Modes of teaching and learning have had to rapidly shift amid the COVID-19 pandemic. As an emergency response, students from Philippine public schools were provided learning modules based on a minimized list of essential learning competencies in Biology. Using a cross-sectional survey method, we investigated students' perceptions of the Biology self-learning modules (BSLM) that were designed in print and digitized formats according to a constructivist learning approach. Senior high school STEM students from grades 11 (n = 117) and 12 (n = 104) participated in a survey using a 3-point Likert-scale questionnaire uploaded online through Google Forms. The survey results indicate that majority of the students perceived the modules positively, suggesting that aspects of the modules that were salient to students corresponded to essential elements of constructivist pedagogies. However, during interviews, students reported several difficulties in learning with BSLM as it was constrained by, to name a few, the use of unfamiliar words, lack of access to supporting resources, slow internet connection, and time constraints. To address these problems, teachers reported that they gave deadline extensions, complemented modules with other channels of support, and used online and offline platforms for reaching out to students to answer their queries and plan out their schedule for the week. The findings across the data sources point to the complex demands of emergency distance education that teachers, as curriculum designers and enactors, need to bear in mind in order to craft productive pedagogies, constructivist or otherwise, during this unprecedented time. ? 2021 The authors and IJLTER.ORG. All rights reserved.

Schools' health screenings can identify students' missed health concerns. Data from the 2016 School Health Policies and Practices Study were used to determine the proportion of U.S. school districts with physical and mental health screening policies and the proportion that arrange off-campus mental health services. We also examined differences between districts with and without mental health screening policies regarding having physical health screening policies, patterns of these policies, and off-campus mental health service arrangements. Eleven percent of districts had no policies on any of the four physical health screenings assessed, and 87% lacked policies on mental health screenings, the latter especially concerning considering the impact of COVID-19. Districts with policies on mental health screenings were significantly more likely to have body mass index (p < .01) and oral health (p < .001) screening policies, and to arrange for off-campus case management (p < .001), family counseling (p < .05), group counseling (p < .01), self-help (p < .05) and intake evaluation (p < .05).

We address the diffusion of information about the COVID-19 with a massive data analysis on Twitter, Instagram, YouTube, Reddit and Gab. We analyze engagement and interest in the COVID-19 topic and provide a differential assessment on the evolution of the discourse on a global scale for each platform and their users. We fit information spreading with epidemic models characterizing the basic reproduction number [Formula: see text] for each social media platform. Moreover, we identify information spreading from questionable sources, finding different volumes of misinformation in each platform. However, information from both reliable and questionable sources do not present different spreading patterns. Finally, we provide platform-dependent numerical estimates of rumors amplification.

BACKGROUND: Multiple factors have been associated with the severity of infection by influenza A(H1N1)pdm09. These include H1N1 cases with proven coinfections showing clinical association with bacterial contagions. PURPOSE: The objective was to identify H1N1 and copathogens in the Oaxaca (Mexico) population. A cross-sectional survey was conducted from 2009 to 2012. A total of 88 study patients with confirmed H1N1 by quantitative RT-PCR were recruited. METHODS: Total nucleic acid from clinical samples of study patients was analyzed using a TessArray RPM-Flu microarray assay to identify other respiratory pathogens. RESULTS: High prevalence of copathogens (77.3%; 68 patients harbored one to three pathogens), predominantly from Streptococcus, Haemophilus, Neisseria, and Pseudomonas, were detected. Three patients (3.4%) had four or five respiratory copathogens, whereas others (19.3%) had no copathogens. Copathogenic occurrence with Staphylococcus aureus was 5.7%, Coxsackie virus 2.3%, Moraxella catarrhalis 1.1%, Klebsiella pneumoniae 1.1%, and parainfluenza virus 3 1.1%. The number of patients with copathogens was four times higher to those with H1N1 alone (80.68% and 19.32%, respectively). Four individuals (4.5%; two males, one female, and one infant) who died due to H1N1 were observed to have harbored such copathogens as Streptococcus, Staphylococcus, Haemophilus, and Neisseria. CONCLUSION: In summary, copathogens were found in a significant number (>50%) of cases of influenza in Oaxaca. Timely detection of coinfections producing increased acuity or severity of disease and treatment of affected patients is urgently needed.

