Whether the COVID-19 pandemic may have modified the clinical planning and course in bronchiectasis patients remains to be fully elucidated. We hypothesized that the COVID-19 pandemic may have influenced the management and clinical outcomes of bronchiectasis patients who were followed up for 12 months. In bronchiectasis patients (n = 30, 23 females, 66 years), lung function testing, disease severity [FEV(1), age, colonization, radiological extension, dyspnea (FACED), exacerbation (EFACED)] and dyspnea scores, exacerbation numbers and hospitalizations, body composition, sputum microbiology, and blood analytical biomarkers were determined at baseline and after a one-year follow-up. Compared to baseline (n = 27, three patients dropped out), in bronchiectasis patients, a significant increase in FACED and EFACED scores, number of exacerbations, and erythrocyte sedimentation rate (ESR) was observed, while FEV(1), ceruloplasmin, IgE, IgG, IgG aspergillus, IgM, and IgA significantly decreased. Patients presenting colonization by Pseudomonas aeruginosa (PA) remained unchanged (27%) during follow-up. In bronchiectasis patients, FEV(1) declined only after a one-year follow-up along with increased exacerbation numbers and disease severity scores, but not hospitalizations. However, a significant decrease in acute phase-reactants and immunoglobulins was observed at the one-year follow-up compared to baseline. Despite the relatively small cohort, the reported findings suggest that lung function impairment may not rely entirely on the patients inflammatory status.

Community-acquired pneumonia is common and important infectious disease in adults. This work represents an update to 2009 treatment guideline for community-acquired pneumonia in Korea. The present clinical practice guideline provides revised recommendations on the appropriate diagnosis, treatment, and prevention of community-acquired pneumonia in adults aged 19 years or older, taking into account the current situation regarding community-acquired pneumonia in Korea. This guideline may help reduce the difference in the level of treatment between medical institutions and medical staff, and enable efficient treatment. It may also reduce antibiotic resistance by preventing antibiotic misuse against acute lower respiratory tract infection in Korea.

PURPOSE: In the absence of effective treatment options, the recent SARS-CoV2 pandemic poses a great challenge to the health and social sectors worldwide. Hereby, we would like to share our proposals in the hope that it will prove helpful for our colleagues in this difficult time. METHODS: The present recommendations are based on the opinion of experts as well as the experience of a group of traumatologists directly involved in the organization of traumatology wards. The reassignment of the healthcare personnel, the separation of the potentially infected patients and the different levels of restriction on the trauma care are all key elements of our protocol. RESULTS: Since the first SARS-CoV2-positive case was confirmed in Hungary, our trauma surgeons were able to avoid contamination with the help of the new guidelines, without reducing the quality of trauma care. CONCLUSION: Reasonably adjusted patient care protocols in every medical field are key to contain the spread of infection and to avoid public health crisis. Sharing experience can be an important element of a successful fight against the recent pandemic.

BACKGROUND In preparing for the fundamentals of laparoscopic surgery (FLS) exam, residents usually adopt a self-learning strategy where practice time can be managed with more flexibility. However, with this self-learning strategy, there is a lack of direct supervision from experts and residents risk understudying for this high-stakes exam. Our objective is to determine study goals for effective self-guided practice for the FLS manual skills tasks that will result in passing the examination. METHODS FLS manual skills data for all PGY-5 residents during 2009-2010 was supplied by the FLS administrative office. Descriptive statistics were performed, and data were regrouped by the pass/fail results of the exam. The minimum practice time requirement for passing each manual skills task is reported in order to guide practice. RESULTS 1,047 proctored FLS exams were completed by 2009-2010 residents. Mean task time achieved by all residents was 84 31 s for peg transfer, 139 54 s for pattern cut, 78 29 s for endoloop, 158 66 s for extracorporeal suturing, and 168 77 s for intracorporeal suturing. In the pass group (n = 988), mean time to complete each task was 80 s for peg transfer, 134 s for pattern cut, 75 s for endoloop, 148 s for extracorporeal suturing, and 160 s for intracorporeal suturing. Calculations suggest a self-study goal for each task of 53 s for peg transfer, 50 s for pattern cut, 87 s for endoloop, 99 s for extracorporeal suturing, and 96 s for intracorporeal suturing. If a resident can reliably achieve these results during self-study, they have an 84% chance of passing the exam. CONCLUSIONS Residents preparing to take the FLS exam can refer to data presented in this study to set practice goals. Referring to these data-based practice goals will help residents to improve their chances of passing this high-stakes exam.

