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Immune thrombocytopenia (ITP) is an acquired autoimmune disorder characterized by low platelet counts with increased risk of bleeding. In particular, ITP induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been increasingly reported. Since immunosuppressive regimens in organ transplantation are often the primary cause of increased risk of infection, ITP following solid organ transplantation has occasionally been observed. However, SARS-CoV-2 infection-induced ITP in a heart transplant patient has not been reported. We report the first case of ITP after SARS-CoV-2 infection in an orthotopic heart transplant patient who did not respond well to first-line ITP treatment. We also review the previously reported cases of SARS-CoV-2 infection-induced ITP on immunosuppressive therapy. Post-transplant immune thrombocytopenia (ITP) may have different mechanisms than ordinal ITP; post-transplant ITP may be associated with donor condition such as history of ITP, autoantibodies, and use of immunosuppressants. Our literature review showed that severe acute respiratory syndrome coronavirus 2 infection-induced ITP patients with autoimmune diseases, with malignant hematologic disorders, or after organ transplantation may be refractory to prednisolone and intravenous immunoglobulin and require second-line ITP treatments. [ABSTRACT FROM AUTHOR]

Long-term effects of coronavirus disease 2019 (long COVID) develop in a substantial number of people following an acute COVID-19 episode. Red beetroot juice may have positive effects on multiple pathways involved in long COVID. The aim of this pilot study was to explore the impact of beetroot juice supplementation on physical function, gut microbiota, and systemic inflammation in adults with long COVID. A single-center, double-blind, placebo-controlled randomized trial was conducted to test the effects of 14 days of beetroot juice supplementation, rich in nitrates and betalains, on functional and biological outcomes in adults aged between 20 and 60 years with long COVID. Participants were randomized 1:1 to receive either daily oral supplementation with 200 mL beetroot juice (∼600 mg nitrate) or placebo (∼60 mg nitrate) for 14 days. The primary endpoint was the change from baseline to day 14 in a fatigue resistance test. Secondary outcomes included the distance walked on the 6-min walk test, handgrip strength, and flow-mediated dilation. Secondary endpoints also included changes from baseline in circulating inflammatory mediators and metagenomic and fecal water metabolomic profiles. Partial least squares discriminant analysis (PLS−DA) models were built to evaluate the differences in biological variables associated with the interventions. Thirty-one participants were randomized in the study. Twenty-five of them (median (interquartile range) age 40 (10), 14 [56 %] women), received either beetroot juice (15) or placebo (10) and completed the study. At 14 days, fatigue resistance significantly improved from baseline (mean difference [standard error]: +21.8 [3.7] s; p < 0.001) with no significant differences between intervention groups. A significant increase from baseline in the distance walked on the 6-min walk test was observed (mean difference [standard error]: +30.0 [9.4] m; p = 0.03), which was not different between groups. Flow-mediated dilation did not differ between participants who received beetroot juice and those on placebo. PLS–DA models allowed correct classification of participants with 92.2 ± 4.4 % accuracy. Those who ingested red beetroot juice had a greater abundance of bacteria with well-known beneficial effects, including Akkermansia , Oscillospira , Prevotella , Roseburia , Ruminococcaceae , and Turicibacter , compared with placebo. Participants allocated to beetroot juice supplementation were also characterized by significantly higher levels of fecal nicotinate, trimethylamine, and markers of beetroot juice intake (e.g., 5,6-dihydroxyindole). Finally, higher levels of interferon gamma and macrophage inflammatory protein-1β were found in participants who consumed beetroot juice. Beetroot juice supplementation for two weeks did not to induce significant improvements in functional outcomes in adults with long COVID compared with placebo. Beneficial effects were observed in both gut microbiota composition (i.e., increase in probiotic species) and inflammatory mediators. Trial was registered under ClinicalTrials.gov. Identifier no. NCT06535165. [ABSTRACT FROM AUTHOR]

The incidence of pediatric hospitalizations has significantly increased since the spread of the omicron variant of COVID-19. Changes of characteristics in respiratory and neurological symptoms have been reported. We performed a retrospective, cross-sectional study to characterize the MRI change in children with an emphasis on the change of cerebral vasculatures. We retrospectively collected clinical and MRI data of 31 pediatric patients with neurological symptoms during the acute infection and abnormalities on MRI during the outbreak of omicron variant from April 2022 to June 2022 in Taiwan. The clinical manifestations and MRI abnormalities were collected and proportion of patients with vascular abnormalities was calculated. Among 31 pediatric patients with post-COVID-19 neurological symptoms, MRI abnormalities were observed in 15 (48.4%), predominantly encephalitis/encephalopathy (73.3%). Notable MRI findings included focal diffusion-weighted imaging (DWI) hyperintensity in cerebral cortex and thalamus, diffuse cortical T2/DWI hyperintensity, and lesions in the medulla, pons, cerebellum, and splenium of corpus callosum. Vascular abnormalities were seen in 12 (80%) patients with MRI abnormalities, mainly affecting the middle cerebral arteries. The spectrum of neurological manifestations ranged from seizures to Alice in Wonderland syndrome, underscoring the diverse impact of COVID-19 on pediatric patients. A high proportion of vascular abnormalities was observed in pediatric patients with neurological involvements, suggesting that vascular involvement is an important mechanism of neurological manifestations in omicron variant infection. [ABSTRACT FROM AUTHOR]

The longitudinal, multidisciplinary care of children with spina bifida was disrupted during the CoVID-19 pandemic with unclear effect. To compare outpatient care utilization and outcomes among children with spina bifida before and during the CoVID-19 pandemic. A pre-post analysis (2018–2020 vs 2020–2022) comparing outpatient care utilization and clinical outcomes was performed using the onset of the CoVID-19 pandemic as a hinge point. Clinical visits and clinically significant events – ED visits, admissions, UTIs, shunt malfunctions – were tabulated from chart review, and patients not seen in the last two years were called for follow up. Differences between visits and outcomes for individuals during pre- and intra-pandemic periods were calculated, and relationships between demographic variables and care utilization as well as clinical visits and clinical outcomes were evaluated via linear regression. A total of 216 patients were included, 39 (18%) of whom were lost to follow up intra-pandemic. Mean in-person visits decreased from 3.7 (SD 2.8) pre-pandemic to 2.5 (SD 2.3, p < 0.00) intra-pandemic. Only six patients (0.03%) had virtual visits pre-pandemic vs 95 (44%) intra-pandemic; virtual visits did not equalize mean total visits with those pre-pandemic (3.3 [2.9], p = 0.02). Recent surgery was significantly associated with difference in clinic visits between periods (p < 0.00). Admissions (44 vs 29%, p < 0.00), ED visits (55 vs 43.5%, p < 0.00), and shunt malfunctions (21 vs 12.6%, p = 0.01) were significantly higher pre-pandemic; UTI incidence was similar (34 vs 31%, p = 0.41). Clinic visits were significantly positively associated with ED visits (p = 0.02), admissions (p < 0.00), and shunt malfunctions (p = 0.04). Nearly half (40.5%) of patients lost to follow up were contacted; 30% of patients reported difficulty accessing appointments and 17% accessing supplies during the pandemic. Despite an increase in telehealth visits during the pandemic, there was a decrease in mean total clinic visits compared to pre-pandemic. Adverse events did not increase during the pandemic period as expected; incidence of all evaluated outcomes was higher pre-pandemic. Additionally, outpatient care utilization during the pandemic was positively associated with ED presentation and shunt malfunction and did not appear to protect against other outcomes. Though clinical follow-up for pediatric spina bifida patients decreased during the COVID-19 pandemic, clinical outcomes did not acutely worsen. Clinic visits were supplemented but not entirely replaced by telemedicine in this period and were associated with poorer clinical outcomes, possibly reflecting an increase in patients' and families' threshold to engage in outpatient care during the pandemic. [ABSTRACT FROM AUTHOR]

COVID-19, caused by SARS-CoV-2 infection, led to a pandemic of acute respiratory illness that is ongoing. High-flow nasal cannula (HFNC) is a commonly used form of respiratory support during acute respiratory distress and is used to treat patients with COVID-19 in many centers. Due to the novel nature of COVID-19 at the onset of the pandemic, evidence to support the use and best practices of HFNC for treating patients with COVID-19 was lacking. This is a review of key peer-reviewed manuscripts from 2022-2023 discussing the efficacy and best practices for using HFNC for patients with COVID-19. Efficacy of HFNC for COVID-19, the use of the respiratory oxygenation index to guide HFNC for COVID-19, and concerns of generated/fugitive aerosols when using HFNC for COVID-19 are emphasized. [ABSTRACT FROM AUTHOR]

