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In the past, vast research has been conducted on biosensors and point-of-care (PoC) diagnostics. Despite rapid advances especially during the SARS-CoV-2 pandemic in this research field a low-cost molecular biosensor exhibiting the user-friendliness of a rapid antigen test, and also the sensitivity and specificity of a PCR test, has not been developed yet. To this end we developed a novel microfluidics based and handheld PoC device, that facilitates viral detection at PCR sensitivity and specificity in less than 40 min, including 15 min sample preparation. This was attained by incorporation of pulse controlled amplification (PCA), a method which uses short electrical pulses to rapidly increase the temperature of a small fraction of the sample volume. In this work, we present a low-cost PCA device with a microfluidic consumable intended for the use in a decentralized or home-setting. We used finite element analysis (FEA) simulations to display the fundamental principle and highlight the critical parameter dependency of PCA, such as pulse length and resistor shape. Furthermore, we integrated a simple and fast workflow for sample preparation and evaluated the limit of detection (LoD) for SARS-CoV-2 viral RNA, which is 0.88 copies/μL (=44 copies/reaction), and thus, comparable to conventional RT-qPCR. Additionally, target specificity of the device was validated. Our device and PCA approach enables cost-effective, rapid and mobile molecular diagnostics while remaining highly sensitive and specific., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Background. By 2023, 1,080,000 cases of COVID-19 have been reported in Harris County. Systemic inequity and vaccine hesitancy have contributed to COVID-19 disparities. Community Health Workers provide health education and instrumental support to alleviate health disparities among vulnerable communities. We conducted an analysis of Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis in June 2022 among a broad coalition of Community Health Work stakeholders to better understand the local landscape in the context of the COVID-19 pandemic. Methods. We recruited 33 community health workers and industry stakeholders in Harris County, Texas, to participate in the SWOT analysis. Participants were asked to describe their opinions on the SWOT facing the Community Health Work landscape and then rank the outcomes of the analysis to prioritize action. Results. A total of 19 themes were identified. Weaknesses included lack of respect and resources for Community Health Workers and poor coordination and capacity among the workforce infrastructure. Limited funding and lack of appreciation for Community Health Workers were deemed important threats. Diversity and community connection were critical strengths, and strong education, training, and raising awareness for community health work were considered opportunities to overcome identified weaknesses and threats. Discussion. Increased funding, greater coordination, greater respect, and amplified training can improve capacity for Community Health Workers and, therefore, improve public health outcomes for respiratory illness and viral infections such as COVID-19. This analysis helps fill an important research gap on the topic Community Health Workers responding to public health crises with racially disparate outcomes.

Aim: This study aimed to gain a better understanding of nursing/midwifery students' perspectives on a pedagogy of caring and online learning during the COVID-19 pandemic. In addition, it aimed to determine if the COVID-19 pandemic impacted students' perceptions and experience of online learning and students' desire to enter the nursing/midwifery workforce., Design: Mixed methods., Methods: A multi-centre cross-sectional survey of Australian nursing and midwifery students was undertaken to explore students' experience of learning during the COVID-19 pandemic., Results: There are several key findings from this study that may be relevant for the future delivery of undergraduate health education, students transitioning to practice and healthcare workforce retention. The study found that although students were somewhat satisfied with online learning during COVID-19, students reported significant issues with knowledge/skill acquisition and barriers to the learning process. The students reported feeling less prepared for practice and identified how clinical staff were unable to provide additional guidance and support due to increased workloads and stress. The textual responses of participants highlighted that connection/disconnection, empathy and engagement/disengagement had an impact on learning during COVID-19., Conclusion: Connection, engagement and isolation were key factors that impacted nursing students' online learning experiences. In addition, graduates entering the workforce felt less prepared for entry into practice due to changes in education delivery during COVID-19 that they perceived impacted their level of clinical skills, confidence and ability to practice as new graduate nurses/midwives., Patient or Public Contribution: Not applicable., Impact: Attention must be given to the transition of new graduate nurses and midwives whose education was impacted by pandemic restrictions, to support their professional career development and to ensure retention of future healthcare workforce. Connection, engagement and isolation were key factors that impacted nursing students' online learning experiences. Educators should consider how connection and engagement can be actively embedded in the online learning environment., (© 2024 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

Background: COVID-19 vaccination has been inconsistently associated with an increased risk of heavy menstrual bleeding in previous studies. This study aimed to assess the risk of heavy menstrual bleeding requiring hospital care following COVID-19 vaccination according to the number of doses received and the time elapsed since vaccination., Methods: Using comprehensive data of the French National Health Data System, we carried out a case-control study. Non-pregnant 15-50 years old women who had a hospital discharge diagnosis of heavy menstrual bleeding between May 12, 2021, and August 31, 2022 (cases) were randomly matched to up to 30 controls of same age, place of residence, social deprivation index, and contraceptive use profile at the date of case hospital admission (index date). Conditional logistic regression models were used to estimate the risk of hospital care for heavy menstrual bleeding associated with primary or booster doses and delay since last COVID-19 vaccination at index date, adjusting for socio-demographic characteristics, comorbidities, healthcare use indicators, and recent SARS-CoV-2 infection., Results: A total of 4610 cases and 89,375 matched controls were included (median age, 42 years). Compared to unvaccinated women, the risk of hospital care for heavy menstrual bleeding was increased in those having received a last dose of primary vaccination in the preceding 1-3 months (Odds Ratio, 1.20 [95% confidence interval, 1.07-1.35]). This association was marked among women residing in the most deprived municipalities (1.28 [1.07-1.52]) and those who were not using hormonal contraception (1.28 [1.11-1.48]). Assuming a causal relationship, a total of 103 cases [54-196] were estimated to be attributable to primary vaccination in France., Conclusion: These findings provide evidence of an increased risk of heavy menstrual bleeding during the three-month period following primary COVID-19 mRNA vaccination. No increased risk was found beyond 3 months after primary vaccination nor following booster doses., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Conflict of interest statement. None., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

We examined candidate biomarkers for efficacy outcomes in hospitalized COVID-19 patients who were treated with sirukumab, an IL-6 neutralizing antibody, in a randomized, double-blind, placebo-controlled, phase 2 trial. Between May 2020 and March 2021, 209 patients were randomized (sirukumab, n = 139; placebo, n = 70); 112 had critical COVID-19. Serum biomarkers were evaluated for the pharmacodynamic effect of sirukumab and for their potential prognostic and predictive effect on time to sustained clinical improvement up to Day 28, clinical improvement at Day 28, and mortality at Day 28. The absence of detectable IL-4 increase and smaller increases in CCL13 post-baseline were most significantly associated with better response to sirukumab (versus placebo) treatment for all clinical efficacy outcomes tested, especially in patients with critical COVID-19. These data suggest that patients with critical COVID-19 without detectable sirukumab-induced IL-4 levels are more likely to benefit from sirukumab treatment. ClinicalTrials.gov Identifier: NCT04380961., (© 2024. The Author(s).)

COVID-19 vaccination recommendations include healthcare workers (HCWs). We measured COVID-19 vaccine effectiveness (CVE) of the autumn 2023 dose against laboratory-confirmed SARS-CoV-2 infection in a prospective cohort study of 1,305 HCWs from 13 European hospitals. Overall CVE was 22% (95% CI: -17 to 48), 49% (95% CI: -8 to 76) before and -11% (95% CI: -84 to 34) after the start of BA.2.86/JN.1 predominant circulation. Autumn 2023 COVID-19 vaccination led to a moderate-to-low reduction in SARS-CoV-2 infection incidence in HCWs. Monitoring of CVE is crucial for COVID-19 prevention.

The COVID-19 pandemic led to a large global effort to sequence SARS-CoV-2 genomes from patient samples to track viral evolution and inform the public health response. Millions of SARS-CoV-2 genome sequences have been deposited in global public repositories. The Canadian COVID-19 Genomics Network (CanCOGeN - VirusSeq), a consortium tasked with coordinating expanded sequencing of SARS-CoV-2 genomes across Canada early in the pandemic, created the Canadian VirusSeq Data Portal, with associated data pipelines and procedures, to support these efforts. The goal of VirusSeq was to allow open access to Canadian SARS-CoV-2 genomic sequences and enhanced, standardized contextual data that were unavailable in other repositories and that meet FAIR standards (Findable, Accessible, Interoperable and Reusable). In addition, the portal data submission pipeline contains data quality checking procedures and appropriate acknowledgement of data generators that encourages collaboration. From inception to execution, the portal was developed with a conscientious focus on strong data governance principles and practices. Extensive efforts ensured a commitment to Canadian privacy laws, data security standards, and organizational processes. This portal has been coupled with other resources, such as Viral AI, and was further leveraged by the Coronavirus Variants Rapid Response Network (CoVaRR-Net) to produce a suite of continually updated analytical tools and notebooks. Here we highlight this portal (https://virusseq-dataportal.ca/), including its contextual data not available elsewhere, and the Duotang (https://covarr-net.github.io/duotang/duotang.html), a web platform that presents key genomic epidemiology and modelling analyses on circulating and emerging SARS-CoV-2 variants in Canada. Duotang presents dynamic changes in variant composition of SARS-CoV-2 in Canada and by province, estimates variant growth, and displays complementary interactive visualizations, with a text overview of the current situation. The VirusSeq Data Portal and Duotang resources, alongside additional analyses and resources computed from the portal (COVID-MVP, CoVizu), are all open source and freely available. Together, they provide an updated picture of SARS-CoV-2 evolution to spur scientific discussions, inform public discourse, and support communication with and within public health authorities. They also serve as a framework for other jurisdictions interested in open, collaborative sequence data sharing and analyses.

