The situation in the world of pandemics is rapidly changing, and the second wave of COVID-19 has put a lot of pressure on the government and private sector, which are primarily responsible for controlling the situation. COVID-19 positive cases have increased in recent months relative to last year, and the number of patients admitted to hospitals has also increased, despite the fact that few of them were denied admission due to shortage of beds. Normal people who experience any symptoms immediately isolate themselves and begin taking the COVID medications prescribed by medical personnel and their team. During these times, all domestic people tossed the wrappers and boxes of medicines into the regular trash can, and the waste was handed over to the waste collector, who treated it like any other domestic waste and disposed of it using open dumping or other methods. The goal of this perspective is to suggest the collections of these types of waste from domestics, and protect the natural resources like water, soil, and even living beings like animals from pollution (from the effect of SARS-CoV-2). The main challenge for environmental waste management agencies is determining who has COVID positive and which houses generate these types of waste; thus, proposed strategy may be beneficial to the long-term sustainability of natural resources and animals.

This study aimed to focus on how to design a low-cost greenhouse for the cultivation of crops, to propose the cost-effectiveness analysis of small agribusiness, and to promote sustainable agricultural production during and after the COVID-19 crisis for helping grassroots and anyone who lost their job. This article is qualitative engineering research, studying of literature reviews of greenhouse farming concept and Micro, Small and Medium Enterprises, then, designing low-cost greenhouse model which was preliminarily adapted for hot climate countries. Three plants that were selected as representative plants of this model include sunflower, water spinach, and wheat. The greenhouse model, measuring 5 x 7 x 4 m (W x L x H), was designed for this mission. The total cost of one building is approximately 97,994 THB. For the worthiness of the investment, farmers should build at least three greenhouse buildings, which will return total income to farmers approximately 34,666.09 THB per month. The suggestion includes further knowledge and financial supports from the government sectors among farmers, then, boost them up using high-level technology and also planting high-price agribusiness production to promote the local economy to be strong and sustainable.

Alcoholism is a condition associated with psychiatric and psychiatric problems, where the respiratory system is damaged through the mucociliary ladder mechanism and alveolar macrophage dysfunction. In the time COVID-19 has been observed a dramatic increase in alcohol consumption mediated by levels of anxiety and situations of confinement. In this work we analyze the relationship between alcoholism and SARS, especially with SARS-CoV-2, explained by a degradation of the host defenses of the respiratory epithelium by changing the barrier function, the discharge of cytokines and the functions of the cilia. All of them involved in the defense mechanism. of the lungs. This leads to a worse prognosis for patients precisely because of alcohol consumption. Based on this approach, alcoholism will exacerbate the consequences of COVID-19.

The COVID-19 pandemic has caused ~ 2 million fatalities. Significant progress has been made in advancing our understanding of the disease process, one of the unanswered questions, however, is the anomaly in the case/mortality ratio with Mexico as a clear example. Herein, this anomaly is explored by spatial analysis and whether mortality varies locally according to local factors. To address this, hexagonal cartogram maps (hexbin) used to spatially map COVID-19 mortality and visualise association with patient-level data on demographics and pre-existing health conditions. This was further interrogated at local Mexico City level by choropleth mapping. Our data show that the use of hexagonal cartograms is a better approach for spatial mapping of COVID-19 data in Mexico as it addresses bias in area size and population. We report sex/age-related spatial relationship with mortality amongst the Mexican states and a trend between health conditions and mortality at the state level. Within Mexico City, there is a clear south, north divide with higher mortality in the northern municipalities. Deceased patients in these northern municipalities have the highest pre-existing health conditions. Taken together, this study provides an improved presentation of COVID-19 mapping in Mexico and demonstrates spatial divergence of the mortality in Mexico.

Increasing global concern over COVID-19 has recently brought greater attention to studies due to the ease of person-to-person transmission and the current lack of effective antiviral therapy. Here, we proposed the application of the adverse outcome pathway (AOP) framework to support re-search on the pathogenesis of viral disease. We first constructed adverse outcome pathways (AOPs) applicable to COVID-19 management to understand whether the infection causes severe acute respiratory distress. Based on the AOP framework where mechanistic elucidation of the pathway from the interaction of chemicals (or viruses) to apical endpoints is represented, our COVID-19 AOP indicated that the molecular initiating event (MIE) was angiotensin-converting enzyme 2 (ACE2) interaction, and the key events (KEs) were the increased pro-inflammatory cytokines in immune cells, with increased mortality as an apical adverse outcome (AO). However, there is still limited information on the toxicity mechanisms of AOPs in COVID-19; therefore, detailed KEs and AOs on toxicity mechanisms will be required to fill these gaps in the data. This study demonstrated that the COVID-19 AOP framework is a suitable tool to design new drugs and to integrate crowded-sourced information for the battle against the COVID-19 pandemic.

School closures (SC) were adopted globally as a COVID-19 disease pandemic containment strategy. This extreme measure provoked a disruption of the educational system involving hundreds of million children worldwide. The return of children to school has been variable and is still an unresolved and contentious issue. Importantly the process has not been directly correlated to the severity of the pandemic s impact and has fueled the widening of disparities, disproportionately affecting the most vulnerable populations. Available evidence shows SC added little benefit to COVID-19 control whereas the harms related to SC severely affected children and adolescents. This unresolved issue has put children and young people at high risk of social, economic and health-related harm for years to come, triggering severe consequences during their lifespan. In this article we describe the process of SC and the reopening timetable across the globe. We highlight the data regarding the international state of educational systems around the world, putting emphasis on the rights of children to come back to school.

Covid-19 pandemic lockdown has slow down the world economic system. The pandemic has cleared the roads, close factories and grounded planes causing severe economic challenges. The damaging impact of the pandemic amid lockdown has been a blessing in guise for the environment because of significant drop in pollution level as transport and industrial sectors shutdown. Transport and industrial sectors are major contributors to environmental degradation through various emissions as a result of fossil fuel consumption. Energy consumed by transport and industrial sectors will have to shift to viable, readily available, economically and environmentally friendly with no carbon build up post Covid-19 pandemic. Hydrogen energy remains the best alternative option technologies containing green house gas emission and pollutions of several forms. Hydrogen holds the potential to provide a clean, reliable, renewable and economical source of energy for meeting the growing and unending global energy needs post pandemic. The present paper explores the economic feasibility and potential of hydrogen to serve as a competitive fuel option post pandemic. In this paper, the role of hydrogen as an energy carrier hydrogen economy structure, potential of hydrogen economy, hydrogen production methods, hydrogen application and the economic and environmental importance of hydrogen as a viable fuel option post covid-19 pandemic were discussed. There will be a surge in demand and investment for hydrogen economy post Covid-19.

Background. The novel coronavirus (SARS-COV-2) and related syndrome (COVID-19) has required a worldwide measure of quarantine with severe consequences for millions of people. Methods. Since psychopathological consequences related to social restrictions have been reported, a systematic review according to Cochrane Collaboration guidelines and the PRISMA Statement was performed to quantify the effects of quarantine on mental health of adults. Major databases - Pubmed, Scopus, Embase, PsycInfo, and Web of Science- were researched for observational studies with data on mental health indexes related to quarantine or isolation for epidemic infections. Results. Twenty-one independent studies were included for 82,312 subjects. Conclusions. The results showed that at least 20% of people exposed to these conditions reported a psychological distress, with a prevalence of PTSD, depression and, less often, generalized anxiety. Important methodological bias weakens the conclusion of most studies, opening to the need of further research on mental health after quarantine and related risk/buffering factors.

In the advent of COVID-19 pandemic, testing is highly essential to be able to isolate, treat infected persons, and finally curb transmission of this infectious respiratory disease. Group testing has been used previously for various infectious diseases and recently reported for large-scale population testing of COVID-19. However, possible sample dilution as a result of large pool sizes has been reported, limiting testing methods’ detection sensitivity. Moreover, the need to sample all individuals prior to pooling overburden the limited resources such as test kits. An alternative proposed strategy where test is performed on pooled samples from individuals representing different households is presented here. This strategy intends to improve group testing method through the reduction in the number of samples collected and pooled during large-scale population testing. Moreover, it introduces database system which enables continuous monitoring of the population’s virus exposure for better decision making.

Abstract The COVID-19 pandemic is thought to began in Wuhan, China in December 2019. Mobility analysis identified East-Asia and Oceania countries to be highly-exposed to COVID-19 spread, consistent with the earliest spread occurring in these regions. However, here we show that while a strong positive correlation between case-numbers and exposure level could be seen early-on as expected, at later times the infection-level is found to be negatively correlated with exposure-level. Moreover, the infection level is positively correlated with the population size, which is puzzling since it has not reached the level necessary for population-size to affect infection-level through herd immunity. These issues are resolved if a low-virulence Corona-strain (LVS) began spreading earlier in China outside of Wuhan, and later globally, providing immunity from the later appearing high-virulence strain (HVS). Following its spread into Wuhan, cumulative mutations gave rise to the emergence of an HVS, known as SARS-CoV-2, starting the COVID-19 pandemic. We model the co-infection by an LVS and an HVS, and show that it can explain the evolution of the COVID-19 pandemic and the non-trivial dependence on the exposure level to China and the population-size in each country. We find that the LVS began its spread a few months before the onset of the HVS, and that its spread doubling-time is $\sim 1.59\pm 0.17$ times slower than the HVS. Although more slowly spreading, its earlier onset allowed the LVS to spread globally before the emergence of the HVS. In particular, in countries exposed earlier to the LVS and/or having smaller population-size, the LVS could achieve herd-immunity earlier, and quench the later-spread HVS at earlier stages. We find our two-parameter (the spread-rate and the initial onset time of the LVS) can accurately explain the current infection levels (R^2$\mathrm{=0.74}$; correlation p-value (p) of 5x10^-13$$). Furthermore, countries exposed early should have already achieved herd-immunity. We predict that in those countries cumulative infection levels could rise by no more than 2-3 times the current level through local-outbreaks, even in the absence of any containment measures. We suggest several tests and predictions to further verify the double-strain co-infection model and discuss the implications of identifying the LVS.

Online transactions are becoming more popular in present situation where the globe is facing an unknown disease COVID-19. Now authorities of Countries requested peoples to use cashless transaction as far as possible. Practically it is not always possible to use it in all transactions. Since number of such cashless transactions have been increasing during lockdown period due to COVID-19, fraudulent transactions are also increasing in a rapid way. Fraud can be analysed by viewing a series of customer transactions data that was done in his/her previous transactions. Normally banks or other transaction authorities warned their customers about the transaction If any deviation is noticed by them from available patterns. These authorities think that it is possibly of fraudulent transaction. For detection of fraud during COVID-19, banks and credit card companies are applying various methods such as data mining , decision tree, rule based mining, neural network, fuzzy clustering approach and machine learning methods. These approaches is try to find out normal usage pattern of customers based on their past activities. The objective of this paper is to find out such fraud transactions during such unmanageable situation.Digital payment schemes are often threatened by fraudulent activities. Detecting fraud transaction in during money transfer may save customers from financial loss. Mobile based money transactions are focused in this paper for fraud detection. A Deep Learning (DL) framework is suggested in this paper that monitors and detects fraudulent activities. Implementing and applying recurrent neural network on PaySim generated synthetic financial dataset, deceptive transactions are identified. The proposed method is capable to detect deceptive transactions with an accuracy of 99.87%, F1-Score of 0.99 and MSE of 0.01.

The current emerging COVID-19 pandemic has caused a global impact on every major aspect of our societies. It is known that SARS-Cov-2 can endure harsh environmental conditions for up to 72 h, which may contribute to its rapid spread. Therefore, effective containment strategies, such as sanitizing, are critical. Nanotechnology can represent an alternative to reduce the COVID-19 spread, particularly in critical areas, such as healthcare facilities and public places. Nanotechnology-based products are effective at inhibiting different pathogens, including viruses, regardless of their drug-resistant profile, biological structure, or physiology. Although there are several approved nanotechnology-based antiviral products, this work aims to highlight the use of nanomaterials as sanitizers for the prevention of the spread of mainly SARS-Cov-2. It has been widely demonstrated that nanomaterials are an alternative for sanitizing surfaces to inactivate the virus. Also, antimicrobial nanomaterials can reduce the risk of secondary microbial infections on COVID-19 patients, as they inhibit the bacteria and fungi that can contaminate healthcare-related facilities. Finally, cost-effective, easy-to-synthesize antiviral nanomaterials could reduce the burden of the COVID-19 on challenging environments and in developing countries.

Real-time estimation of the parameters characterising infectious disease transmission is important for optimization quarantine interventions during outbreaks. One of the most significant parameters is the effective reproduction number - number of secondary cases produced by a single infection. The current study presents an approach for estimating the effective reproduction number and its application to COVID-19 outbreak. The method is based on fitting SIR epidemic model to observation data in a sliding time window and allows to show real-time dynamics of reproduction number at any phase of epidemic for countries globally. Online data on COVID-19 daily cases of infections, recoveries, deaths are used.Finally, time-dependent reproduction number is explored in connection with dynamics of peoples mobility. The method allows to assess the disease transmission potential and understand the effect of interventions on epidemics spread. It also can be easily adapted to future outbreaks of different pathogens. The tool is available online as Python code from the Github repository.

The probability of zoonoses, such as the novel coronavirus (COVID-19), emerging is strongly related to remediable factors such as habitat encroachment and trade in wild animals. Tackling these underlying determinants is important to prevent future pandemics from the approximately 700,000 viruses with the potential to cause zoonoses. Reversing habitat destruction is also vital to halt the accelerating rate of extinction of a wide array of life forms - with all the adverse consequences these extinctions will have for human health. These insights depend on viewing health and disease from within an ecological theoretical framework. We therefore argue that preventing future zoonotic outbreaks as well as dealing with a range of contemporary health issues would be facilitated by grounding our health sciences in more a more explicitly ecological conceptual framework.

We have analysed the death and recovery rate of Covid-19 disease progression. From the analysis, we have argued that the pandemic is over in certain countries (labelled as group-A) and for other countries (labelled as group-B) the disease appears to remain as endemic. Taking into account the serological survey (sero-survey) test results obtained by certain groups and comparing it with herd immunity threshold value one can infer that the low number of infection for group-B is either due to acquired immunity by some previous infection by other coronavirus or due to innate immunity towards this infection. This effect is stronger for group-B to slow the progress of the disease to such an extent resulting in flattening of the disease progression curve compared to group-A.

