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INTRODUCTION: Psoriatic Arthritis (PsA) is a multifaceted disease in which various musculoskeletal and skin manifestations are involved. Beyond these features, PsA is associated with comorbidities that might increase the burden of the disease. AREAS COVERED: In the last years a growing interest has come out for the concept of multimorbidity in rheumatology. Multimorbidity was defined as the 'co-existence of two or more chronic diseases in the same individual.' In the multimorbidity concept, the patient is of central concern and all coexisting diseases are of equal importance. Comorbidity was defined as the 'occurrence of any distinct additional entity during the clinical course of patient who has the index disease under study.' In PsA, comorbidity and multimorbidity have often been confusingly used interchangeably, showing that there is an unmet need on this topic. EXPERT OPINION: This perspective article dealt with these different visions of the co-existence of other diseases in PsA, providing a distinction between them, not only for the impact on the treatment decision but also in how this concept might be incorporated into clinical trials design, choosing the right outcome measures for the patient-centric concept of multimorbidity. For this perspective, the authors searched PubMed and the Cochrane library for articles published. | Multimorbidity and comorbidity in psoriatic arthritis - a perspective |
Adaptive immune responses play critical roles in viral clearance and protection against re‐infection, and SARS‐CoV‐2 is no exception. What is exceptional, is the rapid characterization of the immune response to the virus performed by researchers during the first 20 months of the pandemic. This has given us a more detailed understanding about SARS‐CoV‐2 than we have about many viruses that have been with us for a long time. Furthermore, effective COVID‐19 vaccines were developed in record time, and their rollout worldwide is already making a significant difference, although major challenges remain in terms of equal access. The pandemic has engaged scientists and the public alike, and terms such as seroprevalence, neutralizing antibodies, antibody escape and vaccine certificates have become familiar to a broad community. Here, we review key findings concerning B cell and antibody (Ab) responses to SARS‐CoV‐2, focusing on non‐severe cases and anti‐spike (S) Ab responses in particular, the latter being central to protective immunity induced by infection or vaccination. The emergence of viral variants that have acquired mutations in S acutely highlights the need for continued characterization of both emerging variants and Ab responses against these during the evolving pathogen‐immune system arms race. | Immunity to SARS‐CoV‐2 induced by infection or vaccination |
BACKGROUND: The feline leukemia virus (FeLV) is a gamma-retrovirus of domestic cats that was discovered half a century ago. Cats that are infected with FeLV may develop a progressive infection resulting in persistent viremia, immunodeficiency, tumors, anemia and death. A significant number of cats mount a protective immune response that suppresses viremia; these cats develop a regressive infection characterized by the absence of viral replication and the presence of low levels of proviral DNA. The biological importance of these latter provirus carriers is largely unknown. RESULTS: Here, we demonstrate that ten cats that received a transfusion of blood from aviremic provirus carriers developed active FeLV infections, some with a progressive outcome and the development of fatal FeLV-associated disease. The infection outcome, disease spectrum and evolution into FeLV-C in one cat mirrored those of natural infection. Two cats developed persistent antigenemia; six cats were transiently antigenemic. Reactivation of infection occurred in some cats. One recipient developed non-regenerative anemia associated with FeLV-C, and four others developed a T-cell lymphoma, one with secondary lymphoblastic leukemia. Five of the ten recipient cats received provirus-positive aviremic blood, whereas the other five received provirus- and viral RNA-positive but aviremic blood. Notably, the cats that received blood containing only proviral DNA exhibited a later onset but graver outcome of FeLV infection than the cats that were transfused with blood containing proviral DNA and viral RNA. Leukocyte counts and cytokine analyses indicated that the immune system of the latter cats reacted quicker and more efficiently. CONCLUSIONS: Our results underline the biological and epidemiological relevance of FeLV provirus carriers and the risk of inadvertent FeLV transmission via blood transfusion and demonstrate the replication capacity of proviral DNA if uncontrolled by the immune system. Our results have implications not only for veterinary medicine, such as the requirement for testing blood donors and blood products for FeLV provirus by sensitive polymerase chain reaction, but are also of general interest by revealing the importance of latent retroviral DNA in infected hosts. When aiming to eliminate a retroviral infection from a population, provirus carriers must be considered. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12977-015-0231-z) contains supplementary material, which is available to authorized users. | Retroviral DNA—the silent winner: blood transfusion containing latent feline leukemia provirus causes infection and disease in naïve recipient cats |
Caregiver mental health is crucial to the wellbeing of children. This is most apparent when caregivers face high levels of stress or life adversity. To study this phenomenon in the current global context, this study examined the relation between stress/disruption from the COVID-19 pandemic and the mental health of female and male caregivers. Pre-pandemic childhood adversity was considered as a moderator of this association. A multi-national sample (United Kingdom, 76%; United States, 19%; Canada, 4%, and Australia, 1%) was recruited in May 2020, of whom 348 female and 143 male caregivers of 5-18 year-old children provided data on the constructs of interest. At this time, caregivers reported on their history of adverse childhood experiences (ACEs) and COVID stress/disruption. About two months later (July 2020) caregiver mental health was evaluated. We examined differences between female and male caregivers on ACEs, COVID stress/disruption, and mental health (distress, anxiety, substance use, and posttraumatic stress). Main and interactive effects of ACEs and COVID stress/disruption on each mental health outcome were examined. Female caregivers reported higher COVID stress/disruption, more ACEs, and greater distress, anxiety, and posttraumatic stress symptoms compared to male caregivers. Among female caregivers, higher COVID stress/disruption and more adverse childhood experiences (ACEs) independently predicted all mental health outcomes, consistent with a stress accumulation model. Among male caregivers, a pattern of interactions between COVID stress/disruption and ACEs suggested that the effects of COVID stress/disruption on mental health was stronger for those with higher ACEs, especially for substance use, consistent with a stress sensitization model. Higher levels of stress and mental health difficulties among female caregivers suggests a disproportionate burden due to pandemic-related disruption compared to male caregivers. Findings speak to the disparate effects of COVID-19 on the mental health of female compared to male caregivers, and the role of pre-existing vulnerabilities in shaping current adaptation. | The disparate impact of COVID-19 on the mental health of female and male caregivers |
OBJECTIVE Given the rise in Catholic ownership of U.S. health care facilities, we aimed to examine reproductive health care provision and patient outcomes. We performed a scoping review, which maps the literature and considers inclusion of studies that are not specifically quantitative. DATA SOURCES We searched five databases (MEDLINE, EMBASE, Web of Science and Cochrane Library, ClinialTrials.gov) from inception through August 2018 using terms related to reproductive health care and religion. METHODS OF STUDY SELECTION We screened 2,906 studies. Articles were included if in English, included primary research data, and referenced U.S.-based Catholic facilities. We reviewed the reference lists of included articles. We excluded articles that addressed the relationship of patient or health care provider religion to provision of reproductive services, described reproductive health care services in non-Catholic facilities, or reported legal cases or concerns. Two independent reviewers screened all citations, a third reviewer resolved differences, and all three reviewers categorized included citations. TABULATION, INTEGRATION, AND RESULTS We included 27 studies. Investigators most commonly focused on the provision of emergency contraception (n=9) or other contraceptive and sterilization methods (n=7); few focused on a range of family planning methods (n=3), natural family planning (n=2), ectopic pregnancy management (n=2), abortion care (n=2), miscarriage management (n=1), and infertility care (n=1). The most common study designs were cross-sectional (18/27 [67%]) and qualitative investigations (6/27 [22%]). Common data collection approaches included surveys, interviews, and mystery caller designs. Two studies involved authors with Catholic hospital affiliations and one of these reported patient outcomes; no other patient outcome reports were found. Studies cited restrictions to care in comparison with non-Catholic settings and multisite studies demonstrated variable rates of provision of reproductive health services across Catholic sites. CONCLUSIONS Despite the significant proportion and recent growth of Catholic health care within the U.S. health care sector, little is known about reproductive health outcomes in these settings and in comparison with other settings. | Reproductive Health Care in Catholic Facilities: A Scoping Review. |
Distance education has expanded significantly over the last decade, but the natural sciences have lagged in the implementation of this instructional mode. The abrupt onset of the COVID-19 pandemic left educational institutions scrambling to adapt curricula to distance modalities. With projected effects lasting through the 2020–2021 academic year, this problem will not go away soon. Analysis of the literature has elucidated the costs and benefits of, as well as obstacles to, the implementation of e-learning, with a focus on undergraduate physics education. Physics faculty report that a lack of time to learn about research-driven innovation is their primary barrier to implementing it. In response, this paper is intended to help physics lecturers and lab instructors re-think their courses now that distance learning is far more prevalent due to the pandemic. This paper serves as an all-in-one guide of recommendations for successful distanced educational practices, with an emphasis on smartphones and social media. These technologies were chosen for their utility in a virtual environment. Additionally, this paper can be used as a resource for university administrators to adapt to the changing needs associated with new teaching modalities. | A guide for incorporating e-teaching of physics in a post-COVID world |
BACKGROUND AND AIMS: The coronavirus disease of 2019 (COVID‐19) causes considerable mortality worldwide. We aimed to investigate the frequency and predictive role of abnormal liver chemistries in different age groups. METHODS: Patients with positive severe acute respiratory distress syndrome‐coronavirus‐2 (SARS‐CoV‐2) polymerase chain reaction (PCR) test between 03/2020‐07/2021 at the Vienna General Hospital were included. Patients were stratified for age: 18–39 vs. 40–69 vs. ≥70 years (y). Aspartate aminotransferase (AST), alanine‐aminotransferase (ALT), alkaline phosphatase (ALP), gamma‐glutamyl transferase (GGT) and total bilirubin (BIL) were recorded. RESULTS: 900 patients (18–39 years: 32.2%, 40–69 years: 39.7%, ≥70 years: 28.1%) were included. Number of comorbidities, median D‐dimer and C‐reactive protein increased with age. During COVID‐19, AST/ALT and ALP/GGT levels significantly increased. Elevated hepatocellular transaminases (AST/ALT) and cholestasis parameters (ALP/GGT/BIL) were observed in 40.3% (n = 262/650) and 45.0% (n = 287/638) of patients respectively. Liver‐related mortality was highest among patients with pre‐existing decompensated liver disease (28.6%, p < .001). 1.7% of patients without pre‐existing liver disease died of liver‐related causes, that is consequences of hepatic dysfunction or acute liver failure. Importantly, COVID‐19‐associated liver injury (16.0%, p < .001), abnormal liver chemistries and liver‐related mortality (6.5%, p < .001) were most frequent among 40–69 years old patients. Elevated AST and BIL after the first positive SARS‐CoV‐2 PCR independently predicted mortality in the overall cohort and in 40–69 years old patients. CONCLUSIONS: Almost half of the COVID‐19 patients exhibit abnormal hepatocellular and cholestasis‐related liver chemistries with 40–69 years old patients being at particularly high risk for COVID‐19‐related liver injury and liver‐related mortality. Elevated AST and BIL after SARS‐CoV‐2 infection are independent predictors of mortality, especially in patients aged 40–69 years. | Age‐adjusted mortality and predictive value of liver chemistries in a Viennese cohort of COVID‐19 patients |
Introduction The COVID-19 pandemic was a devastating occurrence that left millions in critical condition in emergency rooms (ER) across the country. While hospitalizations due to COVID-19 increased exponentially in the last year, several reports have indicated declines in ER use due to common non-COVID related problems. There is currently a dearth of literature examining the effect of the COVID-19 pandemic on emergency room use for acute burn injuries. Thus, we performed a retrospective database analysis using the TriNetX database to quantify the effects of COVID-19 on United States ER visits for acute burn injuries. We hypothesize that ER visits due to burn injury decreased, especially in patients with severe burn injuries- defined as burned total burn surface area (TBSA) >20%. Methods Patients who visited the ER from 2010-2020 due to burn injury were identified using ICD-10 codes. We then stratified these patients by age (< 18 and ≥18), severe ( >20% TBSA) vs. non-severe (< 20% TBSA) burn injury, and by change over time in 1-year intervals from 2010 to 2020. Extracted data was analyzed using chi-square with p< .05 considered significant. Results We identified a total of 24,620,393 ER visits from 2010-2020. Of these, 142,007 (0.58%) were due to burn injury. A large majority of burn-related ER visits were for non-severe burns (n=134,120, 94.4%). ER visits for acute burn injury decreased by 21.6% during 2020 when compared to years prior. Stratification by age group revealed that pediatric patients (< 18) had more significant decreases in ER Visits than adult patients (≥18). Pediatric patients visited the ER 71.6% less than adults during 2020. When stratified by burn severity, patients with severe burns ( >20% TBSA) and patients with non-severe burns (< 20% TBSA) had similar decreases in ER usage during 2020 when compared to years prior (21.7% and 24.6%, respectively). Further age analysis revealed that both pediatric patients with severe burns and pediatric patients with non-severe burns visited the ER less than their adult counterparts (71.4% and 60.9%, respectively). All of the above differences were statistically significant (p< .05). Conclusions During the COVID-19 pandemic in 2020, there was a sharp decrease in ER usage by patients with severe and non-severe burn injuries. This decrease was particularly salient in pediatric populations across all TBSA data points measured. | Influence of the COVID-19 Pandemic on Emergency Room Visits for Burn Injury |
As of 29 April 2020, across the globe, there are 3,216,353 confirmed Coronavirus disease 2019 (COVID-19 disease) with 227,894 deaths. The health care infrastructure of most of the countries is overwhelmed due to the gigantic upsurge of the new cases within a short time period. Most of the beds in the regular wards and critical care units are currently occupied by either people under investigation (PUI) or COVID-19 confirmed cases. We hereby discuss the challenges faced while approaching any case of shortness of breath, or other common upper respiratory symptoms during the current COVID-19 pandemic era. | COVID-19 and clinical mimics. Correct diagnosis is the key to appropriate therapy |
Kefir is one of the most consumed traditional fermented dairy products and it has a complex probiotic and nutritional composition. Kefir grain contains casein and other milk solids together with the yeasts and lactobacilli that cause the characteristic kefir fermentation and serve as a starter to induce this fermentation when introduced into fresh milk. Both kefir and kefir grains have a rich microbiota and their composition is affected by many parameters like kefir origin, production method (artisanal or industrial), kefir grain: milk ratio, type of milk, fermentation conditions, inoculum source, equipment used in production and storage conditions. Lactic acid bacteria (LAB) are a significant part of the kefir's microbial composition and the health-promoting effects. Kefir-derived LAB have beneficial effects on colorectal cancer, cardiovascular diseases, type 2 diabetes mellitus, obesity, kidney diseases, modulation of the immune system as well as intestinal microbiota through different biological mechanisms. In addition, bioactive peptides and metabolic products of kefir have shown promising results as health beneficial components along with certain antiviral effects including COVID-19. Therefore, this article is up-to-date information about the production, processing as well as health benefits of dairy kefir-derived LAB with future prospect of work. | Recent developments in dairy kefir-derived lactic acid bacteria and their health benefits |
Great deal pathogenic bacteria and malodorous gases are hidden in municipal solid waste (MSW), which poses excellent environmental sanitation risks for sanitation workers and residents, and preventive measures should be implemented. In this study, the simultaneous annihilation of microorganisms and volatile organic compounds (VOCs) with slightly acidic electrolyzed water (SAEW) was investigated in an MSW storage room of a residential community in Shanghai, China. The microbial population of airborne, surfaces and handles of waste bins, hands of sanitation workers and the main components of VOCs were measured. The results indicated that the bacterial reduction efficiencies of SAEW with an available chlorine concentration (ACC) of 50-100 mg/L on surfaces and handles of waste bins and sanitation workers' hands were 22.7%-84.1%. Also, SAEW effectively reduced the average population of airborne bacteria and fungi by 358 and 378 colony-forming units (CFU)/m3 and decreased the detection rates of coliforms by 14.2%-51.9%. The concentrations of most VOCs were reduced by 21.4%-88.3% after spraying SAEW. And the accumulated values of carcinogenic and noncarcinogenic risks also tended to decrease with spraying SAEW. These findings imply that SAEW has significant application potential to control environmental sanitation risks in MSW storage rooms. | Simultaneous annihilation of microorganisms and volatile organic compounds from municipal solid waste storage rooms with slightly acidic electrolyzed water. |
