Appearance
🎉Ask the doctor🥳
BACKGROUND: The COVID-19 pandemic has presented many countries with significant health system and economic challenges. The role of civilCmilitary cooperation in a health crisis of the magnitude presented by COVID-19 remains virtually unexplored. This review aims to detect and identify typologies, if any, of associations between security or military systems and the national response measures during the COVID-19, as adopted by six European countries during the early phase of the outbreak (January to March 2020). METHODS: We designed a structured qualitative literature review (qualitative evidence synthesis), primarily targeting open-source grey literature using a customised Google web search. Our target countries were UK, France, Spain, Italy, Belgium and Sweden. We employed a best fit framework synthesis approach in qualitative analysis of the result records. RESULTS: A total of 277 result records were included in our qualitative synthesis, with an overall search relevance yield of 46%. We identified 19 distinct descriptive categories of civilCmilitary cooperation extending across seven analytical themes. Most prominent themes included how military support was incorporated in the national COVID-19 response, including support to national health systems, military repatriation and evacuation, and support to wider public systems. CONCLUSION: Findings of this review show the significance of military systems in supporting an expansive response during the COVID-19 pandemic, and our proposed methodological approach for capturing military health data in a reproducible manner and providing a comparative view on common types of interventions provided by civilCmilitary cooperation to inform lessons from the use of military capacities during current COVID-19 outbreak.
CivilCmilitary cooperation in the early response to the COVID-19 pandemic in six European countries
Coronavirus disease 2019 (COVID\19) pandemic has caused high number of infections and deaths of healthcare workers globally. Distribution and possible transmission route of SARS\CoV\2 in hospital environment should be clarified. We herein collected 431 environmental (391 surface and 40 air) samples in the intensive care unit (ICU) and general wards (GWs) of three hospitals in Wuhan, China from February 21 to March 4, 2020, and detected SARS\CoV\2 RNA by real\time quantitative PCR. The viral positive rate in the contaminated areas was 17.8% (28/157), whereas there was no virus detected in the clean areas. Higher positive rate (22/59, 37.3%) was found in ICU than that in GWs (3/63, 4.8%). The surfaces of computer keyboards and mouse in the ICU were the most contaminated (8/10, 80.0%), followed by the ground (6/9, 66.7%) and outer glove (2/5, 40.0%). From 17 air samples in the contaminated areas, only one sample collected at a distance of around 30 cm from the patient was positive. Enhanced surface disinfection and hand hygiene effectively decontaminated the virus from the environment. This finding might help understand the transmission route and contamination risk of SARS\CoV\2 and evaluate the effectiveness of infection prevention and control measures in healthcare facilities.
Environmental contamination with SARS\CoV\2 in COVID\19 hospitals in Wuhan, China, 2020
Fungal infections are common complications of respiratory viral infections and are associated with the increased need for intensive care and elevated mortality. Data regarding microbiological and molecular characteristics of such infections in COVID-19 patients are scarce. Here, we performed a comprehensive analysis, including species identification, antifungal susceptibility testing, molecular resistance determinants analysis, typing, and retrospective clinical data review, of fungal isolates recovered from 19 COVID-19 patients, who were hospitalized at the Hackensack University Medical Center (HUMC) in Hackensack, New Jersey, USA, in the initial phase of the pandemic from AprilCMay 2020. In total, 17 Candida albicans, two C. parapsilosis, and two Aspergillus fumigatus were analyzed. All Candida spp. isolates were susceptible to micafungin and azole drugs (fluconazole, voriconazole, posaconazole, itraconazole, isavuconazole). A. fumigatus isolates were susceptible to micafungin and all triazole drugs except fluconazole (intrinsic resistance). Multilocus sequence typing (MLST) of C. albicans isolates revealed 15 different sequence types (STs), which clustered below the clade-defining limit of p-distance < 0.04. Pulsed-field gel electrophoresis (PFGE) karyotyping revealed no chromosomal rearrangements in these isolates. A. fumigatus isolates were of different, non-related genotypes. We speculate that virus- and drug-induced immunosuppression (94.7% of the patients received corticosteroids), together with prolonged hospital stay (median duration of 29 days) and mechanical ventilation (median duration of 24 days) likely increased the susceptibility to secondary respiratory and bloodstream infections in the studied patient population. The presence of fungi in blood or respiratory tract fluid was a prognosticator for poor clinical outcome, which presented as an 89.5% 30-day mortality in our patient cohort.