BACKGROUND: The dominant feature of COVID-19-associated ARDS is gas exchange impairment. Extravascular lung water index is a surrogate for lung edema and reflects the level of alveolocapillary disruption. The primary aim was the prediction of extravascular lung water index by the alveolar-arterial oxygen difference. The secondary aims were in determining the relationship between the extravascular lung water index and other oxygenation parameters, the FIO2, end-tidal oxygen concentration, pulmonary oxygen gradient (FIO2 minus end-tidal oxygen concentration), and PaO2. Methods: This observational prospective single-center study was performed at the Department of Anaesthesiology and Intensive Care, The University Hospital in Ostrava, The Czech Republic, during the COVID-19 pandemic, from March 20, 2020, until May 24, 2021. Results: The relationship between the extravascular lung water index and alveolar-arterial oxygen difference showed only a mild-to-moderate correlation (r = 0.33, P < .001). Other extravascular lung water index correlations were as follows: FIO2 (r = 0.33, P < .001), end-tidal oxygen concentration (r = 0.26, P = .0032), FIO2 minus end-tidal oxygen concentration (r = 0.15, P = .0624), and PaO2 (r = -0.15, P = .01). Conclusions: The alveolar-arterial oxygen difference does not reliably correlate with the extravascular lung water index and the degree of lung edema in COVID-19-associated ARDS. [ABSTRACT FROM AUTHOR]

BACKGROUND: COVID-19 is associated with prolonged disability, particularly after critical illness. This study aimed to assess and compare disability post--hospital discharge of subjects who were invasively ventilated versus those who were not, following ICU admission due to COVID-19. This study also explored variables associated with long-term disability. METHODS: In this prospective cohort study, subjects with COVID-19 who received invasive ventilation, noninvasive ventilation, or high-flow nasal cannula during ICU stay were assessed with the World Health Organization Disability Assessment Schedule (WHODAS) 2.0 at 3 and 6 months post--hospital discharge. Data were analyzed collectively and stratified as subjects with and without invasive mechanical ventilation. Analysis of variance and multiple regression analyses were applied. RESULTS: The subjects (N = 43) were mainly male, middle age, and overweight. Subjects who were invasively ventilated (n = 21) had decreased physical function compared to those who were not during hospital assessments. From 3-6 months after discharge, all WHODAS domains and the overall score decreased in both groups (P < .001), indicating disability recovery. The participation domain, which assesses joining in society, was the only domain that remained worse in the ventilation group compared to the no ventilation group (P = .01). No interaction was found between time and the study groups, suggesting that the recovery trajectory was similar. At 6 months, considering the entire cohort, 70% and 56% had no disability in self-care and getting along domains, respectively, while 42% exhibited moderate to severe disability in the participation domain. According to the overall WHODAS score, 86% of subjects still had some level of disability at 6 months. In multivariate analyses, the overall WHODAS score along with the household and participation domains showed significant positive correlations, indicating higher disability, with corticosteroid use. CONCLUSIONS: Disability persisted at 6 month post--hospital discharge for ICU survivors of COVID-19, regardless of the need for invasive mechanical ventilation. Participation was the only domain that showed higher disability among those who received invasive ventilation. [ABSTRACT FROM AUTHOR]

Outbreaks of emerging multidrug-resistant organisms (eMDROs), including carbapenem-resistant Enterobacterales, carbapenem-resistant Acinetobacter baumannii , and Candida auris , have been reported among severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients. We describe eMDRO clusters in SARS-CoV-2 units and associated infection control (IC) practices early in the SARS-CoV-2 pandemic. We conducted a retrospective survey of a convenience sample of health departments in 11 states to describe clusters of eMDROs that began before November 1, 2020 and involved SARS-CoV-2 units. Cluster characteristics and IC practices during the cluster period were assessed using a standardized outbreak report form, and descriptive analyses were performed. Overall, 18 eMDRO clusters (10 carbapenem-resistant Enterobacterales, 6 C auris , 1 carbapenem-resistant Pseudomonas aeruginosa , and 1 carbapenem-resistant A baumannii) in 18 health care facilities involving 397 patients were reported from 10 states. During the cluster period, 60% of facilities reported a shortage of isolation gowns, 69% extended use of gowns, and 67% reported difficulty obtaining preferred disinfectants. Reduced frequency of hand hygiene audits was reported in 85% of acute care hospitals during the cluster period compared with before the pandemic. Changes in IC practices and supply shortages were identified in facilities with eMDRO outbreaks during the SARS-CoV-2 pandemic and might have contributed to eMDRO transmission. • Outbreaks of emerging MDROs have been reported among SARS-CoV-2 patients. • Health departments completed a survey describing MDRO clusters in this population. • Eighteen clusters were reported in 11 hospitals and 7 post–acute care facilities. • Changes in infection control practices might have contributed to transmission. [ABSTRACT FROM AUTHOR]

Background and aims: COVID-19 put healthcare systems around the world under significant pressure, and led to a global recession. In response, governments implemented aid programmes to stimulate their economies. This, along with the outbreak of war in Ukraine, complicated the economic situation. All of this may have ramifications on people's access to essential healthcare services. This study aims to investigate the willingness to pay for healthcare among Saudi individuals at time of economic downturn. Methods: Questionnaires were used to collect data from 600 individuals across six provinces of Riyadh City between December 2017 and January 2018. The data were elicited using a closed ended format. A probit regression and marginal effects analyses were used to analyze the data. Results and conclusion: The results showed just over half the sample were willing to pay, suggesting that countries should give careful consideration to whether and when to involve people in financing healthcare services at time of economic turmoil. The results could be used by policymakers in decisions around funding allocation and priority setting. [ABSTRACT FROM AUTHOR]

Background: SARS-CoV-2, was identified as a global pandemic by the World Health Organization a few months after the first epidemic. It penetrates host cells through angiotensin-converting enzyme 2 receptors and spreads by respiratory droplets. Testes are among the several tissues that have high expression levels of ACE-2 receptors. The current study aimed to evaluate the hypothalamic-pituitary-testicular axis integrity among Egyptian post-COVID-19 patients. Methods: This is a cross-sectional study that included patients with a history of COVID-19 infection, at least 3 months from the onset of COVID-19. A detailed clinical history was obtained, and a thorough examination was performed. Laboratory tests included FBG, total testosterone, free testosterone, bioactive testosterone, FSH, LH, prolactin, E2, albumin, and SHBG. Testicular ultrasonography was performed. The data were statistically analyzed. Results: Eighty male patients were evaluated with a mean age of 35.53 ± 10.35 years. The mean serum total testosterone was 5.48 ± 1.65 ng/ml. Low testosterone was detected in 2.8% of the patients. High LH levels were detected in 17/80 patients (21.3%). High FSH levels were detected in 4/80 patients (5%). Six patients had elevated serum E2 level. The mean serum prolactin value was 10.90 ± 5.66 ng/ml. Fourteen patients had elevated prolactin levels. The mean serum T/LH ratio was 3.28 ± 1.52. The ratio of T/LH was decreased in eight COVID-19 patients (10%). In COVID-19 patients, a statistically significant negative correlation was found between age and free testosterone (FT) (r=-0.381, p < 0.001), bioavailable testosterone (Bio. T) (r=-0.375, p = 0.001), and androgen index (A. index) (r=-0.446, p < 0.001). Conclusion: The data of the current study suggest that COVID-19 infection might deteriorate pituitary – gonadal axis. The prevalence of low testosterone in COVID-19 male survivors is low. The risk of hypogonadism is increased with advanced age. More studies are required to confirm the relationship between COVID-19 infection and male gonadal function. [ABSTRACT FROM AUTHOR]

Introduction: Kidney damage in COVID-19 is common and may lead to CKD. Early recognition of progression is mandatory, so there is a need for sensitive markers of kidney damage. Renal functional reserve (RFR) is described as the ability of the kidneys to augment their function in special situations. Aim of Work: Was to assess subclinical renal dysfunction post-COVID-19. Methods: This cross-sectional study investigates 31 patients previously infected with COVID-19 within 2–3 months and 31 healthy subjects with matched age and sex. Assessment of RFR was done by calculating the estimated GFR using the CKD-EPI equation before and 2 hours after 80 g protein load by intravenous infusion. Results: RFR was significantly lower in post-COVID-19 patients (mean of 11.19 ± 4.76) than the control (mean of 25.81 ± 4.42, p < 0.001). Conclusion: Despite preserved eGFR, there is a reduction in RFR, indicating progressive loss of nephron mass post-COVID. [ABSTRACT FROM AUTHOR]

