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Background: The quality of recording and documentation of deteriorating patient management by health professionals has been challenged during the COVID-19 pandemic. Non-adherence to escalation and documentation guidelines increases risk of serious adverse events. Electronic health record (EHR)-integrated dashboards are auditing tools of patients' status and clinicians' performance, but neither the views nor the performance of health professionals have been assessed, relating to management of deteriorating patients., Objective: To develop and evaluate a real-time dashboard of deteriorating patients' assessment, referral and therapy., Settings: Five academic hospitals in the largest National Health Service (NHS) trust in the UK (Barts Health NHS Trust)., Intervention: The dashboard was developed from EHR data to investigate patients with National Early Warning Score (NEWS2)>5, assessment, and escalation of deteriorating patients. We adopted the Plan, Do, Study, Act model and Standards for Quality Improvement Reporting Excellence framework to evaluate the dashboard., Design: Mixed methods: (1) virtual, face-to-face, interviews and (2) retrospective descriptive EHR data analysis., Results: We interviewed three nurses (two quality and safety and one informatics specialists). Participants perceived the dashboard as a facilitator for auditing NEWS2 recording and escalation of care to improve practice; (2) there is a need for guiding clinicians and adjusting data sources and metrics to enhance the functionality and usability. Data analysis (2019-2022) showed: (1) NEWS2 recording has gradually improved (May 2021-April 2022) from 64% to 83%;(2) referral and assessment completion increased (n: 170-6800 and 23-540, respectively)., Conclusion: The dashboard is an effective real-time data-driven method for improving the quality of managing deteriorating patients. Integrating health systems, a wider analysis NEWS2 and escalation of care metrics, and clinicians' learning digital solutions will enhance functionality and experience to boost its value. There is a need to examine the generalisability of the dashboard through further validation and quality improvement studies., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Gene-editing technologies, including the widespread usage of CRISPR endonucleases, have the potential for clinical treatments of various human diseases. Due to the rapid mutations of SARS-CoV-2, specific and effective prevention and treatment by CRISPR toolkits for coronavirus disease 2019 (COVID-19) are urgently needed to control the current pandemic spread. Here, we designed Type III CRISPR endonuclease antivirals for coronaviruses (TEAR-CoV) as a therapeutic to combat SARS-CoV-2 infection. We provided a proof of principle demonstration that TEAR-CoV-based RNA engineering approach leads to RNA-guided transcript degradation both in vitro and in eukaryotic cells, which could be used to broadly target RNA viruses. We report that TEAR-CoV not only cleaves SARS-CoV-2 genome and mRNA transcripts, but also degrades live influenza A virus (IAV), impeding viral replication in cells and in mice. Moreover, bioinformatics screening of gRNAs along RNA sequences reveals that a group of five gRNAs (hCoV-gRNAs) could potentially target 99.98% of human coronaviruses. TEAR-CoV also exerted specific targeting and cleavage of common human coronaviruses. The fast design and broad targeting of TEAR-CoV may represent a versatile antiviral approach for SARS-CoV-2 or potentially other emerging human coronaviruses., (© The Author(s) 2022. Published by Oxford University Press on behalf of Nucleic Acids Research.)

