NodeXL was used for social and semantic network analysis. The results reveal a loosely dense network in which information is conveyed slowly, with homogeneous, medium-sized subgroups typical of the community cluster structure. Citizens, NGOs, and governmental administrations emerged as the main gatekeepers of information in the network. Various semantic themes emerged such as the protection of natural capital for the sustainable production of ecosystem services; nature-based solutions to protect human structures and wellbeing against natural hazards; socio-ecological systems as the interaction between human beings and the environment; focus on specific services such as the storage of atmospheric CO₂ and the provision of food. In conclusion, the perception of social users of the role of ecosystem services can help policymakers and forest managers to outline and implement efficient forest management strategies and plans.

Plasma-Assisted Synthesis of Surfactant-Free and D-Fructose-Coated Gold Nanoparticles for Multiple Applications

The excellent optical properties of gold nanoparticles (AuNPs) make them promising for numerous applications. Herein, we present a facile synthesis of both surfactant-free (SF-AuNPs) and non-toxic D-fructose (DF)-coated gold nanoparticles (DF-AuNPs) via the plasma-liquid interactions (PLIs) method. Moreover, we demonstrate that both SF-AuNPs and DF-AuNPs are potential candidates for trace detection via surface-enhanced Raman scattering (SERS) and catalytic degradation of toxic dyes. However, SF-AuNPs have superior SERS and catalytic performance compared to the DF-AuNPs due to their surfactant-free nature. Moreover, SF-AuNPs have also been shown to quench the fluorescence of analyte molecules, making their SERS-based trace detection more efficient. In particular, SERS enhancement of rhodamine 6G (R6G) and catalytic reduction of a toxic dye methylene blue (MB) have been explored.

The #VaccinesWork Hashtag on Twitter in the Context of the COVID-19 Pandemic: Network Analysis

Background

Vaccination is one of the most successful public health interventions for the prevention of COVID-19. Toward the end of April 2021, UNICEF (United Nations International Children’s Emergency Fund), alongside other organizations, were promoting the hashtag #VaccinesWork.

Objective

The aim of this paper is to analyze the #VaccinesWork hashtag on Twitter in the context of the COVID-19 pandemic, analyzing the main messages shared and the organizations involved.

Methods

The data set used in this study consists of 11,085 tweets containing the #VaccinesWork hashtag from the 29th to the 30th of April 2021. The data set includes tweets that may not have the hashtag but were replies or mentions in those tweets. The data were retrieved using NodeXL, and the network graph was laid out using the Harel-Koren fast multiscale layout algorithm.

Results

The study found that organizations such as the World Health Organization, UNICEF, and Gavi were the key opinion leaders and had a big influence on the spread of information among users. Furthermore, the most shared URLs belonged to academic journals with a high impact factor. Provaccination users had other vaccination-promoting hashtags in common, not only in the COVID-19 scenario.

Conclusions

This study investigated the discussions surrounding the #VaccinesWork hashtag. Social media networks containing conspiracy theories tend to contain dubious accounts leading the discussions and are often linked to unverified information. This kind of analysis can be useful to detect the optimal moment for launching health campaigns on Twitter.

A Retrospective Audit of Demography and Different Surgical Modalities Adopted for Giant Cell Tumor of Bone in Eastern India

Background and objective

There is scarce data on demography and different surgical treatment modalities for giant cell tumor of bone (GCTB) from eastern India. In light of this, the present study aimed to examine the demographic characteristics, different surgical treatment modalities, and recurrence rate of GCTB at a tertiary care institute in Bihar.

Materials and methods

A retrospective audit of 52 GCTB patients who were treated at the center from January 2016 to December 2020 was conducted. The minimum follow-up period was one year. GCTB patients underwent surgical procedures ranging from extended intralesional curettage with bone graft or bone cement with or without fixation to wide local excision to resection with or without reconstruction or amputation depending on the stage and site of the tumors.

Results

The mean age of patients was 31.86 years (range: 13-67 years). The distal femur (20 patients, 38.46%) and proximal tibia (11 patients, 21.15%) were the most common sites of the tumor. Sixty-eight confirmed cases (male: 32, female: 36) of GCTB were operated on, with a male-to-female ratio of 1:1.125. Sixteen patients (four males and 12 females) were lost to follow-up. So, the final study consisted of 52 patients with a median age of 28 years (first quartile: 24 years, third quartile: 38 years). The majority of patients (32 patients, 61.53%) were in the third and fourth decades of life.

Conclusion

Based on this retrospective audit, it is concluded that the knee region is the most common site of GCTB. Surgery is the mainstay of management. Most of the patients came under Campanacci Grade 3 with low compliance with follow-up and adherence to the treatment. Hence, educational programs, the establishment of early detection centers, and timely referral to expert treatment are necessary.

A Retrospective Cohort Analysis of Limb Salvage Surgery Using Mega Prosthesis in Bone Tumours at a Tertiary Care Centre in Eastern India

Background

The method known as "limb salvage surgery" (LSS) aids in the removal of extremity tumours, and reconstruction is completed with satisfactory oncologic, functional, and cosmetic outcomes. Oncologic clearance is given first priority, followed by functional outcomes. Worldwide, the trend has already shifted away from amputations and toward limb salvage surgery for eligible patients due to efficient chemotherapy regimens, improved imaging techniques, precise administration of enhanced radiation, better reconstructive choices, and developments in bio-engineering. The purpose of the present study was to determine the clinicopathological characteristics, surgical techniques, functional outcome, and prognostic factors of limb salvage surgery performed using mega prosthesis in primary malignant or benign resectable tumours.

Methods

Our retrospective cohort study was carried out over a period of two years and included 28 patients who received care for bone tumours. The data gathered comprised the demographic profile, clinical characteristics, histological characteristics, treatments given, functional results, and survival. LSS was performed on all patients by orthopaedics oncologists trained in the surgical oncology department. Following surgery, during the first two years, patients were examined at every three-month interval, then every six months until the fifth year, and then once a year after that. The Kaplan-Meier method was utilized to determine the median follow-up and recurrence-free survival (RFS).

Results

In our study, the mean age of study subjects was 30.0±10.9 years. Almost all of the subjects included in the study had lower limb bone tumours (96.4%). The most common site for the tumour was the distal femur (57.1%) followed by the proximal femur (32.2%). The most common type of benign tumour was giant cell tumour (GCT) (53.6%), including recurrences of giant cell tumour (GCT), and among malignant tumours, osteosarcoma was the most common (25.0%). The mean surgical resection of bone in limb salvage surgery was 125.2±24.2 mm. The most common post-operative complication was leg length discrepancy (LLD) among 25.0% of subjects, which was managed by shoe raise. The overall mean musculoskeletal tumour society (MTSS) score after LSS was 25.0±4.3. Using the Kaplan-Meier method analysis, we found that relapse-free survival was 83.7% among enrolled subjects at a median follow-up period of 80 months.

