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Purpose To assess telehealth services offered by reproductive endocrinology and infertility specialists and to gauge provider experiences with incorporating telehealth into their practices. Methods A 16-question web-based survey on use of telehealth was distributed to Society for Assisted Reproductive Technology (SART) clinics and to Society for Reproductive Endocrinology and Infertility (SREI) members. Clinic demographic data, telehealth descriptive data, and provider satisfaction with use of telehealth were assessed. Results were collected via Survey Monkey. Results A total of 1160 individuals (330 SART clinic contacts and 830 SREI members) were reached via email with an 18.6% (216) survey response rate. All respondents indicated that they offer telehealth visits. Several telehealth platforms were used, with Zoom (62.7%) and telehealth through the clinic’s electronic medical record platform (34.8%) being the most common. The majority of participants (87.0%) anticipate they will offer telehealth visits after the COVID-19 pandemic. Roughly two-thirds (64.4%) of respondents anticipate fewer telehealth visits after the pandemic because of logistics, cost, and patient/provider preference. Nearly all providers are either “very satisfied” (66.2%) or “somewhat satisfied” (31.0%) with telehealth overall. Conclusion Telehealth enabled safe patient-provider interactions throughout the COVID-19 pandemic. While only one-third of survey respondents offered telehealth services before the pandemic, nearly all providers express satisfaction with telehealth and anticipate they will offer telehealth services henceforth.

Global crises have become increasingly more frequent and consequential. Yet the impact of these crises is unevenly distributed across countries, leading to discrepancies in (inter)national crisis-regulating institutions’ ability to uphold public trust and safeguard their constituents’ well-being. Employing the paradigm of citizens as customers of political institutions, drawing on attribution and sociopolitical trust theories, and using the COVID-19 pandemic as an empirical context, the authors investigate how consumers’ relative perceptions of local impact following a global crisis affect the psychological processes of institutional trust formation and consumer well-being. Conducting one survey-based study in two countries affected disproportionately by the pandemic’s first wave (the United States and Greece) and one experimental study in a third country (Italy) during the pandemic’s second wave, the authors find that institutional trust declines more in countries whose citizens hold perceptions of higher relative local impact following a global crisis; institutional blame attributions explain trust erosion; institutional distrust decreases consumer well-being and adherence to institutional guidelines; consumers’ globalization attitudes immunize international institutions from blame and distrust; and political conservatives transfer blame and distrust from national to international institutions amid global crises. The findings enrich the institutional branding and trust literatures and have implications for stakeholders involved in global crisis management (e.g., policy makers, political marketers, institutional brand managers).

Individuals with obsessive-compulsive disorder (OCD) have evidenced resilience against large-scale crises, although emerging research on the impact of COVID-19 is mixed. Little is known about the impact of COVID-19 on mental health providers. Items from an instrument evaluating the impact of the September 11, 2001, terrorist attack were adapted to measure the impact of COVID-19 on emotions, cognitions, and behaviors. Using a sample of 65 patients with primary OCD diagnoses and OCD treatment providers in intensive programs for OCD and anxiety, the authors found that COVID-19 evidenced a less significant overall impact on patients than providers. Specifically, providers reported more significant impact on the amount of time spent worrying about COVID-19, taking additional cleaning and sanitization precautions, and time spent socializing with loved ones. Findings support previous literature indicating that individuals with OCD demonstrate resilience to large-scale crises, and offer insights into the specific struggles of providers who treat OCD.

Resumen Introduccion La colchicina es ampliamente utilizada en enfermedades inflamatorias como la gota y la fiebre mediterranea familiar. Debido a su capacidad inmunomoduladora, podria tener un papel importante en el tratamiento de la COVID-19. Objetivo Explorar la evidencia medica publicada hasta el 28 de diciembre del 2020, acerca de la eficacia y la seguridad de la colchicina en el tratamiento de pacientes con infeccion confirmada por SARS-CoV-2. Material y metodos Revision exploratoria de la literatura que incluyo PubMed y Scopus. Se tuvieron en cuenta registros de ensayos clinicos y publicaciones con datos empiricos (estudios observacionales y experimentales) en ingles y espanol. Resultados Se encontraron 33 ensayos clinicos y 6 publicaciones empiricas: estudios de cohorte prospectivos (n = 2) y retrospectiva (n = 2), ensayo clinico aleatorizado (n = 1) y estudio casos y controles (n = 1). La suma de los participantes en los ensayos es de 46.324 individuos, el 73% (24/33) de los estudios recluta a la poblacion de estudio y el 51% (17/33) son fase 3. Conclusiones Un ensayo clinico respalda la disminucion en marcadores inflamatorios pronosticos y el tiempo de estancia hospitalaria en la infeccion por SARS-CoV-2. Los ensayos clinicos en desarrollo ayudaran a esclarecer la eficacia y la seguridad de la colchicina para el manejo de pacientes con COVID-19.

Using work from home (WFH) scores obtained by matching Philippine occupations with U.S. O*NET occupations, this paper estimates that only 12.38% of all workers can WFH and 25.7% of Philippine occupations are teleworkable––mostly from the following occupational groups: professionals, clerical support workers, and technicians and associate professionals. The education, real estate and, professional, scientific and technical sectors account for the largest share of teleworkable jobs. Those workers belonging to lower per capita income deciles, who are male, who have lower levels of education, who are self-employed, aged 55 and older, and who are working in sectors such as agriculture and retail, are also less likely to be in teleworkable occupations.

