BACKGROUND The frequency of SARS-CoV-2 RNAemia in blood donors is uncertain. Thus, assays for SARS-CoV-2 RNA detection in blood, validated on commercially available PCR systems, are required to allow a good comparability of data. MATERIAL AND METHODS The cobas SARS-CoV-2 dual-target RT-PCR assay, licensed for respiratory swab SARS-CoV-2 RNA testing, was validated for detection of viral RNA in blood. For the validation panel, SARS-CoV-2 positive plasma samples were prepared by spiking SARS-CoV-2 positive respiratory specimens in negative human plasma. The 95% limit of detection (LOD95) was determined by probit analysis. For clinical validation, COVID-19 convalescent plasma (CCP) donors and COVID-19 patients with a severe disease course treated in an intensive care unit (ICU) were included. RESULTS The validation of the SARS-CoV-2 RT-PCR assay for blood demonstrated high sensitivity, specificity, intra- and inter-assay precision and efficiency. The LOD95 for SARS-CoV-2 RNA was 5.0 genome copies/mL (95% CI, 3.3-12 copies/ml) for target 1 and 4.3 genome copies/mL (95% CI, 2.9-10 copies/ml) for target 2. In a cohort of 39 CCP donors with 66 CCP donations no SARS-CoV-2 RNA in plasma was detected. Screening of 25 blood samples of 19 ICU COVID-19 patients showed six positive results for SARS-CoV-2 RNA in at least one target of the assay. CONCLUSION The SARS-CoV-2 RNA assay, only licensed for respiratory swabs, performed on a PCR system for high-throughput testing, showed a good assay performance for blood testing.

A series of scaffolds namely aurones, 3-indolinones, 4-quinolones and cinnamic acid-piperazine hybrids, was designed, synthesized and investigated in vitro against influenza A/H1N1pdm09 virus. Designed molecules adopted different binding mode i.e., in 430-cavity of neuraminidase, unlike sialic acid and oseltamivir in molecular docking studies. All molecules reduced the viral titer and exhibited non-cytotoxicity along with cryo-protective property towards MDCK cells. Molecules (Z)-2-(3'-Chloro-benzylidene)-1,2-dihydro-indol-3-one (2f), (Z)-2-(4'-Chloro-benzylidene)-1,2-dihydro-indol-3-one (2g) and 2-(2'-Methoxy-phenyl)-1H-quinolin-4-one (3a) were the most interesting molecules identified in this research, endowed with robust potencies showing low-nanomolar EC50 values of 4.0 nM, 6.7 nM and 4.9 nM, respectively, compared to reference competitive and non-competitive inhibitors: oseltamivir (EC50 = 12.7 nM) and quercetin (EC50 = 0.56 M), respectively. Besides, 2f, 2g and 3a exhibited good neuraminidase inhibitory activity in sub-micromolar range (IC50 = 0.52 M, 3.5 M, 1.3 M respectively). Moreover, these molecules were determined as non-competitive inhibitors similar to reference non-competitive inhibitor quercetin unlike reference competitive inhibitor oseltamivir in kinetics studies.

BACKGROUND: While literature on psychological consequences among frontline healthcare workers (HCWs) flourishes, understanding the psychological burden on this group is particularly crucial, as their exposure to COVID-19 makes them especially at high risk. We explored what is known about psychological effects of the COVID-19 pandemic on emergency HCWs METHODS: We used a scoping review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. RESULTS: The search identified 5,432 articles, from which a total of 21 were included in the final review. Anxiety, burnout, depression, inadequate sleep, post-traumatic stress disorder (PTSD) symptoms, distress/stress and secondary trauma, were all reportedly experienced by emergency HCWs. Anxiety, burnout, depression and stress levels were higher among physicians and nurses compared to others. Post-traumatic stress disorder symptoms were higher among reserve medics, while Red Cross volunteers developed similar reactions of psychological stress and secondary trauma to other healthcare workers. Male HCWs reported more post-traumatic stress disorder symptoms than females, while stress was higher among females than male HCWs. CONCLUSIONS: Emergency HCWs providing care during the COVID-19 pandemic are at risk from specific psychological impacts, including anxiety, burnout, depression, inadequate sleep, PTSD symptoms, psychological distress/stress and secondary trauma, and stress TWEETABLE ABSTRACT: Emergency healthcare workers are at direct risk of psychological impacts from the COVID-19 pandemic.