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19, caused over 6.8 million deaths globally as of March 2023. The knowledge, attitude, and practices (KAP) of people to COVID-19 varied in different locations around the world. In this study, we investigated the KAP of women attending Maimusari Primary Healthcare in Jere Local Government, Borno state during the pandemic with a view to understanding the KAP related to COVID-19 across different demographics of women. Methods: A cross-sectional survey was carried out using self-administered questionnaire on 400 women attending the health facility. The questionnaire surveyed participants' demographic characteristics, knowledge, attitude, practices, and willingness to take vaccine. Descriptive and inferential statistics was used to analyze the data. Results: Of the 400 participants, a higher proportion were between the ages of 20 and 29 (36.2%), Kanuri by tribe (47.2%), from monogamous family (66.0%) with less than 5 in terms of family size (64.8%) with no formal education (57.8%). The overall mean knowledge score was 13.64 ± 2.36, which differs significantly (p < 0.05) among age, ethnic group, marital status, family size and educational level. Educational level (χ2 = 12.329, p = 0.000) and age (χ2 = 58.943, p = 0.000) were associated with having good knowledge while ethnic group (χ2 = 52.59, p = 0.000) and family size (χ2 = 4.32, p = 0.038) were associated with having a positive attitude. Finally, 68.8% of the respondents were willing to get vaccinated while 82.2% considers the vaccines are safe. Conclusion: The findings in this study suggest that after the peak of the pandemic, majority of the respondents demonstrated good knowledge, positive attitude and undertook safe practices toward minimizing the transmission of COVID-19. However, over 60% have not taken the vaccine suggesting the need for improved awareness on vaccine safety. [ABSTRACT FROM AUTHOR]

To describe echocardiographic findings among mechanically ventilated patients with COVID-19 acute respiratory distress syndrome, comparing those with and without venovenous extracorporeal membrane oxygenation (VV ECMO) support. Single-center, retrospective cohort study. Intensive care unit (ICU) of a quaternary academic center. Patients with COVID-19 admitted between March 2020 and June 2021 receiving mechanical ventilation, with an echocardiogram within 72 hours of admission. Admission and follow-up echocardiograms during ICU stay. Patient characteristics and echocardiographic findings were analyzed. Mortality odds ratio (OR) for right ventricular (RV) systolic dysfunction and acute cor pulmonale (ACP) was calculated. Among 242 patients, 145 (60%) received VV ECMO. Median (IQR) PaO 2 /FiO 2 was 76 (65-95) and 98 (85-140) in ECMO and non-ECMO patients, respectively (p ≤ 0.001). Initial echocardiograms showed no significant differences in left ventricular systolic dysfunction (10% v 15 %, p = 0.31) and RV systolic dysfunction (38% v. 27%, p = 0.27) between ECMO and non-ECMO patients. ACP was more frequent in the ECMO group at baseline (41% v. 26 %, p = 0.02). During the ICU stay, patients on ECMO exhibited a higher prevalence of RV systolic dysfunction (55% v 34%, p = 0.001) and ACP (51% v 26%, p = 0.002). RV systolic dysfunction (OR 1.99; 95% CI 1.09-3.63) and ACP (OR 2.95; 95% CI 1.55-5.62) on the follow-up echocardiograms were associated with higher odds of ICU mortality. The prevalence of echocardiographic abnormalities, in particular RV dysfunction, was frequent among patients with COVID-19 receiving VV ECMO support and was associated with worse clinical outcomes. [ABSTRACT FROM AUTHOR]

Following the onset of the COVID-19 pandemic, courts nationwide abruptly halted operations. Seemingly overnight, courts adopted videoconferencing technology and resumed critical operations virtually. Given that resuming operations took precedence, less attention was given to the numerous concerns surrounding virtual courtrooms, including, for example, constitutional violations and technical-related challenges. In the current study, we used a sample of pretrial detention hearing cases (N = 330) systematically collected in a New Jersey courtroom (April 2020 – April 2021) that expeditiously shifted modalities from in-person to virtual following the pandemic. In doing so, we described the prevalence of technical difficulties (e.g., video/audio glitches and disconnections) experienced by legal actors and defendants, assessed how the court adapted to the new virtual modality, and explored how technical difficulties influenced case decisions. Employing descriptive statistics and multivariate models, we found no evidence to suggest that technical difficulties influenced decisions. However, we found that technical difficulties were commonplace and that defendant disconnections increased over time, putting into question the court's adaptability. Based on our findings, we echo other scholars' concerns surrounding the current use of the technology and signal the need for additional research before continuing and or possibly expanding its use post-pandemic. [ABSTRACT FROM AUTHOR]

BACKGROUND: Postural orthostatic tachycardia syndrome (POTS) is a frequently diagnosed cardiovascular disorder after COVID-19 infection. POTS is characterized by the presence of excessive sinus tachycardia on standing without a fall in blood pressure (BP). We investigated the BP profile using 24-hour ambulatory BP monitoring in patients with new-onset POTS after COVID-19 compared with prepandemic population-based controls. METHODS: We performed a case-control study in 100 patients (mean age, 40.0±12.9 years; 85% women) with verified post–COVID-19 new-onset POTS diagnosed by a positive head-up tilt testing versus 100 controls from a population-based cohort with a negative active standing test, no history of syncope, POTS, or endocrine disease (mean age, 42.3±14.0 years; 78% women). Twenty-four-hour BP profile was assessed for circadian BP variation including hypotensive systolic BP (SBP) episodes (<80, <90, and <100 mm Hg). RESULTS: Patients with post–COVID-19 POTS had significantly higher nighttime SBP, but not daytime SBP, and more daytime SBP hypotensive episodes compared with controls. Nondipping (34% versus 19%; P <0.001) and reverse dipping patterns (9% versus 0%; P <0.001) were more frequent in post–COVID-19 POTS. In the logistic regression, patients with post–COVID-19 POTS had significantly higher mean 24-hour SBP (odds ratio, 1.08 [95% CI, 1.04–1.11]; P <0.001) and nighttime SBP (odds ratio, 1.07 [95% CI, 1.04–1.10]; P <0.001), independent of age and sex. CONCLUSIONS: Patients with post–COVID-19 POTS demonstrate higher mean 24-hour and nighttime SBP and show disruptions of circadian BP rhythm regulation compared with population-based controls, as well as more daytime hypotensive episodes. Future studies are needed to test whether patients with post–COVID-19 POTS may benefit from tailored BP therapy. [ABSTRACT FROM AUTHOR]

As of October 2024, the number of global confirmed cases of COVID-19 goes beyond 776 million, with over 7 million deaths, according to World Health Organization (WHO) website. This scarring figure has led to an impressive effort from the medical community, in the attempt to early detect the signs of the infection. Whereas the Reverse Transcription Polymerase Chain Reaction (RT-PCR) testing protocol is being used to detect the infection, medical imaging plays an important role to evaluate the level of lung's damage caused by the presence of the virus. Both computed tomography (CT) and chest radiographs (CXR) have been utilized for laboratory testing by radiologist to identify and measure the affected lung area by isolating the region of interest (ROI). Manual segmentation of ROI is a complex process requiring extensive time and experienced medical staff. Therefore, there is an urgent need of automated assisted medical tools that accurately measure the infected areas and reduce the manual annotation time. An impressive amount of approaches have been proposed to detect the infection or to segment the infected areas, where most of the proposed techniques rely on deep learning (DL). In this work, an alternative to DL is proposed, that is based on several steps, including statistical measures. More precisely, in the first step, the image is coarsely segmented by using an electromagnetism optimization based multilevel thresholding. The multilevels are a priori estimated with the help of Gaussian mixture models (GMM). Next, a morphological skeleton is constructed for the basis of a localized edge-region-based active contour model considering multi-class segmentation. The segmented class is reevaluated and correction step is performed if necessary, i.e. if the number of components is wrongly estimated. The experiments indicate very promising results, the approach performing similar to recent state-of-the-art methods. [ABSTRACT FROM AUTHOR]