Introduction: This study examined the effects of the coronavirus disease 2019 (COVID-19) pandemic on depression and suicidal ideation in community-dwelling elderly in Korea., Methods: Data were employed from a survey on elderly mental health in Jeollanam-do (southwest province in Korea), conducted by the Jeollanam-do Provincial Mental Health and Welfare Center. A total of 2423 people were recruited from all 22 cities in Jeollanam-do from April to October, 2021. We used self-reported questionnaires including sociodemographic factors, COVID-19-related stress, the Geriatric Depression Scale-Short Form Korean Version, the Multidimensional Scale of Perceived Social Support, the Satisfaction With Life Scale and the Brief Resilience Scale. Logistic regression was performed to examine the factors of depression and suicidal ideation., Results: Of the 2423 subjects, 622 (25.7%) reported depressive symptoms and 518 (21.4%) reported suicidal ideation. The multivariate logistic regression analysis revealed that living alone, poor perceived health status, worry of COVID-19 infection, and restriction of daily activities due to COVID-19 pandemic are significantly associated with depression. Female gender, poor perceived health status, inability to perform household chores, and depressive symptom are risk factors of suicidal ideation., Conclusion: These findings show that old age, negative perception of health, and restriction of daily activities due to COVID-19 are risk factors of depression in community-dwelling elderly in the context of the COVID-19 pandemic. Female gender, poor self-perceived health status, and depression increase the risk of suicidal ideation among the elderly. Social support and life satisfaction are protecting factors of both depression and suicidal ideation. Resilience decreased risk of depression but not in suicidal ideation., (© 2024 John Wiley & Sons Ltd.)

Background: Mouse models that recapitulate key features of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection are important tools for understanding complex interactions between host genetics, immune responses, and SARS-CoV-2 pathogenesis. Little is known about how predominantly cellular (Th1 type) versus humoral (Th2 type) immune responses influence SARS-CoV-2 dynamics, including infectivity and disease course., Methods: We generated knock-in (KI) mice expressing human ACE2 (hACE2) and/or human TMPRSS2 (hTMPRSS2) on Th1-biased (C57BL/6; B6) and Th2-biased (BALB/c) genetic backgrounds. Mice were infected intranasally with SARS-CoV-2 Delta (B.1.617.2) or Omicron BA.1 (B.1.1.529) variants, followed by assessment of disease course, respiratory tract infection, lung histopathology, and humoral and cellular immune responses., Findings: In both B6 and BALB/c mice, hACE2 expression was required for infection of the lungs with Delta, but not Omicron BA.1. Disease severity was greater in Omicron BA.1-infected hTMPRSS2-KI and double-KI BALB/c mice compared with B6 mice, and in Delta-infected double-KI B6 and BALB/c mice compared with hACE2-KI mice. hACE2-KI B6 mice developed more severe lung pathology and more robust SARS-CoV-2-specific splenic CD8 T cell responses compared with hACE2-KI BALB/c mice. There were no notable differences between the two genetic backgrounds in plasma cell, germinal center B cell, or antibody responses to SARS-CoV-2., Interpretation: SARS-CoV-2 Delta and Omicron BA.1 infection, disease course, and CD8 T cell response are influenced by the host genetic background. These humanized mice hold promise as important tools for investigating the mechanisms underlying the heterogeneity of SARS-CoV-2-induced pathogenesis and immune response., Funding: This work was funded by NIH U19 AI142790-02S1, the GHR Foundation, the Arvin Gottleib Foundation, and the Overton family (to SS and EOS); Prebys Foundation (to SS); NIH R44 AI157900 (to KJ); and by an American Association of Immunologists Career Reentry Fellowship (FASB)., Competing Interests: Declaration of interests CC, NS, and KJ were employees of Synbal, Inc. DOC is employed by and holds stock in TransViragen Inc., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Background: More than seven million people with intellectual and/or developmental disabilities (ID/DD) live in the US and may face an elevated risk for COVID-19., Objective: To identify correlates of COVID-19 and related hospitalizations among people with ID/DD in group homes in Massachusetts., Methods: We collected data during March 1, 2020-June 30, 2020 (wave 1) and July 1, 2020-March 31, 2021 (wave 2) from the Massachusetts Department of Public Health and six organizations administering 206 group homes for 1035 residents with ID/DD. The main outcomes were COVID-19 infections and related hospitalizations. We fit multilevel Cox proportional hazards models to estimate associations with observed predictors and assess contextual home- and organizational-level effects., Results: Compared with Massachusetts residents, group home residents had a higher age-adjusted rate of COVID-19 in wave 1 (incidence rate ratio [IRR], 12.06; 95 % confidence interval [CI], 10.51-13.84) and wave 2 (IRR, 2.47; 95 % CI, 2.12-2.88) and a higher age-adjusted rate of COVID-19 hospitalizations in wave 1 (IRR, 17.64; 95 % CI, 12.59-24.70) and wave 2 (IRR, 4.95; 95 % CI, 3.23-7.60). COVID-19 infections and hospitalizations were more likely among residents aged 65+ and in group homes with 6+ resident beds and recent infection among staff and residents., Conclusions: Aggressive efforts to decrease resident density, staff-to-resident ratios, and staff infections through efforts such as vaccination, in addition to ongoing access to personal protective equipment and COVID-19 testing, may reduce COVID-19 and related hospitalizations in people with ID/DD living in group homes., Competing Interests: Declaration of competing interest Dr. Levison is a medical advisor to eMED, LLC. Dr. Tsai receives a financial honorarium from Elsevier, Inc. for his work as Co-Editor in Chief of the Elsevier-owned journal SSM-Mental Health. Dr. Donelan is an unpaid board member of Bridges Associates Inc, a non-profit organization serving persons with intellectual and developmental disabilities. Dr. Becker is a current recipient of the American Academy of Child and Adolescent Psychiatry (AACAP) Junior Investigator Award supported by AACAP and Industry Sponsors (Sunovion Pharmaceuticals, Inc. and Supernus Pharmaceuticals, Inc.). Dr. Skotko occasionally consults on the topic of Down syndrome through Gerson Lehrman Group. He receives remuneration from Down syndrome non-profit organizations for speaking engagements and associated travel expenses. In the past two years, Dr. Skotko received annual royalties from Woodbine House, Inc., for the publication of his book, Fasten Your Seatbelt: A Crash Course on Down Syndrome for Brothers and Sisters. Within the past two years, he has received research funding from F. Hoffmann-La Roche, Inc., AC Immune, and LuMind Research Down Syndrome Foundation to conduct clinical trials for people with Down syndrome. Dr. Skotko is occasionally asked to serve as an expert witness for legal cases where Down syndrome is discussed. Dr. Skotko serves in a non-paid capacity on the Honorary Board of Directors for the Massachusetts Down Syndrome Congress and the Professional Advisory Committee for the National Center for Prenatal and Postnatal Down Syndrome Resources. Dr. Skotko has a sister with Down syndrome., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Although 6-month follow-up of patients with multisystem inflammatory syndrome in children (MIS-C) was reassuring, there is scant data on long-term sequelae, including whether changing variants affect clinical severity and outcomes., Methods: Children (<18 years of age) admitted to Great Ormond Street Hospital between April 4, 2020, and January 2023, meeting diagnostic criteria for MIS-C were included. Admission and follow-up data were categorized by the predominant SARS-CoV-2 circulating variant in the United Kingdom., Results: One hundred and sixty children [median age, 10.1 (interquartile range, 7.9-12.6) years] were included. There was no difference in the time of symptom onset to diagnosis between waves ( P =0.23) or hospitalization days across all waves ( P =0.32). Inflammatory markers were normal for up to 2 years in all patients except one. Eleven patients (6.9%) remain in follow-up: cardiology (n=5), gastroenterology (n=5) and nephrology (n=1). The main self-reported symptoms at 2 years were abdominal pain (n=5) and myalgia (n=2). Fatigue was present in approximately a quarter of patients at admission; this reduced to 14 (9%), (2%) and 1 (2%) at 6-month, 1-year and 2-year follow-ups, respectively. Chronic fatigue or long-COVID symptomatology was rare (n=1) even with high rates of concurrent Epstein-Barr virus positivity (49/134). All patients had sustained neurological recovery with no new neurological pathology observed., Conclusions: Patients with MIS-C have a sustained recovery, which is reassuring for positive long-term outcomes. Across waves, time from symptom onset to diagnosis and treatment, symptomatology and length of stay were similar. Sustained recovery is reassuring for clinicians and parents alike. Differentiating long-COVID symptomatology from that of MIS-C is important in formulating an individualized treatment plan., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Coronavirus disease 2019 (COVID-19) has rapidly escalated into a global pandemic that primarily affects older and immunocompromised individuals due to underlying clinical conditions and suppressed immune responses. Furthermore, COVID-19 patients exhibit a spectrum of neurological symptoms, indicating that COVID-19 can affect the brain in a variety of manners. Many studies, past and recent, suggest a connection between viral infections and an increased risk of neurodegeneration, raising concerns about the neurological effects of COVID-19 and the possibility that it may contribute to Alzheimer's disease (AD) onset or worsen already existing AD pathology through inflammatory processes given that both COVID-19 and AD share pathological features and risk factors. This leads us to question whether COVID-19 is a risk factor for AD and how these two conditions might influence each other. Considering the extensive reach of the COVID-19 pandemic and the devastating impact of the ongoing AD pandemic, their combined effects could have significant public health consequences worldwide., (© 2023 International Society for Neurochemistry.)