The spread of disease through human populations is complex. The characteristics of disease propagation evolve with time, as a result of a multitude of environmental and anthropic factors, this non-stationarity is a key factor in this huge complexity. In the absence of appropriate external data sources, to correctly describe the disease propagation, we explore a flexible approach, based on stochastic models for the disease dynamics, and on diffusion processes for the parameter dynamics. Using such a diffusion process has the advantage of not requiring a specific mathematical function for the parameter dynamics. Coupled with particle MCMC, this approach allows us to reconstruct the time evolution of some key parameters (average transmission rate for instance). Thus, by capturing the time-varying nature of the different mechanisms involved in disease propagation, the epidemic can be described. Firstly we demonstrate the efficiency of this methodology on a toy model, where the parameters and the observation process are known. Applied then to real datasets, our methodology is able, based solely on simple stochastic models, to reconstruct complex epidemics, such as flu or dengue, over long time periods. Hence we demonstrate that time-varying parameters can improve the accuracy of model performances, and we suggest that our methodology can be used as a first step towards a better understanding of a complex epidemic, in situation where data is limited and/or uncertain.

We have shown previously that transplanted bone marrow mononuclear cells (BM-MNC), which are a cell fraction rich in hematopoietic stem cells, can activate cerebral endothelial cells via gap junction-mediated cell-cell interaction. In the present study, we investigated such cell-cell interaction between mesenchymal stem cells (MSC) and cerebral endothelial cells. In contrast to BM-MNC, for MSC we observed suppression of vascular endothelial growth factor uptake into endothelial cells and transfer of glucose from endothelial cells to MSC in vitro. The transfer of such a small molecule from MSC to vascular endothelium was subsequently confirmed in vivo and was followed by suppressed activation of macrophage/microglia in stroke mice. The suppressive effect was absent by blockade of gap junction at MSC. Furthermore, gap junction-mediated cell-cell interaction was observed between circulating white blood cells and MSC. Our findings indicate that gap junction-mediated cell-cell interaction is one of the major pathways for MSC-mediated suppression of inflammation in the brain following stroke and provides a novel strategy to maintain the blood-brain barrier in injured brain. Furthermore, our current results have the potential to provide a novel insight for other ongoing clinical trials that make use of MSC transplantation aiming to suppress excess inflammation, as well as other diseases such as COVID-19 (coronavirus disease 2019).

OBJECTIVE: New coronavirus (COVID-19) pandemic socioeconomically affected the world. In this study, we measured the perceived stress in response to the COVID-19 pandemic among Iranians to determine the groups at both extremes of the spectrum followed by identifying the stressors and coping mechanisms. METHODS: This study was a mixed-methods study. We distributed a web-based 10-item perceived stress scale (PSS-10), to measure perceived stress score (PSS), through social networks from March 12 to 23, 2020. Then, we interviewed 42 students, 31 homemakers, 27 healthcare providers, and 21 male participants to identify the sources of stress and coping mechanisms. RESULTS: Finally, 13,454 participants completed the questionnaires. The median and interquartile range (IQR) of the participants' PSS was 21 (15-25). Students, homemakers, and healthcare workers (HCWs) showed a higher median (IQR) of PSS compared to other groups (23 [18 to 27], 22 [16 to 26], and 19 [14 to 24], respectively). Male participants showed a lower median (IQR) PSS (17 [12 to 23]). Content analysis of 121 participants' answers showed that the most common stressors were school-related issues mentioned by students, family-related issues mentioned by homemakers, and COVID-19-related issues mentioned by healthcare providers. Male participants' coping mechanisms were mostly related to the perception of their abilities to cope with the current crisis. CONCLUSION: Our participants clinically showed a moderate level of PSS. The main stressors among students, homemakers, and HCWs were related to their principal role in this period, and male participants' coping mechanisms were inspired by the self-image retrieved from the social perspectives.

