Exposure histories to SARS-CoV-2 variants and vaccinations will shape the specificity of antibody responses. To understand the specificity of Delta-elicited antibody immunity, we characterize the polyclonal antibody response elicited by primary or mRNA vaccine-breakthrough Delta infections. Both types of infection elicit a neutralizing antibody response focused heavily on the receptor-binding domain (RBD). We use deep mutational scanning to show that mutations to the RBDs class 1 and class 2 epitopes, including sites 417, 478, and 484C486 often reduce binding of these Delta-elicited antibodies. The anti-Delta antibody response is more similar to that elicited by early 2020 viruses than the Beta variant, with mutations to the class 1 and 2, but not class 3 epitopes, having the largest effects on polyclonal antibody binding. In addition, mutations to the class 1 epitope (e.g., K417N) tend to have larger effects on antibody binding and neutralization in the Delta spike than in the D614G spike, both for vaccine- and Delta-infection-elicited antibodies. These results help elucidate how the antigenic impacts of SARS-CoV-2 mutations depend on exposure history.

The coronavirus disease 2019 (COVID-19) pandemic that hit the world in 2020 triggered a massive dissemination of information (an "infodemic") about the disease that was channeled through the print, broadcast, web, and social media. This infodemic also included sensational and distorted information about drugs that likely first influenced opinion leaders and people particularly active on social media and then other people, thus affecting choices by individual patients everywhere. In particular, information has spread about some drugs approved for other indications (chloroquine, hydroxychloroquine, nonsteroidal anti-inflammatory drugs, angiotensin-converting enzyme inhibitors, angiotensin II receptor antagonists, favipiravir, and umifenovir) that could have led to inappropriate and therefore hazardous use. In this article, we analyze the rationale behind the claims for use of these drugs in COVID-19, the communication about their effects on the disease, the consequences of this communication on people's behavior, and the responses of some influential regulatory authorities in an attempt to minimize the actual or potential risks arising from this behavior. Finally, we discuss the role of pharmacovigilance stakeholders in emergency management and possible strategies to deal with other similar crises in the future.

Superior mesenteric artery (SMA) syndrome is a potentially fatal condition that can be difficult to diagnose for emergency medicine physicians due to its rarity and vague gastrointestinal symptom presentation. Patients arriving at the emergency department (ED) with this condition may encounter delays in proper supportive care and treatment. We present the case of a 21-year-old female who was seen in the ED for nausea, non-bloody vomiting, and rapid weight loss. Through point-of-care ultrasound (POCUS) findings, she was diagnosed with SMA syndrome and received appropriate, supportive care for her condition before catastrophic complications could occur. This case demonstrates the utility of POCUS in SMA syndrome and the importance of considering this diagnosis despite its rarity.

Oil palm empty fruit bunches (OPEFB) are the lignocellulosic complex organic waste material from palm oil mills that is cheap, environmentally friendly, and abundant in Indonesia. Slow degradation of OPEFB becomes a problem for oil palm plantations. OPEFB which has decayed naturally for 6 months, 1 year, and 2 years were obtained from the Oil Palm Plantation, PTPN VIII Cikasungka, Bogor, Indonesia. In this study, fungal and bacterial diversity in naturally decaying OPEFB in plantations was identified using Illumina MiSeq sequencing of the ITS2 for fungal, the V3 region of the 16S rRNA gene, and the V4 region of the 18S rRNA gene for bacterial. Bacterial diversity in decaying OPEFB was dominated by the phylum Planctomycetes (40-60%), whereas most of the fungal sequences taken belonged to Ascomycota (60-90%). Biodiversity profile resulting from metagenomic analysis is useful for increasing knowledge about microbial composition in the natural degradation process of OPEFB. The resulting data can be used to compare the diversity of bacteria at different weathering times and depths. In-depth observation of the diversity of lignin-degrading microbes from the natural decomposition of OPEFB has the potential to discover novel enzymes and ligninolytic activities that are useful for the fast degradation of OPEFB, production of biofuels based on enzymatic technology, and the development of high value-added biomass products.