BACKGROUND Flow diversion with the Pipeline embolization device is a well-established method of intracranial aneurysm treatment. However, deployment of the first-generation device (Pipeline Classic) can be technically challenging. The Pipeline Flex contains the same flow-diverting stent with a modified delivery system. OBJECTIVE To compare procedural outcomes between the first-generation device (Pipeline Classic) and the Pipeline Flex. METHODS Thirty-eight of the first 40 consecutive patients who underwent intracranial aneurysm treatment with the Pipeline Flex and 58 of the most recent 60 consecutive patients who underwent treatment with the Pipeline Classic at our institution were evaluated. Patient demographics, aneurysm characteristics, technical procedural details, and early outcomes were analyzed. RESULTS The two groups were comparable for age, gender, and location of target aneurysms. Use of Pipeline Flex decreased procedure time by 44.2 min (p0.001) and fluoroscopy time by 22.0 min (p=0.001) compared with the Pipeline Classic. Similarly, radiation exposure was less in the Flex group with a mean difference of 3473.5 Gy cm2 (p=0.002), while contrast usage was decreased with a mean difference of 22.3 mL (p=0.007). These differences remained significant in multivariate regression analysis. Finally, the rate of device deployment failure was lower in the Flex group (7.1%) than in the Classic group (23.9%) (p=0.034). CONCLUSIONS Use of Pipeline Flex significantly reduces the total procedure and fluoroscopy time, contrast usage, patient radiation exposure, and proportion of recaptured devices in comparison with the Pipeline Classic, probably owing to an enhanced delivery system that allows for more reliable and controlled deployment.

BACKGROUND: Physicians have had to perform numerous extubation procedures during the prolonged coronavirus disease 2019 (COVID 19) pandemic. Future pandemics caused by unknown pathogen may also present a risk of exposure to infectious droplets and aerosols. AIM: This study evaluated the ability of a newly developed aerosol barrier, Extubation-Aerosol (EA)-Shield to provide maximum protection from aerosol exposure during extubation via an aerosolised particle count and high-quality visualisation assessments. METHODS: We employed a cough model having parameters similar to humans and used micron oil aerosol as well as titanium dioxide as aerosol tracers. Aerosol barrier techniques employing a face mask (group M) and EA-Shield (group H) were compared. FINDINGS: The primary outcome was the difference in the number of particles contacting the physicians face before and after extubation. The maximum distances of aerosol dispersal after extubation were measured as the secondary outcomes. All aerosolised particles of the two tracers were significantly smaller in group H than in group M (p < 0.05). In addition, the sagittal and axial maximum distances and sagittal areas of aerosol dispersal for 3, 5, and 10 s after extubation were significantly smaller in group H than in group M (p < 0.05). CONCLUSION: This model indicates that EA-Shield could be highly effective in reducing aerosol exposure during extubation. Therefore, we recommend using it as an aerosol barrier when an infectious aerosol risk is suspected.

Background and aimCOVID-19 can be presented with various gastrointestinal symptoms. Shortly after the pandemic outbreak several machine learning algorithms have been implemented to assess new diagnostic and therapeutic methods for this disease. Aim of this study is to assess gastrointestinal and liver related predictive factors for SARS-CoV-2 associated risk of hospitalization. MethodsData collection was based on questionnaire from the COVID-19 outpatient test center and from the emergency department at the University hospital in combination with data from internal hospital information system and from the mobile application used for telemedicine follow-up of patients. For statistical analysis SARS-CoV-2 negative patients were considered as controls to three different SARS-CoV-2 positive patient groups (divided based on severity of the disease). ResultsTotal of 710 patients were enrolled in the study. Presence of diarrhea and nausea was significantly higher in emergency department group than in the COVID-19 outpatient test center. Among liver enzymes only aspartate transaminase (AST) has been significantly elevated in the hospitalized group compared to patients discharged home. Based on random forest algorithm, AST has been identified as the most important predictor followed by age or diabetes mellitus. Diarrhea and bloating have also predictive importance although much lower than AST. ConclusionSARS-CoV-2 positivity is connected with isolated AST elevation and the level is linked with the severity of the disease. Furthermore, using machine learning random forest algorithm, we have identified elevated AST as the most important predictor for COVID-19 related hospitalizations.