There exists increasing evidence that people with preceding medical conditions, such as diabetes and cancer, have a higher risk of infection with SARS-CoV-2 and are more vulnerable to severe disease. To get insights into the possible role of the immune system upon COVID-19 infection, 2811 genes of the gene ontology term "immune system process GO: 0002376" were selected for coexpression analysis of the human targets of SARS-CoV-2 (HT-SARS-CoV-2) ACE2, TMPRSS2, and FURIN in tissue samples from patients with cancer and diabetes mellitus. The network between HT-SARS-CoV-2 and immune system process genes was analyzed based on functional protein associations using STRING. In addition, STITCH was employed to determine druggable targets. DPP4 was the only immune system process gene, which was coexpressed with the three HT-SARS-CoV-2 genes, while eight other immune genes were at least coexpressed with two HT-SARS-CoV-2 genes. STRING analysis between immune and HT-SARS-CoV-2 genes plotted 19 associations of which there were eight common networking genes in mixed healthy (323) and pan-cancer (11003) tissues in addition to normal (87), cancer (90), and diabetic (128) pancreatic tissues. Using this approach, three commonly applicable druggable connections between HT-SARS-CoV-2 and immune system process genes were identified. These include positive associations of ACE2-DPP4 and TMPRSS2-SRC as well as a negative association of FURIN with ADAM17. Furthermore, 16 drugs were extracted from STITCH (score <0.8) with 32 target genes. Thus, an immunological network associated with HT-SARS-CoV-2 using bioinformatics tools was identified leading to novel therapeutic opportunities for COVID-19. | Immune Interaction Map of Human SARS-CoV-2 Target Genes: Implications for Therapeutic Avenues |
In the current pandemic, finding an effective drug to prevent or treat the infection is the highest priority. A rapid and safe approach to counteract COVID‐19 is in silico drug repurposing. The SARS‐CoV‐2 PLpro promotes viral replication and modulates the host immune system, resulting in inhibition of the host antiviral innate immune response, and therefore is an attractive drug target. In this study, we used a combined in silico virtual screening for candidates for SARS‐CoV‐2 PLpro protease inhibitors. We used the Informational spectrum method applied for Small Molecules for searching the Drugbank database followed by molecular docking. After in silico screening of drug space, we identified 44 drugs as potential SARS‐CoV‐2 PLpro inhibitors that we propose for further experimental testing. | Identification of SARS‐CoV‐2 Papain‐like Protease (PLpro) Inhibitors Using Combined Computational Approach |
With increased participation in telework expected to continue, to support emerging hybrid work models in the aftermath of the Covid-19, it is important to consider the long-term impact this practice could have on sustainability outcomes. This paper describes a systematic review of 113 academic journal articles and identifies associations between telework and sustainability, explored by previous researchers. Those associations were categorized and discussed, based on their contributions to different United Nations Social Development Goals. Most of research was found to focus on countries classified as having a very high human development index status, and regions with a low, medium or high human development index, largely ignored. The SWOT matrix technique was used to illustrate the strengths and weaknesses identified in the current literature as well as threats and opportunities for future work. This can help to ensure policy coherence and that strategies to promote one outcome, such as economic productivity improvements, does not undermine another, such as improved health. Practical implications and potential research opportunities were identified across a range of SDG impact areas, including good health and well-being, gender equality, reduced inequality, climate mitigation, sustainable cities and resilient communities. On the whole, our impression is that increased rates of telework present an important opportunity to improve sustainability outcomes, however, it will be important that integrated and holistic policy is developed that mitigates key risks. | Telework, Hybrid Work and the United Nation’s Sustainable Development Goals: Towards Policy Coherence |
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) enters host cells mainly by the angiotensin converting enzyme 2 (ACE2) receptor, which can recognize the spike (S) protein by its extracellular domain. Previously, recombinant soluble ACE2 (sACE2) has been clinically used as a therapeutic treatment for cardiovascular diseases. Recent data demonstrated that sACE2 can also be exploited as a decoy to effectively inhibit the cell entry of SARS-CoV-2, through blocking SARS-CoV-2 binding to membrane-anchored ACE2. In this study, we summarized the current findings on the optimized sACE2-based strategies as a therapeutic agent, including Fc fusion to prolong the half-life of sACE2, deep mutagenesis to create high-affinity decoys for SARS-CoV-2, or designing the truncated functional fragments to enhance its safety, among others. Considering that COVID-19 patients are often accompanied by manifestations of cardiovascular complications, we think that administration of sACE2 in COVID-19 patients may be a promising therapeutic strategy to simultaneously treat both cardiovascular diseases and SARS-CoV-2 infection. This review would provide insights for the development of novel therapeutic agents against the COVID-19 pandemic. | Killing Two Birds with One Stone by Administration of Soluble ACE2: A Promising Strategy to Treat Both Cardiovascular Diseases and SARS-CoV-2 Infection |
PURPOSE: To assess the long-term results after Rex bypass (RB) shunt and Rex transposition (RT) shunt and determine the optimal approach. METHODS: Between 2010 and 2019, traditional RB shunt was performed in 24 patients, and modified RT shunt was performed in 23 children with extrahepatic portal hypertension (pHTN). A retrospective study was conducted based on comparative symptoms, platelet counts, color Doppler ultrasonography and computed tomographic portography of the portal system, and gastroscopic gastroesophageal varices postoperatively. The portal venous pressure was evaluated intraoperatively. RESULTS: The operation in the RB group was notably more time-consuming than that in the RT group (P < 0.05). Compared to RT shunt, the reduction in gastroesophageal varix grading, the increases in platelets, and the caliber of the bypass were greater in the RB group (P < 0.05). Although not statistically significant, higher morbidity of surgical complications was found after RT shunt (17.4%) compared with RB shunt (8.3%) with patency rates of 82.6 and 91.7%, respectively. Additionally, patients exhibited a lower rate of rebleeding under the RB procedure (12.5%) than under the RT procedure (21.7%). CONCLUSIONS: The RT procedure is an alternative option for the treatment of pediatric extrahepatic pHTN, and RB shunt is the preferred procedure in our center. | Optimal Rex shunt procedures as a treatment for pediatric extrahepatic portal hypertension |
Individuals with developmental disabilities (DD) depend on caregivers to meet physical, emotional, and social needs. This makes relationships with caregivers particularly important to quality of life. Without intervention, social interactions may be limited and ineffective, affecting relationships with caregivers and thus quality of life for individuals with DD. Training may improve interactions between caregivers and individuals with DD. Training content and methods, however, are heterogenous. A review was conducted to identify common elements and methods and analyze variables shown to be most effective in improving outcomes for caregivers and individuals with DD. In general, studies of professional caregiver training (e.g. teachers, staff members) focused primarily on increasing positive interactions or praise, while parent training studies focused more broadly on parenting skills, of which positive interaction was one facet. Training methods differed, but there was some evidence to suggest that those studies that included some element of in situ practice and feedback yielded more robust effects. While caregiver acceptability and/or satisfaction surveys were administered in the majority of studies, fewer studies attempted to measure the satisfaction of individuals with DD. Future research topics are presented in light of these findings. | Improving interactions between parents, teachers, and staff and individuals with developmental disabilities: a review of caregiver training methods and results. |
The increasing emergence of antimicrobial resistance in staphylococcal bacteria is a major health threat worldwide due to significant morbidity and mortality resulting from their associated hospital- or community-acquired infections. Dramatic decrease in the discovery of new antibiotics from the pharmaceutical industry coupled with increased use of sanitisers and disinfectants due to the ongoing COVID-19 pandemic can further aggravate the problem of antimicrobial resistance. Staphylococci utilise multiple mechanisms to circumvent the effects of antimicrobials. One of these resistance mechanisms is the export of antimicrobial agents through the activity of membrane-embedded multidrug efflux pump proteins. The use of efflux pump inhibitors in combination with currently approved antimicrobials is a promising strategy to potentiate their clinical efficacy against resistant strains of staphylococci, and simultaneously reduce the selection of resistant mutants. This review presents an overview of the current knowledge of staphylococcal efflux pumps, discusses their clinical impact, and summarises compounds found in the last decade from plant and synthetic origin that have the potential to be used as adjuvants to antibiotic therapy against multidrug resistant staphylococci. Critically, future high-resolution structures of staphylococcal efflux pumps could aid in design and development of safer, more target-specific and highly potent efflux pump inhibitors to progress into clinical use. | Efflux Pump Mediated Antimicrobial Resistance by Staphylococci in Health-Related Environments: Challenges and the Quest for Inhibition |
INTRODUCTION: With over 82.4 million forcibly displaced persons worldwide, there remains an urgent need to better describe culturally, contextually and age-tailored strategies for preventing COVID-19 in humanitarian contexts. Knowledge gaps are particularly pronounced for urban refugees who experience poverty, overcrowded living conditions and poor sanitation access that constrain the ability to practise COVID-19 mitigation strategies such as physical distancing and frequent hand washing. With over 1.4 million refugees, Uganda is sub-Saharan Africa’s largest refugee hosting nation. More than 90 000 of Uganda’s refugees live in Kampala, most in informal settlements, and 27% are aged 15–24 years old. There is an urgent need for tailored COVID-19 responses with urban refugee adolescents and youth. This study aims to evaluate the effectiveness of an 8-week interactive informational mobile health intervention on COVID-19 prevention practices among refugee and displaced youth aged 16–24 years in Kampala, Uganda. METHODS AND ANALYSIS: We will conduct a pre-test/post-test study nested within a larger cluster randomised trial. Approximately 385 youth participants will be enrolled and followed for 6 months. Data will be collected at three time points: before the intervention (time 1); immediately after the intervention (time 2) and at 16-week follow-up (time 3). The primary outcome (self-efficacy to practise COVID-19 prevention measures) and secondary outcomes (COVID-19 risk awareness, attitudes, norms and self-regulation practices; depression; sexual and reproductive health practices; food and water security; COVID-19 vaccine acceptability) will be evaluated using descriptive statistics and regression analyses. ETHICS AND DISSEMINATION: This study has been approved by the University of Toronto Research Ethics Board, the Mildmay Uganda Research Ethics Committee, and the Uganda National Council for Science & Technology. The results will be published in peer-reviewed journals, and findings communicated through reports and conference presentations. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Registry (NCT04631367). | Kukaa Salama (Staying Safe): study protocol for a pre/post-trial of an interactive mHealth intervention for increasing COVID-19 prevention practices with urban refugee youth in Kampala, Uganda |
Despite a national vaccination effort prioritizing frontline healthcare workers, COVID-19 vaccination rates among nurses have been lower than necessary to protect workforce and patient health. Historically, nurses have been more vaccine hesitant than other healthcare workers. To assess the vaccine attitudes and COVID-19 vaccine intent of California’s registered nurses, we conducted a statewide cross-sectional survey among 603 licensed RNs working in direct patient care. Of 167 respondents (27.7%), 111 met inclusion criteria. Their mean score of 3.01 on a 6-point rating scale on the Vaccine Attitudes Examination scale measuring general vaccine hesitancy was comparable to previous findings among U.S. West Coast adults. Greater vaccine hesitancy was significantly associated with lower COVID-19 vaccine intent, after controlling for relevant confounders. Since nurses make up the largest portion of the healthcare workforce, it is crucial to specifically address this group’s vaccine hesitancy. | COVID-19 Vaccine Hesitancy and Intent in California Registered Nurses |
We used daily real-time reverse-transcription polymerase chain reaction (rRT-PCR) results from 67 cases of SARS-CoV-2 infection in a household transmission study, conducted April 2020--May 2021, to examine the trajectory of cycle threshold (Ct) values, an inverse correlate of viral RNA concentration. Ct values varied across RT-PCR platforms and by participant age. Specimens collected from children and adolescents had higher Ct values and adults aged ≥50 years showed lower Ct values than adults aged 18-49 years. Ct values were lower on days when participants reported experiencing symptoms, with the lowest Ct value occurring 2-6 days after symptom onset. | SARS-CoV-2 virus dynamics in recently infected people – data from a household transmission study |
Objective: To describe the spectrum of neurological and psychiatric complications in patients with Covid-19 seen in a multidisciplinary center over six months. Methods: We conducted a retrospective, observational study on all patients showing neurological or psychiatric symptoms in the context of Covid-19 seen in the Department of Neurology and Psychiatry of the APHP-Sorbonne University. We collected demographic data, medical and treatment history, comorbidities, symptoms, date of onset, and severity of Covid-19 infection, neurological and psychiatric symptoms, neurological and psychiatric examination data and, when available, results from cerebrospinal fluid (CSF) analysis, brain magnetic resonance (MRI) imaging, 18-fluorodesoxyglucose-position emission computed tomography (FDG-PET/CT)), electroencephalography (EEG) and electroneuromyography (ENMG). Results: 245 patients were included in the analysis. One-hundred fourteen patients (47%) were admitted to the intensive care unit (ICU) and 10 (4%) died. The most frequently reported neuropsychiatric symptoms were motor deficit (41%), cognitive disturbance (35%), impaired consciousness (26%), psychiatric disturbance (24%), headache (20%) and behavioral disturbance (18%). The most frequent syndromes diagnosed were encephalopathy (43%), critical illness polyneuropathy and myopathy (26%), isolated psychiatric disturbance (18%), and cerebrovascular disorders (16%). No patients showed evidence of SARS-CoV-2 in their CSF. Encephalopathy was associated with greater age and higher risk of death. Critical illness neuromyopathy was associated with an extended stay in the ICU. Conclusions: The majority of the neuropsychiatric complications recorded could be imputed to critical illness, intensive care and systemic inflammation, which contrasts with the paucity of more direct SARS-CoV-2-related complications or post-infection disorders. | The wide spectrum of neuropsychiatric complications in Covid-19 patients within a multidisciplinary hospital context |
OBJECTIVE: We aimed to assess the impact of early versus late third-trimester maternal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination on transplacental transfer and neonatal levels of SARS-CoV-2 antibodies. METHODS: Maternal and cord blood sera were collected following term delivery after antenatal SARS-CoV-2 BNT162b2 mRNA vaccination, with the first vaccine dose administered between 27 and 36 weeks of gestation. SARS-CoV-2 spike protein (S) and receptor-binding domain (RBD) -specific, IgG levels and neutralizing potency were evaluated in maternal and cord blood samples. RESULTS: The study cohort consisted of 171 parturients—median age 31 years (interquartile range (IQR) 27–35 years); median gestational age 39(+5) weeks (IQR 38(+5)–40(+4) weeks)–83 (48.5%) were immunized in early thrird-trimester (first dose at 27–31 weeks) and 88 (51.5%) were immunized in late third trimester (first dose at 32–36 weeks). All mother–infant paired sera were positive for anti S- and anti-RBD-specific IgG. Anti-RBD-specific IgG concentrations in neonatal sera were higher following early versus late third-trimester vaccination (median 9620 AU/mL (IQR 5131–15332 AU/mL) versus 6697 AU/mL (IQR 3157–14731 AU/mL), p 0.02), and were positively correlated with increasing time since vaccination (r = 0.26; p 0.001). Median antibody placental transfer ratios were increased following early versus late third-trimester immunization (anti-S ratio: 1.3 (IQR 1.1–1.6) versus 0.9 (IQR 0.6–1.1); anti-RBD-specific ratio: 2.3 (IQR 1.7–3.0) versus 0.7 (IQR 0.5–1.2), p <0.001). Neutralizing antibodies placental transfer ratio was greater following early versus late third-trimester immunization (median 1.9 (IQR 1.7–2.5) versus 0.8 (IQR 0.5–1.1), p <0.001), and was positively associated with longer duration from vaccination (r = 0.77; p <0.001). CONCLUSIONS: Early compared with late third-trimester maternal SARS-CoV-2 immunization enhanced transplacental antibody transfer and increased neonatal neutralizing antibody levels. Our findings highlight that vaccination of pregnant women early in the third trimester may enhance neonatal seroprotection. | Timing of SARS-CoV-2 vaccination during the third trimester of pregnancy and transplacental antibody transfer: a prospective cohort study |
INTRODUCTION: Increased alcohol and cannabis consumption and related harms have been reported since the beginning of the COVID-19 pandemic. Existing evidence shows that substance use and related harms differ by gender. Yet, no Canadian study has applied a gendered lens to alcohol and cannabis consumption use during this time. Our objectives were to (1) provide gender-specific prevalence estimates of self-reported increased alcohol and cannabis use; and (2) examine gender-specific associations between sociodemographic and mental health variables and alcohol and cannabis use. METHODS: Using data from the Survey on COVID-19 and Mental Health, we calculated nationally representative, gender-specific prevalence estimates and disaggregated them by sociodemographic and mental health variables. Four logistic regression models were used to assess the likelihood of self-reported increased alcohol and cannabis use. RESULTS: The prevalence of self-reported increase in alcohol use (16.2% women; 15.2% men) and cannabis use (4.9% women; 5.8% men) did not differ by gender. For both genders, income, racialized group membership, working in the past week, being a parent/legal guardian of a child aged under 18 and screening positive for depression and anxiety were associated with increased alcohol use. Men and women who were between the ages of 18 to 44, screened positive for depression, or both, were more likely to report increased cannabis use. For women, education was significantly associated with increased alcohol use. For men, being a parent/legal guardian was significantly associated with lower odds of increased cannabis use. CONCLUSION: Sociodemographic factors, as well as depression and anxiety, were similarly associated with increased alcohol and cannabis use for both men and women in the second wave of the pandemic. | Applying a gendered lens to understanding self-reported changes in alcohol and cannabis consumption during the second wave of the COVID-19 pandemic in Canada, September to December 2020./ Adopter une perspective axée sur le genre pour comprendre les changements autodéclarés dans la consommation d'alcool et de cannabis pendant la deuxième vague de la pandémie de COVID 19 au Canada, septembre à décembre 2020 |