SARS coronavirus ORF6 inhibits the classical nuclear import pathway to antagonize host antiviral responses. Several models were proposed to explain its inhibitory function, but quantitative measurement is needed for model evaluation and refinement. We report a broadly applicable live-cell method for calibrated dose-response characterization of the nuclear transport alteration by a protein of interest. Using this method, we found that SARS-CoV-2 ORF6 is [~]5 times more potent than SARS-CoV-1 ORF6 in inhibiting bidirectional nuclear transport, due to differences in the NUP98-binding C-terminal region that is required for the inhibition. The N-terminal region was also required, but its membrane binding function was dispensable, since loss of the inhibitory function due to N-terminal truncation was rescued by forced oligomerization using a soluble construct. Based on these data, we propose that the hydrophobic N-terminal region drives oligomerization of ORF6 to multivalently cross-link the FG domains of NUP98 at the nuclear pore complex.

Stroke is the second leading cause of death and the third leading cause of disability worldwide and its burden is increasing rapidly in low-income and middle-income countries, many of which are unable to face the challenges it imposes. In this Health Policy paper on primary stroke prevention, we provide an overview of the current situation regarding primary prevention services, estimate the cost of stroke and stroke prevention, and identify deficiencies in existing guidelines and gaps in primary prevention. We also offer a set of pragmatic solutions for implementation of primary stroke prevention, with an emphasis on the role of governments and population-wide strategies, including task-shifting and sharing and health system re-engineering. Implementation of primary stroke prevention involves patients, health professionals, funders, policy makers, implementation partners, and the entire population along the life course.

BACKGROUND: Persons on chronic hemodialysis have a significantly diminished humoral immune response to SARS-CoV-2 vaccines. Whether this translates to reduced vaccine effectiveness (VE) is unknown. METHODS: We used the US Department of Veterans Affairs COVID-19 Shared Data Resource to identify all Veterans who were tested for SARS-CoV-2 between January 26, 2021 and August 31, 2021. Using International Classification of Diseases, 10 th edition codes and attendance at a dialysis clinic or center, we identified those who were on chronic hemodialysis. We used a test-negative, case-control design using a doubly-robust logistic regression model to determine the VE of the BNT-162b2 (Pfizer) or mRNA-1273 (Moderna) vaccines in preventing confirmed SARS-CoV-2 infection. RESULTS: Among 847,199 Veterans tested for SARS-CoV-2 between January 26, 2021 and August 31, 2021, there were 6,076 Veterans on chronic hemodialysis. Among those, we identified 1,270 cases (580 fully vaccinated) and 2,959 controls (2,120 fully vaccinated). The overall VE >14 days after the second dose in preventing documented infection was 68.2% (95% CI:62.6,72.9). VE was 68.9% (95% CI:61.9,74.7) for Pfizer-BNT-162b2 and 66.7% (95% CI:58.9,73.0) for Moderna-mRNA-1273 vaccine. There was no difference in VE by age (<70 vs. >70 years), race or sex. There were no events recorded in persons with a Charlsons comorbidity index score of <2. CONCLUSION: VE of two doses of current mRNA vaccines in preventing SARS-CoV-2 infection in persons on chronic hemodialysis is lower than historic VE rates in the general population. Effect of additional doses in improving VE in this special population needs further study.

COVID-19, as the cause of a global pandemic, has resulted in lockdowns all over the world since early 2020. Both theoretical and experimental efforts are being made to find an effective treatment to suppress the virus, constituting the forefront of current global safety concerns and a significant burden on global economies. The development of innovative materials able to prevent the transmission, spread, and entry of COVID-19 pathogens into the human body is currently in the spotlight. The synthesis of these materials is, therefore, gaining momentum, as methods providing nontoxic and environmentally friendly procedures are in high demand. Here, a highly virucidal material constructed from SiO2-Ag composite immobilized in a polymeric matrix (ethyl vinyl acetate) is presented. The experimental results indicated that the as-fabricated samples exhibited high antibacterial activity towards Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) as well as towards SARS-CoV-2. Based on the present results and radical scavenger experiments, we propose a possible mechanism to explain the enhancement of the biocidal activity. In the presence of O2 and H2O, the plasmon-assisted surface mechanism is the major reaction channel generating reactive oxygen species (ROS). We believe that the present strategy based on the plasmonic effect would be a significant contribution to the design and preparation of efficient biocidal materials. This fundamental research is a precedent for the design and application of adequate technology to the next-generation of antiviral surfaces to combat SARS-CoV-2.

Careful donor quality assessment and size match can impact long-term survival in lung transplantation. With this article, we review the conceptual and practical aspects of the preoperative donor lung quality assessment and size matching.