Coronavirus disease 2019 (COVID-19) is as an emerging infectious disease (EID) that has caused the worst public health catastrophe of the 21st century thus far. In terms of impact, the COVID-19 pandemic is second only to the Spanish Flu pandemic of 1918 in modern world history. As of 7 September 2021, there have been 220 million confirmed cases of COVID-19 and more than 4.5 million deaths. EIDs pose serious public health and socio-economic risks, and 70% of EIDs originate from wildlife. Preventing development of EIDs such as COVID-19 is a pressing concern. Here, taking the COVID-19 pandemic as an example, we illustrate the disastrous effects of EIDs and assess their emergence and evolution from a One Health perspective. We propose a One Health strategy, centered on 'moving the gates forward', for EID prevention and control at the human-animal-environment interface. This strategy may be instructive and provide early warnings of EIDs in the future.

ZusammenfassungDie anästhesiologische Versorgung von Patienten im OP beinhaltet viele Tätigkeiten, bei denen es zu Infektionen kommen kann. Die Händehygiene ist die effektivste Einzelmaßnahme zur Prävention nosokomialer Infektionen. Spender mit Händedesinfektionsmittel sollten gut erreichbar angebracht werden.Bei der Zubereitung von Infusionen und i. v. zu verabreichenden Medikamenten kann ein Eintrag von Mikroorganismen auch bei Beachtung aller hygienischer Vorgaben nicht vollkommen ausgeschlossen werden. Daher dürfen Parenteralia ohne Konservierungsmittel nur unmittelbar vor der Gabe, nicht mehrfach und nicht für mehrere Patienten aus einem Gebinde entnommen werden.Bei Punktionen für Regionalanästhesien und zur Anlage von Gefäßkathetern gelten die höchsten Anforderungen an die Hygiene, wenn lange Seldinger-Drähte verwendet oder Katheter in tiefe Gewebsräume oder Körperhöhlen gelegt werden.Eine rechtzeitig applizierte Antibiotikaprophylaxe ist eine der wichtigsten Maßnahmen der perioperativen Infektionsprävention. Die Substanzauswahl und die Indikation sollten in einer hausinternen Leitlinie festgehalten sein. Die Wahrung eines ausgeglichenen Volumen-, Temperatur- und Glukosehaushalts trägt zur Prophylaxe postoperativer Wundinfektionen bei.Die Aufbereitung eines OP-Saals nach einer Operation muss immer gewährleisten, dass von diesem keine Infektionsgefahr für den folgenden Patienten ausgeht – unabhängig davon, mit welchen Erregern der Vorgängerpatient infiziert oder besiedelt ist. Für weitergehende Maßnahmen zur Trennung von sog. aseptischen und septischen Operationen oder von Patienten mit multiresistenten Erregern gibt es keine Evidenz.Um bei SARS-CoV-2-infizierten Patienten im OP die notwendigen Maßnahmen zum Mitarbeiterschutz ergreifen zu können, ist es essenziell, den aktuellen Infektionsstatus zu kennen. Bei der Übergabe des Patienten im OP sollte das Vorhandensein eines aktuellen Testergebnisses überprüft und z. B. auf der OP-Checkliste dokumentiert werden.

Objectives To perform a survey assessing the use of, attitudes towards, and perceived utility of social media (SoMe) in the 2021 urology residency match. Methods We distributed surveys to urology residency applicants and program directors (PDs) via the Urology Match 2021 Google Spreadsheet and email. The survey collected demographic information as well as SoMe activity, perceived pressure to use SoMe, match results, and attitudes regarding the utility of SoMe in the match process. Results A total of 108/528 (20%) applicants registered for the 2021 match and 61/142 (43%) PDs completed the survey. More applicants than PDs felt that SoMe helped them gain better insight into residency programs or applicants, respectively. Fewer applicants than PDs felt that SoMe activity provided a benefit to them in the match process. No significant relationship was found between SoMe viewing frequency, posting frequency, or tweetorial use with match outcomes. The majority of PDs believed that SoMe played a more important role in the 2021 match process than previous years while 15% and 12% reported that an applicant's SoMe activity helped or hurt the chances of matching to their program respectively. Conclusions SoMe, particularly Twitter, was widely used in the 2021 match by both applicants and PDs. A majority of applicants and PDs believed that SoMe use aided them in some way in the match process, yet there was no relationship between the volume or type of applicant SoMe activity and match outcomes.

Background Patients presenting to Emergency Department (ED) with non-specific low back pain can receive more unnecessary, intensive and costly care than is recommended. The COVID-19 pandemic has provided an unprecedented opportunity to examine how health systems prioritise necessary care that provides clear benefits to patients. The purpose of this study was to examine the impact of COVID-19 on care of low back pain in the ED. Methods We performed a retrospective analysis of electronic medical record data on care for low back pain from three public hospitals in Sydney. We included patients diagnosed with spinal conditions who presented between March and May in 2019 and in 2020. Outcomes were the total number of patients presenting with spinal conditions to ED, the proportion diagnosed with non-specific low back pain, and the proportion receiving potentially unnecessary aspects of care (ambulance use, imaging, opioids, hospital admissions). We calculated relative risk with 95% CIs and examined plots with locally weighted smoothed curves. Results Presentations for spinal conditions over a three-month period to three EDs reduced from 694 in 2019 to 475 in 2020 (31% reduction, 95% CI = 26%–37%). The proportion of patients diagnosed with non-specific low back pain (83% in 2019 vs 86% in 2020), or receiving potentially unnecessary care were similar in 2019 and 2020 (Imaging = 25% vs 25%; Opioids = 54% vs 56%; Admitted = 18% vs 20%; pathology test = 24% vs 23%). The proportion of patients arriving by ambulance was higher during the pandemic; 29% in 2019 vs 41% in 2020 (RR = 1.39, 95% CI = 1.19–1.63). Conclusions ED presentations for low back pain associated with spinal conditions decreased substantially during the COVID-19 pandemic. Use of potentially unnecessary aspects of care did not change or increased during the pandemic.