COVID-19 is causing major turmoil around the globe, and the clinical trial industry is likely to face unprecedented challenges to health and business sectors. In an effort to find a suitable treatment and prevention options for COVID-19, several COVID-19 clinical trials are being planned and initiated, while a large number of clinical trials for non- COVID-19 indications are suffering delays. With over more than 1000 trials being disrupted and more trials being added to this category daily, there is a direct impact on trial site activation and patient enrolment. This analysis deals with the specific impacts of the COVID-19 pandemic on the clinical trial and pharmaceutical industry. The objective of this study is to provide an updated information of the disrupted clinical trials and its impact on various therapeutic areas and different drugs. Among the severely affected clinical trials, oncology and CNS trials are the hardest hit therapy areas.This article will certainly emphasize the need for advanced and innovative approaches to maintain the health of the clinical trial ecosystem by continuing the existing trials and the start of the new studies. We have to take and follow necessary actions to guarantee that the initiatives will not be locked during the COVID-19 pandemic, both for the treatment of patients and for the researchers to conduct decision-relevant clinical trials.

There is much discussion among clinicians, epidemiologists, and public health experts about why case fatality rate from COVID-19 in Italy (at 13.3% as of April 20, 2020, versus a global case fatality rate of 6.9%) is considerably higher than estimates from other countries (especially China, South Korea, and Germany). In this article, we propose several potential explanations for these differences. We suggest that Italy’s overall and relative case fatality rate, as reported by public health authorities, is likely to be inflated by such factors as heterogeneous reporting of coronavirus-related fatalities across countries and the iceberg effect of under-testing, yielding a distorted view of the global severity of the COVID-19 pandemic. We also acknowledge that deaths from COVID-19 in Italy are still likely to be higher than in other equally affected nations due to its unique demographic and socio-economic profile. Lastly, we discuss the important role of the stress imparted by the epidemic on the Italian healthcare system, which weakened its capacity to adequately respond to the sudden influx of COVID-19 patients in the most affected areas of the country, especially in the Lombardy region.

Several epidemiological models are being used around the world to project the number of infected individuals and the mortality rates of the COVID-19 outbreak. Advancing accurate prediction models is of utmost importance to take proper actions. Due to a high level of uncertainty or even lack of essential data, the standard epidemiological models have been challenged regarding the delivery of higher accuracy for long-term prediction. As an alternative to the susceptible-infected-resistant (SIR)-based models, this study proposes a hybrid machine learning approach to predict the COVID-19 and we exemplify its potential using data from Hungary. The hybrid machine learning methods of adaptive network-based fuzzy inference system (ANFIS) and multi-layered perceptron-imperialist competitive algorithm (MLP-ICA) are used to predict time series of infected individuals and mortality rate. The models predict that by late May, the outbreak and the total morality will drop substantially. The validation is performed for nine days with promising results, which confirms the model accuracy. It is expected that the model maintains its accuracy as long as no significant interruption occurs. Based on the results reported here, and due to the complex nature of the COVID-19 outbreak and variation in its behavior from nation-to-nation, this study suggests machine learning as an effective tool to model the outbreak. This paper provides an initial benchmarking to demonstrate the potential of machine learning for future research.

This pandemic of COVID-19 is tedious to control. The only lockdown is the way to stop the spread of this infection. Conventional health care is facing a real challenge to operate. Primarily the challenge is to provide health care support for COVID-19 patients with limited resources and continue the health care services like earlier.Perhaps, this challenge is the same but magnitude is different from different geographical locations around the globe. In this article, we presented a Bayesian algorithm with the Code to predict cancer death due to COVID-19. This code is possible to run at different time points and different geographical locations around the world. This code will help us to get the best strategy and shift the treatment option for cancer treatment. The model would provide physicians with an objective tool for counseling and decision making at different hotspots and small areas to implement.

We have proposed a model considering two equally sized population (group A and group B) with low and high levels of disease tolerance. We have argued that in the more tolerant group (group B) the progression of the disease with respect to time will be slow with lower number of infections at any given time. We attribute this effect to the innate immunity which advantageously, can also be one of the major contributing factors for flattening the curve. We have compared the growth of Covid-19 disease in various countries to understand this effect.

The Bacillus Calmette-Guerin vaccine (BCG vaccine) designed to prevent tuberculosis in children has been shown to induce a trained immune response in the body to fight against bacteria as well as other parasites and viruses. This knowledge has been reciprocated to generate the idea that this vaccine can also offer protection against severe acute respiratory syndrome coronavirus-2 (SARS-COV-2). Some recent pre-print articles have highlighted that countries with mass BCG immunizations seems to have a lower incidence of coronavirus disease 2019 (COVID-19) compared to those without BCG immunization. There are yet no experimental proof of any such association and the world health organisation (WHO) is currently testing the theory with clinical trials on selected cohorts. Epidemiologists and other scientific experts has expressed both their hope and concern simultaneously regarding the success theory of BCG vaccination to prevent COVID-19. Though its still not verified in any way whether the BCG vaccination can actually prevent COVID-19 or not but we believe a thorough analytical research in this regard is indeed worth a shot.

The novel coronavirus, COVID-19 is now officially declared as a pandemic by the World Health Organization (WHO), and most parts of the world are taking drastic measures to restrict human movements to contain the infection. Like millions of others around the world, I am wondering, is there anything that could be done, other than keeping high personal hygiene, and be vigilant of symptoms, to reduce the chances of infection, or at least to reduce the burden of the disease. So far, the National and International health agencies, including the National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), and the WHO have provided clear guidelines for both preventive and treatment suggestions. In this opinion-based article, I want to discuss, why keeping the adequate micronutrient balance might enhance the host response and be protective of viral infections. A detailed in-depth discussion of various micronutrients is not the purpose of this article, I will mostly emphasize on the role of zinc in viral infection.

Background Critical patients with novel coronavirus pneumonia ( COVID-19) have worse outcome and high mortality. However, the histopathology of critical patient with COVID-19 remains undisclosed. Methods We performed the whole lung biopsy, and described the pathological changes of critical COVID-19 patient done with transplant by HE staining, immunohistochemistry and special staining observed under the microscopy. Findings The whole lungs displayed diffuse congestive appearance and partly haemorrhagic necrosis on gross examination. The haemorrhagic necrosis was prominently present in outer edge of the right lower lung. The cut surfaces of the lung displayed severe congestive and haemorrhagic changes. The main pathological changes showed massive pulmonary interstitial fibrosis, and partly hyaline degeneration, variable degrees of hemorrhagic pulmonary infarction. Small vessels hyperplasia, vessel wall thickening, lumen stenosis, occlusion and microthrombosis formation. Focal monocytes, lymphocytes and plasma cells infiltrating into pulmonary interstitium. Bronchiolitis and alveolitis with proliferation, atrophy, desquamation and squamous metaplasia of epithelial cells. Atrophy, vacuolar degeneration, proliferation, desquamation and squamous metaplasia in alveolar epithelial cells. Alveolar cavity congestion was prominent, and contained mucus, edema fluid, desquamated epithelial cells, and inflammatory cells. We also found several multinucleate giant cells and intracytoplasmic viral inclusion bodies. Special stains including Masson stain, sirius red staining, reticular fibers staining indicated massive pulmonary interstitial fibrosis. Immunohistochemistry showed positive for immunity cells including CD3, CD4, CD8, CD20, CD79a, CD5, CD38 and CD68. Interpretation We demonstrate the pathological findings of critical patient with COVID-19, which might provide a deep insight of the pathogenesis and severity of this disease.

After the global challenges posed by COVID-19, researchers strived to identify risk factors for severe cases, which lead to various complications - including death. Lifestyle modifications, such as implementing a healthy diet and recommended physical activity, have shown to be protective against severe COVID-19 cases. Despite an association of a plant-based diet with reduced COVID-19 severity, specific dietary characteristics have not been identified. Also, the methodology for measuring physical activity is variable, with studies overlooking the intensity or the habit components of physical activity. To bridge this gap, our study designed, validated, and applied a retrospective questionnaire with aims of exploring the relationship between lifestyle factors, specifically diet and physical activity, and severe COVID-19. We considered the intensity and years of physical activity habit, which is a limitation of other questionnaires. Results reveal associations of age and BMI with severe COVID-19. An excessive sugar diet was found to be associated with severe COVID-19 and increased symptom duration. We also observed an inverse relationship pattern of moderate and vigorous intensity physical activity across case severity, which is absent in walking PA. This study lays a foundation for research aiming to identify lifestyle factors that prevent severe COVID-19 cases.

Background: The manifestations, severity, and mortality of COVID-19 are considered to be associated with the changes in various hematological parameters and in immunity. Associations of immunoglobulin G antibodies against severe acute respiratory syndrome-linked coronavirus (IgG-SARS)-positive status with cardiac function and hematological and biochemical parameters in apparently health subjects are poorly understood. Methods: The present cross-sectional study included 307 healthy volunteers (24-69 years of age; 44.8±8.6 years; 80.4% men) and was initiated in 2019 before the COVID-19 pandemic. COVID-19 episodes were confirmed by detection of IgG-SARS against SARS-CoV-2 S1 RBD to reveal 70 IgG-SARS-positive and 237 negative participants. Numerous ultrasound characteristics were assessed by echocardiography, and 15 hematological and biochemical parameters were assayed in the blood. Descriptive and comparative analysis was based on the IgG-SARS status of the participants. Results: The left ventricular mass index, mitral ratio of peak early to late diastolic filling velocity or flow velocity across the mitral valve, and deceleration time of early mitral inflow were decreased (P<0.05) in IgG-SARS-positive participants versus those in IgG-SARS-negative participants according to multivariate logistic regression analysis. Erythrocyte sedimentation rate and platelet count were slightly increased, and blood hemoglobin was decreased in IgG-SARS-positive participants compared with those in IgG-SARS-negative participants. Conclusions: LV filling, inflammation, blood coagulation, and hemoglobin appear to be influenced by COVID-19 infection in healthy participants. These observations contribute to the development of a population recovery strategy after the episodes of COVID-19.

Differentiated instruction has been implemented in classrooms where students who come from various backgrounds require appropriate lessons that are tailored to their varied learning preferences. As the spread of coronavirus 19 (Covid-19) is becoming more rampant, online learning has been lifted up as the main platform of teaching and learning, forcing the need to shift from the conventional face-to-face classroom to online, or virtual, mode of knowledge transfer. Having such global phenomenon affecting education, how does it affect the implementation of differentiated instruction that has been practised regularly by teachers before the wake of Covid-19? Previous studies have shown how it is done in the normal classroom setting, and that the practice of differentiated instruction contributes to students’ motivation as well as academic performance. However, there is a need to explore how do teachers go about with online differentiated instruction and how does it affect the students, since online learning poses various threads to both teachers and students; and thus, one might argue the effectiveness of not only the teaching approach but also the overall teaching and learning outcomes. Borg’s framework of teacher cognition, which has been extensively used in exploring how teachers teach, can be utilized to document the practice of online differentiated instruction. This study aimed to explore the practice of online differentiated instruction by teachers and examined its impact on students’ motivation and academic performance during the Covid-19 outbreak. The participants of this study consists of 247 gifted students from a public school in Malaysia. To meet these aims, this study employed a mixed method research design, utilizing the framework of teacher cognition to explore the teachers’ practice of online differentiated through interviews; and, utilizing a survey design using a questionnaire to determine the impact of online differentiated instruction towards students’ motivation and academic performance. The findings revealed that although online differentiated instruction is feasible, however, appropriate combination of differentiation constructs need to be applied in order to achieve higher motivation and better academic performance among the students.

Objective: The objective of this study is to determine the epidemic dynamics and clinical features of COVID-19 in southern Hainan Island, China, and provide experience for other tropical areas of the world. Methods: This retrospective study included confirmed cases of COVID-19 in southern Hainan. All enrolled patients were treated in Sanya, and data on epidemiological and clinical features of the disease and infection prevention and control measures adopted by the local government during the epidemic were collected. Results: Of the 74 cases, 71 (95.95%) were imported from Wuhan, Hubei Province (47, 63.51%), other cities in Hubei Province (11, 14.86%), or provinces other than Hubei and Hainan (13, 17.57%). Three (4.06%) patients were infected in southern Hainan, including one autochthonous case in Sanya. Fifty-four cases (72.97%) were detected in Sanya, and 27 cases (27.03%) were diagnosed in other cities. The rate of severe or critical cases was 28.38% (21/74), and mortality was 2.7% (2/74). The serum lactate levels and base excess of severe-critical patients were higher than those of patients with mild-moderate disease. Multivariate logistic regression analysis showed that chronic conditions were risk factors for severe and critical COVID-19. Seventy-four patients were diagnosed with COVID-19 over a 22-day period in Sanya, and the epidemic period in the city was 48 days. The outbreak was controlled rapidly because the local government adopted strict infection prevention and control measures. Conclusions: The clinical characteristics of COVID-19 in Hainan Island were similar to those reported in other regions. In Sanya, the rate of severe and very severe cases was higher than in other regions; however, most cases were imported, and there was only one autochthonous case. The rapid control of the outbreak in Sanya may be related to the tropical climate, adoption of strict infection prevention and control measures, daily reporting of new cases, increased public awareness about the epidemic, and other emergency actions implemented by the local government.

Background: The purpose of this study was to examine the prevalence and effects of current smoking on adverse outcomes among hospitalized COVID-19 patients. Methods: We performed a systematic review of the literature (PubMed) for studies published until April 25. Studies were included into the analysis if they satisfied all of the following criteria: 1. To present hospitalized patients with COVID-19. 2. To classify patients into less and more severe disease, irrespective of the severity definition (defined as “adverse ourtcome”). 3. To present data on the smoking status, separately for each severity classification. We identified 18 (from a total of 1398) relevant studies. Pooled current smoking prevalence was compared with the gender-adjusted, population-based expected prevalence by calculating Prevalence Odds Ratio (POR). The association between current, compared to non-current and former, smoking and adverse outcome was examined by calculating Odds Ratio (OR). All analyses were performed using random-effects meta-analysis. Results: Among 6515 patients, 440 of whom were current smokers, the pooled prevalence of current smoking was 6.8% (95%CI: 4.8-9.1%) and the POR was 0.21 (95%CI: 0.16-0.26, P < 0.001). In Chinese studies only, the POR was 0.22 (95%CI: 0.17-0.27, P < 0.001). Current smokers were more likely to have an adverse outcome compared to non-current smokers (OR: 1.53, 95%CI: 1.06-2.20, P = 0.022). However, they were less likely to have an adverse outcome compared to former smokers (OR: 0.42, 95%CI: 0.27-0.74, P = 0.003). Conclusion: An unexpectedly low prevalence of current smoking was observed among hospitalized patients with COVID-19. Hospitalized current smokers had higher odds compared to non-current smokers but lower odds compared to former smokers for an adverse outcome. The possibility that nicotine may have a protective effect in COVID-19 which may be masked by smoking-related toxicity and by the abrupt cessation of nicotine intake when smokers are hospitalized should be explored.

