Background There have been concerns that the COVID-19 pandemic may lead to an increase in suicide The coronial system in England is not suitable for timely monitoring of suicide because of the delay of several months before inquests are held Methods We used data from established systems of "real time surveillance" (RTS) of suspected suicides, in areas covering a total population of around 13 million, to test the hypothesis that the suicide rate rose after the first national lockdown began in England Findings The number of suicides in April-October 2020, after the first lockdown began, was 121?3 per month, compared to 125?7 per month in January-March 2020 (-4%;95% CI-19% to 13%, p = 0?59) Incidence rate ratios did not show a significant rise in individual months after lockdown began and were not raised during the 2-month lockdown period April-May 2020 (IRR: 1?01 [0?81C1?25]) or the 5-month period after the easing of lockdown, June-October 2020 (0?94 [0?81C1?09]) Comparison of the suicide rates after lockdown began in 2020 for the same months in selected areas in 2019 showed no difference Interpretation We did not find a rise in suicide rates in England in the months after the first national lockdown began in 2020, despite evidence of greater distress However, a number of caveats apply These are early figures and may change Any effect of the pandemic may vary by population group or geographical area The use of RTS in this way is new and further development is needed before it can provide full national data Funding This study was funded by the Healthcare Quality Improvement Partnership (HQIP) The HQIP is led by a consortium of the Academy of Medical Royal Colleges, the Royal College of Nursing, and National Voices Its aim is to promote quality improvement in patient outcomes, and in particular, to increase the impact that clinical audit, outcome review programs and registries have on healthcare quality in England and Wales HQIP holds the contract to commission, manage, and develop the National Clinical Audit and Patient Outcomes Program (NCAPOP), comprising around 40 projects covering care provided to people with a wide range of medical, surgical and mental health conditions The program is funded by NHS England, the Welsh Government and, with some individual projects, other devolved administrations, and crown dependencies

N95 respirator masks are used by medical providers for respiratory protection from airborne pathogens of transmissible diseases. In extreme situations or pandemics, when N95 masks may be in short supply, the American Society of Anesthesiologists (ASA) reported that some groups created their own N95 mask utilizing an anesthesia circuit mask plus a filter for use in short but high-risk procedures. The makeshift option for personal protective equipment was tested with a qualitative respirator mask fit test.

COVID-19 is undeniably one of the worst incidents in the 21st century There are a wide variety of factors that impact the spreading of COVID-19 This paper presents the study of relations of how public policy implementation might affect the onset and the spread of COVID-19 cases Cluster analysis was employed to identify data patterns associating with the policy implementation profiles The results suggest that the effectiveness of policy adoption relates to the onset spreading of COVID-19 This also indicates that the decision of public administrators was critical in the latter stage of the pandemic situation management ? 2020 IEEE

Considering that most of online training is not effectively supervised, this article presents an online leaning state assessment approach which combines blink detection, yawn detection, and head pose estimation. Blink detection is realized by computing the eye aspect ratio and the ratio of closed eye frames to the total frames per unit time to evaluate the degree of eye fatigue. Yawn detection is implemented by computing the aspect ratio of the mouth by using the feature points of the inner lip and combining it with the time of opening mouth to distinguish the mouth state. Head pose estimation is first implemented by calculating the head rotation matrix by matching the feature points of 2D face with the 3D face model and then calculating the Euler angle of the head according to the rotation matrix to evaluate the change of the head pose. Especially in yawn detection, we employ the feature points of inner lips in the calculation of the mouth aspect ratio to avoid the impact of lip thickness of various participants. Furthermore, the blink detection, yawn detection, and head pose estimation are first calculated based on the two-dimensional grayscale image of human face, which could reduce the computational complexity and improve the real-time performance of detection. Finally, combining the values of blinking, yawning, and head pose, multiple groups of experiments are carried out to assess the state of different online learners; then, the learning state is evaluated by analyzing the numerical changes of the three characteristics. Experimental results show that our approach could effectively evaluate the state of online learning and provide support for the development of online education.