While overall levels of trust and interest in science are high, a significant proportion of audiences are distrustful of or disinterested in science. This is not an esoteric concern. Science literacy is important for the meaningful participation of the public in discussions about the impact of science on society at a time when many key global problems have some basis in science. There are also private benefits for individuals, like preventing them from being misled by misinformation and disinformation. What can science journalists do to address these issues? Using a global media ethics lens, this study deployed a mixed methods approach including surveys and semi-structured interviews, to evaluate how science journalists can produce stories that better engage audiences with science, thereby potentially increasing science literacy. By revealing the cultural barriers holding science back, inherent tensions between journalistic working practices and conveying the true nature of science but also how these might be overcome, the project outlined what strong science journalism could look like in Australia in 2024. [ABSTRACT FROM AUTHOR]

Little is known about changes in depression screening outcomes among adolescents in primary healthcare across the COVID-19 pandemic. We describe trends in depression screening outcomes within a large integrated health care system in Southern California. Retrospective electronic health record data from preventative healthcare visits of 11–12-year-olds and 13–17-year-olds screened for depression from March 1, 2017, to August 31, 2022, were extracted in 6-month blocks. The percentages of screens meeting "threshold depression" were reported overall, and by sex, race or ethnicity, and median household income quintiles. We used Poisson regression to estimate rate ratios of threshold depression in 3 winter blocks (September to February) comparing lockdown (2020), reopening (2021) to a pre-COVID (2019) period, and reopening relative to lockdown. Disparities in trends by sex, race, or ethnicity and household income were tested using interaction terms. Of 735,333 visits with complete screening (183,550 for 11–12-year-olds and 551,783 for 13–17-year-olds), 4.6%, 6.5%, and 7.4% of 11–12-year-olds had "threshold depression" during winter blocks of pre-COVID, lockdown and reopening, respectively. The corresponding rates were 5.8%, 8.5%, and 9.8% for 13–17-year-olds. The rates were higher during lockdown and reopening relative to pre-COVID and higher during reopening relative to lockdown for both age groups (all p -values <.001). Trends differed by sex in both age groups (p -values <.001) and by race or ethnicity (p =.001) in the 13–17-year age group. Californian adolescents demonstrated an increase in threshold depression since COVID lockdown starting March 2020 with further increase observed during reopening in September 2021. Future studies are needed to determine the long-term trends. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic impacted testing and incidence of sexually transmitted infections (STIs), with some studies showing uneven effects across sociodemographic groups. We aim to determine whether rates of gonorrhea and chlamydia testing and infections were affected by the pandemic, overall and by subgroups, defined by sociodemographic factors and comorbidities. We conducted a retrospective cohort study from January 1, 2016, through December 31, 2022, among adolescents and young adults ages 15–29 years within Kaiser Permanente Northern California (KPNC). We determined the rate of testing for gonorrhea/chlamydia, and the incident rates of infections before and during the COVID-19 pandemic by sociodemographic factors. We compared incidence rates of gonorrhea/chlamydia testing and infection before and during the pandemic using Poisson regression. Gonorrhea/chlamydia testing during the pandemic was 19% lower than prepandemic baseline. Testing among Black patients was 1.8-fold higher than White patients. Black patients had 5.5 and 3.6-fold higher rate of gonorrhea and chlamydia infections, respectively, compared with White patients. Patients living in more deprived neighborhoods also had higher rates of infection compared to those in the least deprived neighborhoods. In multivariable analyses stratified by the period before and during the COVID-19 pandemic, there were no significant differences in the incidence rate ratios of testing or infections for any specific sociodemographic factor. STI testing in adolescents and young adults dropped dramatically after the start of the pandemic and has not recovered to its prior levels. Preexisting disparities in STI testing and infections were not exacerbated by the pandemic. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (Covid-19) is a recent and current infectious pandemic caused by severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2). Covid-19 may lead to the development of acute lung injury (ALI), acute respiratory distress syndrome (ARDS), and extrapulmonary manifestations in severe cases. Down-regulation of angiotensin-converting enzyme (ACE2) by the SARS-CoV-2 increases the production of angiotensin II (AngII), which increases the release of pro-inflammatory cytokines and placental growth factor (PlGF). PlGF is a critical molecule involved in vasculogenesis and angiogenesis. PlGF is stimulated by AngII in different inflammatory diseases through a variety of signaling pathways. PlGF and AngII are interacted in SARS-CoV-2 infection resulting in the production of pro-inflammatory cytokines and the development of Covid-19 complications. Both AngII and PlGF are interacted and are involved in the progression of inflammatory disorders; therefore, we aimed in this review to highlight the potential role of the PlGF/AngII axis in Covid-19. [ABSTRACT FROM AUTHOR]

The number of studies and reviews conducted for the Carboxylesterase gene is limited in comparison with other enzymes. Carboxylesterase (CES) gene or human carboxylesterases (hCES) is a multigene protein belonging to the α/β-hydrolase family. Over the last decade, two major carboxylesterases (CES1 and CES2), located at 16q13–q22.1 on human chromosome 16 have been extensively studied as important mediators in the metabolism of a wide range of substrates. hCES1 is the most widely expressed enzyme in humans, and it is found in the liver. In this review, details regarding CES1 substrates include both inducers (e.g. Rifampicin) and inhibitors (e.g. Enalapril, Diltiazem, Simvastatin) and different types of hCES1 polymorphisms (nsSNPs) such as rs2244613 and rs71647871. along with their effects on various CES1 substrates were documented. Few instances where the presence of nsSNPs exerted a positive influence on certain substrates which are hydrolyzed via hCES1, such as anti-platelets like Clopidogrel when co-administered with other medications such as angiotensin-converting enzyme (ACE) inhibitors were also recorded. Remdesivir, an ester prodrug is widely used for the treatment of COVID-19, being a CES substrate, it is a potent inhibitor of CES2 and is hydrolyzed via CES1. The details provided in this review could give a clear-cut idea or information that could be used for further studies regarding the safety and efficacy of CES1 substrate. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (Covid-19) is a pandemic caused by severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2). In Covid-19, there is uncontrolled activation of immune cells with a massive release of pro-inflammatory cytokines and the development of cytokine storm. These inflammatory changes induce impairment of different organ functions, including the central nervous system (CNS), leading to acute brain injury and substantial changes in the neurotransmitters, including serotonin (5-HT) and calcitonin gene-related peptide (CGRP), which have immunomodulatory properties through modulation of central and peripheral immune responses. In Covid-19, 5-HT neurotransmitters and CGRP could contribute to abnormal and atypical vascular reactivity. Sumatriptan is a pre-synaptic 5-HT (5-HT1D and 5-HT1B) agonist and inhibits the release of CGRP. Both 5-HT and CGRP seem to be augmented in Covid-19 due to underlying activation of inflammatory signaling pathways and hyperinflammation. In virtue of its anti-inflammatory and antioxidant properties with inhibition release of 5-HT and CGRP, Sumatriptan may reduce Covid-19 hyperinflammation. Therefore, Sumatriptan might be a novel potential therapeutic strategy in managing Covid-19. In conclusion, Sumatriptan could be an effective therapeutic strategy in managing Covid-19 through modulation of 5-HT neurotransmitters and inhibiting CGRP. [ABSTRACT FROM AUTHOR]

The severe lockdown imposed to prevent the spread of COVID-19 decreased the emissions of air pollutants in large cities. A comparative approach was adopted to analyze the effect of the COVID-19 lockdown on ambient air pollution concentrations and the impacts of meteorological parameters on them using data from air quality monitoring stations (AQMS) in Tabriz, Iran. Air quality improvement was significant for all pollutants, except for O3, in the first phase of the lockdown compared to other phases. The lockdown (restricted social contact, closing of shops, schools, universities, restaurants, and many administrative centers and companies, etc.) temporarily reduced air pollutants. Comparing meteorological parameters between lockdown periods and the same period in previous years showed no statistically significant variations (P-value < 0.05). Therefore, the meteorological parameters did not intervene in reducing air pollutants during the lockdown. The effects of lockdown on the concentration of air pollutants could provide a special way to understand the extent of quarantine compliance by citizens, evaluate additional air quality policies, and assess the impacts of reducing various emission sources.Highlights: A comparative approach to analyze the effect of the COVID-19 lockdown on air pollutants concentrations and the impacts of meteorological parameters on them. Reductions in air pollutants concentrations during COVID-19 lockdown periods compared to the same intervals in the previous years. Lack intervene the meteorological parameters in reducing air pollutants, and mainly due to reduction emissions during COVID-19 lockdown periods. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has had profound global repercussions, leading to substantial fatalities and economic losses worldwide. However, amidst these adversities, the pandemic inadvertently offered a unique opportunity to assess the impact of reduced human activity on environmental noise levels. This study focuses on monitoring and mapping noise pollution levels at 101 locations managed by the Bhubaneswar Development Authority (BDA) in Bhubaneswar, Odisha, India, during three distinct periods: pre-COVID, during COVID-lockdown, and post-COVID. Using ArcGIS 10.2.1, noise data are spatially analysed across different zones designated by the Central Pollution Control Board (CPCB), namely Industrial, Commercial, Residential, and Silence Zones. The findings reveal a significant reduction in traffic noise during the COVID-19 lockdown period compared to both pre-COVID and post-COVID periods across all four zones. To assess the potential impact on human health, the study employs equations developed by Miedema and Vos (Acoust Soc Am 104:3432–3445, 1998, ) for calculating percentages of highly annoyed individuals and estimating sleeping disorders. Additionally, Structural Equation Modeling (SEM) is applied to explore associations between noise levels and health outcomes across different time periods. Despite the significant reduction in traffic noise observed during the COVID-19 lockdown, our analysis suggests that this decrease did not have a statistically significant effect on annoyance levels (p-value: 0.0542) or sleeping disorders (p-value: 0.121). This study provides valuable insights into the unintended consequences of urban lockdowns on environmental noise pollution and their potential implications for public health and urban planning. [ABSTRACT FROM AUTHOR]

