Corporate responses to the COVID-19 pandemic by Fortune 500 companies.

COVID-19 created a challenging environment both for businesses and individuals. Effects of the pandemic on companies had the potential to create negative public relations as entities attempted to deal with the worldwide crisis and to communicate their situation. Many companies were quick to provide information to customers and employees early in the pandemic about how they were responding to the crisis, while other companies provided limited immediate response to COVID-19. An examination of the top 300 companies listed in the 2020 Fortune 500 found that 186 of those companies communicated their status and plans in press releases posted from January 2020 through May 2020 regarding the COVID-19 pandemic. This study, based on Situational Crisis Communication Theory, qualitatively analyzed the releases via constant comparative method. The analysis resulted in four primary categories that dominated company releases: (1) In This Together, (2) Perseverance Through Strength, (3) We are Here for You, and (4) Fighting for the Team.

Effects of hatch window and nutrient access in the hatcher on performance and processing yield of broiler chicks reared according to time of hatch.

The effects of hatch window and hatching basket nutrient availability on organ weights, performance, and processing yield of broilers were investigated. Eggs were hatched in illuminated hatchers. At the end of each hatch window period (HWP), hatched chicks were placed into control (CTL) hatching baskets with no nutrients or baskets providing access to feed and water (FAW). This resulted in 6 treatments in a factorial arrangement of 3 HWP (early, middle, or late) and 2 basket types (CTL or FAW). Chicks remained in experimental baskets until 504 h and were then subjected to a 4 h holding period at the hatchery without nutrient access. Subsequently, 1,500 hatched chicks were reared in floor pens for 42 d with 5 replicate pens per treatment. Common diets and water were provided ad libitum. Bird weights and feed consumption were recorded weekly. Individual bird weights were taken at 21 and 42 d. At 43 d, 14 males from each pen were processed. There was an interaction between HWP and basket type on placement BW (P = 0.028) and BW change in the hatcher (P < 0.001). The HWP influenced BW at hatch (P = 0.007), 7 d (P < 0.001), and 14 d (P < 0.001) and FI at 7 d (P < 0.001) and 14 d (P = 0.002). Chicks from FAW baskets were heavier (P < 0.001) than those from CTL baskets at 7 d; afterward, they were similar (P > 0.05) in BW. Yolk and liver weights were similar (P > 0.05) between basket treatments at 3 d posthatch. No differences (P > 0.05) in FCR, mortality, or processing were observed between basket treatments. Interestingly, early hatching chicks were lightest at hatch but subsequently had higher FI and BWG. These findings indicate that hatcher nutrient access may reduce weight loss in the hatcher, especially for early hatching chicks, but had no influence on subsequent performance or processing yields beyond 7 d.

Effects of Hatch Window and Nutrient Access in the Hatcher on Performance and Processing Yields of Broilers Reared with Equal Hatch Window Representation.

The objective of this experiment was to investigate the effects of feed and water availability in hatching baskets on broiler performance, processing yield, and organ weights while considering the influence of hatch window. Cobb 500 eggs were transferred into illuminated hatchers with two hatching basket types [control (CTL) hatching baskets with no nutrients provided or baskets containing feed and water (FAW)]. Chicks were pulled sequentially to establish four hatch window periods (HWP): early, pre-peak, post-peak, or late. Chicks were then held for 4 h at the hatchery without nutrient access and subsequently reared in 26 floor pens designated as CTL (n = 13) or FAW (n = 13), with 13 chicks from each of the 4 HWP per pen (52 chicks per pen). At 43 d, 16 males from each pen were processed. Chicks from FAW baskets were 1 g heavier (p < 0.001) than those from CTL baskets at placement and were heavier through 28 d (p = 0.003) but similar (p > 0.05) in body weight (BW) for the remainder of the 42 d. No differences (p > 0.05) in feed conversion ratio, mortality, or processing data were observed between CTL and FAW groups. Early-hatching chicks were lighter (p < 0.001) than those from all other HWP at placement, but were only lighter (p < 0.001) than the post-peak group by 42 d. In summary, it was found that hatching basket nutrient access increased the BW of broilers during the first 4 wk of growth, with no other effects on performance or yield. Also, earlier-hatching chicks were generally able to compensate for a lighter placement BW.