BACKGROUND: Since the first observations of patients with COVID-19, significant hypoalbuminaemia was detected. Its causes have not been investigated yet. OBJECTIVE: We hypothesized that pulmonary capillary leakage affects the severity of respiratory failure, causing a shift of fluids and proteins through the epithelial-endothelial barrier. METHODS: One hundred seventy-four COVID-19 patients with respiratory symptoms, 92 admitted to the intermediate medicine ward (IMW) and 82 to the intensive care unit (ICU) at Luigi Sacco Hospital in Milan, were studied. RESULTS: Baseline characteristics at admission were considered. Proteins, interleukin 8 (IL-8) and interleukin 10 (IL-10) in bronchoalveolar lavage fluid (BALF) were analysed in 26 ICU patients. In addition, ten autopsy ultrastructural lung studies were performed in patients with COVID-19 and compared with postmortem findings in a control group (bacterial pneumonia-ARDS and H1N1-ARDS). ICU patients had lower serum albumin than IMW patients [20 (18-23) vs 28 (24-33) g L-1 , P < 0.001]. Serum albumin was lower in more compromised groups (lower PaO2 -to-FiO2 ratio and worst chest X-ray findings) and was associated with 30 days of probability of survival. Protein concentration was correlated with IL-8 and IL-10 levels in BALF. Electron microscopy examinations of eight out of ten COVID-19 lung tissues showed loosening of junctional complexes, quantitatively more pronounced than in controls, and direct viral infection of type 2 pneumocytes and endothelial cells. CONCLUSION: Hypoalbuminaemia may serve as severity marker of epithelial-endothelial damage in patients with COVID-19. There are clues that pulmonary capillary leak syndrome plays a key role in the pathogenesis of COVID-19 and might be a potential therapeutic target. | Hypoalbuminemia in COVID-19: assessing the hypothesis for underlying pulmonary capillary leakage |
Purpose: This paper aims to develop supply chain strategies for the fashion retail supply chain (FRSC), likely to be disrupted by the current pandemic (COVID-19) under physical and online retail stores. The resilient retail supply chain design is proposed under budget allocation and merchandise capacity constraints. Design/methodology/approach: This paper utilises the theory of constraint (ToC) and goal programming (GP) to address the COVID-19 impact on FRSC. The budgetary and capacity constraints are formulated with a constraint optimisation model and tested with six different priorities to deal with the physical and online stores. Next, all priorities are developed under different FRSC business scenarios. The ToC-GP-based optimisation model is validated with one of the Indian fashion retail supply chains. Findings: The proposed optimisation model presents the optimal retailing strategies for selling fashion goods over physical and online platforms. The multiple scenarios are presented for developing trade-offs among different strategies to maximise the retailer's merchandise performance. This paper also highlighted the strategic movement from high merchandise density stores to low merchandise density stores. This implies a reduction of sales targets and aspiration levels of both online and physical fashion stores. Research limitations/implications: The proposed model is validated with one of the fashion retailers in India. Other nations or multiple fashion retailers might be considered for more generalisation of findings in the future. Practical implications: This research helps fashion retail supply chain managers deal with consumer demand uncertainty over physical and online stores in pandemic times. Limitation: Other nations or multiple fashion retailers might be considered for more generalisation of findings in the future. Originality/value: This is the first study that considered the impact of COVID-19 on the retail fashion supply chain. The effect of physical and online platforms is mainly discussed from consumer marketing perspectives, but an inventory and resilience perspective is missing in earlier studies. The role of merchandise planning is highlighted in this study. © 2021, Emerald Publishing Limited. | Modelling resilient fashion retail supply chain strategies to mitigate the COVID-19 impact |
Searches for pseudoscalar axionlike-particles (ALPs) typically rely on their decay in beam dumps or their conversion into photons in haloscopes and helioscopes. We point out a new experimental direction for ALP probes via their production by the intense gamma ray flux available from megawatt-scale nuclear reactors at neutrino experiments through Primakoff-like or Compton-like channels. Low-threshold detectors in close proximity to the core will have visibility to ALP decays and inverse Primakoff and Compton scattering, providing sensitivity to the ALP-photon and ALP-electron couplings. We find that the sensitivity to these couplings at the ongoing MINER and various other reactor based neutrino experiments, e.g., CONNIE, CONUS, ν-cleus, etc., exceeds existing limits set by laboratory experiments and, for the ALP-electron coupling, we forecast the world's best laboratory-based constraints over a large portion of the sub-MeV ALP mass range. | New Directions for Axion Searches via Scattering at Reactor Neutrino Experiments. |
The outbreak of COVID-19 disease is an international public health concern. Therefore, the analysis of information related to mortality and disability due to COVID-19 is considered important, so the present study was designed and conducted with the aim of assessing COVID-19 Disability-Adjusted Life Years (DALYs) in Yazd. In Yazd province, all suspected cases of COVID-19 that would be referred to central hospitals in order to get confirmed through PCR or CT scan test, were recruited to our study. The fatality data of COVID-19 was gathered from the forensic medicine organization. The Disability-Adjusted Life Years (DALYs) combines in one measure years of life lost (YLL), the loss of healthy life due to premature mortality and years of life lived with disability (YLD), the loss of healthy life because of disease and disability. The total burden of COVID-19 was 23,472 years. The number of years lost due to premature death was 23385 and the number of years of life with disability due to COVID-19 was estimated to be 87 years. The disease burden was 12992 years for men and 10480 years for women. The overall incidence of COVID-19 was 1411 per 100,000, of which 1419 in men and 1402 in women per 100,000. The outbreak of COVID-19 pandemic affected a large population and the residents of Yazd Province lost many years of their lives due to this disease. | Burden of severe COVID-19 in center of Iran: results of disability-adjusted life years (DALYs). |
OBJECTIVE CanCope is an internet-delivered, cognitive-behavioural intervention adapted from the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders to improve emotion regulation and support the mental health of cancer survivors. Four separate pilot studies evaluated each of CanCope's modules for (1) feasibility and participant satisfaction, and changes in (2) module-specific outcomes, and (3) global measures of emotion dysregulation and anxiety and depressive symptoms, from pre-to-post module delivery. METHODS Eligible cancer survivors self-selected into one two-week online module designed to improve a specific aspect of emotion regulation ([1] understanding emotions, [2] mindfulness of emotions, [3] cognitive reappraisals, [4] challenging emotion-driven behaviours). RESULTS Across modules, post-intervention surveys were completed by 17-19 participants, (58.1%-90.5% completion rate for participants who received the intervention). Each module was feasible and participants reported high satisfaction. Moderate-to-large pre-to-post effect sizes in mean differences were observed in module-specific target outcomes (p's < 0.05). Emotion dysregulation significantly decreased across modules 1 to 3 (p's < 0.05) with a non-significant decrease for module 4 (p = 0.13). Anxiety symptoms significantly decreased across all modules (p's < 0.05). Depressive symptoms significantly decreased across modules 1 and 3 (p's < 0.05), with non-significant decreases across modules 2 (p = 0.08) and 4 (p = 0.06). CONCLUSIONS Each CanCope module demonstrated promise in targeting emotion regulation skills and supporting the mental health of cancer survivors. Randomised controlled trials are required to test the efficacy of CanCope as an intervention in its entirety. | Piloting CanCope: An internet-delivered transdiagnostic intervention to improve mental health in cancer survivors. |
PURPOSE: This article aims to share northern Italy’s experience in hospital re-organization and management of clinical pathways for traumatic and orthopaedic patients in the early stages of the COVID-19 pandemic. METHODS: Authors collected regional recommendations to re-organize the healthcare system during the initial weeks of the COVID-19 pandemic in March, 2020. The specific protocols implemented in an orthopaedic hospital, selected as a regional hub for minor trauma, are analyzed and described in this article. RESULTS: Two referral centres were identified as the hubs for minor trauma to reduce the risk of overload in general hospitals. These two centres have specific features: an emergency room, specialized orthopaedic surgeons for joint diseases and trauma surgeons on-call 24/7. Patients with trauma without the need for a multi-disciplinary approach or needing non-deferrable elective orthopaedic surgery were moved to these hospitals. Authors report the internal protocols of one of these centres. All elective surgery was stopped, outpatient clinics limited to emergencies and specific pathways, ward and operating theatre dedicated to COVID-19-positive patients were implemented. An oropharyngeal swab was performed in the emergency room for all patients needing to be admitted, and patients were moved to a specific ward with single rooms to wait for the results. Specific courses were organized to demonstrate the correct use of personal protection equipment (PPE). CONCLUSION: The structure of the orthopaedic hubs, and the internal protocols proposed, could help to improve the quality of assistance for patients with musculoskeletal disorders and reduce the risk of overload in general hospitals during the COVID-19 pandemic. | Management of orthopaedic and traumatology patients during the Coronavirus disease (COVID-19) pandemic in northern Italy |
OBJECTIVE: To assess the utility and frequency of use of the Nightingale Communication method, during the early operational phase of the Nightingale Hospital London 4000-bed field hospital Intensive Care Unit DESIGN: Survey based cross sectional assessment SETTING: The intensive care unit at the Nightingale London hospital PARTICIPANTS: Staff working in the clinical area, and therefore requiring full personal protective equipment INTERVENTION: Survey of all staff members sampled from a single shift at the Nightingale Hospital This investigated perceived utility and actual use of identification methods (name and role labels on visors and gowns, coloured role identification tapes) and formal hand signals as an adjunctive communication method MAIN OUTCOME MEASURE: Self reported frequency of use and perceived utility of each communication and personnel identification adjunct RESULTS: 50 valid responses were received (72% response rate) covering all clinical professional groups Prominent name/role identifications and colour-coded identification tapes were very frequently used and were perceived as being highly useful Formal hand signals were infrequently used, and not perceived as being beneficial, with respondents citing use of single taught gestures only in specific circumstances CONCLUSION: PPE is highly depersonalising and interpersonal identification aids are very useful Despite being difficult, verbal communication is not completely prohibited, which could explain the low utility of formal hand signals The methods developed at the Nightingale hospital have enhanced communication in the critical care, field hospital setting There is potential for wider application to a variety of healthcare settings, in both the current situation and future pandemic scenarios | Communication on the Intensive Care Unit during COVID-19: Early Experience with the Nightingale Communication Method |
OBJECTIVES: An accurate prognostic score to predict mortality for adults with COVID-19 infection is needed to understand who would benefit most from hospitalizations and more intensive support and care. We aimed to develop and validate a two-step score system for patient triage, and to identify patients at a relatively low level of mortality risk using easy-to-collect individual information. DESIGN: Multicenter retrospective observational cohort study. SETTING: Four health centers from Virginia Commonwealth University, Georgetown University, the University of Florida, and the University of California, Los Angeles. PATIENTS: Coronavirus Disease 2019-confirmed and hospitalized adult patients. MEASUREMENTS AND MAIN RESULTS: We included 1,673 participants from Virginia Commonwealth University (VCU) as the derivation cohort. Risk factors for in-hospital death were identified using a multivariable logistic model with variable selection procedures after repeated missing data imputation. A two-step risk score was developed to identify patients at lower, moderate, and higher mortality risk. The first step selected increasing age, more than one pre-existing comorbidities, heart rate >100 beats/min, respiratory rate ≥30 breaths/min, and SpO(2) <93% into the predictive model. Besides age and SpO(2), the second step used blood urea nitrogen, absolute neutrophil count, C-reactive protein, platelet count, and neutrophil-to-lymphocyte ratio as predictors. C-statistics reflected very good discrimination with internal validation at VCU (0.83, 95% CI 0.79–0.88) and external validation at the other three health systems (range, 0.79–0.85). A one-step model was also derived for comparison. Overall, the two-step risk score had better performance than the one-step score. CONCLUSIONS: The two-step scoring system used widely available, point-of-care data for triage of COVID-19 patients and is a potentially time- and cost-saving tool in practice. | Development and Validation of a Two-Step Predictive Risk Stratification Model for Coronavirus Disease 2019 In-hospital Mortality: A Multicenter Retrospective Cohort Study |
As the coronavirus disease 2019 (COVID-19) pandemic continues to rise and second waves are reported in some countries, serological test kits and strips are being considered to scale up an adequate laboratory response. This study provides an update on the kinetics of humoral immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and performance characteristics of serological protocols (lateral flow assay [LFA], chemiluminescence immunoassay [CLIA] and ELISA) used for evaluations of recent and past SARS-CoV-2 infection. A thorough and comprehensive review of suitable and eligible full-text articles was performed on PubMed, Scopus, Web of Science, Wordometer and medRxiv from 10 January to 16 July 2020. These articles were searched using the Medical Subject Headings terms 'COVID-19', 'Serological assay', 'Laboratory Diagnosis', 'Performance characteristics', 'POCT', 'LFA', 'CLIA', 'ELISA' and 'SARS-CoV-2'. Data from original research articles on SARS-CoV-2 antibody detection ≥second day postinfection were included in this study. In total, there were 7938 published articles on humoral immune response and laboratory diagnosis of COVID-19. Of these, 74 were included in this study. The detection, peak and decline period of blood anti-SARS-CoV-2 IgM, IgG and total antibodies for point-of-care testing (POCT), ELISA and CLIA vary widely. The most promising of these assays for POCT detected anti-SARS-CoV-2 at day 3 postinfection and peaked on the 15th day; ELISA products detected anti-SARS-CoV-2 IgM and IgG at days 2 and 6 then peaked on the eighth day; and the most promising CLIA product detected anti-SARS-CoV-2 at day 1 and peaked on the 30th day. The most promising LFA, ELISA and CLIA that had the best performance characteristics were those targeting total SARS-CoV-2 antibodies followed by those targeting anti-SARS-CoV-2 IgG then IgM. Essentially, the CLIA-based SARS-CoV-2 tests had the best performance characteristics, followed by ELISA then POCT. Given the varied performance characteristics of all the serological assays, there is a need to continuously improve their detection thresholds, as well as to monitor and re-evaluate their performances to assure their significance and applicability for COVID-19 clinical and epidemiological purposes. | Humoral immunological kinetics of severe acute respiratory syndrome coronavirus 2 infection and diagnostic performance of serological assays for coronavirus disease 2019: an analysis of global reports |
Single suicide attempters (SSAs) and multiple suicide attempters (MSAs) represent distinct subgroups of individuals with specific risk factors and clinical characteristics. This retrospective study on a sample of 397 adult psychiatric inpatients analyzed the main sociodemographic and clinical differences between SSAs and MSAs and the possible differences between SSAs, MSAs, and psychiatric patients with and without suicidal ideation (SI). Clinical variables collected included psychiatric diagnoses (Mini International Neuropsychiatric Interview), presence of substance use, current suicide risk status (Columbia Suicide Severity Rating Scale), Clinical Global Impression at admission, Global Assessment of Functioning improvement between admission and discharge, age at onset of psychiatric illness, duration of untreated illness in years, number of hospitalizations in psychiatric settings, and lethality of the most severe suicide attempt. A multinomial logistic regression model with groups showed that MSAs had a higher lethality of their last suicide attempt as compared to SSAs. In addition, MSAs had distinct sociodemographic characteristics compared to both SSAs and patients with SI. Although the study was limited by the relatively small sample size and retrospective nature, the present results suggest that identifying MSAs could be useful in predicting suicide risk and designing ad hoc prevention strategies. | Clinical Differences Between Single and Multiple Suicide Attempters, Suicide Ideators, and Non-suicidal Inpatients |
To contain the initial spread of the SARS-CoV2 virus and the COVID-19 disease, many countries opted to close schools. However, the importance of schooling to mitigate inequalities motivated many economies to reopen schools after having formulated various COVID-19 mitigation and containment strategies. Using an exploratory sequential mixed method design, we explore the measures undertaken by countries when reopening schools and how these measures varied cross-nationally. We find that countries formulated a wide number (total: 242) and range of school reopening measures to mitigate the spread of the virus in the early months of the COVID-19 pandemic. From a policy diffusion theoretical perspective, findings from our statistical analyses suggest that cross-national diversity in policies is related to both internal and external country factors such as peer emulation mechanisms, income, and past pandemic experiences. We urge international agencies for more explicit guidelines for effective school reopening measures. | Cross-National Variation in School Reopening Measures During the COVID-19 Pandemic |
