Comparative Efficacy of Biologics and Small Molecule Therapies in Improving Patient-Reported Outcomes in Ulcerative Colitis: Systematic Review and Network Meta-Analysis.

BACKGROUND: Ulcerative colitis (UC) is a chronic disorder with a considerable negative impact on health-related quality of life (HRQoL), which has been recently recognized as an important treatment target. The purpose of this study is to compare the efficacy of different biologics and small molecule therapies in achieving better patient-reported outcomes and HRQoL in patients with UC. METHODS: We performed a systematic review and network meta-analysis of the EMBASE, MEDLINE, and Cochrane Central databases from inception until February 1, 2024. The primary endpoint was clinical remission in the patient-reported outcome (PRO-2) score in UC patients who were treated with different biologics or small molecules during induction and maintenance phases. PRO-2 score is the sum of both stool frequency and rectal bleeding subscores. The secondary outcome was improvement of HRQoL defined as an increase in Inflammatory Bowel Disease Questionnaire score of ≥16 points from baseline or any change in total score from baseline. A random effects model was used, and outcomes were reported as odds ratio with 95% confidence interval. Interventions were ranked per the SUCRA (surface under the cumulative ranking curve) score. RESULTS: A total of 54 studies were included in the primary outcome analysis and 15 studies were included in the secondary outcome analysis. The primary analysis showed that during the induction phase all of included drugs were better than placebo in improving the PRO-2 score. Interestingly, upadacitinib was found to be superior to most medications in improving PRO-2 scores. The secondary analysis showed that guselkumab ranked first in the improvement of the Inflammatory Bowel Disease Questionnaire score, followed by upadacitinib during the induction phase. CONCLUSION: Upadacitinib ranked first in PRO-2 clinical remission during the induction and maintenance phases. Guselkumab, mirikizumab, tofacitinib, and upadacitinib were the only novel medications that were superior to placebo in improving HRQoL in UC, with guselkumab ranking the highest, followed by tofacitinib and upadacitinib. During maintenance of remission, tofacitinib ranked highest in improving HRQoL.

Patient-reported outcome (PRO-2) and disease impact on health-related quality of life (HRQoL) have been recognized as important treatment targets in ulcerative colitis. In this systematic review and network meta-analysis, we compared different biologics and small molecules in achieving these outcomes. We found that upadacitinib ranked first in PRO-2 clinical remission during induction and maintenance phases. Guselkumab, tofacitinib, and upadacitinib were the only novel medications that were superior to placebo in improving HRQoL during induction in ulcerative colitis, with guselkumab ranking the highest, followed by tofacitinib and upadacitinib. During maintenance of remission, tofacitinib ranked highest in improving HRQoL.

Postmortem lung and heart examination of COVID-19 patients in a case series from Jordan.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has emerged as a pandemic for more than 2 years. Autopsy examination is an invaluable tool to understand the pathogenesis of emerging infections and their consequent mortalities. The aim of the current study was to present the lung and heart pathological findings of COVID-19-positive autopsies performed in Jordan. METHODS: The study involved medicolegal cases, where the cause of death was unclear and autopsy examination was mandated by law. We included the clinical and pathologic findings of routine gross and microscopic examination of cases that were positive for COVID-19 at time of death. Testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was confirmed through molecular detection by real-time polymerase chain reaction, serologic testing for IgM and electron microscope examination of lung samples. RESULTS: Seventeen autopsies were included, with male predominance (76.5%), Jordanians (70.6%), and 50 years as the mean age at time of death. Nine out of 16 cases (56.3%) had co-morbidities, with one case lacking such data. Histologic examination of lung tissue revealed diffuse alveolar damage in 13/17 cases (76.5%), and pulmonary microthrombi in 8/17 cases (47.1%). Microscopic cardiac findings were scarcely detected. Two patients died as a direct result of acute cardiac disease with limited pulmonary findings. CONCLUSIONS: The detection of SARS-CoV-2 in postmortem examination can be an incidental or contributory finding which highlights the value of autopsy examination to determine the exact cause of death in controversial cases.

