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Objective: This study aims to investigate the trends in otology, rhinology, and head and neck (H&N) operations over the past decade in England. These trends will allow for predictive modelling to forecast the demand over the coming years to aid workforce and resource planning in ENT. Methods: Hospital Episode Statistics data were extracted between April 2012 and April 2023. A total of 121 otology, 114 rhinology, and 122 H&N procedure codes were included. Correlation and linear regression analyses were conducted to examine trends and produce a forecast model for the volume of operations. Results: A gradual upward trend in the volume of operations was observed in rhinology, with a positive correlation coefficient (R = 0.74). In contrast, otology (R = −0.67) and H&N (R= −0.75) showed negative trends, indicating a moderate decline in operational volumes over time. The COVID-19 pandemic significantly disrupted operating activity in rhinology and otology. To address the backlog and reach the pre-pandemic forecasted levels within the next five years, surgical capacity must increase by an additional 33,807 rhinology 25,486 otology, and 10,300 head procedures per year in England. Conclusions: This analysis highlights a need for prioritization and expansion of the ENT workforce and resources to manage the current backlog and anticipated increase in demand over the next five years. [ABSTRACT FROM AUTHOR]

Introduction: During the COVID-19 pandemic, reducing aerosol-generating procedures became fundamental, particularly in ophthalmic surgeries traditionally performed under general anesthesia (GA). Regional anesthesia, such as sub-Tenon's block (STB), is widely used in vitreoretinal surgeries, offering a safer alternative by avoiding airway manipulation. However, the altered orbital anatomy in patients with previous scleral explant surgery creates unique challenges to STB application. This study aims to evaluate the effectiveness, safety, and feasibility of STB in patients after encircling band surgery. Methods: This retrospective analysis included 46 patients with a history of scleral explant surgery, undergoing vitreoretinal procedures at the Bern University Hospital. All procedures were conducted under STB with either analgosedation or GA for additional support when required. An ophthalmic surgeon or an experienced anesthesiologist performed the STBs. Data collected included block success rate, procedural difficulty, incidence of chemosis, and patient satisfaction. The Institutional Ethics Committee approved this study, and all participants provided informed consent. Results: STB was successfully administered in 93.5% of cases, with only three unsuccessful blocks. Block placement was rated as easy in 55% of cases, moderately difficult in 28%, and difficult in 17%. Chemosis was observed in 24% of patients, with severe cases in only 4%. Patient satisfaction scores were high, with most patients expressing satisfaction with the STB procedure. Conversion to GA was required in only one case due to alcohol withdrawal-related agitation. Discussion: The high success rate and minimal complications suggest that STB is a feasible and safe alternative to GA in patients with prior scleral buckling surgery. The altered orbital anatomy presents potential challenges, including scar tissue and compartmentalization, which may lead to patchy anesthesia. However, the use of STB avoids the risks associated with GA and may be especially beneficial for elderly or frail patients. Future studies should further investigate the hemodynamic implications of STB in these cases and the potential for ultrasound-guided techniques to improve accuracy and safety. [ABSTRACT FROM AUTHOR]

Objectives: Chronic pain is a common symptom in Post-Acute COVID-19 Syndrome (PACS), affecting 11–60% of patients, but the link between COVID-19 and chronic pain remains unclear. This study assesses healthcare resource utilization (HRU) for pain management among French COVID-19 survivors, using the National French Claims Database (SNDS). We analyzed medical consultations, rehabilitation services, diagnostic procedures, and medication dispensing to identify PACS-related pain patterns and their impact on the healthcare system. Methods: The cohort included 68,822 patients hospitalized during the first COVID-19 wave (March–June 2020), with 13,939 ICU survivors. HRU was assessed for six months pre- and post-hospitalization in four areas: (1) medical consultations and rehabilitation; (2) pain-related medication dispensing; (3) neuropathic diagnostic procedures; (4) hospital admissions for chronic pain. A post–pre ratio (PP-Ratio) compared post-COVID to pre-COVID HRU. Results: Significant changes in HRU were observed, particularly for ICU survivors. Neurology consultations (PP-Ratio 1.41) and outpatient physical therapy (PP-Ratio 1.69) increased. Dispensing of strong opioids, antiepileptics, anxiolytics, and hypnotics rose, while NSAID use decreased. Hospitalizations for chronic pain also increased (PP-Ratio 1.52). Similar trends were seen among ICU survivors, with notable increases in opioid and antiepileptic use. No distinct PACS-related pain patterns emerged. Conclusions: Non-specific increases in HRU for pain management were found following COVID-19 hospitalization, likely due to disease severity and ICU care rather than PACS-related chronic pain. Further research is needed to explore long-term pain outcomes in this population. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has significantly affected breast cancer patients by causing delays in diagnosis and treatment processes. This study aims to investigate the effects of the pandemic on the treatment process and short-term outcomes of breast cancer patients. Methods: This retrospective, cross-sectional, single-center study included 414 patients who underwent surgery for breast cancer at the Inonu University General Surgery Clinic between March 2018 and June 2021. The patients were divided into two groups: pre-pandemic (Pre-COVID-19; n = 240) and pandemic (COVID-19 Era; n = 174) periods. The groups were compared in terms of demographic, clinical, and histopathological variables. Results: During the pandemic period, the use of neoadjuvant therapy (from 21.3% to 34.5%) and preoperative PET-CT imaging (from 80.4% to 90.8%) rates increased, while breast-conserving surgery (from 27.9% to 19.0%) and the presence of comorbid diseases (from 45.0% to 29.9%) decreased significantly. While there was no significant difference between the groups in terms of the time from diagnosis to surgery (25 vs. 28.5 days, p = 0.121), the time to report the pathology result after surgery decreased during the pandemic period (28 vs. 23 days, p < 0.001). There was no significant difference between the groups in terms of immunohistochemical (ER, PR, Ki-67, E-cadherin, and c-erbB2), histopathological (lymphovascular invasion, perineural invasion, comedo necrosis, modified Bloom–Richardson grade, and TNM classification), and clinical (recurrence, metastasis, and axillary lymph node metastasis) features of the tumor. The mortality rate in the Pre-COVID-19 group (7.1%) was significantly higher than in the COVID-19 Era group (2.3%) (p = 0.049). Finally, in terms of the survival analysis, a statistically significant difference was found between the Pre-COVID-19 and COVID-19 Era groups in terms of the mean follow-up duration of the patients (p = 0.044). Conclusions: The study results show that the use of neoadjuvant therapy and radical surgery preference increased in breast cancer treatment during the pandemic period, but there was no significant change in tumor biology and histopathological features. Breast-conserving surgery rates, comorbidity rates, and pathology reporting times were significantly shortened. Long-term follow-up periods of 3 and 5 years are needed to see the impact of the pandemic on breast cancer patients. [ABSTRACT FROM AUTHOR]

Background/Objectives: COVID-19 has significantly impacted lives, and data show that receiving a booster vaccination has been demonstrated to lower the spread of COVID-19 and reduce the severity of the risk of infection. The Saudi government has actively promoted booster dose vaccines among university students who can spread the virus to older populations, especially in high-density environments, where the risk of virus transmission and spread is elevated. This study focuses on the acceptance of COVID-19 booster shots among students at Imam Abdulrahman bin Faisal University. The study assessed students' willingness to receive a COVID-19 booster dose and the factors influencing their decision. Methods: A descriptive, cross-sectional study design using an online self-administered survey was conducted among medical and non-medical students at Imam Abdulrahman bin Faisal University. A convenience sampling technique was used to recruit participants via email and social media platforms (WhatsApp version 2.3). Quantitative analysis was performed using IBM SPSS version 28.0. using descriptive statistics. Logistic regression analysis was used to predict factors affecting COVID-19 booster dose acceptance and hesitancy. Results: Among 315 respondents, 171 (54.3%) were males, and 144 (45.7%) were females. All the respondents fell in the 18–25 years age group. About 173 (54.9%) respondents were from health-related colleges. Overall, 24.44% (77/315) agreed to get a COVID-19 vaccine booster dose. However, 77.14% (243/315) were confident of getting the vaccine whenever they wanted. About 48.88% (154/315) of respondents considered COVID-19 a serious severe infection, while 14.06% (46/315) of respondents were concerned about the probability of receiving COVID-19 immunization (World Health Organization, 2021). Conclusions: The study revealed that students were not accepting COVID-19 booster doses, highlighting the need for awareness campaigns to dispel myths and improve vaccination rates. [ABSTRACT FROM AUTHOR]