Existing methods for RNA diagnostics, such as reverse transcription PCR (RT-PCR), mainly rely on nucleic acid amplification (NAA) and RT processes, which are known to introduce substantial issues, including amplification bias, cross-contamination, and sample loss. To address these problems, we introduce a confinement effect-inspired Cas13a assay for single-molecule RNA diagnostics, eliminating the need for NAA and RT. This assay involves confining the RNA-triggered Cas13a catalysis system in cell-like-sized reactors to enhance local concentrations of target and reporter simultaneously, via droplet microfluidics. It achieves >10 000-fold enhancement in sensitivity when compared to the bulk Cas13a assay and enables absolute digital single-molecule RNA quantitation. We experimentally demonstrate its broad applicability for precisely counting microRNAs, 16S rRNAs, and SARS-CoV-2 RNA from synthetic sequences to clinical samples with excellent accuracy. Notably, this direct RNA diagnostic technology enables detecting a wide range of RNA molecules at the single-molecule level. Moreover, its simplicity, universality, and excellent quantification capability might render it to be a dominant rival to RT-qPCR. | An Ultralocalized Cas13a Assay Enables Universal and Nucleic Acid Amplification-Free Single-Molecule RNA Diagnostics. |
OBJECTIVE: This study aimed to assess acceptance of COVID-19 vaccination as well as its sociodemographic and clinical determinants, 3 months after the launch of the vaccination programme in Geneva, Switzerland. METHODS: In March 2021, an online questionnaire was proposed to adults included in a longitudinal cohort study of previous SARS-CoV-2 serosurveys carried out in the canton of Geneva, which included former participants of a population-based health survey as well as individuals randomly sampled from population registries, and their household members. Questions were asked about COVID-19 vaccination acceptance, reasons for acceptance or refusal and attitudes to vaccination in general. Data on demographic (age, sex, education, income, professional status, living conditions) and health-related characteristics (having a chronic disease, COVID-19 diagnosis, smoking status) were assessed at inclusion in the cohort (December 2020). The overall vaccination acceptance was standardised according to the age, sex, and education distribution in the Geneva population. RESULTS: Overall, 4067 participants (completion rate of 77.4%) responded to the survey between 17 March and 1 April 2021. The mean age of respondents was 53.3 years and 56.0% were women. At the time of the survey, 17.2% of respondents had already been vaccinated with at least one dose or had made an appointment to get vaccinated, and an additional 58.5% intended or rather intended to get vaccinated. The overall acceptance of COVID-19 vaccination standardised to the age, sex and education distribution of the population of Geneva was 71.8%, with a higher acceptance among men than women, older adults compared with younger adults, high-income individuals compared with those with a low income, and participants living in urban and semi-urban areas compared with rural areas. Acceptance was lower among individuals having completed apprenticeships and secondary education than those with tertiary education. The most common reasons reported by participants intending to get vaccinated were the desire to "get back to normal", to protect themselves, their community and/or society,and their relatives or friends against the risk of infection by SARS-CoV-2, as well as the desire to travel. Less than half (45.6%) of participants having children were willing or rather willing to have their children vaccinated against COVID-19 if it were recommended by public health authorities. CONCLUSION: Although our study found a 71.8% weighted acceptance of COVID-19 vaccination, there were noticeable sociodemographic disparities in vaccination acceptance. These data will be useful for public health measures targeting hesitant populations when developing health communication strategies. | COVID-19 vaccination acceptance in the canton of Geneva: a cross-sectional population-based study |
The COVID-19 pandemic has created a profound mental health challenge worldwide. The goal of this paper is to explore cognitive responses to the pandemic in order to better understand underlying beliefs for those reporting and not reporting symptoms of depression within the context of a period of realistic health, economic and social threat. This paper described a cross-sectional survey carried out with a convenience sample from the general population between December 2020 and February 2021. As part of that survey, adult respondents (n=555) were asked to fill in open text box questions which provided prompts of the Cognitive Triad: “I am…/I am not…”;“Others people are…/Other people are not…”;“The world is…”. These qualitative data were analysed using reflexive thematic analysis. Thematic responses between people who screened above and below the cut-off for moderate depressive symptoms showed noticeable overlap, especially in terms of negative cognitions. The largest distinct difference in cognitions was the lack of positively framed cognitions across the cognitive triad in those screening above the cut-off for moderate depressive symptoms. These data highlight the importance of developing a positive cognitive framework to the pandemic, indicating that approaches such as Positive Psychology or Compassion-Focused Therapy which emphasise positive emotions, empathy, and gratitude may be particularly helpful. | Qualitative analysis of the cognitive triad in a sample of the general population in response to the COVID-19 pandemic |
In December 2019, the world was disrupted by the news of a new strain of virus known as Novel Corona virus, taking lives of many in China. Wuhan, the capital of Central China’s Hubei province is said to be the place where the outbreak started. The city went on lockdown as the disease spread rapidly. After the lockdown, most countries like India and Bangladesh airlifted their citizens who were studying in Wuhan. Similarly, Nepal also has many youth studying medicine in Wuhan. Pleas for help from the students reached the government. This was the first encounter of such experience for Nepal government. With the help of Ministry of Health, Ministry of foreign affair, Health Emergency Organizing committee, Epidemiology and Disease Control Division, Nepal Army Hospital, Nepal Police Hospital, Waste Management team, Nepal Ambulance service, Tribhuwan international Airport Authorities and Royal Airlines the government of Nepal planned, organized and successfully brought back all the 175 students on 15 th February 2019 from Wuhan, China. The present article aims to share the experience, the challenges faced and recommendations for future similar cases. | Air Medical Evacuation of Nepalese Citizen During Epidemic of COVID-19 from Wuhan to Nepal |
A severe public health crisis has been declared worldwide since coronavirus disease 2019 (COVID-19) was classified as a pandemic of acute respiratory infectious disease by the World Health Organisation (WHO). China has taken strict measures to curb the spread of the disease to save lives, and has managed to control the outbreak. COVID-19 is mainly transmitted through respiratory droplets and close physical contact, so it is challenging to prevent nosocomial infection and possible spread during dental treatment. Since the initial phase of the COVID-19 outbreak, a disease prevention and control strategy based on the new concept of population risk classification and rational use of personal protective equipment has been implemented by the Peking University Hospital of Stomatology. Nosocomial infection prevention and control concepts and measures relating to dental diagnosis and treatment are critically checked in the hospital. Our experiences in handling this situation are shared here and may have wide-ranging implications for infection prevention and control (IPC) for COVID-19 in dental practices worldwide. | Preventive and Control Measures for the Coronavirus Pandemic in Clinical Dentistry. |
Knowledge on the mechanisms of viral spread, of time-related changes, and age-specific factors of severe acute respiratory syndrome coronavirus 2 infections is important to develop recommendations aimed at controlling the pandemic. In this context, longitudinal data on proportions of positive results in different age groups are rare. Data on total positive counts and on shares of positive counts deriving from a private (MVZ) and a University (RWTH) laboratory were analyzed retrospectively and compared with public data on total positive counts of the Robert Koch Institute (RKI). Data were covered for Weeks 9-24 of the year 2020 and all patient ages. Total positive counts were lower in children compared to adults. Proportions of children and adults tested positive were 3%-5% and 5%-7%, respectively. RKI and MVZ data showed similar time-related patterns. Patients of 20-60 years of age did account for the initial virus spread (maximum infection rates at Weeks 9-11). Thereafter, infection rates decreased in older patients whereas children did not show a comparable time-related decrease. Pediatric data generated in outpatient settings and hospitals differed markedly which should be considered in further studies. In summary, compared with adults children are less affected by severe acute respiratory syndrome coronavirus 2 infections and are unlikely to account for the initial viral spread. However, children show sustained viral activity and may serve as a viral reservoir. | Retarded decline of the share of SARS-CoV-2-positive children in North Rhine-Westphalia, Germany |
Secondary or high school (HS) educational professionals expressed concerns about dealing with environmental and occupational health and safety protocols due to COVID-19 Concerns related to fall 2020 school re-opening and getting back into in-person teaching-whether full-time, part-time or some other approved hybrid model-plus ongoing uncertainty with how the state and federal government will be handling matters about mandates for virtual learning, rapid testing, vaccine distribution, etc These concerns were related to both their experience as educational professionals and genuine interest in personal and student well-being This study was a cross-sectional online survey in early fall from mid-September-early October 2020 Of a possible maximum participation of 740 New Jersey (NJ) supervisory-level HS teachers and administrators (e g , department chairs, district and school principals), 100 confirmed unique respondents (13 5%) consented and completed the survey Of 100 experienced (mean 18 years teaching) participants, 70% responded to the gender identity question (overall, 61% female, 39% male;by NJ region, gender ratios were similar) There were statistically significant differences (using Fischer's exact test) between NJ regions regarding provision of online counseling and support services for teachers (p < 0 001);for resources and equipment for teachers to mediate online learning (p = 0 02);for assistive video technology tools (p = 0 03) and accessibility to structured online learning and professional development (p = 0 002);concerning learning aids to engage students in online instruction, online counseling, and support services for students and their families (p = 0 006);appropriate protocol is clean and disinfect areas used by a person with COVID-19 (p = 0 002);and, immediately separate staff and students who screen positive for COVID-19 (p = 0 03) There were few statistical differences by gender This study reported what participants wanted regarding the development of future policies then implemented as reopening practices Data can inform recommendations in NJ and elsewhere at federal, state, and local levels Data provide new insights and valuable information to inform the consideration of acceptability of various policy measures among HS education professionals | Fall 2020 COVID-19 Needs Assessment among New Jersey Secondary School Educational Professionals |
BACKGROUND: An increasing number of observational studies have reported the persistence of symptoms following recovery from acute COVID-19 disease. The long-term consequences of COVID-19 are not fully understood and there is no clear consensus on the definition of post-acute sequelae of SARS-CoV-2 infection (PASC). The reported prevalence of PASC widely varies from 10% up to 87%. The purpose of this study is to assess PASC in cancer patients following acute COVID-19 recovery. METHODS: We assessed cancer patients at MD Anderson Cancer Center who were diagnosed with COVID-19 disease between March 1, 2020 and Sept 1, 2020. Using patient questionnaires and medical chart reviews we followed these patients from March 2020 till May 2021. Patient questionnaires were sent out remotely daily for 14 days after COVID-19 diagnosis then weekly for 3 months, and then monthly thereafter. Chart reviews were conducted for each patient hospital re-admission and emergency department visit. These admissions were classified as either COVID-19 related or non-related. The persistence or emergence of new COVID19-related symptoms were captured at each COVID-19 related admission. RESULTS: We included 312 cancer patients with a median age of 57 years (18-86). The majority of patients had solid tumors (75%). Of the 312 patients, 188 (60%) reported long COVID-19 symptoms with a median duration of 7 months and up to 14 months after COVID-19 diagnosis. The most common symptoms reported included fatigue (82%), sleep disturbances (78%), myalgias (67%) and gastrointestinal symptoms (61%), followed by headache, altered smell or taste, dyspnea (47%) and cough (46%). A higher number of females reported a persistence of symptoms compared to males (63% vs 37%; p=0.036). Cancer type, neutropenia, lymphocytopenia, and hospital admission during acute COVID-19 disease were comparable in both groups and did not seem to contribute to a higher number of long-COVID-19 patients in our study group. CONCLUSION: Long-COVID occurs in 60% of cancer patients and may persist up to 14 months after acute illness. The most common symptoms are fatigue, sleep disturbance, myalgia and gastro-intestinal symptoms. DISCLOSURES: Fareed Khawaja, MBBS, Eurofins Viracor (Research Grant or Support) | 300. Long COVID in Cancer Patients: Preponderance of Symptoms in Majority of Patients Over Long Time Period |
Background: Following the pandemic of COVID-19 and the increased COVID-19 risk in transplant patient receptions, the authors assessed the prevalence, clinical course, and the outcome of the COVID-19 infection among liver transplant receptions. Methods: : By designing and the use of researcher made questionnaire and the use of medical services, liver transplantation recipients under our center surveyed in terms of COVID-19 infection. Results: : Seven patients infected with COVID-19 were identified from 265 liver transplantation recipients. The majority of patients were male and had COVID-19 despite being in-home quarantine. All patients received immunosuppressive drugs during infection with COVID-19 with no change in the routine immunosuppressive therapy. Among the identified patients, 5 recovered and 2 died. One of the dead patients, in addition to having a liver transplant, suffered brain cancer with metastasis to the lungs. Conclusion: It seems that the in liver transplants infected with COVID-19, the immunosuppressive drugs causes mild to moderate illness, and even recover from the disease.However, more evidence is needed to prove this hypothesis. It is also recommended that transplant recipients should be warned about personal hygiene and closely be monitored by organ transplant centers. | Management of COVID-19 in Liver Transplant Recipients with Immunosuppressant Therapy: Experiences of an Iranian Transplant Registry |
In this defining moments essay, the author describes a day in her life as a woman living with uterine fibroids. As a Black woman scholar, the author found unwell and bloody bodies are counterproductive to some academic institutions, which make little to no room for the deep, intersectional stories of wounded, healing and recovering academics. Not only is the journey toward healing one that has often been muted, but it has been silent in many journal spaces, though the fibroid condition is a very common epidemic often leading to other health conditions and procedures. This essay discusses how the shared stories found in collective racial, gender, and faith identification work together to address health disparities among specific intersectional identities with the Strong Black Woman image and true strength in mind. In the end, the author urges Black women scholars to participate in loud healing to counter the spiral of silence present in many research spaces and Black bodies. | Body, Blood, and Brilliance: A Black Woman's Battle for Loud Healing and Strength. |
INTRODUCTION: Before the Coronavirus Disease 2019 (COVID-19) arrival and its pandemic, dengue was already a significant cause of epidemics in South East Asia and Latin America. In 2020 with their cocirculation, coinfections began to be observed and reported in different countries. As expected, this syndemic is evident in different areas and deserves proper characterisation and studies in Peru. METHODS: We retrospectively assessed the clinical, epidemiological, diagnostic characteristics and outcomes in a Social Security Hospital of Chiclayo, Lambayeque, Peru, of patients that were diagnosed simultaneously with COVID-19 and dengue during May–August 2020. RESULTS: A total of 50 patients with COVID-19/dengue coinfection were identified. Of them, 60% presented thrombocytopenia, and 52% fever, among other findings. The case fatality rate in this group was 28%, being higher in those patients initially classified as severe dengue (100%), as well as in females (55%) than males (21%) (OR = 4.65; 95%CI 1.18–18.45). DISCUSSION: Co-occurrence of COVID-19/Dengue is growing as a consequence of the syndemic of these viral diseases in endemic areas, such as Latin America, and as both conditions may evolve to severe disease, their epidemiological but clinical interaction in terms of outcomes need further assessment in future studies in the region. | Characteristics of patients coinfected with Severe Acute Respiratory Syndrome Coronavirus 2 and dengue virus, lambayeque, Peru, May–August 2020: A retrospective analysis |
BACKGROUND: The current study aimed to evaluate the previously unexplored correlation between undergraduate medical students’ attendance during their surgical clerkship and their academic performance. It also aimed to explore any difference in the attendance rate between male and female students and whether this difference, if present, affects the academic performance. METHODS: A retrospective descriptive cross-sectional study has been conducted on 331 undergraduate medical students during their surgical clerkships at the College of Medicine and Medical Sciences (CMMS) at Arabian Gulf University (AGU), Bahrain from September 2018 to June 2020. RESULTS: There was a positive statistically significant correlation between students’ attendance during surgical clerkship and academic performance (r = 0.360, P < 0.01). Mean attendance rate was greater in each increasing category of academic performance: 47.95% in the weak category (less than 65%, n = 42), 57.62% in the good performance category (65% to less than 75%, n = 108), 67.82% in the very good performance category (75% to less than 85%, n = 126), 83.16% in the excellent performance category (85% and above, n = 55). The mean attendance rate of male students was 59.76% (SD = 25.73), compared to 66.92% (SD = 24.30) in the female students. T-test indicated that the difference between the mean attendance of the two groups of the students (male, female) was statistically significant (t = 2.483, p < 0.05). On the other hand, the difference between the mean academic performance for the two groups of students, male & female, (t = 0.284, p = 0.777) was not statistically significant. CONCLUSIONS: Our study showed a significant relationship between undergraduate medical students’ attendance during their surgical clerkship and their academic performance. Further studies are needed to stratify this correlation according to clinical and theoretical teaching activities. No significant difference was observed in academic performance between female and male students. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12909-021-02833-2. | The relationship between attendance and academic performance of undergraduate medical students during surgical clerkship |
