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CoVID-19 has been linked to long-term consequences on several human body organs, including lung ailments, kidney malfunctions, heart dysrhythmia, alterations in brain nutrient levels, psychological difficulties, abrupt changes in blood pressure, and more. Because of the considerable variety in the impacts on different body parts, researchers find it challenging to create models that can incorporate these effects for treatment recommendations and future disease prevention scenarios. Thus, this article examines some of the most recently proposed models for identifying the impacts of CoVID19 on various human organs. This review examines the underlying theories in terms of clinical nuances, functional advantages, contextual limits, and potential empirical applications. Based on this discussion, researchers will be able to find the best models for detecting particular diseases on specific body parts. It was discovered that hybrid bioinspired models, when paired with deep learning-based classification algorithms, can effectively detect these impacts. This text also parametrically analyses these models in terms of accuracy, precision, and recall, allowing readers to select the best models for their performance-specific use cases. To expand on this discussion, this book evaluates a unique CoVID19 Classification Rank Metric (CCRM) that integrates these factors for thorough model identification. Based on this criteria, researchers will be able to develop appropriate models for clinical scenarios that have high accuracy, low delay, and scalability while costing less. [ABSTRACT FROM AUTHOR]

Background: COVID19 is a pandemic that has affected millions around the world since March 2020. While many patients recovered completely with mild illness, many patients succumbed to various organ morbidities. This heterogeneity in the clinical presentation of COVID19 infection has posed a challenge to clinicians around the world. It is therefore crucial to identify specific organ-related morbidity for effective treatment and better patient outcomes. We have carried out serum-based proteomic experiments to identify protein biomarkers that can flag organ dysfunctions in COVID19 patients. Methods: COVID19 patients were screened and tested at various hospitals across New Delhi, India. 114 serum samples from these patients, with and without organ morbidities were collected and annotated based on clinical presentation and treatment history. Of these, 29 samples comprising of heart, lung, kidney, gastrointestinal, liver, and neurological morbidities were considered for the discovery phase of the experiment. Proteins were isolated, quantified, trypsin digested, and the peptides were subjected to liquid chromatography assisted tandem mass spectrometry analysis. Data analysis was carried out using Proteome Discoverer software. Fold change analysis was carried out on MetaboAnalyst. KEGG, Reactome, and Wiki Pathway analysis of differentially expressed proteins were carried out using the STRING database. Potential biomarker candidates for various organ morbidities were validated using ELISA. Results: 254 unique proteins were identified from all the samples with a subset of 12–31 differentially expressed proteins in each of the clinical phenotypes. These proteins establish complement and coagulation cascade pathways in the pathogenesis of the organ morbidities. Validation experiments along with their diagnostic parameters confirm Secreted Protein Acidic and Rich in Cysteine, Cystatin C, and Catalase as potential biomarker candidates that can flag cardiovascular disease, renal disease, and respiratory disease, respectively. Conclusions: Label free serum proteomics shows differential protein expression in COVID19 patients with morbidity as compared to those without morbidity. Identified biomarker candidates hold promise to flag organ morbidities in COVID19 for efficient patient care. [ABSTRACT FROM AUTHOR]

Purpose: Outbreak of SARS-CoV2 and the COVID-19 pandemic had posed a threat to the healthcare system. The world had witnessed the failure of the healthcare system in the diagnosis, surveillance, and development of therapeutics effective against COVID-19. Hence, research emphasis has been given to technological inventions in developing robust and effective tools to fight against respiratory viral outbreaks, including SARS-CoV2. Methods: The scientific literature was searched and retrieved from PubMed, PubMed Central, the Cochrane Central Register of Controlled Trials (CENTRAL), and Scielo databases. The scientific literature was screened and selected based on recent studies in the area of nanotechnology based inventions and applications in developing diagnostics, surveillance tools, PPE kits, therapeutics, and vaccines. Results: Based on the scientific literature, there are enormous developments in designing robust diagnostics, surveillance tools, therapeutics, and vaccines. These findings show an increasing demand for nanotechnology-based inventions to tackle zoonotic spillover. Nanotechnology remains a growing area as interdisciplinary science and technology- enable a variety of inventions used in the COVID-19 pandemic. PPE design is a classic example where nanotechnology-driven materials are extensively used. Masks and other fabrics were also developed using nanotechnology-based materials. Conclusion: The study provides insights into nanotechnology based inventions in the fight against respiratory viral pathogens, including SARS-CoV2, and associated diseases. The study showed the application of nanotechnology in the development of diagnostics, surveillance tools, therapeutics, and vaccines. [ABSTRACT FROM AUTHOR]

AbstractCerebral venous thrombosis (CVT) is an uncommon cause of stroke. COVID-19 infection and vaccination have been associated with CVT. Fibrinolysis and mechanical thrombectomy may play an emerging role in management. We conducted a literature review summarizing current evidence on use of antiplatelets, anticoagulants, thrombolysis, and mechanical thrombectomy for the management of CVT and COVID-19 related CVT. This was achieved through a review of MEDLINE, PubMed, and Cochrane Reviews databases, performed using the search terms CVT AND “antiplatelets’ aspirin”, “ticagrelor”, “clopidogrel”, “eptifibatide”, “Low-molecular-weight-heparin (LMWH)”, “Unfractionated heparin (UH)”, “warfarin”, “DOACs”, “rivaroxaban”, “apixaban”, “dabigatran”, “fibrinolysis”, “intra-sinus thrombolysis”, “mechanical thrombectomy”, and “craniectomy”. We found that LMWH and UH are safe and effective for the management of acute CVT and should be considered first line. Warfarin may be used in the sub-acute phase for secondary prevention but has weak evidence. DOACs are potentially a safe warfarin alternative, but only warfarin is currently recommended in international guidelines. Antiplatelets show little evidence for the prevention or management of CVT, but studies are currently limited. COVID-19 related CVT is treated similarly to non-COVID-19 CVT; however, vaccine-related CVT is a newly recognised disease with a different pathophysiology and is treated with a combination of non-heparin anticoagulants, immunotherapy, and steroids. Decompressive craniectomy may be used to reduce intracranial pressure in life-threatening cases. There is a small body of evidence for endovascular therapy in complex cases but should be reserved for complex cases in specialist centres. This paper is of relevance to clinical practice since the safe and effective management of CVT is important to reduce the risk of disability. [ABSTRACT FROM AUTHOR]