Antifungal Drug Susceptibility and Genetic Characterization of Fungi Recovered from COVID-19 Patients
We present a single centre study describing the effect of awake prone position (PP) on oxygenation and clinical outcomes in spontaneously breathing patients with novel coronavirus disease (COVID-19) Between 1st March and 30th April 2020, forty eight of 138 patients managed outside of the critical care unit with facemask oxygen, high flow nasal oxygen (HFNO) or continuous positive airway pressure (CPAP), underwent PP Prone position was associated with significant improvement in oxygenation, lower ICU admission, tracheal intubation, and shorter ICU length of stay Lack of response to PP may be an indicator of treatment failure, requiring early escalation
Effectiveness of prone position in spontaneously breathing patients with COVID-19: A prospective cohort study
Since its recent onset, the COVID-19 pandemic has altered the daily lives of millions around the world. One area particularly affected is our diets, with food supply chain disruptions, media coverage of food safety issues and restaurant closures all influencing consumer dietary behaviour. Given this situation, we pose a timely question - what is the impact of the current pandemic on longer-term meat consumption patterns? This issue is pertinent given accumulating evidence that overconsumption of meat, particularly red meat, is associated with negative environmental and health outcomes. Here, we discuss how the current pandemic has already begun to shift public awareness of illnesses linked to animals and has resulted in short-term changes in patterns of meat consumption. Past zoonotic outbreaks, such as SARS and swine flu, are also referred to, and we find that these led to similar short-term reductions in meat intake, a shift in the type of meat chosen and longer-lasting impacts on consumer perceptions of the health risks associated with meat. We conclude that, if immediate changes in eating patterns as a result of COVID-19 are retained in the longer term, one possible opportunity to emerge from the current pandemic may be a shift away from overconsumption of meat, leading to potential health and environmental benefits in the longer term.
How will the COVID-19 pandemic shape the future of meat consumption?
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), identified for the first time in Wuhan, China, causes coronavirus disease 2019 (COVID-19), which moved from epidemic status to becoming a pandemic. Since its discovery in December 2019, there have been countless cases of mortality and morbidity due to this virus. Several compounds such as chloroquine, hydroxychloroquine, lopinavir-ritonavir, and remdesivir have been tested as potential therapies; however, no effective treatment is currently recommended by regulatory agencies. Some studies on respiratory non-enveloped viruses such as adenoviruses and rhinovirus and some respiratory enveloped viruses including human respiratory syncytial viruses, influenza A, parainfluenza, SARS-CoV, and SARS-CoV-2 have shown the antiviral activity of cardiac glycosides, correlating their effect with Na(+)/K(+)-ATPase (NKA) modulation. Cardiac glycosides are secondary metabolites used to treat patients with cardiac insufficiency because they are the most potent inotropic agents. The effects of cardiac glycosides on NKA are dependent on cell type, exposure time, and drug concentration. They may also cause blockage of Na(+) and K(+) ionic transport or trigger signaling pathways. The antiviral activity of cardiac glycosides is related to cell signaling activation through NKA inhibition. Nuclear factor kappa B (NFB) seems to be an essential transcription factor for SARS-CoV-2 infection. NFB inhibition by cardiac glycosides interferes directly with SARS-CoV-2 yield and inflammatory cytokine production. Interestingly, the antiviral effect of cardiac glycosides is associated with tyrosine kinase (Src) activation, and NFB appears to be regulated by Src. Src is one of the main signaling targets of the NKA -subunit, modulating other signaling factors that may also impair viral infection. These data suggest that Src-NFB signaling modulated by NKA plays a crucial role in the inhibition of SARS-CoV-2 infection. Herein, we discuss the antiviral effects of cardiac glycosides on different respiratory viruses, SARS-CoV-2 pathology, cell signaling pathways, and NKA as a possible molecular target for the treatment of COVID-19.
Na(+)/K(+)-ATPase as a Target of Cardiac Glycosides for the Treatment of SARS-CoV-2 Infection
This paper attempts to evaluate the impact of infectious and contagious diseases and Its final impact on the economic performance anywhere and anytime We are c
The Impact of Infectious and Contagious Diseases and Its Impact on the Economic Performance: The Case of Wuhan, China
Feline angiotensin converting enzyme 2 (fACE2) gene was amplified from domestic cat lung with RT-PCR, cloned and sequenced. The complete coding region is 2418 bp in length and is the closest to human ACE2 among known ACE2 homologs of non-primate animals. The N terminal fragment 19C 367 aa was expressed in Escherishia coli. Both Western blotting and ELISA demonstrated that fACE2 could react with SARS-CoV S1 protein as efficiently as ACE2 of Vero E6 cells did.