Background We aimed to assess the dose needed to achieve the propofol effect-site concentration using target-controlled infusion in intellectually disabled patients and to detail the most effective method for achieving a safe level of consciousness without hemodynamic changes as well as detail any resulting adverse effects. Methods We performed a retrospective review of sedation service records of 138 intellectually disabled patients (51, mental retardation; 36, autism; 30, brain lesion, 12 genetic diseases, 9 dementia) aged over 15 years and weighing over 30 kg. These patients had received propofol via target-controlled infusion in the special care dental clinic of Seoul National University Dental Hospital from May 2008 to September 2018 for restorative treatment (112), minor surgery (13), prosthodontics (7), periodontics treatment (5), and implant (1). Results For all groups, the duration of dental treatments was 43 ± 18 minutes, total sedation time was 73 ± 23 minutes, and total BIS values was 57 ± 12. The propofol maintenance dosage values for each group were: mental retardation, 3 ± 0.5 (2-4) µg/ml; autism, 3.1 ± 0.7 (2-5) µg/ml; brain lesion, 2.8 ± 0.7 (1.5-5) µg/ml; genetic disease, 2.9 ± 0.9 (1-4) µg/ml; and dementia 2.3 ± 0.7 (1-3.4) µg/ml. Conclusions The dementia group needed a lower dosage to reach a safe, effective propofol effect-site concentration than the other groups. Since there were no complications, deep sedation is a great alternative to general anesthesia for dental treatment of intellectually disabled patients. | Effects site concentrations of propofol using target-controlled infusion in dental treatment under deep sedation among different intellectual disability types. |
Virus host shifts occur frequently, but the whole range of host species and the actual transmission pathways are often poorly understood. Deformed wing virus (DWV), an RNA virus described from honeybees (Apis mellifera), has been shown to have a broad host range. Since ants are often scavenging on dead honeybees, foodborne transmission of these viruses may occur. However, the role of the ant Myrmica rubra as an alternative host is not known and foodborne transmission to ants has not been experimentally addressed yet. Here, we show with a 16-week feeding experiment that foodborne transmission enables DWV type-A and -B to infect M. rubra and that these ants may serve as a virus reservoir. However, the titers of both plus- and minus-sense viral RNA strands decreased over time. Since the ants were fed with highly virus-saturated honeybee pupae, this probably resulted in initial viral peaks, then approaching lower equilibrium titers in infected individuals later. Since DWV infections were also found in untreated field-collected M. rubra colonies, our results support the wide host range of DWV and further suggest foodborne transmission as a so far underestimated spread mechanism. | Foodborne Transmission of Deformed Wing Virus to Ants (Myrmica rubra) |
The effects of COVID-19 are being felt in Spain and are having a significant impact on the Telecom companies As the Spanish government's impose restrictions on movement, people are spending more time at home work, leisure and using vastly higher amount of data The 17th March Real Decreto-ley 8/2020, approving urgent exceptional measures to deal with the economic and social impact of COVID-19 are focused on at how telecommunications make changes to benefit consumers during this time © 2020 Ibero-American Law Institute All rights reserved | The universal electronic communications service to fight COVID-19 |
PurposeThe purpose of this study is to examine the impact of information technologies and technology-enabled social networks on the efficiency of knowledge management processes in the Middle Eastern audit and consulting companies.Design/methodology/approachScientific literature analysis, structural equation modeling and expert evaluation (structured questionnaire) were used to develop the research model, collect data from the audit and consulting companies’ experts and test the research hypotheses.FindingsThe empirical results of this research supported the hypotheses stating that information technologies and social networks positively affect the knowledge management cycle, including five processes (acquisition, creation, storage, sharing and application) within the Middle Eastern audit and consulting companies.Research limitations/implicationsThe research results were generated from the Middle Eastern audit and consulting companies, which form a limitation concerning the geographical area and the business sector.Practical implicationsFrom the results of this study, audit and consulting companies, as well as organizations and society broadly, would benefit via the positive effect of information technologies and technology-enabled social networks on the whole knowledge management cycle, which has a further impact on organizational performance. These practical implications are related to a more open, sharing culture that drives organizational performance to the members and stakeholders of organizations, which, in turn, benefits society.Originality/valueThis research analyzes information technologies and technology-enabled social networks’ impact on knowledge management processes, particularly in the context of the Middle Eastern audit and consulting companies. While the phenomena have received some attention in the prior scientific research, the studied context so far remained under-researched, where a gap is found in studying the knowledge management cycle as a whole. | Impact of information technologies and social networks on knowledge management processes in Middle Eastern audit and consulting companies |
The COVID-19 pandemic has caused more than three million deaths globally. The severity of the disease is characterized, in part, by a dysregulated immune response. CD16+ monocytes are innate immune cells involved in inflammatory responses to viral infections, and tissue repair, among other functions. We characterized the transcriptional changes in CD16+ monocytes from PBMC of people with COVID-19, and from healthy individuals using publicly available single cell RNA sequencing data. CD16+ monocytes from people with COVID-19 compared to those from healthy individuals expressed transcriptional changes indicative of increased cell activation, and induction of a migratory phenotype. We also analyzed COVID-19 cases based on severity of the disease and found that mild cases were characterized by upregulation of interferon response and MHC class II related genes, whereas the severe cases had dysregulated expression of mitochondrial and antigen presentation genes, and upregulated inflammatory, cell movement, and apoptotic gene signatures. These results suggest that CD16+ monocytes in people with COVID-19 contribute to a dysregulated host response characterized by decreased antigen presentation, and an elevated inflammatory response with increased monocytic infiltration into tissues. Our results show that there are transcriptomic changes in CD16+ monocytes that may impact the functions of these cells, contributing to the pathogenesis and severity of COVID-19. | Transcriptional Changes in CD16+ Monocytes May Contribute to the Pathogenesis of COVID-19 |
Paediatric drug development faces a number of barriers. These include fragmentation of stakeholders and inconsistent processes during the conduct of research. This review summarises recent efforts to overcome these barriers in Europe. Two exemplar initiatives are described. The European Paediatric Translational Research Infrastructure (EPTRI) facilitates preclinical research and other work that underpins clinical trials. conect4children (c4c) facilitates the design and implementation of clinical trials. Both these initiatives listen to the voices of children and their advocates. Coordination of research needs specific effort that supplements work on science, resources and the policy context. | European research networks to facilitate drug research in children. |
Background COVID-19 disease may present with different clinical presentations in pregnant women. Comorbid diseases are important factors affecting the progression of this disease. In this study, we aimed to evaluate the clinical and laboratory findings in pregnant women with COVID-19 who had no comorbid disease. Material and Methods This retrospective designed study included 217 patients with Covid PCR positive and typically COVID-19 clinic. The patients were classified into asymptomatic, non-severe and severe disease groups. The symptoms, laboratory results, hospital follow-ups and intensive-care records of the patients and the findings of new borns are presented. Results Most of the patients (78%) were in the third trimester of pregnancy, and 103 patients in the study group had severe disease. Fever in the non-severe group and respiratory distress in the severe group were the most common symptoms in the patients. The severe clinical manifestations were specifically observed in the third trimester patients. In the severe group, neutrophil, lactat dehydrogenase, ferritin, CK-MB, IL-6 and hospital stay were statistically higher than those in other groups (p < 0.05). Increase in BUN and creatine were the most predictive parameters in intensive care admission. While the intensive care unit (ICU) requirement was higher in patients in the severe group, premature birth was observed more frequently in the severe group (p < 0.05). Conclusion Observably, COVID-19 positive pregnant women were mostly detected in the third trimester, and the disease was more severe in this period. Also, the need for intensive care, the rate of delivery by caesarean section, and the rate of preterm delivery of these pregnant women were also found to be high. | Comparison of the Clinical and Laboratory Findings in COVID-19 Positive Pregnants without Comorbidity |
The aim of the current study was to examine the mental well-being of healthcare personnel (HCP) working in COVID-19 units in Greece and to calculate the prevalence of burnout (BO) amongst them. A questionnaire based on the Maslach Burnout Inventory for Medical Personnel was utilized between February 21st, 2021 and March 5th, 2021. A total of 190 HCP responded to the questionnaire, of which 73.7% were nurses and midwives. The mean age of the participants was 38.3 (8.4) years. Overall, 71.6% of the participants had a high BO score, while 20.5% had a moderate and 7.9% had a low BO score. Night shifts in COVID-19 wards and job dissatisfaction were significantly associated with a high BO score (P = .03 and P < .0001, respectively). The majority of HCP working in COVID-19 wards in Greece is experiencing high levels of overall BO and emotional exhaustion. | Watch Out for Burnout in COVID-19: A Greek Health Care Personnel Study |
Introduction De nombreuses manifestations neurologiques liées à l’infection par le SARS-CoV-2 ont récemment été décrites. Bien que fréquemment rapportées dans les études rétrospectives, il existe à ce jour peu de descriptions cliniques, biologiques, et radiologiques des cas d’encéphalopathies liées au COVID-19. Matériels et méthodes Nous rapportons les observations de 4 patients pris en charge pour une encéphalopathie liée au COVID-19, pour lesquels le diagnostic a été posé suite à l’apparition au cours du COVID-19 de déficits cognitifs, de signes neurologiques focaux, ou de comitialité. Tous les patients ont bénéficié d’une évaluation neurocognitive, d’une ponction lombaire, d’un électroencéphalogramme, d’une IRM cérébrale, et d’une tomographie cérébrale par émission de positron (TEP-FDG). Résultats Les 4 patients étaient âgés de 60 ans ou plus, et présentaient des troubles cognitifs avec un syndrome frontal au premier plan. Deux patients avaient également un syndrome cérébelleux statique et cinétique. Les deux autres ont présenté des myoclonies, des manifestations psychiatriques, ou une crise convulsive généralisée. Le délai médian entre les premiers symptômes du COVID-19 et l’apparition des signes neurologiques était de 0–12jours. Aucun patient n’avait de signes IRM d’encéphalite ni de pléiocytose à la ponction lombaire. La PCR SARS-CoV-2 dans le liquide céphalorachidien (LCR) était négative dans les 4 cas. Les taux d’interleukine-6 dans le LCR étaient élevés dans 2 cas. Les 4 patients présentaient des anomalies identiques du métabolisme cérébral à la TEP-FDG, à savoir un hypométabolisme orbito-frontal associé à un hypermétabolisme cérébelleux. Nous avons noté une amélioration clinique neurologique chez les 4 patients suite à l’instauration d’un traitement immunomodulateur (corticothérapie systémique et/ou immunoglobulines intraveineuses). Conclusion Malgré des présentations cliniques neurologiques variables, les exploration TEP-FDG cérébrales ont révélé des anomalies du métabolisme cérébral, qui pourrait être le reflet d’un mécanisme immunologique para- ou post-infectieux. La TEP-FDG cérébrale pourrait dans ce contexte guider l’instauration d’un traitement immunomodulateur. | Encéphalopathies liées au COVID-19 : apport de la TEP-FDG cérébrale dans une série de 4 cas |
Long delays in renewal of calibration of secondary standards radiation dosimeters in radiation oncology centers due to the COVID19 pandemic have aroused concerns regarding accuracy in dose delivery to patients. The concerns are mainly due to the uncertainty in the absorbed dose to water calibration factor (N(DW)) over a period of time. In this study, the N(DW)factor for two ion chambers, thimble type (Farmer) and parallel plate type (Markus), used in most of the radiotherapy centers, were retrospectively reviewed for 20 years. The calibration on all occasions except once was carried out at the Secondary Standards Dosimetry Laboratory, Bhabha Atomic Research Centre, Mumbai. The change in the N(DW)factor over this period was < ±3%. We, therefore, believe that a dosimeter with no history of repairs showed reasonable stability in the N(DW)factor over a long period. | Variation in Dosimeter Calibration Factor (N(DW)) Over a Period of 20 Years |
There is a dire need to produce a safe and effective coronavirus disease 2019 (COVID-19) vaccine as quickly as possible to avert an enormous burden of morbidity and mortality This need for speed has thus far resulted in significant deviations from standard approaches to vaccine research and regulatory approval Yet, pandemics do not obviate the need for rigorous scientific evaluation of potential interventions and adherence to universal ethical standards Consequently, steps taken to accelerate clinical research in the context of the current pandemic require an explicit ethical justification, particularly if we expect public trust in the vaccine We argue that accelerating COVID-19 vaccine research can be ethically justified, but only if social value, scientific validity, and a favourable risk-benefit ratio can be maintained or enhanced when doing so | Ethical conditions for accelerating COVID-19 vaccine research [version 1;peer review: awaiting peer review] |
On 13 March 2020 the Hungarian Government announced the immediate closure of all schools throughout the country to prevent the spread of COVID-19 forcing several hundred thousand children to learn from home, and teachers to ensure their education. The Hungarian Educational Authority hurried to issue recommendations on the use of digital education tools. During the COVID-19 pandemic and the special legal order consequently introduced by the Hungarian Government, Hungary has seen the emergence of such non-binding measures adopted by public entities, complementing governmental action against the pandemic, with the aim of providing guidance to bodies exercising a public service function (addressees). These protective measures adopted under the special legal order are deemed to be successful and are largely followed by the addressees. Since soft law has hitherto been neglected by both Hungarian administrative governance and the legal literature, the recent burgeoning of non-binding measures deserves scholarly attention. In this article, we set out to map the specific context of the emergence of domestic soft law and the conditions for its adoption and reception, relying on our case study conducted in respect of the National Educational Authority's recommendations. © | Domestic Soft Law Regulation during the COVID-19 Lockdown in Hungary: A Novel Regulatory Approach to a Unique Global Challenge |
The envelope glycoproteins of the mammalian type C retroviruses consist of two subunits, a surface (SU) protein and a transmembrane (TM) protein. SU binds to the viral receptor and is thought to trigger conformational changes in the associated TM protein that ultimately lead to the fusion of viral and host cell membranes. For Moloney murine leukemia virus (MoMuLV), the envelope protein probably exists as a trimer. We have previously demonstrated that the coexpression of envelope proteins that are individually defective in either the SU or TM subunits can lead to functional complementation (Y. Zhao et al., J. Virol. 71:6967-6972, 1997). We have now extended these studies to investigate the abilities of a panel of fusion-defective TM mutants to complement each other. This analysis identified distinct complementation groups within TM, with implications for interactions between different regions of TM in the fusion process. In viral particles, the C-terminal 16 amino acids of the MoMuLV TM (the R peptide) are cleaved by the viral protease, resulting in an increased fusogenicity of the envelope protein. We have examined the consequences of R peptide cleavage for the different TM fusion mutants and have found that this enhancement of fusogenicity can only occur in cis to certain of the TM mutants. These results suggest that R peptide cleavage enhances the fusogenicity of the envelope protein by influencing the interaction of two distinct regions in the TM ectodomain. | Functional domains in the retroviral transmembrane protein. |
The care needs for aging adults are increasing burdens on health systems around the world. Efforts minimizing risk to improve quality of life and aging have proven moderately successful, but acute shocks and chronic stressors to an individual’s systemic physical and cognitive functions may accelerate their inevitable degradations. A framework for resilience to the challenges associated with aging is required to complement on-going risk reduction policies, programs and interventions. Studies measuring resilience among the elderly at the individual level have not produced a standard methodology. Moreover, resilience measurements need to incorporate external structural and system-level factors that determine the resources that adults can access while recovering from aging-related adversities. We use the National Academies of Science conceptualization of resilience for natural disasters to frame resilience for aging adults. This enables development of a generalized theory of resilience for different individual and structural contexts and populations, including a specific application to the COVID-19 pandemic. | System models for resilience in gerontology: application to the COVID-19 pandemic |