Almost part of the community is in uncertainty and has received a lot of information about COVID-19 through various media that cannot be justified. During this pandemic the community was also required to take COVID-19 preventive measures. This condition unconsciously creates panic and stress in the community. The aim this research is to analysis of the relationship between information exposure and COVID-19 prevention measures to stress levels is known. This research used analytical observational method with cross-sectional design. The research subjects were citizens in residents of household 03 in Seniung Jaya Village Paser Belengkong District Paser Regency East Kalimantan Province Indonesia. The sample in this study amounted to 125 residents. The bivariate analysis of the data used in this study was the Fisher exact Test. The result showed that the characteristics of the respondents are mostly 20-29 years old namely entering early adulthood. Most of the respondents occupations are private and farmers. The level of exposure to COVID-19 information is low and COVID-19 precautions are good. The p-value is 0.214 and 0.588. The conclusion of this study is that there is no significant relationship between exposure to information and COVID-19 prevention measures on stress levels.

BACKGROUND Obesity is closely related to the development of insulin resistance and type 2 diabetes (T2D). The prevention of T2D has become imperative to stem the rising rates of this disease. Weight loss is highly effective in preventing T2D; however, the at-risk pool is large, and a clinically meaningful metric for risk stratification to guide interventions remains a challenge. The objective of this study is to predict T2D risk using full-information continuous analysis of nationally sampled data from white and black American adults age 45 years. METHODS AND FINDINGS A sample of 12,043 black (33%) and white individuals from a population-based cohort, REasons for Geographic And Racial Differences in Stroke (REGARDS) (enrolled 2003-2007), was observed through 2013-2016. The mean participant age was 63.12 8.62 years, and 43.7% were male. Mean BMI was 28.55 5.61 kg/m2. Risk factors for T2D regularly recorded in the primary care setting were used to evaluate future T2D risk using Bayesian logistic regression. External validation was performed using 9,710 participants (19% black) from Atherosclerotic Risk in Communities (ARIC) (enrolled 1987-1989), observed through 1996-1998. The mean participant age in this cohort was 53.86 5.65 years, and 44.6% were male. Mean BMI was 27.15 4.92 kg/m2. Predictive performance was assessed using the receiver operating characteristic (ROC) curves and area under the curve (AUC) statistics. The primary outcome was incident T2D. By 2016 in REGARDS, there were 1,602 incident cases of T2D. Risk factors used to predict T2D progression included age, sex, race, BMI, triglycerides, high-density lipoprotein, blood pressure, and blood glucose. The Bayesian logistic model (AUC = 0.79) outperformed the Framingham risk score (AUC = 0.76), the American Diabetes Association risk score (AUC = 0.64), and a cardiometabolic disease system (using Adult Treatment Panel III criteria) (AUC = 0.75). Validation in ARIC was robust (AUC = 0.85). Main limitations include the limited generalizability of the REGARDS sample to black and white, older Americans, and no time to diagnosis for T2D. CONCLUSIONS Our results show that a Bayesian logistic model using full-information continuous predictors has high predictive discrimination, and can be used to quantify race- and sex-specific T2D risk, providing a new, powerful predictive tool. This tool can be used for T2D prevention efforts including weight loss therapy by allowing clinicians to target high-risk individuals in a manner that could be used to optimize outcomes.

This observational study aims to assess the outcome and safety of O2-therapy by high-flow nasal cannula (HFNC) in 28 consecutive patients with severe hypoxemic acute respiratory failure (hARF) consequent to SARS-CoV-2 infection, unresponsive to conventional O2-therapy. Nineteen patients had a positive response. Nine patients required escalation of treatment to non-invasive ventilation (five subsequently intubated). None of the staff had a positive swab testing during the study period and the following 14 days. Severity of hypoxemia and C reactive protein level were correlated with HFNC failure. These data suggest HFNC to be a safe treatment for less severe patients with SARS-CoV-2 hARF and efficacy will need to be assessed as part of a clinical trial.