Background: The extent of the SARS-CoV-2 short-term evolution under Remdesivir (RDV) exposure and whether it varies across different upper respiratory compartments are not fully understood., Methods: Patients hospitalized for COVID-19, with or without RDV therapy, were enrolled and completed up to three visits, in which they provided specimens from four respiratory compartments. Near full-length genome SARS-CoV-2 sequences were obtained from viral RNA, standard lineage and variant assignments were performed, and viral mutations in the RNA-dependent RNA polymerase (RdRp) region-the RDV target gene-were detected and compared between participants with and without RDV, across the four compartments, within participants across visits, and versus a larger sequence dataset. The statistical analysis used a generalized linear mixed-effects model., Results: A total of 139 sequences were obtained from 37 out of the 44 (84%) enrolled participants. The genotyping success varied across respiratory compartments, which ranged from 42% with oropharyngeal specimens to 67% with nasopharyngeal specimens and showed improvement with higher viral loads. No RdRp mutations known to be associated with RDV resistance were identified, and for 34 detected mutations at 32 amino acid positions that are not known as RDV-associated, there was no evidence of any associations with the RDV exposure, respiratory compartment, or time. At least 1 of these 34 mutations were detected in all participants, and some differed from the larger sequence dataset., Conclusions: This study highlighted the SARS-CoV-2 short-term genomic stability within hosts and across upper respiratory compartments, which suggests a lack of evolution of RDV resistance over time. This contributes to our understanding of SARS-CoV-2 genomic dynamics.

Ultraviolet-C (UV-C) radiation and ozone gas are potential mechanisms employed to inactivate the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), each exhibiting distinct molecular-level modalities of action. To elucidate these disparities and deepen our understanding, we delve into the intricacies of SARS-CoV-2 inactivation via UV-C and ozone gas treatments, exploring their distinct molecular-level impacts utilizing a suite of advanced techniques, including biological atomic force microscopy (Bio-AFM) and single virus force spectroscopy (SVFS). Whereas UV-C exhibited no perceivable alterations in virus size or surface topography, ozone gas treatment elucidated pronounced changes in both parameters, intensifying with prolonged exposure. Furthermore, a nuanced difference was observed in virus-host cell binding post-treatment: ozone gas distinctly reduced SARS-CoV-2 binding to host cells, while UV-C maintained the status quo. The results derived from these methodical explorations underscore the pivotal role of advanced Bio-AFM techniques and SVFS in enhancing our understanding of virus inactivation mechanisms, offering invaluable insights for future research and applications in viral contamination mitigation.

An important aspect of microbiological surveillance is the ability to access live viruses for microneutralization assays, which enables the study of viral characteristics and mechanisms in vitro and production of positive controls for diagnostic methods. During the COVID-19 pandemic, the Public Health Agency of Sweden established a protocol for the rapid collection of clinical samples and subsequent isolation of novel virus variants.

Objective: Health care workers (HCW) experienced significant stress during the COVID-19 pandemic. This qualitative study describes how they contextualized the experience several years later., Methods: In August 2023, 1832 HCW at an academic medical center completed a confidential electronic survey; 443 of them responded to an open-ended question about their experiences during the pandemic. The statements were analyzed qualitatively, using a grounded theory approach to allow themes to emerge from the data., Results: Common themes included fear/anxiety (22%), burnout (15%), protecting family from risk (11%), lack of employer support (11%), fear of illness (8%), increased appreciation for life (8%), and exposure to death/illness (5%)., Conclusion: HCW experienced substantial stress during the pandemic. Mental health services and structural changes in the health care system are needed to protect HCW during future public health emergencies., Competing Interests: Conflict of interest: None declared., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American College of Occupational and Environmental Medicine.)

This chapter of the New York City Panel on Climate Change 4 (NPCC4) report considers climate health risks, vulnerabilities, and resilience strategies in New York City's unique urban context. It updates evidence since the last health assessment in 2015 as part of NPCC2 and addresses climate health risks and vulnerabilities that have emerged as especially salient to NYC since 2015. Climate health risks from heat and flooding are emphasized. In addition, other climate-sensitive exposures harmful to human health are considered, including outdoor and indoor air pollution, including aeroallergens; insect vectors of human illness; waterborne infectious and chemical contaminants; and compounding of climate health risks with other public health emergencies, such as the COVID-19 pandemic. Evidence-informed strategies for reducing future climate risks to health are considered., (© 2024 The Author(s). Annals of the New York Academy of Sciences published by Wiley Periodicals LLC on behalf of The New York Academy of Sciences.)

Purpose: Long COVID is a global health concern which has debilitating effects on the individual experiencing it. In the United Kingdom, psychological therapies are being offered to people with long COVID, although the evidence for these therapies is yet to be demonstrated. This research aimed to understand how therapists and clients define and understand recovery from long COVID, and use hope theory to interpret the results., Methods: An online Q-methodology was employed, where participants sorted a range of statements pertaining to long COVID recovery based on their level of agreement with them. These arranged statements (Q-sorts) were collated and factor analysed to explore and compare underlying perspectives., Results: Sixteen participants were recruited for the study, including eleven clients, four IAPT therapists and one therapist working in the broader long COVID pathway. A four-factor model is reported, including (1) Psychological Pathways to Recovery, (2) Social Context and Agency, (3) Physiological Goals of Recovery and (4) Personal Meaning Making. All IAPT therapists loaded onto the psychological pathways factor, whereas the remaining participants shared more diverse perspectives., Conclusions: The belief that long COVID recovery was possible, taken as an indicator of hopefulness, was rated highest for Factor 1, Psychological Pathways to Recovery, and Factor 3, Physiological Recovery Goals. This suggested that having a clear definition of recovery, or clear guidance on how to intervene, promoted hopefulness and, theoretically, well-being. However, clients reported experiences of being invalidated and disbelieved by health professionals, with psychological explanations sometimes being experienced as dismissive and invalidating. Clinical implications and future research directions are discussed., (© 2024 The Authors. British Journal of Health Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.)

Background: Cardiopulmonary resuscitation training is a mandatory competency, especially for healthcare professionals. However, the spread of COVID-19 caused a sharp decline in the number of participants on advanced life support training, thereby accelerating the diversification of educational methods. Gamification is an increasingly popular method of diversifying instruction, but its effectiveness remains controversial., Aim: To evaluate the effectiveness of gamification learning in advanced life support training., Design: A cluster randomized controlled trial., Setting: A single advanced life support training center., Participants: Clinical nurses who are currently practicing in a hospital., Methods: A part of the existing advanced life support course was gamified using Kahoot! platform. Conventional learning and gamified learning were each conducted 11 times, and the level of knowledge after training was assessed. The assessment questions were categorized into advanced life support algorithms, teamwork, and cardiac arrest rhythms., Results: A total of 267 were enrolled in the study, and 148 and 139 learners were assigned to CL and GL, respectively. There was no difference in post-training knowledge related to teamwork, and cardiac arrest rhythms between the conventional learning and gamified learning groups, but knowledge related to the advanced life support algorithm was low in the gamified learning group., Conclusions: Even if the learners are the same, advanced life support gamification training can lead to negative outcomes depending on the simplicity or goal of the training content. To improve the effectiveness of the training, various methods of gamification training should be applied depending on the goal and content of the training., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2024. Published by Elsevier Ltd.)

Background: Throughout the COVID-19 pandemic, first-line healthcare leaders across the healthcare system played crucial roles leading, motivating, and supporting staff., Purpose: This study aims to describe multidisciplinary first-line healthcare leaders' experiences during the COVID-19 pandemic in Ontario, Canada using transformational and crisis leadership theory., Methods: A descriptive two-phase (quantitative & qualitative) design was conducted in the spring of 2021. Phase 1 employed an online survey sent via email to first-line leaders from various sectors who were members of healthcare professional associations in Ontario. Participants included nurse managers, professional practice leaders (e.g., occupational and physiotherapists), advanced practice nurses, and clinical educators. In Phase 2, a subset (n  =  19) of the Phase 1 participants were interviewed to gain a deeper understanding of these leaders' experiences including role impact and support available. Semistructured individual interviews were conducted and recorded via Zoom©. Inductive and deductive analysis approaches identified key themes. This paper reports the qualitative findings from Phase 2., Results: Leaders' behaviors were representative of the key dimensions of transformational and complexity leadership theories. Recommendations for leading during a crisis included: engaging in self-care activities to manage the personal impact of the crisis; teamwork and collaborative leadership; and support from fellow first-line leaders and senior leaders. Findings can inform healthcare leadership education programs designed to manage future crises for both academic and practice settings., Conclusion: Descriptions of first-line healthcare leaders' roles and experiences during multiple waves of the COVID-19 pandemic validated their important contributions within various health sectors., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: To identify highest-risk subgroups for COVID-19 and Long COVID(LC), particularly in contexts of influenza and cardiovascular disease(CVD)., Methods: Using national, linked electronic health records for England (NHS England Secure Data Environment via CVD-COVID-UK/COVID-IMPACT Consortium), we studied individuals (of all ages) with COVID-19 and LC (2020-2023). We compared all-cause hospitalization and mortality by prior CVD, high CV risk, vaccination status (COVID-19/influenza), and CVD drugs, investigating impact of vaccination and CVD prevention using population preventable fractions., Results: Hospitalization and mortality were 15.3% and 2.0% among 17,373,850 individuals with COVID-19 (LC rate 1.3%), and 16.8% and 1.4% among 301,115 with LC. Adjusted risk of mortality and hospitalization were reduced with COVID-19 vaccination ≥ 2 doses(COVID-19:HR 0.36 and 0.69; LC:0.44 and 0.90). With influenza vaccination, mortality was reduced, but not hospitalization (COVID-19:0.86 and 1.01, and LC:0.72 and 1.05). Mortality and hospitalization were reduced by CVD prevention in those with CVD, e.g., anticoagulants- COVID:19:0.69 and 0.92; LC:0.59 and 0.88; lipid lowering- COVID-19:0.69 and 0.86; LC:0.68 and 0.90. COVID-19 vaccination averted 245044 of 321383 and 7586 of 8738 preventable deaths after COVID-19 and LC, respectively., Interpretation: Prior CVD and high CV risk are associated with increased hospitalization and mortality in COVID-19 and LC. Targeted COVID-19 vaccination and CVD prevention are priority interventions., Funding: NIHR. HDR UK., Competing Interests: Declarations of competing interest KK is chair of the ethnicity subgroup of the UK Scientific Advisory Group for Emergencies (SAGE) and is a member of SAGE. KK (Chair) and AB are members of the LC Research Group that reports to the Chief Medical Officer for England. All other authors declare no competing interests., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Post-COVID-19 condition in children is a still largely unknown syndrome with a diverse pattern of symptoms, which can have a major impact on daily life. Currently, there are no evidence-based proven treatments, and the focus is on symptom management and recovery of daily functioning. A multidisciplinary, tailored approach is recommended, with attention to energy management and activity building, where the main goal should be a return to baseline levels of cognitive, physical and social activity., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