The psychological consequences of the global COVID-19 pandemic are just now starting to be understood; however, the behavioral consequences are less understood. Thus, the current report examined whether cyberbullying processes and frequency are affected by the COVID-19 pandemic. We compared US adult participant data from six months before the start of the pandemic (July 2019; n = 181) to data collected in the middle of the pandemic (May, 2020; n = 173) to determine if there are any significant differences in anonymity perceptions, belief in the irrelevance of muscularity for online bullying (BIMOB), cyberbullying attitudes, and cyberbullying perpetration. Results showed that there were significant increases in BIMOB, cyberbullying attitudes, and cyberbullying perpetration during the pandemic, but no significant change for anonymity perceptions. Further, the relationships between several variables germane to cyberbullying perpetration prediction were stronger during the pandemic than before. Overall, these findings add to our understanding of the behavioral impact the COVID-19 pandemic has on US adults.

Design, Modeling and Reliability in Rotating Machinery Editor: Robert X. Perez Publisher: Wiley This broad collection of current rotating machinery topics, written by industry experts, is a must have for rotating equipment engineers, maintenance personnel, students and anyone else wanting to stay abreast with current rotating machinery concepts and technology. The stresses on rolling bearings in particular are very high and will continue to increase in the future, as will expectations of reliability. [...]appropriate bearing selection and dimensioning, as well as the optimal design of the bearing environment, are indispensable. Visitors from both the lubricant community and end-user OEMs will find a comprehensive showcase of all lubricant technologies, including finished lubricants, additives, process equipment and machinery, condition monitoring, automation systems, testing and analysis, data technologies, lubricant manufacturing equipment, end-user application systems and more.

Background: The problematic use of social media (SM) is a rising phenomenon, especially in adolescents. It can be assessed by self-rating screeners such as the Social Media Disorder Scale (SMDS). However, young age or symptom denial might reduce adolescent assessment accuracy. Therefore, the development and validation of a parental scale (SMDS-P) is desirable. Method: A representative sample of 961 parents and corresponding frequently SM-using children aged 10 to 17 years participated in an online study. Factorial analyses were performed to determine item structure. Adolescents SMDS self-reports, SM usage time, emotional dysregulation, and academic performance were used to assess validity. The SMDS-P cut-off value was calculated by ROC-analysis. Results: A one-factorial structure of the SMDS-P could be confirmed. The internal consistency was good (Cronbachs = 0.85, McDonalds = 0.88) and the accordance between parental and self-ratings moderate (kappa = 0.51). SMDS-P was positively associated with adolescents self-ratings (r = 0.68), SM usage time (r = 0.26) and frequency (? = 0.16) as well as with emotional dysregulation (r = 0.35) in a highly significant manner. Conclusions: SMDS-P offers a promising new approach to assess problematic SM usage in adolescence. Further studies including clinical validations are required.

Inorganic nanomaterials showed great potential as drug carriers for chemotherapeutics molecules due to their biocompatible physical and chemical properties. A manganese-based inorganic nanomaterial manganese phosphate (MnP) had become a new drug carrier in cancer therapy. However, the approach for manganese phosphate preparation and drug integration is still confined in complex methods. Inspired by mimetic mineralization, we proposed a "one-step" method for the preparation of manganese phosphate-doxorubicin (DOX) nanomedicines (MnP-DOX) by manganese ion and DOX complexation. The structural characterization results revealed that the prepared MnP-DOX nanocomplexes were homogeneous with controlled sizes and shapes. More importantly, the MnP-DOX nanocomposites could significantly induce cancer inhibition in vitro and in vivo. The results indicated that the drug molecules were integrated into MnP nanocarriers by mimetic mineralization, which not only prevented the premature release of the drug but also reduced excessive modification. Moreover, the designed MnP-DOX complex showed high loading efficacy and pH-dependent degradation leading to drug release, achieving high efficiency for cancer chemotherapy in vitro and in vivo via a facile process. These achievements presented an approach to construct the manganese phosphate-based chemotherapy nanomedicines by mimetic mineralization for cancer therapy.