BACKGROUND AND OBJECTIVE: Societies require prosocial activities during crises. The COVID\19 pandemic presents individuals with unique challenges that may affect their emotional state leading to reformed personal moral norms. Crucially, personal moral norms are important predictors of moral behaviour. Given the longevity of the pandemic, studying its impact on affect, satisfaction and internal drive of (non\)donors during COVID\19 and if personal moral norms are affected is paramount. MATERIAL AND METHODS: This study relies on longitudinal data, consisting of six waves carried out biweekly. Our panel is representative for the German population, capturing changes in affect, satisfaction, internal drive and personal moral norms. We compare the emotional state and personal moral norms of (non\)donors in the pandemic to pre\pandemic phase. Moreover, we analyse changes in emotional state and personal moral norms during the pandemic and investigate the role of emotional state on personal moral norms. RESULTS: Firstly, our results show that personal moral norms of (non\)donors drop compared to pre\pandemic. Within pandemic, personal moral norms of active donors are not further altered. Secondly, we find significant changes of emotional state in the pandemic compared to pre\pandemic phase, for example individuals feel more optimistic, but less satisfied and less energetic. Thirdly, we find that feeling more grateful increases personal moral norms of non\donors. CONCLUSION: This study provides insights into how crises shape (non\)donors emotional state and its impact on relevant donor motivations, that is, personal moral norms. Blood banks can use this knowledge to enhance recruiting and retention efforts during crises.

Covid-19 has affected the global economy, influencing firm and household financial decisions worldwide. The Central Bank of the United Arab Emirates (CBUAE) released an AED 256 billion stimulus package to provide banks with sufficient capital to support economic activities and development by providing temporary relief to large corporations, small- and medium-sized enterprises, and households. New financial products have rapidly appeared, including relief packages for rent, mortgages, personal loans, credit cards, SMEs, and corporate entities. Regression analysis explores the effect of such relief packages on UAE firm and household finances. Using online survey data gathered via convenience sampling of UAE households, econometric analysis confirms that select demographic factors and financial instruments positively relate to effective financial decision-making. Our results guide policymakers on which relief packages effectively manage firm-level and household financial distress during a health pandemic. ? 2021, The Author(s), under exclusive licence to Springer Nature Limited.

Refugee women experience more negative pregnancy and neonatal outcomes, such as low birth weight and preterm birth. The aim of the present study was to compare the clinical characteristics and pregnancy and neonatal outcomes between Turkish citizens and Syrian refugees with high-risk pregnancies. This prospective cohort study was conducted between March and December 2020 in Sanliurfa, Turkey. The maternal characteristics and pregnancy and neonatal outcomes were compared between the two groups. In this study, a total of 302 high-risk pregnant women (233 Turkish citizens and 69 Syrian refugees) were included. Parity and pregnancy spacing shorter than 2 years were significantly higher in Syrian refugees. Age, previous abortion or miscarriage and rates of cesarean section (C/S) were significantly higher in Turkish citizens. The live birth (Turkish: 94.8% vs Syrian: 92.8%), preterm birth (Turkish: 10% vs Syrian: 9.4%), low birth weight (Turkish: 7.7% vs Syrian: 3.1%) rates and birth weight (g) (Turkish: 3097.5 501.3 g; Syrian: 2980.2 395.0 g) were not significantly different between Turkish citizens and Syrian refugees with high-risk pregnancy. Similar pregnancy and neonatal outcomes could be attributed to the Syrians receiving adequate and free maternity care, similar to the Turkish citizens.