Gathering your 'sea legs': Extended durations in an offshore environment increases postural sway excursions.

BACKGROUND: Mal de debarquement (MdD), or often called 'sea legs', is the perception of self-motion after exposure to passive movement such as being on a boat at sea. Previous studies highlight sensory re-organization difficulties and postural control impairments after disembarking from sea travel in experienced crew members. However, the impact of MdD in individuals with minimal offshore experience, defined as participating in less than 2 offshore excursions per year, has not been investigated. RESEARCH QUESTION: Does exposure to boat motion while at sea alter static postural control after disembarking in individuals with minimal offshore experience? METHODS: Healthy adults (n = 24) with minimal offshore experience had their static balance assessed on a force platform before (PRE) and after (POST) a 7-h deep sea fishing excursion. Static balance was tested in eyes open (EO), eyes closed (EC), eyes open on a foam surface (EOF), and eyes closed on a foam surface (ECF) conditions. Sway excursions, sway velocity and sway variability in the medial-lateral (ML) and anterior-posterior (AP) directions were computed and then compared PRE/POST using a paired t-test (p < 0.05). RESULTS: Significant increases in ML sway excursion (p = 0.004), ML sway range (p < 0.001), ML sway variability (p < 0.001), AP sway excursion (p = 0.045), AP sway range (p = 0.020), and AP sway variability (p = 0.030) were observed at POST during EOF. Significant increases in ML sway excursion (p = 0.027), AP sway excursion (p = 0.020), and AP sway variability (p = 0.014) at POST were also observed during ECF. No differences were found in the EO condition (p > 0.05). SIGNIFICANCE: Increases in postural sway excursion and variability were observed in individuals with minimal offshore experience after disembarking. Our findings suggest sensory re-organization difficulties in order to maintain an upright posture in challenging sensory conditions are dependent on vestibular and somatosensory inputs following exposure to boat motion at sea.

Does intra-operative flexible endoscopy reduce anastomotic complications following left-sided colonic resections? A systematic review and meta-analysis.

AIM: Postoperative anastomotic leakage (AL) or bleeding (AB) significantly impacts on patient outcome following colorectal resection. To minimize such complications, surgeons can utilize different techniques perioperatively to assess anastomotic integrity. We aim to assess published anastomotic complication rates following left-sided colonic resection, comparing the use of intra-operative flexible endoscopy (FE) against conventional tests used to assess anastomotic integrity. METHODS: PubMed/MEDLINE and Embase online databases were searched for non-randomized and randomized case-control studies that investigated postoperative AL and/or AB rates in left-sided colonic resections, comparing intra-operative FE against conventional tests. Data from eligible studies were pooled, and a meta-analysis using Review Manager 5.3 software was performed to assess for differences in AL and AB rates. RESULTS: Data from six studies were analysed to assess the impact of FE on postoperative AL and AB rates (1084 and 751 patients respectively). Use of FE was associated with reduced postoperative AL and AB rates, from 6.9% to 3.5% and 5.8% to 2.4% respectively. Odds ratios favoured intra-operative FE: 0.37 (95% CI 0.21-0.68, P = 0.001) for AL and 0.35 (95% CI 0.15-0.82, P = 0.02) for AB. CONCLUSION: This meta-analysis showed that the use of intra-operative FE is associated with a reduced rate of postoperative AL and AB, compared to conventional anastomotic testing methods.

Longitudinal Assessment of Medical Student Emotional Intelligence Over Preclinical Training.