COVID-19 remains a major public health concern. Monoclonal antibodies have received emergency use authorization (EUA) for pre-exposure prophylaxis against COVID-19 among high-risk groups for treatment of mild to moderate COVID-19. In addition to recombinant biologics, engineered synthetic DNA-encoded antibodies (DMAb) are an important strategy for direct in vivo delivery of protective mAb. A DMAb cocktail was synthetically engineered to encode the immunoglobulin heavy and light chains of two different two different Fc-engineered anti-SARS-CoV-2 antibodies. The DMAbs were designed to enhance in vivo expression and delivered intramuscularly to cynomolgus and rhesus macaques with a modified in vivo delivery regimen. Serum levels were detected in macaques, along with specific binding to SARS-CoV-2 spike receptor binding domain protein and neutralization of multiple SARS-CoV-2 variants of concern in pseudovirus and authentic live virus assays. Prophylactic administration was protective in rhesus macaques against signs of SARS-CoV-2 (USA-WA1/2020) associated disease in the lungs. Overall, the data support further study of DNA-encoded antibodies as an additional delivery mode for prevention of COVID-19 severe disease. These data have implications for human translation of gene-encoded mAbs for emerging infectious diseases and low dose mAb delivery against COVID-19.

Background: Selecting informative genes or eliminating uninformative ones before any downstream gene expression analysis is a standard task with great impact on the results. A carefully curated gene set significantly enhances the likelihood of identifying meaningful biomarkers., Method: In contrast to the conventional forward gene search methods that focus on selecting highly informative genes, we propose a backward search method, DenoiseIt, that aims to remove potential outlier genes yielding a robust gene set with reduced noise. The gene set constructed by DenoiseIt is expected to capture biologically significant genes while pruning irrelevant ones to the greatest extent possible. Therefore, it also enhances the quality of downstream comparative gene expression analysis. DenoiseIt utilizes non-negative matrix factorization in conjunction with isolation forests to identify outlier rank features and remove their associated genes., Results: DenoiseIt was applied to both bulk and single-cell RNA-seq data collected from TCGA and a COVID-19 cohort to show that it proficiently identified and removed genes exhibiting expression anomalies confined to specific samples rather than a known group. DenoiseIt also showed to reduce the level of technical noise while preserving a higher proportion of biologically relevant genes compared to existing methods. The DenoiseIt Software is publicly available on GitHub at https://github.com/cobi-git/DenoiseIt., (© 2024. The Author(s).)

Background: COVID-19 vaccines were key to controlling the pandemic and vaccination has been discussed extensively by the media and the public since 2020. We aimed to explore parents' attitudes towards routine childhood vaccination since COVID-19 and how the pandemic impacted their experiences of getting their child vaccinated., Methods: We used a mixed-methods approach-involving a questionnaire survey followed by focus groups. We partnered with The Mosaic Community Trust, an ethnic minority women's group based in a deprived area of North-West London, United Kingdom (UK) with historically low childhood vaccine uptake. Descriptive findings from the questionnaires were reported and chi-square analyses performed to examine differences by ethnicity. Thematic analysis of the free-text questionnaire responses and focus groups was undertaken, guided by the COM-B model of Capability, Opportunity, and Motivation., Results: Between Jun-Oct 2022, 518 parents completed the questionnaire (25% from ethnic minorities). Between March-May 2023 we held four focus groups with 22 parents (45% from ethnic minorities). Most parents (>90%) thought routine childhood vaccines for children were important. Over a third (38%) of all parents reported having more questions about childhood vaccines since COVID-19, though among parents belonging to an ethnicity group other than white, 59% said they had more questions compared to those of any white ethnicity group (30%, (p = <0.0001)). Difficulties accessing vaccine appointments were commoner reasons for children's vaccinations being delayed than parents increased concerns about vaccines. Since COVID-19 some parents felt vaccinations were even more important, and a very small minority felt the pandemic had made them mistrust vaccinations., Conclusion: Following COVID-19, we found parents remain confident in childhood vaccines. However, some parents, particularly from ethnic minority groups may have more questions about childhood vaccines than pre-pandemic. Post COVID-19, to address declining vaccine uptake, parents need easy access to healthcare professionals to answer questions about childhood vaccinations., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Skirrow et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: StandingTall uses eHealth to deliver evidence-based balance and functional strength exercises. Clinical trials have demonstrated improved balance, reduced falls and fall-related injuries and high adherence. This study aimed to evaluate the implementation of StandingTall into health services in Australia and the UK., Methods: Two hundred and forty-six participants (Australia, n = 184; UK, n = 62) were recruited and encouraged to use StandingTall for 2 h/week for 6-months. A mixed-methods process evaluation assessed uptake and acceptability of StandingTall. Adherence, measured as % of prescribed dose completed, was the primary outcome., Results: The study, conducted October 2019 to September 2021 in Australia and November 2020 to April 2022 in the UK, was affected by COVID-19. Participants' mean age was 73 ± 7 years, and 196 (81%) were female. Of 129 implementation partners (e.g. private practice clinicians, community exercise providers, community service agencies) approached, 34% (n = 44) agreed to be implementation partners. Of 41 implementation partners who referred participants, 15 (37%) referred ≥5. Participant uptake was 42% (198/469) with mean adherence over 6 months being 41 ± 39% of the prescribed dose (i.e. 39 ± 41 min/week) of exercise. At 6 months, 120 (76%) participants indicated they liked using StandingTall, 89 (56%) reported their balance improved (moderately to a great deal better) and 125 (80%) rated StandingTall as good to excellent. For ongoing sustainability, health service managers highlighted the need for additional resources., Conclusions: StandingTall faced challenges in uptake, adoption and sustainability due to COVID-19 and a lack of ongoing funding. Adherence levels were lower than the effectiveness trial, but were higher than other exercise studies. Acceptance was high, indicating promise for future implementation, provided sufficient resources and support are made available., Trial Registration: Australian and New Zealand Clinical Trials Registry ACTRN12619001329156., (© The Author(s) 2024. Published by Oxford University Press on behalf of the British Geriatrics Society.)

Background: Online learning during the COVID-19 pandemic is associated with unfavorable habitual upper body postures., Objective: This study explored whether adding a remedial exercise routine to an ergonomic advice intervention, delivered remotely, is helpful for reducing habitual postures of the neck, shoulders, and upper back., Design: Pragmatic randomized controlled trial., Methods: 42 male adolescent students, initially selected with a forward head posture, were randomized to one of two intervention groups: ergonomic advice alone or exercise + ergonomic advice. Outcome measures were specific postural angles of, measured by a photogrammetric profile technique using a bespoke app before and after the 8-week intervention period., Results: During online learning, most students used mobile phones (76%), while 35% used a table-chair-computer arrangement. At 8-week follow-up, a statistically significant reduction of forward head, shoulder protraction, and thoracic kyphosis angles was found in both groups (P < 0.001). However, the effect was significantly greater in the exercise + ergonomic advice group (P < 0.001): forward head, shoulder protraction, and thoracic kyphosis angles reduced by some 9, 6, and 5° respectively, compared with 4° for head and 2° for shoulder and thoracic angles for the ergonomic advice alone group., Conclusion: The results show that, a remedial online exercise routine is a beneficial addition to an ergonomic advice program for improving unfavorable habitual upper body postures. The impact of this intervention may extend beyond postural issues related just to online learning at home., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

The COVID-19 pandemic catapulted Telehealth to the forefront of Emergency Medicine (EM) as an alternative way of assessing and managing patients. This challenged the traditional idea that EM can only be practised within brick-and-mortar EDs. Many Emergency Physicians may find the idea of practising Telehealth in Emergency Medicine (TEM) confronting, particularly in the absence of training and clear practice guidelines. The purpose of the present paper is to describe the current use of TEM in Australasia, and outline the advantages and barriers in adopting this practice domain., (© 2024 Australasian College for Emergency Medicine.)