Expression of feline angiotensin converting enzyme 2 and its interaction with SARS-CoV S1 protein
Background COVID-19 has resulted in many infections in healthcare workers (HCWs) globally. We performed state-wide SARS-CoV-2 genomic epidemiological investigations to identify HCW transmission dynamics and provide recommendations to optimise healthcare system preparedness for future outbreaks. Methods Genome sequencing was attempted on all COVID-19 cases in Victoria, Australia. We combined genomic and epidemiologic data to investigate the source of HCW infections across multiple healthcare facilities (HCFs) in the state. Phylogenetic analysis and fine-scale hierarchical clustering were performed for the entire Victorian dataset including community and healthcare cases. Facilities provided standardised epidemiological data and putative transmission links. Findings Between March and October 2020, approximately 1,240 HCW COVID-19 infection cases were identified; 765 are included here. Genomic sequencing was successful for 612 (80%) cases. Thirty-six investigations were undertaken across 12 HCFs. Genomic analysis revealed that multiple introductions of COVID-19 into facilities (31/36) were more common than single introductions (5/36). Major contributors to HCW acquisitions included mobility of staff and patients between wards and facilities, and characteristics and behaviours of individual patients including super-spreading events. Key limitations at the HCF level were identified. Interpretation Genomic epidemiological analyses enhanced understanding of HCW infections, revealing unsuspected clusters and transmission networks. Combined analysis of all HCWs and patients in a HCF should be conducted, supported by high rates of sequencing coverage for all cases in the population. Established systems for integrated genomic epidemiological investigations in healthcare settings will improve HCW safety in future pandemics.
State-wide Genomic Epidemiology Investigations of COVID-19 Infections in Healthcare Workers: Insights for Future Pandemic Preparedness
OBJECTIVE: Adenotonsillectomy (AT) is one of the most common surgical procedures performed in children and adults. We aim to assess the factors associated with changes in the incidence of and indications for AT using population-level data. STUDY DESIGN: This retrospective cohort study investigated patients who underwent AT between 1997 and 2010 by using data from the Taiwan National Health Insurance Research Database. We examined surgical rates and indications by the calendar year as well as age, sex, hospital level, and insured residence areas for the correlating factors. RESULTS: The average annual incidence rate of AT was 14.7 per 100,000 individuals during 1997C2010. Pediatric (<18 years) patients represented 48.2% of the total AT population. More than 99% of the patients underwent the AT procedures as an inpatient intervention. Longitudinal data demonstrated an increasing trend in the pediatric AT rates from 1997 (4.3/100,000) to 2010 (5.7/100,000) (p = 0.029). In the adult subgroup, a decreasing prevalence of infectious indications (p = 0.014) coincided with an increasing neoplastic indications (p = 0.001). In the pediatric subgroup, the prevalence of obstructive indications increased (p = 0.002). The logistic regression analyses indicated that the significant factors associated with the changing surgical indications for AT were the age in the adult subgroup and hospital level in the pediatric subgroup. CONCLUSIONS: This study revealed a low AT rate in Taiwan than that in other countries. Pediatric AT incidence increased during 1997C2010. Although a rising prevalence of obstructive and neoplastic indications was noted, infection remained the most common indications for AT. Age in the adult subgroup and hospital level in the pediatric subgroup were factors associated with the changing indications for AT.
Factors associated with changing indications for adenotonsillectomy: A population-based longitudinal study
The purpose of this study was to predict the recipients of cash assistance and to evaluate Na?ve Bayes in predicting recipients of cash assistance from families affected by Covid19 This study uses the Na?ve Bayes algorithm to calculate the accuracy and classification of cash transfer recipient data The data used is logical data then processed and calculated The variables usedare Age, Income, College Status, and labels using two classes, namely Cannot and Can From the results of this study, it can be concluded that the recipients of cash assistance in Village X can be predicted Na?ve Bayes using a training value of 10% Based on the results of the evaluation using confusion matrix and testing the accuracy of Na?ve Bayes is 67% For the calculation of theWeighted Product method using variables Age, Income, Education, Working Status, Family Status and there are two alternatives, namely Cannot and Can From the Weighted Product calculation, it produces a Vector S ranking value of 2 24 and Vector V of 0 66, which states that families affected by Covid19 have the right to receive cash assistance ? 2020 IEEE
Decision Support System for Covid19 Affected Family Cash Aid Recipients Using the Na?ve Bayes Algorithm and the Weight Product Method
The term epidemic (from the Greek epi [on] plus demos [people]), first used by Homer, took its medical meaning when Hippocrates used it as the title of one of his famous treatises. At that time, epidemic was the name given to a collection of clinical syndromes, such as coughs or diarrheas, occurring and propagating in a given period at a given location. Over centuries, the form and meaning of the term have changed. Successive epidemics of plague in the Middle Ages contributed to the definition of an epidemic as the propagation of a single, well-defined disease. The meaning of the term continued to evolve in the 19th-century era of microbiology. Its most recent semantic evolution dates from the last quarter of the 20th century, and this evolution is likely to continue in the future.