CONTEXT: Given the importance of emotional intelligence (EI) in physician leadership and success, the possible decline of EI over the course of training is a concern in medical education. OBJECTIVES: To assess the EI of osteopathic medical students as they progress through the preclinical years of medical school, to discover the course of EI over time, and to identify specific core EI competencies to be enhanced or coached. METHODS: This exploratory, longitudinal study used survey data to assess the course and competencies of EI in the incoming 2019 class of medical students at a college of osteopathic medicine. Changes in EI overall scores and the 8 core competency scale scores were assessed, and additional demographic data were collected for use in analysis. Methods of analysis included paired samples t test, independent samples t test, Pearson product moment correlation, and multiple regression analysis. Statistical significance was defined as P<.05. RESULTS: Sixty-two participants completed the Six Seconds Emotional Intelligence Assessment survey at orientation and again after their second year. Overall EI scores declined over the course of the preclinical training for men and women (t61=4.24, P<.001), although no differences were noted by gender when independent-samples t tests were run. However, 2 of the 8 competency scales of the composite EI scores did not decline over time-Enhanced Emotional Literacy and Pursue Noble Goals. A weak negative correlation was found between Medical College Admission Test scores and the scale of Apply Consequential Thinking (r=-0.3, P<.05). A weak positive correlation was found between grade point average and intrinsic motivation (r=0.3, P<.05) and optimism (r=0.3, P<.05), and a moderate positive correlation existed between preboard examination scores and intrinsic motivation (r=0.5, P<.001) and optimism (r=0.4, P<.01). None of the chosen independent variables (academic grades, test scores, age, or gender) contributed to overall EI scores. CONCLUSIONS: During the preclinical training, osteopathic medical students' overall EI scores, as well as 6 of the 8 core competency scales, declined. Therefore, EI coaching is warranted to address specific core competencies needed to build, enhance, and prevent the decline of EI through preclinical training.

Google Ranking of Plastic Surgeons Values Social Media Presence Over Academic Pedigree and Experience.

BACKGROUND: Patients increasingly rely on online resources to make healthcare decisions. Google dominates the search engine market; first-page results receive most of the web traffic and therefore serve as an important indicator of consumer reach. OBJECTIVES: Our objective was to analyze the respective importance of physician academic pedigree, experience, and social media presence on plastic surgeon Google first-page search result placement. METHODS: A Google.com search was conducted in the top 25 United States metropolitan areas to identify the top 20 websites of board-certified plastic surgeons. Social media presence was quantified by tracking the number of followers on Facebook, Twitter, and Instagram for every surgeon as well as medical school and year of graduation. The primary outcome was website ranking in the first page of Google search results. To identify the independent predictors of presence on the front page, we performed a multivariate logistic regression. RESULTS: Total number of social medial followers was associated with Google front-page placement (P < 0.001), whereas medical school ranking and years in practice were not (P = 0.17 and 0.39, respectively). A total 19.6% of plastic surgeon practices in our study cohort still had no social media accounts whatsoever. CONCLUSIONS: For the past few decades, plastic surgery practices relied on referrals, word of mouth, and the surgeon's reputation and academic pedigree to attract new patients. It is now clear that this practice-building model is being rapidly supplanted by a new paradigm based on social media presence to reach potential patients.

Plastic Surgery-Related Hashtag Utilization on Instagram: Implications for Education and Marketing.

BACKGROUND: Recent data suggest patients are seeking aesthetic surgery to improve their appearance on Instagram and other social media. Despite the rising influence of Instagram in plastic surgery, few academic publications address Instagram, let alone evaluate its utilization in plastic surgery. OBJECTIVES: We set out to answer the following three questions: 1) what plastic surgery-related content is being posted to Instagram; 2) who is posting this content; and 3) what specific hashtags are they using? METHODS: Our study queried 21 Instagram plastic surgery-related hashtags. Content analysis was used to qualitatively evaluate each of the nine "top" posts associated with each hashtag (189 posts). Duplicate posts and those not relevant to plastic surgery were excluded. RESULTS: A total of 1,789,270 posts utilized the 21 hashtags sampled in this study. Of the top 189 posts for these 21 queried hashtags, 163 posts met inclusion criteria. Plastic surgeons eligible for membership in American Society for Aesthetic Plastic Surgery (ASAPS) accounted for only 17.8% of top posts, whereas noneligible physicians accounted for 26.4%. All nonplastic surgery trained physicians marketed themselves as "cosmetic surgeons." Nine top posts (5.5%) were by nonphysicians, including dentists, spas with no associated physician, and a hair salon. The majority of these posts were self-promotional (67.1%) as opposed to educational (32.9%). Board-certified plastic surgeons were significantly more likely to post educational content to Instagram as compared to nonplastic surgeons (62.1% vs 38.1%, P = 0.02). CONCLUSIONS: ASAPS eligible board-certified plastic surgeons are underrepresented amongst physicians posting top plastic surgery-related content to Instagram.