The coronavirus pandemic has seen a marked rise in medical disinformation across social media. A variety of claims have garnered considerable traction, including the assertion that COVID is a hoax or deliberately manufactured, that 5G frequency radiation causes coronavirus, and that the pandemic is a ruse by big pharmaceutical companies to profiteer off a vaccine. An estimated 30% of some populations subscribe some form of COVID medico-scientific conspiracy narratives, with detrimental impacts for themselves and others. Consequently, exposing the lack of veracity of these claims is of considerable importance. Previous work has demonstrated that historical medical and scientific conspiracies are highly unlikely to be sustainable. In this article, an expanded model for a hypothetical en masse COVID conspiracy is derived. Analysis suggests that even under ideal circumstances for conspirators, commonly encountered conspiratorial claims are highly unlikely to endure, and would quickly be exposed. This work also explores the spectrum of medico-scientific acceptance, motivations behind propagation of falsehoods, and the urgent need for the medical and scientific community to anticipate and counter the emergence of falsehoods.

Immunotherapy has recently garnered plenty of attention to improve the clinical outcomes in the treatment of various diseases. However, owing to the dynamic nature of the immune system, this approach has often been challenged by concerns regarding the lack of adequate long-term responses in patients. The development of microneedles (MNs) has resulted in the improvement and expansion of immuno-reprogramming strategies due to the housing of high accumulation of dendritic cells, macrophages, lymphocytes, and mast cells in the dermis layer of the skin. In addition, MNs possess many outstanding properties, such as the ability for the painless traverse of the stratum corneum, minimal invasiveness, facile fabrication, excellent biocompatibility, convenient administration, and bypassing first-pass metabolism that allows direct translocation of therapeutics into the systematic circulation. These advantages make MNs excellent candidates for the delivery of immunological biomolecules to the dermal antigen-presenting cells in the skin with the aim of vaccinating or treating different diseases, such as cancer and autoimmune disorders, with minimal invasiveness and side effects. This review discusses the recent advances in engineered MNs and tackles limitations relevant to traditional immunotherapy of various hard-to-treat diseases.

This article analyzes the news coverage of the COVID-19 health crisis by Televisin Espa?ola (TVE1), to determine if this media reported the news with rigor and in accordance with journalism professional codes and best practice guidelines. For this purpose, content analysis was conducted on the universe of news stories (n=1,449) in the TVE1 daily newscast, starting with the first outbreak of the pandemic on the Iberian Peninsula on February 26, 2020, until the end of the first state of emergency on June 21, 2020. Our categories of analysis were: information sources, news frames, predominant topics, resources used for dramatic effects, and breaches of journalism ethics in reporting news. In general, TVE1 did not engage in sensationalized or dramatized news coverage, but instead attempted to transmit a message that was educational and instructional. Its policy was to provide information on measures adopted by authorities to help prevent the spread of the pandemic. Nevertheless, TVE's benevolent attitude towards the government and its policies can be observed in its news reporting, revealing a lack of impartiality and editorial independence by this media. Despite the importance of specialized and expert information in times of a pandemic, eyewitness sources were those most used in reporting news, even in economic news framing. Furthermore, these latter sources were employed instead of expert ones, which were in fact the least used, and whose presence progressively declined during the analyzed period. (English) [ FROM AUTHOR] Se analiza el tratamiento informativo que llev a cabo Televisin Espa?ola (TVE1) sobre la crisis sanitaria de la COVID-19, a fin de constatar si inform con rigurosidad y con apego a las normas deontolgicas de la profesin periodstica en correspondencia con las directrices de su manual de estilo. Para ello, se llev a cabo un anlisis de contenido del universo de noticias emitidas (n=1.449) por el telediario de TVE1 a partir del primer brote epidmico detectado en la pennsula ibrica (26/02/2020), hasta la finalizacin del primer estado de alarma (21/06/2020). Como categoras de anlisis se contemplaron las fuentes informativas, los encuadres noticiosos y las temticas predominantes, la presencia de recursos que tuvieran una funcin preferentemente espectacularizadora y las vulneraciones de carcter deontolgico presentes en las noticias. Como rasgo general, TVE1 no realiz una cobertura abocada al sensacionalismo o a la dramatizacin, sino que pretendi transmitir un mensaje formativo. Su poltica fue aportar con informacin sobre medidas adoptadas por la autoridad, a fin de contribuir a evitar la expansin de la pandemia. No obstante, destaca en su tratamiento informativo la benevolencia hacia el gobierno y sus polticas, lo que evidenci una falta de imparcialidad e independencia editorial del medio. Pese a la importancia de la informacin especializada en tiempos de pandemia, las fuentes testimoniales fueron las ms utilizadas en los relatos informativos -inclusive en el encuadre noticioso econmico-, por encima de las fuentes expertas que ocuparon las ltimas posiciones y cuyo uso fue disminuyendo a lo largo del periodo analizado. (Spanish) [ FROM AUTHOR] Copyright of Communication & Society is the property of Servicio de Publicaciones de la Universidad de Navarra, S.A. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Most of the existing literature on the current pandemic focuses on approaches to model the outbreak and spreading of COVID-19. This paper proposes a generalized Markov-Switching approach, the SUIHR model, designed to study border control policies and contact tracing against COVID-19 in a period where countries start to re-open. We offer the following contributions. First, the SUIHR model can include multiple entities, reflecting different government bodies with different containment measures. Second, constraints as, for example, new case targets and medical resource limits can be imposed in a linear programming framework. Third, in contrast to most SIR models, we focus on the spreading of infectious people without symptoms instead of the spreading of people who are already showing symptoms. We find that even if a country has closed its borders completely, domestic contact tracing is not enough to go back to normal life. Countries having successfully controlled the virus can keep it under check as long as imported risk is not growing, meaning they can lift travel restrictions with similar countries. However, opening borders towards countries with less controlled infection dynamics would require a mandatory quarantine or a strict test on arrival.