This paper examines the impact of Covid‐19 lockdowns on exports by Chinese cities. We use city‐level export data at a monthly frequency from January 2018 through April 2020. Differences‐in‐differences estimates suggest cities in lockdown experienced a ceteris paribus 34 percentage points reduction in the year‐on‐year growth rate of exports. The lockdown impacted the intensive and extensive margin, with higher exit and lower new entry into foreign markets. The drop in exports was smaller in (i) coastal cities; (ii) cities with better‐developed ICT infrastructure; and (iii) cities with a larger share of potential teleworkers. Time‐sensitive and differentiated goods experienced a more pronounced decline in export growth. Global supply chain characteristics matter, with more upstream products and industries that had accumulated larger inventories experiencing a smaller decline in export growth. Also, products that relied more on imported (domestic) intermediates experienced a sharper (flatter) slowdown in export growth. The rapid recovery in cities' exports after lockdowns were lifted suggests the policy was cost‐effective in terms of its effects on trade.

Coronavirus causes significant damage to human health and the global economy. In this paper, we undertake patent analysis and data mining to systematically analyze the trend in patent applications for coronavirus detection, prevention, and treatment technologies. Our goals are to determine the correlation between typical coronavirus outbreaks and changes in patent technology applications, and to compare the research and development (R&D) progress, patent layout, and characteristics of major institutions in various countries experiencing coronavirus outbreaks. We find that the United States commenced coronavirus detection and vaccine technology R&D earlier than other countries, as it attached importance to the R&D for treatment technologies from the time of the SARS outbreak and initiated the trend of multi-party R&D, with full technology chain coverage by the government, enterprises, universities, and research institutions. China’s patent applications have grown rapidly in recent years, mainly based on the R&D of research institutions and universities, although it has formed full technology chain coverage. However, the patent quality and technology global layout still need to be improved. This paper reviews the patent development trends of important coronavirus technologies, and proposes that policymakers should establish a long-term mechanism for R&D, pay attention to intellectual property protection, and deepen international technical cooperation to provide a reference for the development and application of coronavirus detection technology, vaccine technology, and treatment technology.

Introduction The aim of this study was to determine the impact of the COVID-19 pandemic on the provision of clinical services (perioperative clinical outcomes and productivity) of the department of endocrine and general surgery at a teaching hospital in the UK. Methods A retrospective chart review was conducted of all patients who were operated in our department during two periods: 1 April to 31 October 2019 (pre-COVID-19 period) and 1 April to 31 October 2020 (COVID-19 period). The perioperative clinical outcomes and productivity of our department for the two time periods were compared. Results In the pre-COVID-19 period, 130 operations were carried out, whereas in the COVID-19 group, this reduced to 89. The baseline characteristics between the two groups did not significantly differ. Parathyroid operations decreased significantly by 68% between the two study periods. Overall, during the COVID-19 phase, the department maintained 68% of its operating workload compared with the respective 2019 time period. The clinical outcomes for the patients who had a thyroid/parathyroid/adrenal operation were not statistically different for the two study periods. There were no COVID-19 related perioperative complications for any of the operated patients and no patient tested positive for COVID-19 while an inpatient. For the COVID-19 group, the department maintained 67% of its outpatient appointments for endocrine surgery and 26% for general surgery pathologies. Conclusions The COVID-19 pandemic significantly reduced the clinical activity of our department. However, it is possible to continue providing clinical services for urgent/cancer cases with the appropriate safety measures in place.

This survey examined the experiences of individuals receiving treatment in a large public mental health system during the early months of the COVID-19 pandemic.The survey, conducted between May and June 2020, assessed four domains: impacts on mental health, experiences with telehealth, access to care and resources, and sources and adequacy of support. Descriptive analyses were conducted.Of 4,046 respondents, 70% reported increases in their anxiety and stress because of the pandemic. A majority (55%) reported experiencing challenges related to the social determinants of health and functional needs. Most respondents reported that their care went undisrupted, with 92% using telehealth and 90% reporting feeling adequately supported.The pandemic substantially affected individuals with mental illness, particularly with regard to mental health related to the social determinants of health and functional needs. However, respondents felt that their mental health care was maintained and that they were adequately supported.

Admissions teams are challenged to select the best applicants for their college. There is a growing emphasis on selecting applicants with personal attributes important for success in a variety of veterinary careers, but there is no clear consensus on how to best identify these individuals. A number of veterinary colleges are utilizing multiple mini-interviews (MMIs), a highly structured type of interview in this selection process. However, due to travel restrictions currently associated with COVID-19, many are now considering virtual MMIs. Long Island University (LIU) took the step to conduct MMIs virtually for its inaugural class before the pandemic restrictions occurred, largely because it hoped to reduce the cost of admission by eliminating travel costs. In this process, we encountered a unique set of challenges, the resolution of which we believe constitutes best practices for virtual MMIs. This report describes the design and execution of an MMI for LIU. We were able to interview 340 applicants in 7 days. Based on feedback from applicants as well as raters, most considered it an acceptable means of interviewing students. Both raters and applicants expressed a high degree of satisfaction with the process, and we were able to separate applicants based on MMI scores with 88% reliability.

BACKGROUND: Advance health directives (AHDs) can be used to explore and document patient preferences for treatment and are therefore an important aspect of care planning. AIMS: To investigate the prevalence and factors associated with AHDs among older inpatients. METHODS: This retrospective study included 6449 patients, aged ≥65 years referred for specialist geriatric consultation between 2007 and 2018 in Queensland, Australia. The interRAI-Acute Care Comprehensive Geriatric Assessment tool was used to calculate a frailty index (FI), range 0-1, based on 52 possible deficits, and categorised into intervals of 0.1 for analysis. FI was also grouped according to previously reported cut points: fit (FI ≤0.25), moderately frail (FI >0.25-0.4), frail (FI >0.4-0.6) and severely frail (FI >0.6). RESULTS: An AHD was present in 1032/6449 (16.0%) patients. Those with an AHD were significantly frailer than those without an AHD (mean FI 0.52 vs 0.45; p < 0.001). Higher frailty (OR:1.34(1.27-1.40)), older age (OR:1.04(1.03-1.05)), living in an institution (OR:1.33(1.01-1.73)), and recent hospitalisation (OR:1.42(1.23-1.62)) were significantly associated with higher prevalence of AHDs. Prevalence of AHD increased over time, from 7.6%(n = 66) in 2008 to 35.4%(n = 99) in 2017. CONCLUSION: The presence of AHDs is associated with sociodemographic factors, as well as higher frailty levels. Prevalence of AHDs among inpatients has increased over the past decade but remains modest. This article is protected by copyright. All rights reserved.