Machine Learning is recent emerging technique in prediction of various health related issues in medical system. It is very essential to predict the COVID-19 virus before it spreads and affects an entire community. Machine Learning is being used to detect the presence of COVID-19 virus as early as possible by analyzing patient's health condition and collecting data such as gender, age, Body Mass Index (BMI), asthma symptoms, wheezing, dyspnea, respiratory failure, cough, blood sugar level etc., with this information used eighteen machine learning algorithms such as ELM, Logistic Regression, SGD, KNN, SVM, QDA, LDA, XGBoost etc., to analyze the data and predict the presence of COVID-19 virus. Table and Charts are plotted with the help of the results acquired from the machine learning algorithm. As a result, early prediction of COVID-19 becomes possible and huge loss in terms of both health and economy can be avoided. [ABSTRACT FROM AUTHOR]

(1) Background: Since the onset of the COVID-19 pandemic, it has been recognized that a considerable proportion of critically ill patients may die of this disease. The current study aims to assess the overall 1-year outcomes within the UMFST COVID-19 Unit, providing valuable insights into the efficacy of specialized care facilities in managing severe cases of COVID-19. (2) Methods: This is a retrospective monocentric observational study including 294 patients confirmed to have SARS-CoV-2 infection. Demographic data and clinical and paraclinical parameters were assessed. Survival probabilities were estimated using Kaplan–Meier curves. (3) Results: Overall, the 1-year mortality was 89.4%. All deaths occurred in-hospital, with two patients dying after 28 days. Diabetes mellitus, chronic kidney failure, cerebrovascular disease, and atrial fibrillation were more prevalent in deceased patients. Thirty percent of patients needed endotracheal intubation during the first 24 h. The incidence of hospital-acquired pneumonia was higher among deceased patients. The SOFA score was significantly different between deceased vs. survivors. The survival analysis showed that the use of noradrenaline increased the likelihood of surviving COVID-19. (4) Conclusions: The severe comorbidities of the patients were the primary factors contributing to the increased mortality rate in the COVID-19 unit. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Immune dysregulation and SARS‐CoV‐2 plasma viremia have been implicated in fatal COVID‐19 disease. However, how these two factors interact to shape disease outcomes is unclear.We carried out viral and immunological phenotyping on a prospective cohort of 280 patients with COVID‐19 presenting to acute care hospitals in Boston, Massachusetts and Genoa, Italy between June 1, 2020 and February 8, 2022. Disease severity, mortality, plasma viremia, and immune dysregulation were assessed. A mouse model of lethal H1N1 influenza infection was used to analyze the therapeutic potential of Notch4 and pyroptosis inhibition in disease outcome.Stratifying patients based on %Notch4+ Treg cells and/or the presence of plasma viremia identified four subgroups with different clinical trajectories and immune phenotypes. Patients with both high %Notch4+ Treg cells and viremia suffered the most disease severity and 90‐day mortality compared to the other groups even after adjusting for baseline comorbidities. Increased Notch4 and plasma viremia impacted different arms of the immune response in SARS‐CoV‐2 infection. Increased Notch4 was associated with decreased Treg cell amphiregulin expression and suppressive function whereas plasma viremia was associated with increased monocyte cell pyroptosis. Combinatorial therapies using Notch4 blockade and pyroptosis inhibition induced stepwise protection against mortality in a mouse model of lethal H1N1 influenza infection.The clinical trajectory and survival outcome in hospitalized patients with COVID‐19 is predicated on two cardinal factors in disease pathogenesis: viremia and Notch4+ Treg cells. Intervention strategies aimed at resetting the immune dysregulation in COVID‐19 by antagonizing Notch4 and pyroptosis may be effective in severe cases of viral lung infection. [ABSTRACT FROM AUTHOR]

Background: Several factors may be associated with the severity of COVID-19. Lifestyle, social relations, and socio-economic status can also influence how external stressors, including health crises, are perceived. However, limited research has addressed their role as risk factors in the severity of COVID-19 in both hospitalized and non-hospitalized patients. Aims: The present study was conducted with the aim of In the investigation of the role of lifestyle, social relations and socio-economic status of the family in the severity of Covid-19. Methods: This cross-sectional (analytical) research included all individuals aged 18 years and older in Kerman city who had experienced COVID-19 between March 2020 and April 2021. The statistical sample, selected through stratified random sampling, comprised 180 hospitalized patients and 220 non-hospitalized patients out of a total of 146,000 patients. Data were collected using lifestyle questionnaires (Laali, 2013), quality of relationships (Pierce, 1991), and demographic questionnaires. Data analysis was performed using the logistic regression method with SPSS26 software. Results: Logistic regression revealed that lifestyle, social relations, and socio-economic status significantly contribute to the severity of COVID-19 infection in both hospitalized and nonhospitalized adults. The likelihood of hospitalization is higher in COVID-19 patients with an inappropriate lifestyle, low socio-economic status, and weak social relations (p> 0.05). Conclusion: Recognizing the role of these factors in the severity of COVID-19 enhances officials' understanding of their impact and strengthens preparedness for responding to potential future outbreaks or other infectious epidemics. [ABSTRACT FROM AUTHOR]