Background: Physical inactivity is an ongoing problem throughout the lifespan. For older people, inactivity has a negative impact on wellbeing, which worsened during the COVID-19 pandemic. Digital technologies can be employed to encourage uptake of social and physical activity through remotely delivered interventions to improve wellbeing, however, we need to understand older people's perceptions and experiences of using digital technologies before implementing these interventions. Aims: To explore the perceptions and experiences of older people on the use of digital technologies during the COVID-19 pandemic. Methods: Qualitative semi-structured interviews were conducted with 16 community dwelling older people from Hertfordshire, United Kingdom who were all programme participants in a remotely delivered mind-body physical activity programme called Positive Movement. Interviews were conducted before programme participation. The audio recorded interviews were transcribed and analysed using thematic analysis. Results: Four themes emerged from the data. The perceived impact of COVID-19 on social contact, perceived impact of COVID-19 on mental wellbeing, using digital platforms for health or exercise and using digital platforms for social contact. Discussion: Participants reported reduced social contact due to COVID-19. Most participants reported using digital technologies for social inclusion rather than health reasons, and there were mixed views on the willingness to use digital technologies for physical activity. Conclusion: Digital technologies offered a lifeline during COVID-19 to maintain social contact and their use was found acceptable by older people. Digital platforms such as Zoom can be further employed to conduct remotely delivered interventions with the aim to increase uptake of social and physical activity interventions within this population. [ABSTRACT FROM AUTHOR]

Researchers have devoted decades to striving to create a plethora of distinctive distributions in order to meet specific objectives. The argument is that traditional distributions have typically been found to lack fit in real-world situations, which include pharmaceutical studies, the field of engineering, hydrology, environmental science, and a number of others. The Weibull-inverse Nadarajah Haghighi (WINH) distribution is developed by combining the Weibull and inverse Nadarajah Haghighi distributions. The proposed distribution's fundamental characteristics have been established and analyzed. Several plots of the distributional properties, notably probability density function (PDF) with corresponding cumulative distribution function (CDF) are displayed. The estimation of model parameter is performed via the MLE procedure. Simulation-based research is conducted to demonstrate the performance of proposed estimator's using some measure, like the average bias, variance, and associated mean square error (MSE). Two real datasets represent the morality due to COVID 19 in France and Canada are illustrated to see the practicality of the recommended model. [ABSTRACT FROM AUTHOR]

Sampling is crucial in basic statistics due to the large size of certain populations. Sampling theory focuses on selecting samples based on appropriate population characteristics and approaches to estimating population characteristics from the sample. Firstly, we use the ratio-type estimator proposed by Prasad (1989). We adapt this unbiased ratio-type estimator to two new different estimators using the Hartley-Ross and non-response approaches. Finally, we combine these approaches and propose a new estimator. The theoretical results were supported by COVID-19 data and a simulation study with various scenarios. Based on the COVID-19 data result, it was concluded that the new t N 3 estimator is the most effective estimator among those proposed and compared, with the minimum MSE and maximum PRE. Upon examining the changes in the COVID-19 data set in detail, it is evident that the PRE value increases with an increase in sample size, non-response rate, and k values. As in the COVID-19 dataset, the t N 3 estimator was the most effective in the simulation study results. It is also important to note that these results are not applicable to only one scenario in simulation study. The t N 2 estimator was the most effective in the scenario with rho=0.90, T=1000, n=400, non-response rate=0.30 and k equal to 2, 4 and 5. [ABSTRACT FROM AUTHOR]

OBJECTIVE: COVID-19, first identified in December 2019, quickly became a global pandemic and remains a significant public health concern. Robust data is rare, especially in pregnant women. The symptoms of this disease range from mild to severe respiratory distress syndrome and mortality. The present study aimed to evaluate the factors influencing COVID-19 severity in women to be better prepared in case of a new epidemic. PATIENTS AND METHODS: This retrospective matched case-control study based on body mass index, smoke, and drug use was conducted on all women hospitalized with COVID-19 at Afzalipour Hospital in Kerman, Iran from the beginning of 2020 to 2021. In this study, 130 female patients with COVID-19 were included, with 65 patients in the case group (moderate and severe cases of COVID-19) and 65 patients in the control group (mild cases of COVID-19). The data were entered into the Stata software, and to determine the effective risk factors for the severity of COVID-19 disease, both univariate and multivariable conditional logistic regression analyses were utilized, assuming individual matching. Finally, the odds ratios (OR), along with 95% confidence intervals (CI), were estimated. RESULTS: The average age of women in the case group was 36.92 ± 7.07 years, compared to 30.12 ± 6.27 years in the control group. Among all patients, 50% were pregnant, with a mean gestational age of 30.03 weeks. Significant factors affecting disease severity included age, education, employment status, place of residence, insurance coverage, comorbidities, and pregnancy status. The highest adjusted odds ratio for severe COVID-19 was associated with comorbidities (OR = 7.8, 95% CI: 2.3-11.1), while the lowest was associated with urban residence (OR = 2.8, 95% CI: 1.02-4.5). Overall, significant predictors of severe COVID-19 included age over 30, urban residence, lack of insurance, a short duration between diagnosis and hospitalization, comorbidities, and non-pregnancy. CONCLUSIONS: The study identified several significant predictors of severe COVID-19 among women, including age over 30, urban residency, lack of insurance coverage, presence of comorbidities, and non-pregnancy, all of which were associated with a heightened risk of severe illness. Notably, comorbidities emerged as the strongest predictor. These findings underscore the critical need for targeted interventions to protect vulnerable populations. [ABSTRACT FROM AUTHOR]

At the onset of the COVID-19 pandemic, clinicians and researchers were concerned about its impact on the health of people living with HIV (PLWH). Although mitigation measures during the early part of the pandemic used telehealth, it was uncertain whether PLWH would be amenable to this type of care and whether health outcomes would be affected. PLWH actively seeking treatment at a large urban outpatient practice in Essex County, New Jersey, were interviewed from October 2020 to June 2021 about their healthrelated experiences during COVID-19. The sample was dichotomized by age (< 55 and ≥ 55). In all, participants (69.2%, n = 92) used telehealth during this period, 85.0% (n = 113) actively tested for COVID-19, with only 7% (n = 8) testing positive at the time of interview. Our findings demonstrate that PLWH who engaged with health care before the COVID-19 pandemic continued doing that and had relatively favorable health outcomes with few differences by age. [ABSTRACT FROM AUTHOR]

The rise of emerging infectious diseases has become notably prominent due to ecological changes and mutations in pathogens. The respiratory illness outbreak caused by the COVID-19 pandemic has spread globally. Natural products contain numerous structures and biological activities, offering ample options for discovering new antiviral drugs with unique targets and mechanisms. Andrographis paniculata has been utilized in Indian Ayurvedic, Swedish, Traditional Thai, and Chinese medicine to alleviate coughs, colds, and influenza symptoms. Early-stage laboratory studies indicate that this herbal extract may reduce inflammation and fever, and boost the body's natural defenses against viruses, potentially leading to symptom relief. This review aims to systematically present clinical trial data about antiviral herbal formulations derived from Andrographis paniculata , delineating the antiviral effects of both natural and synthetic derivatives, along with in silico analyses. [ABSTRACT FROM AUTHOR]