Background: Foot and ankle injuries are one of the leading orthopedic causes of emergency department (ED) admissions. The purpose of this study was to analyze, through 5 years of data collection, differences in number and type of admissions, as well as the severity of foot and ankle trauma to the ED in the pre-pandemic period, during the COVID-19 emergency, and in the post-pandemic period. This study aims to assess epidemiological and clinical data. Methods: Five years of data were collected on admissions to the ED at the Fondazione Policlinico Universitario A. Gemelli using an electronic database. The system allowed the use of a numeric code assessed at triage ranging from 1 to 5, where 1 indicated a patient with compromised vital functions, and it continued in decreasing criticality. Data were extensively analyzed and extrapolated to obtain epidemiological and clinical evaluation. Results: Data from 3787 patients, including 1945 males with a mean age of 41.4 years, were collected. Data were evaluated in the three different periods. In the pre-pandemic period, 2228 ED admissions were recorded, including 1138 males with a mean age of 37.4 years and a mean of 2.79 admissions per day. Codes 3 and 4 reported in the ED triage were 4.8% and 90.1%, respectively; the average surgical treatment was 5.6%. During the COVID period, the total number of admissions was 981, with 501 males with an average age of 43.8 years and a mean of 1.30 admissions per day. Codes 3 and 4 were 22.5% and 72.7%, respectively; the average surgical treatment was 10.4%. In the post-COVID period, 578 admissions were, including 306 males with a mean age of 43.2 years, and a daily access rate of 1.58 patients. Codes 3 and 4 reported in the ED triage were 25.4% and 70.8%, respectively; the average surgical treatment was 8.6%. Conclusions: During the pandemic period due to COVID-19 a substantial decrease in total admissions per day in the ED was noted, but an increase in more complex codes occurred, as evidenced by the percentage increase in surgical admissions compared to total admissions during the pandemic; the mean age of users gradually increased. Total hospitalization data remained stable in the post-pandemic period, likely due to the global impact of the pandemic. COVID-19 radically and concretely changed people's living habits and priorities for accessing the ED. [ABSTRACT FROM AUTHOR]

Background/Objectives: In response to the COVID-19 pandemic, Australian state and federal governments enacted boarder closures, social distancing measures, and lockdowns. By the end of October 2020, the 112-day lockdown in the Australian state of Victoria was the longest continuous lockdown period internationally. Previous studies have examined how the COVID-19 pandemic and government restrictions have affected Australians' mental health and well-being; however, less is known about the relationship between psychological variables and well-being. Methods: We administered a national survey of Australians aged 16 years and over (N = 1380) in November 2020 to examine the psychological factors that promoted and hindered Australians' well-being and resilience during the first year of the pandemic. Results: Our study found that Australians reported normal to moderate levels of anxiety, moderate stress, mild depression, and moderate to high loneliness. Interpersonal trust was consistently a protective factor for well-being and resilience and was associated with less depression, anxiety, stress, and loneliness, and greater resilience. Participants with greater inhibitory anxiety (intolerance of uncertainty) and an external locus of control were more likely to be depressed, anxious, stressed, and lonely, and less resilient, compared with those with less inhibitory anxiety and those who believed that these outcomes were determined by their own actions. COVID-19 beliefs were associated with more depression, anxiety, stress, and resilience. Conclusions: This study seeks to inform the development of mental-health, well-being, and resilience strategies by government agencies, non-government organisations, and healthcare providers in times of crisis and in "ordinary" times. [ABSTRACT FROM AUTHOR]

A novel time-dependent deterministic SEIRS model, extended with vaccination, hospitalization, and vital dynamics, is introduced. Time-varying basic and effective reproduction numbers associated with this model are defined, which are crucial metrics in understanding epidemic dynamics. Furthermore, a parameter identification approach has been used to develop a numerical method to compute these numbers for long-term epidemics. We analyze the actual COVID-19 data from the USA, Italy, and Bulgaria to solve appropriate inverse problems and gain an understanding of the time evolution behavior of the basic and effective reproduction numbers. Moreover, an insightful comparison of key coronavirus data and epidemiological parameters across these countries has been conducted. For this purpose, while the basic and effective reproduction numbers provide insights into the virus transmission potential, we propose data-driven criteria for assessing the actual realization of the transmission potential of the SARS-CoV-2 virus and the effectiveness of the applied restrictive measures. To obtain these results, we conduct a mathematical analysis to demonstrate various biological properties of the new differential model, including non-negativity, boundedness, existence, and uniqueness of the solution. The new model and the associated numerical simulation tools proposed herein could be applied to COVID-19 data in any country worldwide and hold a promising potential for the transmission capacity and impact of the virus. [ABSTRACT FROM AUTHOR]

Infectious diseases impose a significant burden on global health systems due to high morbidity and mortality rates. According to the World Health Organization, millions die from infectious diseases annually, often due to delays in accurate diagnosis. Traditional diagnostic methods in clinical microbiology, primarily culture-based techniques, are time-consuming and may fail with hard-to-culture pathogens. Molecular biology advancements, notably the polymerase chain reaction (PCR), have revolutionized infectious disease diagnostics by allowing rapid and sensitive detection of pathogens' genetic material. PCR has become the gold standard for many infections, particularly highlighted during the COVID-19 pandemic. Following PCR, next-generation sequencing (NGS) has emerged, enabling comprehensive genomic analysis of pathogens, thus facilitating the detection of new strains and antibiotic resistance tracking. Innovative approaches like CRISPR technology are also enhancing diagnostic precision by identifying specific DNA/RNA sequences. However, the implementation of these methods faces challenges, particularly in low- and middle-income countries due to infrastructural and financial constraints. This review will explore the role of molecular diagnostic methods in infectious disease diagnosis, comparing their advantages and limitations, with a focus on PCR and NGS technologies and their future potential. [ABSTRACT FROM AUTHOR]

Background/Objectives: We aimed to characterize the fibrosis following COVID-19 pneumonia, using quantitative analysis, after three months and subsequently, after two years of patients' release from the hospital, and to identify the risk factors for pulmonary fibrosis. Methods: We performed a retrospective, observational cohort study on 420 patients with severe forms of COVID-19. For all patients, we registered demographic, inflammatory and biochemical parameters, complete blood count and D-dimers; all patients underwent three computed tomography scans (at admittance, at 3 months and at 2 years). Results: We found fibrosis in 67.9% of patients at the 3-month evaluation and in 42.4% of patients at the 2-year evaluation, registering a significant decrease in the severe and moderate fibrosis cases, with a slight increase in the mild fibrosis cases. The risk of fibrosis was found to be proportional to the values of age, duration of hospital stay, inflammatory markers (ESR, fibrinogen), cytolytic markers (LDH, AST) and D-dimers. The highest correlations with lung fibrosis were registered for interstitial pulmonary involvement (for the 3-month evaluation) and total pulmonary involvement (for the 2-year evaluation). Conclusions: Lung fibrosis represents a significant post-COVID-19 complication found in 42% of patients with severe forms of pneumonia at the 2-year evaluation. A significant overall decrease in the severity of lung fibrosis was registered at the 2-year evaluation compared to the 3-month evaluation. We consider that the amount of interstitial pulmonary involvement represents the optimal parameter to estimate the risk of lung fibrosis following SARS-CoV-2 pneumonia. [ABSTRACT FROM AUTHOR]

The SARS-CoV-2 pandemic has significantly impacted global health and has led the population and the scientific community to live in fear of a future pandemic. Based on viral infectious diseases, innate immunity cells such as mast cells and basophils play a fundamental role in the pathogenesis of viral diseases. Understanding these mechanisms could be essential to better study practical therapeutic approaches not only to COVID-19 but also to other viral infections widely spread worldwide, such as influenza A, HIV, and dengue. In this literature review, we want to study these concepts. Mast cells and basophils intervene as a bridge between innate and acquired immunity and seem to have a role in the damage mechanisms during infection and in the stimulation of humoral and cellular immunity. In some cases, these cells can act as reservoirs and favor the replication and spread of the virus in the body. Understanding these mechanisms can be useful not only in therapeutic but also in diagnostic and prognostic perspectives. The prospects of applying artificial intelligence and machine learning algorithms for the creation of very accurate diagnostic/prognostic tools are interesting. [ABSTRACT FROM AUTHOR]

Latin America was one of the hotspots of COVID-19 during the pandemic. Therefore, understanding the COVID-19 mortality rate in Latin America is crucial, as it can help identify at-risk populations and evaluate the quality of healthcare. In an effort to find a more flexible and suitable model, this work formulates a new quantile regression model based on the unit ratio-Weibull (URW) distribution, aiming to identify the factors that explain the COVID-19 mortality rate in Latin America. We define a systematic structure for the two parameters of the distribution: one represents a quantile of the distribution, while the other is a shape parameter. Additionally, some mathematical properties of the new regression model are presented. Point and interval estimates of maximum likelihood in finite samples are evaluated through Monte Carlo simulations. Diagnostic analysis and model selection are also discussed. Finally, an empirical application is presented to understand and quantify the effects of economic, social, demographic, public health, and climatic variables on the COVID-19 mortality rate quantiles in Latin America. The utility of the proposed model is illustrated by comparing it with other widely explored quantile models in the literature, such as Kumaraswamy and unit Weibull regressions. [ABSTRACT FROM AUTHOR]