Noninvasive mechanical ventilation (NIV) may reduce postoperative complications of obesity--associated restrictive pulmonary syndrome. We evaluated the effects of NIV use after extubation in patients undergoing bariatric surgery on acute changes in lung function. A randomized clinical trial was performed with patients in the immediate postoperative period of bariatric surgery. The intervention group used NIV for 1 hour after arrival at the post-anesthesia recovery room, the control group received standard care. Pulmonary function assessment was performed preoperatively, immediately after surgery and 1 hour after arrival in the recovery room. Statistical analysis was performed using the Generalized Estimation Equations test and Bonferroni's post-hoc test. The significance level adopted was 0.05. A total of 46 individuals were evaluated, of which 31 were able to perform spirometry in the pre and immediate postoperative period. The sample consisted of 25 women, mean age of 42.55 ± 10.39 years and mean Body Mass Index of 50.82 ± 10.20. Preoperative spirometry showed that most patients had mild restrictive disorders (46.7% versus 43.8%) or no respiratory disorder (40% versus 31.3%). In the post-extubation evaluation, most patients had severe restrictive disorder (66.7% versus 53.8%), after one hour in the recovery room, 64.3% versus 60% of patients had severe restriction and 21.4% versus 20% severe obstruction. It was concluded that the use of prophylactic NIV did not improve pulmonary function in the immediate postoperative period. [ABSTRACT FROM AUTHOR]

Introduction: This study evaluated the effect of the COVID-19 pandemic on temporal trends in mental health and addiction--related inpatient hospitalization rates among youth (aged 10--17 years) in Canadian provinces and territories (excluding Quebec) from 1 April 2018 to 5 March 2022. Methods: We conducted an interrupted time series analysis across three periods: T0 (pre-pandemic: 1 April 2018 to 15 March 2020); T1 (early pandemic: 15 March 2020 to 5 July 2020); and T2 (later pandemic: 6 July 2020 to 5 March 2022). Results: Pre-pandemic mental health and addiction--related hospitalization rates had significant regional variability, with weekly rates from 6.27 to 85.59 events per 100 000 persons in Manitoba and the territories combined, respectively. During T1, the national (excluding Quebec) weekly hospitalization rate decreased from a pre-pandemic level of 12.82 (95% CI: 12.14 to 13.50) to 5.11 (95% CI: 3.80 to 6.41) events per 100 000 persons. There was no statistically significant change in the mental health and addiction--related hospitalization rate across provinces and territories in T2 compared to T0. However, there was a significant increase in the rate of self-harm--related hospitalizations among females Canada-wide and in most provinces during this period. Conclusion: Although several Canadian studies have reported increases in mental health and addiction--related outpatient and emergency department visits among youth during the COVID-19 pandemic, this did not correspond to an increase in the inpatient hospital burden, with the notable exception of self-harm among young females. [ABSTRACT FROM AUTHOR]

Listening is essential to student learning. But how can instructors build practices of listening into their courses? This article makes the case for adopting a listening-centered approach to university instruction to subvert the dominant "transmission model" of education. It also provides an example of how such an approach can be implemented in practice. Specifically, I present the "plague narrative," a reflective writing assignment modeled after Thucydides' account of the plague of Athens in 430 BCE. The plague narrative gives instructors the opportunity to listen to students' experiences and to learn about their needs and situations. The exercise also offers students a relatively "low stakes" opportunity to engage in political theorizing and critique. Instructors, if properly focused on listening, can use this assignment to better understand their students while helping them make sense of contemporary political life. I conclude by considering how this assignment can disrupt the forces that might push a student to rely on generative AI tools and instead encourage them to use their own critical thinking and writing skills. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 (COVID19) can cause gastrointestinal complications as well as respiratory tract disease. Coagulation abnormalities and thrombosis frequently occur in COVID19, especially in cases with severe clinical outcome. The relationship between gastrointestinal perforation and coagulopathy due to COVID19 remains unclear. Case presentation: A 49-year-old female received Chimeric antigen receptor T (CAR-T) therapy for an early recurrence of diffuse large B-cell lymphoma (DLBCL) that was refractory to chemotherapy. She was diagnosed with cytokine release syndrome (CRS) because of a fever and oxygen desaturation, and administered tocilizumab. Forty days after completing CAR-T therapy, she was infected with COVID19 and transferred to our hospital. Her general condition worsened and she developed COVID19 pneumonia, and then steroid pulse therapy was started. While her respiratory condition improved, she experienced pain in the anal region and computed tomography (CT) revealed a rectal perforation. An emergency surgery was undertaken, and the lower rectum wall was found to be completely necrotic. Removal of the necrotic part of the rectum tissue, and drainage and lavage of necrotic tissue in the pelvic cavity were performed. The remaining rectum was resected with partial sigmoidectomy, but we could not make the anal stump closed. In addition, an end colostomy in the sigmoid colon was performed. Histopathological findings showed thromboses in the rectal mesentery veins. After the first surgery, the pelvic abscess cavity persisted and her high-grade fever continued. Reoperation was laparoscopically performed, and she underwent a resection of anal canal with residual necrotic rectal and mesorectal tissue, and a drainage of the pelvic abscess. After the reoperation, her general condition improved and CT showed that the abscess cavity had significantly improved. Conclusions: Gastrointestinal perforation, especially rectal necrosis due to coagulopathy caused by severe COVID19 infection, is a rare but life-threatening complication. Physicians should have a high degree of clinical suspicion for timely diagnosis and management, and surgical intervention is necessary in cases of rectal necrosis. [ABSTRACT FROM AUTHOR]

In the context of the COVID-19 pandemic, the early and accurate identification of patients at risk of deterioration was crucial in overcrowded and resource-limited emergency departments. This study conducts an external validation for the evaluation of the performance of the National Early Warning Score 2 (NEWS2), the S/F ratio, and the ROX index at ED admission in a large cohort of COVID-19 patients from Colombia, South America, assessing the net clinical benefit with decision curve analysis. A prospective cohort study was conducted on 6907 adult patients with confirmed COVID-19 admitted to a tertiary care ED in Colombia. The study evaluated the diagnostic performance of NEWS2, S/F ratio, and ROX index scores at ED admission using the area under the receiver operating characteristic curve (AUROC) for discrimination, calibration, and decision curve analysis for the prediction of intensive care unit admission, invasive mechanical ventilation, and in-hospital mortality. We included 6907 patients who presented to the ED with confirmed SARS-CoV-2 infection from March 2020 to November 2021. Mean age was 51 (35–65) years and 50.4% of patients were males. The rate of intensive care unit admission was 28%, and in-hospital death was 9.8%. All three scores have good discriminatory performance for the three outcomes based on the AUROC. S/F ratio showed miscalibration at low predicted probabilities and decision curve analysis indicated that the NEWS2 score provided a greater net benefit compared to other scores across at a 10% threshold to decide ED admission at a high-level of care facility. The NEWS2, S/F ratio, and ROX index at ED admission have good discriminatory performances in COVID-19 patients for the prediction of adverse outcomes, but the NEWS2 score has a higher net benefit underscoring its clinical utility in optimizing patient management and resource allocation in emergency settings. [ABSTRACT FROM AUTHOR]