2,500-year Evolution of the Term Epidemic
BACKGROUND Leg ulceration is a feared complication of venous insufficiency. It is not known whether varicose veins predispose skin to poor wound healing. The expression pattern of gap junctional protein connexin, a known marker of poor wound healing, was investigated across various stages of venous disease. METHODS Patients undergoing intervention for varicose veins were assessed according to the Clinical Etiologic Anatomic Pathophysiologic (CEAP) classification of varicose veins. Paired 4-mm punch biopsies were taken from above the ankle (pathological) and above the knee (control). Tissues were stained with haematoxylin and eosin, and for connexin 43, connexin 30 and connexin 26. RESULTS Forty-eight paired biopsies were taken (12 each for CEAP class C0, C2, C4 and C6). The pathological skin showed progressive epithelial hyperthickening, an increase in the number and depth of rete ridges, increased inflammation and loss of dermal architecture with disease progression from C4 onwards. The overall absolute connexin expression and mean connexin expression per cell in the pathological skin similarly increased across the CEAP classes from as early as C2. Increasing levels of connexin in control skin were also noted, indicating progression of the disease proximally. Connexin 43 expression showed the strongest positive correlation between pathological and control skin. CONCLUSION Connexins were overexpressed in patients with simple varicose veins, with a stepwise increased expression through venous eczema to ulceration. Connexin 43 is a potential biomarker for venous disease. This finding suggests that varicose veins predispose skin to poor wound healing. Surgical relevance The overexpression of connexins, a family of gap junctional proteins, is known to cause poor healing in venous leg ulceration. It is not known whether there is any association with superficial venous disease. Here, connexin proteins were overexpressed in patients with uncomplicated varicose veins, before histological skin changes. Connexin could be a biomarker of venous disease progression.
Upregulation of epidermal gap junctional proteins in patients with venous disease.
BACKGROUND: Childhood cancer represents a leading cause of death and disease burden in high income countries (HICs) and low-and-middle income countries (LMICs). It is postulated that the current COVID-19 pandemic has hampered global development of pediatric oncology care programs. This systematic review aimed to comprehensively review the global impact of COVID-19 on childhood cancer clinical outcomes and care delivery. METHODS: A systematic search was conducted on PubMed, Embase, Medline, and the African Medical Index from inception to November 3, 2021 following PRISMA guidelines. A manual search was performed to identify additional relevant studies. Articles were selected based on predetermined eligibility criteria. FINDINGS: The majority of studies reported patients with cancer and COVID-19 presenting as asymptomatic (HICs: 33.7%, LMICs: 22.0%) or with primary manifestations of fever (HICs: 36.1%, LMICs: 51.4%) and respiratory symptoms (HICs: 29.6%, LMICs: 11.7%). LMICs also reported a high frequency of patients presenting with cough (23.6%) and gastrointestinal symptoms (10.6%). The majority of patients were generally noted to have a good prognosis; however the crude mortality rate was higher in LMICs when compared to HICs (8.0% vs 1.8%). Moreover, the pandemic has resulted in delays and interruptions to cancer therapies and delays in childhood cancer diagnoses in both HICs and LMICs. However, these findings were disproportionately reported in LMICs, with significant staff shortages, supply chain disruptions, and limited access to cancer therapies for patients. CONCLUSIONS: The COVID-19 pandemic has resulted in delays and interruptions to childhood cancer therapies and delays in childhood cancer diagnoses, and disproportionately so within LMICs. This review provides lessons learned for future system-wide disruptions to care, as well as provides key points for moving forward better with care through the remainder of this pandemic. SYSTEMATIC REVIEW REGISTRATION: CRD42021266758, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=266758
The Global Impact of COVID-19 on Childhood Cancer Outcomes and Care Delivery - A Systematic Review
Background COVID-19 has created major challenges for academic education and clinical training, as well as on routine, emergency, and elective patients who have been impacted by the health service's response to COVID-19 Simulation helps recognize and correct both active and latent threats in health institutions
A Simulation-Based Program for Preparedness for COVID-19 at a Pediatric Tertiary Hospital in Saudi Arabia