OBJECTIVE To explore the pathological characteristics and outcomes of elderly patients with community acquired pneumonia (CAP) accompanied by coronavirus disease 2019 (COVID-19). METHODS The diagnosis and treatment process of one elderly patient with CAP accompanied by COVID-19 who was admitted to COVID-19 Treatment Center of Liaoning Province on February 7, 2020 were reviewed. The experience of treatment by analyzing the characteristics of such type of patients during diagnosis and treatment were summarized. RESULTS A female patient, aged 79 years ald, was admitted to the Center with following features: fever, dry cough, fatigue with dyspnea, scattered moist rales in both lungs, oxygenation index (PaCO2/FiO2) of 95 mmHg (1 mmHg = 0.133 kPa), and diffuse interstitial pneumonia in both lungs indicated by chest CT, of which the majority were ground glass-like and fibrous lesions. It was confirmed to be consistent with the feature of severe COVID-19 cases. The patient was successfully cured one month later following anti-inflammatory, anti-viral and high-flow oxygen therapies, homeostasis maintenance of the body, psychological counseling, etc. Accordingly, the treatment experience in CAP combined with COVID-19 in the elderly patients was summarized as follows. In respiratory system, the timing of high-flow oxygen therapy and mechanical ventilation should be seized. As for anti-inflammatory and antiviral therapy, attention should be paid to the treatment of CAP as well as antiviral therapy and symptomatic and supportive therapy. With the progression of the disease, the production of drug-resistant bacteria and the possibility of fungal infection should be paid attention to. For the circulatory system, we should pay attention to the stability of fluid volume and internal environment, and strengthen hemodynamic monitoring and bedside ultrasound to evaluate the cardiovascular capacity-load. In the aspect of the immune system, the selection of the application time of immune-enhancers and glucocorticoids should be paid attention to. In terms of enteral nutrition, early low-fat and high-protein diet is conducive to the recovery of intestinal function and the prevention of bacterial translocation. In addition to the protection of the function of important organs, therapies such as reasonable sedation and psychological intervention should also be used. CONCLUSIONS Elderly patients with CAP accompanied by COVID-19 have complicated conditions and high degree of difficulty in treatment. Comprehensive evaluation of the disease as well as synthetic and effective intervention are the key factors of successful treatment of such patients.