Purpose: Amoebic dysentery ranks third as the most prevalent food and waterborne diseases in Thailand and is responsible for 5-15% of all diarrheal deaths annually. Children and infants are more vulnerable for this fecal-oral transmitted disease. In prior years, this disease received less public health attention. Fortunately, improvements in water supply infrastructures, waste management, and community awareness on hygiene indirectly affect the prevalence of this disease. This study evaluated the trends of amoebic dysentery and related factors in the past five years in Thailand. Methods & Materials: We collected and analysed data of amoebic dysentery annual prevalence, age groups, population density, water sources and household utilities from all provinces in Thailand during 2016-2020. Data were retrieved from National Statistical Office and Bureau of Epidemiology, Ministry of Public Health, Thailand. Results: There was a constant fall in amoebic dysentery morbidity rates from 2016 (4.65/100.000) to 2020 (0.95/100,000), with an average annual reduction of 0.8 points, and the highest decline from 2019 to 2020. The most vulnerable age group was children below 15 years, followed by geriatrics of over 55 years, with geometric means of 35.2% and 26.4%, respectively. The decrease in cases is correlated with increased number of clean water supplies with over 600,000 artesian and shallow wells countrywide (accounting for roughly 1 well for 11 people), and 89% of households having access to tap water. Interestingly, the highest case contributions persistently stemmed from the provinces at the country borders with Myanmar (Chiang Mai, Mae Hong Son, Tak), Cambodia (Sisaket, Ubon Ratchatani), and Malaysia (Songkhla, Yala), which accounts for an average of 49.8% of total cases. Further exploration is required to elucidate geographical- and cultural-related risks in these areas. Conclusion: The consistent reduction of amoebic dysentery cases in the last five years depicts a promising trend of amoebiasis control. Beside improvement of infrastructures, more training opportunities and empowerments were provided for laboratory technicians and village health volunteers. Nevertheless, the sharp decline in 2020 might be influenced by the COVID-19 pandemic. Thus, sustainable risk-mitigation and monitoring programs still need to be implemented for thorough elimination of amoebic dysentery.

Irritable bowel syndrome (IBS) is a common disorder of the lower gastrointestinal tract. The pathophysiology is far from settled, but a gut microbial dysbiosis is hypothesized to be a contributing factor. We earlier published a randomized double-blind placebo-controlled clinical trial on fecal microbiota transplantation (FMT) for IBS - the REFIT trial. The present data set describes the engraftment and includes participants from the study who received active FMT; 14 participants with effect of FMT (Effect) and 8 without (No effect). Samples were collected at baseline, after 6 and 12 months. Samples from the transplants (Donor) served as a comparator. In total 66 recipient samples and 17 donor samples were subjected to deep metagenomic sequencing, and taxonomic and functional analyses were performed. Alpha diversity measures showed a significantly increased diversity and evenness in the IBS groups compared to the donors. Taxonomic profiles showed higher relative abundance of phylum Firmicutes, and lower relative abundance of phylum Bacteroidetes, compared to donors at baseline. This profile was shifted toward the donor profile following FMT. Imputed growth rates showed that the resulting growth pattern was a conglomerate of donor and recipient activity. Thirty-four functional subclasses showed distinct differences between baseline samples and donors, most of which were shifted toward a donor-like profile after FMT. All of these changes were less pronounced in the No effect group. We conclude that FMT induces long-term changes in gut microbiota, and these changes mirror the clinical effect of the treatment. The study was registered in ClinicalTrials.gov (NCT02154867).