Objective Research from the early months of the SARS-Cov-2 (COVID-19) pandemic identifies many COVID-related stressors, including fears of infection, disruptions to work/learning and daily self-care routines, and lack of access to reliable information and resources. Measuring the complex, ongoing nature of the stressors related to COVID-19 is of great practical utility, as is investigating how people may differently respond to stressors. The objective of the present study was to identify the possible profiles of COVID-19-related stressors using a recently developed measure, the COVID-19 Stressors Scale. Method The present study sampled individuals from Amazon Mechanical Turk (MTurk; n = 1,530) and examined the COVID-19 Stressors Scale with a latent profile analysis. Results Using a latent profile analysis, three profiles of COVID-19-related stressors were identified, Moderate Disruption Distress, High Disruption Distress, and Identity and Role Strain. Conclusions Based on the results of the study, the authors encourage researchers to differentiate types of stressors profiles of individual experiences COVID-19 or future pandemics. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Abstract. Background: Coronavirus disease 2019 (COVID-19) threatens people's physical and mental health, globally, and it may even trigger suicide ideation and suicidal behavior. Aims: We aimed to examine the impact of COVID-19 on suicide risk by sampling Chinese Weibo users and analyzing their social media messages. Method: We predicted the probability of suicide (including hopelessness, suicidal ideation, negative self-evaluation, and hostility) of Weibo users in order to assess the changes in suicide probability at different times. Repeated-measures ANOVA was performed to examine the differences in suicide probability in different regions during different periods. Results: There was no significant difference in suicide probability between profoundly infected areas (PIAs) and less infected areas (LIAs) before the outbreak of COVID-19. LIAs had an increase in hopelessness during the COVID-19 growth period, while hopelessness and hostility in PIA increased during the COVID-19 decline period, indicating potential suicide probability. Limitations: Results should be interpreted with caution, and cross-cultural research may be considered in the future. Conclusion: COVID-19 has a dynamic impact on suicide probability. Using data from online social networks may help to understand the impact pattern of COVID-19 on people's suicide probability.

Objective To describe, among pediatricians (Peds) and family physicians (FPs), 1) changes made to routine childhood vaccination delivery as a result of the pandemic, and 2) perceived barriers to delivering vaccinations from March 2020 through the time of the survey. Methods A nationally representative survey among Peds and FPs was administered by mail or Internet in October-December 2020. Results Response rate was 64% (579/909). For children aged 0–2 years, among those who vaccinated that age group pre-pandemic (Peds n=265, FPs n=222), 5% of Peds and 15% of FPs reported they had stopped vaccinating these children at any time. For children aged 4–6 years (Peds n=264, FPs n=229), 19% of Peds and 17% of FPs reported they had stopped vaccinating at any time. For children aged 11–18 years (Peds n=265, FPs n=251), 24% of Peds and 19% of FPs reported they had stopped vaccinating at any time. Nearly all reported returning to pre-pandemic vaccination services at the time of the survey. Factors most frequently reported as major/moderate barriers to providing vaccinations included fewer in-person visits because patients/parents were concerned about risk of SARS-CoV-2 infection (Peds, 52%; FPs, 54%), fewer in-person visits for sports clearance (Peds, 39%; FPs, 44%), and fewer back-to-school in-person visits because some children were in virtual learning (Peds, 25%; FPs, 33%). Conclusions Although some physicians reported interrupting vaccination services at some point during the pandemic, the majority reported continuing to provide vaccinations throughout, with essentially all returning to pre-pandemic vaccination services by end of 2020.

In this paper, Transfer Learning is used in LSTM networks to forecast new COVID cases and deaths. Models trained in data from early COVID infected countries like Italy and the United States are used to forecast the spread in other countries. Single and multistep forecasting is performed from these models. The results from these models are tested with data from Germany, France, Brazil, India, and Nepal to check the validity of the method. The obtained forecasts are promising and can be helpful for policymakers coping with the threats of COVID-19.

Background/purpose The COVID-19 pandemic, caused by the spread of SARS-CoV-2 infection that is mainly through the airborne transmission, is a worldwide health concern. This review seeks to assess the potential effectiveness of mouthwash in reducing the oropharyngeal load of SARS-CoV-2 based on the available evidence. Methods Articles related to mouthwash and COVID-19 in PubMed were electronically searched in July, 2021. After manually excluding articles lacking sufficient scientific evidence or validation processes, those with inaccessible online full text, those that did not test the effectiveness of mouthwash against SARS-CoV-2, and those not written in English, 17 original and 13 review articles were chosen for this review. Results The eligible articles revealed that the main virucidal mechanism of mouthwash was via interactions with the viral envelope. Povidone-iodine (PVP-I), cetylpyridinium chloride (CPC), and essential oils with ethanol showed virucidal effects on SARS-CoV-2 in vitro, potentially by interfering with the viral envelope. A few clinical studies demonstrated that PVP-I, CPC, hydrogen peroxide, and chlorhexidine reduced the oropharyngeal load of SARS-CoV-2. Conclusion Although the available evidence is limited, mouthwash containing PVP-I or CPC shows potential for reducing the oropharyngeal load of SARS-CoV-2 and thus may present a risk-mitigation strategy for COVID-19 patients.