The Ethics of Sharing Plastic Surgery Videos on Social Media: Systematic Literature Review, Ethical Analysis, and Proposed Guidelines.

Recent videos shared by plastic surgeons on social media applications such as Snapchat, Instagram, and YouTube, among others, have blurred the line between entertainment and patient care. This has left many in the plastic surgery community calling for the development of more structured oversight and guidance regarding video sharing on social media. To date, no official guidelines exist for plastic surgeons to follow. Little is known about the ethical implications of social media use by plastic surgeons, especially with regard to video sharing. A systematic review of the literature on social media use in plastic surgery was performed on October 31, 2016, with an emphasis on ethics and professionalism. An ethical analysis was conducted using the four principles of medical ethics. The initial search yielded 87 articles. Thirty-four articles were included for analyses that were found to be relevant to the use of social media in plastic surgery. No peer-reviewed articles were found that mentioned Snapchat or addressed the ethical implications of sharing live videos of plastic surgery on social media. Using the four principles of medical ethics, it was determined that significant ethical concerns exist with broadcasting these videos. This analysis fills an important gap in the plastic surgery literature by addressing the ethical issues concerning live surgery broadcasts on social media. Plastic surgeons may use the guidelines proposed here to avoid potential pitfalls.

Evaluation of chlorine dioxide based product as a hatchery sanitizer.

Formaldehyde is commonly used to overcome contaminants introduced by hatching eggs or water supply in the hatcher cabinets. However, health risks associated with its use make economical alternatives important. This project evaluated a chlorine dioxide based product (CDBP) (0.3% concentrate) as a hatchery sanitizer in decontaminating microbial populations on the shell surface of hatching eggs (>18 d old), as well as its impact on hatchability and chick performance. Hatchers (0.20 m2) designed to hold approximately 50 eggs and equipped with circulation fans, heaters, and thermostats were used for the evaluation. For each of the 2 trials conducted, 450 hatching eggs were obtained and incubated in a common setter. Eggs used in trial 1 were floor eggs whereas in trial 2 nest eggs were used. On d 18 of incubation, eggs were removed from the setter, and viable eggs were randomly allocated to 9 hatchers. Pre-treatment egg rinse samples (10 eggs per hatcher) were collected for initial microbial analysis. Three hatchers were treated with CDBP and 3 hatchers with a formaldehyde based product (FBP). Three untreated hatchers served as control (C). Prior to hatch, 10 eggs/incubator, not previously rinsed, were used for post treatment microbial counts. The hatched chicks were reared until d 21 in floor pens with a common starter diet. For the CDBP treated eggs, hatchability and chick performance (weight gains, mortality, and FCR on d 7 and d 21) were similar to the other treatments. The application rate of CDBP evaluated in this study was not an effective antimicrobial alternative to formaldehyde for sanitizing hatching eggs in hatcher cabinets prior to hatch.

Pathological changes associated with white striping in broiler breast muscles.