This study investigates the dual dynamics of investment shocks and policy responses in stabilizing South Korea's macroeconomy during the COVID-19 pandemic, utilizing a Bayesian DSGE framework. The model integrates sophisticated mathematical components, including stochastic differential equations, Bayesian inference, and impulse response functions, to analyze the transmission mechanisms of investment shocks and the relative efficacy of fiscal and monetary interventions. The estimation is conducted through Markov Chain Monte Carlo simulations. Using data from the first quarter of 2020 to the first quarter of 2023, the analysis quantifies the pandemic-induced shocks' impact on critical macroeconomic indicators, including enterprise output, household consumption, employment, and investment. The findings reveal that heightened investment costs significantly constrained economic performance, with fiscal measures, such as increased government spending and targeted stimulus packages, demonstrating superior stabilization effects compared to monetary interventions. These results emphasize the importance of well-coordinated policy responses in mitigating economic disruptions and enhancing resilience during crises. This study not only provides novel insights into the mathematical modeling of economic stabilization strategies but also offers actionable recommendations for policymakers navigating pandemic-induced challenges. [ABSTRACT FROM AUTHOR]

Simple Summary: What makes 'man's best friend' a human's ideal friend? Previous studies examining ideal characteristics for companion dogs were conducted before the rise of social media and the COVID-19 pandemic, events that changed how humans live and, potentially, their preferences for the ideal dog. Over 330 Australian adults were recruited online and surveyed. The ideal dog was found to be medium-sized, with a short low- or non-shedding coat. It would be acquired as a puppy from a shelter/rescue. It would also be affectionate, healthy, non-aggressive, safe with children, housetrained, non-destructive when left alone, and would not escape the property. Differences across age, gender, perceived income in comparison to others, and number of household children were observed for desired physical and behavioural traits, but no significant differences regarding dog behaviour satisfaction were found between pandemic and non-pandemic acquisitions. Findings resemble those of a previous Australian ideal dog study, suggesting that preferences for the ideal dog are relatively stable. Breeders, prospective owners, and policymakers can benefit from this research by using the findings to guide choices, reduce relinquishment, and improve human–dog relationships. Defining the ideal characteristics of canine companions is imperative to those seeking to improve human–dog relationships. Previous investigations into the preferred traits of companion dogs were conducted before substantial recent events, such as the rise of social media and the COVID-19 pandemic, which altered human lifestyles and potentially affected canine preferences and owner satisfaction. This study surveyed Australian adults (n = 337) online to assess these shifts. The ideal dog was characterised as medium-sized, with a short- low- or non-shedding coat, and acquired as a puppy from a shelter/rescue. Desired traits included being affectionate, healthy, non-aggressive, safe with children, housetrained, non-destructive when alone, and not prone to escaping. Principal Component Analysis identified five factors: 'calm and obedient', 'inhibitory control', 'energy and drive', 'non-aggressive and safe', and 'affectionate and healthy'. Demographic variables of age, gender, perceived income, and household children influenced preferences. No significant differences in owner satisfaction with behaviour were observed between dogs acquired during versus outside the pandemic. The findings align with prior Australian research, suggesting enduring stability in preferences for the ideal companion dog. These insights offer valuable guidance for breeders, prospective owners, and policymakers to reduce dog relinquishment and improve human–dog relationships. [ABSTRACT FROM AUTHOR]

Antibiotic resistance is a silent global crisis intensified by the recent pandemic of coronavirus disease 2019 (COVID-19). To address this growing threat, wastewater-based surveillance (WBS) is emerging as a promising public health tool for monitoring antibiotic resistance within communities. Our meta-analysis aims to reveal the landscape of antibiotic-resistance genes (ARGs) in global wastewater during and after the COVID-19 pandemic. The analysis included wastewater samples collected between 2020 and 2024 from five countries across three continents: Asia (China), Europe (United Kingdom and Russia), and North America (United States and Canada). Our findings showed higher observed ARGs in Russia and China despite their small sample size, while the USA showed more diverse ARGs. Distinct patterns of ARGs were observed in European and North American wastewater samples (p-value < 0.001). We identified 2483 ARGs, with multidrug-resistant (MDR) genes dominating most regions and accounting for almost 45% of all ARGs detected in Europe. Country-specific indicator ARGs showed 22 unique ARGs for Russia, 3 for each of the UK and Canada, and 2 were specific for China. Continentally, 100 indicator ARGs were specific to Asia, 38 to Europe, and 18 to North America. These findings highlight the regional variations in ARG profiles, emphasizing the urgent need for region-specific strategies to combat antibiotic-resistance threat. Additionally, our study further supports the value of WBS as a valuable public health tool for monitoring antibiotic resistance. [ABSTRACT FROM AUTHOR]

Background: Large-scale vaccination was crucial to address the global COVID-19 pandemic and its associated health risks, including fatal and disabling diseases. However, there were significant challenges to be overcome to ensure the safe and effective implementation of the vaccination program. The aim of the present study was to assess patient safety threats related to the anti-COVID-19 large-scale vaccination process. Methods: Between February and May 2021, we conducted a proper analysis to proactively identify risks and potential Failure Modes (FMs) in the COVID-19 vaccination process using the Failure Mode, Effects, and Criticality Analysis (FMECA) technique at an Italian Public Health Authority. A standardized risk scoring system was used to assess the severity, frequency, and detectability of events associated with potential failures. Criticalities were identified in both the preparatory and operational areas of the vaccination process, and several potential FMs were listed in descending order of risk score (Risk Priority Number, RPN) to ensure prioritization of interventions. Results: The most critical steps were found to be in the operational area rather than in the preparatory one. The highest RPNs were associated with failure or inadequate management of severe allergic reactions that can lead to serious harm and even death of the vaccinated person (RPN 60) and failure to keep updated vaccination teams' knowledge (RPN 36). Conclusions: Ensuring patient safety and effective clinical risk management are crucial in mass vaccination campaigns. By prioritizing these aspects through collaboration with various stakeholders and implementing preventive measures, patient trust—on which vaccination campaign success relies—can be built and maintained. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has significantly impacted healthcare systems worldwide, including dental care. This study aimed to investigate the effects of the pandemic on the management of medication-related osteonecrosis of the jaw (MRONJ). Abnormal blood glucose levels may contribute to the development of MRONJ and act as an important risk factor. This retrospective study included 217 patients with MRONJ. The patients were divided into two groups: the pre-COVID-19 group (16 March 2018 to 16 March 2020; 75 patients; 46 females and 29 males; average age, 74.5 years) and the post-COVID-19 group (1 June 2022 to 1 June 2024; 142 patients; 91 females and 51 males; average age, 69.6 years). Data pertaining to demographic characteristics, length of hospital stay, glucose levels, location of lesions, and underlying diseases were collected. The average length of hospital stays was 4 and 5 days in the pre- and post-COVID-19 groups, respectively. The average fasting glucose levels were 5.5 and 5.9 mmol/L in the pre- and post-COVID-19 groups, respectively. Localization patterns shifted, with a higher incidence in the maxilla in the post-COVID-19 group. These findings suggest a significant increase in MRONJ cases and changes in clinical outcomes due to the pandemic. The increase in the number of patients treated after the pandemic highlights the importance of ongoing vigilance and adaptation in preventing MRONJ, with a particular focus on risk factors. [ABSTRACT FROM AUTHOR]