OBJECTIVES: In this paper, we estimate the impact after 4–8 months of a large one-off unconditional cash transfer delivered to refugees during a time of dual shocks: the COVID-19 pandemic and cuts to monthly aid. We focus on four key outcomes: (1) health-seeking behaviour; (2) COVID-19 specific preventive health practices; (3) food security and (4) psychological well-being. METHODS: We use both quantitative and qualitative data to understand the impact of a cash transfer in this context. Quantitatively, we use a baseline survey of 1200 households (Q4 2019) and follow-up with three rounds of phone surveys in Q2 and Q3 2021, capturing at least half the sample in each round. We exploit an experimental variation in the timing of the cash transfer to assess the effect of the cash transfer through ordinary least squares regressions of intention to treat. Controlling for key baseline characteristics, we analyse the effect of the cash transfer on health access, COVID-19 health practices, food security and psychological well-being. Qualitatively, we make use of a longitudinal, small-n sample of refugee respondents, each of whom we interviewed up to 15 times between February and September 2020 to understand change over time and to go deeper into key topics. RESULTS: We do not find a statistically significant effect (6.2%, p=0.188) of receiving the cash transfer on preventative measures against COVID-19. However, households receiving the cash transfer were more food secure, with a 14.4% (p=0.011) improvement on the food security index, have better psychological well-being (24.5%, p=0.003) and are more likely to seek healthcare in the private health facilities (10.4%, p=0.057) as compared with control households. We do not find significant results on the value of food consumption. Overall, we find stronger treatment effects for households that were the first to receive the cash transfers. CONCLUSION: Taken together, we find significant support for the importance of cash transfers to refugee households mitigating against declines in food security and mental well-being in the face of shocks. | Cash, COVID-19 and aid cuts: a mixed-method impact evaluation among South Sudanese refugees registered in Kiryandongo settlement, Uganda |
The COVID-19 pandemic has had a major impact on the mental health of refugees and migrants. This study aimed to assess refugee clinician perspectives on mental health care during the COVID-19 pandemic, specifically access to and delivery of community mental health care services. We utilized a mixed methods design. We surveyed members of a national network of Canadian clinicians caring for refugees and migrants. Seventy-seven clinicians with experience caring for refugee populations, representing an 84% response rate, participated in the online survey, 11 of whom also participated in semi-structured interviews. We report three major themes: exacerbation of mental health issues and inequities in social determinants of health, and decreased access to integrated primary care and community migrant services. Clinicians reported major challenges delivering care during the first 6 months of the pandemic related to access to care and providing virtual care. Clinicians described perspectives on improving the management of refugee mental health, including increasing access to community resources and virtual care. The majority of clinicians reported that technology-assisted psychotherapy appears feasible to arrange, acceptable and may increase health equity for their refugee patients. However, major limitations of virtual care included technological barriers, communication and global mental health issues, and privacy concerns. In summary, the COVID-19 pandemic has exacerbated social and health inequities within refugee and migrant populations in Canada and challenged the way mental health care is traditionally delivered. However, the pandemic has provided new avenues for the delivery of care virtually, albeit not without additional and unique barriers. | Access to Refugee and Migrant Mental Health Care Services during the First Six Months of the COVID-19 Pandemic: A Canadian Refugee Clinician Survey |
OBJECT: The aim of this retrospective infodemiological study was to evaluate people’s interests in dietary supplements and functional foods during the coronavirus pandemic via analysis of Google search engine statistics. DESIGN & SETTINGS: The category, period, and regions selected in the Google Trends were “health,” “15 January–15 May 2020,” in the USA, the United Kingdom (UK), Germany, Italy, and France, respectively. The most commonly searched dietary supplements and functional foods (n = 32) during the pandemic were determined from a pool of keywords (n = 1,286) based on the terms’ relative search volumes (RSVs) within the last five years. Correlation analyses were conducted to invesitgate associations between coronavirus-related parameters with each keyword’s RSV for each country. Selected keywords (n = 25) were analyzed using the gtrendsR package in the R programming language; the ggplot2 package was used to visualize the data, the Prophet package was used to estimate the time series, and the dplyr package was used to create the data frame. RESULTS: Significantly strong positive correlations were identified between daily RSVs of the terms “black seed,”“vitamin C,”“zinc,” and “quercetin,” and search queries for “coronavirus” and “COVID-19” in the USA (Spearman’s correlation coefficient >0.8, p < 0.000), and between the RSVs of the terms “vitamin C” and “zinc,” and daily search queries for “coronavirus” and/or “COVID-19” in the UK (Spearman’s correlation coefficient > 0.8, p < 0.05). CONCLUSION: Google Trends can be a beneficial tool for following public interest in identifying outbreak-related misinformation, and scientific studies and statements from authorities and the media play a potential role in driving internet searches. | The Popularity of the Dietary Supplements and Functional Foods in The Coronavirus Pandemic Among The Google Users in the USA, UK, Germany, Italy and France |
Robots assist in many areas that are considered unsafe for humans to operate. For instance, in handling pandemic diseases such as the recent Covid-19 outbreak and other outbreaks like Ebola, robots can assist in reaching areas dangerous for humans and do simple tasks such as pick up the correct medicine (among a set of bottles prescribed) and deliver to patients. In such cases, it might not be good to rely on the fully autonomous operation of robots. Since many mobile robots are fully functional with low-level tasks such as grabbing and moving, we consider the mixed-initiative control where the user can guide the robot remotely to finish such tasks. For this mixed-initiative control, the user controlling the robot needs to visualize a 3D scene as seen by the robot and guide it. Mixed reality can virtualize reality and immerse users in the 3D scene that is reconstructed from the real-world environment. This technique provides the user more freedom such as choosing viewpoints at view time. In recent years, benefiting from the high-quality data from Light Detection and Ranging (LIDAR) and RGBD cameras, mixed reality is widely used to build networked platforms to improve the performance of robot teleoperations and robot-human collaboration, and enhanced feedback for mixed-initiative control. In this paper, we proposed a novel haptic-enabled mixed reality system, that provides haptic interfaces to interact with the virtualized environments and give remote guidance for mobile robots towards high-level tasks. The experimental results show the effectiveness and flexibility of the proposed haptic enabled mixed reality system. | Haptic-enabled Mixed Reality System for Mixed-initiative Remote Robot Control |
Importance: Waning immunity against COVID-19 in parallel with an increased incidence during the Omicron outbreak led the Israeli Ministry of Health to recommend a second booster dose of BNT162b2 (Pfizer) to high-risk individuals. Israel was the first country to recommend this, allowing evaluation of the added protection of a fourth vaccine dose to hospitalized patients with severe diseases. Objective: To assess the effect of a fourth dose for hospitalized patients with severe/critical breakthrough COVID-19. Design: A cohort study of hospitalized adults from 01/15/2022-01/31/2022. Settings: A multi center study of 14 medical centers in Israel. Participants: Hospitalized adult patients with PCR-confirmed severe/critical COVID-19. Excluded were patients lacking data on vaccination status. Exposure: Cases were divided according to the total number of vaccine doses received up to 7 days before diagnosis. Unvaccinated adults and single-dose recipients were grouped into an unvaccinated group. Main Outcome: A composite of mechanical ventilation or in-hospital death was defined as poor outcome. Outcomes were compared between 3- and 4-dose vaccinees. Results: Included were 1,049 patients with severe/critical COVID-19, median age 80 (IQR 69-87), 51% males. Among them, 360 unvaccinated, 34, 172, 386 and 88 were after 1, 2, 3 or 4 doses, respectively. Patients after 3 doses were older, had more males and immunosuppression, but with similar outcomes, 49% vs. 51% compared to unvaccinated patients (p=0.72). Patients after 4 doses were similarly older and immunosuppressed, but had improved outcomes compared to unvaccinated patients, 34% vs. 51% (p<0.01). We proceeded to examine independent predictors for poor outcome in fully-vaccinated patients with either 3 doses given a median of 161 (IQR 147-168) days earlier, or 4 doses given a median of 14 (IQR 10-18) days before diagnoses. Receipt of the fourth dose conferred significant protection: OR 0.51 (95%CI 0.30.87). Conclusion and Relevance: Within a population of hospitalized patients with severe/critical breakthrough COVID-19, a recent fourth dose was associated with significant protection against mechanical ventilation or death, compared to fully-vaccinated single boosted individuals. | Hospitalized patients with severe COVID-19 during the Omicron wave in Israel - benefits of a fourth vaccine dose |
Numerous studies report brain potential evidence for the anticipation of specific words during language comprehension. In the most convincing demonstrations, highly predictable nouns exert an influence on processing even before they appear to a reader or listener, as indicated by the brain’s neural response to a prenominal adjective or article when it mismatches the expectations about the upcoming noun. However, recent studies suggest that some well-known demonstrations of prediction may be hard to replicate. This could signal the use of data-contingent analysis, but might also mean that readers and listeners do not always use prediction-relevant information in the way that psycholinguistic theories typically suggest. To shed light on this issue, we performed a close replication of one of the best-cited ERP studies on word anticipation (Van Berkum, Brown, Zwitserlood, Kooijman & Hagoort, 2005; Experiment 1), in which participants listened to Dutch spoken mini-stories. In the original study, the marking of grammatical gender on pre-nominal adjectives (‘groot/grote’) elicited an early positivity when mismatching the gender of an unseen, highly predictable noun, compared to matching gender. The current pre-registered study involved that same manipulation, but used a novel set of materials twice the size of the original set, an increased sample size (N=187), and Bayesian mixed-effects model analyses that better accounted for known sources of variance than the original. In our study, mismatching gender elicited more negative voltage than matching gender at posterior electrodes. However, this N400-like effect was small in size and lacked support from Bayes Factors. In contrast, we successfully replicated the original’s noun effects. While our results yielded some support for prediction, they do not support the Van Berkum et al. effect and highlight the risks associated with commonly employed data-contingent analyses and small sample sizes. Our results also raise the question whether Dutch listeners reliably or consistently use adjectival inflection information to inform their noun predictions. | Anticipating words during spoken discourse comprehension: A large-scale, pre-registered replication study using brain potentials() |
OBJECTIVE/DESIGN: Cross-sectional study to examine the determinants of sleep health among postpartum women during the COVID-19 pandemic in New York City (NYC). SETTING/PARTICIPANTS: A subset of participants recruited as part of the COVID-19 Mother Baby Outcomes (COMBO) cohort at Columbia University (N = 62 non-Hispanic White, N = 17 African American, N = 107 Hispanic). MEASUREMENTS: Data on maternal sleep, COVID-19 infection during pregnancy, sociodemographic, behavioral, and psychological factors were collected via questionnaire at 4 months postpartum. Self-reported subjective sleep quality, latency, duration, efficiency, disturbances, and daytime dysfunction were examined as categorical variables (Pittsburgh Sleep Quality Index [PSQI]). Associations between sleep variables and COVID-19 status, time of the pandemic, sociodemographic, behavioral, and psychological factors were estimated via independent multivariable regressions. RESULTS: Mothers who delivered between May-December 2020, who delivered after the NYC COVID-19 peak, experienced worse sleep latency, disturbances and global sleep health compared to those who delivered March-April 2020, the peak of the pandemic. Maternal depression, stress and COVID-19-related post-traumatic stress were associated with all sleep domains except for sleep efficiency. Maternal perception of infant's sleep as a problem was associated with worse global PSQI score, subjective sleep quality, duration, and efficiency. Compared to non-Hispanic White, Hispanic mothers reported worse global PSQI scores, sleep latency, duration and efficiency, but less daytime dysfunction. CONCLUSIONS: These findings provide crucial information about sociodemographic, behavioral, and psychological factors contributing to sleep health in the postpartum period. | Postpartum sleep health in a multiethnic cohort of women during the COVID-19 pandemic in New York City |
Work from home is one of the policies chosen by the government due to the COVID -19 pandemic;however, work-home interactions (WHIs) can place a burden on one domain. This study aimed to examine the relationship between the dimensions of WHIs and psychological distress and how cyberloafing mediates this relationship. Data were collected with an online survey tool from 2349 participants who worked at a government institution in Indonesia with employees across the country to test the proposed hypothesis. The results show that all forms of WHIs cause psychological distress. Further a high level of negative work-home interactions (NWHIs) and negative home-work interactions (NHWIs) increase psychological distress. Conversely a high level of positive work-home interactions (PWHIs) and positive home-work interactions (PHWIs) reduce psychological distress. In addition, this study’s results also show that cyberloafing mediates the relationships between NWHIs NHWIs PWHIs and psychological distress. This study implies the organization need to provide mental support and technology support to ensure the work of employees effective. Organizations also need to support employees to reduce work-family conflict. | Work-home interaction and psychological distress during the COVID-19 pandemic: the mediation effect of cyberloafing |
During the coronavirus disease of 2019 (COVID-19) emergency, in the pediatric surgical setting, it has been essential to avoid and contain infections as well as to protect both the patients and the surgical team. During this emergency, procedures and workflow were adapted to provide the safest possible environment for both the surgical team and the patients. Pediatric surgical activities were reorganized during the COVID-19 pandemic at the “Vittore Buzzi” Children’s Hospital, which is a pediatric/maternal hospital located in Milan (Lombardy Region), Italy. Resources were optimized in order to maintain high levels of care and quality of assistance. During the COVID-19 emergency, the pediatric surgical department at the “Vittore Buzzi” Children’s Hospital became an acute care surgical service. For the reorganization of surgical activities, institutional protocols were adapted in order to preserve the pediatric-specific characteristics of our service; five crucial points were specifically addressed. The pediatric surgical procedures carried out during the initial two months of the Italian lockdown are also reported. Continuity of care was maintained for children affected by severe diseases, such as tumors and neurosurgical conditions, whose treatment could not be deferred. Telemedicine and telecommunication were adopted as quick-support modalities for pre- and post-operative care. This reorganization allowed us to preserve the “pediatric specificity” and all care-related procedures offered at this high-quality/high-volume surgical care referral center. | The Challenges of a Children’s Hospital during the COVID-19 Pandemic: The Pediatric Surgeon’s Point of View |
BACKGROUND Early recognition of sepsis and prompt treatment improves patient outcome. C-reactive protein (CRP) is a sensitive marker for tissue damage and inflammation but Procalcitonin (PCT) has greater specificity for bacterial infection. Limited research exists regarding the use of CRP and PCT at term pregnancy and the immediate postpartum period. AIM This study sought to define reference values for CRP and PCT at term and the early postnatal period. METHODS A prospective cross-sectional study was performed in a university teaching hospital. Venous blood was collected from healthy women (n=196), aged between 19-45 years with an uncomplicated singleton pregnancy, at term (37-40 weeksâ gestation) and on day 1 and day 3 postpartum for the measurement of CRP and PCT. RESULTS The reference population comprised of 189 participants: term pregnancy (n=51), postpartum day 1 vaginal delivery (VD, n=70) and caesarean section (CS, n=38) and day 3 (CS, n=30). The maximum PCT value at term pregnancy was 0.1µg/L. On day 1 postpartum, 90% and 86.8% of PCT results for VD and CS respectively were below the decision-threshold of 0.25 µg/L. The specificity of PCT to rule out infection in the reference population was 91.5%. CONCLUSIONS Reference values for PCT were established in a well-characterised population of healthy pregnant women at term and immediately postpartum. The variability of CRP limits its clinical utility in the assessment of systemic sepsis. Application of the PCT cut-off of 0.25 µg/L in this population will be a valuable adjunct to clinicians ruling out infection in pregnancy and postpartum. | EXPRESS: Reference values for C-reactive protein and procalcitonin at term pregnancy and in the early postnatal period. |
BACKGROUND: Coronavirus disease 2019 (COVID-19) is an infection with possible serious consequences. The plasma of recovered patients might serve as treatment, which we aim to assess in the form of a prospective meta-analysis focusing on mortality, multi-organ failure, duration of intensive care unit stay, and adverse events. METHODS: A systematic search was conducted to find relevant registered randomized controlled trials in five trial registries. A comprehensive search will be done continuously on a monthly basis in MEDLINE (via PubMed), Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science to find the results of previously registered randomized controlled trials. The selection will be done by two independent authors. Data extraction will be carried out by two other independent reviewers. Disagreements will be resolved by a third investigator. An update of the search of the registries and the first search of the databases will be done on the 21st of July. Data synthesis will be performed following the recommendations of the Cochrane Collaboration. In the case of dichotomous outcomes (mortality and organ failure), we will calculate pooled risk ratios with a 95% confidence interval (CI) from two-by-two tables (treatment Y/N, outcome Y/N). Data from models with multivariate adjustment (hazard ratios, odds ratio, risk ratio) will be preferred for the analysis. P less than 0.05 will be considered statistically significant. In the case of ICU stay, weighted mean difference with a 95% confidence interval will be calculated. Heterogeneity will be tested with I(2), and χ(2) tests. Meta-analysis will be performed if at least 3 studies report on the same outcome and population. DISCUSSION: Convalescent plasma therapy is a considerable alternative in COVID-19, which we aim to investigate in a prospective meta-analysis. | Convalescent plasma therapy for COVID-19 patients: a protocol of a prospective meta-analysis of randomized controlled trials |