Background Establishing who is at risk from a novel rapidly arising cause of death, and why, requires a new approach to epidemiological research with very large datasets and timely data. Working on behalf of NHS England we therefore set out to deliver a secure and pseudonymised analytics platform inside the data centre of a major primary care electronic health records vendor establishing coverage across detailed primary care records for a substantial proportion of all patients in England. The following results are preliminary. Data sources Primary care electronic health records managed by the electronic health record vendor TPP, pseudonymously linked to patient-level data from the COVID-19 Patient Notification System (CPNS) for death of hospital inpatients with confirmed COVID-19, using the new OpenSAFELY platform. Population 17,425,445 adults. Time period 1st Feb 2020 to 25th April 2020. Primary outcome Death in hospital among people with confirmed COVID-19. Methods Cohort study analysed by Cox-regression to generate hazard ratios: age and sex adjusted, and multiply adjusted for co-variates selected prospectively on the basis of clinical interest and prior findings. Results There were 5683 deaths attributed to COVID-19. In summary after full adjustment, death from COVID-19 was strongly associated with: being male (hazard ratio 1.99, 95%CI 1.88-2.10); older age and deprivation (both with a strong gradient); uncontrolled diabetes (HR 2.36 95% CI 2.18-2.56); severe asthma (HR 1.25 CI 1.08-1.44); and various other prior medical conditions. Compared to people with ethnicity recorded as white, black people were at higher risk of death, with only partial attenuation in hazard ratios from the fully adjusted model (age-sex adjusted HR 2.17 95% CI 1.84-2.57; fully adjusted HR 1.71 95% CI 1.44-2.02); with similar findings for Asian people (age-sex adjusted HR 1.95 95% CI 1.73-2.18; fully adjusted HR 1.62 95% CI 1.43-1.82). Conclusions We have quantified a range of clinical risk factors for death from COVID-19, some of which were not previously well characterised, in the largest cohort study conducted by any country to date. People from Asian and black groups are at markedly increased risk of in-hospital death from COVID-19, and contrary to some prior speculation this is only partially attributable to pre-existing clinical risk factors or deprivation; further research into the drivers of this association is therefore urgently required. Deprivation is also a major risk factor with, again, little of the excess risk explained by co-morbidity or other risk factors. The findings for clinical risk factors are concordant with policies in the UK for protecting those at highest risk. Our OpenSAFELY platform is rapidly adding further NHS patients' records; we will update and extend these results regularly. Keywords COVID-19, risk factors, ethnicity, deprivation, death, informatics.