INTRODUCTION Lung injury in severe COVID-19 pneumonia can rapidly evolve to established pulmonary fibrosis, with prognostic implications in the acute phase of the disease and long-lasting impact on the quality of life of COVID-19 survivors. This is an emerging medical need, and it has been hypothesized that antifibrotic treatments could have a role in ameliorating the fibrotic process in the lungs of these patients.Areas covered: The safety and efficacy of available antifibrotic drugs (nintedanib and pirfenidone) and novel promising agents are being assessed in several ongoing clinical trials that were performed either in critically ill patients admitted to intensive care, or in discharged patients presenting fibrotic sequalae from COVID-19. Literature search was performed using Medline and Clinicaltrials.org databases (2001-2021).Expert opinion: Despite the strong rationale support the use of antifibrotic therapies in COVID-related fibrosis, there are several uncertainties regarding the timing for their introduction and the real risks/benefits ratio of antifibrotic treatment in the acute and the chronic phases of the disease. The findings of ongoing clinical trials and the long-term observation of longitudinal cohorts will eventually clarify the best management approach for these patients.

The abrupt shift to a primarily remote environment for higher education learning due to the COVID-19 pandemic left many academic institutions unprepared to provide students with the quality of education traditionally expected in an in-person modality. Students were deprived of the hands-on activities and shared experiences of in-person learning that increase engagement, learning, and the overall educational experience that students rely on to grow as people and engineers. The lab-based nature of Geo-Education has rendered it particularly susceptible to this issue. New tools capable of bringing hands-on learning to remote students and an instructional focus on promoting shared experiences in this new era of learning are essential for the continued development of students in higher education through the COVID-19 pandemic and other future disruptions. The GeoExplorer CPT Operator module is a mixed reality environment that was adopted for remote implementations in the Spring 2020, Fall 2020, and Spring 2021 semesters. Originally developed to advance and equalize how undergraduate civil engineering students obtain geotechnical field experience, GeoExplorer gave in-person and remote students the opportunity to simulate hands-on learning when most other opportunities for this style of learning were impossible. This mixed reality platform was presented to students in the same modality as laboratory experiments for which students would typically go into the physical laboratory space in the Spring 2021 semester, which is the focus of this paper. The difference between students interacting with this platform and other shared experience interventions when in-person versus remote was leveraged to assess the ability of these strategies to augment or fully replace hands-on experiences. Mixed methods data acquired through surveys, intermediate quizzes, laboratory reports, and interviews show the benefit of using mixed reality platforms in remote learning with respect to both engagement and learning gains. This research found that there was a difference in grades between remote and in-person students, and that there are new approaches to instruction and shared experience strategies that can help equalize the experience for in-person and remote learning. This attempt at equalization may be what carries students through times of future disruption to higher education.

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BACKGROUND: Women with BRCA1/2 mutations are at high risk to develop breast and ovarian cancer. To support these women to participate in shared decision-making, structured nurse-led decision coaching combined with an evidence-based decision aid may be employed. In preparation of the interprofessional randomized controlled trial to evaluate a decision coaching program to support preventive decisions of healthy female BRCA 1/2 gene mutation carriers (EDCP-BRCA), we adapted and piloted an existing training program for specialized nurses and included elements from an existing physician communication training. METHODS: The training was adapted according to the six-step-approach for medical curriculum development. The educational design is based on experience- and problem-based learning. Subsequently, we conducted a qualitative pilot study. Nurses were recruited from six German centers for familial breast and ovarian cancer. The acceptability and feasibility were assessed by structured class observations, field notes and participants feedback. Data were analyzed using qualitative content analysis. The training was revised according to the results. Due to the COVID-19 pandemic, the patient intervention was adapted as a virtual coaching and a brief additional training for nurses was added. RESULTS: The training consists of two modules (2 + 1 day) that teach competences in evidence-based medicine and patient information, (risk) communication and decision coaching. One pilot test was conducted with six nurses of which three were specialized and experienced in patient counselling. A final set of eight main categories was derived from the data: framework conditions; interaction; schedule, transparency of goals, content, methods, materials and practical relevance and feasibility. Overall, the training was feasible and comprehensible. Decision coaching materials were awkward to handle and decision coaching role plays were set too short. Therefore, materials will be sent out in advance and the training was extended. CONCLUSIONS: Specialized nurses are rarely available and nurse-led counselling is not routinely implemented in the centers of familial breast and ovarian cancer. However, training of less qualified nurses seems feasible. Decision coaching in a virtual format seems to be a promising approach. Further research is needed to evaluate its feasibility, acceptability and effectiveness. TRIAL REGISTRATION: The main trial is registered under DRKS-ID: DRKS00015527. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12912-022-00810-8.