In this paper, we explore women's use of ICTs in urban Afghanistan in the period between 2015 and 2022 to examine the changing gender dynamics of ICT access and usage in the context of expanding opportunities for women's education and employment (2015–2020) and different forms of crises, including the COVID19 pandemic (2020–2021) and political takeover by the fundamentalist and violent Taliban regime (2021–2022). Drawing on feminist theorization of empowerment and using a mixed methods study of 817 questionnaires (2015) and observation data (2015–2022) allows us to make visible the contingent and unintended dynamics of the relationship between women's empowerment and ICTs, especially in conflict zones. These findings contribute to ongoing debates on gender, empowerment and ICTs by emphasizing the multifaceted nature of technology adoption and usage, the significance of education in overcoming barriers, and the evolving role of ICTs, especially for women, in the face of radical political changes and crises. [ABSTRACT FROM AUTHOR]

This paper aims to identify herding biases and assess the inefficiency of Ethereum using an inefficiency index (MLM). Additionally, it investigates the nonlinear dynamical properties of Ethereum by estimating the MFDFA, aiming to deduce the impact of COVID-19 on Ethereum's performance. The paper also captures abnormal changes resulting from COVID-19-related events and assesses their influence on the Ethereum market response. The empirical results show that Ethereum was multifractal before the pandemic and became less fractal in the period following the outbreak using Generalized Hurst Exponent (GHE) estimation. Based on the MLM measure of efficiency, we found Ethereum to be more efficient in the first phase of the pandemic than before it, and as in the Hausdorff topology, the pandemic reduced herd bias. The event study analysis took into account specific events related to the pandemic and showed that each led to significant abnormal returns in the Ethereum market. The results reported are used to empirically establish differences in the value of Ethereum before and during the COVID-19 pandemic. The results are useful in a general sense for traders, investors, and policy makers because they provide new information about market trading opportunities and social responses. [ABSTRACT FROM AUTHOR]

Copyright of Dokuz Eylul University Muhendislik Faculty of Engineering Journal of Science & Engineering / Dokuz Eylül Üniversitesi Mühendislik Fakültesi Fen ve Mühendislik Dergisi is the property of Dokuz Eylul Universitesi Muhendislik Fakultesi Fen ve Muhendislik Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

During and subsequent to a natural disaster, there is an expectation that certain elements of society will continue to operate with a degree of normalcy. For example, it is expected that emergency medical services will continue to function and remain reliable for the community served. Expectations such as these are based on the presumed reliability of government and the assumption that those responsible for the relevant infrastructure will have made plans to ensure it remains functional and taken steps to mitigate known weaknesses. The COVID-19 pandemic provides a case in point. Specifically, data captured during the pandemic are now the subject of ongoing review and analysis, and the findings from such studies are being used to inform planning and preparedness for the next public health disaster. This particular study was conducted in response to circumstantial evidence indicating that frontline workers in the healthcare profession may share some of the same ambivalence towards transmission mitigation as seen in the general population when confronted with new and emerging communicable diseases. This is a concern, as when medical personnel are either unable or unwilling to take reasonable steps to protect themselves and their patients, it undermines the readiness of the essential service. To explore this situation in greater depth, the study examines the real-time responses from a sample of frontline personnel interviewed during the pandemic. The results indicate that there are a number of opportunities to improve workforce readiness to assure reliable continuity during the next outbreak, epidemic or pandemic. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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Investigating the impact of teleworking during the COVID-19 pandemic on work-related musculoskeletal disorders (WMSDs) and psychosocial factors of employees: a review article Ghasemi N1, Fallah H2, Nabian M3, Ghasemi M4, Halvani Gh5, Najafipour A6[1] 1 Master of ergonomic, Department of occupational health, School of health, Yazd university of medical sciences, Yazd, Iran 2 Assistant professor, Department of occupational health, School of health, Yazd university of medical sciences, Yazd, Iran 3 Orthopedics assistant professor, Trans-disciplinary research Institute of COTAR, Tehran, Iran 4 Associate Professor, School of nursery, Islamic Azad University, Arak Science and Research Unit, Arak, Iran 5 Associate Professor, Department of occupational health, School of health, Yazd university of medical sciences, Yazd, Iran 6 Medical student, Medical school, Tehran university of medical sciences, Tehran, Iran Abstract Introduction: Advances in technology have increased job flexibility for employees and employers alike. On the other hand, effective teleworking requires planning, the COVID-19 pandemic has forced many employees to quickly change their workplace from outside to home, without ensuring that the conditions are ready. The purpose of this study is to investigate the impact of teleworking on musculoskeletal disorders and psychosocial factors in the days of Corona. Materials and Methods: This research was done by a review method. Articles were searched from 2020 to 2023 on PubMed, Science Direct, and Google Scholar sites with the key words Ergonomics, Teleworking, MSDs, and COVID19. Results: A total of 93 articles were reviewed. By evaluating the titles, 45 related articles and 30 articles were selected by reviewing the abstracts, and finally 13 articles which full text was available were selected. These articles refer to the study of the effects of teleworking on musculoskeletal disorders and psychosocial factors in the era of Corona. Conclusion: Most of the studies point to the increase of musculoskeletal disorders. Teleworkers have experienced more musculoskeletal pain and discomfort in different areas of the body. Longer working hours with shorter breaks to meet increased work demands, social isolation, lack of support from colleagues, blurred boundaries between work and home, and omnipresence of work are some of the psychosocial and organizational factors associated with musculoskeletal disorders. For some employees, teleworking will remain a common way of working in the post-pandemic era. Therefore, it is necessary to identify telework-related risk factors for musculoskeletal disorders and address them with timely telework preventive measures and the individual needs of employees.