Purpose: To identify the impact of psychosocial factors on quality of life (QoL) of older adults hospitalized and isolated after contracting coronavirus disease 2019 (COVID-19)., Method: Data were collected between April 30 and June 18, 2022, from 117 discharged older adults who were in isolation for COVID-19 treatment in a tertiary hospital in South Korea., Results: Of participants, 33.3% were at high risk for posttraumatic stress symptoms (PTSS), and 21.4% of participants were identified as having severe depressive symptoms. Participants' QoL negatively correlated with PTSS, depressive symptoms, and fear of social stigma. Depressive symptoms were the primary psychosocial factor identified as significantly affecting QoL (β = -0.682, p < 0.001), and the explanatory power of the regression model was 41.2%., Conclusion: To enhance QoL of older adults who have experienced hospitalization and isolation due to COVID-19, identifying pertinent psychosocial factors, especially depressive symptoms, is necessary. [ Journal of Gerontological Nursing, 50 (8), 29-36.].

Immune responses to primary COVID-19 vaccination were investigated in 58 patients with follicular lymphoma (FL) as part of the PETReA trial of frontline therapy (EudraCT 2016-004010-10). COVID-19 vaccines (BNT162b2 or ChAdOx1) were administered before, during or after cytoreductive treatment comprising rituximab (depletes B cells) and either bendamustine (depletes CD4 + T cells) or cyclophosphamide-based chemotherapy. Blood samples obtained after vaccine doses 1 and 2 (V1, V2) were analysed for antibodies and T cells reactive to the SARS-CoV-2 spike protein using the Abbott Architect and interferon-gamma ELISpot assays respectively. Compared to 149 healthy controls, patients with FL exhibited lower antibody but preserved T-cell responses. Within the FL cohort, multivariable analysis identified low pre-treatment serum IgA levels and V2 administration during induction or maintenance treatment as independent determinants of lower antibody and higher T-cell responses, and bendamustine and high/intermediate FLIPI-2 score as additional determinants of a lower antibody response. Several clinical scenarios were identified where dichotomous immune responses were estimated with >95% confidence based on combinations of predictive variables. In conclusion, the immunogenicity of COVID-19 vaccines in FL patients is influenced by multiple disease- and treatment-related factors, among which B-cell depletion showed differential effects on antibody and T-cell responses., (© 2024 The Author(s). British Journal of Haematology published by British Society for Haematology and John Wiley & Sons Ltd.)

Carceral communities face heightened COVID-19-related risks while simultaneously experiencing medical mistrust and limited access to health information and services. Health education programs that incorporate dialogue-based, participatory learning models have been shown to motivate health behavior and increase health knowledge in carceral settings. To increase health literacy and change COVID-19-related health behavior among jail residents in the United States, a local health department developed a dialogue-based education program centered around COVID-19 prevention, misinformation, and navigating health care systems. Dialogue-based health information sessions took place in person in a county jail. Pre- and postsurveys gauged the sessions' influence on self-reported health literacy and behavior intention. Overall, 595 residents collectively attended 43 facilitated discussions. Key findings indicate that dialogue-based education can temper medical mistrust, influencing COVID-19 preventive behaviors and increasing health literacy in a carceral setting.

The Panbio COVID-19/Flu A&B Panel (Abbott) is an in vitro diagnostic rapid test designed for the qualitative detection of nucleocapsid proteins SARS-CoV-2 and nucleoprotein influenza A and B antigens in nasal mid-turbinate (NMT) swab specimens from symptomatic individuals meeting COVID-19 and influenza clinical and/or epidemiological criteria. This study, the largest global one to date using fresh samples, aimed to assess the diagnostic sensitivity and specificity of the Panbio COVID-19/Flu A&B Panel in freshly collected NMT swab specimens from individuals suspected of respiratory viral infection consistent with COVID-19 and/or influenza within the first 5 days of symptom onset compared with results obtained with the cobas SARS-CoV-2 and influenza A/B qualitative assay (cobas 6800/8800 systems), which were tested using nasopharyngeal swab samples. A total of 512 evaluable subjects were enrolled in the COVID-19 cohort across 18 sites, and 1,148 evaluable subjects were enrolled in the influenza cohort across 22 sites in the Asia-Pacific, Europe, and the USA. The Panbio COVID-19/Flu A&B Panel demonstrated a sensitivity of 80.4% and a specificity of 99.7% for COVID-19. For influenza A, the sensitivity and specificity rates were 80.6% and 99.3%, respectively. Likewise, for influenza B, the sensitivity and specificity rates were 80.8% and 99.4%, respectively. In conclusion, the Panbio COVID-19/Flu A&B Panel emerges as a suitable rapid test for detecting COVID-19 and influenza in symptomatic subjects across diverse global populations, exhibiting high sensitivity. The assay achieved a sensitivity of 94.4% in samples with Ct ≤24 for COVID-19 and 92.6% in samples with Ct ≤30 for influenza A and B., Importance: The Panbio COVID-19/Flu A&B Panel is a suitable rapid test for detecting COVID-19 and influenza in symptomatic subjects across diverse global populations, exhibiting high sensitivity. The assay achieved a sensitivity of 94.0% in samples with Ct ≤24 for COVID-19 and 92.6% in samples with Ct ≤30 for influenza A and B., Competing Interests: The authors declare no conflict of interest.

Background: The ongoing global crisis of Higher Education (HE) institutions during the post-COVID-19 pandemic period has increased the likelihood of enduring psychological stressors for staff. This study aimed to identify factors associated with job insecurity, burnout, psychological distress and coping amongst staff working at HE institutions globally., Methods: An anonymous cross-sectional study was conducted in 2023 with staff at HE institutions across 16 countries. Job insecurity was measured using the Job Insecurity Scale (JIS), burnout using the Perceived Burnout measure question, psychological distress using the Kessler Psychological Distress Scale (K10), and coping using the Brief Resilient Coping Scale. Multivariable logistic regression with a stepwise variable selection method was used to identify associations., Results: A total of 2,353 staff participated; the mean age (± SD) was 43(± 10) years and 61% were females. Most staff (85%) did not feel job insecurity, one-third (29%) perceived burnout in their jobs, more than two-thirds (73%) experienced moderate to very high levels of psychological distress, and more than half (58%) exhibited medium to high resilient coping. Perceived job insecurity was associated with staff working part-time [Adjusted Odds Ratio 1.53 (95% Confidence Intervals 1.15-2.02)], having an academic appointment [2.45 (1.78-3.27)], having multiple co-morbidities [1.86 (1.41-2.48)], perceived burnout [1.99 (1.54-2.56)] and moderate to very high level of psychological distress [1.68 (1.18-2.39)]. Perceived burnout was associated with being female [1.35 (1.12-1.63)], having multiple co-morbidities [1.53 (1.20-1.97)], perceived job insecurity [1.99 (1.55-2.57)], and moderate to very high levels of psychological distress [3.23 (2.42-4.30)]. Staff with multiple co-morbidities [1.46 (1.11-1.92)], mental health issues [2.73 (1.79-4.15)], perceived job insecurity [1.61 (1.13-2.30)], and perceived burnout [3.22 (2.41-4.31)] were associated with moderate to very high levels of psychological distress. Staff who perceived their mental health as good to excellent [3.36 (2.69-4.19)] were more likely to have medium to high resilient coping., Conclusions: Factors identified in this study should be considered in reviewing and updating current support strategies for staff at HE institutions across all countries to reduce stress and burnout and improve wellbeing., (© 2024. The Author(s).)

The Toxicology Investigators Consortium (ToxIC) was launched as a prospective multi-center registry of cases who receive medical toxicology consultations. Now, with over 100,000 cases, the Core Registry continues to address many medical toxicology research questions and has served as the foundation for multiple sub-registries, including the North American Snakebite Registry and the Medications for Opioid Use Disorder sub-registry. ToxIC also has evolved a portfolio of non-registry-based projects utilizing medical toxicology physician site principal investigators who enroll patients through emergency departments, irrespective of whether they received a medical toxicology consultation. These studies include the FDA-ACMT COVID-19 ToxIC Pharmacovigilance Project, which identifies adverse drug reactions related to the treatment of COVID-19, the Fentalog Study a toxico-surveillance study of suspected opioid overdose cases, the Drug Overdose Toxico-Surveillance Reporting Program which enrolls either suspected stimulant or opioid overdose cases, and the just being launched Real-World Examination of Naloxone for Drug Overdose Reversal project. Given ToxIC's experience in multi-center studies and its well-developed infrastructure, it is well-positioned to provide a nimble response on the part of the medical toxicology community to addressing evolving toxicological threats, drug and chemical toxicosurveillance, and other important medical toxicology priorities., (© 2024. American College of Medical Toxicology.)

Background: Critical illness survival rates have improved, but patients frequently face prolonged new or worsened physical, cognitive and psychosocial impairments. These difficulties associated with critical care admission are known as post-intensive care syndrome (PICS)., Aims: The multidisciplinary Intensive care Syndrome: Promoting Independence and Return to Employment (InS:PIRE) programme was developed to support patients in the recovery period from critical illness. During the COVID-19 pandemic, the psychology support offered by this service was adapted from an in-person group to individual remote review. This audit evaluated both the extent to which this input aligned with the recommended guidelines and the acceptability of this adapted delivery to this patient group, which could help guide post-pandemic psychology input to the service., Study Design: The records of 207 patients were analysed retrospectively. The nature of support offered to a sub-sample of 50 patients detailed in clinical summary letters was compared with the Faculty of Intensive Care Medicine (2019) guidelines. Telephone calls were made to gather feedback on the virtual psychology support from 10 patients., Results: Psychological difficulties were identified by 111 of the 207 patients who attended the virtual clinic. A total of 88 of these patients accepted referral for virtual psychology support and 67 (76%) of those patients attended. The virtual psychology support offered was found to be largely in accordance with ICU aftercare guidance and acceptable to patients. Patients found the summary letters of consultations accurate and helpful. Most patients expressed a preference for in-person support and the opportunity to meet other patients., Conclusions: The adaptations to the psychology support offered by InS:PIRE during the COVID-19 pandemic were found to be largely in line with ICU aftercare psychology guidelines and were acceptable to patients. Further research is needed on future methods of delivering psychology support for this patient group., Relevance to Clinical Practice: This audit highlights issues important to patients in the post-ICU period based on individual consultations not previously possible. Patient opinion was sought on the impact of changing the delivery of post-ICU psychological support, which will help guide future improvements in the service., (© 2024 British Association of Critical Care Nurses.)