Introduo Anemias carenciais s?o patologias de alta prevalncia dentre as doen?as da srie vermelha, o qual a Deficincia de Vitamina B12 se destaca na sua pluralidade de sintomas clnicos. Objetivos Relatar caso de paciente internada por Covid-19 com quadro clnico grave de anemia, paraparesia e psicose por Deficincia de B12. Relato de caso Paciente sexo Feminino, 45 anos, sem comorbidades prvias, internada em junho/2021 em enfermaria Covid-19 devido sintomas respiratrios altos com teste Rpido sorolgico por mtodo imunocromatogrfico positivo. Iniciou h 08 meses quadro progressivo de astenia, parestesia de membros inferiores, evoluindo progressivamente para paraparesia, associado nos ltimos 02 meses com quadro de embotamento, alucinaes visuais e sonoras, dficit cognitivo e reteno urinria. Em hemograma prvio a internao apresenta resultado: HB 6,0. Ht 17,9%, VCM 111,9. HCM 37,5; CHCM 37,5; RDW 18,5%; Leuccitos: 2800; BAST: 2%; SEGMEN: 40%; LINF 56%; EOSI 1%; MONO: 1%; PLAQ 149.000; DHL 1.920U/L; PCR 12,7. FERRITINA 339 ALT: 23, AST: 31. MAGNSIO 1,7. SDIO 146. POTASSIO 4,5; FOSFORO 3,49; CALCIO TOTAL: 8,61; CLORO: 98; UREIA 25. CREAT 0,46. Foi solicitado dosagem de VIT B12 e cido flico, demonstrado seguintes resultados: Acido flico srico >20 ng/mL. Vitamina B12 srica: < 50,00 pg/mL. Foi iniciado reposio na primeira semana com Cobalamina 15.000ui divididas em 03 doses em dias alternados, posteriormente com 5.000ui/semana. Sua resposta ao tratamento na primeira semana foi a normalizao da contagem de plaquetas e de leuccitos (177.000 e 5050 respectivamente), melhora dos sintomas psiquitricos e neuro cognitivo, e breve melhora da parestesia e paraparesia de membros inferiores. A paciente foi encaminhada para Endoscopia Digestiva Alta e Ressonancia Magntica de Coluna Lombossacra em sua alta da enfermaria Covid-19 para investigao etiolgica Discuss?o Diante do contexto da Pandemia Covid-19, a investigao de sinais e sintomas clnicos n?o compatveis com a infeco em uma internao, torna-se importante para o atendimento integral ao paciente, reconhecendo e investigando diagnsticos diferenciais que podem coexistir. Em meio aos sintomas psiquitricos e neurolgicos, a investigao de Deficincia de Vitamina B12 entra como importante hiptese diagnstica diante de alteraes hematolgicas associado ao quadro clnico. Conclus?o no contexto da Pandemia, vrios diagnsticos podem ser elucidados em meio a coexistncia de infeco por Covid-19.

Background: Since the coronavirus disease 2019 (COVID-19) was declared a pandemic, there was no doubt that vaccination is the ideal protocol to tackle it. Within a year, a few COVID-19 vaccines have been developed and authorized. This unparalleled initiative in developing vaccines created many uncertainties looming around the efficacy and safety of these vaccines. This study aimed to assess the side effects and perceptions following COVID-19 vaccination in Jordan. Methods: A cross-sectional study was conducted by distributing an online survey targeted toward Jordan inhabitants who received any COVID-19 vaccines. Data were statistically analyzed and certain machine learning (ML) tools, including multilayer perceptron (MLP), eXtreme gradient boosting (XGBoost), random forest (RF), and K-star were used to predict the severity of side effects. Results: A total of 2213 participants were involved in the study after receiving Sinopharm, AstraZeneca, Pfizer-BioNTech, and other vaccines (38.2%, 31%, 27.3%, and 3.5%, respectively). Generally, most of the post-vaccination side effects were common and non-life-threatening (e.g., fatigue, chills, dizziness, fever, headache, joint pain, and myalgia). Only 10% of participants suffered from severe side effects;while 39% and 21% of participants had moderate and mild side effects, respectively. Despite the substantial variations between these vaccines in the presence and severity of side effects, the statistical analysis indicated that these vaccines might provide the same protection against COVID-19 infection. Finally, around 52.9% of participants suffered before vaccination from vaccine hesitancy and anxiety;while after vaccination, 95.5% of participants have advised others to get vaccinated, 80% felt more reassured, and 67% believed that COVID-19 vaccines are safe in the long term. Furthermore, based on the type of vaccine, demographic data, and side effects, the RF, XGBoost, and MLP gave both high accuracies (0.80, 0.79, and 0.70, respectively) and Cohens kappa values (0.71, 0.70, and 0.56, respectively). Conclusions: The present study confirmed that the authorized COVID-19 vaccines are safe and getting vaccinated makes people more reassured. Most of the post-vaccination side effects are mild to moderate, which are signs that bodys immune system is building protection. ML can also be used to predict the severity of side effects based on the input data;predicted severe cases may require more medical attention or even hospitalization.