IMPORTANCE: Seroprevalence studies complement data on detected cases and attributed deaths in assessing the cumulative spread of the SARS-CoV-2 virus. OBJECTIVE: To estimate seroprevalence of SARS-CoV-2 antibodies in patients receiving dialysis and adults in the US in January 2021 before the widespread introduction of COVID-19 vaccines. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used data from the third largest US dialysis organization (US Renal Care), which has facilities located nationwide, to estimate SARS-CoV-2 seroprevalence among US patients receiving dialysis. Remainder plasma (ie, plasma that would have otherwise been discarded) of all patients receiving dialysis at US Renal Care facilities from January 1 to 31, 2021, was tested for SARS-CoV-2 antibodies. Patients were excluded if they had a documented dose of SARS-CoV-2 vaccination or if a residence zip code was missing from electronic medical records. Crude seroprevalence estimates from this sample (January 2021) were standardized to the US adult population using the 2018 American Community Survey 1-year estimates and stratified by age group, sex, self-reported race/ethnicity, neighborhood race/ethnicity composition, neighborhood income level, and urban or rural status. These data and case detection rates were then compared with data from a July 2020 subsample of patients who received dialysis at the same facilities. EXPOSURES: Age, sex, race/ethnicity, and region of residence as well as neighborhood race/ethnicity composition, poverty, population density, and urban or rural status. MAIN OUTCOMES AND MEASURES: The spike protein receptor-binding domain total antibody assay (Siemens Healthineers; manufacturer-reported sensitivity of 100% and specificity of 99.8%) was used to estimate crude SARS-CoV-2 seroprevalence in the unweighted sample, and then the estimated seroprevalence rates for the US dialysis and adult populations were calculated, adjusting for age, sex, and region. RESULTS: A total of 21 464 patients (mean [SD] age, 63.1 [14.2] years; 12 265 men [57%]) were included in the unweighted sample from January 2021. The patients were disproportionately older (aged 65-79 years, 7847 [37%]; aged 80 years, 2668 [12%]) and members of racial/ethnic minority groups (Hispanic patients, 2945 [18%]; non-Hispanic Black patients, 4875 [29%]). Seroprevalence of SARS-CoV-2 antibodies was 18.9% (95% CI, 18.3%-19.5%) in the sample, with a seroprevalence of 18.7% (95% CI, 18.1%-19.2%) standardized to the US dialysis population, and 21.3% (95% CI, 20.3%-22.3%) standardized to the US adult population. In the unweighted sample, younger persons (aged 18-44 years, 25.9%; 95% CI, 24.1%-27.8%), those who self-identified as Hispanic or living in Hispanic neighborhoods (25.1%; 95% CI, 23.6%-26.4%), and those living in the lowest-income neighborhoods (24.8%; 95% CI, 23.2%-26.5%) were among the subgroups with the highest seroprevalence. Little variability was observed in seroprevalence by geographic region, population density, and urban or rural status in the January 2021 sample (largest regional difference, 1.2 [95% CI, 1.1-1.3] higher odds of seroprevalence in residents of the Northeast vs West). CONCLUSIONS AND RELEVANCE: In this cross-sectional study of patients receiving dialysis in the US, fewer than 1 in 4 patients had evidence of SARS-CoV-2 antibodies 1 year after the first case of SARS-CoV-2 infection was detected in the US. Results standardized to the US population indicate similar prevalence of antibodies among US adults. Vaccine introduction to younger individuals, those living in neighborhoods with a large population of racial/ethnic minority residents, and those living in low-income neighborhoods may be critical to disrupting the spread of infection.

The authors present a premedical education program, unprecedented in the United Arab Emirates (UAE), that has been able to address the challenges posed by the COVID-19 pandemic. The Pre-Medicine Bridge Program (PMBP) at Khalifa University uses holistic methods to prepare graduate students for the Medical College Admission Test (MCAT) and application to the MD program. Participants are predominantly Emirati and international STEM graduates who are at a disadvantage for success on the Critical Analysis and Reasoning Skills (CARS) section of the MCAT for linguistic, educational, and sociocultural reasons. COVID-19 lockdown exacerbates the intrinsic CARS struggles facing these PMBP students, but through swift course restructuring and sound distance-learning pedagogy, their CARS learning has progressed. Program details are discussed to benefit premedical education and to expand access to medical education and careers.

COVID-19 forced radical changes to the delivery of college curricula world-wide during the spring of 2020 with little to no warning Commonly, classes that had been delivered face to face were moved to a virtual delivery format;a practice that continued during the fall 2020 semester The purpose of this investigation was to perform an interim analysis of COVID-related changes on student performance We hypothesized that despite adequate preparation time for conversion to online delivery and a student body comprised largely of digital natives, the collective challenges associated with COVID-19 would negatively impact student performance To address this hypothesis we compared midterm data from fall 2020 to a comparison population comprised of midterm data pooled from the 2015-2019 fall semesters from a large, public, Midwest university Midterms are assigned as letter grades to students receiving a C- or below in a class Letter grades were tallied for each term and then converted to a numerical score using a five-point scale (C- = 1, F = 5) and summed across all midterm grades within a term to allow quantitation and statistical comparison We discovered that the percent of students with a midterm (<C in a class) was ~15% lower in 2020 compared to the comparison group (p<0 0001) and that this rate has been declining since 2015 (p<0 0001) However, of the students that received midterms, there was a slight but significant increase in the number of midterms/student (p<0 01) as well as in the variation of the midterms/student (p<0 001) in 2020 compared to the comparison group Moreover, students had lower grades reported (0 39 summed points;p<0 0001) and a greater amount of variance among those reported grades in the 2020 midterm group compared to the comparison group (p<0 0001) Finally, within the 2020 dataset, STEM majors had 10% more midterms/student (p<0 05) and these midterms were more severe (0 52 summed points;p<0 05) compared to non-STEM majors These data indicate that, surprisingly, and despite COVID-19 related challenges, the percent of total students with midterms was decreased compared to previous semesters Importantly though, despite significant efforts of faculty and universities, there is a population of students with exaggerated performance deficits compared to previous semesters Given our finding of a smaller population of students with midterms, the exaggerated performance deficits in students with midterms may be due to factors external to instructional quality and point to social-, economic-, health-, and internet access-related barriers, which themselves maybe independent or interdependent, as well as the suitability and/or preparedness of the student for online instruction Identification and remediation of these factors is essential given the likelihood of continued and expanded virtual learning, particularly for STEM students