Conclusion

It can be difficult to surgically treat patients who have malignant bone tumours. In limb-sparing surgery for bone tumours, the modular segmental-replacement system prosthesis that we preferred produced satisfactory results in terms of tumour control and limb function. To get good long-term results, the case selection must be appropriate.

Football Fandom as a Platform for Digital Health Promotion and Behaviour Change: A Mobile App Case Study

Background: The last decade has seen a dramatic shift toward the study of fitness surveillance, thanks in part to the emergence of mobile health (mHealth) apps that allow users to track their health through a variety of data-driven insights. This study examines the adoption trends and community mediation of the mobile fitness application ‘FanFit’, a platform aimed at promoting physical activity among sports fans by creating a fitness app branded to their favourite team for health promotion. Objective: Our study looked at the impact of a specially designed mobile app (FanFit) as a digital health intervention for initiating and maintaining physical activity as part of football club membership. Our analysis indicates that app users will adopt healthier behaviours as a result of the app’s sense of fan community and behaviour change. Methods: The findings reported here are based on an implementation of the FanFit app and, in particular, on those who participated in a more in-depth study (n = 30). These participants were Rangers FC supporters with a mix of genders (n = 19 males and n = 11 females). Focus groups and interviews were conducted with participants to ascertain users’ perspectives on the most effective methods for nudging users toward adopting and maintaining a pattern of fitness behaviours. Results: The findings show that the user community was interested in fitness and wanted to live a ‘healthy lifestyle,’ which was augmented and fuelled by the app’s competitive architecture design. Furthermore, the data reveal a new fan-health discourse about a person’s developing wants, talents, and identities as embodied beings. Conclusions: We have developed and presented valid links between the use of sports club apps and health programmes. The app could be useful for sports programmes and club providers looking for mHealth applications that provide community support through fan discourse with opportunities for both male and female fans.

Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study

BACKGROUND

Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications.

METHODS

We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC).

FINDINGS

In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]).

INTERPRETATION

In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required.

FUNDING

British Journal of Surgery Society.

The impact of COVID-19 pandemic on type A aortic dissection care

Funding Acknowledgements

Type of funding sources: None.

Introduction

COVID-19 created a challenging situation for cardiac surgery and associated acute care programs around the world. While non-urgent cases might be postponed, operating on life-threatening conditions, including type A aortic dissection (TAAD), must be sustained despite the ongoing pandemic. Therefore, we investigated the impact of the COVID-19 pandemic on our urgent aortic program.

Methods

36 individuals presenting with TAAD in a single centre were analysed from the pre-pandemic period (2019, n=16) and the pandemic era (2020, n=20). Retrospective data review was conducted on patient characteristics, TAAD presenting symptoms, operative techniques, postoperative outcomes and length of stay. A comparison was made between both eras applying appropriate testing methods, and a p-value <0.05 was considered statistically significant.

Results

A 25% increase in TAAD referrals occurred during the pandemic era. Patients were featured by younger age of presentation in contrast to Western data (pre-pandemic group: 47.6 ± 18.7, and the pandemic group: 50.6 ± 16.2 years, p=0.6) but showed similar male predominance (4:1) in both groups. There was no statistical difference in baseline comorbidities between the groups. Length of hospital and intensive care unit stays were comparable between both groups. Low rates of postoperative complications were registered in both groups with no significant between-group difference.

Conclusion

Emergent surgical management remains essential in patients with TAAD regardless of the pandemic. Furthermore, temporary structural departmental re-configuration and optimal personal protective equipment utilisation warrant maintained satisfactory outcomes in such critical healthcare scenarios.

Predictors of non-invasive ventilation failure in adult patients with cardiac dysfunction presenting with community acquired pneumonia; an Egyptian multicenter prospective study

Funding Acknowledgements

Type of funding sources: None.

Background

Non-invasive ventilation (NIV) might be successful if properly selected in adult patients with cardiac dysfunction presenting with community acquired pneumonia. The main objective was to identify contributing factors to NIV failure.

Methods

All adult patients with LV EF less than 50% admitted to the ICU with community acquired pneumonia and acute respiratory failure were enrolled in our multicenter prospective study after getting informed consents . The study was registered and given a number (ID ISRCTN14641518). Non-invasive ventilation failure was defined as requirement of intubation after institution of NIV intervention.

Results

We prospectively enrolled 177 patients between February 2019 to July 2020. Fifty-three patients (29.9%) were considered failed NIV. The mean age of studied patients was 64.1±12.6 years with a male predominance (73.4%) and a mean left ventricle EF of 36.4±7.8%. There were insignificant differences between the NIV success and NIV failure groups regarding the underlying morbidities nor the inflammatory markers. The patients who failed NIV were significantly older with higher mean SOFA and APACHE II scores compared to the patients with succeeded NIV. Non-invasive Ventilation failure was associated with longer ICU stay (p&lt;0.001), higher SOFA at 48 hours (p&lt;0.001) and higher mortality (p&lt;0.001) compared to the NIV success group. NIV failure was independently predicted with APACHE II (OR:1.420, p 0.01, 95% CI:1.224 – 1.647), SOFA (OR:17.6 , p &lt;0.001, 95% CI: 4.148-74.68), baseline HACOR (OR:2.041, P 0.026, 95% CI:1.225 –3.401), lung ultrasound score (OR:1.209,P 0.017,95% CI:1.014–1.441) and blood lactate (OR:9.702,P &lt;0.001,95%CI:1.357–69.37).Conclusion: High initial APACHE II and SOFA scores , hindered lactate clearance as well as non-decrementing patterns of HACOR and LUS scores were associated with early NIV failure in patients with heart failure presenting with community acquired pneumonia.

