Background: Surgical mortality data are collected routinely in high-income countries, yet virtually no low-or middle-income countries have outcome surveillance in place. The aim was prospectively to collect worldwide mortality data following emergency abdominal surgery, comparing findings across countries with a low, middle or high Human Development Index (HDI).Methods: This was a prospective, multicentre, cohort study. Self-selected hospitals performing emergency surgery submitted prespecified data for consecutive patients from at least one 2-week interval during July to December 2014. Postoperative mortality was analysed by hierarchical multivariable logistic regression.
Purpose and objective We performed a systematic review on COVID-19 and its potential urological manifestations. Methods A literature search was performed using combination of keywords (MeSH terms and free text words) relating to COVID-19, urology, faeces and stool on multiple databases. Primary outcomes were the urological manifestations of COVID-19, and SARS-CoV-2 viral RNA detection in urine and stool samples. Meta-analyses were performed when there were two or more studies reporting on the same outcome. Special considerations in urological conditions that were relevant in the pandemic of COVID-19 were reported in a narrative manner. Results There were a total of 21 studies with 3714 COVID-19 patients, and urinary symptoms were absent in all of them. In patients with COVID-19, 7.58% (95% CI 3.30-13.54%) developed acute kidney injury with a mortality rate of 93.27% (95% CI 81.46-100%) amongst them. 5.74% (95% CI 2.88-9.44%) of COVID-19 patients had positive viral RNA in urine samples, but the duration of viral shedding in urine was unknown. 65.82% (95% CI 45.71-83.51%) of COVID-19 patients had positive viral RNA in stool samples, which were detected from 2 to 47 days from symptom onset. 31.6% of renal transplant recipients with COVID-19 required non-invasive ventilation, and the overall mortality rate was 15.4%. Conclusions Acute kidney injury leading to mortality is common amongst COVID-19 patients, likely as a result of direct viral toxicity. Viral RNA positivity was detected in both urine and stool samples, so precautions are needed when we perform transurethral or transrectal procedures.
To compete in a highly dynamic marketplace, firms must frequently adapt and align their competitive strategies and information systems. The dominant literature on the strategic fit of a firm's information systems focuses primarily on high-level measures of the strategic fit of a firm's overall IS portfolio and the impact of fit on business performance. This paper addresses the need for a more fine-grained approach for assessing the specific areas of misfit between a firm's competitive strategies and IS capabilities. We describe the design and evaluation of a multilevel strategic fit (MSF) measurement model that enables researchers and practitioners to measure the strategic fit of a firm's information systems at both an overall and a detailed level. The steps in the model include identifying the relevant IS capabilities according to the type of system; measuring the current level of support for each capability using a capabilities instrument; identifying the ideal level of support for each capability using an adaptation of Conant et al.'s (1990) instrument to assess strategic archetype; and comparing the ideal and realized level of support for each capability. Evidence from a multiple case study analysis indicates that the fine-grained assessment of strategic fit can strengthen the validity, utility, and ease of corroboration of the strategic fit measurement outputs. The paper also demonstrates how an iterative design science research approach, with its emphasis on evaluating the utility of prototype artifacts, is well suited to developing field-tested and theoretically grounded measurement models and instruments that are accessible to practitioners. This focus on practical utility in turn provides researchers with results that can be more readily corroborated, thus improving the quality and usefulness of the research findings.
The TNF family is involved in the regulation of the immune system, and its members have been implicated in a variety of biological events such as apoptosis, cell proliferation, differentiation and survival. Here we present a new member of the TNF family, tumor necrosis factor superfamily member 20 (TNFSF20) that we have identified from the expressed sequence tag (EST) database and characterized. The human protein is a 285 amino acid long type II transmembrane protein and is 19% homologous to TNF in its extra-cellular domain. TNFSF20 is expressed at the surface of antigen presenting cells such as cells of the macrophagemonocyte lineage and dendritic cells. After treatment with bacterial lipopolysaccharide (LPS), TNFSF20 expression is downregulated at the surface of the expresssing cells, suggesting that the membrane-bound protein gets cleaved, and that a soluble factor is released in the extra-cellular compartment. The soluble form of the recombinant TNFSF20 induces proliferation of resting peripheral blood monocytes (PBMC) and cell death of activated lymphocytes. TNFSF20 might therefore play a critical role in the regulation of cell-mediated immune responses.
The tumor immune microenvironment (TIME) is commonly infiltrated by diverse collections of myeloid cells. Yet, the complexity of myeloid cell identity and plasticity has challenged efforts to define bona fide populations and determine their connections to T cell function and their relation to patient outcome. Here we leverage single-cell RNA-sequencing (scRNA-seq) analysis of several mouse and human tumors and find that monocyte-macrophage diversity is characterized by a combination of conserved lineage states as well as transcriptional programs accessed along the differentiation trajectory. Using mouse models, we also find that tumor monocyte-to-macrophage progression is profoundly tied to regulatory T cell (Treg) abundance. Importantly, in human kidney cancer, heterogeneity in macrophage accumulation and myeloid composition corresponded to variance in, not only Treg density, but also the quality of infiltrating CD8+ T cells. In this way, holistic analysis of monocyte-to-macrophage differentiation creates a framework for critically different immune states in kidney tumors.
This paper defines the notion of key inventors -those whose patenting is simultaneously highly productive and also widely cited. By implication, key inventors should be the leaders in any developing new field and we investigate the validity of the notion through an exploration of two emerging technological fields: fuel cell and nanotechnology. The nature of the two groups is compared to discuss the differences between the technological groups.
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