This editorial for the special issue of FutureS is not intended to provide a comprehensive, analytical overview of the future of health care; rather, it collects the perspectives on which scholars have focused most. There is a danger that what we report will quickly become obsolete for numerous reasons; think of the speed of current technological progress or the fact that the Covid-19 pandemic could further stress health care systems around the world. However, we would like to outline some of the current topics explored in the literature and focus on the scenarios envisioned by practitioners. We write this piece being interested in the innovative impulses of all the actors belonging to the "renewed" health care ecosystem, aware of the fact that there are significant differences between the countries of the North and South of the world and, consequently, between their health care systems. What we can say with certainty is that the healthcare and life sciences are the protagonists of an unparalleled revolution. The aging population and changing needs, the increasingly common occurrence of chronic disorders, and digitization are some of the challenges facing the sector. The technological change of the fourth industrial revolution is disruptive and changes the logic of the market, not only that of healthcare but also that of adjacent markets. Because of the intensity with which insiders have to face these new trends, the topic has been the focus of interest of scholars and practitioners in recent years. The big players in consulting, as well as the scholars, have deepened the issues of healthcare of the future, focusing on what will be the major challenges in 10 years and imagining potential scenarios that will reconfigure the way health care is delivered and used. In the next 10 years, there will be profound demographic changes and the healthcare system will necessarily have to reconfigure the supply of the necessary services and the methods of delivery (KPMG, 2018). Due to the aging of the population, there has already been a dramatic increase in chronic and degenerative diseases requiring complex treatment in recent years. In addition, the Covid-19 pandemic that has been sweeping the world since 2019 has strained global health systems, revealed already existing weaknesses, even in the most advanced countries, and is representing an important moment of reflection for all policymakers. The whole world is questioning what will need to be done to foster greater effectiveness of national systems as well as better capacity to cope with shocks of such magnitude. In this document we explore what practitioners and scholars consider the main future challenges and the major changes that need to be made in the healthcare sector in order to embrace a new paradigm of care, based on the centrality of the patient, on prevention and not on cure, on technologies at the side of humans.

BACKGROUND: Dementia of Alzheimers type has been characterized as marked deterioration in cognitive processes. The impairment has been progressive and could not be reverse because of its irreversible nature. However, there are some therapies or intervention like Cognitive Rehabilitation which have been proved to be effective for DAT in enhancing the patients' abilities to manage for decreased cognitive functioning. Recent scenario brings an attention on differences in cognitive rehabilitation in dementia of Alzheimers disease patients with Covid 19 positive (experimental group) and dementia of Alzheimers disease patients with Covid 19 negative (control group). METHOD: The present study has been an attempt to compare the effect of video games in cognitive rehabilitation in experimental and control group by incorporating a definite time, frequency and duration for video games in their activities of daily living on 2 cases each for experimental and control group who were matched on Hindi version of Montreal Cognitive Assessment (MoCA). RESULT: The findings revealed that the score of MoCA has been increased by mean of 1.5 point in dementia of Alzheimers disease patients with Covid 19 positive and mean of 2.5 points in dementia of Alzheimers disease patients with Covid 19 negative. CONCLUSION: The cognitive rehabilitation using video games has been effective in both experimental and control group, however, it was better in control group as compared to experimental group.

Background: Interleukin-6 (IL-6) is known to be detrimental in coronavirus disease 2019 (COVID-19) because of its involvement in driving cytokine storm. This systematic review and meta-analysis aimed to assess the safety and efficacy of anti-IL-6 signaling (anti-IL6/IL-6R/JAK) agents on COVID-19 based on the current evidence. Methods: Studies were identified through systematic searches of PubMed, EMBASE, ISI Web of Science, Cochrane library, ongoing clinical trial registries (clinicaltrials.gov), and preprint servers (medRxiv, ChinaXiv) on August 10, 2020, as well as eligibility checks according to predefined selection criteria. Statistical analysis was performed using Review Manager (version 5.3) and STATA 12.0. Results: Thirty-one studies were included in the pooled analysis of mortality, and 12 studies were identified for the analysis of risk of secondary infections. For mortality analysis, 5630 COVID-19 cases including 2,132 treated patients and 3,498 controls were analyzed. Anti-IL-6 signaling agents plus standard of care (SOC) significantly decreased the mortality rate compared to SOC alone (pooled OR = 0.61, 95% CI 0.45C0.84, p = 0.002). For the analysis of secondary infection risk, 1,624 patients with COVID-19 including 639 treated patients and 985 controls were included, showing that anti-IL-6 signaling agents did not increase the rate of secondary infections (pooled OR = 1.21, 95% CI 0.70C2.08, p = 0.50). By contrast, for patients with critical COVID-19 disease, anti-IL-6 signaling agents failed to reduce mortality compared to SOC alone (pooled OR = 0.75, 95% CI 0.42C1.33, p = 0.33), but they tended to increase the risk of secondary infections (pooled OR = 1.85, 95% CI 0.95C3.61, p = 0.07). A blockade of IL-6 signaling failed to reduce the mechanical ventilation rate, ICU admission rate, or elevate the clinical improvement rate. Conclusion: IL-6 signaling inhibitors reduced the mortality rate without increasing secondary infections in patients with COVID-19 based on current studies. For patients with critical disease, IL-6 signaling inhibitors did not exhibit any benefit.