White striping is a condition in broiler chickens characterized grossly by the occurrence of white striations, seen parallel to the direction of muscle fibers, on broiler breast fillets and thighs. Based on visual evaluation of the intensity of white striping, breast fillets can be categorized into normal (NORM), moderate (MOD), and severe (SEV) categories. This study was undertaken to evaluate the details of changes in histology as well as proximate composition occurring in the fillets with respect to the 3 degrees of white striping. In experiment 1, representative breast fillets for each degree of white striping (n = 20) were collected from 45-d-old broilers, approximately 2 h postmortem. From each fillet, 2 skeletal muscle samples were obtained and fixed in 10% neutral buffered formalin. To identify and differentiate the histological changes, slides were prepared and stained using hematoxylin and eosin, Masson's Trichrome, and Oil Red O stains. In experiment 2, samples with 3 degrees of white striping were collected from 57-d-old birds for conducting proximate analysis. Major histopathological changes observed in the MOD and SEV samples consisted of loss of cross striations, variability in fiber size, floccular/vacuolar degeneration and lysis of fibers, mild mineralization, occasional regeneration (nuclear rowing and multinucleated cells), mononuclear cell infiltration, lipidosis, and interstitial inflammation and fibrosis. Microscopic lesions were visually scored for degeneration and necrosis, fibrosis, and lipidosis. The scale used to score the samples ranged from 0 (normal) to 3 (severe). There was an increase (P < 0.05) in mean scores for degenerative or necrotic lesions, fibrosis, and lipidosis as the degree of white striping increased from NORM to SEV. The results from the histopathological study were supported by the findings from proximate analysis confirming that the fat and protein contents of muscle increased (P < 0.05) and decreased (P < 0.05), respectively, as the degree of white striping increased. In conclusion, the histopathological changes occurring in white striping indicate a degenerative myopathy that could be associated with increased growth rate in birds.

Effects of high fat diets or prednisolone treatment on femoral head separation in chickens.

1. The effects of high fat diets and prednisolone treatment were studied to understand the etiology of femoral head separation (FHS) in fast growing broiler chickens. Dietary effects on production parameters such as growth, feed conversion ratio (FCR) and blood chemistry were also measured. 2. Three groups of chickens, consisting of 30 birds each, in two replicate pens, were fed isonitrogenous diets containing 40 (control), 60, or 80 g poultry fat supplements per kg feed. The birds were fed a starter diet containing the fat supplements for the first three weeks, then switched to a grower diet containing the same supplements for the rest of the experimental period. Two groups of birds were also raised with the control diets, but were administered either cholesterol or prednisolone intramuscularly at 30 and 32 days of age to evaluate their effects on FHS incidences. 3. The chickens were euthanised and necropsied at 37 d of age. The presence of femoral head weakness was determined by applying mild pressure on the pelvic joint to cause the growth plate to become detached from its articular cartilage in affected cases. 4. High fat diets did not change FHS incidences, but increased 28 d body weights (BW) and FCR. At 37 d of age the BW differences were not significant but the FCR (gain: feed ratio) remained higher in high fat fed groups. Prednisolone treatment, by contrast, resulted in decreased BW, decreased feed efficiency, increased FHS index, and elevated blood lipid levels. 5. The results suggest that high dietary fats do not affect FHS incidence in broilers. Prednisolone treatment causes hyperlipidaemia and increases FHS index, and may therefore provide a suitable experimental model of FHS pathogenesis in growing chickens.

Monensin use against Neospora caninum challenge in dairy cattle.

Using a randomized controlled trial design, a randomly allocated intervention group of 15 cows received a slow-release bolus that delivered 100 days of monensin. The negative control group of 15 cows received a placebo bolus that was identical to the monensin bolus, except without the monensin. Two weeks after bolus administration, all cows were challenged with a 2 ml subcutaneous injection of a live tachyzoite suspension. Whole blood and serum samples were collected from each cow every week for the first month post-challenge, and then every 2 weeks for the next 2 months. The extracted DNA from whole blood was tested for the Nc-5 gene fragment of Neospora caninum using a quantitative real time polymerase chain reaction. Serum was tested for antibodies to N. caninum using the IDEXX ELISA. Cows treated with monensin boluses had a significantly lower humoral immune response than cows treated with placebo boluses at one time point post-challenge (week 4 post-challenge). However, when adjusting for repeated measures within cows, the P value for this humoral difference was 0.098. No DNA for N. caninum was detected in either group, likely due to study design features.

Tertiary structure and characterization of a glycoside hydrolase family 44 endoglucanase from Clostridium acetobutylicum.