Since electrical resistivity of concrete can be measured in a more rapid and simple way than chloride diffusivity, it should be primarily regular quality control of the electrical resistivity of concrete which provides the basis for indirect of quality control of concrete durability during the concrete construction. If this is realized, the electrical resistivity of concrete can be a crucial parameter to establish maintenance strategy for marine concrete structures. Electrical resistivity of concrete is important to estimate two processes involved in corrosion of reinforcement: initiation (chloride penetration) and propagation (corrosion rate). The resistivity of concrete structure exposed to chloride indicates the risk of early corrosion damage, because a low resistivity is related to rapid chloride penetration and to high corrosion rate. Concrete resistivity is a geometry-independent material property that describes the electrical resistance, which is the ratio between applied voltage and resulting current in a unit cell. The current is carried by ions dissolved in the pore liquid. While some data exist on the relationship between moisture content on electrical resistivity of concrete, very little research has been conducted to evaluate the effect of chloride on the conduction of electricity through concrete. The purpose of this study is to examine and quantify the effect of pore water and chloride content on surface electrical resistivity measurement of concrete. It was obvious that chloride content had influenced the resistivity of concrete and the relationship showed a linear function. That is, concrete with chloride ions had a comparatively lower resistivity. Chloride can lead to underestimate the electrical resistivity of concrete. Conclusively, this paper suggested the quantitative solution to depict the electrical resistivity of concrete with various chloride contents.

Abstract: The contribution of breakfast to diet quality (DQ) can inform future dietary guidelines. This study examined breakfasts that were associated with highest-quality diets. Dietary data came from the first reported day of the National Health and Examination Survey (NHANES) 2011-2014 (n=14,488). DQ measures were the Nutrient Rich Foods Index (NRF9.3) and the USDA Healthy Eating Index 2015 (HEI 2015). Analyses of breakfast intakes were conducted by NRF9.3 tertiles and by age and socioeconomic groups. Four out of 5 NHANES participants ate breakfast. Breakfast provided 19-22% of dietary energy depending on age. Breakfast intakes of complex carbohydrates and total sugars were higher and intakes of protein and fats were lower relative to energy intakes. Breakfast provided more that 20% of daily intakes of B vitamins, vitamins A and D, folate, calcium, iron, potassium and magnesium. Eating breakfast was associated with higher NRF9.3d scores. Breakfasts associated with top tertile of NRF9.3d had more carbohydrates and less added sugars and fats. Such breakfasts had more fruit and juices, more whole grains, more milk and yogurt and less meat and eggs. Breakfast patterns that favored fruit, whole grains, and dairy were associated with healthiest diets.

Background: Coronavirus disease 2019 (COVID-19) caused several cardiovascular complications, including acute myocardial infarction(AMI) in infected patients. Our study aims to understand the overall trends of AMI among COVID-19 patients during the first two years of the pandemic and the disparities and outcomes between the first and second years. Methods: Our retrospective analysis via the 2020 and 2021 National Inpatient Sample(NIS) for hospitalizations between April 2020 and December 2021 analyzed adults with a primary diagnosis of COVID-19 who experienced events of AMI. We compared month-to-month events of AMI and mortality of AMI patients with COVID-19, patient characteristics, and outcomes between the 2020 and 2021 AMI samples. Results: There were 2,541,992 COVID-19 patients, with 3.55% experiencing AMI. The highest rate of AMI was in December 2021 (4.35%). No statistical differences in trends of AMI mortality were noted over the 21 months. AMI cases in 2021 had higher odds of undergoing PCI (aOR 1.627, p

1) Background: Northwest Syria (NWS), is a conflict-affected and unstable area. Due to its limited health infrastructure, accessing advanced COVID-19 testing services is challenging. COVID-19 antigen rapid diagnostic tests (Ag-RDTs) have the potential to overcome this barrier. Therefore, a pilot project was implemented to introduce Ag-RDTs in this setting aiming to a) describe the feasibility, uptake, and results of Ag-RDTs; and b) identify facilitators and barriers to Ag-RDTs testing. 2) Methods: A cross-sectional study design involving secondary analysis of data collected during the project’s monitoring was developed. A local NGO implemented 25,000 Ag-RDTs cross boarder through trained community health workers. 3) Results: A total of 27,888 persons were found eligible and enrolled, of which 24,956 (89.5%) consented to test and 121 (0.5%) were found positive. Highest positivity was observed among those with severe COVID-19 symptoms (12.7%), those with respiratory illnesses (2.5%), persons enrolled at Afrin Hospitals (2.5%), and healthcare workers (1.9%). A non-random sample of 236 people underwent confirmatory rt-PCR test. Accordingly, observed sensitivity, specificity, positive and negative predictive values, were 80.0%, 96.1%, 91.4% and 90.3%, respectively. Key encountered challenges included obtaining informed consent and conducting confirmatory rt-PCR testing. 4) Conclusion: This project demonstrated great feasibility utilizing Ag-RDTs as a screening/diagnostic tool for COVID-19 infections with nearly 90% uptake. Considering the high specificity and negative predictive values and the higher positivity rates among severe COVID-19 symptomatic, embedding Ag-RDTs into COVID-19 testing strategies for ruling out and in COVID-19 infections would hold a great advantage.

Long COVID (Post-Acute Sequelae of COVID-19, PASC) is a consequence of infection by SARS-CoV-2 that continues to disrupt the well-being of millions of affected individuals for many months beyond their first infection. While the exact mechanisms underlying PASC remain to be defined, hypotheses regarding the pathogenesis of Long COVID are varied and include (but are not limited to) dysregulated local or systemic inflammatory responses, autoimmune mechanisms, viral-induced hormonal imbalances and long-term persistence of virus and/or fragments of viral RNA or proteins. This review article is based on a comprehensive review of the wide range of symptoms most often observed in long COVID and an attempt to integrate that information into a plausible hypothesis for the pathogenesis of PASC. In particular, it is proposed that longterm dysregulation of the gut in response to viral persistence could lead to the myriad of symptoms observed in PASC.

Abstract: Field studies with large-stemmed plants Artemisia dubia (wormwood) have been carried out at Vėžaičiai Branch LAMMC since 2018. According to three years of experimental results, annual dry matter (DM) yield varied from 7.94 to 10.14 t ha-1. Growing conditions, nitrogen ap-plication level and harvesting time had significant impacts on Artemisia dubia productivity. This article presents the results of research on preparation and use of Artemisia dubia biomass for en-ergy conversion and evaluation of technological-technical and environmental parameters of these plants utilization for solid biofuel. For experiments were used 6 variants of Artemisia dubia samples, which were grown in 2021: plants were cut three times and two fertilization options were used: (1) no fertilization and (2) fertilization with 180 kg ha-1 of nitrogen fertilizer. These harvested plants were chopped, milled and were pressed into the pellets. The physi-cal-mechanical characteristics (mоisture content, density and strength) of Artemisia dubia pellets were investigated. During this study, it was found that the density in dry mass (DM) of pellets ranged from 1119.86 to 1192.44 kg m-3. The pellet moisture content ranged from 8.80 to 10.49%. After testing of pellet strength, it was found that the pellets which were made from plant bio-mass PK-1-1, were the most resistant to compression, they withstood 560.36 N of pressure. Dry fuel lower heating value (LHV) of pellets was sufficiently high and was very close to pine saw-dust pellets, it varied from 17.46±0.25 MJ kg-1 to 18.14±0.28 MJ kg-1. The ash content of burned pellets ranged from 3.62±0.02% to 6.47±0.09%. Emissions of harmful pollutants – CO2, CO, NOx and unburnt hydrocarbons (CxHy) did not exceed the maximum permissible levels. Summariz-ing the results of investigated properties, cоmbustion and emissiоns of Artemisia dubia pellets, it can be concluded that this biofuel can be used for production of pressed biofuel and it is charac-terized by sufficient high quality, efficient combustion and permissible emissions to the envi-ronment.

People are increasingly encouraged to reduce animal food consumption and shift towards plant-based diets, however the implications for children’s health are unclear. In this narrative review of research in high-income settings, we summarize evidence on the increasing consump-tion of plant-based diets in children, and update an earlier systematic review regarding their associations with children’s health outcomes. The evidence indicates that vegan but not vege-tarian diets can restrict growth relative to omnivorous children, and increase the risk of being stunted and underweight although the percentage affected is relatively small. Bone mineral content is reduced in vegetarian and especially vegan children, compared to omnivores. Both vegetarian and vegan children who do not use vitamin B12 supplements manifest with B12 defi-ciency, however supplementation rectifies this problem. Both vegetarians and vegans have lower concentrations of 25 (OH)D if unsupplemented, and lower body iron stores, but usually have normal iron metabolism markers. Both groups are at risk of iodine deficiency and this might affect thyroid health. Children consuming a vegan diet have more favorable lipid profile than omniv-orous children, however the results for vegetarian diet are inconsistent and vary by outcome. Based on the same scientific evidence, national and international dietary recommendations are heterogeneous, with some countries supporting plant-based diets among infants, children and adolescents, and others discouraging them. We offer a research roadmap, highlighting what is needed to provide adequate evidence to harmonize dietary recommendations for plant-based diets in children. A number of measures should urgently be introduced at international and na-tional levels to improve the safety of their use in children.

Abstract: Brassinosteroids (BR) are essential plant hormones that play a crucial role in regulating plant growth and development, as well as their resistance to abiotic and biotic stresses, including pathogen infections. In the context of plant im-munity, BR influence various processes such as the expression of genes related to pathogen defense, the production of antimicrobial compounds, and the re-inforcement of the plant cell structure. The aim of work is understand the role of BR in plant defense against abiotic and biotic stresses. BR are involved in the regulation of metabolic processes, water economy, and photosynthesis, contributing to increased plant resistance to abiotic stresses. The study discusses various mechanisms of BR action on plant immunity, including the regulation of gene expression related to defense, activation of the plant defense system, in-teraction with other plant hormones, regulation of water and salt balance, and influence on photosynthetic processes. In the context of plant immunity, BR influence various processes, including the expression of genes related to pathogen defense, the production of antimicrobial compounds, and the reinforcement of the plant cell structure. Additionally, BR are involved in the regulation of metabolic processes, water economy, and photosynthesis, con-tributing to increased plant resistance to abiotic and biotic stresses. The paper emphasizes the importance of further research on the role and mechanisms of action of BR in plant immunity, which may contribute to the development of more effective strategies for the use of BR in agriculture, horticulture, and plant protection.

We are in amidst of COVID-19 pandemic. Since Dec 2019, severe acute respiratory corona virus (SAR-CoV-2) has infected more than half a billion people killing nearly 7 million people worldwide. Now the BA.5 variant of SARS-CoV-2 is causing mayhem and driving the global surge. Epidemiologist are aware of the fact that this virus is capable of escaping immunity and likely to infect the same person multiple times despite adequate vaccination status. Elderly people of age more than 60 years and those with underlying health conditions are considered as high-risk who are likely to suffer complications and death. While it is tempting to frame complications and mortality from COVID-19 as a simple matter of too much of a virulent virus in too weak of a host, much more is at play here. Framing the pathophysiology of COVID-19 in the context of the Chrousos and Gold model of the central stress response system can shed insight into its complex pathogenesis. Understanding the mechanisms by which pharmacologic modulation of the central stress response system via administration of clonidine and/or dexamethasone may offer an explanation as to why a viral pathogen can be well tolerated and cleared by one host while inflaming and killing another.

The aims of the study are: a) Describe the reactogenicity of WHO-approved two mRNA (Pfizer-BioNTech, Moderna) and two non-RNA vaccines (Oxford-AstraZeneca, Sinovac) among lactating mother and baby pairs; and b) compare and contrast the reactogenicity between mRNA and non-mRNA vaccines. A cross-sectional, self-reported survey was conducted amongst 1784 lactating women who received COVID-19 vaccinations. The most common maternal adverse reaction was a local reaction at the injection site; the largest minority of respondents, 43.7% (780/1784), reported experiencing worse symptoms when receiving the second dose compared to the first dose. There were no major reported adverse effects or behavioural changes in the breastfed infants. Among the respondents who received non-mRNA COVID-19 vaccinations, a majority reported no change in lactation but those who did more commonly reported an increase in milk supply, decrease in milk supply and pain in the breast. The more commonly reported lactation changes (fluctuations in breastmilk supply and pain in the breast) for the non-mRNA vaccines were similar to that of respondents who received mRNA vaccines. Our study, with a large cohort and wide geographical and racial mix, further augments earlier reported findings that COVID-19 vaccines are safe for breastfeeding mothers and her children.

Background: The COVID 19 pandemic and associated public health measures have disrupted the lives of people around the world. It is already evident that the direct and indirect psychological and social effects of the COVID 19 pandemic are insidious and affect the mental health of young children and adolescents now and will in the future. The aim and objectives of this knowledge-synthesis study were to identify the impact of the pandemic on children’s and adolescent’s mental health and to evaluate the effectiveness of different interventions employed during previous and the current pandemic to promote children’s and adolescent’s mental health. Methodology: We conducted the systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and included experimental randomized, nonrandomized controlled trials; observational studies; and qualitative studies. Results: Of the 5,828 articles that we retrieved, 18 articles met the inclusion criteria. We thematically analyzed and put up the major findings under the thematic areas of impact of pandemic on children and adolescent’s mental health. These studies reported that pandemics cause stress, worry, helplessness, and social and risky behavioral problems among children and adolescents (e.g., substance abuse, suicide, relationship problems, academic issues, absenteeism from work). Interventions such as art-based programs, support services, and clinician-led mental health and psychosocial services effectively decrease mental health issues among children and adolescents. Conclusion: Children and adolescents are more likely to experience high rates of depression and anxiety during and after a pandemic. It is critical that future researchers explore effective mental health strategies that are tailored to the needs of children and adolescents. Explorations of effective channels regarding the development and delivery of evidence-based, age-appropriate services are vital to lessen the effects and improve long-term capacities for mental health services for children and adolescents.

Results: A total of 6270 individuals were assessed (1615 severe and 4655 non-severe patients). The median age was 63 (95% CI: 49-74) and 47 (95% CI: 19-63) years in the severe and non-severe groups, respectively. Moreover, about 41% of patients had comorbidities. Severity was higher in patients with history of cerebrovascular disease: OR 4.85 (95% CI: 3.11-7.57). The odds of being in severe group increase by 4.81(95% CI: 3.43-6.74) for history of cardiovascular disease (CVD). This was 4.19 (95% CI: 2.84-6.19) for chronic lung disease and 3.18, 95% CI: 2.09-4.82 for cancer .The odds ratio of a diabetes and hypertension were 2.61 (95% CI: 2.02-3.3), and 2.37( 95% CI: 1.80-3.13) respectively.