Background: Given the increasing number of people achieving exceptionally long lifespans, there is an urgent need for a better understanding of mental health in centenarians. This study aimed to understand the prevalence of mental health conditions-depressive symptoms, anxiety, sleep disturbances, disinhibition, and aberrant motor behaviour-among centenarians in Switzerland., Methods: Data were collected from N = 169 participants via telephone interviews or paper questionnaires, either directly from centenarians or through proxy informants. Half the data were collected during a period when protective measures were imposed due to the COVID-19 pandemic, and half were collected after the measures were lifted., Results: Mental health conditions were prevalent in our sample, particularly depressive symptoms (44.51%) and anxiety (42.17%). Significant positive associations were found between depressive symptoms and anxiety, and between disinhibition and aberrant motor behaviour. Furthermore, we identified statistical predictors for the occurrence of mental health conditions. Notably, institutionalised living increased the odds of depressive symptomatology, while those with higher education levels or an absence of cognitive impairment experienced more sleep disturbances. Finally, cognitive impairment was linked to increased disinhibition and aberrant motor behaviour., Conclusions: The high prevalence of mental health conditions underscores the need for proactive mental health care strategies in advanced old age. Moreover, it is vital to consider the interconnected nature of mental health conditions and to prioritise vulnerable groups, such as centenarians in institutional settings., (© 2024 The Author(s). Psychogeriatrics published by John Wiley & Sons Australia, Ltd on behalf of Japanese Psychogeriatric Society.)

This study aimed to describe differences in prevalence and the long-term presence of nucleocapsid antibodies (N-antibodies) elicited by SARS-CoV-2 infection in a Swedish blood donor population not subjected to lockdown. We tested 20,651 blood donor samples for nucleocapsid antibodies from the beginning of March 2020 and 27 months onwards using the Roche Elecsys Anti-SARS-CoV-2 assay. The proportion of positive SARS-CoV-2 antibody samples was determined each week. After the exclusions of one-time donors and subjects with incomplete data, 19,726 samples from 4003 donors remained. Differences in antibody prevalences stratified for age, sex, and blood groups (ABO and RhD) were determined, as well as antibody loss and recovery. Lower antibody prevalence was seen for older donors, blood group AB, and RhD-negative subjects. A significant decrease in antibody titer between the first and the second antibody-positive donation was seen for the whole study group, females, older subjects, blood group O, AB, and RhD-positive subjects. The titer waned below the detection limit in 60 (3.0%) of 1983 N-antibody-positive donors, and for 18 of these donors, a second episode with antibodies was detected. We showed that N-antibodies persist for months or years and that surprisingly few antibody-positive donors lost their antibodies. We also conclude that antibody prevalence in a Swedish population never subject to lockdown did not apparently differ from populations that were subject to stricter regulations.

Background: Ayush (Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy) system of medicine has been extensively used in India for the prevention and management of coronavirus disease 2019 (COVID-19). The present report is the second update of a living systematic review and meta-analysis and has been intended to assess the preventive potential and safety of Ayush drugs against COVID-19. Methods: A search of databases such as PubMed, the Cochrane central register of controlled trials, the World Health Organization (WHO) COVID-19 database, the clinical trial registry-India, the AYUSH research portal, and preprint repositories was performed till March 1, 2023. Randomized controlled trials or analytical observational studies were included. Incidences of COVID-19 infections and mortality were taken as primary outcome measures; and symptomatic severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) infection, incidences of hospital admissions, and adverse events were taken as secondary outcomes. The risk of bias was evaluated by version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB-2) and the Risk of Bias in Non-Randomized Studies-of Interventions (ROBINS-I) tool. Data were synthesized through the RevMan 5.4 tool, and the certainty of the evidence was ranked through the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Results: Out of 2350 articles, 15 studies were included in the review. The pooled estimate of Guduchi [ Tinospora cordifolia (Thunb.) Miers], Chyawanprasha , and Ayuraksha kit was obtained. Meta-analysis of the data suggested that Guduchi may reduce the incidences of COVID-19 infections (risk ratio [RR]: 0.67 [95% confidence interval, CI: 0.48-0.95]) and the symptom development among the infected (RR: 0.88 [95% CI: 0.73-1.08]), however, no change was observed in hospital admissions (RR: 0.96 [95% CI: 0.20-4.53]). It is uncertain that Chyawanprasha reduces the incidence of COVID-19 infection (RR: 0.28; [95% CI: 0.07-1.08]). Ayuraksha kit as chemoprophylaxis may reduce the incidences of COVID-19 infections (RR: 0.49; [95% CI: 0.32-0.77]). The certainty of the evidence was low to moderate mainly due to the serious risk of bias. Conclusion: Prophylactic use of Ayush medicines for populations at risk may help to prevent COVID-19 infection by reducing incidence and severity. However, considering the certainty and fewer studies, high-quality studies are still desired to confirm the efficacy and safety of Ayush chemoprophylaxis for COVID-19. Nevertheless, this update will serve as a torchbearer for policymakers, physicians, and other stakeholders for their decision-making through evidence-based medicine.

Background: In spite of major effectiveness, a residual risk after COVID-19 primary vaccination was identified, in particular, for vulnerable individuals of advanced age or with comorbidities. Less is known about the Omicron period in people protected by a booster dose. We aimed to identify the characteristics associated with severe COVID-19 during the Omicron period in a population that had received a booster dose in France and to compare differences with the previous periods of the pandemic., Methods: This study was carried out using the French national COVID-19 vaccination database (VAC-SI) coupled with the National Health Data System (SNDS). Individuals aged 12 years or over who received at least one booster dose were identified. Associations between socio-demographic and clinical characteristics and the risk of COVID-19 hospitalisation occurring at least 14 days after receiving a third dose of vaccine during the period of Omicron predominance, i.e., from 1 January 2022 to 10 November 2022, were assessed using Cox proportional hazard models adjusted for age, sex, time since booster dose and vaccination schedule. Analyses were performed overall and by sub-period of circulation of the strains BA.1, BA.2, and BA.4/BA.5, defined as periods where the main sub-variant accounted for more than 80 % of genotyped samples., Findings: In total, 35,640,387 individuals received a booster dose (mean follow-up of 291 days) and 73,989 were hospitalised for COVID-19 during the total period. Older age (aHR 20.5 95 % CI [19.6-21.5] for 90 years of age or older versus 45-54 years of age), being male (aHR 1.52 [1.50-1.55]), and social deprivation (aHR 1.33 [1.30-1.37] for the most deprived areas versus the least deprived) were associated with an increased risk of hospitalisation for COVID-19. Most of the chronic diseases considered were also positively associated with a residual risk, in particular, cystic fibrosis (aHR 9.83 [7.68-12.56]), active lung cancer (aHR 3.26 [3.06-3.47]), chronic dialysis (aHR 3.79 [3.49-4.11]), psychological and neurodegenerative diseases (more markedly than during the periods of circulation of the alpha and delta variants), and organ transplantation. The use of immunosuppressants was also associated with an increased risk (aHR 2.24 [2.14-2.35], including oral corticosteroids aHR (2.58 [2.50-2.67])., Conclusion: Despite an effective booster and a generally less virulent circulating variant, a residual risk of severe COVID-19 still exists in vulnerable populations, especially those with neurological disorders., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Understanding of students' musculoskeletal health under home-schooling during the COVID-19 pandemic is limited., Objectives: (1) To investigate the prevalence and severity of musculoskeletal symptoms in home-schooled adolescents during the COVID-19 pandemic. (2) To evaluate the effect of an online exercise + ergonomics advice protocol on symptoms, compared with ergonomics advice alone., Design: Cross-sectional symptom survey identifying eligible participants, followed by a pragmatic randomized controlled trial., Setting: Online classes., Participants: Survey: 354 students (mean 16.6 years)., Trial: 188 students with upper body musculoskeletal symptoms., Interventions: Randomization to three groups (physical therapy exercises + ergonomics postural advice, ergonomics postural advice alone, nonintervention control) stratified by the site of symptoms (neck, shoulder, upper back). Interventions were orally delivered online (via WhatsApp) supplemented with written/illustrative material. Follow-up occurred at 8 weeks., Outcome Measures: Survey: prevalence of symptoms (Nordic Questionnaire)., Trial: primary outcome = change in intensity of upper body symptoms (visual analogue scale); secondary outcome = number of participants reporting improvement in upper body symptoms., Results: The 12-month prevalence of musculoskeletal disorders in the survey was 38% neck, 28% shoulder, and 35% upper back, with mean pain intensity of 3.6, 3.9, and 3.8, respectively, on 0-10 visual analogue scale: Two-thirds reported symptoms in multiple anatomical regions. In the trial, there was no statistically significant difference between the exercise + ergonomics group and ergonomics alone group on the primary outcome, yet both groups showed reduced symptom intensity compared with control (p < .001). More participants in the exercise + ergonomics group reported improvement than in the ergonomics advice alone group (p < .02)., Conclusions: The prevalence of musculoskeletal symptoms was relatively high in home-schooled adolescents. Symptoms can be reduced by ergonomics advice with or without exercises, but the effect is enhanced by the addition of physical therapy exercises. The latter approach may be considered for improving schoolchildren's musculoskeletal health in the usual classroom setting., (© 2023 American Academy of Physical Medicine and Rehabilitation.)