Building and its environment are in focus owing to health impact attributed to indoor air quality. This study was carried out to assess indoor air quality in terms of particulate matter (PM) and carbon dioxide in a residential building, during COVD-19 pandemic lockdown from March 25 to April 23, 2020, Abha, Saudi Arabia. The PM concentration range for kitchen, bedroom, and hall were 40,000-81000 μg/m 3 (PM 0.3 ), 15,000-26000 μg/m 3 (PM 0.5 ), 4000-6000 μg/m 3 (PM 1 ), 1100-1500 μg/m 3 (PM 2.5 ), 160-247 μg/m 3 (PM 5 ), and 60-95 μg/m 3 (PM 10 ). The results of this study suggest that bedroom needs to be ventilated as CO 2 concentration was reaching 700 ppm during sleep hours. PM concentration was exceeding 300 μg/m 3 (unhealthy) for all particle sizes of PM 0.3 , PM 0.5 , PM 1 , and PM 2.5 except for PM 10 which was also above safe limits (0-50 μg/m 3 ). Also, with influential habit (aromatic smoke), these concentrations increased 2-28 times for PM. The hazard quotient value greater than 1 revealed potential health risk to the inhabitants. Hence, future studies are needed for developing indoor air quality guidelines for residential buildings in Saudi Arabia and better planning and management of energy consumption., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective: Our study aims to evaluate the impact of a stay-at-home order on stroke metrics during the 2019-novel coronavirus (COVID-19) pandemic., Methods: Data on baseline characteristics, stroke subtype, initial National Institutes of Health Stroke Scale (NIHSS) score, the time between last known well (LKW) to emergency department (ED) arrival, tissue plasminogen activator (tPA) administration, the involvement of large vessel occlusion (LVO), and whether mechanical thrombectomy (MT) was pursued in patients with acute stroke were extracted from 24 March to 23 April 2020 (the time period of a stay-at-home order was placed due to the COVID-19 pandemic as the study group) at a tertiary care hospital in West Michigan, USA, compared with data from 24 March to 23 April 2019 (control group)., Results: Our study demonstrated a reduction in cases of acute ischemic stroke (AIS), although this did not reach statistical significance. However, there was an increase in hemorrhagic stroke (7.5% controls vs. 19.2% study group). The age of stroke patients was significantly younger during the period of the stay-at-home order compared to the control group. We identified a significant overall delay of ED arrivals from LKW in the study group. Additionally, an increased number of AIS patients with LVO in the study group (34.8%) was found compared to the control group (17.5%). A significantly increased number of patients received MT in the study group. Additionally, 11 patients were COVID-19 PCR-positive in the study group, 10 with AIS and only 1 with hemorrhagic stroke. Patients with COVID-19 had a high incidence of atrial fibrillation and hyperlipidemia. One AIS patient with COVID-19 rapidly developed cytotoxic edema with corresponding elevated inflammatory biomarkers. No statistical significance was noted when stroke subtype, LVO, and MT groups were compared., Conclusions: There was a trend of decreasing AIS admissions during the COVID-19 pandemic. There was also a significantly increased number of AIS patients with LVO who received MT, especially those with COVID-19. We conclude that cytokine storm resulting from SARS-CoV-2 infection might play a role in AIS patients with COVID-19., (© 2020 The Author(s) Published by S. Karger AG, Basel.)

The COVID-19 pandemic has had a significant impact on spread of the coronavirus disease. Currently, valuation and analysis of COVID-19 is a trending topic in the research industry that has been explored deeply. Many researches have been done in the selected time frame so far that evaluated the damages within the given conditions through different approaches. In our Study by taking certain parameters, we have deduced the direct relationship between spread of COVID-19 and the probable factors. This will be going to help researchers and stakeholders of the healthcare system to understand the pandemic in a better way, which may lead to potential enhancements that can be done in this field to counter this pandemic in a smarter way.

The current global health crisis is a consequence of the pandemic caused by COVID-19. It has impacted the lives of people from all factions of society. The re-emergence of new variants is threatening the world, which urges the development of new methods to prevent rapid spread. Places with more extensive social dealings, such as offices, organizations, and educational institutes, have a greater tendency to escalate the viral spread. This research focuses on developing a strategy to find out the key transmitters of the virus, particularly at educational institutes. The reason for considering educational institutions is the severity of the educational needs and the high risk of rapid spread. Educational institutions offer an environment where students come from different regions and communicate with each other at close distances. To slow down the virus's spread rate, a method is proposed in this paper that differs from vaccinating the entire population or complete lockdown. In the present research, we identified a few key spreaders, which can be isolated and can slow down the transmission rate of the contagion. The present study creates a student communication network, and virus transmission is modeled over the predicted network. Using student-to-student communication data, three distinct networks are generated to analyze the roles of nodes responsible for the spread of this contagion. Intra-class and inter-class networks are generated, and the contagion spread was observed on them. Using social network strategies, we can decrease the maximum number of infections from 200 to 70 individuals, with contagion lasting in the network for 60 days. [ABSTRACT FROM AUTHOR]

Introduction: As coronavirus disease 2019 (COVID-19) is a new disease which has ruining and dismantling the harmony of people internationally, its development and spread, creates turmoil, nervousness and dread among worldwide. Aim: To evaluate seriousness of peritraumatic problems among southern Indian inhabitants during the COVID-19 pandemic. Methodology: A referral sampling technique was continued until a sufficient sample size was reached, while this self-administered survey catches insights about depression, fears, psychological change, evasion cognitive change, and collectively quantifies the stress on a scale of 0–60. Expressive factual examinations were utilized to sum up clear cut information and inferential measurable investigations included Chi-square tests and Pearson's correlations were done. Results: The study included only those participants who understood English and had access to the internet. Inconsequential outcomes were found among gender in which both male and female members frequently showed apprehension and nervousness about COVID-19. 44.8% tried not to watch the news on COVID-19 as they were excessively frightened and make frenzy to family members. 90.9% of participants with lower education levels were more stressed over the thought of getting COVID-19 when showing manifestations related with the novel corona virus, which was statistically significant. Conclusion: The current assessment shows that almost all the study participants have felt restless, uncomfortable and terrified of watching the news whilst stressed over appearances related with COVID-19 due to their greater access to information. [ABSTRACT FROM AUTHOR]