Background: Persistent alterations in taste and smell affect a significant proportion of individuals following COVID-19, representing a component of post-acute COVID-19 syndrome, commonly referred to as long COVID. The degradation of sphingomyelin by acid sphingomyelinase is regarded as a biomarker for acquired demyelinating neuropathies. Objectives: This study was aimed to enroll women who contracted COVID-19 during pregnancy and experienced persistent alterations in taste and/or smell for more than 1 year post-infection, in comparison to pregnant women without any disturbances in these senses. Methods: The patients were subjected to a questionnaire investigating smell and taste disorders more than 1 year after the infection. Then, the levels of acid sphingomyelinase in the plasma of the participants were assessed. Results: The results showed that in women who had been pregnant and who had been infected with SARS Cov-2 during the COVID period and who still had taste and smell disorders 1 year later, plasma acid sphingomyelinase levels were double that of pregnant women who had contracted the infection during the COVID period but had not reported taste and smell disorders and that of pregnant women analyzed after the COVID period. Conclusions: The results suggest a hypothesis that the persistence of sensory disturbances in long COVID was probably due to a failure to utilize brain circuitry with demyelination resulting from chemosensory dysfunction of the olfactory epithelium. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic severely impacted healthcare systems, affecting patient outcomes and resource allocation. This study applied automated machine learning (AutoML) to analyze key health outputs, such as discharge conditions, mortality, and COVID-19 cases, with the goal of improving responses to future crises. Methods: AutoML was used to train and validate models on an ICD-10 dataset covering the first wave of COVID-19 in Romania (January–September 2020). Results: For discharge outcomes, Light Gradient Boosted models achieved an F1 score of 0.9644, while for mortality 0.7545 was reached. A Generalized Linear Model blender achieved an F1 score of 0.9884 for "acute or emergency" cases, and an average blender reached 0.923 for COVID-19 cases. Older age, specific hospitals, and oncology wards were less associated with improved recovery rates, while mortality was linked to abnormal lab results and cardiovascular/respiratory diseases. Patients admitted without referral, or patients in hospitals in the central region and the capital region of Romania were more likely to be acute cases. Finally, counties such as Argeş (South-Muntenia) and Brașov (Center) showed higher COVID-19 infection rates regardless of age. Conclusions: AutoML provided valuable insights into patient outcomes, highlighting variations in care and the need for targeted health strategies for both COVID-19 and other health challenges. [ABSTRACT FROM AUTHOR]

(1) With persistent symptoms emerging as a possible global consequence of COVID-19, the need to understand, diagnose, and treat them is paramount. This systematic review aims to explore the potential of optical coherence tomography (OCT) and/or optical coherence tomography angiography (OCTA) in effectively diagnosing long COVID. (2) The database PubMed and, to reduce selection bias, the AI research assistant Elicit, were used to find relevant publications in the period between February 2021 and March 2024. Included publications on OCT and OCTA analysis of participants with acute COVID symptoms, those after recovery, and participants with long COVID symptoms were organized in a table. Studies with participants under the age of 18, case reports, and unrelated studies, such as pure slit-lamp examinations and subgroup analyses were excluded. (3) A total of 25 studies involving 1243 participants and 960 controls were reviewed, revealing several changes in the posterior eye. Long COVID participants displayed significant thinning in retinal layers in the OCT, including the macular retinal nerve fiber layer (mRNFL), ganglion cell layer (GCL), and inner plexiform layer (IPL). Divergent findings in recovered cohorts featured mRNFL reduction, GCL increase and decrease, and GCL-IPL decrease. Long COVID OCTA results revealed reduced vessel density (VD) in the superficial capillary plexus (SCP), intermediate capillary plexus (ICP), and deep capillary plexus (DCP). In recovered patients, SCP consistently showed a reduction, and DCP exhibited a decrease in five out of six publications. The foveal avascular zone (FAZ) was enlarged in five out of nine publications in recovered participants. (4) During various stages of COVID-19, retinal changes were observed, but a comparison between long COVID and recovered cohorts was aggravated by diverse inclusion and exclusion criteria as well as small sample sizes. Changes in long COVID were seen in most OCT examinations as thinning or partial thinning of certain retinal layers, while in OCTA a consistently reduced vessel density was revealed. The results suggest retinal alterations after COVID that are variable in OCT and more reliably visible in OCTA. Further research with larger samples is important for advancing long COVID diagnosis and management. [ABSTRACT FROM AUTHOR]

Health systems around the world continue to experience healthcare workforce shortages, including shortages of nurses. This results in staff experiencing prolonged shifts and other stressors, which are linked to burnout, yet burned-out staff are then entrusted with the provision of patient care, despite healthcare facilities being regarded as safety-critical areas. It is assumed that the situation may have been worsened by the COVID-19 pandemic. This scoping review aims to identify the prevalence of burnout among nurses in Europe before and during the pandemic, the factors associated with this burnout, and its impact on patient safety. A literature search was conducted in the MEDLINE database; search terms included Nurse and Burnout and Patient Safety and their synonyms. The search limits used were English language, 2013 to 2023 publication years, original published research only (excluding review papers, dissertations, and unpublished reports), and studies conducted in European countries. A total of 16 papers were included for analysis: four indicated burnout levels of study participants, while 11 gave scores for individual burnout symptoms. Almost all studies indicated factors that were linked to burnout or individual dimensions of burnout. A few papers touched on the implications of these factors on patient safety. The review findings concluded that the few studies providing burnout levels on study participants could not give a clear picture of the burnout prevalence among nurses across Europe, either in general, before, or during the pandemic; therefore, this objective was not achieved and more research is required to establish this. Several factors thematically classified as sociodemographic, personal, organizational, and patient/client-related were linked to burnout. However, there were some contradictions in sociodemographic factors. Low personal accomplishment was the most common symptom of burnout before the pandemic, followed by emotional exhaustion and lastly depersonalization. Emotional exhaustion took the lead during the COVID-19 pandemic, followed by low personal accomplishment, and depersonalization remained the least common. More research is needed to establish the relationship between burnout and these factors. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic severely affected teaching and student outcomes throughout the world, yet the long-term impacts of the pandemic on teachers and students in Latin America and Spain remain largely underexamined. This study examined the experiences of 5416 teachers from 20 Spanish-speaking countries during and after the pandemic, with an emphasis on teachers' health, teaching experiences, and school-based support; perceptions of their students' experiences and struggles; and relationships with students, families, and colleagues. The study used an online survey design with recruitment primarily based on snowball sampling, with most variables being collected using Likert-style responses. Descriptive statistics as well as bivariate correlations between variables were calculated. The results suggested that teachers were mostly healthy and reported moderate fear of COVID-19, though there was much variability. While, on average, teachers did not believe the pandemic had had a negative impact on their relationships with parents, colleagues, and students, they believed that the pandemic had a meaningful negative impact on their students by increasing problems in five key domains: educational, behavioral, social, emotional, and familial. Teachers had received very little training regarding online teaching, although they were moderately satisfied with the resources they had received to teach online and the safety measures their schools had implemented. Schools should provide additional support to teachers, students, and families during times of prolonged stress such as pandemics to help mitigate their lasting effects on students' academic and psychosocial functioning. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, the New Jersey Safe Schools Program (NJSS) surveyed a subset of newer NJ high school (HS) teachers who completed NJSS work-based learning supervisory trainings from October 2021 to June 2023. The purpose of this study was to gain insight on NJ HS teacher perceptions of school provided mental health services, and well-being supports received during the COVID-19 pandemic. Via online surveys, teachers anonymously identified who should be responsible for supporting mental well-being in schools, satisfaction with existing mental health services, and self-care practices implemented during the COVID-19 pandemic. Of the 114 HS teachers surveyed, nearly 70% would recommend existing school mental health services to colleagues, 53% would like an increase in mental health and counseling services available at their school, and 44% would like their schools to improve mental health literacy. This study presents insight into the needs teachers expressed for appropriate school mental health support and services. Data will inform guidance for how to better address identified needs, including employee wellness, and creating positive social and emotional school environments. School districts should prioritize the implementation of suitable and equitable school-based mental health services to teachers and students alike to promote healthy and productive school environments. [ABSTRACT FROM AUTHOR]

With the rapid development of information technology from one side and the experience of the COVID-19 pandemic from the other side, people presently prefer to access healthcare services remotely. Telecare Medical Information System (TMIS) provides more flexible, faster, and more convenient e-healthcare services available to all people, particularly those who lack access to physicians due to their geographical restrictions. However, due to the sensitivity of medical information, preventing unauthorized access to patient data and preserving patient privacy is crucial. In this paper, we propose an authenticated key agreement scheme for TMIS to preserve the privacy of the patient's identity from all internal (even the health server and the physician) and external entities. Moreover, the physician's identity is kept secret from all external entities. Formal and informal security analysis of the proposed scheme indicates that it is secure against all attacks in the context. [ABSTRACT FROM AUTHOR]

Background/Objective: Over the past two decades, the utilization of virtual care in rehabilitation has witnessed a significant surge; this is owing to the widespread availability of technological tools and the global impact of the COVID-19 pandemic. As a result, discussions surrounding the relevance and benefits of telerehabilitation have gained prominence among practitioners, who continually seek to enhance patient care while maintaining high standards of quality. Associated with these discussions are concerns over being able to provide care in an ethical way, as well as addressing equity issues that might be hindered or improved via telerehabilitation. To address the ethical and equity concerns around telerehabilitation, a series of five parallel rapid reviews of the scientific literature were conducted, focusing on different rehabilitation fields: physiotherapy and occupational therapy (1); speech therapy and audiology (2); psychology and neuropsychology (3); and in two age groups: older adults (4); and pediatrics and young adults (5). The objective of this series of rapid reviews is to evaluate the evidence presented regarding telerehabilitation; identifying and recommending best practices especially in the realm of ethics and equity. Methods: Medline; CINAHL; and EMBASE were searched between 2010 and 2023 for English or French-language reviews (2010–2020) and individual studies (2020–2023) pertaining to telerehabilitation and these fields of interest. Data were extracted following a standardized form focusing on: outcomes; findings; quality assessment/biases; limitations; and discussion of ethical and equity concerns. Results: The results are presented according to the most relevant themes, which include: findings; strengths; limitations; and ethical/equity considerations. Conclusions: This research presents a methodology rarely published before, on how to conduct multiple parallel rapid reviews on the theme of telerehabilitation, based on different rehabilitation fields and age groups. This research will shape future guidelines and standards in applying ethical and equity standards in telerehabilitation. [ABSTRACT FROM AUTHOR]