The purpose of this longitudinal, qualitative study was to examine the impact of the COVID-19 pandemic on self-efficacy and diabetes management among youth diagnosed with type 1 diabetes mellitus (T1DM). We conducted two semi-structured interviews with adolescents diagnosed with T1DM (n = 18) and their maternal caregivers (n = 20) over 6–9 months, to understand how their confidence in the adolescent's ability to manage their diabetes changed during the pandemic. Interviews were transcribed and coded by four raters, establishing inter-reliability. Four themes emerged: Preventing Adverse Glycemic Events, Useful Glucose Trend Information, Improved Diabetes Management, and Downsides of Technology. Most adolescents (63%) reported increased confidence in their ability to manage diabetes during the pandemic. Over half of these adolescents were already using an insulin pump, and a substantial number (33%) updated their insulin delivery method. Both adolescents and caregivers cited diabetes devices as a factor in their self-efficacy for diabetes management. Findings illustrate the importance of diabetes management in the daily lives of adolescents diagnosed with T1DM, and the potential benefits of diabetes devices during disruptions to care. [ABSTRACT FROM AUTHOR]

The coronavirus disease 2019 (COVID-19) has caused a crisis worldwide. Amounts of efforts have been made to prevent and control COVID-19′s transmission, from early screenings to vaccinations and treatments. Recently, due to the spring up of many automatic disease recognition applications based on machine listening techniques, it would be fast and cheap to detect COVID-19 from recordings of cough, a key symptom of COVID-19. To date, knowledge of the acoustic characteristics of COVID-19 cough sounds is limited but would be essential for structuring effective and robust machine learning models. The present study aims to explore acoustic features for distinguishing COVID-19 positive individuals from COVID-19 negative ones based on their cough sounds. By applying conventional inferential statistics, we analyze the acoustic correlates of COVID-19 cough sounds based on the ComParE feature set, i.e., a standardized set of 6,373 acoustic higher-level features. Furthermore, we train automatic COVID-19 detection models with machine learning methods and explore the latent features by evaluating the contribution of all features to the COVID-19 status predictions. The experimental results demonstrate that a set of acoustic parameters of cough sounds, e.g., statistical functionals of the root mean square energy and Mel-frequency cepstral coefficients, bear essential acoustic information in terms of effect sizes for the differentiation between COVID-19 positive and COVID-19 negative cough samples. Our general automatic COVID-19 detection model performs significantly above chance level, i.e., at an unweighted average recall (UAR) of 0.632, on a data set consisting of 1,411 cough samples (COVID-19 positive/negative: 210/1,201). Based on the acoustic correlates analysis on the ComParE feature set and the feature analysis in the effective COVID-19 detection approach, we find that several acoustic features that show higher effects in conventional group difference testing are also higher weighted in the machine learning models. [ABSTRACT FROM AUTHOR]

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Copyright of Zentralblatt fuer Arbeitsmedizin, Arbeitsschutz und Ergonomie is the property of Springer Nature 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 abstract 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 abstract. (Copyright applies to all Abstracts.)

Purpose: The purpose of this study was to describe labor and delivery nurses' experiences in caring for patients during the COVID-19 pandemic. Methods: We used a descriptive phenomenological design and purposeful sampling to recruit experienced labor and delivery nurses for flexible semi-structured face-to-face audiotaped interviews. Constant comparison was used to analyze data. Results: Ten nurses employed in a labor and delivery unit in two acute care hospitals in southern Texas participated and were interviewed from June through August 2022. The mean age of nurse participants was 36.5 years. Seven had over 5 years' experience as a labor and delivery nurse before the pandemic. Five distinct themes were identified: Psychological stress during COVID-19 ; Feelings of satisfaction and gratitude ; Resilience and readiness for positive change ; Patient-centered care ; and Interprofessional collaboration. Clinical Implications: These findings build on our understanding of key determinants contributing to labor and delivery nurses' ability to adjust to the unprecedented and chaotic working conditions during the COVID-19 pandemic and highlighted several factors that could influence nurses' resilience and job satisfaction. Nurses faced many challenges as they navigated the changes and risks of patient care during the height of the COVID-19 pandemic. In this study, labor nurses recount their experiences and how they handled the stress and uncertainty while doing their best to offer women support and high-quality maternity care. These findings highlight key determinants contributing to labor nurses' ability to adjust to the working conditions during the COVID-19 pandemic and include factors that could influence nurses' resilience and job satisfaction. [ABSTRACT FROM AUTHOR]

The study examines issues related to achieving meaningful participation in class activities as an element of social inclusion of learners with cognitive disabilities aged 14–19 years that are enrolled in educational institutions (schools/centres) during COVID-19 in United Arab Emirates. The paper relied on a qualitative approach with 5 sessions of virtual observation and 18 semi-structured virtual interviews with learners themselves and their care givers/parents as the main methodological tool given lack of access to physical means at the time of data collection during the global pandemic (2021–22). The analysis was thematic, focusing on explored and extracted main issues that impact one important aspect of the social inclusion of such learners, which is their active participation during a difficult time. The results showed that learners with cognitive disabilities faced additional several issues in addition to what members of the surrounding community dealt with during the disaster. Data revealed that they were immensely affected by the pandemic, with another layer of social isolation, lack of peer interaction as well as family restriction that is directed at them with additional measures than everyone in the household. It also showed that despite the efforts and programmes designed by schools/institutes that were in place to support their engagement in academic and social activities, participation as an important social aspect of their school lives was badly impacted. Despite calls for prioritizing such learners, the study revealed that learners with cognitive disability were constructed as 'last on the list' among class community members in terms of their participation and active engagement in different class activities. The data were purposefully collected at a time that is unlikely to be replicated for many years to come (a global pandemic), the purpose was to give a reflection on the status allocated to such individuals during hard, unusual and/or difficult times for any future practice. The paper forwards recommendations to support educational institutions to promote active participation of learners with cognitive disabilities. [ABSTRACT FROM AUTHOR]

Peripheral arterial disease (PAD) has been associated with suboptimal treatment, high mortality, and high amputation rates. It is unclear how the COVID-19 (coronavirus disease 2019) pandemic affected this development in a long term context. This is a registry based, retrospective, nationwide cohort study including patients hospitalised with PAD as a main or secondary diagnosis and amputation surgery between 2012 – 2021 in Germany. Primary endpoints were population wide major and minor amputation rates, in hospital death, and in hospital mortality rates. Secondary endpoints were same admission revascularisations and in hospital death in the event of complications, i.e., failure to rescue (FTR). Pre-pandemic and pandemic trends, focusing on lockdown periods, were analysed. A total of 365 926 patient records with PAD and amputation surgery were analysed. The median patient age was 75 years and 28.8% were female. Overall population wide amputation and in hospital mortality rates (monthly decrease –0.002/100 000, p <.001, and –0.001/100 000, p <.001, respectively) and in hospital mortality rate (8.0% for 2012 – 2014 vs. 6.5% for 2020 – 2021; p <.001) declined between 2012 and 2020. Concurrently, same admission revascularisations increased (41.0% for 2012 – 2014 vs. 47.0% for 2020 – 2021; p <.001), while FTR decreased in a subset of complications (acute ischaemia, major bleeding, compartment syndrome, and mesenterial ischaemia). In the first pandemic lockdown, there was a temporary trend change to higher major amputations rates (+0.02/100 000; p <.001) and higher in hospital mortality rates (+0.007/100 000; p <.001), which changed to a decrease as of the second lockdown (–0.03/100 000, p =.034, and –0.010/100 000, p <.001, respectively) in an interrupted time series analysis. There was no statistically significant change in observed amputation rates during lockdowns, while observed in hospital mortality rates decreased by 12.0% in the first lockdown (0.22/100 000 vs. 0.25/100 000; p =.005) compared with reference periods of the two previous years. Between 2012 and 2021, pre-pandemic trends toward decreasing population wide overall amputation rates, fewer major amputations, more amputation related revascularisation procedures, and lower in hospital mortality were maintained despite a temporary trend to increased major amputations and in hospital mortality during the first COVID-19 related lockdown in Germany. [ABSTRACT FROM AUTHOR]