More than 64 countries and regions have, so far, developed COVID-19 contact-tracing apps to limit the spread of coronavirus. However, many experts and scientists cast doubt on the effectiveness of those apps. For each app, between a few hundred to a few thousand reviews have been entered by end-users in app stores. In this paper, we mine insights from the user reviews of contact-tracing apps of eight European countries to find out what end users think of COVID contact-tracing apps and the main problems that users have reported. IEEE

Historical antecedents of pharmaceutical sciences are sound on product orientation based on (analytical) chemistry, drug delivery and basic pharmacology. Over the last decades we have seen a transition towards a stronger disease orientation. This raises questions on whether, how and to what extent unmet medical need (UMN) is important in priority setting, funding and impact in pharmaceutical sciences. An online survey in 2020 collected perspectives of internationally recognised pharmaceutical scientists (N = 92), mainly from academia and industry, on drivers and influencing factors in pharmaceutical sciences. The study offers a unique global perspective, demonstrating a solid command of the global needs in pharmaceutical sciences. The survey revealed that UMN is currently seen as one of the three most important drivers, also in addition to emerging trends in science and opportunities driven by collaboration. There are expectations that UMN's impact becomes more influential. This was consistent for both industry and academic respondents. The majority of respondents also indicated that anticipated lessons learned from COVID-19 will strengthen the impact of UMN on science and leadership. This is important as prioritisation of research towards UMN can address the clinical needs where needed the most.

Objectives To evaluate the performance of nasal mid-turbinate self-testing using rapid antigen detection tests (RDT) for persons with suspected coronavirus disease 2019 (COVID-19) in the community. Self-testing for COVID-19 infection with lateral flow assay severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RDT, provides rapid results and could enable frequent and extensive testing in the community, thereby improving the control of SARS-CoV-2. Methods Participants visiting a municipal SARS-CoV-2 testing centre, received self-testing kits containing either the BD Veritor System (BD-RDT) or Roche SARS-CoV-2 antigen detection test (Roche-RDT). Oro-nasopharyngeal swabs were collected from the participants for quantitative RT-PCR (qRT-PCR) testing. As a proxy for contagiousness, viral culture was performed on a selection of qRT-PCR positive samples to determine the Ct-value at which the chance of a positive culture dropped below 0.5 (Ct-value cut-off). Sensitivity and specificity of self-testing were compared to qRT-PCR with a Ct-value below the Ct value cut-off. Determinants independently associated with a false-negative self-test result were determined. Results A total of 3201 participants were included (BD-RDT n = 1595; Roche-RDT n = 1606). Sensitivity and specificity of self-testing compared with the qRT-PCR results with a Ct-value below the Ct-value cut-off were 78.4% (95% CI 73.2%–83.5%) and 99.4% (95% CI 99.1%–99.7%), respectively. A higher age was independently associated with a false-negative self-testing result with an odds ratio of 1.024 (95% CI 1.003–1.044). Conclusions Self-testing using currently available RDT has a high specificity and relatively high sensitivity to identify individuals with a high probability of contagiousness.

This study compares the performance demanded from central referees and soccer assistants during professional games before and after the quarantine of COVID-19 during the same competition.Ten central referees and 19 assistants were monitored. Using a watch with Global Positioning System technology and a heart rate monitor, data were obtained of the distance they moved and information on their heart rate. A game before the quarantine period was compared to a game played 128 days after the quarantine period. These participants represented all the referees who played at least one game in the pre- and post-quarantine period of the same high-level competition in Brazil.The results indicated that the total distance, average, and maximum heart rate did not present significant differences between the pre-and post-quarantine time of the central and assistant referees, except for the distance covered by the assistant referees in the second half, which was significantly greater in the post-quarantine period (Δ% = 6.27;Cette étude compare les performances exigées des arbitres centraux et des assistants de football lors de matchs professionnels avant et après la mise en quarantaine pour COVID-19 lors de la même compétition.Dix arbitres centraux et 19 assistants ont été suivis. À l’aide d’une montre dotée de la technologie Global Positioning System et d’un moniteur de fréquence cardiaque, des données ont été obtenues sur la distance parcourue et des informations sur leur fréquence cardiaque. Un jeu avant la période de quarantaine a été comparé à un jeu joué 128 jours après la période de quarantaine. Ces participants représentaient tous les arbitres qui ont joué au moins un match dans la période pré et post-quarantaine de la même compétition de haut niveau au Brésil.Les résultats ont indiqué que la distance totale, la fréquence cardiaque moyenne et maximale ne présentaient pas de différences significatives entre le temps avant et après la quarantaine des arbitres centraux et assistants, à l’exception de la distance parcourue par les arbitres assistants en seconde période, qui était significativement plus élevée dans la période post-quarantaine (Δ % = 6,27

We investigate the spatiotemporal dynamics and control of an epidemic using a partial differential equation (PDE) based Susceptible-Latent-Infected-Recovered (SLIR) model. We first validate the model using empirical COVID-19 data corresponding to a period of 45 days from the state of Ohio, United States. Upon optimizing the model parameters in the learning phase of the analysis using actual infection data from a period of the first 30 days, we then find that the model output closely tracks the actual data for the next 15 days. Next, we introduce a control input into the model to represent the Non-Pharmaceutical Intervention of social distancing. Implementing the control using two distinct schemes, we find that in both cases the control input is able to significantly mitigate the infection spread. In addition to opening a novel pathway towards the characterization, analysis and implementation of Non-Pharmaceutical Interventions across multiple geographical scales using Control frameworks, our results highlight the importance of first-principles based PDE models in understanding the spatiotemporal dynamics of epidemics triggered by novel pathogens.