Coronavirus Disease 2019 Infection and ABO Blood Groups in a Hemodialysis Cohort in the United Arab Emirates

Some epidemiological data have implicated blood groups in susceptibility to coronavirus disease 2019 (COVID-19) infection. We were interested to see if there was any apparent effect of different ABO blood groups on susceptibility to COVID-19 infection in unvaccinated hemodialysis (HD) patients, as they had a high rate of mortality from this infection. Blood group O has been suggested to be protective against COVID-19 infection; however, since the ABO frequency is affected by ethnicity, we looked at infection frequency and blood group and corrected the expected frequency for the ethnicity of our cohort. We examined 249 HD patients presenting with a positive COVID-19 polymerase chain reaction regarding their ABO blood group and compared the ABO frequencies with published data for the United Arab Emirates (UAE), as well as international and historical ABO data on dialysis frequency. Although there was an apparent protective effect of blood group O when we compared blood group frequencies with the UAE data, this disappeared when corrected for ethnicity. We concluded that any association of the ABO blood group with COVID-19 infection is unlikely to be of major importance and should not be used to reassure patients that they are mildly protected against COVID-19 without vaccination.

A Social Network Analysis of Twitter Data Related to Blood Clots and Vaccines

After the first weeks of vaccination against SARS-CoV-2, several cases of acute thrombosis were reported. These news reports began to be shared frequently across social media platforms. The aim of this study was to conduct an analysis of Twitter data related to the overall discussion. The data were retrieved from 14 March to 14 April 2021 using the keyword 'blood clots'. A dataset with n = 266,677 tweets was retrieved, and a systematic random sample of 5% of tweets (n = 13,334) was entered into NodeXL for further analysis. Social network analysis was used to analyse the data by drawing upon the Clauset-Newman-Moore algorithm. Influential users were identified by drawing upon the betweenness centrality measure. Text analysis was applied to identify the key hashtags and websites used at this time. More than half of the network comprised retweets, and the largest groups within the network were broadcast clusters in which a number of key users were retweeted. The most popular narratives involved highlighting the low risk of obtaining a blood clot from a vaccine and highlighting that a number of commonly consumed medicine have higher blood clot risks. A wide variety of users drove the discussion on Twitter, including writers, physicians, the general public, academics, celebrities, and journalists. Twitter was used to highlight the low potential of developing a blood clot from vaccines, and users on Twitter encouraged vaccinations among the public.

Binge Watching and the Role of Social Media Virality towards promoting Netflix’s Squid Game

The management literature has extensively studied viral marketing in the last decade; however, there is a lack of research in understanding network structures and the role of influencers within popular cultural consumption, such as on-demand digital media and binge-watching. In this article, we investigate the role of social media in popularising the East Asian dystopian cultural drama Squid Game. We studied this phenomenon by analysing social network structures, dynamics and influencer characteristics that transformed Squid Game into a popular global digital cultural consumption sensation. Stemming from the foundational theories of popular culture binge-watching, network theory and the social media echo chamber effect, we demonstrate how careful ‘seeding’ and ‘broadcasting’ behaviour adopted by Netflix and key influencers helped the ‘reciprocal merging’ of creative media content within the broader social media space. Our study found that 13,727 Twitter users were tweeting or mentioned on the day show was released. Our research findings further present the characteristic of individual group-based echo chambers and their role in value co-creation towards expanding the network boundary through e-WOM. This phenomenon led to the show’s unprecedented popularity amongst a global audience within a short period. Contributions of our work expand viral marketing and echo-chamber concepts into the binge-watching and popular digital culture realm, where the interplay between dramatized Asian and Western dystopian social norms provided the very fabric of user-led promotion and value co-creation.

Outcomes of operative management in the delayed presenting neck of femur fractures in children: A case series

Introduction: Fracture neck of femur in pediatric age group occurs due to high energy trauma and is an uncommon entity with high complication rate. No uniform guidelines are present to manage these fractures, especially in delayed presentation of fracture neck of femur as a smaller number of such cases were reported. Case Report: Eight children (nine hips), five boys and three girls of age <15 years, were operated on. The mean delay in surgery time was 8.6 days (range: 5–22 days). The mean union time was 13.44 weeks. The mean follow-up was 20.88 months (range: 12–36 months). All the cases were managed with closed or open reduction followed by internal fixation with or without hip spica application and resulted in satisfactory outcomes in most of the cases. Conclusion: Anatomical reduction (open or closed) and fixation reduce the risk of complications even in delayed presentation if the orthopedic surgeon is familiar with the management.

Isolation, Characterization, and Efficacy of Three Lytic Phages Infecting Multidrug-Resistant Salmonella Serovars from Poultry Farms in Egypt

Multidrug-resistant (MDR) Salmonella serovars are considered a significant threat to veterinary and public health. Developing new antimicrobial compounds that can treat the infection caused by these notorious pathogens is a big challenge. Bacteriophages can be adsorbed on and inhibit the growth of bacteria, providing optimal and promising alternatives to chemical antimicrobial compounds against foodborne pathogens due to their abundance in nature and high host specificity. The objective of the current study was to isolate and characterize new phages from poultry farms and sewage and to evaluate their efficacy against S. Enteritidis isolates. The study reports three lytic phages designated as ϕSET1, ϕSET2, and ϕSET3 isolated from poultry carcasses and sewage samples in Qalubiya governorate Egypt. The effectiveness of phages was evaluated against multidrug-resistant S. Enteritidis strains. Electron microscopy showed that these phages belong to the Siphoviridae family. Phages were tested against 13 bacterial strains to determine their host range. They could infect four S. Enteritidis and one S. Typhimurium; however, they did not infect other tested bacterial species, indicating their narrow infectivity. The bacteriophage's single-step growth curves revealed a latent period of 20 min for ϕSET1 and 30 min for ϕSET2 and ϕSET3. The isolated Salmonella phages prevented the growth of S. Enteritidis for up to 18 hrs. The findings revealed that Salmonella phages could be used as alternative natural antibacterial compounds to combat infection with MDR S. Enteritidis in the poultry industry and represent a step forward to using large panels of phages for eliminating Salmonella from the food chain.

Social network analysis of Twitter data from Pakistan during COVID-19

Purpose

The use of social media has increased during the COVID-19 pandemic. Social media platforms provide opportunities to share news, ideas and personal stories. Twitter is used by citizens in Pakistan to respond and comment on emerging news stories and events. However, it is not known whether Twitter played a positive or negative role in spreading updates and preventive messages during the COVID-19 pandemic. The purpose of this study is to analyse content from Twitter during the pandemic.

Design/methodology/approach

NodeXL was used to retrieve data using the keyword وائرس کورونا (written in Urdu and which translates to Coronavirus). The first data set (Case Study 1) was based on 10,284 Twitter users from the end of March. The second data set (Case Study 2) was based on 10,644 Twitter users from the start of April. The theoretical lens of effective message framing was used to classify the most retweeted content on Twitter.