Purpose: This research investigates the impact of the COVID-19 pandemic on the use of transitional spaces in a Korean academic setting, to assess the impact of the pandemic on users' utilization of transitional spaces and evaluate any changes in their usage patterns. The research explores whether transitional spaces can function as social interactive spaces, aligning with Ray Oldenburg's "third-place" theory. The focus is on South Korean academic settings, aiming to create neutral and safe zones for users. Design/methodology/approach: The adopted methodology involves reviewing the literature and employing design charrette as a major data collection tool. The design charrette provided a platform for users to share insights on current transitional spaces during the pandemic and envision these spaces as future social and interactive spaces. Findings: The design charrette participants advocated for modifying the current transitional space design to transform these spaces into shared spaces for both visitors and regular users in the future. Restricting access for external users to the main building area until necessary. The significance of site amenities in determining transitional spaces as "third-places" was emphasized. While the nature of the building, its location and transitional space amenities are crucial aspects to consider, designers may prioritize user opinions and preferences, as the success or failure of the design ultimately centers on user behaviors. Research limitations/implications: The research focused on a specific university, hindered by limited access to other institutions during the pandemic. Restrictions on external users discouraged entry without proper permission, which was challenging to obtain. The conventional design charrette outlined in the research method was impossible due to pandemic-related limitations on gathering participants in one location. Therefore, the researcher modified the design charrette method to align with strict social distancing measures. Social implications: The results of the research are not limited to academic settings, but they can be implied in other environments where social interaction spaces are required and where there is a constant flow of visitors and regular users. The design charrette can be used as a methodology for interior spaces along with large-scale projects of urban planning. Originality/value: The research analyzed transitional spaces during the pandemic, suggesting redesign to serve and act as buffer zones between private and public areas and become a common social gathering place for visitors and regular users within the built environment. [ABSTRACT FROM AUTHOR]

The document "Spanish Translated Abstracts" from the journal "PM & R: Journal of Injury, Function & Rehabilitation" discusses various research studies related to different medical topics. These studies include evaluating the use of onabotulinumtoxinA for treating spasticity, assessing the association between electrodiagnostic studies and neuromuscular ultrasound in carpal tunnel syndrome, describing injury rates in high school track and field athletes, examining risk factors for Achilles tendon injuries in long-distance runners, exploring the integration of dogs in pediatric rehabilitation therapy, correlating patient-reported physical function with objective measures in cancer survivors, and characterizing functional outcomes in COVID-19 survivors undergoing rehabilitation. The studies provide valuable insights into different aspects of injury, rehabilitation, and medical care, highlighting the importance of patient-centered approaches and evidence-based treatments. [Extracted from the article]

Early warning scores serve as valuable tools for predicting adverse events in patients. This study aimed to compare the diagnostic performance of National Early Warning Score, Hamilton Early Warning Score, Standardized Early Warning Score, and Triage Early Warning Score in forecasting intubation and mortality among patients with coronavirus disease 2019. This predictive correlation study included 370 patients admitted to the emergency department of 22 Bahman Hospital in Neyshabur, Iran, from December 2021 to March 2022. The aforementioned scores were assessed daily upon patient admission and throughout a 1-month hospitalization period, alongside intubation and mortality occurrences. Data analysis used SPSS 26 and MEDCALC 20.0.13 software. We adhered to the Standards for Reporting of Diagnostic Accuracy Studies guidelines to ensure the accurate reporting of our study. The patients' mean age was 65.03 ± 18.47 years, with 209 (56.5%) being male. Both Standardized Early Warning Score and Hamilton Early Warning Score demonstrated high diagnostic performance, with area under the curve values of 0.92 and 0.95, respectively. For Standardized Early Warning Score, the positive likelihood ratio was 10.81 for intubation and 17.90 for mortality, whereas for Hamilton Early Warning Score, the positive likelihood ratio was 7.88 for intubation and 10.40 for mortality. The negative likelihood ratio values were 0.23 and 0.17 for Standardized Early Warning Score and 0.21 and 0.18 for Hamilton Early Warning Score, respectively, for the 24-hour period preceding intubation events and mortality. Findings suggest that Standardized Early Warning Score, followed by Hamilton Early Warning Score, has superior diagnostic performance in predicting intubation and mortality in patients with coronavirus disease 2019 within 24 hours before these outcomes. Therefore, serial assessments of Hamilton Early Warning Score or Standardized Early Warning Score may be valuable tools for health care providers in identifying high-risk patients with coronavirus disease 2019 who require intubation or are at increased risk of mortality. [ABSTRACT FROM AUTHOR]

Key Points: Question: What are the associations between mental illnesses and diagnosed COVID-19 by vaccination status in patients hospitalized for COVID-19 and the general population? Findings: In this cohort study, depression, serious mental illness, general anxiety, posttraumatic stress disorder, eating disorders, addiction, self-harm, and suicide were elevated during weeks 1 through 4 after COVID-19 diagnosis compared with before or without COVID-19. Incidence was lower in people who were vaccinated when they had COVID-19 and incidence was higher, and persisted longer, after hospitalization for COVID-19. Meaning: The findings support recommendation of COVID-19 vaccination in the general population and particularly among those with mental illness, who may be at higher risk of both SARS-CoV-2 infection and adverse outcomes following COVID-19. This cohort study evaluates associations between mental illness and COVID-19 by vaccination status. Importance: Associations have been found between COVID-19 and subsequent mental illness in both hospital- and population-based studies. However, evidence regarding which mental illnesses are associated with COVID-19 by vaccination status in these populations is limited. Objective: To determine which mental illnesses are associated with diagnosed COVID-19 by vaccination status in both hospitalized patients and the general population. Design, Setting, and Participants: This study was conducted in 3 cohorts, 1 before vaccine availability followed during the wild-type/Alpha variant eras (January 2020-June 2021) and 2 (vaccinated and unvaccinated) during the Delta variant era (June-December 2021). With National Health Service England approval, OpenSAFELY-TPP was used to access linked data from 24 million people registered with general practices in England using TPP SystmOne. People registered with a GP in England for at least 6 months and alive with known age between 18 and 110 years, sex, deprivation index information, and region at baseline were included. People were excluded if they had COVID-19 before baseline. Data were analyzed from July 2022 to June 2024. Exposure: Confirmed COVID-19 diagnosis recorded in primary care secondary care, testing data, or the death registry. Main Outcomes and Measures: Adjusted hazard ratios (aHRs) comparing the incidence of mental illnesses after diagnosis of COVID-19 with the incidence before or without COVID-19 for depression, serious mental illness, general anxiety, posttraumatic stress disorder, eating disorders, addiction, self-harm, and suicide. Results: The largest cohort, the pre–vaccine availability cohort, included 18 648 606 people (9 363 710 [50.2%] female and 9 284 896 [49.8%] male) with a median (IQR) age of 49 (34-64) years. The vaccinated cohort included 14 035 286 individuals (7 308 556 [52.1%] female and 6 726 730 [47.9%] male) with a median (IQR) age of 53 (38-67) years. The unvaccinated cohort included 3 242 215 individuals (1 363 401 [42.1%] female and 1 878 814 [57.9%] male) with a median (IQR) age of 35 (27-46) years. Incidence of most outcomes was elevated during weeks 1 through 4 after COVID-19 diagnosis, compared with before or without COVID-19, in each cohort. Incidence of mental illnesses was lower in the vaccinated cohort compared with the pre–vaccine availability and unvaccinated cohorts: aHRs for depression and serious mental illness during weeks 1 through 4 after COVID-19 were 1.93 (95% CI, 1.88-1.98) and 1.49 (95% CI, 1.41-1.57) in the pre–vaccine availability cohort and 1.79 (95% CI, 1.68-1.90) and 1.45 (95% CI, 1.27-1.65) in the unvaccinated cohort compared with 1.16 (95% CI, 1.12-1.20) and 0.91 (95% CI, 0.85-0.98) in the vaccinated cohort. Elevation in incidence was higher and persisted longer after hospitalization for COVID-19. Conclusions and Relevance: In this study, incidence of mental illnesses was elevated for up to a year following severe COVID-19 in unvaccinated people. These findings suggest that vaccination may mitigate the adverse effects of COVID-19 on mental health. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, one of the most prominent shifts in consumer behavior was the growth in online shopping. This study examined Polish consumers' shopping behavior before, during, and after the pandemic, focusing in particular on (1) the extent to which preexisting trends in online shopping continued, were modified, or were abandoned and (2) the change in the proportion of online and offline shopping before and after the pandemic. The key factors influencing these changes were identified by applying the extended unified theory of acceptance and use of technology (UTAUT2), supplemented with trust/risk and sociodemographic variables as moderating factors. Data were collected through computer-assisted telephone interviews in May and June 2022 (N = 1010). The results of the logistic regression analysis confirmed that the modified UTAUT2 model explains the differences in Polish consumers' shopping behaviors. Performance expectancy and social influence positively influenced the propensity for online shopping, and adding interaction effects to the models demonstrated that sociodemographic factors moderated the positive impact of facilitating conditions and hedonic motivation. The trust/risk factor negatively influenced the respondents' propensity for online shopping, and only age, gender, place of residence, and car usage were significant factors influencing this propensity directly or through moderating effects. [ABSTRACT FROM AUTHOR]