Vaccines offer a hope toward ending the global pandemic caused by SARS-CoV2 Mass vaccination of the global population offers hope to curb the spread Developing nations, however, face monumental challenges in procurement, allocation, distribution and uptake of vaccines Inequities in vaccine supply are already evident with resource-rich nations having secured a large chunk of the available vaccine doses for 2021 Once supplies are made available, vaccines will have to be distributed and administered to entire populationswith considerations for individual risk level, remote geography, cultural and socio-economic factors This would require logistical and trained personnel support that can be hard to come by for resource-poor nations Several vaccines also require ultra-cold temperatures for storage and transport and therefore the need for specialized equipment and reliable power supply which may also not be readily available Lastly, attention will need to be paid to ensuring adequate uptake of vaccines since vaccine hesitancy has already been reported for COVID vaccines However, existing strengths of local and regional communities can be leveraged to provide innovative solutions and mitigate some of the challenges Regional and international cooperation can also play a big role in ensuring equity in vaccine access and vaccination

OBJECTIVE The aim of the study was to investigate chest computed tomography (CT) findings and the value of CT in the diagnosis in children with suspected coronavirus disease 2019 (COVID-19). MATERIALS AND METHODS Chest CT images of pediatric patients with suspected COVID-19 were retrospectively evaluated. Computed tomography findings were divided into 3 groups: normal, consistent, and inconsistent with COVID-19. The sensitivity and specificity of CT were calculated by reference to reverse transcriptase polymerase chain reaction. RESULTS The study included patients with a mean age of 11.1 years (1 month-17 years). Of the patients, 43 (40.19%) had normal CT, 34 (31.77%) had CT findings consistent with COVID-19, and 30 (28.04%) had CT findings inconsistent with COVID-19. The sensitivity, specificity, positive predictive value, and negative predictive value of CT were 47.92%, 81.36%, 67.65%, and 65.75%, respectively. CONCLUSIONS Because the sensitivity of CT in the pediatric age group is low, it should be used cautiously for the evaluation of COVID-19 in the pediatric age group.

Neanderthal genes possibly gave modern human protection against viruses However, a recent study revealed that that a long sequence of DNA that is inherited from our Neanderthal ancestors can be linked to severe COVID-19 infection and hospitalization Substantial evidence now indicates that our genetic background may be involved in the transmissibility of SARS-CoV-2 and the rapid progress of COVID-19 in some infected individuals Although both morbidity and mortality of COVID-19 strongly depends on key factors such as age and co-existing health conditions, potential classes of human genomic variants possibly affect the likelihood of SARS-CoV-2 infection and its progress Despite Iran and Mongolia seem to share the same SARS-CoV-2 mutation cluster, the COVID-19 mortality rates in these two countries are drastically different While the population in Iran is 25 8 times higher than that of Mongolia, the number of confirmed cases is 1170 times higher Moreover, the death rate shows a drastic difference Since Neanderthals interbred with modern humans in Middle East between 47,000 and 65,000 years ago before going extinct 40,000 years ago, some Iranians have much more Neanderthal DNA than other people Although neither genetic background nor environmental factors alone can determine our risk of developing severe COVID-19, our genes clearly affect both the development and progression of infectious diseases including COVID-19 Given these considerations, we believe that these great differences, at least to some extent, can be due to the proportion of Neanderthal genes among the people of these two countries