Findings

Twitter was used for personal and professional projections and included certain tweets included political motives even during the unfolding health crisis. There appeared to be very few successful attempts to use Twitter as a tool for health awareness and risk communication. The empirical findings indicate that the most retweeted messages were gain-framed and can be classified as personal, informative and political in nature.

Originality/value

The present study provides insights likely to be of interest to researchers, health organizations, citizens, government and politicians that are interested in making more effective use of social media for the purposes of health promotion. The authors also provide novel insights into the key topics of discussions, websites and hashtags used by Pakistani Twitter users during the COVID-19 pandemic.

#radonc: Growth of the global radiation oncology Twitter network

INTRODUCTION

Social media connects people globally and may enhance access to radiation oncology information. We characterized the global growth of the radiation oncology Twitter community using the hashtag #radonc.

MATERIALS AND METHODS

We analyzed all public tweets bearing the hashtag #radonc from 2014 to 2019 using Symplur Signals. We collected data on #radonc activity and growth, stakeholder distribution, user geolocation, and languages. We obtained global Twitter user data and calculated average annual growth rates for users and tweets. We analyzed growth rates by stakeholder. We conducted thematic analysis on a sample of tweets in each three-year period using frequently occurring two-word combinations.

RESULTS

We identified 193,115 tweets including #radonc composed by 16,645 Twitter users. Globally, users wrote in 35 languages and came from 122 countries, with the known highest users from the United States, United Kingdom, and Spain. Use of #radonc expanded from 23 countries in 2014 to 116 in 2019. The average annual growth rate in #radonc users and tweets was 70.5% and 69.2%, respectively. The annual growth rate of #radonc users was significantly higher than for all Twitter users (p = 0.004). While doctors were the source of 46.9% of all tweets, research and government organizations had annual increases in tweet volume of 84.6% and 211.4%, respectively. From 2014 to 2016, promotion of the radiation oncology community was the most active theme, though this dropped to 7th in 2017-2019 as discussion increased regarding aspects of radiation and treated disease sites.

CONCLUSION

Use of #radonc has grown rapidly into a global community. Focused discussion related to radiation oncology has outpaced the growth of general Twitter use, both among physicians and non-physicians. #radonc has grown into a self-sustaining community. Further research is necessary to define the risks and benefits of social media in medicine and to determine whether it adds value to oncology practice.

Rethinking Fake News: Disinformation and Ideology during the time of COVID-19 Global Pandemic

Digital media and citizen journalism has escalated the infiltration of fake news attempting to create a post truth society (Lazer et al., 2018). The COVID-19 pandemic has seen a surge of misinformation leading to anti-mask, anti-vaccine and anti-5G protests on a global scale. Although the term ‘misinformation’ has been generalized in media and scholarly work, there is a fundamental difference between how misinformation impacts society, compared to more strategically planned disinformation attacks. In this study we explore the ideological constructs of citizens towards acceptance or rejection of disinformation during the heightened time of a COVID-19 global health crisis. Our analysis follows two specific disinformation propagandas evaluated through social network analysis of Twitter data in addition to qualitative insights generated from tweets and in-depth interviews.

Exploring nurses' online perspectives and social networks during a global pandemic COVID-19

Objectives

Examine the online interactions, social networks, and perspectives of nursing actors on COVID‐19 from conversations on Twitter to understand how the profession responded to this global pandemic.

Design

Mixed methods.

Sample

Ten‐thousand five‐hundred and seventy‐four tweets by 2790 individuals and organizations.

Measurements

NodeXL software was used for social network analysis to produce a network visualization. The betweenness centrality algorithm identified key users who were influential in COVID‐19 related conversations on Twitter. Inductive content analysis enabled exploration of tweet content. A communicative figurations framework guided the study.

Results

Nursing actors formed different social groupings, and communicated with one another across groups. Tweets covered four themes; (1) outbreak and clinical management of the infectious disease, (2) education and information sharing, (3) social, economic, and political context, and (4) working together and supporting each other.

Conclusion

In addition to spreading knowledge, nurses tried to reach out through social media to political and healthcare leaders to advocate for improvements needed to address COVID‐19. However, they primarily conversed within their own professional community. Action is needed to better understand how social media is and can be used by nurses for health communication, and to improve their preparedness to be influential on social media beyond the nursing community.

Antioxidant potential and α-glucosidase inhibitory activity of onion (Allium cepa L.) peel and bulb extracts

Allium cepa L. is a commonly consumed vegetable that belongs to the Amaryllidaceae family and contains nutrients and antioxidants in ample amounts. In spite of the valuable food applications of onion bulb, its peel and outer fleshy layers are generally regarded as waste and exploration of their nutritional and therapeutic potential is still in progress with a very slow progression rate. The present study was designed with the purpose of doing a comparative analysis of the antioxidant potential of two parts of Allium cepa, i.g., bulb (edible part) and outer fleshy layers and dry peels (inedible part). Moreover, the inhibitory effect of the onion bulb and peel extracts on rat intestinal α-glucosidase and pancreatic α-amylase of porcine was also evaluated. The antioxidant potential of onion peel and bulb extracts were evaluated using 2,2-diphenyl- 1-picryl hydrazyl (DPPH), ferric-reducing antioxidant power assay (FRAP), 2,2'-azino-bis- 3-ethylbenzothiazoline-6-sulfonic acid (ABTS) radical scavenging assay, H2O2 radical scavenging activity and Fe2+ chelating activity. Total flavonoids and phenolic content of ethanolic extract of onion peel were significantly greater as compared to that of onion bulb. Ethanolic extract of onion peel also presented better antioxidant and free-radical scavenging activity as compared to the ethanolic extract of bulb, while the aqueous extract of bulb presented weakest antioxidative potential. Onion peel extract's α-glucosidase inhibition potential was also correlated with their phenolic and flavonoid contents. The current findings presented onion peel as a possible source of antioxidative agents and phenolic compounds that might be beneficial against development of various common chronic diseases that might have an association with oxidative stress. Besides, outer dry layers and fleshy peels of onion exhibited higher phenolic content and antioxidant activities, compared to the inner bulb. The information obtained by the present study can be useful in promoting the use of vegetable parts other than the edible mesocarp for several future food applications, rather than these being wasted.

An analysis of antibody responses and clinical sequalae of the Sinopharm HB02 COVID19 vaccine in dialysis patients in the United Arab Emirates

AIM

To establish the responses to the Sinopharm HB02 COVID-19 vaccination in the dialysis population, which are not well established. We examined the humoral responses to the Sinopharm COVID vaccine in haemodialysis patients.