In this study, a novel duplex nanoparticle-assisted polymerase chain reaction (nanoPCR) assay was developed to detect porcine epidemic diarrhea virus (PEDV) and porcine transmissible gastroenteritis virus (TGEV). Two pairs of primers were designed based on the conserved region within the N gene of PEDV and TGEV. In a screening of 114 clinical samples from four provinces in China for PEDV and TGEV, 48.2 and 3.5 % of the samples, respectively, tested positive. Under optimized conditions, the duplex nanoPCR assay had a detection limit of 7.6 × 10(1) and 8.5 × 10(1) copies μL(−1) for PEDV and TGEV, respectively. The sensitivity of the duplex nanoPCR assay was ten times higher than that of a conventional PCR assay. Moreover, no fragments were amplified when the duplex nanoPCR assay was used to test samples containing other porcine viruses. Our results indicate that the duplex nanoPCR assay described here is useful for the rapid detection of PEDV and TGEV and can be applied in clinical diagnosis. | A sensitive duplex nanoparticle-assisted PCR assay for identifying porcine epidemic diarrhea virus and porcine transmissible gastroenteritis virus from clinical specimens |
This article will deal with the pandemic and one university's response I am sure everyone has their own story, but I am from a town in New Jersey that was called the epicenter of the virus in the early stages of its spread | Adjusting to life during a pandemic |
People living with HIV (PLWH) may be at higher risk for adverse outcomes indirectly associated with the severe acute respiratory syndrome coronavirus (SARS-CoV-2). When comparing responses to questionnaires administered when social distancing and quarantine guidelines were first implemented, we found that PLWH were more likely to have restricted access to medical care, increased financial stress, increased symptoms of anxiety and depression, and increased substance use compared to demographically-similar people without HIV. | Collateral damage: Impact of SARS-CoV-2 pandemic in people living with HIV |
BACKGROUND: The COVID-19 pandemic has exacerbated the challenges of meaningful health care digitization. The need for rapid yet validated decision-making requires robust data infrastructure. Organizations with a focus on learning health care (LHC) systems tend to adapt better to rapidly evolving data needs. Few studies have demonstrated a successful implementation of data digitization principles in an LHC context across health care systems during the COVID-19 pandemic. OBJECTIVE: We share our experience and provide a framework for assembling and organizing multidisciplinary resources, structuring and regulating research needs, and developing a single source of truth (SSoT) for COVID-19 research by applying fundamental principles of health care digitization, in the context of LHC systems across a complex health care organization. METHODS: Houston Methodist (HM) comprises eight tertiary care hospitals and an expansive primary care network across Greater Houston, Texas. During the early phase of the pandemic, institutional leadership envisioned the need to streamline COVID-19 research and established the retrospective research task force (RRTF). We describe an account of the structure, functioning, and productivity of the RRTF. We further elucidate the technical and structural details of a comprehensive data repository-the HM COVID-19 Surveillance and Outcomes Registry (CURATOR). We particularly highlight how CURATOR conforms to standard health care digitization principles in the LHC context. RESULTS: The HM COVID-19 RRTF comprises expertise in epidemiology, health systems, clinical domains, data sciences, information technology, and research regulation. The RRTF initially convened in March 2020 to prioritize and streamline COVID-19 observational research; to date, it has reviewed over 60 protocols and made recommendations to the institutional review board (IRB). The RRTF also established the charter for CURATOR, which in itself was IRB-approved in April 2020. CURATOR is a relational structured query language database that is directly populated with data from electronic health records, via largely automated extract, transform, and load procedures. The CURATOR design enables longitudinal tracking of COVID-19 cases and controls before and after COVID-19 testing. CURATOR has been set up following the SSoT principle and is harmonized across other COVID-19 data sources. CURATOR eliminates data silos by leveraging unique and disparate big data sources for COVID-19 research and provides a platform to capitalize on institutional investment in cloud computing. It currently hosts deeply phenotyped sociodemographic, clinical, and outcomes data of approximately 200,000 individuals tested for COVID-19. It supports more than 30 IRB-approved protocols across several clinical domains and has generated numerous publications from its core and associated data sources. CONCLUSIONS: A data-driven decision-making strategy is paramount to the success of health care organizations. Investment in cross-disciplinary expertise, health care technology, and leadership commitment are key ingredients to foster an LHC system. Such systems can mitigate the effects of ongoing and future health care catastrophes by providing timely and validated decision support. | Rapid Response to Drive COVID-19 Research in a Learning Health Care System: Rationale and Design of the Houston Methodist COVID-19 Surveillance and Outcomes Registry (CURATOR) |
INTRODUCTION: Traditionally, health care delivery in the USA has been structured around in-person visits. The COVID-19 pandemic has forced a shift to virtual care models in order to reduce patient exposure to high-risk environments and to preserve valuable health care resources. This report describes one large primary care system's model for rapid transition to virtual care (RTVC). SETTING AND PARTICIPANTS: A RTVC model was implemented at the VA Connecticut Health Care System (VACHS), which delivers care to over 58,000 veterans. PROGRAM DESCRIPTION: The RTVC model included immediate virtual care conversion, telework expansion, implementation of virtual respiratory urgent care clinics, and development of standardized note templates. PROGRAM EVALUATION: Outcomes include the rates of primary encounter types, staff teleworking, and utilization of virtual respiratory urgent care clinics. In under 2 weeks, most encounters were transitioned from in-person to virtual care, enabling telework for over half of the medical staff. The majority of virtual visits were telephone encounters, though rates of video visits increased nearly 18-fold. DISCUSSION: The RTVC model demonstrates expeditious and sustained transition to virtual care during the COVID-19 pandemic. Our experiences help inform institutions still reliant on traditional in-person visits, and future pandemic response. | A Model for Rapid Transition to Virtual Care, VA Connecticut Primary Care Response to COVID-19 |
Even before it had been developed there had already been skepticism among the general public concerning a vaccine for COVID-19. What are the factors that drive this skepticism? While much has been said about how political differences are at play, in this article I draw attention to two additional factors that have not received as much attention: witnessing the fallibility of the scientific process play out in real time, and a perceived breakdown of the distinction between experts and non-experts. | Beyond politics: additional factors underlying skepticism of a COVID-19 vaccine |
The SARS-CoV-2 Omicron exhibits striking immune evasion and is spreading rapidly worldwide. Understanding the structural basis of the high transmissibility and enhanced immune evasion of Omicron is of high importance. Here through cryo-EM analysis, we present both the closed and open states of the Omicron spike (S), which appear more compact than the counterparts of the G614 strain1, potentially related to Omicron residue substitutions-induced enhanced inter-protomer and S1-S2 interactions. The closed state showing dominant population may indicate a conformational masking mechanism for Omicron's immune evasion. Moreover, we capture three states for the Omicron S-ACE2 complex, revealing that the substitutions on the Omicron RBM result in new salt bridges/H-bonds, more favorable electrostatic surface properties, and overall strengthened S-ACE2 interaction, in line with the observed higher ACE2 affinity of Omicron S relative to G614. Furthermore, we determine structures of Omicron S in complex with the Fab of S3H3, an antibody able to cross-neutralize major variants of concern including Omicron, elucidating the structural basis for S3H3-mediated broad-spectrum neutralization. Our findings shed new lights on the receptor engagement and antibody neutralization/evasion of Omicron and may also inform design of broadly effective SARS-CoV-2 vaccines. | Molecular basis of receptor binding and antibody neutralization of Omicron. |
Iran is the country most affected by COVID-19 in the Middle East and was one of the first after China to experience an exponential development of the pandemic The pandemic has coincided with three parallel and interlinked crises: a geopolitical confrontation with the US and Iran's Arab neighbours;the dual shock of the oil price decline and hard-hitting US secondary sanctions, and the US refusal to ease its sanctions during the pandemic Sanctions had already affected Iran's health security system and crisis preparedness before COVID-19, reducing access to medical supplies and increasing the country's vulnerability But the interplay of multiple crises could shape Iran's capability handle a second wave of COVID-19 in the future and complicate the transnational management of the pandemic However, adopting a cooperative approach could create positive incentives for a change of direction in the Middle East, reducing pressures on a stressed global health security system © 2020 Deutsches Orient-Institut All rights reserved | The COVID-19 pandemic: One more challenge for Iran |
Dementia is a major public health issue worldwide and chronic use of benzodiazepine, which is very frequent in northern countries, was found to be a risk factor of dementia. This work aims at evaluating the impact of a reduction in chronic use of benzodiazepine on the future burden of dementia in France. Using estimations of dementia incidence and of benzodiazepine use and nation-wide projections of mortality and population sizes, a Monte Carlo approach based on an illness-death model provided projections of several indicators of dementia burden. With no change in benzodiazepine consumption, the prevalence of dementia between age 65 and 99 in France in 2040 was estimated at 2.16 millions (95% confidence interval (CI) 1.93-2.38), with a life expectancy without dementia at 65 years equal to 25.0 years (24.7-25.3) for women and 23.8 years (23.5-24.2) for men. Assuming a disappearance of chronic use of benzodiazepine in 2020, the prevalence would be reduced by about 6.6% in 2040 and the life expectancy without dementia would increase by 0.99 (0.93-1.06) year among women and 0.56 (0.50-0.62) among men. To conclude, a modest but significant reduction in future dementia burden could be obtained by applying current recommendation for duration of benzodiazepine use. | Impact of benzodiazepine consumption reduction on future burden of dementia |
The COVID-19 pandemic provides a rare opportunity to reveal the impact of reduced human activity on wildlife. I compared traffic volume and wildlife roadkill data along 18 km of highway before, during and after a 3-month period of COVID-19 restrictions with baseline data from the previous four years. Three marsupial herbivores comprised 89% of the 1820 roadkills recorded during the 4.5-year survey period: rufous-bellied pademelon Thylogale billardierii (31.5% of total), common brushtail possum Trichosurus vulpecula (29.8%) and red-necked wallaby Notamacropus rufogriseus (27.9%). During April 2020, when human activity was most restricted in the study area, traffic volume decreased by 36% (i.e. by an average 13,520 vehicle movements per day) and wildlife roadkill decreased by 48% (i.e. from 44 to 23 roadkills). However, when restrictions eased, traffic volume and wildlife roadkill returned to baseline levels indicating that the respite was brief in terms of animal welfare and of limited conservation value for these widespread and abundant species. Nevertheless, the results of this study suggest that even short periods of traffic reduction or road closures could be used as part of a management strategy for the conservation of endangered wildlife populations and re-wildling programs where roadkill is a risk factor. | COVID-19 restrictions provide a brief respite from the wildlife roadkill toll |
A novel series of diethyl {4-[(5-substituted-1,3-dioxo-1H-benzo[de]isoquinolin-2(3H)-yl)-methyl]-1H-1,2,3-triazol-1-yl}alkylphosphonates designed as analogues of amonafide was synthesized. All phosphonates were assessed for antiviral activity against a broad range of DNA and RNA viruses and several of them showed potency against varicella-zoster virus (VZV) [EC(50) (50% effective concentration) = 27.6–91.5 μM]. Compound 16b exhibited the highest activity against a thymidine kinase-deficient (TK(−)) VZV strain (EC(50) = 27.59 μM), while 16d was the most potent towards TK(+) VZV (EC(50) = 29.91 μM). Cytostatic properties of the compounds 14a–i–17a–i were studied on L1210, CEM, HeLa and HMEC-1 cell lines and most of them were slightly cytostatic for HeLa [IC(50) (50% inhibitory concentration) = 29–130 µM] and L1210 cells [IC(50) (50% inhibitory concentration) = 14–142 µM]. | Synthesis and the Biological Activity of Phosphonylated 1,2,3-Triazolenaphthalimide Conjugates |
The COVID 19 pandemic has challenged professors and students of all disciplines to adjust quickly to remote online teaching and education platforms. In this new era of remote teaching a greater challenge has been presented in the field of Equine Science; how to effectively share knowledge that is most often demonstrated by providing students access to live, in-person animal examples. Historically, students and teachers believed skill sets which are vital for future careers in the industry (e.g. veterinarian) must be learned through hands-on experience. However, in-person methods were not available, so students were taught through the Zoom platform. Students enrolled in various levels of Equine Science classes were invited to complete a short voluntary questionnaire measuring their response and perception to equine courses taught in an entirely online remote setting by the same professor. One group was comprised of undergraduates majoring in the field (n= 44) in upper level equine science courses, Advanced Equine Reproduction Physiology and/or Equine Enterprise. These students, 41 females and 3 males, ranged in age from 20-25 years, were provided a voluntary questionnaire seeking responses related to the perceived effectiveness and individual preferences of in-class lectures and in-person labs versus remote online teaching practices. A similar questionnaire was offered on a volunteer basis to pre-college students (n = 17). These students, female, high-school students from freshman to senior status (14-18 years of age), were interested in equine Science as a major at UC Davis in the future. This questionnaire evaluated their response to a two-week remote synchronous online equine science course which included multiple teaching methods, including lectures, mini labs and full labs. Responses from both populations suggested that equine courses were perceived as effective when offered as online, remote courses. Live (synchronous) classes and labs offered on Zoom increased engagement and interaction, but students also appreciated the opportunity to access recorded materials. Students responded positively to online remote teaching and found courses to be effective for increasing their knowledge about Equine Science in an engaging manner, despite their continued preference for in-person instruction. | Back in the Saddle: Student Response to Remote Online Equine Science Classes |
In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. | Expanding nonclinical roles in specialty pharmacy: How to grow a high-performance specialty pharmacy team |
The 2019 novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19, characterised by potentially severe respiratory and gastrointestinal symptoms As of early October 2020, there were around 34 million confirmed cases of COVID-19 and more than 1,000,000 associated deaths globally Initial data indicated that COVID-19 affected children with fewer symptoms and less severe disease compared with adults, however more recently some have developed an unusual associated systemic inflammatory condition: paediatric inflammatory multisystem syndrome temporally related to SARS-CoV-2 infection (PIMS-TS) In the UK, Public Health England outlined a shielding strategy designed to protect those extremely vulnerable to SARS-CoV-2 infection, such as individuals who are immunocompromised At the same time, the UK Government enforced a National Lockdown for all except key workers As such, researchers were unable to continue working on site at hospitals and Universities The web-based Digital Research Environment platform at GOSH made it possible for research on GOSH patients to continue despite those limitations Even more, the efficient data integration processes that the DRE have implemented enabled a rapid extraction of COVID-19 related data from the GOSH EPR system to support initial research results We were able to examine a cohort of paediatric patients, presenting to GOSH, with suspected COVID-19 or PIMS-TS to document their clinical characteristics and outcomes with regard to the presence of underlying medical conditions associated with vulnerability and to establish whether underlying conditions such as vitamin D deficiency were prominent in these patients By analysing this data during the first wave, we were able to identify that apparently ‘vulnerable’ groups were not overrepresented in patients hospitalised with COVID-19 or PIMS-TS | 10 Researching SARS-CoV-2 from home: maximising the benefit of the GOSH digital research environment during national lockdown |
The recent emergence of novel coronavirus (SARS-CoV-2) has been a major threat to human society, as the challenge of finding suitable drug or vaccine is not met till date. With increasing morbidity and mortality, the need for novel drug candidates is under great demand. The investigations are progressing towards COVID-19 therapeutics. Among the various strategies employed, the use of repurposed drugs is competing along with novel drug inventions. Based on the therapeutic significance, the chemical constituents from the extract of Tinospora cordifolia belonging to various classes like alkaloids, lignans, steroids and terpenoids are investigated as potential drug candidates for COVID-19. The inhibition potential of the proposed compounds against viral spike protein and human receptor ACE2 were evaluated by computational molecular modeling (Auto dock), along with their ADME/T properties. Prior to docking, the initial geometry of the compounds were optimized by Density functional theory (DFT) method employing B3LYP hybrid functional and 6-311 + + G (d,p) basis set. The results of molecular docking and ADME/T studies have revealed 6 constituents as potential drug candidates that can inhibit the binding of SARS-CoV-2 spike protein with the human receptor ACE2 protein. The narrowed down list of constituents from Tinospora cordifolia paved way for further tuning their ability to inhibit COVID-19 by modifying the chemical structures and by employing computational geometry optimization and docking methods. Supplementary Information: The online version contains supplementary material available at 10.1007/s13337-021-00666-7. | Computationally approached inhibition potential of Tinospora cordifolia towards COVID-19 targets |