Trends from around the world suggest that the omicron BA.2 subvariant is increasing in proportion to the original BA.1 subvariant. Here we report two cases of co-infection with omicron BA.1 and omicron BA.2 in co-exposed individuals. In both individuals, genome sequencing and/or S-gene specific PCR identified omicron BA.1 at early time-points, which was replaced by omicron BA.2 at later time-points of the infection. The timeline of our data supports the proposition that BA.2 outcompetes BA.1 in a real-life scenario, and in time becomes the dominant variant in the upper respiratory tract of the host.

By using the US economy as an example, the paper shows how the COVID-19 pandemic has changed its short-term dynamics, causing a deep crisis recession in 2020 rather than the expected short-term and shallow recession in 2022 caused by the inflation of the financial bubble during the credit expansion that followed the financial and economic crisis of 2008C2009 To predict the latter scenario, which is natural for the US economy, the authors first developed a mathematical model based on Hyman Minskys theory of financial instability, which can serve to manage the processes of credit expansion and contraction in an unstable economy

Background The performance of the Roche Elecsys? Anti-SARS-CoV-2, Abbott Architect SARS-CoV-2 IgM and IgG, Euroimmun SARS-CoV-2 IgA, Euroimmun SARS-CoV-2 IgG ELISA, and Trillium IgG/IgM rapid assays was evaluated in Jamaica. Methods Diagnostic sensitivities of the assays were assessed by testing serum samples from SARS-CoV-2 PCR-confirmed persons and diagnostic specificity was assessed by testing serum samples collected during 2018-2019 from healthy persons and from persons with antibodies to a wide range of viral infections. Results Serum samples collected 14 days after onset of symptoms, or an initial SARS-CoV-2 RT-PCR positive test for asymptomatics, showed diagnostic sensitivities ranging from 67.9-75.0% when including all possible disease severities and increased to 90.0-95.0% when examining those with moderate to critical disease. Grouping moderate to critical disease showed a significant association with a SARS-CoV-2 antibody positive result for all assays. Diagnostic specificity ranged from 96.7-100.0%. For all assays examined, SARS-CoV-2 real-time PCR cycle threshold (Ct) values of the initial nasopharyngeal swab sample testing positive were significantly different for samples testing antibody positive versus negative. Conclusions These data from a predominantly African descent Caribbean population shows comparable diagnostic sensitivities and specificities for all testing platforms assessed and limited utility of these tests for persons with asymptomatic and mild infections.

This article seeks to analyze the reactions and responses of three churches of the Brazilian diaspora in Florida, United States, to the COVID-19 pandemic. Drawing on sermons posted on YouTube and Facebook in March, April, and May, we argue that Brazilian immigrant churches in Florida reacted to the pandemic in civil, theological, practical ways. We begin by providing a general introduction to evangelicalism in the United States and its influence in Brazilian evangelical life to give a historically sound background to the study. We also present the story of Brazilian migration to the United States. Then, we analyze the content posted in social media by pastors and churches of the Brazilian diaspora in the United States and other church leaders to ascertain their position regarding the responses to the COVID-19 crisis. Results show the churches responded to the pandemic in three primary ways: they adhered to authorities guidelines, provided sermons with apocalyptic undertones, and organized food pantries and donations for members in need.

BACKGROUND: Decision-makers for public policy are increasingly utilising systems approaches such as system dynamics (SD) modelling, which test alternative interventions or policies for their potential impact while accounting for complexity. These approaches, however, have not consistently included an economic efficiency analysis dimension. This systematic review aims to examine how, and in what ways, system dynamics modelling approaches incorporate economic efficiency analyses to inform decision-making on innovations (improvements in products, services, or processes) in the public sector, with a particular interest in health. METHODS AND FINDINGS: Relevant studies (n = 29) were identified through a systematic search and screening of four electronic databases and backward citation search, and analysed for key characteristics and themes related to the analytical methods applied. Economic efficiency analysis approaches within SD broadly fell into two categories: as embedded sub-models or as cost calculations based on the outputs of the SD model. Embdedded sub-models within a dynamic SD framework can reveal a clear allocation of costs and benefits to periods of time, whereas cost calculations based on the SD model outputs can be useful for high-level resource allocation decisions. CONCLUSIONS: This systematic review reveals that SD modelling is not currently used to its full potential to evaluate the technical or allocative efficiency of public sector innovations, particularly in health. The limited reporting on the experience or methodological challenges of applying allocated efficiency analyses with SD, particularly with dynamic embedded models, hampers common learning lessons to draw from and build on. Further application and comprehensive reporting of this approach would be welcome to develop the methodology further.