Background: The perioperative and intensive care management of COVID-19 patients that requires invasive airway management generating aerosols puts anesthesiologists at very high risk as compared to other health care professionals. This study was aimed to reduce the need for General Anesthesia and hence aerosol generation, by providing safe alternative in the form of peripheral nerve blocks whenever feasible in operation theatres hence reducing the risk of exposure to health care personnel and conserving oxygen during the pandemic. Methods: Patients scheduled for elective or emergency surgery during COVID-19 pandemic from April 2020 to June 2021 who were found eligible to receive an ultrasound guided peripheral nerve block were included in the study. All patients had their COVID-19 status checked before the surgery. Standard monitoring including NIBP, ECG, Sp02 were instituted in all patients. COVID-19 appropriate precautions were followed in all patients. Results: A total of 325 patients were enrolled in the study. During the study period 117 upper limb and 96 lower limb blocks were performed as sole anesthetic.92 truncal and 22 cervical blocks were performed in patients as addition to GA. Midazolam was the most common sedative and ropivacaine as most common local anesthetic used. Pneumothorax was the most common complication observed with Supraclavicular block. Conclusion:We conclude that peripheral nerve blocks are safer alternative to GA during COVID-19 pandemic. They reduce aerosol generation in the operating room and conserve important resources like oxygen which are in high demand especially during peak periods. Peripheral nerve blocks are preferred over general anesthesia in COVID- 19 patients where ever feasible. [ABSTRACT FROM AUTHOR]

The world has been waging a fight against the novel coronavirus (COVID-19) since December 2019. The current coronavirus crisis is a catastrophe affecting billions of families worldwide. So far, COVID-19 has wreaked havoc across the globe: by slowing down economic growth; decreasing global trade; hurting health sector; increasing unemployment and underemployment; reducing FDI and hurting the tourism sector. This study investigates the economic costs of COVID-19. By using descriptive analysis, this study shows that the major economic variables, such as economic growth, global trade, health sector, unemployment and underemployment, foreign direct investment and travel and tourism sector have significantly affected by COVID-19. [ABSTRACT FROM AUTHOR]

The existing finite natural resources have witnessed unsustainable usage in the past few years, especially for food production, with accompanying environmental devastation and ecosystem damage. Regrettably, the global population and consumption demands are increasing ceaselessly, leading to the need for more resources for food production, which could potentially aggravate the sustainability and ecosystem degradation issues, while stimulating drastic climate change. Meanwhile, the unexpected emergence of the COVID-19 pandemic and some implemented measures to combat its spread disrupted agricultural activities and the food supply chain, which also led to a reduction in ecosystem carbonization. This study sets out to explore policy framework and selected feasible actions that are being adopted during the COVID-19 pandemic, which could potentially reduce the emissions even after the pandemic to promote a resilient and sustainable agri-food system. In this study, we reviewed 27 articles that focus on the current state of the agri-food system in light of the COVID-19 pandemic and its impact on the decarbonization of the agroecosystem. This review has taken the form of a systematic methodology in analyzing the adoption and implementation of various measures to mitigate the spread of COVID-19 on the impact of the agri-food system and reduction in ecosystem degradation. Up to 0.3 Mt of CO 2 reduction from the agri-food system alone was reportedly achieved during the first 6 months of the pandemic in 23 European countries. The various adopted measures indicate that the circular economy approach is a panacea to achieve the needed sustainability in the agri-food system. Also, it dictates a need for a paradigm change towards improvement on localized food production that promotes sustainable production and consumption. • The recent emergence of the agro-food system nexus as impacted by COVID-19 is reviewed. • Feasible adoption of COVID-19 measures for agroecosystem decarbonization is explored. • The gaps and constraints in the adoption of the CE approach to the agro-food systems were uncovered. • Circular economy in agroecosystems a panacea to sustainable agri-food system. [ABSTRACT FROM AUTHOR]