Objective: We examined weather a protocol for fraction of inspired oxygen (FiO2) adjustment can reduce hyperoxemia and excess oxygen use in COVID-19 patients mechanically ventilated. Design: Prospective cohort study. Setting: Two intensive care units (ICUs) dedicated to COVID-19 patients in Brazil. Patients: Consecutive patients with COVID-19 mechanically ventilated. Interventions: One ICU followed a FiO2 adjustment protocol based on SpO2 (conservative-oxygen ICU) and the other, which did not follow the protocol, constituted the control ICU. Main variables of interest: Pprevalence of hyperoxemia (PaO2>100 mmHg) on day 1, sustained hyperoxemia (present on days 1 and 2), and excess oxygen use (FiO2>0.6 in patients with hyperoxemia) were compared between the two ICUs. Results: 82 patients from the conservative-oxygen ICU and 145 from the control ICU were included. The conservative-oxygen ICU presented lower prevalence of hyperoxemia on day 1 (40.2% vs. 75.9%, p<0.001) and of sustained hyperoxemia (12.2% vs. 49.6%, p<0.001). Excess oxygen use was less frequent in the conservative-oxygen ICU on day 1 (18.3% vs. 52.4%, p<0.001). Being admitted in the control ICU was independently associated with hyperoxemia and excess oxygen use. Multivariable analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FiO2 use and adverse clinical outcomes. Conclusions: Following FiO2 protocol was associated with lower hyperoxemia and less excess oxygen use. Although those results were not associated with better clinical outcomes, adopting FiO2 protocol may be useful in a scenario of depleted oxygen resources, as was seen during the COVID-19 pandemic. | Impacts Of A Fraction Of Inspired Oxygen Adjustment Protocol In Covid-19 Patients Under Mechanical Ventilation: A Prospective Cohort Study |
INTRODUCTION: Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2 virus, RNA family. It has continued to spread across the world after its first outbreak in China in 2019. On 11 March 2020 the WHO declared COVID-19 a pandemic given its global public health and economic impacts. OBJECTIVE: To assess knowledge, attitude and practice (KAP) on lifestyle, public health measures practiced by society and their impact to contain COVID-19 transmission in the Afar community, Afar Region, Ethiopia. METHODS: Community-based cross-sectional study design was conducted from May to July, 2020, on purposively selected districts and the Peasant Association (PA). Simple random sampling was applied to select households and study participants. Structured and semi-structured questionnaire was used to collect information from study participants. The collected data were entered into Microsoft Excel and transferred to SPSS version 20 for analysis. Both descriptive and analytical analysis was provided and a p-value of less than 0.05 was considered as statistically significant. RESULTS: Of the total (266) study participants, most of them had no formal education (61.7%) and were aged from 35–40 (34.2%). More than half, 67.7% and 56.8%, of participants did not know chewing chat and smoking cigarettes as a risk factor for COVID-19, respectively. Almost half, 49.6%, of participants live in a house which is non-partitioned and without ventilation. The participants were took part in public gatherings such as funerals (27.1%), weddings (13.9%), meetings (13.5%) and went to a market (9%) during the pandemic. Nearly half (47.7%) of the study participants did not wear facemasks. Of the total, 27.4% and 71.4% participants lost their daily income more than and less than half, respectively. CONCLUSION: This study revealed knowledge, attitude and practice of the community in the area to contain COVID-19 spread were minimal. Therefore, more improvement of public health measures will be required. | Knowledge, Attitude and Practice (KAP) Assessment on LifeStyle, Public Health Measures Practiced by Society and Their Impact to Contain COVID-19 Transmission Among Afar Community in Selected Parts of Afar Region, Ethiopia |
BACKGROUND: To prepare for future work stoppages in the medical industry, this study aimed to identify the effects of healthcare worker strikes on the mortality rate of patients visiting the emergency department (ED) at six training hospitals in Daegu, South Korea. METHODS: We used a retrospective, cross-sectional, multicenter design to analyze the medical records of patients who visited six training hospitals in Daegu (August 21–September 8, 2020). For comparison, control period 1 was set as the same period in the previous year (August 21–September 8, 2019) and control period 2 was set as July 1–19, 2020. Patient characteristics including age, sex, and time of ED visit were investigated along with mode of arrival, length of ED stay, and in-hospital mortality. The experimental and control groups were compared using t-tests, and Mann-Whitney U-test, chi-square test, and Fisher exact tests, as appropriate. Univariate logistic regression was performed to identify significant factors, followed by multivariate logistic regression analysis. RESULTS: During the strike period, 31,357 patients visited the ED, of which 7,749 belonged to the experimental group. Control periods 1 and 2 included 13,100 and 10,243 patients, respectively. No significant in-hospital mortality differences were found between strike periods; however, the results showed statistically significant differences in the length of ED stay. CONCLUSION: The ED resident strike did not influence the mortality rate of patients who visited the EDs of six training hospitals in Daegu. Furthermore, the number of patients admitted and the length of ED stay decreased during the strike period. | Impact of an emergency department resident strike during the coronavirus disease 2019 (COVID-19) pandemic in Daegu, South Korea: a retrospective cross-sectional study |
Oxygen vacancy sites on a catalyst surface have been extensively studied and been proved to promote the adsorption and activation of carbon dioxide. We use Sn-doped ZrO2 to prepare a Zr/Sn catalyst rich in oxygen vacancies (OVs) by co-precipitation. The yield of dimethyl carbonate is 5 times that of ZrO2. Compared with the original ZrO2, Zr/Sn exhibits a higher specific surface area, number of acid-base sites and a lower band gap, which improves the conductivity of electrons and creates more surface. The number of reaction sites greatly enhances the adsorption and activation capacity of CO2 molecules on the catalyst surface. In situ infrared spectroscopy shows that CO2 adsorbs on oxygen vacancies to form monomethyl carbonate, and participates in the reaction as an intermediate species. This work provides new clues for the preparation of ZrO2-based catalysts rich in oxygen vacancies to directly catalyze the synthesis of dimethyl carbonate from methanol and CO2. | Oxygen vacancies generated by Sn-doped ZrO2 promoting the synthesis of dimethyl carbonate from methanol and CO2 |
Background: Digital technologies are creating unprecedented opportunities to improve and increase support to older people with cognitive and mental health problems, and to their family and carers. However, barriers that preclude the implementation of technology driven programs for the assessment and intervention of adults at risk of cognitive decline need to be better understood. This study investigated these outstanding issues, as well as considering the impact that the COVID-19 Pandemic has had on such barriers. Methods: A sample of 105 participants completed an online survey. Their ages ranged from 18 to 92 years. Of these,72%were female,83%had higher education and beyond, 42% were working, 42% were retired, and 14% were unemployed. The questionnaires assessed IT experience alongside awareness, attitudes, and stigmas regarding the use of technologies, particularly those used to support cognitive and mental health. Questionnaires also explored the impact of the COVID-19 pandemic on these technology-related factors. We compared these across groups of young (n=45), middle age (n=12) and older adults (n=48). Results: Relative to younger participants, older participants were less aware of, and held stronger stigmas against healthcare technologies, even though they reported more IT experience. IT awareness was associated to more positive (r=0.619, p<0.001) and less negative IT Attitudes (r=-0.271, p=0.015), more acceptability (r=-0.374, p=0.001) and receptiveness towards technologies (r=-0.610, p<0.001). Male participants appeared to be more aware of such technologies than female participants. However, relative to men, women had increased the number of ways and frequency with which they used technologies since the COVID-19 pandemic started, and older people in general felt more inclined to endorse the need to learn more about healthcare technologies. Conclusions: Having more accumulated IT experience throughout our lives may not necessarily lead to better acceptance of healthcare technologies. More awareness about such specific technologies will help overcome stigmas, and challenging environments such as those imposed by the COVID-19 pandemicmay lead to positive changes in perception and acceptance of such technologies. These are necessary steps towards the personalisation of healthcare technologies to support vulnerable adults at risk of dementia. | Factors influencing acceptance of technology across age: Amid the COVID-19 pandemic (preprint)/ en |
Currently, there are scarce data on how COVID-19 affects people with myasthenia gravis. Theoretically, there is a higher risk of experiencing severe manifestations of COVID-19 due to the common use of immunosuppressive drugs and potential respiratory failure in relation to respiratory muscle weakness. This is one of the early cases of COVID-19 reported in association with myasthenia gravis. Here, we highlight the prognosis, discuss the pathophysiological mechanisms, and prompt the consideration of convalescent plasma therapy in myasthenia gravis patients with concomitant COVID-19. | COVID-19 Presentation in Association with Myasthenia Gravis: A Case Report and Review of the Literature |
Patient: Male, 2-month-old Final Diagnosis: Kawasaki disease Symptoms: Bleeding and peeling lips • conjunctival injection • erythema of the palms and soles • erythematous (polymorphous) maculopapular rash • fever • nasal congestion Medication: — Clinical Procedure: Echocardiography • electrocardiogram Specialty: Pediatrics and Neonatology OBJECTIVE: Rare disease BACKGROUND: Kawasaki disease (KD) is an acute inflammatory vasculitis, which occurs mostly in childhood, predominantly between the ages of 6 months and 5 years. The incidence of coronary artery abnormalities associated with KD has decreased from 25% to 4% as a result of timely diagnosis and treatment with intravenous immunoglobulin (IVIG). Infants ≤6 months of age are the most likely to develop prolonged fever without the other clinical criteria for KD, and diagnosis can sometimes be challenging or delayed. They are therefore at particularly high risk of developing coronary artery abnormalities. CASE REPORT: A 2-month-old male infant with no significant medical history initially presented with a history of nasal congestion, right conjunctivitis, red lips, and 1 loose stool in the pre-COVID-19 era. He was diagnosed with otitis media and was started on oral amoxicillin. By day 7 of fever, he had developed symptoms and signs and laboratory findings consistent with Kawasaki disease, which is rare in this age group. His echocardiogram showed dilated proximal left anterior descending and right coronary arteries. He was successfully treated, and his most recent echocardiogram, performed 17 months after his treatment, showed remarkable improvement in the coronary arteries. CONCLUSIONS: Kawasaki disease in children less than 6 months of age is still rare, and the presentation can sometimes make the diagnosis somewhat challenging. Increased clinical suspicion is required for recognition in the youngest patients, as they are more likely to present with few features of KD. Early diagnosis and treatment are needed to prevent or minimize the risk of significant coronary artery abnormalities. | A 2-Month-Old with Kawasaki Disease with Coronary Artery Dilation in the Pre-COVID-19 Era |
[Introdução]: Em janeiro de 2020, a Organização Mundial da Saúde (OMS) declarou o surto de uma nova doença causada pelo coronavírus, na província de Hubei na China, como Emergência de Saúde Pública de Importância Internacional A OMS declarou que há um alto risco de disseminação da doença causada pelo Coronavírus 2019 (COVID-19) para outros países do mundo As medidas de baixo custo a seguir ajudarão na prevenção da disseminação de infecções em seu local de trabalho, como gripes, resfriados e viroses estomacais, além de protegerem seus clientes, contratados e funcionários As empresas devem implementar essas medidas agora, mesmo que a COVID-19 ainda não tenha chegado à comunidade onde operam Elas podem reduzir os dias de trabalho perdidos devido à doença e impedir ou retardar a disseminação da COVID-19 caso chegue a um de seus locais de trabalho | Preparando seu local de trabalho para a COVID-19 - 27 de fevereiro de 2020 |
We investigate the effect of COVID-19 home confinement on levels of physical activity, sedentary behavior, and health-related quality of life (HRQL) in older women previously participating in exercise and educational programs. Our hypothesis was that home confinement would result in a reduction in levels of physical activity, an increase in sedentary behavior, and a reduction in HRQL. Sixty-four older women (age = 72 ± 5 yrs) under home confinement who participated in a physical exercise/educational program had their levels of physical activity, sedentary behavior, and HRQL assessed before and during (11 to 13 weeks after the introduction of government recommendations to reduce virus transmission) COVID-19 pandemic. There were significant reductions in total physical activity (−259 METs/week, P = .02), as a result of a ~17.0% reduction in walking (−30.8 min/week, P = .004) and ~41.8% reduction in vigorous-intensity activity (−29.6 min/week, P < .001). Sedentary behavior also increased (2.24 h/week, P < .001;1.07 h/week days, P < .001;and 1.54 h/weekend days, P < .001). However, no significant change occurred in moderate-intensity physical activity, and HRQL domains and facets, except for an improvement in the environment domain. Home confinement due to COVID-19 pandemic decreased levels of physical activity and increased levels of sedentary behavior in previously active older women. However, there were no significant changes in HRQL. These results suggest that educational programs promoting healthy behaviors may attenuate the impact of home confinement in older women. [ FROM AUTHOR] Copyright of Educational Gerontology is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.) | Home confinement during COVID-19 pandemic reduced physical activity but not health-related quality of life in previously active older women |
The aminoglycoside, geneticin (G418), was recently shown to have antiviral activity against bovine viral diarrhea virus (BVDV). Since BVDV, dengue virus (DENV) and yellow fever virus (YFV) all belong to the Flaviviridae family, it seemed possible that a common step in their life cycle might be affected by this aminoglycoside. Here it is shown that geneticin prevented the cytopathic effect (CPE) resulting from DENV-2 infection of BHK cells, in a dose-dependent manner with an 50% effective concentration (EC(50)) value of 3+/-0.4microg/ml. Geneticin had no detectable effect on CPE caused by YFV in BHK cells. Geneticin also inhibited DENV-2 viral yield with an EC(50) value of 2+/-0.1microg/ml and an EC(90) value of 20+/-2microg/ml. With a CC(50) value of 165+/-5microg/ml, the selectivity index of anti-DENV activity of geneticin in BHK cells was established to be 66. Furthermore, 25microg/ml of geneticin nearly completely blocked plaque formation induced by DENV-2, but not YFV. In addition, geneticin, inhibited DENV-2 viral RNA replication and viral translation. Gentamicin, kanamycin, and the guanidinylated geneticin showed no anti-DENV activity. Neomycin and paromomycin demonstrated weak antiviral activity at high concentrations. Finally, aminoglycoside-3'-phosphotransferase activity of neomycin-resistant gene abolished antiviral activity of geneticin. | Antiviral activity of geneticin against dengue virus. |
OBJECTIVES: To assess awareness of the neurological manifestation of COVID-19 on the Saudi population. METHODS: This was a cross-sectional study conducted using a Google Form survey to obtain responses randomly from the Saudi population between February and March 2021 using social media. RESULTS: A total of 831 participants completed the questionnaire. The distribution of the identified isolated neurological manifestations of COVOD-19 infections by participants’ age was assessed among the respondents. Loss of smell (88.9%), loss of taste (86.8%), and headache (72.6%) were the most identified first manifestations among all the age groups, while stroke (13.4%) was the least identified for all ages with no statistical significance (p>0.05 for all). Regarding COVID-19 related neurological symptoms, the same was reported: loss of smell, taste, and headache were the most identified symptoms among all the age groups, while stroke was the least identified for all ages with no statistical significance (p>0.05 for all). CONCLUSION: The study concluded that awareness of COVID-19’s neurological symptoms could help detect an atypical case, which can help in early intervention and its medical treatment. Moreover, the study also suggested conducting educational programs that emphasize the early identification of neurological symptoms of COVID-19. | Public awareness of the neurological manifestation of COVID-19 in Saudi Arabia |
XendoU is the endoribonuclease involved in the biosynthesis of a specific subclass of Xenopus laevis intron-encoded small nucleolar RNAs. XendoU has no homology to any known cellular RNase, although it has sequence similarity with proteins tentatively annotated as serine proteases. It has been recently shown that XendoU represents the cellular counterpart of a nidovirus replicative endoribonuclease (NendoU), which plays a critical role in viral replication and transcription. In this paper, we combined prediction and experimental data to define the amino acid residues directly involved in XendoU catalysis. Specifically, we find that XendoU residues Glu-161, Glu-167, His-162, His-178, and Lys-224 are essential for RNA cleavage, which occurs in the presence of manganese ions. Furthermore, we identified the RNA sequence required for XendoU binding and showed that the formation of XendoU-RNA complex is Mn2+-independent. | Functional characterization of XendoU, the endoribonuclease involved in small nucleolar RNA biosynthesis. |
Nursing homes and other long-term care facilities account for a disproportionate share of COVID-19 cases and fatalities worldwide. Outbreaks in US nursing homes have persisted despite nationwide visitor restrictions beginning in mid-March. An early report issued by the Centers for Disease Control and Prevention identified staff members working in multiple nursing homes as a likely source of spread from the Life Care Center in Kirkland, WA, to other skilled nursing facilities. The full extent of staff connections between nursing homes-and the role these connections serve in spreading a highly contagious respiratory infection-is currently unknown given the lack of centralized data on cross-facility employment. We perform a large-scale analysis of nursing home connections via shared staff and contractors using device-level geolocation data from 50 million smartphones, and find that 5.1% of smartphone users who visited a nursing home for at least 1 h also visited another facility during our 11-wk study period-even after visitor restrictions were imposed. We construct network measures of connectedness and estimate that nursing homes, on average, share connections with 7.1 other facilities. Traditional federal regulatory metrics of nursing home quality are unimportant in predicting outbreaks, consistent with recent research. Controlling for demographic and other factors, a home's staff network connections and its centrality within the greater network strongly predict COVID-19 cases. | Nursing home staff networks and COVID-19 |