Resumen Antecedentes: Recientemente se ha sugerido que la vacunacion contra influenza puede ser un factor asociado con la disminucion de la mortalidad por COVID-19. Metodos: Mediante un estudio de casos y controles pareado por edad, basado en casos hospitalarios. Incluimos sujetos de 18 anos en adelante con diagnostico de COVID-19 moderado a grave. La infeccion se corroboro por RT-PCR para SARS-COV-2. Los sujetos fallecidos fueron considerados casos, los controles fueron los pacientes que egresaron por mejoria del cuadro agudo. Se utilizo analisis bivariado, para determinar los factores asociados con la muerte por COVID-19, con calculo de razon de momios e intervalos de confianza del 95%. Resultados: Un total de 560 pacientes fueron incluidos en el estudio, 214 (38.2%) fueron considerados casos y 346 (61.7%) controles. Se observo diferencia significativa con la presencia de diabetes mellitus tipo 2 [54% vs. 39.3% entre casos y controles, respectivamente (p=0.04)] y haber recibido la vacuna contra la influenza (p= 0.02). La diabetes mellitus tipo 2 se asocio con mayor mortalidad por COVID-19 [OR 1.8 (IC 95% 1.2-2.5) p=0.01], mientras que el haberse inmunizado contra influenza en 2019 se asocio con menor mortalidad en este grupo de pacientes [OR 0.6 (IC 95% 0.4-0.9) p=0.02]. Conclusiones: La vacunacion contra influenza en el ano previo parece asociarse con una menor mortalidad por COVID-19; mientras que se confirma a la diabetes mellitus tipo 2 como una condicion asociada con mayor mortalidad.

Abstract: Over-prescription of medicines leads to some crucial health issues like resistance, non-specificity, etc. Therefore, a human consumes various natural foods, therapeutics, and nutritional supplements to combat this problem. Various therapeutic properties of secondary metabolites, such as anticancer, anti-inflammatory, and antibacterial properties, are important in drug discovery and medicinal application. These natural products have replaced synthetic materials, resulting in a great deal of sustainability, rational use, and preservation of biodiversity. This review described the potential therapeutic applications of secondary plant metabolites found in Himalayan Indian plants. The database contains 45 plants to treat various diseases, such as cancer, inflammation, and microbial infections. Besides authorized ITIS names, it includes Hindi names, family names, and active constituents. The most important information about the molecules can be found in the hyperlinks for the active constituents. It includes structures (two-dimensional and threedimensional), names and identifiers, chemical and physical properties, spectral information, biochemistry, literature and patents. The review also references various phytochemicals responsible for preventing COVID-19. Despite several challenges in manufacturing natural products, researchers may conduct research to produce successful medicines with few side effects.

In recent decades, RNA-based therapeutics have transitioned from a near impossibility to a compelling treatment alternative for genetic disorders and infectious diseases. The mRNA vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are truly groundbreaking, and new adaptations are already being proposed to fight other microbes. Unfortunately, the potential of RNA-based therapeutics to treat human fungal infections has remained mostly absent from the conversation, despite the fact that invasive fungal infections kill as many per year as tuberculosis and even more than malaria. Here, we argue that RNA-based therapeutics should be investigated for the treatment of human fungal infections and discuss several major roadblocks and potential circumventions that may allow for the realization of RNA-based therapies against human fungal pathogens.

Myriad conditions may affect both the neurologic system and the thorax, while other diseases primarily affecting the thorax may manifest with neurologic abnormalities. Correlation of signs, symptoms, and imaging findings in the neurological system with those in the thorax can help diagnose certain conditions and/or guide further diagnostic work-up and treatment. We will review and illustrate the imaging appearance of several systemic/neurological diseases with thoracic manifestations as well as discuss conditions in the thorax that can lead to neurologic symptoms.

Symptom and functional assessment is challenging in geriatric oncology care. This multicenter cross-sectional study examined the use of a multiple-symptom assessment tool, the MD Anderson Symptom Inventory (MDASI), on Chinese patients with cancer aged 65 years and older.Patient-rated symptoms and functioning were assessed using MDASI and the European Organization for Research and Treatment of Cancer quality-of-life questionnaire.The most severe symptoms were fatigue and poor appetite. The older group (75-84 years old, n = 224) reported a more severe difficulty remembering (effect size [ES] 0.32; P.001), shortness of breath (ES 0.20; P = .020), and interference with general activity (ES 0.14; P = .027), with significantly worse physical functioning (ES -0.33; P.001) and cognitive functioning on the European Organization for Research and Treatment of Cancer quality-of-life questionnaire (ES 0.20; P .001) than the younger group (65-74 years old, n = 555). For MDASI measures of the core symptoms and total interference with daily activity, Cronbach α coefficients were 0.90 and 0.93, respectively, for the younger group; and 0.93 and 0.94 for the older group, respectively. Moderate to severe (score ≥4) interference with general activity and walking on MDASI accurately indicated poor performance status (area under the curve 0.8089 and 0.7969, respectively) and lack of independence status of Activities of Daily Living (area under the curve 0.7993 and 0.8304, respectively).MDASI is psychometrically reliable, valid, and clinically sensitive for the measuring symptom burden and functional status of Chinese patients with cancer aged 65 years and older. MDASI could be adopted to measure multiple symptoms and physical functioning outcomes in geriatric oncology practice as well as for research on treatment benefits.

In the face of climate change, development and humanitarian practitioners increasingly recognize the need to anticipate and manage multiple, concurrent risks. One prominent example of this increasing focus on anticipation is the rapid growth of Forecast-based Financing (FbF), in particular within Red Cross and Red Crescent (RCRC). To evaluate how anticipatory efforts managed multiple compounding risks during the COVID-19 pandemic, we examine how 14 RCRC Societies adapted their Early Action Protocols to COVID-19. Though many National Societies successfully adapted to the onset of the additional hazard of COVID-19, we find that multi-hazard risk management can be improved by: proactively developing guidelines that enable rapid adaptation of existing plans; more flexible funding mechanisms; surge capacity to provide additional human resources; and increasing local capacity and ownership for implementation to ensure supplies, skills, and decision-making authority are available when communication or travel is restricted. These findings align with wider recommendations for improving development, humanitarian, and climate adaptation practice towards local capacity and agency. They also add urgency to broader calls for more flexible disaster financing and more practitioner-oriented investment in climate risk and multi-hazard management.