The agrarian continent of Africa has many fruits with nutritional, medicinal and spiritual values. Regardless, Africa leads the statistics of poor healthcare globally. Two major challenges in Africa's healthcare system are poor access and the high cost of medical healthcare. Among others, the effects of such challenges include low responsiveness to medical treatment and a high mortality rate. However, it seems the nosophobia that accompanied the global mortality rate during the COVID-19 pandemic may have triggered a spiritually influenced alternative. One of the traditional alternatives was a subscription to Garcinia Kola, popularly known as Bitter Kola (BK). This article, majoring in spiritual and not psychological influence, raised a hypothetical question: does spirituality influence Africans' traditional response to COVID-19? To answer this question, Sunnyside in Pretoria was chosen as a demography to investigate the hypothesis. Data were collected via mixed research methods. There were 16 qualitative respondents, including sellers, herbalists and clergies, and 75 consumers as quantitative respondents under probability sampling. The results analysed using Excel and Python's regression analysis demonstrated strong connections between consumers' spiritual motivations, the sales period, the sales rate, and the swift traditional response to the pandemic and related illnesses. The outcome validated the influence of spirituality on 60.9% of quantitative respondents and showed how 25–72% responded to COVID-19 symptoms with BK. Likewise, 87.5% of qualitative respondents consumed BK via indigenous spiritual knowledge in response to the pandemic. Subsequently, this article discussed the benefits, limitations and lessons of spiritual influence on BK consumption in the post-COVID-19 era. [ABSTRACT FROM AUTHOR]

Religious leaders are highly influential actors in many societies across the globe. In the singular global crisis brought upon by the COVID-19 pandemic, their perspective on the pandemic itself but also the post-pandemic future is of high relevance. Against this background, we conducted the Religious Leaders' Perspectives on Corona Survey, a comprehensive survey of 1200 religious leaders globally, in 2020/2021. Its aim was to investigate the role of religious communities and religious leaders during the COVID-19 pandemic. This article provides an in-depth outline and discussion of the survey methodology and the resultant dataset, thereby paving the way for future research using the survey data. Moreover, the first set of key results is highlighted. It emerges that the COVID-19 pandemic was not primarily a health crisis. Rather, in terms of its consequences, COVID-19 had the characteristics of a primarily economic crisis in the Global South and a primarily psychosocial crisis in the Global North. Moreover, the pandemic has had a fundamental impact on religious practice across the globe. This impact, however, seems to be highly unequal between the Global South and North. Religious communities are shown to have had an important role as civil society actors in the pandemic, providing both psychosocial and material support. Regarding the post-pandemic world, religious leaders envision a more equitable society and emphasize the need for environmental sustainability. [ABSTRACT FROM AUTHOR]

Background: Unlike psychological distress, which has been extensively studied during the COVID-19 pandemic, the impact of the pandemic on stress hormones has been overlooked. The aim of this study is to examine the hair cortisol/dehydroepiandrosterone sulfate (DHEA-S) ratios as markers of HPA axis dysregulation in healthcare workers and their patients. Methods: A total of 200 healthcare workers and 161 "patients" patients with special healthcare needs due to chronic illness or motor disabilities were included in this study. The hormone concentrations were measured using a radioimmunoassay. Results: Our results show that the patients had significantly higher cortisol/DHEA-S ratios than the workers. A high cortisol/DHEA-S ratio in the patients reflects higher cortisol concentrations (p < 0.001) and lower DHEA-S (p < 0.05) concentrations compared to those of the healthcare workers, suggesting that they may be exposed to a greater degree of stress and a decrease in their ability to cope with their disease. The cut-off value of the hair cortisol/DHEA-S ratio in our study for detecting people with needs that require special consideration and attention was 1.46 (p ≤ 0.01). Conclusions: Assessing the hair cortisol/DHEA-S ratios in both healthcare workers and the patients allowed us to identify a non-homeostatic condition that could lead to disease and to understand psychophysical well-being during the COVID-19 pandemic. They also play a crucial role in preventive and personalized medicine. [ABSTRACT FROM AUTHOR]

Background/Objectives: During the COVID-19 pandemic, Austria, like many European countries, implemented lockdown measures to curb viral transmission. These public health interventions, including social distancing and improved hygiene, were anticipated to affect various infectious diseases. This study aimed to assess whether the incidence of peritonsillar abscess, a severe upper respiratory inflammatory disease, decreased during the lockdown period of 2020 compared to previous years. Methods: This retrospective study analyzed all patients diagnosed with peritonsillar abscess from 2010 to 2020 at the Department of Otorhinolaryngology, Medical University of Graz. Patients were grouped based on the onset of disease into two periods: the lockdown period (16 March–29 May) and the rest of the year = Period 2 (1 January–15 March and 30 May–31 December). The incidence during the lockdown period of 2020 was compared to the incidence in the same timeframe in the previous years from 2010 to 2019 using chi-squared tests and Poisson regression models. Results: A total of 1768 patients (female: 44%, male: 56%; mean age: 34.6 ± 18.4 years) diagnosed with peritonsillar abscess were treated between 2010 and 2020 at the Department of Otolaryngology, Medical University of Graz. The analysis revealed that the proportion of peritonsillar abscesses in Period 1 in 2020 (15/127, 12%) was significantly lower than the mean proportion in Period 1 from 2010 to 2019 (36/164, 22%) (p = 0.004). The incidence rate of peritonsillar abscess cases per year in Period 1 (16 March–29 May) was significantly higher in each previous year from 2010 to 2019 compared to 2020 (p < 0.05). Conclusions: The findings suggest that the COVID-19 lockdown measures contributed to a reduction in the incidence of peritonsillar abscess, highlighting the broader impact of public health interventions on infectious diseases. Further research is needed to explore the effects on other respiratory infections and diseases. [ABSTRACT FROM AUTHOR]

As indoor space becomes more important in our daily life, the demand to build digital twins for indoor spaces is increasing accordingly. The properties of indoor spaces, however, differ from those of outdoor spaces, and we need to apply different approaches to build indoor digital twins. In our work, we propose a framework for building an indoor digital twin with a use case for hospitals in general and large hospitals in particular, which may be considered as one of the most complicated types of digital twin. One of our goals is to establish a framework for building indoor digital twins based on standards and our framework starts from OGC IndoorGML, which is a standard for indoor data models and encoding schemes for indoor spatial data. In this paper, each step of the framework is presented for the construction of an indoor hospital digital twin focusing on a use case of epidemic analysis of COVID-19 transmission in a hospital. The use case study covers the entire life cycle of the indoor spatial application from requirement analysis, data modeling, and building indoor spatial data to the development of a COVID-19 transmission analysis. Our work represents a use case for indoor digital twins based on the OGC IndoorGML standard and eventually may serve as a framework and reference for building indoor digital twins. As our work is mainly focused on the construction of hospital digital twins, the study on COVID-19 infection model itself is limited in this paper. Improvement of the infection models and validations will be the next step of our work. As HVAC (heat, ventilation, and air conditioning) was not fully considered in our use case, we also expect that it is possible to strengthen our use case by including HVAC for the analysis of airflow dynamics. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, a Canadian recreation centre launched a community-based intervention to increase physical activity (PA) and reduce sedentary behaviour (SB). The Vivo Play Scientist (VPS) program provided a free wearable device (Garmin Vivofit4) that synchronized with a customized eHealth dashboard. Aim: The study investigated the feasibility and effectiveness of the VPS program through the participants' use and experiences of the device and dashboard using the Technology Acceptance Model (TAM). Method: We employed a concurrent mixed-methods approach of online surveys and semi-structured telephone interviews and estimated the device and dashboard's perceived usefulness and ease of use with TAM. Results: Of the 318 participants (mean age 39.8) 87 enrolled and completed the survey at baseline-T0, 4 wks-T1, and 8 wks-T2. Maximal-variation sampling was used to select 23 participants (78%, F) for interviews. We compared frequency of use, perceived usefulness and ease of use of the device and dashboard across all surveys using non-parametric statistical tests. A thematic analysis was used to analyze data. Participants had some experience using a wearable device (46%) or eHealth application (49%). A high use (≥4 d/wk.) of Vivofit4 at T1 (93%) and T2 (87%) occurred, but dashboard use was less frequent (≥1 d/wk. T1 54.0% and T2 47.1%). Average levels of perceived usefulness and ease of use for the Vivofit4 and dashboard remained constant from T1 to T2. Average daily PA scores decreased from T1 to T2 (4.9 to 4.5; p = 0.017). Conclusion: Participants were guarded about the value of the dashboard use and reported several challenges associated with the VPS program, but the free device and dashboard did provide PA support during the pandemic. [ABSTRACT FROM AUTHOR]