In the end of April nearly 100 cases of children aged between 6 month and 9 years with Kawasaki like disease were reported (mostly in Europe) probably linked to COVID-19. With the increasing awareness of this condition the number of cases reported is increasing worldwide. We aim to sum up the known data about this new entity based on published data (in a case report, a series of 8 cases and in newspapers and society statement) and using our knowledge of classical Kawasaki disease. It seems to be a post infectious disease with an onset between 2-4 weeks after the infection, probably in genetically predisposed children aged between 6 month to 17 years. A very rough estimation of incidence based on current data from Bergamo, Italy, and New York State and a lot assumption is between 0.016% (95% CI:0.013-0.02%) - 0.31% (95% CI: 0.2-0.47%) of infected children. Clinical signs overlaps with Kawasaki disease in some children, but another feature is prominent gastrointestinal manifestations. For the 9 detailed patients most had incomplete presentation for Kawasaki disease (with a mean 1.7 (+/-1.2) criteria per patient for the 5 non fever criterion) and only one had a classical form. In some cases, presentation is closer to toxic shock syndrome or isolated myocarditis. Persistent fever seems to be constant and biological exploration are consistent with inflammation (elevated CRP, ferritin and D-Dimers). Management is described as supportive and children seem to improve rapidly, but can require cardiac or respiratory support. In date of 11 may 2020 there is 4 deaths confirmed linked to these new entities (1 in UK and 3 in New York). Paediatricians and general practitioners need to be aware of these possible evolution following COVID-19 infection. However it seems to be rare and children are probably still spared from most morbidities and mortality linked to COVID-19 infection .There are need of published detailed cohorts to better delineate these entities.

The world is in the grips of the COVID-19 pandemic. Public health measures that can reduce the risk of infection and death in addition to quarantines are desperately needed. This article reviews the roles of vitamin D in reducing risk of respiratory tract infections, knowledge about the epidemiology of influenza and COVID-19, and how vitamin D supplementation might be a useful measure to reduce risk. Through several mechanisms, vitamin D can reduce risk of infections. Those mechanisms include inducing cathelicidins and defensins that can lower viral replication rates and reducing concentrations of pro-inflammatory cytokines that produce the inflammation that injures the lining of the lungs, leading to pneumonia, as well as increase concentrations of anti-inflammatory cytokines. Several observational studies and clinical trials reported that vitamin D supplementation reduced risk of influenza, whereas others did not. Evidence supporting the role of vitamin D in reducing risk of COVID-19 includes that the outbreak occurred in winter, a time when 25-hydroxyvitamin D [25(OH)D] concentrations are lowest; that the number of cases in the Southern Hemisphere near the end of summer are low; that vitamin D deficiency has been found to contribute to acute respiratory distress syndrome, and that case-fatality rates increase with age and with chronic disease comorbidity, both of which are associated with lower 25(OH)D concentration. To reduce risk of infection, it is recommended that people at risk of influenza and/or COVID-19 consider taking 10,000 IU/d of vitamin D₃ for a few weeks to rapidly raise 25(OH)D concentrations, followed by 5000 IU/d. The goal should be to raise 25(OH)D concentrations above 40–60 ng/ml (100–150 nmol/l). For treatment of people who become infected with COVID-19, higher vitamin D₃ doses might be useful. Randomized controlled trials and large population studies should be conducted to evaluate these recommendations.

Importance: The rapidly expanding 2019 novel coronavirus pandemic (COVID-19, caused by the SARS-CoV-2 virus) has challenged the medical community to an unprecedented degree. Physicians and healthcare workers are at added risk of exposure and infection during the course of the patient care. Due to the rapid spread of this disease through respiratory droplets, healthcare providers such as otolaryngologists-head & neck surgeons who come in close contact with the upper aerodigestive tract during diagnostic and therapeutic procedures are particularly at risk. Here we present a set of safety recommendations based on our review of literature and communications with physicians with first-hand knowledge of safety procedures during the 2019 COVID-19 pandemic.Observations: A high number of healthcare providers were infected during the first phase of the pandemic in Wuhan province. Subsequently, by adopting strict safety precautions, other regions were able to achieve high levels of safety for healthcare providers without jeopardizing the care of patients. We reviewed the most common procedures related to the examination and treatment of upper aerodigestive tract diseases. Each category was reviewed based on the potential risk imposed to healthcare workers. Specific recommendations were made, based on the literature, when available, or consensus best practices. Specific safety recommendations were made for performing tracheostomy in COVID-19 patients. Conclusions and Relevance: Preserving highly skilled healthcare work force is a top priority for any community and healthcare system. Based on the experience of healthcare systems in Asia and Europe, by following strict safety guidelines, the risk of exposure and infection of healthcare providers could be significantly reduced, while providing high levels of care. The provided recommendations could be used as broad guidance for all healthcare workers who are involved with the care of COVID-19 patients.

We examine here characteristics of electromagnetic waves that propagate through an unbounded space filled with a homogeneous isotropic chiral medium. Resulting characters are compared to those of the electromagnetic waves propagating through an achiral free space. To this goal, we form energy conservation laws for key bilinear parameters in a chiral case. Due to a nonzero medium chirality, conservation laws turn out to contain extra terms that are linked to the spin-orbit coupling, which is absent for an achiral case. As an example, we take a plane wave for achiral case to evaluate those bilinear parameters. Resultantly, the conservation laws for a chiral case are found to reveal inconsistencies among several bilinear parameters that constitute the con-servation laws , thereby prompting us to establish partial remedies for formulating proper wave-propagation problems.

Background: While the clinical factors of the post-COVID-19 condition (PCC) are becoming clearer, the economic implications remain uncertain, posing a challenge to healthcare professionals in terms of understanding and managing this emerging phenomenon. This article aims to investigate the demographic and clinical characteristics of PCC patients and quantify the economic impact of their healthcare resource utilisation. Methods: A retrospective and case-control observational study was conducted, comparing the case group of PCC population before and after diagnosis with a control group. Demographic and clinical variables were analysed with the objective of describing the population. Economic analysis was performed to evaluate the resource costs in procedures and primary, secondary (both outpatient and inpatient) and emergency care. Findings: PCC patients (N=341) exhibited older age and elevated cardiovascular risk factors compared to controls (N=49,078). There were differences in the socio-economic distribution between male and female patients in the PCC patients. Hypertension and diabetes mellitus type 2 were the most common chronic diseases observed among the case patients. Economic analysis revealed that PCC patients were approximately four times as costly as control patients, with increased utilisation of healthcare resources. However, post-diagnosis PCC patients showed a reduction in costs, primarily driven by decreased primary care visits and hospitalisations. Conclusion: Coordinated care management for PCC patients is associated with reduced costs and improved healthcare resource utilisation. Further research is warranted to investigate long-term health outcomes and establish causal relationships between COVID-19 sequelae and healthcare resource utilisation.

Background: Online teaching has resulted in university students adopting a sedentary lifestyle. Prolonged sitting and reduced physical activity due to pandemic restrictions have led to musculoskeletal pain in various body areas, significantly impacting the students’ quality of life. This study aims to investigate the effects of remote learning on Sicilian physiotherapy students during the COVID-19 pandemic, specifically focusing on the occurrence of musculoskeletal pain. Methods: An observational study was conducted using an online survey administered through Google Forms. The survey consisted of 26 multiple-choice questions and was distributed to students enrolled in Physiotherapy programs at the Universities of Catania, Messina, and Palermo. Participants were contacted via social channels or email, and data collection spanned 5 weeks. The collected data were analyzed using R software. Results: A total of 128 questionnaires were collected. More than half of the students (51.6%) reported dedicating 15–22 h per week to distance learning for a duration of 6–12 months (50%). Regarding study location, most students preferred studying at a desk (82.8%), with slightly over half (57.8%) adopting a backrest while studying remotely. Analysis of the students’ posture during study hours revealed common positions, including tilting the head forward by more than 20 degrees (47.8%), leaning the trunk forward by more than 20 degrees (71.9%), both shoulders being hunched forward (57.0%), wrists positioned above the level of the elbows (46.1%), thighs pointing upwards (41.4%), and one or both feet in a downward or dorsiflexed position (69.5%). Conclusion: The questionnaire responses indicate that the lifestyle of university students, influenced by online teaching, has deteriorated, leading to musculoskeletal pain, including myofascial pain. These results are primarily influenced by the adopted posture and the duration of time spent in these positions.

Objective: Several authors have analyzed the impact of the pandemic on the incidence rates of different conditions. Our aim was to analyze the impact of the COVID-19 pandemic on primary care new diagnoses of respiratory diseases. Methods: This was an observational retrospective study performed to describe the impact of COVID-19 pandemic on primary care new diagnosis of respiratory diseases other than lung cancer. Incidence rate ratio between pre-pandemic and pandemic period was calculated. Results: We found an decrease in the incidence of respiratory conditions (IRR 0.65) during the pandemic period. When we compared the different groups of diseases according to ICD-10, we found a significant decrease in the number of new cases during the pandemic period, except in the case of pulmonary tuberculosis, abscesses or necrosis of the lungs and other respiratory complications. Instead, we found increases in new diagnoses of flu and pneumonia (IRR 2.17) and respiratory interstitial diseases (IRR 1.41). Conclusion: There has been a decrease in new diagnosis of most respiratory diseases during the COVID-19 pandemic. The real clinical impact of this situation is still unknown. Large-scale real-life studies will make it possible to evaluate the long-term true impact of COVID-19 pandemic on the respiratory diseases management.

With arrival of highly transmissible Omicron variants in global pandemic, dentistry is facing another challenge to preserve biosafety of dental care. With a mission to protect both patients and healthcare workers, adaptability to the changing epidemiologic situation is required from dental professionals. This work presents a prospective sustainable biosafety setting for routine orthodontic care. The protocol is composed from combination of available technologies focused on the air-borne part of a virus pathway. Introduced biosafety protocol has been clinically evaluated after 18 months of application in the real clinical environment. The protocol has three fundamental pillars: (1) UVC air disinfection; (2) air saturation with certified virucidal oils through nebulizing diffusers; (3) complementary solutions. As a method of evaluation pseudonymous on-line smart form was used. Protocol operates with premise that everybody as a hypothetical asymptomatic carrier. Results from 115 patient feedbacks imply that with this protocol in place, there was no observed or reported translation of virus from patient to another patient or from patient to doctor or nurse and vice versa, albeit nine patients have retrospectively admitted visiting the clinic as probably infectious. Despite promising results, a larger clinical sample and exposition to current mutated strains is necessary for reliable conclusions about protocol virucidal efficiency.

The obligation to keep a distance from other people due to the pandemic has changed the pattern of human life, especially in shopping for their primary needs, namely food. The food marketplace's presence presents new hope in maintaining health and food availability without having to crowd with other people while shopping. The main problem that is often a concern for shopping online is the security of transactions and the ease of using this food marketplace application. This research is the intensity of using the Food Marketplace in terms of interest, transaction security, and ease of use of this application. Researchers analyzed the relationship between variables with the Structural equation model. Respondents who became this sample were 300 application users spread across various major cities in Indonesia. This study's results provide a view that the intensity of the use of the food marketplace has increased significantly during the new normal life. This paper's main value lies in providing a better understanding of consumer behavior in the Indonesian food marketplace that has not been previously researched. By investigating the factors that influence the intensity of use of the food marketplace, it is hoped that it will provide a basis for further research

In critically ill patients with COVID-19, concomitant abnormalities of coagulation have been seen with an unusually high incidence. Standard coagulation tests are limited in their ability accurately to reflect the severity of the pro-thrombotic phenotype observed in severe COVID-19 infections. In this narrative review we consider the role of rotational thromboelastometry (ROTEM) as a near bedside test allowing a more comprehensive assessment of haemostatic function in the context of COVID-19 infection. Comprehensive literature search was conducted on PubMed, revealing 13 publications on the subject. The coagulopathy of this disease process appears to be insufficiently represented with often normal conventional coagulation test parameters. Whilst not the perfect substitute for in vivo coagulation, studies utilising rotational thromboelastometry assays in COVID-19 patients have demonstrated increased maximum clot firmness (consistent with hyper-coagulability) and reduced maximum lysis (consistent with “fibrinolytic shutdown”). ROTEM appears to be a possible tool for risk stratification and to monitor the potential modulation of fibrinogen-dependent coagulation processes with enhanced anti-coagulation strategies. Precisely how these coagulation abnormalities can be modified by optimum, individualised medical interventions to improve clinical outcome, however, remains unclear.

The 2019 Coronavirus pandemic which was initially referred to as 2019-nCoV, was first identified in Wuhan, China. Early response from the Chinese government included quarantine of infected persons, isolation and total lockdown of Wuhan province to prevent further spread. With the spread of the disease across national borders and declaration of the disease as a global pandemic, there has been a robust response by the international community to contain this deadly virus and prevent its further spread worldwide. Africa is not left out of this rampaging pandemic with documented cases in over 40 countries and still rising. Although extensive studies have been carried out on the novel SARS-CoV-2 on its pathogenesis, mode of infection and virulence but much is still unknown. However, potentially infectious samples are received routinely in the medical laboratory for analysis. This technical note reviews good laboratory practice (GLP) and processes across the different specialities of Medical Laboratory practice that should minimize the risk of infection to laboratory staff especially in resource-limited settings.

COVID-19 (SARS-Cov-2) is spreading around the globe in a highly contagious manner. China has shown the way to halt the progression of the disease by totally sealing Wuhan from rest of china but they could not prevent community spread resulting in more than 4000 deaths in a short period of time. India, following example of china, ordered national Lockdown early on 23 March, 2020. But it is difficult to determine the transition Here we have changed the way we look at available data to detect an early onset of the effect of Lockdown. Here a simple method is described for the first time to determine at the earliest when a change is beginning to take effect after Lockdown on the progression/regression of the spread of novel COVID-19 virus which could help to frame strategy for intervention to prevent community spread and save lives.