ABSTRACTIntroduction The rapid development of mRNA vaccines against SARS-CoV-2 has revolutionized vaccinology, offering hope for swift responses to emerging infectious diseases. Initially met with skepticism, mRNA vaccines have proven effective and safe, reducing vaccine hesitancy amid the evolving COVID-19 pandemic. The COVID-19 pandemic has demonstrated that the time required to modify mRNA vaccines to counter new mutant strains is significantly shorter than the time it takes for pathogens to mutate and generate new variants that can thrive in vaccinated populations. This highlights the notion that mRNA vaccine technology appears to be outpacing viruses in the ongoing evolutionary race.Areas covered This review article offers valuable insights into several crucial aspects of mRNA vaccine development and deployment, including the fundamentals of mRNA vaccine design and synthesis, the utilization of delivery systems, considerations regarding vaccine safety, the longevity of the immune response, strategies for modifying the original mRNA vaccine to address emerging mutant strains, as well as addressing vaccine hesitancy and potential approaches to mitigate reluctance.Expert opinion Challenges such as stability, storage, manufacturing complexities, production capacity, allergic reactions, long-term effects, accessibility, and misinformation must be addressed. Despite these hurdles, mRNA vaccine technology holds promise for revolutionizing future vaccination strategies.

Objectives: The aim of this work was to rapidly produce in plats two recombinant antigens (RBDw-Fc and RBDo-Fc) containing the receptor binding domain (RBD) of the spike (S) protein from SARS-CoV-2 variants Wuhan and Omicron as fusion proteins to the Fc portion of a murine IgG2a antibody constant region (Fc). Results: The two recombinant antigens were expressed in Nicotiana benthamiana plants, engineered to avoid the addition of N-linked plant-typical sugars, through vacuum agroinfiltration and showed comparable purification yields (about 35 mg/kg leaf fresh weight). Conclusions: Their Western blotting and Coomassie staining evidenced the occurrence of major in planta proteolysis in the region between the RBD and Fc, which was particularly evident in RBDw-Fc, the only antigen bearing the HRV 3C cysteine protease recognition site. The two RBD N-linked glycosylation sites showed very homogeneous profiles free from plant-typical sugars, with the most abundant glycoform represented by the complex sugar GlcNAc4Man3. Both antigens were specifically recognised in Western Blot analysis by the anti-SARS-CoV-2 human neutralizing monoclonal antibody J08-MUT and RBDw-Fc was successfully used in competitive ELISA experiments for binding to the angiotensin-converting enzyme 2 receptor to verify the neutralizing capacity of the serum from vaccinated patients. Both SARS-Cov-2 antigens fused to a murine Fc region were rapidly and functionally produced in plants with potential applications in diagnostics. [ABSTRACT FROM AUTHOR]

Abstract Early in the SARS-CoV2 pandemic, in this journal, Hou et al. (BMC Med 18:216, 2020) interpreted public genotype data, run through functional prediction tools, as suggesting that members of particular human populations carry potentially COVID-risk-increasing variants in genes ACE2 and TMPRSS2 far more often than do members of other populations. Beyond resting on predictions rather than clinical outcomes, and focusing on variants too rare to typify population members even jointly, their claim mistook a well known artifact (that large samples reveal more of a population’s variants than do small samples) as if showing real and congruent population differences for the two genes, rather than lopsided population sampling in their shared source data. We explain that artifact, and contrast it with empirical findings, now ample, that other loci shape personal COVID risks far more significantly than do ACE2 and TMPRSS2—and that variation in ACE2 and TMPRSS2 per se unlikely exacerbates any net population disparity in the effects of such more risk-informative loci.

Objective: Diabetic patients with COVID-19 are at the higher risk of clinical complications and intensive care unit )ICU( admission. There is limited information available on the risk factors of mortality in diabetic patients with COVID-19 admitted to the ICUs. The aim of this study was identifying the mortality risk factors in diabetic patients with COVID-19 who are admitted to the ICU. Materials and Methods: In this study, we conducted a descriptive-analytical observational analysis on 391 patients admitted to the ICU for 18 months. We assessed the demographic, clinical, pharmaceutical, laboratory and imaging data of diabetic patients and statistically analyzed them to identify mortality risk factors. Results: The study found 156 (39.89%) diabetic out of 391 patients. The group of diabetic patients had significantly higher rates of endotracheal intubation (P< 0.001), mortality (P< 0.001), and complications during hospitalization due to COVID-19, including secondary bacterial infections (P = 0.005), venous thrombosis (P = 0.008), and gastrointestinal bleeding (P = 0.011), compared to the nondiabetic patient. Conclusion: Patients with diabetes who also have COVID-19 tend to experience more severe clinical outcomes and a higher mortality rate when admitted to the intensive care unit. The likelihood of mortality in these patients is closely associated with factors such as stroke occurrence, oxygenation levels, and the presence of secondary infections at the time of admission.