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 19 (COVID-19), has resulted in dramatic changes in human lifestyles and the geographic distribution of populations. However, despite the unequal impact of COVID-19 across urban spaces, research on the association between socioeconomic disparities in the usage of various types of urban amenities during the pandemic is limited. Thus, this study utilized mobile phone data and land use/land cover (LULC) data to investigate COVID-19-induced changes in the hot spots of the daytime and nighttime populations of two districts in Seoul, South Korea: Gangnam (a high-income community) and Gangbuk (a low-income community). First, the differences between Gangnam and Gangbuk in the LULC and mobile phone data, before and during the pandemic, were statistically analyzed by age. Second, the areas with significantly increased mobile phone-based populations during COVID-19 were identified using a hot spot analysis method and Welch's t-test. This study identified that there were significant disparities in the use of green spaces during the pandemic, with a higher percentage of the mobile phone-based population in Gangnam than Gangbuk. Youths and adults in Gangnam were more likely to visit schools and enjoy physical activities in forests and open spaces during the pandemic, whereas there was no such increase in Gangbuk. The findings contribute to the understanding of the impact of COVID-19 on human behaviors and socioeconomic disparities in the quality of urban life. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic had a negative impact on mental health in the general population. The fear, stress, and uncertainty surrounding that traumatic period could have contributed to the aggravation or possible new onset of obsessive–compulsive symptoms. Methods: The COvid Mental hEalth Trial (COMET) is a nationwide project organized by the University of Campania "Luigi Vanvitelli", designed as an observational investigation that aimed to gather data from a representative sample of the Italian general population. The current study is a report from the main project and it focuses on obsessive–compulsive (OC) symptoms. Results: A total sample of N = 20,720 took part in the survey. N = 2332 individuals had a total Obsessive–Compulsive Inventory—Revised (OCI-R) score greater than or equal to 21 (11.3% of the entire sample), indicating the presence of clinically relevant obsessive–compulsive symptoms. By excluding patients with a history of previous mental illnesses, we still obtained a high number of individuals with an OCI-R score greater than or equal to 21 (N = 2024), representing 10.3% of the overall sample, possibly indicating a new incidence of OC symptoms during the pandemic. Discussion: Our study highlights a substantial new incidence of obsessive–compulsive symptoms in the general public. Risk factors or red flags such as being male, being of working age, living in a highly stressful environment such as one of the Italian regions most affected and severely hit by the pandemic, having higher levels of loneliness, and using substances to cope with stress, should be paid particular attention in order to prevent the development of OC symptoms during a critical and traumatic event such as the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Mild cognitive impairment (MCI) affects nearly 20% of older adults worldwide, with no targetable interventions for prevention. COVID-19 adversely affects cognition, with >70% of older adults with Long COVID presenting with cognitive complaints. Neurovascular coupling (NVC), an essential mechanism of cognitive function, declines with aging and is further attenuated in neurocognitive disorders. The effect of COVID-19 on NVC responses has yet to be addressed in older adults who are vulnerable to dementia progression. Participants with MCI and a history of COVID-19 (COV+, N = 31) and MCI participants with no history of infection (COV− N = 11) participated in this cross-sectional study to determine if COVID-19 affects cerebrocortical NVC responses and vascular function. Functional near-infrared spectroscopy was used to measure cerebrocortical NVC responses, and endothelial function was assessed via insonation of the brachial artery during a flow-mediated dilation protocol. NVC responses were elicited by the working memory n-back paradigm. NVC in the left dorsolateral prefrontal cortex and endothelial function was decreased in the COV+ group compared to the COV− group. These data provide mechanistic insight into how COVID-19 may exacerbate long-term cognitive sequela seen in older adults, highlighting the urgent need for further research and clinical trials to explore novel therapeutic interventions aimed at preserving/restoring NVC. [ABSTRACT FROM AUTHOR]

Simple Summary: By analyzing inflammatory scores (INFLA-score, Systemic Inflammation Response Index—SIRI) and the Aging-Related Immune Phenotype (ARIP) in 249 participants aged 19–111 years, this study investigates the role of immune-inflammatory responses in semi- and supercentenarians who have survived significant challenges like pandemics. Statistical analyses indicated that the INFLA-score and SIRI increase with age, but no significant differences were observed between semi- and supercentenarians and other age groups. Moreover, ARIP values, specifically CD8 Naïve/Effector scores, calculated from a subcohort of 54 individuals, showed no notable differences across groups. These findings suggest that effective management of immune-inflammatory responses may play a role in achieving extreme longevity. Studying models of healthy aging and exceptional longevity is crucial to understanding a possible longevity signature, as most show resistance to age-related diseases. In particular, semi- and supercentenarians are a highly selected group, having survived significant adversities, including the Spanish flu and COVID-19 pandemics, indicating distinctive immune system characteristics. This paper analyzes the inflammatory scores (INFLA-score, Systemic Inflammation Response Index (SIRI)) and Aging-Related Immune Phenotype (ARIP) indicators calculated from the dataset of the DESIGN project, including 249 participants aged 19–111 years, aiming to understand the immune-inflammatory (IMFLAM) role in achieving longevity. Statistical analyses, including linear regression and one-way ANOVA, were performed to explore the correlations between these parameters and age. Both INFLA-score and SIRI showed a significant increase with age. However, no statistical differences were found when comparing the values of semi- and supercentenarians to other age groups, which are similar to adults and lower than younger centenarians. Regarding ARIP values, it is noteworthy that when comparing the CD8+ Naïve/Effector scores between groups, no significant differences were observed between the semi- and supercentenarian group and the other groups. These results support the idea that the control of IMFLAM response can promote extreme longevity. [ABSTRACT FROM AUTHOR]

In recent years, the public health system of the United Kingdom, the National Healthcare System (NHS), has encountered difficulties that have been acknowledged in research studies and public policy discussions, such as resignations and staff shortages. During the COVID-19 pandemic, NHS healthcare workers were confronted with demanding circumstances, exacerbating the constraints of an already struggling system. With this, the authors of this paper aim to better understand the relationships between frustration at work, fear of infection, working hours, and the turnover intention of healthcare workers during the pandemic. This study employed a mixed-methods research approach, as a questionnaire survey was conducted along with an online self-administered interview questionnaire. Using mediation and moderated mediation analyses, it was found that the indirect effect of frustration at work through fear of infection on turnover intention was positively significant. Working hours moderated the mediation effect of fear of infection on the relationship between frustration at work and turnover intention. Surprisingly, the conditional indirect effect of frustration at work on turnover intention through fear of infection was the strongest among those with short working hours. This evidence was supplemented with qualitative results that enhance the understanding of why healthcare workers want to leave the system and the actions that can be taken on the organisational and policy fronts to address this issue. [ABSTRACT FROM AUTHOR]

This study aimed to examine the relationship between resilience and the hope levels of healthcare workers who have experienced the COVID-19 pandemic, the effects of resilience and gender on individual performance, the effects of hope levels on individual performance, and aimed to determine whether hope mediated the effect of resilience on individual performance. This was a descriptive cross-sectional study. The psychological resilience, hope, and individual performance of healthcare workers affiliated with the Istanbul Provincial Health Directorate were obtained from online questionnaires completed by participants between April 2021 and August 2021. This purpose was served by the Brief Resilience Scale, the continuous hope scale, and the Individual Performance Scales. A hierarchical regression analysis, mediation analysis, and moderation analysis were performed on 412 healthcare workers to test the hypotheses. There was a significant relationship between resilience and hope levels among healthcare professionals. Healthcare professionals' levels of resilience and hope also had significant effects on their individual performance. The indirect effect of healthcare professionals' psychological resilience levels on their individual performance through hope was not significant. Gender also had a significant effect on resilience, hope, and agency thinking. Men's mean scores for resilience, hope, and agency thinking are higher than women's. The findings show that employees with high hope and resilience are more likely to recover from stressful situations and display better individual performance. This study has significant implications for the advancement of the field of psychosocial assessment of healthcare workers in times of health crisis. It offers both a practical and a theoretical perspective on the effects of hope and resilience on employee performance as psychological capital that can help all healthcare managers and employees, especially in times of crisis such as the COVID-19 pandemic. It can be said that hope is more important than resilience in terms of its propensity to enhance individuals' performance. Our findings suggest that employees with high levels of hope and resilience are more likely to recover from stressful situations and achieve better personal performance. Organizations should focus more on hope and resilience by promoting positive attitudes among employees and managers to improve their ability to cope with crises. [ABSTRACT FROM AUTHOR]