Particulate matter (PM) contains heavy metals that affect various cellular functions and gene expression associated with an array of acute and chronic diseases, in humans. However, their specific effects on the stem cells remain unclear. Here, we report the effects of PM collected from Jeddah city on bone marrow mesenchymal stem cells (BM-MSCs) on proliferation, cell death, related gene expression and systems biological analysis aiming to understand the underlying mechanisms. Two different sizes (PM_2.5-₁₀) were tested in vitro at various concentrations (15 to 300 µg/ml) and durations (24 to 72 h). PMs induced cellular stress including membrane damage, shrinkage and death. Lower concentrations of PM_2.5 increased BM-MSCs proliferation, while higher concentrations decreased it. PM₁₀ decreased BM-MSCs proliferation in a concentration-dependant manner. The X-Ray Fluorescence spectrometric analysis showed that PM contains high levels of heavy metals. Ingenuity Pathway Analysis (IPA) and hierarchical clustering analyses showed that heavy metals were associated with signalling pathways involving cell stress/death, cancer and chronic diseases. qRT-PCR results showed differential regulation of the apoptosis genes (BCL2, BAX); upregulation of inflammation associated genes (TNF-a and IL-6) and downregulation of cell cycle regulation gene (P53). We conclude that PM could affect different cellular functions and predispose to debilitating diseases.

Aging-related disorders pose significant challenges due to their complex interplay of physiological and metabolic factors, including inflammation, oxidative stress, and mitochondrial dysfunction. Curcumin, a natural compound with potent antioxidant and anti-inflammatory properties, has emerged as a promising candidate for mitigating these age-related processes. However, gaps in understanding the precise mechanisms of curcumin's effects and the optimal dosages for different conditions necessitate further investigation. This systematic review synthesizes current evidence on curcumin's potential in addressing age-related disorders, emphasizing its impact on cognitive function, neurodegeneration, and muscle health in older adults. By evaluating the safety, efficacy, and mechanisms of action of curcumin supplementation, this review aims to provide insights into its therapeutic potential for promoting healthy aging. A systematic search across three databases using specific keywords yielded 2,256 documents, leading to the selection of 15 clinical trials for synthesis. Here we highlight the promising potential of curcumin as a multifaceted therapeutic agent in combating age-related disorders. The findings of this review suggest that curcumin could offer a natural and effective approach to enhancing the quality of life of aging individuals. Further research and well-designed clinical trials are essential to validate these findings and optimize the use of curcumin in personalized medicine approaches for age-related conditions.

The dynamic landscape of AI adoption and its impact on employment in Malaysia demands a multifaceted approach to navigate the challenges and harness the opportunities presented. While the government's commitment to fostering AI adoption through initiatives like the National AI Framework and the Malaysia Digital Economy Blueprint is commendable, it is imperative to address concerns regarding job displacement and ensure inclusive growth. This study identifies the pressing research problem of workforce readiness for the AI-driven future, emphasizing the need to explore strategies for reskilling and upskilling affected workers. By employing critical lenses such as Marxist, feminist, and postcolonial perspectives, scholars highlight the power dynamics and societal implications inherent in AI deployment, guiding the development of policies and interventions that prioritize workers' interests and address social inequalities. Moving forward, a comprehensive approach combining policy interventions, educational reforms, and inclusive strategies is essential to maximize the benefits of AI adoption while mitigating its potential risks. Longitudinal studies, interdisciplinary research, and comparative analyses will further advance our understanding and inform evidence-based policymaking in this evolving field. Ultimately, by prioritizing workforce preparedness, social equity, and sustainable development, Malaysia can position itself as a leader in the AI-driven global economy, fostering a resilient, inclusive, and prosperous society for all.

Supported Wellbeing Centres have been set up in UK hospital trusts in effort to mitigate the psychological impact of COVID-19 on healthcare workers, although the extent to which these are utilised and the barriers and facilitators to access are not known. The aim of the study was to determine facility usage and gather insight into employee wellbeing and the views of employees towards this provision. The study included i) 17-week service use monitoring, ii) employee online survey with measures of wellbeing, job stressfulness, presenteeism, turnover intentions, job satisfaction, and work engagement as well as barriers and facilitators to accessing the Wellbeing Centres. Over 17 weeks, 14,934 facility visits were recorded across two sites (peak attendance in single week n= 2,605). Facilities were highly valued, but the service model was resource intensive with 134 wellbeing buddies supporting the centres in pairs. 819 hospital employees completed an online survey (88% female; 37.7% working in COVID-19 high risk areas; 52.4% frontline workers; 55.2% had accessed a wellbeing centre). There was moderate-to-high job stress (62.9%), low wellbeing (26.1%), presenteeism (68%) and intentions to leave (31.6%). Wellbeing was higher in those that accessed a wellbeing centre. Work engagement and job satisfaction were high. Healthcare organisations are urged to mobilise access to high-quality rest spaces and Psychological First Aid, but this should be localised and diversified. Strategies to address presenteeism and staff retention should be prioritised, and high dedication of healthcare workers should be recognised.

We explored the impacts of the remote and return to in-person work periods on sleep and well-being as reported by faculty (n = 22) and non-teaching staff (n=21) with and without disabilities. Our results show that contrary to expectations, the Covid-19 remote teaching/working period resulted in better sleep, as well as greater well-being, than the return to in-person. With respect to sleep, faculty members had slightly more negative outcomes than staff, most evident in heightened anxiety and work aspects. Faculty with disabilities had somewhat worse sleep and well-being during the remote period than faculty without disabilities. During the return to in-person work, both faculty and non-teaching staff reported more negative than positive sleep and well-being outcomes. In particular, during the in-person period faculty members experienced slightly more negative sleep outcomes related to anxiety and work, while staff members experienced slightly more negative sleep outcomes related to the need to commute and lifestyle. Our findings show that there were benefits and disadvantages to both remote and in-person work periods, suggesting a hybrid work schedule should be considered in more detail, particularly as an optional reasonable accommodation for faculty and staff with disabilities. Our study highlights that training to keep faculty abreast of the latest technological innovations, ways to promote work-life balance and steps to remedy classroom size and building ventilation to prevent the spread of disease all need urgent attention.

Background: The COVID-19 pandemic has exacerbated existing healthcare disparities among American Indian/Alaska Native (AI/AN) populations, rooted in historical traumas and systemic marginalization. Methods: This study conducted at a single Indian Health Service (IHS) clinic in central Michigan examines the effectiveness of educational interventions in enhancing COVID-19 knowledge and attitudes among AI/AN populations. Utilizing a pre/post prospective study design, participants received either a video or infographic educational intervention, followed by a survey assessing COVID-19 knowledge and attitudes. Results: The results indicate significant improvements in knowledge and attitudes post-intervention, with both modalities proving effective. However, specific factors such as gender, political affiliation, and place of residence influenced COVID-19 attitudes and knowledge, emphasizing the importance of tailored interventions. Conclusions: Despite limitations, this study highlights the critical role of educational interventions in addressing vaccine hesitancy and promoting health equity within AI/AN communities. Moving forward, comprehensive strategies involving increased Indian Health Service funding, culturally relevant interventions, and policy advocacy are crucial in mitigating healthcare disparities and promoting health equity within AI/AN communities.

The individual and combined effects of extracellular products (ECP) from Arthrobotrys oligospora (Ao) and A. musiformis (Am) growth in liquid media against Haemonchus contortus L3 (HcL3) were assessed. The following methodological steps were established: isolation, morphological (MI) and molecular identification (Mol-I), assessment of nematocidal activity (NA) of fungal liq-uid culture filtrates (LCF) produced in two liquid media alone and in combination and finally, the myco-compound profile identification (MCP). The MI of both isolates suggested that the fungi corresponded to the species Ao and Am. This result was confirmed by PCR analysis followed by sequencing, alignment and obtaining coverage and similarity with respect to isolates reported in the NCBI database. Likewise, the highest Hc mortalities were 91.4% with individual LCF of Am and 86.2% with those of Ao at the highest concentration (100 mg/mL) in Czapek-Dox Broth. The combination of both LCF resulted in a similarly high larval mortality with no statistical differ-ences in relation to individual activity (P>0.05). The MCP showed the presence of alkaloids in both fungi. Coumarins, triterpenes and saponins were found only in Ao. Both fungi produced ECP with a high NA that could be identified and assessed in future studies as potential natural an-thelmintic compounds.

Introduction Atherosclerotic disease is a major contributor to heart failure, stroke, and myocardial infarction, significantly lowering the quality of life and life expectancy, with a significant burden on healthcare. Not all lesions deemed non-significant are benign, and conversely, not all significant lesions are causative of ischemia. Fractional flow reserve (FFR) provides a functional assessment of coronary lesions, while optical coherence tomography (OCT) offers detailed imaging of plaque morphology, aiding in therapeutic decision-making. The objective of this study was to evaluate the utility of OCT and FFR as adjunctive tools in the catheterization laboratory for guiding therapeutic decisions in patients with multivessel disease for non-culprit vessels. Specifically, we aimed to assess how OCT and FFR influence therapeutic decision-making in patients with multi-vessel coronary artery disease. Methods 36 patients with acute coronary syndrome (ACS) and multivessel disease were randomized 1:1 into two groups: one guided by FFR alone, and the other by a combination of FFR and OCT. For the FFR group, revascularization decisions for non culprit lesions were based solely on FFR measurements. If the FFR was >0.8, the procedure concluded, and the patient received maximal medical treatment. If the FFR was ≤0.8, a stent was placed. For the FFR + OCT group, if the FFR was >0.8, the revascularization decision was based on OCT findings. If there were no vulnerable plaques (VP), the procedure concluded, and the patient received maximal medical treatment. If OCT imaging indicated VP, then the patient underwent revascularization. If the FFR was ≤0.8, the patient underwent revascularization regardless of OCT findings. Results OCT imaging altered the therapeutic decision in 11 cases where FFR measurements were above 0.8, but the lesions were characterized as VP. Analyzing the total change in the decision to stent, 4 cases in the FFR group and 15 cases in the FFR and OCT group (4 based on FFR and 11 on OCT) revealed a statistically significant difference (p = 0.0006; Relative Risk = 0.2556; 95% CI: 0.1013 to 0.5603). When analyzing the change in the total decision both to stent and not to stent, we observed a statistically significant difference, with Group 1 having 7 cases and Group 2 having 15 cases (p = 0.0153; Relative Risk = 0.4050; 95% CI: 0.2004 to 0.7698) Conclusion Based on the findings of this study, OCT significantly increases the percentage of stenting procedures by identifying vulnerable lesions. The use of intracoronary imaging facilitates the timely identification and treatment of these vulnerable lesions. This underscores the crucial role of OCT in enhancing the precision of coronary interventions by ensuring timely intervention for vulnerable lesions, thereby potentially improving patient outcomes Acknowledgment funding „This work was supported by the University of Medicine, Pharmacy, Science and Technology ,, George Emil Palade’’ of Targu Mures Research Grant number 510/14/17.01.2022”

Background: This study aimed to analyze the psychometric properties of the Brief-COPE Inventory and to determine its concurrent validity by exploring its association with perceived stress in Peruvian nurses. Methods: Psychometric study carried out in 434 Peruvian nurses to determine the psychometric properties by confirmatory factor analysis. Three stepwise variable selection regression models were implemented. Results: The three-factor of the Brief-COPE Inventory reported adequate fit (root mean square error of approximation = 0.052, standardized root mean square = 0.068, and both the comparative fit index and the Tucker–Lewis index = 0.95). Likewise, we found that its factors are correlated (p &lt; 0.001) and that there is adequate reliability (ω= 0.90). Moreover, nurses showed a medium level of perceived stress and the following associated factors: sex, having received stress management training, fear of COVID-19, and problem-focused coping strategies (p &lt; 0.05). Conclusion: This study proved that Brief-COPE Inventory is a valid tool for measuring coping strategies in Peruvian nurses because it has a good fit to the model, excellent reliability, and concurrent validity with perceived stress. However, further studies are required to evaluate its validity according to the nursing professionals’ perceived areas of performance.

In 2019, due to the global pandemic of the new coronavirus (SARS-CoV-2), lockdown was imposed in Greece. Children with Type 1 Diabetes (T1D) during that period had to maintain a good level of glycemic control despite the subversive changes in their lives. The aim of this study was to assess the impact of lockdown on glycemic control and lifestyle changes of children with type 1 diabetes. The present cross-sectional study included 59 children with T1D who measured their glucose levels through glucose monitoring systems (Continuous Glucose Monitoring, CGM) and Flash Glucose Monitoring (FGM)). Their glycemic profile and demographic data were recorded in three different periods (before, during and after the lockdown). The changes in their daily routine were farther investigated through a short questionnaire which assesses changes in lifestyle-related behavior during COVID 19 pandemic. A significant improvement was noted in the glycemic control of children with T1D during the restrictive measures. Boys scored higher on scale of lifestyle behavior changes during the pandemic (-0.1 vs. -0.3, p=0.015). The results of this study highlight the need for continuous education and insistence on children's adherence with the treatment plan and the beneficial effects of using the new technology for easier monitoring.

Severe acute respiratory syndrome coronavirus 2 infects many people, but many infected individuals do not develop symptoms. COVID-19 is an inflammatory disease that affects a portion of individuals infected with the virus, and it is associated with liver injury and other complications leading to hospitalization, critical illness, and death. Remdesivir is an antiviral agent used for treatment of hospitalized patients with COVID-19 to improve time to recovery, reduce duration of mechanical ventilation, decrease the need for supplemental oxygen, and decrease the risk of mortality. Remdesivir-associated hepatotoxicity has been observed as increased transaminases more than 5 times the upper limit of normal in hospitalized patients with COVID-19 but causality has not been proven. It is generally difficult to distinguish between remdesivir-associated hepatotoxicity and COVID-19-induced hepatotoxicity. The purpose of this review is to evaluate the evidence for remdesivir-associated hepatotoxicity. Current evidence suggests that elevated liver enzymes in hospitalized COVID-19 patients are more likely to be due to the infection than remdesivir and that a 5-day course of remdesivir seems to be safe in regards to hepatotoxicity.

Severe COVID-19 is frequently associated with thromboembolic complications. Increased platelet activation and platelet-leukocyte aggregate formation can amplify thrombotic responses by inducing tissue factor (TF) expression on leukocytes. Here, we characterized TF-positive extracellular vesicles (EVs) and their cellular origin in 12 patients suffering from severe COVID-19 (time course, 134 samples overall) and 25 healthy controls. EVs exposing phosphatidylserine (PS) were characterized by flow cytometry. Their cellular origin was determined by staining with anti-CD41, anti-CD45, anti-CD235a, and anti-CD105 as platelet, leukocyte, red blood cell, and endothelial markers. We further investigated the association of EVs with TF, platelet factor 4 (PF4), C-reactive protein (CRP) and high mobility group box-1 protein (HMGB-1). COVID-19 patients showed higher levels of PS-exposing EVs compared to controls. The majority of these EVs originated from platelets. A higher amount of EVs in patient samples were associated with CRP, HMGB-1, PF4, and TF, as compared to EVs from healthy donors. In COVID-19 samples, 16.5% of all CD41+ EVs displayed the leukocyte marker CD45, and 55.5% of all EV aggregates (CD41+CD45+) co-expressed TF, which reflects the interaction of platelets and leukocytes in COVID-19 on an EV level.