Sickle cell disease (SCD), which occurs primarily in individuals of African descent, has been identified as a preexisting health condition for COVID-19 with higher rates of hospitalization, intensive care unit admissions, and death. National data indicate Black individuals have higher rates of vaccine hesitancy and lower COVID-19 vaccination rates. Understanding the key predictors of intention to receive a COVID-19 vaccine is essential as intention is strongly associated with vaccination behavior. This multisite study examined attitudes, beliefs, intentions to receive COVID-19 vaccines, and educational preferences among adolescents, young adults, and caregivers of children living with SCD. Participants completed an online survey between July 2021 and March 2022. Multivariate logistic regression was used to examine the association between participant age and COVID-19 vaccine attitudes, beliefs, and vaccine intentions. Of the 200 participants, 65.1% of adolescents, 62.5% of young adults, and 48.4% of caregivers intended to receive a COVID-19 vaccine for themselves or their child. Perception that the vaccine was safe was statistically significant and associated with patient and caregiver intention to receive the COVID-19 vaccine for themselves or their child. Participant age was also statistically significant and associated with the intent to get a booster for patients. Study findings highlight key concerns and influencers identified by patients with SCD and their caregivers that are essential for framing COVID-19 vaccine education during clinical encounters. Study results can also inform the design of messaging campaigns for the broader pediatric SCD population and targeted interventions for SCD subpopulations (eg, adolescents, caregivers)., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

SARS-CoV-2 induces delayed type-I/III interferon production, allowing it to escape the early innate immune response. The delay has been attributed to a deficiency in the ability of cells to sense viral replication upon infection, which in turn hampers activation of the antiviral state in bystander cells. Here, we introduce a cellular automaton model to investigate the spatiotemporal spreading of viral infection as a function of virus and host-dependent parameters. The model suggests that the considerable person-to-person heterogeneity in SARS-CoV-2 infections is a consequence of high sensitivity to slight variations in biological parameters near a critical threshold. It further suggests that within-host viral proliferation can be curtailed by the presence of remarkably few cells that are primed for IFN production. Thus, the observed heterogeneity in defense readiness of cells reflects a remarkably cost-efficient strategy for protection., Competing Interests: XX, BN, KS No competing interests declared, (© 2024, Xu et al.)

The evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in variants that can escape neutralization by therapeutic antibodies. Here, we describe AZD3152, a SARS-CoV-2-neutralizing monoclonal antibody designed to provide improved potency and coverage against emerging variants. AZD3152 binds to the back left shoulder of the SARS-CoV-2 spike protein receptor binding domain and prevents interaction with the human angiotensin-converting enzyme 2 receptor. AZD3152 potently neutralized a broad panel of pseudovirus variants, including the currently dominant Omicron variant JN.1 but has reduced potency against XBB subvariants containing F456L. In vitro studies confirmed F456L resistance and additionally identified T415I and K458E as escape mutations. In a Syrian hamster challenge model, prophylactic administration of AZD3152 protected hamsters from weight loss and inflammation-related lung pathologies and reduced lung viral load. In the phase 1 sentinel safety cohort of the ongoing SUPERNOVA study (ClinicalTrials.gov: NCT05648110), a single 600-mg intramuscular injection of AZD5156 (containing 300 mg each of AZD3152 and cilgavimab) was well tolerated in adults through day 91. Observed serum concentrations of AZD3152 through day 91 were similar to those observed with cilgavimab and consistent with predictions for AZD7442, a SARS-CoV-2-neutralizing antibody combination of cilgavimab and tixagevimab, in a population pharmacokinetic model. On the basis of its pharmacokinetic characteristics, AZD3152 is predicted to provide durable protection against symptomatic coronavirus disease 2019 caused by susceptible SARS-CoV-2 variants, such as JN.1, in humans.

Background: People with serious mental illness (SMI) and people with intellectual disabilities/developmental disabilities (ID/DD) are at higher risk for COVID-19 and more severe outcomes. We compare a tailored versus general best practice COVID-19 prevention program in group homes (GHs) for people with SMI or ID/DD in Massachusetts (MA)., Methods: A hybrid effectiveness-implementation cluster randomized control trial compared a four-component implementation strategy (Tailored Best Practices: TBP) to dissemination of standard prevention guidelines (General Best-Practices: GBP) in GHs across six MA behavioral health agencies. GBP consisted of standard best practices for preventing COVID-19. TBP included GBP plus four components including: (1) trusted-messenger peer testimonials on benefits of vaccination; (2) motivational interviewing; (3) interactive education on preventive practices; and (4) fidelity feedback dashboards for GHs. Primary implementation outcomes were full COVID-19 vaccination rates (baseline: 1/1/2021-3/31/2021) and fidelity scores (baseline: 5/1/21-7/30/21), at 3-month intervals to 15-month follow-up until October 2022. The primary effectiveness outcome was COVID-19 infection (baseline: 1/1/2021-3/31/2021), measured every 3 months to 15-month follow-up. Cumulative incidence of vaccinations were estimated using Kaplan-Meier curves. Cox frailty models evaluate differences in vaccination uptake and secondary outcomes. Linear mixed models (LMMs) and Poisson generalized linear mixed models (GLMMs) were used to evaluate differences in fidelity scores and incidence of COVID-19 infections., Results: GHs (n=415) were randomized to TBP (n=208) and GBP (n=207) including 3,836 residents (1,041 ID/DD; 2,795 SMI) and 5,538 staff. No differences were found in fidelity scores or COVID-19 incidence rates between TBP and GBP, however TBP had greater acceptability, appropriateness, and feasibility. No overall differences in vaccination rates were found between TBP and GBP. However, among unvaccinated group home residents with mental disabilities, non-White residents achieved full vaccination status at double the rate for TBP (28.6%) compared to GBP (14.4%) at 15 months. Additionally, the impact of TBP on vaccine uptake was over two-times greater for non-White residents compared to non-Hispanic White residents (ratio of HR for TBP between non-White and non-Hispanic White: 2.28, p = 0.03)., Conclusion: Tailored COVID-19 prevention strategies are beneficial as a feasible and acceptable implementation strategy with the potential to reduce disparities in vaccine acceptance among the subgroup of non-White individuals with mental disabilities., Trial Registration: ClinicalTrials.gov, NCT04726371, 27/01/2021. https://clinicaltrials.gov/study/NCT04726371 ., (© 2024. The Author(s).)

Difficulties in executive functioning (EF) can result in impulsivity, forgetfulness, and inattention. Children living in remote/regional communities are particularly at risk of impairment in these cognitive skills due to reduced educational engagement and poorer access to interventions. This vulnerability has been exacerbated by the COVID-19 pandemic and strategies are needed to mitigate long-term negative impacts on EF. Here we propose a pilot trial investigating the benefits, feasibility, and acceptability of a school-based EF intervention for primary school students (6-8 years) living in regional, developmentally vulnerable, and socio-economically disadvantaged communities. Students were randomised to a digital intervention or teaching as usual, for 7 weeks. Children completed measures of EF and parents/educators completed ratings of everyday EF and social/emotional wellbeing at pre-intervention, post-intervention, and 3-month follow-up. Change in EFs (primary outcome), everyday EF, and social/emotional wellbeing (secondary outcomes) from pre- to post-intervention and pre-intervention to 3-month follow-up were examined. Feasibility and acceptability of the intervention was assessed through educator feedback and intervention adherence.Protocol Registration: The stage 1 protocol for this Registered Report was accepted in principle on 20 April 2023. The protocol, as accepted by the journal, can be found at: https://doi.org/10.17605/OSF.IO/WT3S2 . The approved Stage 1 protocol is available here: https://osf.io/kzfwn ., (© 2024. The Author(s).)

Background: COVID-19 can have a particularly detrimental effect on patients with cancer, but no studies to date have examined if the presence, or site, of metastatic cancer is related to COVID-19 outcomes., Methods: Using the COVID-19 and Cancer Consortium (CCC19) registry, the authors identified 10,065 patients with COVID-19 and cancer (2325 with and 7740 without metastasis at the time of COVID-19 diagnosis). The primary ordinal outcome was COVID-19 severity: not hospitalized, hospitalized but did not receive supplemental O 2 , hospitalized and received supplemental O 2 , admitted to an intensive care unit, received mechanical ventilation, or died from any cause. The authors used ordinal logistic regression models to compare COVID-19 severity by presence and specific site of metastatic cancer. They used logistic regression models to assess 30-day all-cause mortality., Results: Compared to patients without metastasis, patients with metastases have increased hospitalization rates (59% vs. 49%) and higher 30 day mortality (18% vs. 9%). Patients with metastasis to bone, lung, liver, lymph nodes, and brain have significantly higher COVID-19 severity (adjusted odds ratios [ORs], 1.38, 1.59, 1.38, 1.00, and 2.21) compared to patients without metastases at those sites. Patients with metastasis to the lung have significantly higher odds of 30-day mortality (adjusted OR, 1.53; 95% confidence interval, 1.17-2.00) when adjusting for COVID-19 severity., Conclusions: Patients with metastatic cancer, especially with metastasis to the brain, are more likely to have severe outcomes after COVID-19 whereas patients with metastasis to the lung, compared to patients with cancer metastasis to other sites, have the highest 30-day mortality after COVID-19., (© 2024 American Cancer Society.)

