COVID-19 patients' clinical profile and outcome with respect to their vaccination status: A prospective observational multicentre cohort study during third wave in Western India.

PURPOSE: To understand the benefits of COVID-19 vaccination (Covishield, Covaxin) on clinical features and outcome of COVID-19 during the third wave in India. MATERIALS AND METHODS: The primary study aim was to describe the clinical profile and outcome of COVID-19 regarding their vaccination and to identify risk factors for disease progression in vaccinated patients. This was a prospective observational multicentric study of COVID-19 attended by Infectious Disease physicians during January 15, 2022 to February 15, 2022. Adult patients with positive RT-PCR or rapid antigen test for COVID-19 were enrolled. Patient received treatment as per local institutional protocol. Chi square test for categorical and Mann Whitney test for continuous variables were applied for the analysis. Logistic regression was used to calculate adjusted odds ratios. RESULTS: A total of 788 patients were included in analysis out of 883 enrolled patients from 13 centers across Gujarat. By the end of two weeks' follow up, 22 patients (2.8%) had expired. The Median age of subjects was 54 years, with a (55.8%) male. 90% of the subjects were vaccinated, majority (77%) of them had received 2 doses of vaccine with Covishield (659, 93%). Mortality among the non-vaccinated was significantly (11.4%) higher than vaccinated (1.8%). Logistic regression analysis showed numbers of comorbidities (p â€‹= â€‹0.027), baseline higher WBC count (p â€‹= â€‹0.02), higher NLR (p â€‹= â€‹0.016), and Ct value (p â€‹= â€‹0.046) were associated with mortality while vaccination was associated with survival (p â€‹= â€‹0.001). The factors associated with mortality among vaccinated were age, comorbidities, baseline higher WBC, NLR, and CRP. CONCLUSIONS: Omicron variant was associated with mild symptoms. Clinical and laboratory risk factors for getting severe disease with Omicron variant were the same with previous SARS CoV-2 strain. Two doses of vaccine protect people against severe disease and death. Age, comorbidities, baseline leucocytosis, high NLR, elevated CRP are the risk factors for poor outcome in vaccinated patients.

Disproportionate positive feedback facilitates sense of agency and performance for a reaching movement task with a virtual hand.

This study investigated the generalized effects of positive feedback (PF) versus negative feedback (NF) during training on performance and sense of agency for a reach-to-touch task with a virtual hand. Virtual reality (VR) is increasingly employed for rehabilitation after neuromuscular traumas such as stroke and spinal cord injury. However, VR methods still need to be optimized for greater effectiveness and engagement to increase rates of clinical retention. In this study, we observed that training with disproportionate PF subsequently produced greater reaching performance (minimizing path length) and greater agency (perception of control) than with disproportionate NF. During PF training, there was also progressive increase in agency, but conversely a decrease in performance. Thus, the increase in performance after training may not be due to positively bolstered learning, but rather priming higher confidence reflected in greater agency. Agency was positively measured as compression in perceived time-intervals between the action of touch to a sound consequence, as standard with intentional binding paradigms. Positive feedback desirably increased agency (~180 msec) and reduced path length (1.8 cm) compared to negative feedback, which itself showed insignificant, or neutral, effects. Future investigations into optimizing virtual reality paradigms for neuromotor rehabilitation should consider agency as a driving factor for performance. These studies may serve to optimize how feedback is better presented with performance results for complex motor learning. Investigators should also ponder how personal characteristics, both cognitive and physical, may further affect sensitivity to feedback and the rate of neuromotor rehabilitation.

Agency and Performance of Reach-to-Grasp With Modified Control of a Virtual Hand: Implications for Rehabilitation.

This study investigated how modified control of a virtual hand executing reach-to-grasp affects functional performance and agency (perception of control). The objective of this work was to demonstrate positive relationships between reaching performance and grasping agency and motivate greater consideration of agency in movement rehabilitation. We hypothesized that agency and performance have positive correlation across varying control modes of the virtual hand. In this study, each participant controlled motion of a virtual hand through motion of his or her own hand. Control of the virtual hand was modified according to a specific control mode. Each mode involved the virtual hand moving at a modified speed, having noise, or including a level of automation. These specific modes represent potential control features to adapt for a rehabilitation device such as a prosthetic arm and hand. In this study, significant changes in agency and performance were observed across the control modes. Overall, a significant positive relationship (p < 0.001) was observed between the primary performance metric of reach (tracking a minimum path length trajectory) and an implicit measurement of agency (intentional binding). Intentional binding was assessed through participant perceptions of time-intervals between grasp contact and a sound event. Other notable findings include improved movement efficiency (increased smoothness, reduced acceleration) during expression of higher agency and shift toward greater implicit versus explicit agency with higher control speed. Positively relating performance and agency incentivizes control adaptation of powered movement devices, such as prostheses or exoskeletons, to maximize both user engagement and functional performance. Agency-based approaches may foster user-device integration at a cognitive level and facilitate greater clinical retention of the device. Future work should identify robust and automated methods to adapt device control for increased agency. Objectives include how virtual reality (VR) may identify optimal control of real-world devices and assessing real-time agency from neurophysiological signals.

Surgical Outcome of Mastoid Cavity Obliteration Using Postauricular Composite Bone with Periosteum Flap.

This study was aimed to evaluate surgical outcome of patients undergoing obliteration of mastoid cavity with postauricular composite osteo-periosteal flap. This interventional study was carried out on 100 patients having unsafe CSOM from Nov. 2012 to Oct. 2014 who underwent canal wall down mastoidectomy with tympanoplasty and obliteration of cavity using composite osteo-periosteal flap. The primary outcome measure was control of suppuration and creation of dry, low-maintenance mastoid cavity, which was assessed using Merchant et al. grading system. At the end of 1 year follow-up, 89% patients had Grade 0 summary score while Grade 3 which was considered as failure of control of infection was not obtained in any patient during the entire follow-up period. Mastoid cavity obliteration using composite osteo-periosteal flap is an effective technique to avoid cavity problems.