The COVID-19 pandemic globally had worrisome effects on health-promoting behaviors of children. Currently, the impact on primary school children's membership in sports clubs, especially considering gender differences, is poorly studied. The main objective of this study was to analyze the status of sports club memberships among children in Austria after the stringent COVID-19 restrictions in June 2021 and to identify gender differences. 755 Austrian school children (mean age 9.9 years, 49.9% girls) were interviewed about their sports club memberships. Our results show significantly lower self-reported sports club membership in June 2021 compared to pre-pandemic studies. 50% of boys reported being a member of a sports club, while the percentage for girls was only at 29.7% (p<0.001). Besides, a significant gender difference in the type of sports club membership was observed with most boys being members of ball sports clubs, while girls were more likely to be members of other sports clubs (p<0.001). Reduced rates of sports club membership after the COVID-19 pandemic underline the need of intervention programs. Health authorities, schools, sports clubs and families should form an alliance to promote an overall increase of physical activity and thus to support the long-term healthy development of children.

Qatar experienced five SARS-CoV-2 waves dominated sequentially by the original virus, Alpha, Beta, Omicron BA.1 and BA.2, and Omicron BA.4 and BA.5, in addition to a prolonged low-incidence phase dominated by the Delta variant. The two-dose primary series of BNT162b2 (Pfizer-BioNTech) COVID-19 vaccine against SARS-CoV-2 infection has been approved for use in 10µg formulations among children and adolescents aged 12-17 years as of May 16, 2021. This study aimed at estimating the effectiveness of the 30µg BNT162b2 Pfizer-BioNTech mRNA COVID-19 vaccine against the pre-Omicron variants of SARS-CoV-2 infection in children and adolescents aged 12-17 years residing in Qatar. A test-negative matched case-control study was conducted where any child or adolescent aged 12-17 years who had been tested for SARS-CoV-2, RT-PCR tests performed on nasopharyngeal or oropharyngeal swabs, as part of contact tracing, between June and November 2021 and eligible to receive the BNT162b2 vaccine as per the national guidelines. Data regarding 14,161 children/adolescents meeting inclusion-exclusion criteria were retrieved from the national Surveillance and Vaccine Electronic System (SAVES). Of the total, 3.1% (444) were positive for SARSCoV-2. More than half (55.96%) were vaccinated with two doses of Pfizer-BioNTech-mRNA COVID-19 vaccine. Amongst those immunized with two doses, 1.2% tested positive for SARS CoV2, while 5.6% amongst the unvaccinated tested positive. The vaccine effectiveness was calculated to be 79%. Pfizer-BioNTech mRNA COVID-19 vaccine provides protection from COVID-19 infection for children/adolescents, hence it is crucial to ensure they receive the recommended vaccines.

Background: COVID-19 represents a threat for frailty patients. Objective: Investigate efficacy, safety and economic value of treatment with Molnupiravir in a cohort of fragile patients affected by COVID-19. Methods: Observational, prospective study. The data collected allowed to assess efficacy and safety of Molnupiravir in real life, compare the results with a subgroup of patients treated with Nirmatrelvir-Ritonavir and to effect a cost-effectiveness analysis. Results: In January-December 2022, 435 patients (225 males, 220 females; median age 72 years), were enrolled; 24 patients were unvaccinated, 280 patients had ≥2 risk factors. Molnupiravir appeared to give better results than the SOC both clinically and economically. In these patients in comparison with literature data or SOC, hospitalization was 2.5% vs 6.8% (p&lt;0.005), overall adverse effects 14,3% vs 30.4% (p&lt;0.0001), severe adverse effects 2.6 vs 6.9% (p&lt;0.001), thus involving a potential total savings of about € 92.954 per patient (8% of standard of care cost). Conclusions: early Molnupiravir treatment helped fragile patients who partially responded to vaccine, or with absolute contraindications to vaccination, to overcome COVID-19 without the need of hospitalization. Molnupiravir represents a clinical and economic effective treatment, avoiding disease progression in old patients suffering from multiple pathologies and taking several drugs.

(1) Background: To fight for COVID-19 pandemic, immunity against SARS-CoV-2 should be achieved not only through natural infection but also vaccination. Controversies exist about the effect of COVID-19 vaccination on previously infected persons; (2) Methods: A prospective cohort was undergone to collect sera from unvaccinated survivors and vaccinated persons--with and without COVID-19 pre-infection. The sera were analyzed for the anti-Receptor Binding Domain (RBD) titers by ELISA and for the capacity to neutralize the pseudovirus of the Wuhan-Hu-1 strain by luciferase assays; (3) Results; Neither the antibody titers nor the neutralization capacity was significantly different between the three groups. However, the correlation between the antibody titers and the percentage of viral neutralization derived from sera of unvaccinated survivors was higher than that from vaccinated persons with pre-infection (Spearman correlation coefficient (r) = -0.8558; 95% CI, -0.9259 to -0.7288), p &lt;0.0001 vs -0. 581; 95% CI, -0.7679 to -0.3028; p = 0.0002, respectively), indicating the capacity to neutralize the virus is better among the unvaccinated individuals. (4) Conclusions: Vaccines induced anti-RBD titers as high as the natural infection with lower neutralization capacity, and it did not boost the immunity in pre-infected persons.

The non-pharmaceutical interventions implemented to prevent the spread of COVID-19 have affected the epidemiology of other respiratory viruses. In South Korea, Human metapneumovirus (HMPV) typically occurs from winter to the following spring; however, it was not detected for two years during the COVID-19 pandemic and re-emerged in the fall of 2022, which is a non-epidemic season. To examine the molecular genetic characteristics of HMPV before and after the COVID-19 pandemic, we analyzed 427 HMPV-positive samples collected in the Gwangju area from 2018 to 2022. Among these, 24 samples were subjected to whole-genome sequencing. The results showed a shift in the predominant genotype from A2b2 before the COVID-19 pandemic to A2b1 in 2022. Furthermore, a significant increase in HMPV cases was observed in the 6–10-year age group. Since the onset of the COVID-19 pandemic, social distancing have reduced the possibility of HMPV exposure and herd immunity due to non-transmission, resulting in the introduction of new HMPV genotypes in different seasons.

Suffocation syndrome is the leading cause of hypoxia and mortality in the most common lung diseases, asthma and COVID-19. Inhaled corticosteroids (ICSs) have been shown to be the main-stay of critical care in these diseases. Meanwhile, mortality from strangulated hypoxia is highest in low-income countries because ICSs are not currently available to many patients. Warm alkaline hydrogen peroxide solutions (WAHPSs) have reportedly been invented in recent years to urgently turn thick sputum, mucus, pus, serous fluid, blood clots and many other biological masses con-taining the enzyme catalase into a fluffy oxygenated foam. It has been shown that the mechanism of action of WAHPSs consists in alkaline saponification of lipid and protein-lipid complexes of bi-ological masses and their transformation into oxygen foam, because hydrogen peroxide is urgently decomposed into water and oxygen gas under the action of the biological masses catalase enzyme At that excess oxygen is absorbed into blood through lungs and increases blood oxygen saturation. Based on the described mechanism of action of WAHPSs and the high availability of their ingre-dients, it is suggested that mortality from choking and hypoxia in asthma and COVID-19 can be reduced by combining ICSs with inhaled WAHPSs, especially in poor countries. The essence of the inventions underlying the formation of WAHPSs is given.

Since the outbreak of the Covid-19, working from home has become the norm for millions of workers worldwide. The current research focuses on the benefits and challenges of teleworking in the administrative sectors of greek healthcare units, with a view to harnessing the knowledge gained through experience, in order to create the frame for sustainable behaviors. Anyways, the implementation of teleworking requires complex and dynamic changes in technical and behavioral aspects. Therefore, a systematic review was also conducted to identify the relationships between telecommuting and organizational behavior, with the aim of achieving sustainable development in businesses. Moreover, an important positive aspect of telework that emerged from this literature review appears to create opportunities for potential direct or indirect linkages between telework and many SDGs areas, based on the fact that telework appears to be a community-friendly form of work. In summary, this research strongly suggests that leaders facilitate telecommuters to adopt green practices and volunteerism that can consequently contribute to the SDGs. However, in order to meet the challenges arising from unprecedented times, the leaders of the organizations will have to redesign their policies, while the states will have to focus on guaranteeing the rights and freedoms of the workers.

The COVID-19 epidemic and the measures adopted to contain it have had a significant impact on energy patterns throughout the world. The pandemic and movement restrictions led to unpredictable fluctuations in power systems demand and the fuel price for a delayed period. Monkeypox, another viral disease, appeared during the post-COVID period. It is assumed that the outbreak of monkeypox is unlikely due to the implication of preventive measures experienced by COVID-19. At the same time, the probability of an epidemic cannot be blindly overlooked. This paper aims to examine and analyze historical data to look at how much petroleum fuel was used for generating power and how the price of petroleum fuel changed over seven years, from January 2016 to August 2022. This period covers the time before the COVID-19 pandemic, during the pandemic, and after the pandemic. Several time-series forecasting models, including all four benchmark methods (Mean, Naïve, Drift, and Snaïve), Seasonal and Trend decomposition using Loess (STL), Exponential Smoothing (ETS), and Autoregressive Integrated Moving Average (ARIMA) methods have been applied for both fuel consumption and price prediction. The best forecasting method for fuel price and consumption has been identified among these methods. The paper also utilizes the ARIMAX model by incorporating multiple exogenous variables, such as monthly mean temperature, mean fuel price, and mileage of vehicles traveling during a certain period of pandemic lock-down. It will assist in capturing the non-smooth and stochastic pattern of fuel consumption and price due to the pandemic by separating the seasonal influence and thus provide a prediction of the consumption pattern in the event of any future pandemic.

The Covid-19 pandemic that hit the world in early 2020 has had a major impact on social and economic life in every country, including Malaysia. Many socio-economic activities have been disrupted globally, leading to the closure of companies and the suspension of work activities, which have drastically increased the unemployment rate and narrowed employment opportunities. This study uses a qualitative method to explore the initiatives taken by Malaysia Ministry of Higher Education and university in improving the sustainability graduates’ employability at the post pandemic Covid-19 phase. The total sample of the study involved is ten officers who are experienced and responsible in organizing initiatives for university graduates’ employability programs and ten participant students who attended the programme were purposively selected. The study showed that Short -term training & placement programmes (MyStep), Career Advancement Programmes (Penjana CAP), Professional certification programmes (Penjana PACE), Career Advancement Programmes at State (Penjana KPT CAP@ State) were the major initiatives taken by Malaysia Ministry of Higher Education in improving graduate employability at the post Covid-19 phase. The findings also revealed upskilling and reskilling, gig economy, entrepreneur, finishing school programmes and online career fair were the important initiatives taken by university in improving graduate employability rate at the post Covid-19 phase. Interviews with student respondents showed that the initiative taken by the government and university to increase the marketability of graduates in the post-covid-19 era has given them the opportunity to learn and improve new skills that are very necessary to get new job opportunities in the post-covid 19 eras. The main contribution of this study is that upskilling and reskilling programs are essential to improve the sustainability of graduates’ employability in the post-covid 19 era.

Vaccination is the key infection control measure against Coronavirus Disease 2019 (COVID-19). Most municipalities in Japan have adopted an opt-in system for COVID-19 vaccination, but its background information is limited. We, therefore, aimed to examine the differences in vaccination coverages and their cancellation rates between opt-in and opt-out settings for COVID-19 vaccination in 10 cities in A prefecture, Japan. 10 cities in A Prefecture were surveyed by email as of 10 October 2021 on the vaccination coverage by age group (12 years and older) and the cancellation rate on the day of vaccination. We also checked on the complaints received in the opt-out group. Opt-out was adopted in one of the ten cities in which vaccination was designed for all household members aged 15-64, thus serving as the opt-out group. Vaccination coverage in the opt-out group was 88.2%-89.2% for the first dose and 84.9%-86.0% for the second dose at 95% confidence intervals in the comparable 20–64-year age group. In contrast, the overall opt-in group (nine cities, one of which did not have an identified vaccination rate) was 51.3%-83.6% for the first dose and 63.5%-74.8% for the second dose in the same age group. For the opt-out group, the cancellation rate on the day was 11.3% for the first dose and 3.7% for the second dose, which had a lower cancellation rate than that of the opt-out on influenza vaccines in previous studies, 71%. Meanwhile, the opt-in group did not monitor them. There were no complaints about default changes in the opt-out group. While there is room for further research, such as understanding the reasons for accepting the default change by residents in the opt-out group, it was suggested that making opt-out the default would promote COVID-19 vaccination.

In New Orleans, Louisiana the population’s poor baseline health led to its establishment as an early epicenter for severe acute COVID-19. Antici-pating future outbreaks of COVID-19 and other respiratory viruses, we need to identify correlates of outcome, from real clinical experience. 89 patients were recruited into the ClinSeqSer acute COVID-19 longitudinal observational study, from the beginning of the outbreak in March to July 2020. Patients admitted for acute COVID-19 were enrolled in person. The cohort is unique as it is 68% Black, 53% female, of average age of early 60s, and prevalence of obesity and hypertension respectively of 55% and 83%. The outcomes are: 53% severe (20% fatal, 33% non-fatal) and 47% non-severe, with severe defined as death or requiring mechanical ventila-tion or high flow oxygen. Obesity and admit systolic blood pressure (SBP) >140mmHg are each associated with severe outcome and, despite respective sensitivity of 71% and 76%, specificity ~66% for both, and ac-curacy of 60% and 70% by ROC analysis, would likely provide useful predictors of outcome in critically stressed health care systems. We discuss pathophysiologic hypotheses to explain why high admit SBP is observed only in half of patients with pre-COVID hypertension and is associated with severe outcome.

We primarily study a possible link between 2021 COVID-19 vaccination uptake in Europe and monthly 2022 excess all-cause mortality, i.e., mortality higher than before the pandemic. Analyses of 31 countries weighted by population size show that all-cause mortality during the first nine months of 2022 increased more the higher the 2021 vaccination uptake; a one percentage point increase in 2021 vaccination uptake was associated with a monthly mortality increase in 2022 by 0.105 percent (95% CI, 0.075-0.134). When controlling for alternative explanations, the association remained robust, and we discuss the result emphasizing causality as well as potential ecological fallacy. Also, the study shows that 2021 all-cause mortality was lower the higher the vaccination uptake, but this association became non-significant when controlling for alternative explanations.