Early in the SARS-CoV2 pandemic, in this journal, Hou et al. (BMC Med 18:216, 2020) interpreted public genotype data, run through functional prediction tools, as suggesting that members of particular human populations carry potentially COVID-risk-increasing variants in genes ACE2 and TMPRSS2 far more often than do members of other populations. Beyond resting on predictions rather than clinical outcomes, and focusing on variants too rare to typify population members even jointly, their claim mistook a well known artifact (that large samples reveal more of a population's variants than do small samples) as if showing real and congruent population differences for the two genes, rather than lopsided population sampling in their shared source data. We explain that artifact, and contrast it with empirical findings, now ample, that other loci shape personal COVID risks far more significantly than do ACE2 and TMPRSS2—and that variation in ACE2 and TMPRSS2 per se unlikely exacerbates any net population disparity in the effects of such more risk-informative loci. [ABSTRACT FROM AUTHOR]

Summary: 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. [ABSTRACT FROM AUTHOR]

Objective: During the COVID-19 pandemic, the prevalence of depression and anxiety among children and adolescents significantly increased, along with the number of visits to emergency departments due to suicidality and/or suicide attempts. Relatedly, health care workers experienced significant burnout and symptoms of anxiety, depression, and posttraumatic stress disorder during this time. However, the corresponding impact on psychiatric inpatient treatment has not yet been researched. We hypothesized that during the pandemic, adolescents hospitalized in an acute care psychiatric inpatient unit had increased incidents of suicide attempts and nonsuicidal self-injurious behaviors and of aggressive behaviors toward others, resulting in greater use of constant observation and restraints. Method: This study was a retrospective chart review based on electronic medical record data examining use of restraints and constant observation one year before the pandemic (March 2019 to February 2020) and 1 year following the onset of the pandemic (March 2020 to February 2021) in an acute-care adolescent (12 to 17 years old) psychiatric inpatient unit. Results: There were 571 admissions during the year before the pandemic and 500 admissions during the pandemic. The number of patients who were restrained (χ2 = 7.86, p = 0.005), number of patients who were placed on constant observation (χ2 = 13.41, p < 0.001), and number of constant observation orders per patient (χ2 = 91.90, p < 0.001) were all significantly greater during the pandemic. Conclusion: Psychiatrically hospitalized adolescents during the pandemic received more intensive interventions such as restraints and constant observation. Severe patient psychopathology and staff shortages, as well as limitations of and decreases to the dialectical behavior therapy program, may have been the contributing factor. [ABSTRACT FROM AUTHOR]

Severe Acute Respiratory Syndrome caused by a coronavirus is a recent viral infection. There is no scientific evidence or clinical trials to indicate that possible therapies have demonstrated results in suspected or confirmed patients. This work aims to perform a virtual screening of 1430 ligands through molecular docking and to evaluate the possible inhibitory capacity of these drugs about the Mpro protease of Covid-19. The selected drugs were registered with the FDA and available in the virtual drug library, widely used by the population. The simulation was performed using the MolAiCalD algorithm, with a Lamarckian genetic model (GA) combined with energy estimation based on rigid and flexible conformation grids. In addition, molecular dynamics studies were also performed to verify the stability of the receptor-ligand complexes formed through analyses of RMSD, RMSF, H–Bond, SASA, and MMGBSA. Compared to the binding energy of the synthetic redocking coupling (−6.8 kcal/mol/RMSD of 1.34 Å), which was considerably higher, it was then decided to analyze the parameters of only three ligands: ergotamine (−9.9 kcal/mol/RMSD of 2.0 Å), dihydroergotamine (−9.8 kcal/mol/RMSD of 1.46 Å) and olysio (−9.5 kcal/mol/RMSD of 1.5 Å). It can be stated that ergotamine showed the best interactions with the Mpro protease of Covid-19 in the in silico study, showing itself as a promising candidate for treating Covid-19. [ABSTRACT FROM AUTHOR]

Aim Design Methods Results Conclusion Impact Reporting Method Patient or Public Contribution To explore the challenges experienced by Executive Nurse Directors during the COVID‐19 pandemic, and to inform future nursing leadership strategies.A qualitative research project involving interviews with 21 Executive Nurse Directors from England and Wales.Participants were purposively sampled and recruited through Chief Nursing Officers and nursing leadership networks. Semi‐structured interviews were conducted and recorded online via Teams. Braun and Clarke's approach to thematic reflexive analysis was applied to data analysis.Executive Nurse Directors played a critical role during the COVID‐19 pandemic. Six themes are explored: tensions, and adaptive response to personal leadership styles; uncertainty and support at the board level; responding to national political decision‐making; the personal and emotional impact of the role and the sources of effective support; the voice and public profile of nursing; lessons learnt and strategies for future leadership development. Enablers of decision‐making included effective multidisciplinary working, freedom from normal organizational constraints, support for innovation, and the development of stronger bonds with colleagues. Barriers to decision‐making included limited knowledge of the virus and its impact and lack of guidance, particularly at a national level. Priorities, strategies and actions for recovery include recognizing the emotional impact of being in a high‐level decision‐making role, protecting staff from burnout and understanding the long‐term implications of pandemic work for nurse leaders.Future strategies for nursing leadership during public health, national and global emergencies are recommended.This study contributes to the literature exploring the Executive Nurse Director role and their experiences of leading through the COVID‐19 pandemic, and identifies priorities, strategies and actions for recovery and learning for the future of senior leadership.The study adhered to the Consolidated Criteria for Reporting Qualitative Research.No patient or public contribution. [ABSTRACT FROM AUTHOR]

During COVID-19, the authenticity and degree of marketing information services at Al-Balqa Applied University Center (Salt) confronted various challenges in obtaining information sources. This study however aimed at examining those issues and challenges using a questionnaire designed for library patrons. Based on the findings, the library should take a further step ahead by developing plans and strategies to boost the level of techniques to offer services to users and to expand continuous training programs. The limitations of the library and its services in this area are reflected in the problems that the community customers experience. The study also aimed at examining the library's potential role in marketing services, which was represented in the educational process and scientific research to develop and interact with worldwide quality standards as well as the implementation of local environmental laws. [ABSTRACT FROM AUTHOR]

This article put together information about the formation of the warao self-care practices, exposing the centrality of shamanism in the processes of health and illness. The reflection is built from the context of coping with the COVID-19 pandemic in indigenous shelters in Manaus (Amazonas), between March and December of 2020. These actions not only systematically disregarded shamanism and native theories, but also produced strong control over the presence of these indigenous people in the city. Through a critical analysis of the situation in the Amazonian capital, it reflects on the need for adaptation in health care for the Warao in Brazil and, by extension, for other indigenous people, especially those residing in urban contexts. The data presented were obtained through fieldwork with an ethnographic perspective, in addition to documentary and bibliographical research. [ABSTRACT FROM AUTHOR]