Porcine reproductive and respiratory syndrome virus (PRRSV) and swine influenza A virus (swIAV) are major pathogens of the porcine respiratory disease complex, but little is known on their interaction in super-infected pigs. In this study, we investigated clinical, virological and immunological outcomes of successive infections with PRRSV-1 and H1N2 swIAV. Twenty-four specific pathogen-free piglets were distributed into four groups and inoculated either with PRRSV at study day (SD) 0, or with swIAV at SD8, or with PRRSV and swIAV one week apart at SD0 and SD8, respectively, or mock-inoculated. In PRRSV/swIAV group, the clinical signs usually observed after swIAV infection were attenuated while higher levels of anti-swIAV antibodies were measured in lungs. Concurrently, PRRSV multiplication in lungs was significantly affected by swIAV infection, whereas the cell-mediated immune response specific to PRRSV was detected earlier in blood, as compared to PRRSV group. Moreover, levels of interferon (IFN)- measured from SD9 in the blood of super-infected pigs were lower than those measured in the swIAV group, but higher than in the PRRSV group at the same time. Correlation analyses suggested an important role of IFN- in the two-way interference highlighted between both viral infections.

BACKGROUND: Parents have faced substantial social and economic challenges during the COVID-19 pandemic. Preliminary cross-sectional research has demonstrated increases in mental health problems in mothers during the COVID-19 pandemic compared with pre-pandemic estimates. We aimed to study an existing longitudinal cohort of mothers to assess changes in the prevalence of maternal depression and anxiety symptoms as a result of the COVID-19 pandemic over time and at the individual level. METHODS: In this longitudinal observational study, women who took part in the All Our Families pregnancy cohort in Canada were invited to complete a COVID-19 impact survey between May 20 and July 15, 2020. Women who had not agreed to additional research, had discontinued, were lost to follow-up, or who were not contactable via email were excluded. Maternal depression and anxiety symptoms during the COVID-19 pandemic were compared with three previous estimates collected at 3, 5, and 8-year timepoints (between April, 2012, and October, 2019). Depression symptoms were assessed using the 10-item Center for Epidemiological Studies Depression scale and anxiety symptoms were assessed using the short form of the Spielberger State-Trait Anxiety Inventory. Repeated cross-sectional analyses were done to assess temporal trends and fixed-effects regression models were fitted to assess within-person change over time. FINDINGS: Of the 3387 women included in the All Our Families study, 2445 women were eligible and were invited to participate in the COVID-19 impact study, of whom 1333 consented to participate, and 1301 were included in the longitudinal analysis. At the COVID-19 impact survey timepoint, a higher proportion of mothers had clinically significant depression (3521%, 95% CI 3248-3804) and anxiety symptoms (3139%, 2876-3415) than at all previous data collection timepoints. The mean depression score (831, 95% CI 797-865) and anxiety score (1190, 1166-1213) at the COVID-19 pandemic timepoint were higher than previous data collection waves at the 3-year timepoint (mean depression score 505, 485-525; mean anxiety score 951, 935-966), 5-year timepoint (mean depression score 543, 520-566; mean anxiety score 949, 933-965), and 8-year timepoint (mean depression score 579, 555-602; mean anxiety score 1026, 1010-1042). For the within-person comparisons, depression scores were a mean of 230 points (95% CI 195-265) higher and anxiety scores were a mean of 104 points (065-143) higher at the COVID-19 pandemic timepoint, after controlling for time trends. Larger increases in depression and anxiety symptoms were observed for women who had income disruptions, difficulty balancing home schooling with work responsibilities, and those with difficulty obtaining childcare. White mothers had greater increases in anxiety scores than non-white mothers and health-care workers had smaller increases in depressive symptoms than non-health-care workers. INTERPRETATION: Compared with previous estimates, the prevalence of maternal depression and anxiety among mothers in a Canadian cohort increased during the COVID-19 pandemic. Financial support, childcare provision, and avoiding the closure of schools, might be key priorities for preventing future increases in maternal psychological distress. FUNDING: Alberta Innovates Health Solutions Interdisciplinary Team, Canadian Institutes of Health Research, Alberta Innovates, and Alberta Children's Hospital Foundation.

[Image: see text] Vaccines have had a profound impact on the management and prevention of infectious disease. In addition, the development of vaccines against chronic diseases has attracted considerable interest as an approach to prevent, rather than treat, conditions such as cancer, Alzheimers disease, and others. Subunit vaccines consist of nongenetic components of the infectious agent or disease-related epitope. In this Review, we discuss peptide-based vaccines and their potential in three therapeutic areas: infectious disease, Alzheimers disease, and cancer. We discuss factors that contribute to vaccine efficacy and how these parameters may potentially be modulated by design. We examine both clinically tested vaccines as well as nascent approaches and explore current challenges and potential remedies. While peptide vaccines hold substantial promise in the prevention of human disease, many obstacles remain that have hampered their clinical use; thus, continued research efforts to address these challenges are warranted.