Background: COVID-19, caused by SARS-CoV-2, is still a global public health concern due to the absence of effective antiviral treatment against different strains. Studies have shown that pregnant women are more susceptible to COVID-19 due to altered physiology and immunological features. Therefore, this study was designed to investigate pregnant women's knowledge, attitudes, and practice (KAP) to prevent COVID-19 and determine the factors associated with KAP. Methods: A community-based cross-sectional study was conducted among 425 pregnant women in Northern Bangladesh. The samples were obtained using a simple random sampling technique from April 5 to June 15, 2020. The data were collected by face-to-face survey with a structured and pre-tested questionnaire and analyzed using SPSS version 25. Bivariable and multivariable logistic regression analyses were performed, and p-values < 0.05 at 95% CI were considered statistically significant. Results: Overall, the score of KAP among the respondents was 47.76%, 49.41%, and 56.24%, respectively. Participants' area of residence, educational status of the husband, and antenatal care (ANC) visit were significantly associated with the level of knowledge, whereas age, educational status of the husband, number of living children, and knowledge were significant predictors of attitude. The knowledge of COVID-19 was the only predictor associated with the practice. Conclusion: Our study shows that almost half of the participants had poor knowledge, a negative attitude, and poor practices toward COVID-19. Additional health education programs by healthcare professionals and different media, coordinated and combined efforts of government and individuals' participation will be required to fight the spread of the infection.

The COVID-19 pandemic has caused detrimental impacts on different population groups throughout the world. This study aimed to explore the impacts of the COVID-19 pandemic’s mandatory lockdown protocols on activities and mental health conditions of community-dwelling older people in Jakarta, Indonesia. A qualitative design using one-on-one in-depth interviews was employed to collect data from the participants (n=24) who were recruited using the snowball sampling technique. Data analysis was guided by a qualitative data analysis framework. The findings showed that before the COVID-19 outbreak participants engaged in different kinds of regular individual and social activities. However, the COVID-19 outbreak and its mandatory lockdown protocols significantly influenced both their activities and social life, which led to social disconnection and financial difficulties for them. COVID-19 outbreak, mandatory lockdown protocols, and disruption of individual and social activities of the participants also caused mental health challenges to them, including feelings of loneliness, loss, sadness, stress, and anger. The findings suggest that there is a need for intervention programs addressing the socio-economic and mental health impacts of the COVID-19 pandemic on older populations to help them cope with these challenges. Future studies involving large-scale older populations to comprehensively understand COVID-19 impacts on them are recommended.

Objectives: COVID-19 pandemic interrupted the Spanish professional football competition until May 2020, when it was restarted following a surveillance protocol established by LaLiga. The aims were to describe the infective and serological status of professional football players (PLY) and staff (STF) between May 5th 2020 until April 22nd 2021, to analyze the spatial-temporal distribution of the COVID-19 disease in this cohort and its comparison to the Spanish population. Methods: a prospective observational cohort study was carried out. Differences between PLY and STF were assessed by Chi-squared test and test of equality of proportions. Pearson correlation test was used to measure the presence of an association between the percentages of positivity in population and LaLiga cohort. Results: 137,420 RT-PCR and 20,376 IgG serology tests were performed in 7,112 professionals. Positive baseline serology was detected in 10.57% of PLY and 6.38% of STF. Among those who started the follow-up as not infected and before STF vaccination, 11.87% of PLY and 5.03% of STF became positive. Before summer 2020 the prevalence of infection was similar than the observed at national level. The percentage of positivity in the Spanish population was higher than in LaLiga cohort, but both series showed a similar decreasing trend.

Background Recently, a surge of COVID 19 was observed globally, regionally and nationally. With increasing numbers of cases, the frequency of long COVID is on the rise. Management and control of long COVID depend on changes in respect of human behaviors and requires an understanding of knowledge, attitudes, and practices (KAP) regarding health threats. MethodsA descriptive cross sectional study using online survey to gather data on the socio-economic background, knowledge, attitudes and practices on long-term complications of COVID. Results: Out of 201 respondents, 89.2% participants have heard about long-term complications of COVID 19. Only 35.9% have demonstrated adequate knowledge in the questions relating to co-morbidities and risk factors of COVID-19. A total of 92.2% believe that they should adhere to preventive measures following vaccination. Less than 60 % were following the advice on avoiding unnecessary travel and crowded places. Further, less than 50% were following COVID preventive measures. ConclusionAlthough the majority of participants have heard about long-term complications and common symptoms, the knowledge regarding co-morbidities that can lead to severe disease and long COVID was not satisfactory. The attitudes of the participants indicated increasing concern about long COVID. Practices indicate lack of adherence to key measures such as avoiding crowded places. These findings highlight the need for further increasing of awareness.

Background-The outbreak of COVID-19 pandemic has affected the global economy from its starting. Indian economy is also affected by the pandemic and experienced a lot of economic damages. India has become the global hotspot of COVID-19 during the second wave of the pandemic and recorded the second-highest position in terms of positivity rate after China. The present study attempts to analyze the economic issues that emerged in the first and second waves of the pandemic in India. Method/Approach-There is no econometric tools or analytical models used in the present study. This study attempts to evaluate the two research questions which are formed on the basis of some previous studies by various organizations and researchers. The research questions are as follow, First, what are the sectors those are primarily affected at the time of the first COVID-19 outbreak? Second, which economic issues and impacts emerged in the second wave of the pandemic? Results/ Findings-From the study, it is found that the second wave of COVID-19 is not much affected by the Indian economy. At this time, no nationwide lockdown was announced by the Government. But so, it was much severe in the time of the first wave of COVID-19. Many sectors were affected by the pandemic like agriculture, MSMEs, Tourism, etc., and these resulted in substantial unemployment problems in the economy. The study is trying to analyze these problems and concluding it with a few policy recommendations for the economy of India.

The spread of the Coronavirus pandemic has been accompanied by an infodemic. The false information that is embedded in the infodemic affects people’s ability to have access to safety information and follow proper procedures to mitigate the risks. This research aims to target the falsehood part of the infodemic, which prominently proliferates in news articles and false medical publications. Here, we present NeoNet, a novel supervised machine learning text mining algorithm that analyzes the content of a document (news article, a medical publication) and assigns a label to it. The algorithm is trained by TFIDF bigram features which contribute a network training model. The algorithm is tested on two different real-world datasets from the CBC news network and Covid-19 publications. In five different fold comparisons, the algorithm predicted a label of an article with a precision of 97-99 %. When compared with prominent algorithms such as Neural Networks, SVM, and Random Forests NeoNet surpassed them. The analysis highlighted the promise of NeoNet in detecting disputed online contents which may contribute negatively to the COVID-19 pandemic.

Strategies implemented worldwide to contain COVID-19 outbreaks varied in severity across different countries, and established a new normal for work and school life (i.e. from home) for many people, reducing opportunities for physical activity. Positive relationships of physical activity with both mental and physical health are well recognised, therefore the aim was to ascertain how New Zealand’s lockdown restrictions impacted physical activity and mental health and wellbeing. Participants (n=4007; mean±SD: age 46.5±14.7y, 72% female, 80.7% New Zealand European) completed (10–26 April 2020) an online amalgamated survey (Qualtrics): International Physical Activity Questionnaire: Short Form; Depression, Anxiety and Stress Scale-9; World Health Organization-Five Well-being Index; Stages of Change Scale. Positive dose response relationships between physical activity levels and wellbeing scores were demonstrated for estimates that were unadjusted (moderate activity OR 3.79, CI 2.88-4.92; high activity OR 8.04, CI 6.07-10.7) and adjusted (confounding variables: age, gender, socioeconomic status, time sitting, co-morbidities) (moderate activity 1.57, CI 1.11-2.52; high activity 2.85, CI 1.97-4.14). The study results support previous research demonstrating beneficial effects of regular physical activity on mental health and wellbeing. Governments may use such results to promote meeting physical activity guidelines in order to protect mental health and wellbeing during the ongoing COVID-19 and future pandemics.

Angiotensin converting enzyme 2 (ACE2) is a key entry point of SARS-CoV-2 virus known to induce COVID-19. We have recently outlined the concept to reduce ACE2 expression by the administration of glycyrrhizin, a component of Glycyrrhiza glabra extract, via its inhibitory activity on 11beta hydroxysteroid dehydrogenase type 2 (11betaHSD2) and resulting activation of mineralocorticoid receptor (MR). We hypothesized that in organs, such as the intestine, which co-express 11betaHSD2, MR and ACE2, the expression of ACE2 would be suppressed. We studied organ tissues from an experiment originally designed to address the effects of Glycyrrhiza glabra extract on the stress response. Male Sprague Dawley rats were left undisturbed or exposed to chronic mild stress for five weeks. For the last two weeks, animals continued with a placebo diet or received a diet containing extract of Glycyrrhiza glabra root at a dose of 150 mg/kg of body weight/day. Quantitative PCR measurements showed a significant decrease in gene expression of ACE2 in the small intestine of rats fed with diet containing Glycyrrhiza glabra extract. This effect was independent of the stress condition and failed to be observed in non-target tissues, namely the heart and the brain cortex. In the small intestine we confirmed the reduction of ACE2 also at the protein level. Present findings provide first evidence to support the hypothesis that Glycyrrhiza glabra extract may reduce an entry point of SARS-CoV-2. Whether this phenomenon, when confirmed in additional studies, is linked to the susceptibility of cells to the virus requires further studies.

International data suggests that exposure for nature is beneficial for mental health and well-being. The restrictions related to Covid-19 pandemic have created a setting that allows us to investigate the importance of greenness exposure on mental health during a period of increased isolation and worry. Based on 2060 responses from an online survey in the Stockholm County, Sweden, we investigated: 1) weather the Covid-19 pandemic changed peoples’ life-style and nature-related habits, and 2) if peoples’ mental health differed depending on their exposure to greenness. Neighbourhood greenness levels were quantified by using the average Normalized Difference Vegetation Index (NDVI) within 50m, 100m, 300m, and 500m buffers surrounding the participant’s place of residence. We found that the number of individuals that reported that they visited natural areas “often” was significantly higher during the pandemic than before the pandemic. Higher levels of greenness surrounding one’s location of residence were in general associated with higher mental health/wellbeing and vitality scores, and less symptoms of depression, anxiety, and perceived and cognitive stress, after adjustments for demographic variables and walkability. In conclusion, the results from the present study provided support to the suggestion that contact with nature may be important for mental health in extreme circumstances.

Objectives: There are limited data regarding the efficacy of methylprednisolone in patients with acute respiratory distress syndrome (ARDS) due to coronavirus disease 2019 (COVID-19) requiring invasive mechanical ventilation. We aimed to determine whether methylprednisolone increases the number of ventilator-free days (VFDs) among these patients. Design: Retrospective single-center study Setting: Intensive care unit Patients: All patients with ARDS due to confirmed SARS-CoV-2 infection and requiring invasive mechanical ventilation between 1 March and 29 May 2020 were included Interventions: None Measurements and Main Results: The primary outcome was ventilator-free days (VFDs) during the first 28 days, defined as being alive and free from mechanical ventilation. The primary outcome was analyzed with competing-risks regression based on Fine and Gray’s proportional subhazards model. Death before day 28 was considered to be the competing event. A total of 77 patients met the inclusion criteria. Thirty-two patients (41.6%) received methylprednisolone. The median dose was 1 mg.kg-1 (IQR: 1-1.3 mg.kg-1) and median duration of 5 days (IQR:5-7 days). Patients who received methylprednisolone had a mean 18.8 VFDs (95% CI, 16.6-20.9) during the first 28 days vs. 14.2 VFDs (95% CI, 12.6-16.7) in patients who did not receive methylprednisolone (difference, 4.61; 95% CI, 1.10-8.12; P = 0.001). In the multivariable competing-risks regression analysis and after adjusting for potential confounders (ventilator settings, prone position, organ failure support, severity of the disease, tocilizumab, and inflammatory markers), methylprednisolone was independently associated with a higher number of VFDs (subhazards ratio: 0.10, 95%CI: 0.02-0.45; p=0.003). Hospital mortality did not differ between the two groups (31.2% vs. 28.9%, p=0.82). Hospital length of stay was significantly shorter in the methylprednisolone group (24 days [IQR:15-41 days] vs. 37 days [IQR:23-52 days], p=0.046). The incidence of positive blood cultures was higher in patients who received methylprednisolone (37.5% vs. 17.8%, p=0.052). However, 91% of patients who received methylprednisolone also received tocilizumab. The number of days with hyperglycemia was similar in the two groups. Conclusions: Methylprednisolone was independently associated with increased VFDs and shortened hospital length of stay. The combination of methylprednisolone and tocilizumab was associated with a higher rate of positive blood cultures. Further trials are needed to evaluate the benefits and safety of methylprednisolone in moderate or severe COVID-19 ARDS.

To define and evaluate the areas of consideration concerning in identifying the critical factors that top universities in Nueva Ecija, Philippines can be used for triangulating the courses of actions that can be applied to improve the current practices of universities towards its combat to the COVID–19 disease is the primary objective of this study. The researchers used a descriptive design of methodology by using questionnaire–checklist to scientifically describe the situation, problems, phenomenon, or program, or provide information about certain issues related to the virus outbreak. The respondents of the study were faculty and staff of five established universities in Nueva Ecija, Philippines wherein the researchers employed a non–probability sampling technique to be logically assumed as the representative of the entire population. The results of the study shown that the top universities in Nueva Ecija have made efforts to ensure the safety of university workers by complying with the Inter–Agency Task Force (IATF) protocols. It can be inferred, in reality, that there are some areas that must be improved especially when it comes to ensuring the welfare of the personnel who are still reporting to work even in this time of the pandemic. The researchers suggested an enhancement plan that can be adapted by these universities to resolve the concerns of the faculty and staff especially in reducing the spread of the virus without sacrificing the day–to–day transactions of the academic institutions.

The objective of the study was to examine the effects of perceived stress on depression and subsequently to examine the effects of depression on alcohol use disorders. The data were obtained by an electronic questionnaire survey during the coronavirus disease 2019 (COVID-19) pandemic (n=1523 Slovak college students). Descriptive, regression and correlation analysis were used in the analytical processing, while the analyses included students' scores in three diagnostic tools (Perceived Stress Scale (PSS), Patient Health Questionnaire for depression (PHQ 9) and Alcohol Use Disorders Identification Test (AUDIT)), as well as gender and income characteristics. The PSS identified an increased level of perceived stress in female students, in contrast, the AUDIT showed an increased level of alcohol use disorders in male students. Differences in mental and behavioural disorders between the gender and income categories were significant in most of the analysed cases. In terms of gender-income characteristics, it was possible to confirm a significant positive effect of the PSS score on the PHQ 9 score, as well as a significant positive effect of the PHQ 9 score on the AUDIT score. As a result, efforts to reduce stress will be reflected in a reduction of depressive disorders as well as a reduction of excessive alcohol consumption among students.