Background: Persistent mortality in adults hospitalized due to acute COVID-19 justifies pursuit of disease mechanisms and potential therapies. The aim was to evaluate which virus and host response factors were associated with mortality risk among participants in Therapeutics for Inpatients with COVID-19 (TICO/ACTIV-3) trials., Methods: A secondary analysis of 2625 adults hospitalized for acute SARS-CoV-2 infection randomized to 1 of 5 antiviral products or matched placebo in 114 centers on 4 continents. Uniform, site-level collection of participant baseline clinical variables was performed. Research laboratories assayed baseline upper respiratory swabs for SARS-CoV-2 viral RNA and plasma for anti-SARS-CoV-2 antibodies, SARS-CoV-2 nucleocapsid antigen (viral Ag), and interleukin-6 (IL-6). Associations between factors and time to mortality by 90 days were assessed using univariate and multivariable Cox proportional hazards models., Results: Viral Ag ≥4500 ng/L (vs <200 ng/L; adjusted hazard ratio [aHR], 2.07; 1.29-3.34), viral RNA (<35 000 copies/mL [aHR, 2.42; 1.09-5.34], ≥35 000 copies/mL [aHR, 2.84; 1.29-6.28], vs below detection), respiratory support (<4 L O2 [aHR, 1.84; 1.06-3.22]; ≥4 L O2 [aHR, 4.41; 2.63-7.39], or noninvasive ventilation/high-flow nasal cannula [aHR, 11.30; 6.46-19.75] vs no oxygen), renal impairment (aHR, 1.77; 1.29-2.42), and IL-6 >5.8 ng/L (aHR, 2.54 [1.74-3.70] vs ≤5.8 ng/L) were significantly associated with mortality risk in final adjusted analyses. Viral Ag, viral RNA, and IL-6 were not measured in real-time., Conclusions: Baseline virus-specific, clinical, and biological variables are strongly associated with mortality risk within 90 days, revealing potential pathogen and host-response therapeutic targets for acute COVID-19 disease., Competing Interests: Potential conflicts of interest. N. R. A. reports support for attending meetings and/or travel to their institution from the National Institutes of Health (NIH). D. L. B. reports consulting fees and payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events, and participation on a Data Safety Monitoring Board (DSMB) or Advisory Board with Pfizer, Gilead, MSD, and ViiV; and support for attending meetings and/or travel from ViiV and Gilead. M. K. J. reports a grant to their institution from Gilead Sciences and a contract for a clinical trial to their institution from Regeneron; and a role on the HIV MA Board of Directors. J. P. H. reports consulting fees to the author from Pfizer, MSD, Menarini, Angelini, Zambon, and Tillots; payment or honoraria payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events to their institution and the author from Pfizer and to the author from MSD and Angelini; support for attending meetings and/or travel from MSD and Pfizer; and paid participation as a DSMB member for a TFT Pharmaceuticals clinical trial. K. K. reports grants or contracts to their institution from the NIH, COVID Vaccine Prevention Network, (NIH), Regeneron, Abbott, Pfizer, Romark, and Raisonance; royalties or licenses to book author for Elsevier; consulting fees to the author from Regeneron; payment for expert testimony to the author from the State of Florida; support for travel from Sanford Guide, Burroughs Wellcome Fund, ParaFrap, and the Infectious Diseases Society of America (IDSA) Board of Directors; patents planned, issued, or pending to University of South Florida (USF) F and USF faculty from 3D swabs; leadership or a fiduciary role on the Sanford Guide, Burroughs Wellcome Fund, IDSA board, and ParaFrap; and personal stocks from Gilead. S. L. P. reports grants paid to the University College London, which are completely separate from this work, with Medical Research Council, United Kingdom Research and Innovation, The European and Developing Countries Clinical Trial Partnership, Janssen-Cilag, Gilead Sciences, and ViiV Healthcare; participation as member of the DSMB for the TIPAL trial (The effectiveness and risks of Treating people with Idiopathic Pulmonary fibrosis with the Addition of Lansoprazole: a randomized placebo-controlled multicenter clinical trial). This is an academic trial funded in the United Kingdom by the National Institute for Health and Care Research (NIHR), UK. C. R. reports grants or contracts from NIH and participation on a DSMB or Advisory Board from Mayo Clinic and NIH. U. S. reports research grants or contracts from ViiV Healthcare and AstraZeneca; consulting fees from Shionogi, Paratek, ViiV, and Pfizer; and payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Shionogi, Pfizer, and Paratek. B. W. T. reports grants or contracts from Veterans Affairs (VA) Health Services and Development Service Center for Innovations in Quality, Effectiveness, and Safety (13-413), Agency for Healthcare Research and Quality (AHRQ), VA Rehabilitation Research and Development, and Peptilogics; consulting fees from Phiogen; and payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from the George Washington ID Board Review Course, the Warren Alpert Medical School of Brown University. A. A. G. reports grants to their institution from Centers for Disease Control, Department of Defense, Faron Pharmaceuticals, and AbbVie; participation on a DSMB or Advisory Board from NIH; and a role on the Scientific Advisory Board from Biomeme. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed., (© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: In response to the devastating drug toxicity crisis in Canada driven by an unregulated opioid supply predominantly composed of fentanyl and analogues, safer supply programs have been introduced. These programs provide people using street-acquired opioids with prescribed, pharmaceutical opioids. We use six core components of safer supply programs identified by people who use drugs to explore participant perspectives on the first year of operations of a safer supply program in Victoria, BC, during the dual public health emergencies of COVID-19 and the drug toxicity crisis to examine whether the program met drug-user defined elements of an effective safer supply model., Methods: This study used a community-based participatory research approach to ensure that the research was reflective of community concerns and priorities, rather than being extractive. We interviewed 16 safer supply program participants between December 2020 and June 2021. Analysis was structured using the six core components of effective safer supply from the perspective of people who use drugs, generated through a prior study., Results: Ensuring access to the 'right dose and right drugs' of medications was crucial, with many participants reporting success with the available pharmaceutical options. However, others highlighted issues with the strength of the available medications and the lack of options for smokeable medications. Accessing the safer supply program allowed participants to reduce their use of drugs from unregulated markets and manage withdrawal, pain and cravings. On components related to program operations, participants reported receiving compassionate care, and that accessing the safer supply program was a non-stigmatizing experience. They also reported receiving support to find housing, access food, obtain ID, and other needs. However, participants worried about long term program sustainability., Conclusions: Participants in the safer supply program overwhelmingly appreciated it and felt it was lifesaving, and unlike other healthcare or treatment services they had previously accessed. Participants raised concerns that unless a wider variety of medications and ability to consume them by multiple routes of administration became available, safer supply programs would remain unable to completely replace substances from unregulated markets., (© 2024. The Author(s).)

Advances in surface-enhanced Raman scattering (SERS) detection have helped to overcome the limitations of traditional in vitro diagnostic methods, such as fluorescence and chemiluminescence, owing to its high sensitivity and multiplex detection capability. However, for the implementation of SERS detection technology in disease diagnosis, a SERS-based assay platform capable of analyzing clinical samples is essential. Moreover, infectious diseases like COVID-19 require the development of point-of-care (POC) diagnostic technologies that can rapidly and accurately determine infection status. As an effective assay platform, SERS-based bioassays utilize SERS nanotags labeled with protein or DNA receptors on Au or Ag nanoparticles, serving as highly sensitive optical probes. Additionally, a microdevice is necessary as an interface between the target biomolecules and SERS nanotags. This review aims to introduce various microdevices developed for SERS detection, available for POC diagnostics, including LFA strips, microfluidic chips, and microarray chips. Furthermore, the article presents research findings reported in the last 20 years for the SERS-based bioassay of various diseases, such as cancer, cardiovascular diseases, and infectious diseases. Finally, the prospects of SERS bioassays are discussed concerning the integration of SERS-based microdevices and portable Raman readers into POC systems, along with the utilization of artificial intelligence technology.

Background:  The EuroQol Health and Wellbeing Short Version (EQ-HWB-S) instrument has been developed to measure the health and wellbeing of care-recipients and their caregivers for use in economic evaluation.The EQ-HWB-S has nine items, and pilot UK preference weights have now been developed., Objective: We aimed to investigate the validity of the instrument in parents of children with and without health conditions., Methods: EQ-HWB-S data were sourced from an Australian paediatric multi-instrument comparison study. We analysed the baseline characteristics and response distribution of the EQ-HWB-S items. Assessment of known-group validity was conducted for EQ-HWB-S items, level sum-scores and preference-weighted scores, including partial effects. Known-group analyses included three child health variables and where caregivers reported coronavirus disease 2019 (COVID-19) had impacted their wellbeing. We included analyses across gender, controlled for child and parent demographic variables, and compared scores across child health conditions., Results:  Item responses were distributed as expected, with higher skew for mobility and activities. Parents experienced high levels of exhaustion. We detected significant differences between groups for level sum-scores and preference-weighted scores, as hypothesised; all tests were significant (p < 0.001), with moderate effect sizes (effect sizes were slightly higher for female than male parents). The regression analysis identified significantly different EQ-HWB-S scores for child health samples compared with the general population after controlling for demographic variables. Differences were observed between child health conditions., Conclusion: The EQ-HWB-S is a useful instrument to measure parent quality of life for economic evaluation in this population. Data were limited to one time point; further research should investigate the instrument's sensitivity to change and test-retest reliability in this population., (© 2024. The Author(s).)