The study is to evaluate the impact of COVID-19 in the Pediatric Oncology Units (POUs) of Pakistan. Data from 1 April 2019 to 30 June 2019 and 1 April 2020 to 30 June 2020 for the first and second cohort, respectively, in order to compare the registration, abandonment rate, and delay in treatment. Six hundred and thirty-four were registered cases, 379 and 255 in the first and second cohort, respectively, which was significantly different0.005. Seventy-seven were abandoned, 45 and 32 in the first and second cohort, respectively. Fifty-nine COVID-19 positive cases, 24, 4, 27, and 4 were admitted, referred, home isolated, and leave against medical advice (LAMA), respectively. Delayed treatment and reduction in new cases were observed.

We discuss common errors and fallacies when using naive "evidence based" empiricism and point forecasts for fat-tailed variables, as well as the insufficiency of using naive first-order scientific methods for tail risk management. We use the COVID-19 pandemic as the background for the discussion and as an example of a phenomenon characterized by a multiplicative nature, and what mitigating policies must result from the statistical properties and associated risks. In doing so, we also respond to the points raised by Ioannidis et al. (2020)., Accepted, International Journal of Forecasting

At the beginning of the COVID-19 pandemic, organizations around the world rapidly transitioned to enforced remote work. We examined the relationship between personality and within-person changes in five job outcomes (self-reported performance, engagement, job satisfaction, burnout, and turnover intentions) during this transition. We conducted a four-wave longitudinal study, from May to August 2020, of employees working from home due to COVID-19, N = 974. On average, self-reported performance decreased over the course of the study, whereas the other outcomes remained stable. There was also significant between-person variability in job outcomes. Extroversion and conscientiousness, two traits traditionally associated with desirable outcomes, were associated with deteriorating outcomes over time. Extroverted employees and conscientious employees became less productive, less engaged, and less satisfied with their jobs; and extroverted employees reported increasing burnout. These results add to our understanding of how personality predicts within-person changes in performance, well-being, and turnover intentions during the pandemic.

PURPOSE: Given the perioperative morbidity and intensity of multimodality treatment, patients with resected pancreatic ductal adenocarcinoma (PDAC) spend a substantial amount of time in clinical care. The primary aim was to determine total time spent in multimodality care for patients with locoregional PDAC. METHODS: A cohort study of all patients who underwent curative-intent resection for PDAC at a single-institution, tertiary care center was performed (2015-2019). Exact times for all relevant visits were abstracted from the primary medical record, and travel time was calculated. Care time was divided into preoperative, surgical, radiation, and systemic therapy phases of care. Primary outcome measures were the percentage of total survival time (TST) and percentage of overall survival (OS) days spent in receipt of care. RESULTS: One hundred seven patients were included. Patients spent a median of 5.0% (interquartile range [IQR] 2.4%-10.1%) of TST and 11.0% (IQR, 5.7%-20.4%) of OS days in receipt of clinical care. Preoperative, surgical, radiation, and systemic therapy phases of care comprised a median of 0.9% (IQR, 0.4%-2.2%), 3.0% (IQR, 1.9%-6.8%), 4.4% (IQR, 3.6%-6.3%), and 10.0% (IQR, 6.2%-14.1%) of OS days. The median per-visit travel time was 60 minutes (IQR, 32-120), and the median cumulative travel time was 22.0 hours (IQR, 12.0-51.5). 12.1% (n = 13) and 7.8% (n = 4) of patients spent > 10% of TST in receipt of surgical and systemic therapy care, respectively. CONCLUSION: Patients with locoregional pancreatic cancer spend a considerable percentage of their survival time in receipt of oncologic care. Further research to determine predictors of increased time burden is warranted to better inform shared decision making.

The study examined temporal and geographic trends in telehealth availability at U.S. behavioral health treatment facilities and risk factors for not offering telehealth.Longitudinal data on 15,691 outpatient behavioral health treatment facilities were extracted daily from the Substance Abuse and Mental Health Services Administration's Behavioral Health Treatment Services Locator between January 20, 2020, and January 20, 2021. Facilities operated by the Department of Veterans Affairs were excluded. Bivariate analyses were used to assess trends in telehealth availability in 2020 and 2021. Multivariable regression analysis was used to examine facility- and county-level characteristics associated with telehealth availability in 2021.Telehealth availability increased by 77% from 2020 to 2021 for mental health treatment facilities and by 143% for substance use disorder treatment facilities. By January 2021, 68% of outpatient mental health facilities and 57% of substance use disorder treatment facilities in the sample were offering telehealth. Mental health and substance use disorder treatment facilities that did not accept Medicaid as a form of payment were less likely to offer telehealth in 2021, compared with facilities that accepted Medicaid. Mental health and substance use disorder treatment facilities that accepted private insurance were more likely to offer telehealth in 2021, compared with facilities that did not accept private insurance.Although 2020 saw a dramatic increase in telehealth availability at behavioral health treatment facilities, 32% of mental health treatment facilities and 43% of substance use disorder treatment facilities did not offer telehealth in January 2021, nearly 1 year into the pandemic.