Emotional intelligence (EI) is increasingly recognized as a key factor in healthcare, where managing emotions is vital for job satisfaction, productivity, and interpersonal relationships. For nurses, particularly during the COVID-19 pandemic, EI plays a pivotal role in navigating emotional challenges and improving their quality of work life (QoWL). This study examined how EI moderates the relationship between nurses' preparedness to care for COVID-19 patients and their QoWL. A cross-sectional, correlational design was used, involving 267 nurses from various healthcare settings. Data were collected through the Emotional Intelligence Scale, the Quality of Nursing Work Life survey, and demographic questionnaires. The sample was predominantly female (94.4%), with a mean age of 37.47 years (SD = 8.09) and an average of 8.43 years of experience (SD = 6.33). Most nurses (87.3%) attended COVID-19-related workshops, with 76.4% feeling prepared to care for COVID-19 patients. Emotional intelligence levels were high, with 93.6% of nurses reporting good personal competence and 85.4% reporting good social competence. Descriptive results showed that 71% of nurses perceived their QoWL as good, while 29% rated it as fair. Pearson correlation analysis revealed significant positive correlations between both personal competence (r = 0.33, p < 0.001) and social competence (r = 0.34, p < 0.001) with QoWL, but preparedness to care for COVID-19 patients did not correlate significantly with either EI or QoWL. Hierarchical regression analysis demonstrated that, although nurses' preparedness alone did not predict QoWL (β = 0.034, p = 0.57), including emotional intelligence as a moderator explains 41% of the variance in QoWL. Both personal (β = 0.578, p < 0.001) and social competence (β = 0.665, p < 0.001) components of EI had significant buffering effects on the relationship between preparedness and QoWL. These findings suggest that fostering EI in nurses can enhance their resilience and improve their work life quality, particularly in high-stress healthcare environments like those experienced during the pandemic. [ABSTRACT FROM AUTHOR]

Longitudinal research into the impact of COVID-19 on university students' mental health beyond the pandemic is lacking. This study aims to address the gap in the literature by tracking the mental health of university students over a two-year period, spanning the COVID-19 pandemic and its aftermath. A two-year longitudinal study surveyed a sample of university students (n = 302) three times between May 2020 and May 2022. Students' psychological distress, generalised anxiety, flourishing, and personal wellbeing were assessed at each time point. It was found that students' psychological distress levels spiked in May 2021 (T1) during the first year of the pandemic but reverted back to similar levels seen in May 2020 (T0) at the two-year follow-up (T2). While generalised anxiety gradually improved, both students' psychological distress and generalised anxiety remained considerably worse than pre-pandemic norms obtained in other studies. Students' flourishing scores remained very low, while their life satisfaction and state happiness improved slightly between May 2021 (T1) and May 2022 (T2). These findings clearly demonstrate that students' mental health is still in crisis, even after the COVID-19 pandemic. More needs to be done to support students beyond the pandemic generally, including this particularly unique cohort of students who endured unprecedented challenges for prolonged periods, and who are now transitioning into the working world. Practical implications and recommendations are discussed. [ABSTRACT FROM AUTHOR]

This study explored changes in leisure styles among adults during the periods before (2019), during (2020–2022), and after (2023) the COVID-19 pandemic. A quantitative, cross-sectional, and exploratory design was employed using a non-probabilistic sample of 300 participants aged 18–60 years (mean age = 31.7 ± 10.8). Data were collected via an online survey using the Leisure Practices Scale, which measures engagement in artistic, manual, physical activity, intellectual, social, touristic, virtual, and contemplative practices. The results showed a significant increase in intellectual activities between the pre- and during-pandemic periods (p = 0.05), with the level of engagement remaining high in the post-pandemic period. Similarly, virtual activities demonstrated a significant increase in engagement between the pre- and during-pandemic periods (p = 0.00), returning to pre-pandemic levels afterward. Artistic (p = 0.91), manual (p = 0.60), and contemplative (p = 0.52) activities showed no significant changes, remaining stable across the analyzed periods. Significant reductions were observed in physical (p = 0.00), social (p = 0.05), and touristic (p = 0.04) activities during the pandemic, with the latter two returning to pre-pandemic levels afterward. These findings underscore the pandemic's differentiated impact on leisure practices. [ABSTRACT FROM AUTHOR]

The increasing integration of digital technologies into daily life, particularly during the COVID-19 pandemic, has raised concerns about internet and social media addictions and their potential impact on mental health. This study aimed to examine the prevalence of internet and social media addictions among adults in Cyprus in the post-pandemic period and explore their relationship with demographic characteristics, mental well-being (i.e., depression, anxiety, and stress), and self-esteem. Participants included 502 adults from Cyprus recruited using the convenience and snowball sampling methods. The data were collected via an internet-based questionnaire that examined participants' levels of internet addiction, social media addiction, mental well-being, and self-esteem. The results suggest that (a) while the prevalence of severe addiction was low for both internet and social media addictions, approximately one-third of participants exhibited mild to moderate levels of addiction; (b) younger adults, particularly those between 18 and 28 years of age, were more prone to problematic online behaviors; (c) internet and social media addictions were positively associated with depression, anxiety, and stress and negatively associated with self-esteem; and (d) stress was found to be a significant predictor of both internet and social media addictions, while self-esteem acted as a protective factor against problematic use. These findings highlight the enduring mental health implications of increased digital engagement and emphasize the need for targeted interventions to promote healthy online behaviors, manage stress, and enhance self-esteem. [ABSTRACT FROM AUTHOR]

Research on the impact of the COVID-19 pandemic on the Roma community consistently demonstrates that it has exacerbated pre-existing social exclusion and marginalization. However, few studies have specifically addressed the transformative actions or strategies that helped to mitigate these adverse effects. This study aimed to identify and analyze transformative elements through a systematic review, following PRISMA guidelines. The search was conducted across Web of Science, SCOPUS, and Google Scholar, yielding 995 records, of which 46 were included in the final phase and 25 in our synthesis. Our analysis focused on community-led initiatives that addressed inequalities, particularly when Roma community members were involved in the design of solutions or took on mediation roles. The results underscore the critical importance of inclusive, community-driven actions in overcoming structural barriers and promoting long-term resilience within Roma communities during the pandemic. [ABSTRACT FROM AUTHOR]

The recent COVID-19 pandemic has fundamentally changed the long-established approach to death. Among the workers who suffered most from the effects of this new situation are those in death care, who had to take care of the disposal of bodies throughout the pandemic. This study explores the experiences of these professionals to better understand the difficulties they faced in their daily work during the first wave of the pandemic. The narratives of 29 Italian death care professionals were collected. The data were analysed using Template Analysis, and four main themes were identified: the changes in funeral practices, the management of the increased workload, stigmatisation and a lack of support. The results of this study have also shown that institutions and the public know too little about the death care system, a factor that significantly influenced the difficulties faced by these professionals in coping with the pandemic. [ABSTRACT FROM AUTHOR]