Context: COVID-19 pandemic and the Lockdown implemented as a measure to contain the virus spread has taken a toll over the psychological well-being of the people especially the young adults, the confinement along with the environment of a highly infectious pandemic around the induvial are put under great stress.Aims: The current study aims to assess the psychological impact and perceived stress due to COVID-19 lockdown in Young Adult population of India.Settings and Design: It is a cross sectional, observational study.Methods and Material: The survey was conducted using Google forms involving snowball sampling technique which obtained 267 responses in total. (IES-R) and (PSS) scales were used for the study.Statistical analysis used: Descriptive analysis were performed on the sociodemographic parameters and the comparison of means were done by Chi-square test in SPSS Statistic 21.0 (IBM SPSS Statistics, New York, United States). Results: The mean IES-R and PSS scores obtained for the population in this study was 25.64±18.95 and 18.27±6.10 respectively. Out of the 267 respondents in total 61.4% (n=164) of them were males. Maximum of the respondents 62.54%(n=167) belonged to the age group of 18-23 with mean age being 23.14± 2.913. 92.5% of the respondents were unmarried and only 26.6% belonged to the rural part of India. Females, younger individuals were found to have higher IES-R and PSS scores. Conclusions: There is significant psychological burden and stress on the young Indian population with females and younger individuals particularly students are the most vulnerable population.

COVID-19 is a pandemic with no cure. There is an urgent need for low-cost interventions. Macroclimate work through affecting microclimate. In many situations, man-made microclimate, such as air conditioning, may override the effect of natural macroclimate in determining SARS-CoV-2 pathogenicity. Ambient temperature (AT) has been roughly associated to SARS-CoV-2 transmission. To translate into a feasible practice in controlling COVID-19 pandemic, in-depth and implementable knowledge of AT role in SARS-CoV-2 transmission should be unveiled. This study aimed to determine if there is a ‘safe’ temperature that is comfortable to human beings while significantly inhibitory for SARS-CoV-2 pathogenicity. Data on monthly new deaths or new cases per million population (MDPM or MCPM) and monthly cumulated days with more cases than the previous day (DI) from March 2 to June 30, 2020 were collected from all 118 countries with population over five million. Monthly average AT negatively correlated with the transmission parameters. A significant decrease in transmission was observed when AT reached above 20 ºC. Monthly average (not average high) AT of countries with MDPM <2, MCPM<10, or DI<=7 was found to be between 24.54 and 26.89 ºC (25.18 ºC on average) with average standard error of 4.81. Thus, average AT <20, 20-25, >25 ºC were considered as high, medium, and low risk AT. Furthermore, MDPM in countries with AT <20 ºC were 80.93, 50.23, 13.52, and 5.05 times of those in countries with AT >25 ºC in March, April, May, and June, respectively. MDPM low-risk rates (<2) in countries with AT >25 ºC were 100, 83.33, 52.73, and 52.46%, respectively. In countries with AT <20 ºC, the trends were opposite. Setting indoor temperature to 25 ºC could decrease the need of social distancing for containing SARS-CoV-2 transmission. Ventilation and sanitizing the air with ultraviolet light in nonbusiness hours may be additionally effective. Cooling indoor temperature too low may be a reason of COVID-19 outbreak in some high AT countries. Authorities and the general population can evaluate COVID-19 risk level and manipulate microclimate to reduce the risk anywhere anytime based on local day average AT.

Coronavirus disease 2019 (COVID-19) fatal outcomes have been associated with multiple cardiovascular risk factors. In new epidemic areas, such as Latin America, there is a lack of studies about this. Here, we evaluated those factors in a retrospective cohort of patients in a national reference hospital of Lima, Peru. Design. A retrospective cohort observational study was done. For this study, information was obtained from clinical records of the hospital for the cases that were laboratory-diagnosed and related, during March 6^th and April 30^th, 2020. rRT-PCR was used for the detection of the RNA of SARS-CoV-2 following the protocol Charité, Berlin, Germany, from nasopharyngeal swabs at the National Institute of Health. Calculation of the odds ratio (OR) with the respective 95% confidence interval (95% CI) was done, also logistic regression for adjusted OR (multivariate) was done. Values of p < 0.05 were considered significant for all analyses. Results. One hundred six hospitalized patients were evaluated. The mean age of patients was 61.58 years (SD 16.81). Cardiovascular risk factors among them were hypertension (46.2%), diabetes (28.3%), and obesity (28.3%), among others. Fifty-six patients died (52.8%). Mortality associated factors at the multivariate analysis were arterial hypertension (OR=1.343, 95% 1.089-1.667), myocardial injury (OR=1.303, 95% 1.031-1.642), and mechanical ventilation (OR 1.262, 95% 1.034-1.665), as associated factors. Conclusion. As observed in other regions of the world, cardiovascular risk factors represent a significant and independent threat to be considered in patients with COVID-19. Further studies and interventions in Peru and Latin America are expected.

COVID-19 virus has become a global threat to the human population and society. The virus which originated from China in December, 2019 has swept across continents in the world. Cameroon has been one of the countries with a high infectious rate in the recent period having a majority of the infectious cases in the Littoral region. Lack of awareness play a major role in the rise of COVID-19 cases. This paper examined the perceptions of the existence and spread of the COVID-19 virus in Wouri Division, Littoral Region of Cameroon. The study involved a qualitative survey designed by online questionnaires which were forwarded to the inhabitants of Wouri Division through e-mails and ‘WhatsApp’. The survey included the perception of the origin and existence of the COVID-19 virus, its mode of disease transmission, preventive and control measures. A total of 573 respondents were obtained (317 females and 256 males). From the results, although a greater proportion of the respondents showed knowledge towards the COVID- 19 virus existence, transmission and prevention that could lead to a reduction in the spread of the disease, our findings suggested that there’s more need for public sensitisation of the virus especially its method of transmission, control and prevention.

This study aims to investigate the changes in the structural relationship between alienation in physical education (PE) class, school happiness, and future healthy life expectancy in Korean adolescents after the COVID-19 pandemic. The data were collected from adolescents in the Republic of Korea using scales for these factors. The collected data were analyzed with frequency analysis, reliability analysis, validity analysis, independent t-test, and path analysis. The key results were as follows. First, there were partial changes in each of the parameters since the outbreak of COVID-19. Second, before the pandemic, alienation in PE class negatively affected school happiness, and school happiness positively affected future healthy life expectancy; however, alienation in PE class did not affect future healthy life expectancy showing a complete mediating effect. Third, during the pandemic, alienation in PE class negatively affected school happiness, and school happiness positively affected future healthy life expectancy; alienation in PE class negatively affected future healthy life expectancy, showing a partial mediating effect. These findings emphasize the importance and potential of school education, especially PE, in promoting happiness and healthy life in adolescents. We expect these findings to have practical implications for future research by presenting theoretical and empirical data.

Background: The COVID-19 outbreak has accelerated the huge difference between medical care and disease prevention in Chinese medical institutions. This study aimed to investigated the relationship between the symbiotic units, environments, models, and effects of the integration of medical and disease prevention. Methods: This cross-sectional study involved 762 employees of public hospitals in 11 cities in Zhejiang Province by random stratified sampling. We analyzed the influence paths of elements in the mechanism of integration of medical and disease prevention and the mediating effect of symbiotic models among symbiotic units, symbiotic environments, and effects for on this integration. Results: The path coefficient of symbiotic unit on the symbiosis model was 0.46 (p&lt;.001), the path coefficient of symbiotic environment on symbiosis model was 0.52 (p&lt;.001). The path coefficient of the symbiotic unit and environment was 0.91 (p&lt;.001). The symbiotic models exhibited a partial mediation effect between symbiotic units and the effect of this integration. Sobel test = 3.27, β = 0.152, and the mediating effect accounted for 34.6%. Conclusions: It is suggested that Health policy-makers and public hospital managers should provide sufficient symbiotic units, establish collaborative symbiotic models, and improve the effects of integration of medical and disease prevention in public hospitals.

Irrational belief is a product of complex personality traits and Machiavellianism Intelligence. The present study is conducted to trace the significance of predictive nature of personality characteristics and Machiavellianism Intelligence (Mach Intelligence) on irrational beliefs among chronically ill older people. The research method is cross-sectional with correlational design, purposive sampling with a total of 200 chronically ill older people aged between 40–60 years with disease type such as Systemic lupus erythematosus, Complicated Diabetes, Glomerulonephritis and Chronic Heart Failure. The analysis revealed that personality characteristics and irrational belief subscales such as worrying, rigidity, problem avoidance and Mach Intelligence are significantly positively correlated; however, Emotional irresponsibility has significant negative correlation with personality characteristics and Mach Intelligence. Gender differences revealed that males are high on all the subscales of personality characteristics, irrational beliefs (except emotional irresponsibility) and Mach Intelligence as com-pared to female chronically ill older people. Predictive analysis also revealed that overall personality characteristics explained a total of 67% variance in irrational beliefs. Moreover, Mach Intelligence predicts irrational beliefs. Future health related recommendations should be planned accordingly.

The work presented in this paper makes multiple scientific contributions with a specific focus on the analysis of misinformation about COVID-19 on YouTube. First, the results of topic modeling performed on the video descriptions of YouTube videos containing misinformation about COVID-19 revealed four distinct themes or focus areas - Promotion and Outreach Efforts, Treatment for COVID-19, Conspiracy Theories regarding COVID-19, and COVID-19 and Politics. Second, the results of topic-specific sentiment analysis revealed the sentiment associated with each of these themes. For the videos belonging to the theme of Promotion and Outreach Efforts, 45.8% were neutral, 39.8% were positive, and 14.4% were negative, for the videos belonging to the theme of Treatment for COVID-19, 38.113% were positive, 31.343% were neutral, and 30.544% were negative, for the videos belonging to the theme of Conspiracy Theories regarding COVID-19, 46.9% were positive, 31.0% were neutral, and 22.1% were negative, and for the videos belonging to the theme of COVID-19 and Politics, 35.70% were positive, 32.86% were negative, and 31.44% were negative. Third, topic-specific language analysis was performed to detect the various languages in which the video descriptions per topic were published on YouTube. This analysis revealed multiple novel insights. For instance, for all the themes, English and Spanish were the most widely used and second-most widely used languages, respectively. Fourth, the patterns of sharing these videos on other social media channels such as Facebook and Twitter were also investigated. The results revealed that videos containing video descriptions in English were shared the highest number of times on Facebook and Twitter. Finally, correlation analysis was performed by taking into account multiple characteristics of these videos. The results revealed that the correlation between the length of the video title and the number of Tweets as well as the correlation between the length of the video title and the number of Facebook posts was statistically significant.

The coronavirus disease 2019 (COVID-19), instigated by the zoonotic Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), rapidly transformed from an outbreak in Wuhan, China, into a widespread global pandemic. A significant post-infection condition, known as ‘long- COVID’, emerges in a substantial subset of patients, manifesting with a constellation of over 200 reported symptoms that span multiple organ systems. This condition, also known as 'post-acute sequelae of SARS-CoV-2 infection' (PASC), presents a perplexing clinical picture with far-reaching implications, often persisting long after the acute phase. While initial research focused on the immediate pulmonary impact of the virus, the recognition of COVID-19 as a multiorgan disruptor has unveiled a gamut of protracted and severe health issues. This review provides a summary of the primary effects of long COVID on the cardiovascular, nervous, and respiratory systems. It also delves into the mechanisms underlying these impacts and underscores the critical need for a comprehensive understanding of long COVID's pathogenesis.

The Covid-19 crisis has been one of the most relevant economic shocks in the history of the modern economy, mainly due to the restrictions on travel and social interaction taken by the authorities (quarantines, closure of schools, artistic activities, bars, and restaurants, capacity in stores), to reduce the transmission of the virus (Sars-Cov2), having consequences on the national productions of all countries (about 7% for the loss of GDP worldwide). In our study, we analyze, through clustering methods, the effects of the level of contagion, economic projections, and economic mitigation measures taken by governments for managing the pandemic. According to the analyses, it can be concluded that a low infection rate implies a lower loss of product and economic savings when applying economic mitigation measures, taking relevance in the management of sanitary measures to reduce the transmission of the virus (and the temporality of these).

The 2019 COVID-19 pandemic caused by SARS-CoV-2 has resulted in many fatalities worldwide. Despite various types of supportive care, mortality rates for patients with comorbidities remain high. To explore alternative treatment options, interferons (IFNs) have emerged as promising therapeutic drugs for SARS-CoV-2. This review aims to investigate the potential of IFNs as a drug with details on their mechanisms of action, and available data on their use with ongoing clinical trials, results, potential limitations, and challenges. Recently published research articles, which were systematically searched through online databases, have been selected and found that IFNs have colossal potential in treating SARS-CoV-2 infection by modulating the host's immune response and inhibiting viral replication and decreasing the severity of disease and hospitalization (p = 0.03, ±0.05) and (p = 0.04, ±0.05) respectively. However, due to less available data, more controlled and randomized trials are needed to confirm the efficacy and safety of IFN therapy. The optimal dosing and duration of IFN therapy also remain to be determined. Although further research is needed the wait for ongoing clinical trial results under investigation is also important for a better understanding of IFN therapy.

Several vaccines against COVID -19 have been developed and licenced to enhance the immune response against SARS-CoV-2. Similarly, infection with SARS-CoV-2 before vaccination has been shown to provide significant protection against severe infection and hospitalisation. The aim of this study was to investigate the effect of three doses of Sinopharm vaccine and SARS-CoV-2 infection on the specific immune response in 103 volunteers, measuring neutralizing antibodies, anti-S1 IgG, anti-RBD IgM, anti-N IgM, anti-N IgG antibodies and interferon γ. Our results showed that the presence of cardiovascular diseases increased the level of anti-N-IgG antibodies, while endocrinological diseases decreased the level of neutralizing antibodies and anti-N-IgG antibodies, suggesting that these diseases alter the effect of vaccine immunity. In addition, there was a significant decrease in anti-S1 IgG levels 6 months and in anti-N IgG levels 18 months post-infection, while neutralizing antibody and interferon γ levels were constant at 3, 6 and 18 months post-infection. Therefore, our results confirm the importance of hybrid immunity as the strongest and most durable compared to exclusively natural or vaccine-induced immunity. Significant positive correlations were found between humoral and cellular immunity markers: neutralizing antibodies, anti-S1 IgG, anti-N IgG and interferon γ, indicating a unique coordinated response specific to COVID-19.