Despite the efficacy of COVID-19 vaccines, patients with hematologic malignancy may still be fatal from COVID19. Therefore, we prospectively performed the analysis of administration of tixagevimab/cilgavimab in the real-world. In August 2022, 94 patients under active chemotherapy for lymphoma, multiple myeloma, or acute leukemia received a single dose AZD7442/Evusheld (two consecutive intramuscular injections of tixagevimab and cilgavimab, 300 mg each). Quantitative measurement of anti-SARS-CoV-2 spike protein (anti-S) and viral nucleocapsid (anti-N) titers were conducted before administration of tixagevimab/cilgavimab and at 1, 3, and 6 months after administration. Twenty-five patients (26.6%) had previously confirmed COVID-19 infection. Fifty-eight patients (61.7%) had previously received COVID-19 vaccinations, with a median of two doses (range, 1–5). The median anti-S Ab level increased from baseline (997.05 AU/mL) to 1 month (20,967.25 AU/mL), then decreased at 3 months (13,145.0 AU/mL), and 6 months (7123.0 AU/mL) (p < 0.001). There was no significant safety issue with tixagevimab/cilgavimab. With a median follow-up time of 6 months, thirteen patients (13.8%) had documented SARS-Cov-2 infection. A 20.2% rate of anti-N positivity was observed six months after the administration of tixagevimab/cilgavimab. The results of this study support the potential role of tixagevimab/cilgavimab for the prevention of symptomatic and severe COVID-19. Trial registration: KCT0007617; August 16, 2022. [ABSTRACT FROM AUTHOR]

• First year health students who work in the health sector have higher professional identity. • Positive career influencers and positive university experiences during the COVID-19 pandemic, were associated with higher professional identity and greater student resilience. • Promoting greater student connectedness, professional identity, and resilience should be the focus of university student transition and retention strategies. Factors associated with professional identity are of interest to university health professional programs because of its association with successful student transition, retention, and progression into the workforce. To explore the factors associated with students' decisions in choosing their current program of study, and how the COVID-19 pandemic impacted their learning experience and sense of belonging to health professionals in their program. Convergent parallel mixed-methods design was used, collecting quantitative, and qualitative data through an online questionnaire. First year students enrolled in health-related baccalaureate programs across two institutions in two different countries were invited to participate in the study. Participants were asked to complete the standardised Professional Identity Scale (PIS) and questions regarding factors that influenced their enrolment in a health course and first year experiences during the COVID-19 pandemic. A total of 395 students participated in this study. Overall, students achieved high average PIS scores. Students who were working in the health sector showed higher professional identity. Similarly, those who had positive career influencers and positive university experiences also produced higher professional identity scores. Qualitative analysis produced categories related to health profession career influencers, positive university experiences, and the impact of physical distancing and COVID-19 news. For students, the experience was 'tough', but they were committed to staying in their programs. Disrupted Professional Identity Formation represents students' experiences of beginning identity formation in a context of mandated physical distancing and regular representation of health professionals in the news media. The perseverance demonstrated by students offers insight into how adversity supports development of resilience and grit and in this study positively influenced professional identity. Factors that were positively associated with higher professional identity can be embedded within university programs to strengthen student progression and readiness for health profession practice. [ABSTRACT FROM AUTHOR]

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To understand and approach the spread of the SARS-CoV-2 epidemic, machine learning offers fundamental tools. This study presents the use of machine learning techniques for projecting COVID-19 infections and deaths in Mexico. The research has three main objectives: first, to identify which function adjusts the best to the infected population growth in Mexico; second, to determine the feature importance of climate and mobility; third, to compare the results of a traditional time series statistical model with a modern approach in machine learning. The motivation for this work is to support health care providers in their preparation and planning. The methods compared are linear, polynomial, and generalized logistic regression models to describe the growth of COVID-19 incidents in Mexico. Additionally, machine learning and time series techniques are used to identify feature importance and perform forecasting for daily cases and fatalities. The study uses the publicly available data sets from the John Hopkins University of Medicine in conjunction with the mobility rates obtained from Google's Mobility Reports and climate variables acquired from the Weather Online API. The results suggest that the logistic growth model fits best the pandemic's behavior, that there is enough correlation of climate and mobility variables with the disease numbers, and that the Long short-term memory network can be exploited for predicting daily cases. Given this, we propose a model to predict daily cases and fatalities for SARS-CoV-2 using time series data, mobility, and weather variables. [ABSTRACT FROM AUTHOR]

Introduction: Several effective vaccines for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been developed and implemented in the population. However, the current production capacity falls short of meeting global demand. Therefore, it is crucial to further develop novel vaccine platforms that can bridge the distribution gap. AVX/COVID-12 is a vector-based vaccine that utilizes the Newcastle Disease virus (NDV) to present the SARS-CoV-2 spike protein to the immune system. Methods: This study aims to analyze the antigenicity of the vaccine candidate by examining antibody binding and T-cell activation in individuals infected with SARS-CoV-2 or variants of concern (VOCs), as well as in healthy volunteers who received coronavirus disease 2019 (COVID-19) vaccinations. Results: Our findings indicate that the vaccine effectively binds antibodies and activates T-cells in individuals who received 2 or 3 doses of BNT162b2 or AZ/ChAdOx-1-S vaccines. Furthermore, the stimulation of T-cells from patients and vaccine recipients with AVX/COVID-12 resulted in their proliferation and secretion of interferon-gamma (IFN-g) in both CD4+ and CD8+ T-cells. Discussion: The AVX/COVID-12 vectored vaccine candidate demonstrates the ability to stimulate robust cellular responses and is recognized by antibodies primed by the spike protein present in SARS-CoV-2 viruses that infected patients, as well as in the mRNA BNT162b2 and AZ/ChAdOx-1-S vaccines. These results support the inclusion of the AVX/COVID-12 vaccine as a booster in vaccination programs aimed at addressing COVID-19 caused by SARS-CoV-2 and its VOCs. [ABSTRACT FROM AUTHOR]