Acute respiratory distress syndrome (ARDS) is an acute respiratory illness characterised by bilateral chest radiographical opacities with severe hypoxaemia due to non-cardiogenic pulmonary oedema. The COVID-19 pandemic has caused an increase in ARDS and highlighted challenges associated with this syndrome, including its unacceptably high mortality and the lack of effective pharmacotherapy. In this Seminar, we summarise current knowledge regarding ARDS epidemiology and risk factors, differential diagnosis, and evidence-based clinical management of both mechanical ventilation and supportive care, and discuss areas of controversy and ongoing research. Although the Seminar focuses on ARDS due to any cause, we also consider commonalities and distinctions of COVID-19-associated ARDS compared with ARDS from other causes.

The current COVID-19 pandemic has spread rapidly worldwide and has challenged fragile health care systems, vulnerable socioeconomic conditions, and population risk factors, and has led to an overwhelming tendency to misuse prescription drugs and self-medication with prescription drugs, over-the-counter (OTC) drugs, herbals products, and unproven chemicals as a desperate preventive or curative measure for COVID-19. In this chapter, we present the legislative differences between prescription drugs, OTC drugs, and herbals. Various approved and nonapproved prescription and OTC drugs as symptomatic treatment for COVID-19 are listed and evaluated based on their reported efficacy, safety, and toxicological profile. We also present the various herbal products that are currently studied and used as treatment and preventive for COVID-19. The efficacy, toxicology profile, safety, and legal issues of some speculative preventive and treatment options against COVID-19, such as Miracle Mineral Solution (MMS), chlorine dioxide solution (CDS), colloidal silver, and hydrogen peroxide is presented. The chapter also emphasizes the specific strategies that need to be implemented to guide the population in the effective and safe use of prescribed medications, such as the Medication Therapy Management or Pharmaceutical Care process. Finally, this chapter aims to provide a deeper insight into the lack of health literacy in the population and the effect that drug utilization research (DUR) has in the decision making of health authorities and general public. We aim to provide the current information about the various treatment and preventive options used for COVID-19.

Abstract Sanitation, food control, vaccines, and antibiotics have reduced the toll of communicable diseases, saving millions of lives. Smallpox was eradicated in 1977, and poliomyelitis eradication is close. Measles mortality has reduced drastically yet outbreaks occur where immunization lags. HIV/AIDS emerged in the 1980s, grew into a global pandemic costing millions of lives, and despite progress remains a major global health issue. Malaria and tuberculosis still cause millions of deaths. Influenza pandemics with new, deadly versions continue to appear. Neglected tropical diseases are responding to global donor efforts. Newly emerging diseases move to new regions and became endemic, and deadly localized hemorrhagic fevers threaten to transmit more widely. Rapid mass travel allows infectious diseases in isolated villages to quickly become global threats. New strains of viruses, antibiotic resistance, and microorganisms causing chronic diseases are challenges for infectious disease control requiring continuing political, financial, and scientific support, and much tenacity.