METHODS

Standard vaccinations (two doses at interval of ~21 days) were given to all consenting haemodialysis patients on dialysis (n = 1296). We measured the antibody responses at 14-21 days after the second vaccine to define the development of anti-spike antibodies >15 AU/ml after vaccination and observed the clinical effects of vaccination.

RESULTS

Vaccination was very well tolerated with few side-effects. In those who consented to antibody measurements, (n = 446) baseline sampling showed 77 had positive antibodies, yet received full vaccination without any apparent adverse events. Positive anti-spike antibodies developed in 50% of the 270 baseline negative patients who had full sampling, compared with 78.1% in the general population. COVID infection continues to occur in both vaccinated and unvaccinated individuals, but in the whole group vaccination appears to have been associated with a reduction in the case fatality rate.

CONCLUSION

The humoral immune responses to standard HB02 vaccination schedules are attenuated in a haemodialysis cohort, but likely the vaccine saves lives. We suggest that an enhanced HB02 vaccination course or antibody checking may be prudent to protect this vulnerable group of patients. We suggest a booster dose of this vaccine at 3 months should be given to all dialysis patients, on the grounds that it is well tolerated even in those with good antibody levels and there may be a survival advantage.

Osteochondrosis of Primary Center of Patella: A Case Report

Introduction

Osteochondrosis of the primary ossification center of the patella (Kohler's Disease) is a rare and self-limiting condition of unknown etiology. Sometimes it may be found as normal variant.

Case Report

A 7-year-old boy presented with anterior right knee pain. On radiological examination, there was increased density, irregularity, and fragmentation of the patellar primary ossification center. Activity modification and exercise led to marked symptomatic improvement after 1 year.

Conclusion

It was concluded that the disease either physiological or pathological, diagnosis is usually difficult. However, the treatment is simple. There was improvement functionally as well as radiologically with activity modification.

International Gynaecological Cancer Society (IGCS) 2020 Annual Global Meeting: Twitter activity analysis

OBJECTIVES

Twitter is the most frequently used social media platform by healthcare practitioners, at medical conferences. This study aimed to analyze Twitter conversations during the virtual International Gynecological Cancer Society 2020 conference to understand the interactions between Twitter users related to the conference.

METHODS

Tweets using the hashtag '#IGCS2020' were searched using the Twitter Search Application Programming Interface (API) during the period 10-13 September 2020. NodeXL Pro was used to retrieve data. The Clauset-Newman-Moore cluster algorithm clustered users into different groups or 'clusters' based on how users interacted.

RESULTS

There were 2009 registrants for the virtual IGCS 2020 conference. The total number of users within the network was 168, and there were 880 edges connecting users. Five types of edges were identified as follows: 'replies to' (n=18), 'mentions' (n=221), 'mentions in retweets' (n=375), retweets (n=198), and tweets (n=68). The most influential account was that of the IGCS account itself (@IGCSociety). The overall network shape resembled a community where distinct groups formed within the network. Our current analyses demonstrated that less than 10% of the total members interacted on Twitter.

CONCLUSION

This study identified the most influential Twitter users within the '#IGCS2020' community. he results also confirmed the community network shape of the #IGCS2020 hashtag and found that the most frequent co-related words were 'ovarian' and 'cancer' (n=39).

Molecular Epidemiology of Plasmodium species in Conflicted Federally Administered Tribal Area (FATA) Pakistan

Military conflicts have been significant obstacles in detecting and treating infectious disease diseases due to the diminished public health infrastructure, resulting in malaria endemicity. A variety of violent and destructive incidents were experienced by FATA (Federally Administered Tribal Areas). It was a struggle to pursue an epidemiological analysis due to continuing conflict and Talibanization. Clinical isolates were collected from Bajaur, Mohmand, Khyber, Orakzai agencies from May 2017 to May 2018. For Giemsa staining, full blood EDTA blood samples have been collected from symptomatic participants. Malaria-positive microscopy isolates were spotted on filter papers for future Plasmodial molecular detection by nested polymerase chain reaction (nPCR) of small subunit ribosomal ribonucleic acid (ssrRNA) genes specific primers. Since reconfirming the nPCR, a malariometric study of 762 patients found 679 positive malaria cases. Plasmodium vivax was 523 (77%), Plasmodium falciparum 121 (18%), 35 (5%) were with mixed-species infection (P. vivax plus P. falciparum), and 83 were declared negative by PCR. Among the five agencies of FATA, Khyber agency has the highest malaria incidence (19%) with followed by P. vivax (19%) and P. falciparum (4.1%). In contrast, Kurram has about (14%), including (10.8%) P. vivax and (2.7%) P. falciparum cases, the lowest malaria epidemiology. Surprisingly, no significant differences in the distribution of mixed-species infection among all five agencies. P. falciparum and P. vivax were two prevalent FATA malaria species in Pakistan's war-torn area. To overcome this rising incidence of malaria, this study recommends that initiating malaria awareness campaigns in school should be supported by public health agencies and malaria-related education locally, targeting children and parents alike.

Comparison of different diagnostic modalities for isolation of Mycobacterium Tuberculosis among suspected tuberculous lymphadenitis patients

Tuberculosis is a communicable disease with high morbidity and mortality rates in developing countries. The study's primary objective is to compare conventional methods such as acid-fast bacillus (AFB) culture and microscopy with rapid diagnostic methods. The secondary objective is to compare histopathological and microbiological findings in suspected patients with tubercular lymphadenitis. A total of 111 samples (August 2018 to September 2019) of lymph nodes were processed for AFB microscopy, AFB cultures, drug-susceptibility testing (DST), histopathology, and Xpert Mycobacterium Tuberculosis (MTB)/resistance to Rifampin (RIF) assays. Out of 111 lymph node samples, 6 (5.4%) were positive for AFB smear microscopy, 84 (75.6%) were positive for AFB culture, 80 (70.7%) were positive on Gene Xpert, and 102 (91.8%) were indicative of tuberculosis for histopathology studies. Mycobacteria growth indicator tube (MGIT) culture positivity was 84 (75.6%) higher than solid Lowenstein-Jensen (LJ) culture 74 (66.6%). Positive cultures underwent phenotypic DST. Two cases were Multidrug-resistant (MDR) on DST, while three cases were Rifampicin resistant on Gene Xpert. The sensitivity of Genexpert was (62%) against the conventional AFB culture method. The poor performance of conventional lymphadenitis diagnostic methods requires early and accurate diagnostic methodology. Xpert MTB/RIF test can help in the treatment of multidrug-resistant TB cases. Nonetheless, rapid and conventional methods should be used for complete isolation of Mycobacterium tuberculosis.