This study aims to evaluate how far the principles of Gated Community can break the chain of the spread of the COVID19 virus In 2020, the world was widely shocked by Coronavirus (COVID19), which started in Wuhan, spread throughout the globe without exception to Indonesia As one of the busiest cities in Indonesia, Jakarta becomes one of the gateways for COVID19 in Indonesia The outbreak of COVID19, made the Jakarta City Government implement a quarantine system policy, which has an impact on the daily lives of Jakartas inhabitants This situation causes the inhabitants community only to be able to move around in their neighborhood The access restrictions for outsiders of residence arose so that some settlements in Jakarta imposed a gated community system The research method used is a qualitative method, which is carried out with literature and observation studies The data used comes from several regulations issued by the government regarding the COVID19 pandemic and phenomena in the field The research location is the Kelapa Gading This region is a residential area with a majority of the gated community, in the area of the gated community housing can prevent or even break the COVID19 chain in the study area
COVID 19 in gated community at Jakarta, Indonesia
Recent data on coronavirus disease 2019 (COVID-19) pandemic showed that the virus is mostly conveyed by respiratory droplets that are produced at high intensity especially when an infected subject coughs or sneezes. Therefore, elevated volume ventilations, usually reached during physical efforts and exercise, are a potential source of contamination. On the other hand, the lockdown period which has lasted for nearly 2 months and is actually involving several countries worldwide, obliged a large part of human population to sedentary behaviors, drastically reducing their physical activity level, and reducing their cardiopulmonary fitness. Therefore, cardiopulmonary exercise testing could be beneficial, so that a safe and well-weighted return to pre-lockdown active lifestyle can be efficiently planned. However, specific guidelines on exercise testing safety procedures in the era of COVID-19 are unavailable so far. This article is aimed to provide an overview of safety procedures for exercise testing during and after COVID-19 worldwide pandemic.
Safety procedures for exercise testing in the scenario of COVID-19: a position statement of the Societ Italiana Scienze Motorie e Sportive
Many countries are concerned about how concentrations of outdoor air pollutants have decreased due to control measures aftermath of the COVID-19 outbreak. In Saudi Arabia, the measures started with suspending entry to Saudi Arabia on February 27, 2020, and ended with full prevention of Saudis for outdoor movement on April 2, 2020, until the back return to normal life by the start of September 2020. These measures are expected to impact air quality levels during this period by decreasing the concentrations of air pollutants. This paper investigates the major trends of ambient air pollution (SO(2), NO(2), CO, O(3), and PM(10)), and maps the spatiotemporal variability of air pollutants in Makkah city, using a continuous air quality monitoring network (6 sites) during the pre-pandemic period. Findings indicate the presence of a significant decrease of concentration rates during the lockdown period, compared with the pre-pandemic period, by 26.34% for SO(2), 28.99% for NO(2), 26.24% for CO, 11.62% for O(3), and 30.03% for PM(10). Therefore, the vehicular traffic activities represent 25C30% of the total air pollution load in Makkah city. The COVID-19 lockdown conditions in Makkah provide a unique opportunity to evaluate the impact of the reduction of vehicular traffic activities on the air quality levels of Makkah city and similar mega-cities and introduce credible solutions to improve the conditions of the ambient environment and air quality in such settings.
Assessing the air quality of megacities during the COVID-19 pandemic lockdown: a case study from Makkah City, Saudi Arabia
Taiwan has strictly followed infection control measures to prevent spread of coronavirus disease. Meanwhile, nationwide surveillance data revealed drastic decreases in influenza diagnoses in outpatient departments, positivity rates of clinical specimens, and confirmed severe cases during the first 12 weeks of 2020 compared with the same period of 2019.
Collateral Benefit of COVID-19 Control Measures on Influenza Activity, Taiwan
Summary Air-filtering masks, also known as respirators, protect wearers from inhaling fine particulate matter (PM2 5) in polluted air, as well as airborne pathogens during a pandemic, such as the ongoing COVID-19 pandemic Fibrous medium, used as the filtration layer, is the most essential component of an air-filtering mask This article presents an overview of the development of fibrous media for air filtration We first synthesize the literature on several key factors that affect the filtration performance of fibrous media We then concentrate on two major techniques for fabricating fibrous media, namely, meltblown and electrospinning In addition, we underscore the importance of electret filters by reviewing various methods for imparting electrostatic charge on fibrous media Finally, this article concludes with a perspective on the emerging research opportunities amid the COVID-19 crisis
Air-Filtering Masks for Respiratory Protection from PM2.5 and Pandemic Pathogens