Organizational Behavior in Green Supply Chain Integration: Nexus Between Information Technology Capability, Green Innovation, and Organizational Performance.

Stakeholder pressure and public awareness of environmental protection drive organizations to improve environmental practices in the supply chain (SC), such as green supply chain integration (GSCI) and green innovation (GI). The use of information technology (IT) is crucial to manufacturing organizations' GSCI and performance. However, the research on the relationship between IT capabilities, GSCI, GI and organizational performance is still limited. Therefore, empirical research is needed on the cognitive thinking of employees using IT capabilities to improve GSCI and organizational performance. The data for this study comes from SC personnel in manufacturing organizations through a structured questionnaires and was analyzed by employing structural equation modeling. Based on the results, this paper concludes that organizational IT capabilities positively affect the GSCI and improve organizational performance (environmental and operational performance). Furthermore, the study discovered that GI increases organizational performance and acts as a positive mediator in the link between GSCI and performance. The findings contribute to existing GSCI and GI knowledge, which can provide a bird's eye-view to develop an organization's IT capabilities to achieve competitive performance goals.

Corrigendum: Organizational Behavior in Green Supply Chain Integration: Nexus Between Information Technology Capability, Green Innovation, and Organizational Performance.

[This corrects the article DOI: 10.3389/fpsyg.2022.874639.].

Sensitivity analysis of greenhouse gas emissions at farm level: case study of grain and cash crops.

Sensitivity analysis is useful to downgrade/upgrade the number of inputs to limit greenhouse emissions and enhance crop yield. The primary data from the 300 rice (grain crop) and 300 cotton (cash crop) farmers were gathered in face-to-face interviews by applying a multistage random sampling technique using a well-structured pretested questionnaire. Energy use efficiency was estimated with data envelopment analysis (DEA) model, and a second-stage regression analysis was conducted by applying Cobb-Douglas production function to evaluate the influencing factors affecting. The results exhibit that chemical fertilizers, diesel fuel and water for irrigation are the major energy inputs that are accounted to be 15,721.55, 10,787.50 and 6411.08 MJ ha-1 for rice production, while for cotton diesel fuel, chemical fertilizer and water for irrigation were calculated to be 13,860.94, 12,691.10 and 4456.34 MJ ha-1, respectively. Total GHGs emissions were found to be 920.69 and 954.71 kg CO2eq ha-1 from rice and cotton productions, respectively. Energy use efficiency (1.33 and 1.53), specific energy (11.03 and 7.69 MJ ha-1), energy productivity (0.09 and 0.13 kg MJ-1) and energy gained (14,497.85 and 20,047.56 MJ ha-1) for rice and cotton crop, respectively. Moreover, the results obtained through the second-stage regression analysis revealed that excessive application of fertilizer had a negative impact on the yield of rice and cotton, while farm machinery, diesel fuel and biocides had a positive effect. We hope that these findings could help in the management of the energy budget that we believe will reduce the high emissions of GHGs to address the growing environmental hazards.

Comparative evaluation of thermal and emission performances for improved commercial coal-fired stoves in China.

The extensive use of traditional cooking stoves to meet daily cooking and heating requirements has highlighted the serious problem of indoor and outdoor air pollution. This study evaluates seven improved coal-fired space-heating and cooking stoves and compares them with a widely used stove of an older design, selected as a baseline reference. The seven stoves were selected from a range of candidate improved stoves submitted by manufacturers for testing as part of the air quality improvement in the Hebei Clean Air Project, Hebei Province, China. Stove performance was evaluated when burning raw coal and coal briquettes during the high and low power stages respectively. All seven improved cooking stoves surpassed the baseline stove in combined heating and cooking thermal and emission performance. Among the improved cooking stoves, Model 2-TL was found to have the highest average thermal efficiency, 87.2 ± 0.5%, when burning coal briquettes at high and low power. The lowest emission of PM2.5 was 0.94 ± 0.5 mg MJNET -1, CO 0.55 ± 0.28 g MJNET -1, and CO/CO2 1.1 ± 0.6%, respectively. It is concluded that the use of these improved heating and cooking stoves should be promoted for daily cooking and heating requirements. This strategy will not only save fuel to the benefit of the household, but widespread adoption could contribute to significant reductions of CO and PM2.5 emissions in Hebei Province.