In the article, the author reflects on labour migration in Egypt amidst the COVID-19 pandemic Also cited are how migration eases pressures on the country's domestic labour market and supports the economy through financial remittances, the loan agreement between the government and the International Monetary Fund (IMF), and the expected decline in remittances due to the pandemic

BACKGROUND: The COVID-19 pandemic represents an unprecedented worldwide crisis with serious socioeconomic, physical and mental health consequences. However, its long-lasting effects on both mental health and decision-making difficulties remain unexplored. This study aimed to determine the prevalence and severity of psychological disorders in Italy's populace one-year after the outbreak; further, we investigated potential risks impacting mental health and decision-making. METHODS: In March 2021, 586 individuals (18C73 years) completed an online-survey plus a computerized delay discounting task for hypothetical money rewards. RESULTS: Psychological symptoms prevalence exceeded the Italy's lockdown rates, with about one-third reporting moderate-to-extremely severe depression, another third anxiety, and the rest stress; mirrored by an increase of symptoms at clinically significant severity levels. One year into the pandemic, half of our sample presented at least one psychological problem, and one-third was at risk of developing a more clinically severe psychological outcome. Fear of job loss, loneliness and intolerance of uncertainty were among the major risk factors to mental health. Plus, social-relationships and financial uncertainty were key determinants of depression, while fear of COVID-19 infection predicted anxiety symptoms. For decision-making tendencies, elevated delay discounting rates, implying less future-oriented behaviors, were mostly predicted by increased job loss fear and older age (>35 years). LIMITATIONS: This study provides cross-sectional evidence. CONCLUSIONS: Depression, anxiety and stress levels were still alarming one-year into COVID-19. Individuals experiencing financial insecurity, loneliness and intolerance of uncertainty perhaps benefit most from early interventions. Governments need to implement timely recovery plans to reduce financial insecurity, given its significant mental health impact and decision-making outcomes.

On March 12, the World Health Organization declared a pandemic following the exponential increase of SARS-CoV-2 cases. The rapid spread of the virus is due to both its high infectivity and the free circulation of unrecognized infectious cases. Thus, diagnostic testing is a key element to prevent further dissemination of the virus. Urged by WHO's call, laboratories worldwide have been working on nucleic acid tests protocols and immunoassays that became available, albeit poorly validated, within a comparatively short time. Since then, external studies evaluating these diagnostic tests have been published. The present study is a review of the COVID-19 diagnostic approaches, discussing both direct and indirect microbiological diagnoses. A compendium of the literature on commercial assays kits available to date is provided together with the conclusions drawn as well as RT-PCR protocols published by the WHO. Briefly, diagnostic accuracy varies according to time elapsed since symptom onset and evolves together with understanding of the COVID-19 disease. Taking into account all these variables will allow determining the most adequate diagnostic test to use and how to optimize diagnostic testing for COVID-19.

Intensive-care unit nurses may experience difficulties in end-of-life care because of frustration or lethargy. The purpose of this study was to develop a mobile end-of-life care program for intensive-care unit nurses and evaluate the effects on competence factors such as knowledge, self-efficacy, and compassion. A quasi-experimental design was used. The participants included 44 nurses who had less than three years of experience in the intensive-care unit, divided into the experimental group and control group. After the intervention, the experimental group showed a significant improvement in self-efficacy in end-of-life care and compassion in end-of-life care. Based on the results of this study, the end-of-life care mobile app was an effective educational method for nurses with experience of less than 3 years in an intensive-care unit. To improve the quality of end-of-life care, it is necessary to develop various educational programs considering the greater role of the fourth industrial revolution in the future.

The purpose of this study was to evaluate the feasibility and acceptability of randomizing adults with overweight and obesity (BMI 25C40 kg/m(2)) to morning (06:00C10:00) or evening (15:00C19:00) aerobic exercise. Participants completed four exercise sessions per week in the morning (AM, n = 18) or evening (PM, n = 15). The exercise program was 15 weeks and progressed from 70 to 80% heart rate maximum and 750C2000 kcal/week. Bodyweight, body composition, total daily energy expenditure (TDEE), energy intake (EI), sleep, sedentary behavior (SB), non-exercise physical activity (NEPA), and maximal aerobic capacity were assessed at baseline and week 15. Study retention was 94% and adherence to the supervised exercise program was 90% in both groups. Weight change was ?0.9 2.8 kg and ?1.4 2.3 kg in AM and PM, respectively. AM and PM increased TDEE (AM: 222 399 kcal/day, PM: 90 150 kcal/day). EI increased in AM (99 198 kcal/day) and decreased in PM (?21 156 kcal/day) across the intervention. It is feasible to randomize adults with overweight and obesity to morning or evening aerobic exercise with high levels of adherence. Future trials are needed to understand how the timing of exercise affects energy balance and body weight regulation.