Introduction: Public health disinformation is a significant problem as demonstrated by the recent scientific literature on the COVID-19 pandemic. However, further studies that analyse the presence of the disinformation mitigation strategies in public health initiatives within specific contexts and which contains a multidimensional approach (gender, social and environmental) are required. Evidence shows that disinformation, information overload, misinformation or fake news on health issues are also influenced by these issues. Objective: The inclusion of the health disinformation dimension within national public implemented by the governments of Argentina and Spain before, during and after the COVID-19 pandemic. Additionally, this paper incorporated a gender-based approach and social and environmental determinants in order to identify the limitations of these initiatives and offer certain recommendations. We conducted a descriptive, qualitative and quantitative study, as well as content analysis. We focused on documents from the websites of the national health ministries of Argentina and Spain, and digital repositories of regulations at the national level. Various strategies for systematic searches on government websites were designed and implemented. This included manual searches on Google. The first step involved a general analysis of all documents found by the searches, followed by a qualitative analysis of the documents that were related to health issues. Based on this work, a comprehensive and flexible framework of (pre-established and emerging) dimensions and categories of health disinformation and infodemics was generated. Results. The work was based on a total of 202 documents (both downloadable information and information included in websites); 117 for Argentina and 85 for Spain. Of the total, 60.9% were published during the COVID-19 pandemic. In the second stage of the analysis, 55 texts were selected for Argentina and 47 for Spain. In both countries, the central communications approach used was disinformation and/or infodemics (although definitions such as fake news were also used). They were mainly linked to the COVID-19 pandemic, but other emerging health problems were also detected to a lesser degree. However, disinformation (or a related concept) was prominently present in only 17 documents in Argentina and 3 documents in Spain. In terms of document type, working materials were foremost in Argentina (44.4%) and Spain (37.6%), with little presence of policy, regulatory and evaluation documents (only 5). Gender binary language was predominantly used in these texts. Vulnerable groups and social determinants were poorly included. Environmental determinants were mentioned in conjunction with health disinformation in only one paper on the use of plastics and its impact on human health in Argentina, and in another paper from the Global Summit on Climate and Health in Spain. Conclusions: Based on the document analysis, the inclusion of health disinformation within public actions in both countries before, during and after the COVID-19 pandemic, was detected. However, different limitations were observed: it was clear that the problem was strongly linked to the health emergency and did not extend much beyond that. Health disinformation was secondary and did not play a key role in public policy nor did it have greater institutional importance. Limitations were also detected in terms of gender perspectives, vulnerable groups and social and environmental determinants linked to health disinformation, displaying a reductionist approach. Based on these results, this paper makes certain policy recommendations. [ABSTRACT FROM AUTHOR]

Social media may have the double potential to support and undermine mental health, and research is needed to investigate these relationships in age-specified populations. The purpose of this study was to investigate associations between the use of social media and psychological distress among older adults (60 years and above) both nine and 19 months after the outbreak of the COVID-19 pandemic. An online repeated cross-sectional survey was conducted in Australia, Norway, the United Kingdom, and the United States. Participants (9 months: n = 679; 19 months: n = 238) reported the extent of social media use, motives for using social media, and level of psychological distress using the 12-item version of the General Health Questionnaire (GHQ-12). The data were analysed with descriptive analyses, independent t-tests and multiple linear regression analyses. Time spent on social media was not associated with psychological distress. Higher psychological distress was associated with higher scores on using social media to 'reduce loneliness' at both measurement points. At nine months, higher psychological distress was associated with higher scores on using social media for 'entertainment', but the association was not statistically significant at 19 months. Psychological distress was associated with the motive to 'maintain relationships' at 19 months, but not at nine months. Guidance for older adults' use of social media should emphasise how they can be used to promote communication and maintain existing relationships. [ABSTRACT FROM AUTHOR]

Background: There are still discrepancies in the literature as to whether COVID-19 infection could impact biochemical, anthropometric, and cardiovascular markers. The purpose of this study was firstly to observe the effects of COVID-19 infection over 12 months on Type 2 diabetes (T2D) and obesity. Secondarily, we analyzed the individual influence of COVID-19 infection on changes in biochemical, anthropometric, and cardiovascular markers. Methods: This study is part of a secondary analysis of a recently published article. The research involved 84 participants with T2D, divided into two groups: the control group (40 participants) received only medical care, while the intervention group (44 participants) received both medical care and nutritional assessment. Consultations were held quarterly over 12 months, with a follow-up after 3 months. Data Analysis: For influence analysis, non-normal variables were compared using the Mann–Whitney test, and normal variables were compared using unpaired t-tests. For all cases, α = 0.05 and p < 0.05 were considered significant. Results: The analysis revealed a high percentage of patients in both groups who had a COVID-19 infection (70% control and 72.7% intervention) over 12 months. Regarding the influence analysis, participants in the intervention group who were infected with COVID-19 showed smaller reductions in glycated hemoglobin (HbA1c) (p = 0.0120) and systolic blood pressure (SBP) (p = 0.0460). For the other biochemical, anthropometric, and cardiovascular markers, in both groups, no significant differences were found (p > 0.05). Conclusion: COVID-19 possibly influenced SBP and HbA1c levels over 12 months in people with T2D and obesity. However, caution should be exercised in generalizing these results due to the limitations of this study. Additionally, influence analysis does not establish a causal relationship, and more clinical trials in different populations are needed to fully analyze this topic. [ABSTRACT FROM AUTHOR]

Businesses are leveraging digital technology through e-commerce platforms as a strategy to continue operating following the movement control order (MCO). Online shopping, a subset of e-commerce platforms, allows consumers to browse, select, and purchase products using digital interfaces. Unfortunately, there is a lack of understanding of how this platform can impact customer behavior. Therefore, this study aims to develop new knowledge of customer behavior and assess the relationship between consumer behavior and e-service quality in online shopping to better understand the e-service quality provided by the vendor in Malaysia. A novel model of e-service quality and consumer behavior has been developed and investigated. Survey questionnaires were distributed and tested using structural equation modeling (SEM) to 200 customers who had experienced online shopping during COVID-19. The finding revealed that website design, security/privacy, and fulfillment are statistically correlated with e-service quality. However, customer service is not significantly correlated with e-service quality. Meanwhile, the quality of e-services is statistically significantly related to customer behavior. This study shows that e-service quality can provide good customer behavior post-COVID-19. Online shopping is therefore predicted to boost the economy of the country, but consumers also want high-quality e-services to continue. Retailers can improve their storefronts, engage customers, and promote responsible consumption. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has not just gently nudged but forcefully thrust environmental issues into the forefront of public consciousness. This shift in awareness has been a long-time aspiration of conservation scientists, who have played a crucial role in advocating for recognizing nature's contributions to human life and a healthy environment. I explain the advantages of using newly available tools and sources of digital data, i.e., the absolute search volume in Google using the flag keywords biodiversity, climate change, and sustainability, Τhe GDELT Project, which monitors the world's broadcast, print, and web news, and the difference-in-differences method comparing paired samples of public interest before and after the pandemic outbreak. We focus on the case of UK citizens' public interest. Public interest in the flag keywords in the UK showed a highly significant increase during the pandemic. The results contradict hypotheses or findings presented elsewhere that the public interest is attenuated during and because of the public health crisis. I support growing public awareness of the existential risks springing from human materialism misappropriating nature, environment, and resources. In conclusion, I advocate for a "new conservation narrative" that could be fostered by the increased public interest in environmental topics during the pandemic. [ABSTRACT FROM AUTHOR]

Social media platforms, such as Twitter (X), have a critical role in disseminating health information. The study aims to highlight the potential of Twitter (X) as an influential tool for health communication, in addition to providing findings related to public health communication strategies in Ghana. The study investigated the role of Twitter (X) as a platform for building interactive health communication between the health communication system and citizens in Ghana during the COVID-19 pandemic of 2020–2022. Additionally, it has the potential to contribute to building dialogical health communication. The study analyzed a sample of COVID-19-related tweets from the official Ghana Health Service Twitter (X) account @_GHS from 2020 to 2022. The results showed that Twitter (X) was a key tool for health communication during the COVID-19 pandemic in Ghana, with both health institutions and the public sharing large amounts of health information. Furthermore, the study found evidence of dialogic communication, in which healthcare institutions and professionals are actively engaging with the public on Twitter (X). It concluded that public health communication on Twitter (X) has changed over time, as well as that the interactive health communication between the health communication system and citizens in Ghana was affected positively during the COVID-19 outbreak. It highlighted Twitter (X)'s potential as a tool for establishing a dialogue loop and building dialogic health communication. The results showed that before COVID-19, Ghana did not use Twitter (X) effectively to communicate with citizens about health matters. Twitter (X), with its wide reach and highly interactive nature through features such as retweets, has become a major platform for interactions facilitating dialogue between health institutions and health professionals and facilitating dialogue in public spaces surrounding health issues like COVID-19. [ABSTRACT FROM AUTHOR]

This paper examines the ethical implications of healthcare resource allocation during the first wave of COVID-19 in Italy, from 21 February to 31 May 2020, with a focus on the utilitarian principles that prioritized age-based resource allocation. By comparing this approach to an ontological personalist bioethics framework, the study aims to offer a more equitable strategy for healthcare allocation applicable to any pandemic. Data from governmental reports, healthcare policies, and ethical guidelines were analyzed, revealing that Italy's utilitarian method led to significant ethical concerns, particularly regarding age discrimination. In contrast, the ontological personalist approach emphasizes the dignity and intrinsic worth of each individual, irrespective of age or health condition. The findings demonstrate that this personalist framework fosters a more balanced and fair allocation of resources, respecting human dignity and offering a universally applicable alternative to age-based prioritization. Ultimately, the study suggests that integrating ontological personalist principles into healthcare policies could enhance ethical decision-making in future pandemics, ensuring that resource allocation practices align more closely with human rights and individual dignity. [ABSTRACT FROM AUTHOR]