Performance Evaluation of the Chinese Healthcare System.

This study aims to evaluate the performance of the Chinese healthcare system. It uses sustainable development goal (SDG) 3, set by the United Nations to ensure healthy lives and promote well-being for all at all ages as a benchmark. It uses data of 17 variables ranging from the year 2000 to 2017 and uses a multistage methodology to evaluate the performance. In the first stage, it uses difference in mean test to know whether or not the indicators show an improvement in the second decade of the 21st century compared to the first decade. In the second phase, simple linear regression has been used to know the rate of change of performance of every indicator over the sample period. The third step compares the performance of the healthcare sector with the sustainable goals set by the UN and the fourth phase attempts to forecast performance for the next five years i.e., 2018 to 2022. As per the results, the Chinese healthcare sector has performed very well on many fronts except alcohol consumption in males, road accidents and the incidence of non-communicable diseases. Alcohol consumption by males is touching dangerous levels. Therefore, the policies should focus on educating males to lower their alcohol consumption to stay fit and healthy.

Experimental and comparative study of Chinese commercial improved coal-fired cooking and space-heating stoves.

The extensive use of traditional cooking stoves to meet daily cooking and heating requirements has highlighted the serious problem of indoor and outdoor air pollution. This study evaluates three improved cooking and heating stoves (ICHSs) and compared them with a traditional stove as a baseline reference. The stoves' performance regarding emission and thermal efficiency was evaluated with burning raw coal. All ICHSs surpassed the baseline stove in combined heating and cooking thermal and emission performance. Among the ICHSs, Model ICHS-3 was found to have the highest average thermal efficiency, 69.6±0.8%. The lowest emission of PM2.5 was 3.2±1.6 mg/MJNET, CO 2.9±0.34 g/MJNET, and CO/CO2 2.3±0.3%, respectively. It is concluded that the use of the ICHSs should be promoted for daily cooking and heating needs. The adoption of ICHSs could contribute to significant reductions of PM2.5 and CO emissions as well as save fuel to the benefit of the household.

Perceived Threat of COVID-19 Contagion and Frontline Paramedics' Agonistic Behaviour: Employing a Stressor-Strain-Outcome Perspective.

Historically, infectious diseases have been the leading cause of human psychosomatic strain and death tolls. This research investigated the recent threat of COVID-19 contagion, especially its impact among frontline paramedics treating patients with COVID-19, and their perception of self-infection, which ultimately increases their agonistic behaviour. Based on the stressor-strain-outcome paradigm, a research model was proposed and investigated using survey-based data through a structured questionnaire. The results found that the perceived threat of COVID-19 contagion (emotional and cognitive threat) was positively correlated with physiological anxiety, depression, and emotional exhaustion, which led toward agonistic behaviour. Further, perceived social support was a key moderator that negatively affected the relationships between agonistic behaviour and physiological anxiety, depression, and emotional exhaustion. These findings significantly contributed to the current literature concerning COVID-19 and pandemic-related effects on human behaviour. This study also theorized the concept of human agonistic behaviour, which has key implications for future researchers.

A primary care study of the correlates of depressive symptoms among Jordanian women.

A standardized Arabic version of the Beck Depression Inventory-II was administered to 493 randomly selected Arab women attending primary care out-patient centers in West Amman, Jordan. Women were asked about demographic data as well as questions from a negative life events questionnaire. The mean Beck score was 13.02 (+/- 8.13). Demographic factors and negative life events accounted for 17.1% of the variance in the total Beck score. Self-reported financial problems and health problems as well as marital separation were the strongest contributors. Family problems and work stress made smaller contributions to depressive symptoms.