A Hemodynamic Study to assess response, tolerance and dose optimization of Carvedilol in Child Class A patients with Portal Hypertension

Background: Carvedilol has an established role in Chronic Liver disease (CLD) associated Portal Hypertension, however its role in specific subclasses of CLD has not been studied, neither the factors leading to non-response thereby predisposing such patients to variceal bleed with empiric therapy. Aims and Objectives: The purpose of this study was. 1. To evaluate the hemodynamic response to Carvedilol and optimum dosage in patients of CTP Class A Cirrhosis. 2. To determine any clinical variables that would help in differentiating responders from non-responders. Materials and Methods: In forty-three consecutive patients of chronic liver disease Child Turcotte Pugh (CTP) Class A with esophageal varices, Hepatic Venous Pressure Gradient (HVPG) was measured at baseline, 90 minutes after initial administration of 12.5 mg of Carvedilol and after 3 months of dose optimization. Results: Twenty-one (48.8%) patients demonstrated Acute Response and after dose optimization Chronic Response was seen in 29 (67.4%) patients with additional 8 (18.6%) patients responding to dose optimization. Fourteen (32.55%) patients failed to show any response. Low pre-drug Cardiac Output (CO), High pre-drug mean arterial pressure (MAP), more than 2.5mmHg drop in HVPG acutely, higher dose toleration of more than 18.5mg and lower change in HR predicted response. Conclusion: Patients with CTP Class A Cirrhosis with Portal Hypertension and Esophageal Varices tolerate Carvedilol well and nearly two-thirds show hemodynamic response when dose is optimized over a period of time, including patients who initially show no acute response. Nearly one-third of patients show no response even after dose optimization.

Social Media Conversations About High Engagement Sports Team Brands

This study conducts an analysis of social media discussions related to high engagement sports brands. More specifically, our study examined the English Premier League (EPL); it sought to retrieve data systematically over the same day, weekly, for a period of five months. After this process, we had built 20 datasets and NodeXL was utilized to analyse the data. After we had this data, we were able to use qualitative observations to identify key users and conversations that formed around the EPL as well as the connections between the conversations that arose from the brand’s posts and the people involved in them. We also analyzed the quantitative data underpinning our network visualisations to provide further insights. The most obvious initial finding was that when the EPL tweets, it prompts a large volume of conversations directly related to these tweets. However, we also noted that EPL tweets also help instigate further, sometimes unrelated, tweets and conversations. More specifically, we identified that the visualized network of conversations was of a broadcast form, which is characterized by messages being generated by a central account (the EPL) and shared by a number of decentralized users. Based on our analysis, we propose guidance around (S)ocial media presence, (C)rafting the message, Planned (i)ntervention, (S)pontaneous follow-up, and (M)essage mortality to form the SCISM framework. This framework is likely to be of interest to brands that wish to promote, sustain and benefit from their instigation of social media.

DOP76 No durable impact of COVID-19 on disease activity and microbiome composition in patients with IBD

Background

Although patients with inflammatory bowel disease (IBD) reported an increased frequency of gastrointestinal (GI) symptoms following infection, the durable impact of COVID-19 on underlying IBD is not well defined.

Methods

In 118 IBD patients with COVID-19, clinical and endoscopic IBD activity, laboratory markers (ESR, CRP, hemoglobin (Hb), fecal calprotectin(FCP)), and medication utilization was assessed up to 6 months post-infection and compared to during infection or up to 6 months prior to infection. Active disease was defined by a Harvey Bradshaw Index > 4, Mayo Score ≥2, SES-CD ≥2, Mayo endoscopic score ≥1. 16S rRNA analysis was used to evaluate microbiome composition in a subset of 12 patients before and after COVID-19.

Results

Although upper respiratory (86.6%) and new GI symptoms (39.1%) were common in patients with IBD, there was no significant change in IBD clinical disease activity (Pre vs. Post-COVID-19 HBI: 4.7 vs. 4.9; partial Mayo: 3.0 vs. 2.1), endoscopic evaluation (Pre vs. Post-COVID-19 SES-CD: 7.2 vs. 8.9, Mayo endoscopic score: 1.5 vs. 1.7), or laboratory markers (Pre vs. Post-COVID-19 CRP: 1.2 vs. 1.3; ESR: 25 vs. 26; Hb 12.8 vs. 13.2; FCP: 388 vs. 250) up to 7 months post-COVID-19 compared to the 6 months prior to infection (Table 1). Overall active disease was present in 60% of the cohort prior to COVID-19 and 55% and 59% during and post-COVID-19, respectively. More subjects (8.5%) reported a delay in medical therapy during COVID-19, but there were no differences in the need for corticosteroids, a change in medical therapy, or IBD-related surgery or hospitalization during or post-COVID-19 compared to the prior 6 months. Microbiome composition stratified by underlying IBD disease activity, but did not show significant change post-COVID-19 (Figure 1).

Conclusion

COVID-19 showed no durable impact on clinical IBD disease activity or microbiome composition supporting guidelines for continued maintenance care.

Outcomes of patients with end stage kidney disease on dialysis with COVID-19 in Abu Dhabi, United Arab Emirates; from PCR to antibody

BACKGROUND

Individuals with end-stage kidney disease (ESKD) on dialysis are vulnerable to contracting COVID-19 infection, with mortality as high as 31 % in this group. Population demographics in the UAE are dissimilar to many other countries and data on antibody responses to COVID-19 is also limited. The objective of this study was to describe the characteristics of patients who developed COVID-19, the impact of the screening strategy, and to assess the antibody response to a subset of dialysis patients.

METHODS

We retrospectively examined the outcomes of COVID19 infection in all our haemodialysis patients, who were tested regularly for COVID 19, whether symptomatic or asymptomatic. In addition, IgG antibody serology was also performed to assess response to COVID-19 in a subset of patients.