The present study assesses copper metabolism of the host organism as a target of antiviral strategy, basing on the virocell concept. Silver nanoparticles (AgNPs) were used as a specific active agent because they reduce the level of holo-ceruloplasmin, the main extracellular cuproenzyme. The mouse model of influenza virus A infection was used with two doses: 1 LD(50) and 10 LD(50). Three treatment regimens were used: Scheme 1mice were pretreated 4 days before infection and then every day during infection development; Scheme 2mice were pretreated four days before infection and on the day of virus infection; Scheme 3virus infection and AgNP treatment started simultaneously, and mice were injected with AgNPs until the end of the experiment. The mice treated by Scheme 1 demonstrated significantly lower mortality, the protection index reached 60C70% at the end of the experiment, and mean lifespan was prolonged. In addition, the treatment of the animals with AgNPs resulted in normalization of the weight dynamics. Despite the amelioration of the infection, AgNP treatment did not influence influenza virus replication. The possibility of using nanosilver as an effective indirectly-acting antiviral drug is discussed.

Global responses to COVID-19 will impact on delivery of the 17 Sustainable Development Goals by 2030, creating large uncertainties just at the time efforts need to be accelerated This paper explores how COVID-19 could impact the success of meeting the targets with priority given to the four foundational goals: SDG 1 No Poverty;SDG3 Good Health;SDG 14 Life Below Water and SDG 15 Life on Land as these are critical in maintaining a healthy human and environmental resource base on which progress towards all goals can be built A scenario analysis examines futures across a spectrum in which i) social and health imperatives (lives) dominate, to ii) where economic imperatives (livelihoods) take precedence Similarly levels of international co-operation are considered ranging from international recognition of urgent global agendas to fragmentation due to the isolation of individual states around national priorities These give rise to 4 scenarios: a) Global Well-being Prioritized b) World Trade Recovers c) Poverty Gaps Widen c) Earth Systems in Danger and the likelihood of achieving the foundational SDGs in each is discussed The paper concludes opportunities exist to refocus efforts on delivery of the SDGs but may be hampered by the competing interests of a new geopolitics

Many survivors of the 2003 outbreak of severe acute respiratory syndrome (SARS) developed residual pulmonary fibrosis with increased severity seen in older patients. Autopsies of patients that died from SARS also showed fibrosis to varying extents. Pulmonary fibrosis can be occasionally seen as a consequence to several respiratory viral infections but is much more common after a SARS coronavirus (SARS-CoV) infection. Given the threat of future outbreaks of severe coronavirus disease, including Middle East respiratory syndrome (MERS), it is important to understand the mechanisms responsible for pulmonary fibrosis, so as to support the development of therapeutic countermeasures and mitigate sequelae of infection. In this article, we summarize pulmonary fibrotic changes observed after a SARS-CoV infection, discuss the extent to which other respiratory viruses induce fibrosis, describe available animal models to study the development of SARS-CoV induced fibrosis and review evidence that pulmonary fibrosis is caused by a hyperactive host response to lung injury mediated by epidermal growth factor receptor (EGFR) signaling. We summarize work from our group and others indicating that inhibiting EGFR signaling may prevent an excessive fibrotic response to SARS-CoV and other respiratory viral infections and propose directions for future research.