Intentional recovery communities, such as Clubhouses, exist as physical spaces for individuals living with Serious and Persistent Mental Illness. Due to the COVID-19 pandemic, it was necessary for these facilities to rapidly convert to virtual platforms. The aim of this study was to assess the extent to which virtual Clubhouse communities impacted the well-being of their members during the initial weeks of pandemic-related closures. Two hundred and eighty nine Clubhouse members across 19 countries responded to weekly measures of Clubhouse engagement, contact with other members, and well-being. A repeated measures multivariate analysis of covariance indicated that members with high levels of Clubhouse engagement reported higher mental and physical health ratings over time than those with low levels of engagement. These findings support the virtual Clubhouse model and highlight the efficacy of Clubhouses rapid adaptations to the pandemic.

BACKGROUND: Patients with heart failure (HF) and preserved ejection fraction (HFpEF), in contrast to those with reduced ejection fraction, are older, have more comorbidities, and are not candidates for effective therapeutic measures. Therefore, they are at high risk for hospital admission and mortality. This study evaluated the benefit of a comprehensive continuous care program (UMIPIC program) in patients with HFpEF. METHODS: We prospectively analyzed data on 2401 patients with HFpEF attended to in internal medicine departments who form part of the RICA registry. They were divided into 2 groups: one was followed-up on in the UMIPIC program (UMIPIC group, n: 1011) and another received conventional care (RICA group, n: 1390). A total of 753 patients in each group were selected by propensity score matching and admissions and mortality were assessed during 12 months of follow-up after an episode of hospitalization due to HF. RESULTS: Compared to the RICA group, the UMIPIC group had a lower rate of HF admissions (19.2% versus 36.5%, respectively; hazard ratio [HR]a?=a?0.56; 95% confidence interval [CI]: 0.45-0.68; pa?<a?0.001) and mortality (12.6% versus 28%, respectively; HRa?=a?0.40; 95% CI: 0.31-0.51; pa?<a?0.001). There were no differences in hospitalizations for non-HF causes. CONCLUSIONS: Implementation of the UMIPIC program, which is based on comprehensive continuous care, for patients with HFpEF and a high degree of comorbidity reduces both admissions and mortality in the first year of follow-up.

The purpose of an electronic health information system (EHIS) is to support health care workers in providing health care services to an individual client and to enable data exchange among service providers. The demand to explore the use of EHIS for diagnosis and management of communicable and non-communicable diseases has increased dramatically due to the volume of patient data and the need to retain patients in care. In addition, the advent of Coronavirus disease 2019 (COVID-19) pandemic in high disease burdened low and middle income countries (LMICs) has increased the need for robust EHIS to enable efficient surveillance of the pandemic. EHIS has potential to enable efficient delivery of disease diagnostics services at point-of-care (POC) and reduce medical errors. This review provides an overview of literature on EHIS's with a focus on describing the key components of EHIS and presenting evidence on enablers and barriers to implementation of EHISs in LMICs. With guidance from the presented evidence, we proposed EHIS key stakeholders' roles and responsibilities to ensure efficient utility of EHIS for disease diagnosis and management at POC in LMICs.

The world of technology is transitioning fast as a result of the Fourth Industrial Revolution (the 4IR). The digital revolution is not only making fundamental changes to how we live, but it is also having a profound impact on how we conduct business. The global market is adapting to new trends and faster turnaround times, and all sectors, including the energy and extractives sector (oil and gas, and mining sectors), will be forced to adapt to the transition. This change aligns with the clean energy developments and the global move to transition to a low-carbon economy which is characterized by technological advancements. The world is gradually discovering new things to do with technology, as its potential is beginning to be embraced. The present COVID-19 pandemic, for example, has altered the way we use technology, with many people spending more time online, thus creating the impetus to fast track the implementation of the 4IR. These changes will affect gender inclusivity and the future of work. Apart from the above issues, this chapter examines: why it is essential to include women in the workforce and along the different value chains, the need for automation in the extractives sector and how it will affect how we work. Lastly, the proposed solutions to address the challenges of gender disparity and promote inclusivity in the energy and extractives sector will be explored from the perspectives of the different role players in this sector, i.e. the public sector/governments; the private sector, including business entities; and Non-Governmental Organizations (NGOs).