A gene encoding a glycoside hydrolase family 44 (GH44) protein from Clostridium acetobutylicum ATCC 824 was synthesized and transformed into Escherichia coli. The previously uncharacterized protein was expressed with a C-terminal His tag and purified by nickel-nitrilotriacetic acid affinity chromatography. Crystallization and X-ray diffraction to a 2.2-A resolution revealed a triose phosphate isomerase (TIM) barrel-like structure with additional Greek key and beta-sandwich folds, similar to other GH44 crystal structures. The enzyme hydrolyzes cellotetraose and larger cellooligosaccharides, yielding an unbalanced product distribution, including some glucose. It attacks carboxymethylcellulose and xylan at approximately the same rates. Its activity on carboxymethylcellulose is much higher than that of the isolated C. acetobutylicum cellulosome. It also extensively converts lichenan to oligosaccharides of intermediate size and attacks Avicel to a limited extent. The enzyme has an optimal temperature in a 10-min assay of 55 degrees C and an optimal pH of 5.0.

Risk factors for compartment syndrome in traumatic brachial artery injuries: an institutional experience in 139 patients.

BACKGROUND: The brachial artery is the most common vascular injury encountered in upper extremity trauma. If not treated promptly, it can result in compartment syndrome (CS) and long-term disability. Here, we report an institutional experience of traumatic brachial artery injuries and establish risk factors for the development of upper extremity CS in this setting. METHODS: A retrospective review of 139 patients with traumatic brachial artery injury from 1985 to 2001 at a single institution. Patients were divided into two cohorts, those with evidence of CS and those without CS (NCS), for comparison. RESULTS: One hundred thirty-nine patients presented with traumatic brachial artery injuries (mean age, 28.4 years). Twenty-nine patients (20.9%) were diagnosed with upper extremity CS, and 28 of these patients underwent fasciotomy on recognition of their CS. Seven patients (6.4%) in the NCS cohort underwent fasciotomy as a result of absent distal pulses on initial examination. Mean follow-up was 51.6 days. Two patients required revision of their arterial repair, and one patient underwent amputation. The risk of CS was increased in the presence of combined arterial injuries (p = 0.03), combined nerve injuries (p = 0.04), motor deficits (p < 0.0001), fractures, and increased intraoperative blood loss (p = 0.001). Multivariate logistic regression performed on these variables revealed that elevated intraoperative blood loss, combined arterial injury, and open fracture were independent risk factors for the development of CS (OR 1.12, 5.79, and 2.68, respectively). CONCLUSION: Prompt evaluation and management of traumatic brachial artery injuries is important to prevent CS, which can lead to functional deficits. In the setting of combined arterial injury, open fracture, and significant intraoperative blood loss, prophylactic fasciotomy should be considered.

Eyebrow papule in an elderly man.

A 70-year-old Caucasian man presented with a several-month history of a solitary, asymptomatic papule on the left eyebrow. His medical history included stage 1A lentigo maligna melanoma and multiple non-melanoma skin cancers. Physical examination demonstrated a solitary 5-mm smooth, dome-shaped skin colored papule with subtle central erosion on the left eyebrow. No overlying telangiectasias were noted. A biopsy of the lesion was performed. The lesion was composed of plump spindle cells arranged in a plexiform pattern in the background of thick, keloidal collagen bundles. The lesional cells were NKI/C3-positive and S-100-negative. A diagnosis of cellular neurothekeoma was made.

Staphylococcal biofilms impair wound healing by delaying reepithelialization in a murine cutaneous wound model.

Bacterial biofilms have gained increasing visibility in recent years as a ubiquitous form of survival for microorganisms in myriad environments. A number of in vivo models exist for the study of biofilms in the setting of medically relevant implanted foreign bodies. Growing evidence has demonstrated the presence of bacterial biofilms in the setting of a number of chronic wound states including pressure sores, diabetic foot ulcers, and venous stasis ulcers. Here we present a novel murine cutaneous wound system that directly demonstrates delayed reepithelialization caused by the presence of a bacterial biofilm. We established biofilms using either Staphylococcus aureus or Staphylococcus epidermidis in splinted cutaneous punch wounds created on the backs of normal C57Bl6/J mice. Wound reepithelialization was significantly delayed by bacterial biofilms. This effect was specifically dependent on the ability of the bacteria to form biofilms as demonstrated by exogenous administration of biofilm inhibiting peptides and the use of mutant Staphylococcus spp. deficient in biofilm formation. This represents the first direct evidence for the effect of bacterial biofilms on cutaneous wound healing.