We aimed to compare serum concentrations of sclerostin and DKK-1 in young (20-30 yrs, n = 25) and middle-aged (35-45 yrs, n = 25) premenopausal women and based on physical activity (PA) status. PA status was assessed by the International Physical Activity Questionnaire (low-moderate (≤ 2999 MET-min/week) and high (≥ 3000 MET-min/week). Serum sclerostin and DKK-1 levels were measured in fasting morning blood samples by ELISA. Areal bone mineral density (aBMD) was measured by DXA, and non-dominant tibia bone characteristics were assessed by pQCT. After adjusting for total body aBMD, middle-aged women had significantly (p0.001) higher (0.54 ± 0.01 ng/mL) serum sclerostin than young women (0.41 ± 0.01 ng/mL), and sclerostin was positively correlated with age (r

The awareness of ``social distancing'' is something we have heard because of the coronavirus (COVID-19) pandemic. Second wave of COVID-19 is started, and maintaining social distance and managing our psychological and physical well-being are the new challenges today. We are constantly reminded to maintain a safe distance from other people around us to stop the spread of COVID-19. But what if there was any solution that could make us aware if someone is in your social distance radius and alert us to maintain enough distance? Our article describes a solution using smartphones that delivers near-field peer-to-peer communication by using the present hardware to convert the messages in sound waves. IEEE

Resumen Introduccion La pandemia por COVID-19 ha tenido un importante impacto en todos los ambitos; uno de los mas afectados ha sido la sanidad. La pandemia ha supuesto una reorganizacion de los recursos tanto humanos como materiales, dada la saturacion del sistema sanitario. Como especialistas en el cancer de mama hemos tenido que adaptarnos a esta situacion, reorganizando y ajustando los cuidados a los medios profesionales e infraestructuras de los que disponiamos en cada momento. La incidencia variable a lo largo del ano ha permitido desarrollar una actividad normalizada en algunas ocasiones. Nos proponemos describir nuestra experiencia en la cirugia del cancer de mama durante este ano de pandemia de COVID-19. Material y metodos Estudio observacional retrospectivo de pacientes intervenidas de neoplasia de mama desde el 14 de marzo de 2020 hasta el 14 de marzo de 2021. Resultados Se han intervenido 138 neoplasias de mama en 136 mujeres. La edad media fue de 62 anos (36-88). Hubo 86 pacientes (63,2%) en regimen de cirugia mayor ambulatoria y 50 pacientes (36,8%) con ingreso. El tiempo medio desde el diagnostico hasta la visita en consultas externas fue de 5,7 dias y el tiempo medio desde el diagnostico hasta el inicio del tratamiento de 45 dias. Conclusiones Durante este ano de pandemia de COVID-19 hemos podido asegurar la asistencia y tratamiento de las mujeres con cancer de mama con adecuados intervalos entre el diagnostico y el tratamiento. A este proceso ha contribuido la implementacion previa de la cirugia mayor ambulatoria en el cancer de mama.

Background: Andrographis paniculata, commonly known as “Kalmegh”, is an annual herbaceous plant from family Acanthaceae. The whole plant of A. paniculata has explored for multiple pharmacological activities and is scientifically recognized by in-vivo and in-vitro studies. Various biotechnologically engineered techniques have been explored to enhance the bioavailability of this plant. Objective: In this review, we aim to present comprehensive recent advances in the ethnopharmacology, phytochemistry, specific pharmacology, safety and toxicology and bioavailability of A. paniculata and its pure compounds. Possible directions for future research are also outlined in brief, which will encourage advance investigations on this plant. Methods: Information on the recent updates of the present review is collected from different electronic scientific databases such as Science Direct, PubMed, Scopus, and Google Scholar. All the composed information is classified into different sections according to the objective of the paper. Results: More than hundred research and review papers have been studied and incorporated in the present manuscript. After vast literature search of A. paniculata, we present a noteworthy report of various phytoconstituents present in plant, which are accountable for potential therapeutic properties of the plant. Forty-five of studied articles give general information about introduction, ethnobotany and traditional uses of the plant. Twenty-two papers enclosed information about the phytoconstituents present in different parts of A. paniculata and seventy-two papers briefly outlined the pharmacological activities like antioxidant, anti-dengue, anti-ulcerogenic, antifungal, some miscellaneous activities like activity against SARS-CoV-2, antidiarrhoeal. Nineteen studies highlighted the research work conducted by various researchers to increased bioavailability of A. paniculata and two studies reported the safety and toxicology of the plant. Conclusion: This review incorporated the scientifically validated research work encompassing the ethnobotanical description of the subjected plant, phytochemical profile, various pharmacological activities, and recent approaches to enhance the bioavailability of active metabolites.

PURPOSE: The COVID-19 pandemic led to rapid shifts in cancer survivorship care, including the widespread use of telehealth. Given the swift transition and limited data on preferences and experiences around telehealth, we surveyed oncology providers and post-treatment survivors to better understand experiences with the transition to telehealth. METHODS: We distributed provider (MD, PA or NP, nurse, navigator, and social worker) and survivor surveys through the American College of Surgeons Commission on Cancer in mid-October 2020. Survivor surveys were also disseminated through patient advocacy organizations. We included questions on demographics, experiences with telehealth, and preferences for future telehealth utilization. RESULTS: Among N = 607 providers and N = 539 cancer survivors, there was overwhelmingly more support from providers than from survivors for delivery of various types of survivorship care via telehealth and greater comfort with telehealth technologies. The only types of appointments deemed appropriate for survivorship care by both > 50% of providers and survivors were discussion of laboratory results or imaging, assessment and/or management of cancer treatment symptoms, nutrition counseling, and patient navigation support. Only a quarter of survivors reported increased access to health care services (25.5%), and 32.0% reported that they would use telehealth again. CONCLUSION: Although there have been drastic changes in technological capabilities and billing reimbursement structures for telehealth, there are still concerns around delivery of a broad range of survivorship care services via telehealth, particularly from the patient perspective. Still, offering telehealth services, where endorsed by providers and if available and acceptable to cancer survivors, may provide more efficient and accessible care following the COVID-19 pandemic.