COVID-19 is a pathogen which is transmitted by the respiratory route may be sufficient enough to prove that mass gatherings, mass migrations and other types of clusters play a menacing role in the spread of contagious diseases Globally, the source of several infectious diseases includes mass gatherings for sports events, religious events, concerts etc People participating in such clusters as religious pilgrims, Olympic spectators and others becomes a carrier for leading to spread of disease So any social gathering relating to religion or any other should be bannedguidelines developed by WHO are vital data for cen-tral organizations for formulating the multitude planning for a cluster Risk evaluation, response, and monitoring are the basis of preparation;the International Organization for Standardization (ISO) 31000 is a well-accepted risk management methodology In India, control and preparedness are dependent on the state Government because of Nipah virus which was experienced by Kerala in 2018 Hence this state can maintain low mortality because of the use of contact tracing, social distancing and avoiding clusters All the pandemic has made us realize the need to respect the species, social and environmental relationships to live and flourish The epidemiological investigations should be carried out timely to confirm the cluster belonging to a particular family, workplace or public area The strategies such as the reversal of social gatherings (such as work from home and home-schooling), social distancing and cancellation of social events can prevent mass gathering and a global threat of an epidemiologic expansion of disease outbreaks ? International Journal of Research in Pharmaceutical Sciences

The currently ongoing COVID-19 pandemic caused by SARS-CoV-2 has accounted for millions of infections and deaths across the globe. Genome sequences of SARS-CoV-2 are being published daily in public databases and the availability of these genome data sets has allowed unprecedented access to the mutational patterns of SARS-CoV-2 evolution. We made use of the same genomic information for conducting phylogenetic analysis and identifying lineage-specific mutations. The catalogued lineage-defining mutations were analyzed for their stabilizing or destabilizing impact on viral proteins. We recorded persistence of D614G, S477N, A222V, and V1176F variants and a global expansion of the PANGOLIN variant B.1. In addition, a retention of Q57H (B.1.X), R203K/G204R (B.1.1.X), T85I (B.1.2-B.1.3), G15S+T428I (C.X), and I120F (D.X) variations was observed. Overall, we recorded a striking balance between stabilizing and destabilizing mutations, therefore leading to well-maintained protein structures. With selection pressures in the form of newly developed vaccines and therapeutics to mount in the coming months, the task of mapping viral mutations and recording their impact on key viral proteins should be crucial to preemptively catch any escape mechanism for which SARS-CoV-2 may evolve.

BACKGROUND: Addition of high-dose cytarabine (HDCA) to the conventional cyclophosphamide/total-body irradiation (CY/TBI) regimen significantly improved prognosis after cord blood transplantation (CBT) for adult acute myelogenous leukemia (AML) and myelodysplastic syndrome (MDS). The efficacy of HDCA in bone marrow or peripheral blood stem cell transplantation (BMT/PBSCT), however, has not yet been elucidated. FINDINGS: We conducted a cohort study to compare the prognosis of HDCA/CY/TBI (N = 435) and CY/TBI (N = 1667) in BMT/PBSCT for AML/MDS using a Japanese transplant registry database. The median age was 38 years, and 86.0 % of the patients had AML. Unrelated donors comprised 54.6 %, and 63.9 % of donors were human leukocyte antigen (HLA)-matched. Overall survival (OS) was not improved in the HDCA/CY/TBI group (adjusted hazard ratio (HR), 1.14; p = 0.13). Neutrophil engraftment was inferior (HR, 0.80; p < 0.01), and the incidence of hemorrhagic cystitis and thrombotic microangiopathy increased in HDCA/CY/TBI (HR, 1.47 and 1.60; p = 0.06 and 0.04, respectively), leading to significantly higher non-relapse mortality (NRM; HR, 1.48; p < 0.01). Post-transplant relapse and tumor-related mortality were not suppressed by the addition of HDCA. CONCLUSIONS: This study indicated the inefficacy of HDCA/CY/TBI in BMT/PBSCT for AML/MDS. Our results should be validated in large-scale prospective studies. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13045-015-0201-x) contains supplementary material, which is available to authorized users.

Hypersensitivity pneumonitis (HP) is an immune-mediated syndrome caused by allergen inhalation. High-resolution computed tomography (HRCT) of HP usually shows diffuse ground-glass opacities, but can show centrilobular ground-glass nodules, areas of air-trapping, or fibrotic changes. The clinical presentation of HP as well as the imaging findings can resemble coronavirus disease 2019 (COVID-19) pneumonia. This resemblance, in the absence of a high level of suspicion for other etiologies, led to anchor bias and delayed diagnosis in the case presented here.