The COVID-19 global pandemic exposed healthcare system vulnerabilities, further endangering patient safety. This article explores perspectives on resilience and patient safety among healthcare workers using data from the Taiwan Patient Safety Culture Survey (TPSCS) and implementing Patient Safety Leadership Walkrounds (PSLWs) at E-Da Hospital. In 2021 and 2022, 1340 and 1114 staff members from clinical departments completed TPSCS questionnaires, respectively. 89 leaders from clinical departments participated in PSLWs in 2022. Among the four job categories, scores of Safety Attitude Questionnaire (SAQ) were lower among nurses and medical technicians, while perceptions of resilience and work-life balance were lowest among nurses. Between the two-year surveys, nurses exhibited significant decreases in SAQ in 2022 compared to 2021, while perceptions of work condition and work-life balance significantly declined among pharmacists. Resilience perception significantly decreased among all job categories except physicians during the pandemic. Mediation analyses showed teamwork climate, job satisfaction, management, work condition, and work-life balance were directly associated with safety climate, while resilience acts as a mediator, indirectly potentiating these relationships. Through PSLWs, we identified concerns about patient safety, including workforce, systems, processes, equipment, and work environment. Among these, workforce shortages and unsatisfactory pay emerged as the most pressing challenges. Strong leadership was recognized as a crucial factor in enhancing resilience and patient safety. This study suggests that TPSCS and PSLWs are worth regularly promoting among hospital institutions. Additionally, our findings highlight the urgency of healthcare organizations and governmental agencies to undertake policy reforms to improve healthcare workers' well-being. [ABSTRACT FROM AUTHOR]

This paper examines the resilience of Taiwan's oral healthcare system in response to COVID-19, focusing on pre-pandemic conditions, pandemic impacts, and policy recommendations for future resilience. In Taiwan, oral diseases were prevalent, with 80.48% of adults affected by periodontitis in 2016, and 65.43% of 5-year-old children experiencing dental caries. Taiwan's National Health Insurance (NHI) covers over 99% of the population, providing comprehensive dental care. The global budget (GB) payment system, implemented in 1998, ensured financial stability. During the pandemic, dental visits in Taiwan decreased by 5.1% in 2021 compared to 2019. Despite reduced visits, the GB system maintained financial stability, mitigating financial impacts on healthcare institutions. The pandemic generally negatively affected healthcare workers' well-being, increasing resignation intentions. However, the number of practicing dentists in Taiwan remained stable from 2016 to 2022, with slight increases. Urban-rural disparities persisted, and workplace transitions increased, indicating greater mobility among dental professionals. To enhance resilience, the following recommendations are proposed: 1. Strengthen hierarchy of oral healthcare system: Balance dental resources across regions, and improve referrals between hospital and clinics; 2. Provide integrated patient-centered care: Integrate oral health into disease prevention and offer comprehensive services across all stages of life; 3. Integrate digital technology: Promote teledentistry and leverage Taiwan's strengths in information and communication technology (ICT). [ABSTRACT FROM AUTHOR]

The integrated home-based medical care (iHBMC) program has been implemented by the Taiwanese government since 2016. The pandemic of coronavirus disease 2019 (COVID-19) accelerated the shift from hospital-based to community-based healthcare, with a special focus on advanced home care for frail older adults. This study focuses on home-based advanced care, such as hospital at home (HaH), aiming to explore the feasibility and resilience of HaH within a home-based medical care model in a rural community in Taiwan. We conducted a retrospective review of medical records from February 2020 to August 2022. Two clinical professionals reviewed and abstracted data from the electronic medical records of 189 patients receiving home healthcare during the COVID-19 pandemic. The HaH event was calculated if patients had any acute infection and received treatment at home. A total of 62 HaH events occurred during 2020–2022 and the average HaH events per person was 1.4. In these events, the top reason for patients receiving HaH was pneumonia, followed by urinary tract infection, soft tissue infection, and sepsis. 77.4% of patients completed the HaH treatment and did not experience any recurrent acute infections in the 30-day follow-up. Different forms of home healthcare enhance the resilience of medical care provision in rural areas. As Taiwan approaches a hyper-aged society by 2025, it is crucial that National Health Insurance policies support various home-based care models that address transportation issues and maintain high care standards in underserved rural areas. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has significantly shaped population dynamics and healthcare systems. Primary care clinics in Taiwan demonstrated remarkable resilience in managing the pandemic. This adaptability is reflected in rigorous screening processes, proactive vaccination efforts, and the seamless integration of telehealth services. Noteworthy shifts have been observed in the redistribution of primary care clinics and a decline in preventive healthcare measures. In response to these challenges, Taiwan has embraced a multifaceted approach, with telehealth services, home-based clinical care initiatives, community-based care, and innovative programs, like the Hospital at Home initiative, assuming central roles in mitigating the impact of the pandemic. These strategies underscore a forward-thinking healthcare delivery approach that prioritizes patient well-being. Critical solutions include ongoing reforms in clinical practices, the contingency plans for preventive healthcare, the promotion of telehealth services, the adoption of home-based clinical care, and the enhancement of the integration of practice. Taiwan's visionary initiatives, including digital intelligent healthcare approaches, serve as a robust foundation for building a resilient and patient-centered healthcare system. These concerted efforts and healthcare innovations are necessary for shaping a comprehensive, accessible, and responsive future. Taiwan is setting a noteworthy example for global healthcare systems to follow by prioritizing the well-being of the population. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, there was a marked increase in alcohol and drug-induced deaths. In the US, there was a rapid increase in the rate of alcohol- and drug-induced deaths within the first year of the COVID-19 pandemic compared to pre-pandemic years. This study examines mortality data within Hawai'i to assess both alcohol and drug-induced mortality during the pandemic compared to the nation overall. Data from the Centers for Disease Control and Prevention Underlying Cause of Death database were used to compare numbers and rates of alcohol-induced, drug-induced, and all-cause deaths among individuals aged 15 years or older between 2018 and 2021. The percentage of alcohol-induced and drug-induced deaths in the US and Hawai'i increased annually in 2018, 2019, 2020, and 2021. Unlike the US, in Hawai'i between 2020 and 2021 the age-adjusted rate of drug-induced deaths per 100 000 people decreased from 20.6 to 18.6. Overall, this study found that alcohol-related deaths in Hawai'i increased similarly to those in the US during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Objective: To estimate the potential economic burden of long COVID in Australia. Design: A stock‐and‐flow model of weekly estimated numbers of people with long COVID (January 2021 to June 2023); application of proxy cost estimates from people living with myalgic encephalomyelitis/chronic fatigue syndrome; time series analysis of labour market and social security datasets. Setting: The working age Australian population. Main outcome measures: The likely number of Australians severely impacted by long COVID; the economic cost of long COVID; and the impacts of long COVID, determined by analysis of labour market data. Results: At its peak in late 2022, between 181 000 and 682 000 Australians may have experienced some long COVID symptoms, of whom 40 000–145 000 may have been severely affected. Severe cases potentially decreased to affecting 10 000–38 000 people by June 2023. The likely economic burden of long COVID in Australia during 2022 was between $1.7 billion and $6.3 billion (some 0.07% to 0.26% of gross domestic product). Labour market data suggest that between 25 000 (February 2023) and 103 000 (June 2023) more working age Australians reported being unable to work due to long term sickness than would have been predicted based on pre‐COVID‐19 trends. This does not appear to have translated into increased claims for Disability Support Pensions, but numbers of working age Carer Allowance recipients have grown markedly since 2022. Conclusions: Long COVID likely imposed a small but significant aggregate toll on the Australian economy, while exposing tens of thousands of Australians to substantial personal economic hardship and contributing to labour market supply constraints. Yet while some signal from long COVID is discernible in the labour force data, Australia lacks adequate direct surveillance data to securely guide policy making. [ABSTRACT FROM AUTHOR]