RESULTS

152 (13 %) of 1180 dialysis patients developed COVID-19 during the study period from 1st of March to the 1st of July 2020. Of these 81 % were male, average age of 52​ years and 95 % were on in-centre haemodialysis. Family and community contact was most likely source of infection in most patients. Fever (49 %) and cough (48 %) were the most common presenting symptoms, when present. Comorbidities in infected individuals included hypertension (93 %), diabetes (49 %), ischaemic heart disease (30 %). The majority (68 %) developed mild disease, whilst 13 % required critical care. Combinations of drugs including hydroxychloroquine, favipiravir, lopinavir, ritonavir, camostat, tocilizumab and steroids were used based on local guidelines. The median time to viral clearance defined by two negative PCR tests was 15 days [IQR 6-25]. Overall mortality in our cohort was 9.2 %, but ICU mortality was 65 %. COVID-19 IgG antibody serology was performed in a subset (n = 87) but 26 % of PCR positive patients (n = 23) did not develop a significant antibody response.

CONCLUSIONS

Our study reports a lower mortality in this patient group compared with many published series. Asymptomatic PCR positivity was present in 40 %. Rapid isolation of positive patients may have contributed to the relative lack of spread of COVID-19 within our dialysis units. The lack of antibody response in a few patients is concerning.

Twitter dialogue: an analysis of Pakistani politicians’ information sharing

Purpose

The use of Twitter by political parties and politicians has been well studied in developed countries. However, there is a lack of empirical work, which has examined the use of Twitter in developing countries. This study aims to explore the information-sharing patterns of Pakistani politicians through Twitter accounts during the pre-election campaign of 2018.

Design/methodology/approach

Data of three weeks of the official party accounts and the politicians running for prime minister were analysed. The mixed-methods approach has been used to analyse quantitative and qualitative data retrieved through Twitonomy.

Findings

It was found that the most active Twitter account belonged to the winning party. The prominent Twitter account functions were a call to vote, promotional Tweets, promises and Tweeting about party developments. The present study provides evidence that there is a difference between the Tweeting behaviour of established and emerging parties. The emerging party heavily posted about changing traditional norms/culture/practices.

Practical implications

The study contributed to existing knowledge and has practical implications for politicians, citizens and social media planners.

Originality/value

The present study was designed carefully and based on empirical research. The study is unique in its nature to fill the research and knowledge gap by adding a variety of Twitter functions used by politicians.

Towards understanding a football club’s social media network: an exploratory case study of Manchester United

Purpose

The purpose of this work is to study how different stakeholders of a football club engage with interactions online through Twitter. It analyses the football club’s Twitter network to discover influential actors and the topic of interest in their online communication.

Design/methodology/approach

The authors analysed the social networks derived from over two million tweets collected during football matches played by Manchester United. The authors applied social network analysis to discover influencers and sub-communities and performed content analysis on the most popular tweets of the prominent influencers.

Findings

Sub-communities can be formed around current affairs that are irrelevant to football, perhaps due to opportunistic attempts of using the large networks and massive attention during football matches to disseminate information. Furthermore, the popularity of tweets featuring different topics depends on the types of influencers involved.

Practical implications

The methods can help football clubs develop a deeper understanding of their online social communities. The findings can also inform football clubs on how to optimise their communication strategies by using various influencers.

Originality/value

Compared to previous research, the authors discovered a wide range of influencers and denser networks characterised by a smaller number of large clusters. Interestingly, this study also found that bots appeared to become influential within the network.

A Social Network Analysis of Tweets Related to Masks during the COVID-19 Pandemic

BACKGROUND

High compliance in wearing a mask is a crucial factor for stopping the transmission of COVID-19. Since the beginning of the pandemic, social media has been a key communication channel for citizens. This study focused on analyzing content from Twitter related to masks during the COVID-19 pandemic.

METHODS

Twitter data were collected using the keyword "mask" from 27 June 2020 to 4 July 2020. The total number of tweets gathered were n = 452,430. A systematic random sample of 1% (n = 4525) of tweets was analyzed using social network analysis. NodeXL (Social Media Research Foundation, California, CA, USA) was used to identify users ranked influential by betweenness centrality and was used to identify key hashtags and content.

RESULTS

The overall shape of the network resembled a community network because there was a range of users conversing amongst each other in different clusters. It was found that a range of accounts were influential and/or mentioned within the network. These ranged from ordinary citizens, politicians, and popular culture figures. The most common theme and popular hashtags to emerge from the data encouraged the public to wear masks.

CONCLUSION

Towards the end of June 2020, Twitter was utilized by the public to encourage others to wear masks and discussions around masks included a wide range of users.

COVID-19 and the "Film Your Hospital" Conspiracy Theory: Social Network Analysis of Twitter Data

BACKGROUND

During the COVID-19 pandemic, a number of conspiracy theories have emerged. A popular theory posits that the pandemic is a hoax and suggests that certain hospitals are "empty." Research has shown that accepting conspiracy theories increases the likelihood that an individual may ignore government advice about social distancing and other public health interventions. Due to the possibility of a second wave and future pandemics, it is important to gain an understanding of the drivers of misinformation and strategies to mitigate it.

OBJECTIVE

This study set out to evaluate the #FilmYourHospital conspiracy theory on Twitter, attempting to understand the drivers behind it. More specifically, the objectives were to determine which online sources of information were used as evidence to support the theory, the ratio of automated to organic accounts in the network, and what lessons can be learned to mitigate the spread of such a conspiracy theory in the future.

METHODS

Twitter data related to the #FilmYourHospital hashtag were retrieved and analyzed using social network analysis across a 7-day period from April 13-20, 2020. The data set consisted of 22,785 tweets and 11,333 Twitter users. The Botometer tool was used to identify accounts with a higher probability of being bots.

RESULTS

The most important drivers of the conspiracy theory are ordinary citizens; one of the most influential accounts is a Brexit supporter. We found that YouTube was the information source most linked to by users. The most retweeted post belonged to a verified Twitter user, indicating that the user may have had more influence on the platform. There was a small number of automated accounts (bots) and deleted accounts within the network.

CONCLUSIONS

Hashtags using and sharing conspiracy theories can be targeted in an effort to delegitimize content containing misinformation. Social media organizations need to bolster their efforts to label or remove content that contains misinformation. Public health authorities could enlist the assistance of influencers in spreading antinarrative content.

Synthesis and bioactivity of phenyl substituted furan and oxazole carboxylic acid derivatives as potential PDE4 inhibitors

In this present study, a series of 5-phenyl-2-furan and 4-phenyl-2-oxazole derivatives were designed and synthesized as phosphodiesterase type 4 (PDE4) inhibitors. In vitro results showed that the synthesized compounds exhibited considerable inhibitory activity against PDE4B and blockade of LPS-induced TNF-α release. Among the designed compounds, Compound 5j exhibited lower IC₅₀ value (1.4 μM) against PDE4 than parent rolipram (2.0 μM) in in vitro enzyme assay, which also displayed good in vivo activity in animal models of asthma/COPD and sepsis induced by LPS. Docking results suggested that introduction of methoxy group at para-position of phenyl ring, demonstrated good interaction with metal binding pocket domain of PDE4B, which was helpful to enhance inhibitory activity.