Objective: Diabetic patients with COVID-19 are at the higher risk of clinical complications and intensive care unit)ICU(admission. There is limited information available on the risk factors of mortality in diabetic patients with COVID-19 admitted to the ICUs. The aim of this study was identifying the mortality risk factors in diabetic patients with COVID-19 who are admitted to the ICU. Materials and Methods: In this study, we conducted a descriptive-analytical observational analysis on 391 patients admitted to the ICU for 18 months. We assessed the demographic, clinical, pharmaceutical, laboratory and imaging data of diabetic patients and statistically analyzed them to identify mortality risk factors. Results: The study found 156 (39.89%) diabetic out of 391 patients. The group of diabetic patients had significantly higher rates of endotracheal intubation (P< 0.001), mortality (P< 0.001), and complications during hospitalization due to COVID-19, including secondary bacterial infections (P = 0.005), venous thrombosis (P = 0.008), and gastrointestinal bleeding (P = 0.011), compared to the nondiabetic patient. Conclusion: Patients with diabetes who also have COVID-19 tend to experience more severe clinical outcomes and a higher mortality rate when admitted to the intensive care unit. The likelihood of mortality in these patients is closely associated with factors such as stroke occurrence, oxygenation levels, and the presence of secondary infections at the time of admission. [ABSTRACT FROM AUTHOR]

Background & objectives: COVID-19 pandemic affected people all around the world since its first notification in 2020. The virus also affected pregnant ladies as well as their neonates. We aimed to accumulate data and report the clinical characteristics and outcomes of COVID-19 childbirths in two teaching hospitals during the pandemic. Methodology: We retrospectively extracted data of COVID-19 infected parturients and their newborns at the time of delivery from electronic record system of the two target hospitals. Results: Electronic records of 44 parturients, known to have COVID infection, and delivered in two hospitals. Out of them, 21 were on medication for the viral infection and 26 needed supplement oxygen. Six patients gave birth naturally and 38 had cesarean section to deliver. Rate of cesarean section and preterm labor was 81.81% and 31.81% respectively. Out of 36 patients who underwent cesarean section, 28 initially had spinal anesthesia. Conclusion: COVID-19 infection increased risk of preterm labor; however, Covid itself did not affect the mode of delivery and type of anesthesia. The most important lesson of covid was real time sharing of vital data. [ABSTRACT FROM AUTHOR]

This systematic review and meta-analysis aimed to investigate the impact of COVID19 lockdown on the anthropometric and glycaemic outcomes of adults with type 2 diabetes mellitus (T2DM) and assess whether socioeconomic status (SES) was relevant to these changes. A search of three databases was conducted. Meta-analyses using random effects models were undertaken to combine anthropometric and glycaemic measures pre- and post-confinement. Subgroup analyses according to SES were also conducted. This systematic review of 19 articles demonstrated that prolonged pandemic-related confinement is associated with a deterioration in both anthropometric and glycaemic outcomes among adults with T2DM. Furthermore, SES was found to be relevant to these changes. Specifically, BMI (kg/m2) showed an increase in mean difference of 0.72 (95% CI; 0.13, 1.31; p<0.05) between pre and post lockdown cohorts. High income countries displayed a greater increase in BMI compared to their lower middle-income counterparts. Regarding, fasting blood glucose (FBG), a statistically significant difference was observed in the upper middle-income group (mean difference: 5.10; 95% CI: 2.92, 7.27), and high-income group (mean difference: 6.03; 95% CI: 0.04, 12.02). There were no significant changes to weight, waist circumference, or HbA1C over the lockdown period. Our findings suggest adults with T2DM may have received less effective care over the lockdown period, particularly in high income countries. Clinics and care providers may need to adopt more intensive contact and treatment plans in the post lockdown period to prevent lasting impacts on disease progression and metabolic sequelae. • Prolonged COVID-19 lockdown is associated with deterioration in anthropometric and glycaemic outcomes in adults with T2DM. • High SES is associated with poorer anthropometric and glycaemic outcomes following prolonged confinement. • Adults with T2DM may have received less effective care over the lockdown period, particularly in high income countries. [ABSTRACT FROM AUTHOR]

The recent worldwide SARS-CoV-2 (COVID-19) pandemic has reshaped the way people live, how they access goods and services, and how they perform various activities. For public transit, there have been health concerns over the potential spread to transit users and transit service staff, which prompted transportation agencies to make decisions about the service, e.g., whether to reduce or temporarily shut down services. These decisions had substantial negative consequences, especially for transit-dependent travelers, and prompted transit users to explore alternative transportation modes, e.g., bikeshare. However, local governments and the public in general have limited information about whether and to what extent bikeshare provides adequate accessibility and mobility to those transit-dependent residents. To fill this gap, this study implemented spatial and visual analytics to identify how micro-mobility in the form of bikesharing has addressed travel needs and improved the resilience of transportation systems. The study analyzed the case of San Francisco in California, USA, focusing on three phases of the pandemic, i.e., initial confirmed cases, shelter-in-place, and initial changes in transit service. First, the authors implemented unsupervised machine learning clustering methods to identify different bikesharing trip types. Moreover, through spatiotemporally matching bikeshare ridership data with transit service information (i.e., General Transit Feed Specification, GTFS) using the tool called OpenTripPlanner (OTP), the authors studied the travel behavior changes (e.g., the proportion of bikeshare trips that could be finished by transit) for different bikeshare trip types over the three specified phases. This study revealed that during the pandemic, more casual users joined bikeshare programs; the proportion of recreation-related bikeshare trips increased; and routine trips became more prevalent considering that docking-station-based bikeshare trips increased. More importantly, the analyses also provided insights about mode substitution, because the analyses identified an increase in dockless bikeshare trips in areas with no or limited transit coverage.