Epidemiological figures of the SARS-CoV-2 epidemic in Italy are higher than those observed in China. Our objective was to model the SARS-CoV-2 outbreak progression in Italian regions vs. Lombardy to assess the epidemic's progression. Our setting was Italy, and especially Lombardy, which is experiencing a heavy burden of SARS-CoV-2 infections. The peak of new daily cases of the epidemic has been reached on the 29th, while was delayed in Central and Southern Italian regions compared to Northern ones. In our models, we estimated the basic reproduction number (R0), which represents the average number of people that can be infected by a person who has already acquired the infection, both by fitting the exponential growth rate of the infection across a 1-month period and also by using day-by-day assessments based on single observations. We used the susceptible-exposed-infected-removed (SEIR) compartment model to predict the spreading of the pandemic in Italy. The two methods provide an agreement of values, although the first method based on exponential fit should provide a better estimation, being computed on the entire time series. Taking into account the growth rate of the infection across a 1-month period, each infected person in Lombardy has involved 4 other people (3.6 based on data of April 23rd) compared to a value of R0 = 2.68, as reported in the Chinese city of Wuhan. According to our model, Piedmont, Veneto, Emilia Romagna, Tuscany and Marche will reach an R0 value of up to 3.5. The R0 was 3.11 for Lazio and 3.14 for the Campania region, where the latter showed the highest value among the Southern Italian regions, followed by Apulia (3.11), Sicily (2.99), Abruzzo (3.0), Calabria (2.84), Basilicata (2.66), and Molise (2.6). The R0 value is decreased in Lombardy and the Northern regions, while it is increased in Central and Southern regions. The expected peak of the SEIR model is set at the end of March, at a national level, with Southern Italian regions reaching the peak in the first days of April. Regarding the strengths and limitations of this study, our model is based on assumptions that might not exactly correspond to the evolution of the epidemic. What we know about the SARS-CoV-2 epidemic is based on Chinese data that seems to be different than those from Italy; Lombardy is experiencing an evolution of the epidemic that seems unique inside Italy and Europe, probably due to demographic and environmental factors.

The viruses causing the SARS outbreak of 2002-2003 and current COVID-19 pandemic are related betacoronaviruses. What insights were learned from SARS that can inform SARS-CoV-2 vaccine development? Focusing on important lessons from SARS vaccine development and two SARS vaccines evaluated in humans may guide SARS-CoV-2 vaccine design, testing, and implementation.

The issue of COVID-19 surfaced in late December of 2019 Since then, it is a global threat One of the major attributes of COVID-19 is the highly infectious nature of the virus Researchers have been trying to find ways to cure or at least prevent additional spreading In the literature, we observe developments toward COVID-19 positive case detection with the use of artificial intelligence-driven tools (Santosh in J Med Syst 44:93 [1]) As multitudinal and multimodal data can make a difference in decision-making, there has recently been a trend to put together several datasets of varied sizes over time Besides, COVID-19 has socio-economic impact across the World In this chapter, we provide a quick understanding of COVID-19 from both technical innovations (AI-driven tools for prediction and detection) and socio-economic issues In other words, challenges, innovations and opportunities are discussed in this chapter ? 2021, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd

A most discussed topic of the new decade, COVID-19 is an infectious disease caused by the recently discovered SARS-CoV-2. With an exceedingly high transmission rate, COVID-19 has affected almost all the countries in the world. Absent any vaccine or specific treatment, the humanity is left with nothing but the legacy method of quarantine. However, quarantine can only be effective when combined with early diagnosis of suspected cases. With their high sensitivity and unmatched specificity, biosensors have become an area of interest for development of novel diagnostic methods. Compared to the more traditional diagnostics, nanobiotechnology introduces biosensors as different diagnostics with greater versatility in application. Today, a growing number of analytes are being accurately identified by these nanoscopic sensing machines. Several reports of validated application with real samples further strengthen this idea. As of recent, there has been a rise in the number of studies on portable biosensors. Despite the slow progression, certain devices with embedded biosensors have managed to be of diagnostic value in several countries. The perceptible increase in development of mobile platforms has revolutionized the healthcare delivery system in the new millennium. The present article reviews the most recent advancements in development of diagnostic nanobiosensors and their application in the clinical fields. KEY POINTS: a? There is no specific treatment for highly transmissible SARS-CoV-2. a? Early diagnosis is critical for control of pandemic. a? Highly sensitive/specific nanobiosensors are emerging assets against COVID-19.