The outbreak of coronavirus disease-19 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly evolved into a global pandemic. One major challenge in the battle against this deadly disease is to find effective therapy. Due to the availability and proven clinical record of hydroxychloroquine (HCQ) and chloroquine (CQ) in various human diseases, there have been enormous efforts in repurposing these two drugs as therapeutics for COVID-19. To date, substantial amount of work at cellular, animal models and clinical trials have been performed to verify their therapeutic potential against COVID-19. However, neither lab-based studies nor clinical trials have provided consistent and convincing evidence to support the therapeutic value of HCQ/CQ in the treatment of COVID-19. In this mini review we provide a systematic summary on this important topic and aim to reveal some truth covered by the mystery regarding the therapeutic value of HCQ/CQ in COVID-19.

OBJECTIVE To investigate the impact of age, comorbidity, and vaccination in the fatality of older COVID-19 patients in the state of Kerala, India. METHODS A cross sectional study, adopting a mixed method approach was used and conducted among the older population in Kerala. To study the health profile of study participants 405 older people were surveyed and 102 people were interviewed in-depth at their households between June to November 2020. The results of the study were triangulated with elderly COVID-19 fatality data available from the citizen-science dashboards of the research team and Department of Health, Kerala. Vaccination data was retrieved from the Co-WIN government website (cowin.gov.in) to study its impact. The data was analyzed using the IBM SPSS version 22.0. RESULTS Age is a predictor of COVID-19 fatality. Diabetes, hypertension, CAD, CKD and COPD are the significant predictors of elderly COVID-19 fatality in Kerala. The current comorbidity profile of the total older population matches with the comorbidities of the COVID-19 elderly death cases. CFR and IFR have declined even when the CMR is high in the second wave of COVID-19 with more deaths. This is attributable to vaccination even though there exists a lesser chance for breakthrough infection. CONCLUSIONS Age and comorbidities can predict potential fatality among older COVID-19 patients. Timely and accurate health data and better knowledge of high-risk factors such as comorbidity can easily guide the healthcare system and authorities to efficient prevention and treatment methodologies. Knowledge on prevailing NCDs can drive early preparedness before it converges with an epidemic like the present zoonotic disease. Vaccination is an effective tool in preventing infection compared to the unvaccinated even though the chance for breakthrough infection is there, particularly, in people with comorbidities.

A leishmaniose visceral canina uma zoonose considerada doen?a tropical de prioridade. A leishmaniose afeta vrios sistemas do corpo dos c?es, incluindo vsceras e pele. A protena C reativa (PCR) e o fator reumatoide (FR) s?o exames realizados na medicina para detec??o de inflama??o e artrites em seres humanos, no entanto, h poucos trabalhos voltados para c?es com leishmaniose que demonstrem as altera??es ocorridas na PCR e FR. Este trabalho teve como objetivo demonstrar as altera??es de PCR e FR e sua correla??o com a hiperproteinemia e hiperalbuminemia, alm da comparara??o com o desvio a esquerda presente no exame hematolgico. O trabalho foi realizado no Hospital Veterinrio do Centro Universitrio da Grande Dourados/MS e Centro de Controle de Zoonoses, no qual foram avaliados 34 c?es, de diversar ra?as e idade e submetidos a colheita de sangue venosa para realiza??o de exames em imuno-ltex, bioqumica srica e hemograma, em c?es naturalmente infectados por Leishmania spp. Foram utilizados somente c?es positivos ao teste rpido DPP? para leishmaniose, juntamente com resultado positivo no exame parasitolgico, depois de diagnosticados foram realizados exames hematolgicos e bioqumicos. Quando realizado o teste para quantifica??o de FR em soro sanguneo, para os 34 animais estudados, foi observado positividade em apenas 1 animal, enquanto que os c?es foram positivos para a PCR em 38,23% dos casos estudados. Em casos de animais com leishmaniose possvel estabelecer nveis inflamatrios precocemente, enquanto que o FR demonstrou n?o ser um bom marcador para animais soropositivos para a doen?a.(AU)