Public Disclosure on Social Media of Identifiable Patient Information by Health Professionals: Content Analysis of Twitter Data

Background

Respecting patient privacy and confidentiality is critical for doctor-patient relationships and public trust in medical professionals. The frequency of potentially identifiable disclosures online during periods of active engagement is unknown.

Objective

The objective of this study was to quantify potentially identifiable content shared on social media by physicians and other health care providers using the hashtag #ShareAStoryInOneTweet.

Methods

We accessed and searched Twitter’s API using Symplur software for tweets that included the hashtag #ShareAStoryInOneTweet. We identified 1206 tweets by doctors, nurses, and other health professionals out of 43,374 tweets shared in May 2018. Tweet content was evaluated in January 2019 to determine the incidence of instances where names or potentially identifiable information about patients were shared; content analysis of tweets in which information about others had been disclosed was performed. The study also evaluated whether participants raised concerns about privacy breaches and estimated the frequency of deleted tweets. The study used dual, blinded coding for a 10% sample to estimate intercoder reliability using Cohen κ statistic for identifying the potential identifiability of tweet content.

Results

Health care professionals (n=656) disclosing information about others included 486 doctors (74.1%) and 98 nurses (14.9%). Health care professionals sharing stories about patient care disclosed the time frame in 95 tweets (95/754, 12.6%) and included patient names in 15 tweets (15/754, 2.0%). It is estimated that friends or families could likely identify the clinical scenario described in 242 of the 754 tweets (32.1%). Among 348 tweets about potentially living patients, it was estimated that 162 (46.6%) were likely identifiable by patients. Intercoder reliability in rating the potential identifiability demonstrated 86.8% agreement, with a Cohen κ of 0.8 suggesting substantial agreement. We also identified 78 out of 754 tweets (6.5%) that had been deleted on the website but were still viewable in the analytics software data set.

Conclusions

During periods of active sharing online, nurses, physicians, and other health professionals may sometimes share more information than patients or families might expect. More study is needed to determine whether similar events arise frequently and to understand how to best ensure that patients’ rights are adequately respected.

COVID-19 and the 5G Conspiracy Theory: Social Network Analysis of Twitter Data

Background

Since the beginning of December 2019, the coronavirus disease (COVID-19) has spread rapidly around the world, which has led to increased discussions across online platforms. These conversations have also included various conspiracies shared by social media users. Amongst them, a popular theory has linked 5G to the spread of COVID-19, leading to misinformation and the burning of 5G towers in the United Kingdom. The understanding of the drivers of fake news and quick policies oriented to isolate and rebate misinformation are keys to combating it.

Objective

The aim of this study is to develop an understanding of the drivers of the 5G COVID-19 conspiracy theory and strategies to deal with such misinformation.

Methods

This paper performs a social network analysis and content analysis of Twitter data from a 7-day period (Friday, March 27, 2020, to Saturday, April 4, 2020) in which the #5GCoronavirus hashtag was trending on Twitter in the United Kingdom. Influential users were analyzed through social network graph clusters. The size of the nodes were ranked by their betweenness centrality score, and the graph’s vertices were grouped by cluster using the Clauset-Newman-Moore algorithm. The topics and web sources used were also examined.

Results

Social network analysis identified that the two largest network structures consisted of an isolates group and a broadcast group. The analysis also revealed that there was a lack of an authority figure who was actively combating such misinformation. Content analysis revealed that, of 233 sample tweets, 34.8% (n=81) contained views that 5G and COVID-19 were linked, 32.2% (n=75) denounced the conspiracy theory, and 33.0% (n=77) were general tweets not expressing any personal views or opinions. Thus, 65.2% (n=152) of tweets derived from nonconspiracy theory supporters, which suggests that, although the topic attracted high volume, only a handful of users genuinely believed the conspiracy. This paper also shows that fake news websites were the most popular web source shared by users; although, YouTube videos were also shared. The study also identified an account whose sole aim was to spread the conspiracy theory on Twitter.

Conclusions

The combination of quick and targeted interventions oriented to delegitimize the sources of fake information is key to reducing their impact. Those users voicing their views against the conspiracy theory, link baiting, or sharing humorous tweets inadvertently raised the profile of the topic, suggesting that policymakers should insist in the efforts of isolating opinions that are based on fake news. Many social media platforms provide users with the ability to report inappropriate content, which should be used. This study is the first to analyze the 5G conspiracy theory in the context of COVID-19 on Twitter offering practical guidance to health authorities in how, in the context of a pandemic, rumors may be combated in the future.

A model predictive optimal control system for the practical automatic start-up of anaerobic digesters

The optimal automatic start-up of anaerobic digesters has remained an elusive problem over the years to be solved at the lowest possible costs, including that of process monitoring. In this work, a non-linear model predictive control (NMPC) system was developed, under two proposed configurations, for the optimal start-up of anaerobic digesters treating soluble non-recalcitrant substrates. The minimum set of low cost practical control variables (CVs) selected for process start-up include (i) the effluent quality as acetate COD, (ii) the level of aceticlastic methanogenic biomass in the reactor, and (iii) the methane production rate (only for one of the NMPC configurations). The manipulated variables (MVs) consist of the volumetric inflow rates of the organic substrate, dilution water, and of a possible concentrated alkali addition. To be able to apply the above selected CVs (technically and economically feasible to measure/estimate), a simplified tailored AD model was specifically designed as the prediction model, integral part of the NMPC system. The NMPC system developed was evaluated for a case scenario consisting of the automatic start-up of a high rate AD reactor treating a readily biodegradable carbohydrate based substrate. The AD plant was virtually represented by the complex Anaerobic Digestion Model No. 1. Compared to other manual start-up strategies, the two configurations of the NMPC developed appeared to reach the target methane production rate faster (39 and 18 days for the NMPC versus 70-75 days for the manual strategies) together with an overall superior CV set-point tracking error performance. Interestingly, the two configurations of the NMPC developed appear to propose two very different, almost opposite, start-up feeding strategies to both eventually start-up the reactor successfully with no process destabilizations throughout. A number of practical scenarios were also considered to evaluate the NMPC configurations for robustness and any possible improvements. These tests indicate that the NMPC objective function formulation is a key factor of the success and robustness exhibited during start-up.