We all are aware of COVID 19 pandemic. As the numbers are increasing, the critical care demand is also increasing. Tracheostomy is one of the commonest procedures which has been performed on COVID positive ventilated patients. It is important to understand and follow the utmost safe practices for the patient and the health care workers for such aerosol generating procedures. The aim of this study is to identify the lacunae in tracheostomy practices during this COVID times and suggest a systematic approach for the safe practices. An online questionnaire survey-based study was performed in September 2020. The target population was practicing otolaryngologists of India with various years of experience. The aim of the study was to evaluate the lacunae in tracheostomy safe practices and to create a systematic approach for the safety of health care workers. Data compilation and analysis was done by using Microsoft Excel. A systematic COVID TIDE tracheostomy safe practices approach was designed after reviewing various tracheostomy guidelines and recommendations. Total 114 otolaryngologists responded with a complete survey report. 72.2% responders were not up to date with their knowledge of tracheostomy safe practices. 79.8% were not performing this procedure in a negative pressure room. 15.8% were not aware of the personal protective equipment level they are using. Only 56.1% survey responders were holding the ventilation before tracheal incision. Overall, 94.7% responders were keen to know about the safe approach of tracheostomy in COVID positive patients. Tracheostomy is an aerosol generating procedure, lacunae in the knowledge can cause major risk to health care professionals. Finally, in such crises, consideration should be taken for simulation exercises, dedicated airway teams and a systematic COVID TIDE approach to improve the safety of the staff and patients. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-021-02370-w.

OBJECTIVE: Patients admitted to the hospital may unknowingly carry SARS-CoV-2 and hospitals have implemented SARS-CoV-2 admission screening. However, because SARS-CoV-2 RT-PCR may remain positive for months after infection, positive results may represent active or past infection. We determined the prevalence and infectiousness of patients who were admitted for reasons unrelated to COVID-19 but tested positive on admission screening. METHODS: We conducted an observational study at the University of Iowa Hospitals & Clinics from July 7 to October 25, 2020. All patients admitted without suspicion of COVID-19 infection were included and medical records of those with a positive admission screening test were reviewed. Infectiousness was determined using patient history, PCR cycle threshold (Ct) value, and serology. RESULTS: A total of 5,913 patients were screened and admitted for reasons unrelated to COVID-19. Of these, 101 had positive admission RT-PCR results. Thirty-six patient were excluded because they had respiratory signs/symptoms on admission on chart review. Sixty-five patients (1.1%) did not have respiratory symptoms. A total of 55 patients had Ct values available and were included in this analysis. The median age was 56 years, and (51%) were male. Our assessment revealed that 23 patients (42%) were likely infectious. The median duration of in-hospital isolation was five days for those likely infectious and two days for those deemed non-infectious. CONCLUSIONS: COVID-19 infection was infrequent among patients admitted for reasons unrelated to COVID-19. An assessment of the likelihood of infectiousness using clinical history, RT-PCR Ct values, and serology may help discontinue isolation and conserve resources.

Aim: Telemedicine is a promising solution to extend traditional health care services. Even though mainly discussed during the past two decades, its roots go back into the past century and even further, considering the use of bonfires to warn other villages of diseases. Insights from historical cases can therefore be useful for the ongoing discussion regarding the successful implementation of telemedicine. Subject and Methods: We analyzed three historical telemedicine cases (varying regarding time and place) and extracted their success factors and barriers as well as assessed their maturity by using the Telemedicine Community Readiness Model (TCRM). Evidence-based categories of success factors and barriers as well as the TCRM's dimensions were used as deductive categories to analyze the study material's content. Results: The analysis showed that the readiness for telemedicine is higher when the technology is the only option to access health care services. In all three cases, core readiness played a central role. However, the health sector, existing technology, and finance were barriers present at all times, while during pandemics, some barriers are only temporarily removed, for example, by putting legal issues on hold. The analyzed cases were all on lower levels of maturity as they mainly represent pilot tests or exceptional circumstances. Conclusion: Results indicate the important core functions in telemedicine initiatives as well as the diversity of their circumstances. Insights from such historical meta-perspectives can, for example, help to strengthen the sustainability of the increased use of telemedicine during the COVID-19 pandemic and scale up current telemedicine projects.