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Introduction Acute appendicitis (AA) is the most common cause of acute abdomen in young adults. The diagnosis is usually made on various clinical findings. However, a missed case of acute appendicitis is a catastrophe as it later presents with life-threatening complications and results in medicolegal issues. Raised total leukocyte count (TLC) is a frequent finding in patients with acute appendicitis. As a convention, a normal leukocyte count usually rules out the differential diagnosis of acute appendicitis. Recent studies claimed that a substantial proportion of patients with normal TLC also had acute appendicitis and warranted a careful evaluation of such cases before sending them home. However, the reported frequency of acute appendicitis among TLC normal patients varied greatly among studies which necessitated the present study. Aim Our aim was to determine the frequency of acute appendicitis in patients of normal TLC. Materials and methods This descriptive cross-sectional study was conducted at the Department of Surgery, KRL Hospital Islamabad. This study was carried out from 1 July 2019 to 31 December 2019. This study involved 238 patients of both genders aged between 12 and 70 years suspected of acute appendicitis on physical and ultrasound findings but with a normal TLC (4,500-11,000 WBCs/L). The outcome variable was the frequency of acute appendicitis among such patients which was diagnosed upon surgery (inflamed appendix with free fluid) and histopathology of excised tissue (mucosal inflammation, neutrophil infiltrates, wall necrosis). Frequency of acute appendicitis was compared across various age and gender groups. Written informed consent was obtained from every patient. Results The mean age of the patients was 27.415.5 years. Majority (n = 167, 70.2%) of the patients were aged 25 years, followed by 40 (16.8%) patients aged 46 years and 31 (13.0%) patients aged between 26 and 45 years. There were 135 (56.7%) male and 103 (43.3%) female patients with a male to female ratio of 1.3:1. All of the patients (100.0%) had pain in the right iliac fossa (RIF) while rebound tenderness, anorexia, nausea/vomiting, fever and dysuria were noted in 83.6%, 79.0%, 73.9%, 63.9% and 15.1% patients, respectively. The diagnosis of acute appendicitis was made in 198 (83.2%) patients with normal TLC and suspicion of acute appendicitis on physical findings and ultrasound. When stratified, there was no statistically significant difference in the frequency of acute appendicitis across various age (p-value = 0.988) and gender (p-value = 0.913) groups. Conclusion In the present study, contrary to the routine impression that normal TLC rules out the differential diagnosis of acute appendicitis, a substantial proportion of patients with clinical and ultrasound suspicion of acute appendicitis but normal TLC had acute appendicitis which is worrisome as a missed case may later present with complications. The present study thus warrants cautious evaluation of clinically suspected cases with normal TLC count to avoid a missed appendicitis and improve the outcome in future surgical practice.
Total Leukocyte Count Depicting the Degree of Inflammation in Acute Appendicitis.
ImportanceWith the emergence of more transmissible SARS-CoV-2 variants of concern (VOC), there is an urgent need for evidence about disease severity and the health care impacts of VOC in North America, particularly since a substantial proportion of the population have declined vaccination thus far. ObjectiveTo examine 30-day outcomes in Canadians infected with SARS-CoV-2 in the first year of the pandemic and to compare event rates in those with VOC versus wild-type infection. DesignRetrospective cohort study using linked healthcare administrative datasets. SettingAlberta and Ontario, the two Canadian provinces that experienced the largest third wave in the spring of 2021. ParticipantsAll individuals with a positive SARS-CoV-2 reverse transcriptase polymerase chain reaction swab from March 1, 2020 until March 31, 2021, with genomic confirmation of VOC screen-positive tests during February and March 2021 (wave 3). Exposure of InterestVOC versus wild type SARS-CoV-2 Main Outcomes and MeasuresAll-cause hospitalizations or death within 30 days after a positive SARS-CoV-2 swab. ResultsCompared to the 372,741 individuals with SARS-CoV-2 infection between March 2020 and January 2021 (waves 1 and 2 in Canada), there was a shift in transmission towards younger patients in the 104,232 COVID-19 cases identified in wave 3. As a result, although third wave patients were more likely to be hospitalized (aOR 1.34 [1.29-1.39] in Ontario and aOR 1.53 [95%CI 1.41-1.65] in Alberta), they had shorter lengths of stay (median 5 vs. 7 days, p<0.001) and were less likely to die within 30 days (aOR 0.66 [0.60-0.71] in Ontario and aOR 0.74 [0.62-0.89] in Alberta). However, within the third wave, patients infected with VOC (91% Alpha) exhibited higher risks of death (aOR 1.52 [1.27-1.81] in Ontario and aOR 1.67 [1.13-2.48] in Alberta) and hospitalization (aOR 1.57 [1.47-1.69] in Ontario and aOR 1.88 [1.74-2.02] in Alberta) than those with wild-type SARS-CoV-2 infections during the same timeframe. Conclusions and RelevanceOn a population basis, the shift towards younger age groups as the COVID-19 pandemic has evolved translates into more hospitalizations but shorter lengths of stay and lower mortality risk than seen in the first 10 months of the pandemic in Canada. However, on an individual basis, infection with a VOC is associated with a higher risk of hospitalization or death than the original wild-type SARS-CoV-2 - this is important information to address vaccine hesitancy given the increasing frequency of VOC infections now.
Lessons from the Covid-19 Third Wave in Canada: the Impact of Variants of Concern and Shifting Demographics
OBJECTIVE To investigate clinical characteristics and long-term effects of SARS. METHODS Clinical characteristics of 197 SARS patients in Xiao Tang-shan hospital were analyzed retrospectively, and prognosis of them were analyzed prospectively. RESULTS Among the 197 patients, 153 patients (77.7%) have positive results of serum SARS coronavirus-specific antibodies test, and 44 patients (22.3%) have negative results. The average age of SARS and non-SARS patients were (40 +/- 12) and (31 +/- 12) years, male/female ratio were 1.0:1.6 and 2.1:1.0, average body temperature were (38.5 degrees C +/- 0.3 degrees C) and (38.1 degrees C +/- 0.4 degrees C), median of fever length were 7.0 d (0.4 approximately 50 d) and 2.3 d (0.3 approximately 37 d) respectively. The occurrence of dyspnea, malaise and gastrointestinal symptom were more often in SARS patient than in non-SARS patients. Some patients have residual symptoms (such as cough, fatigue, dyspnea, abnormality of liver function, hyperglycemia and hyperglyceridemia), and only few patients have lung fibrosis. CONCLUSION Some patients with other respiratory diseases were misdiagnosed as SARS. There were several obvious differences of clinical characteristics between SARS patient and non-SARS patients. Prognosis of most patients were preciously well, and few still had abnormality of lung function. Residual symptoms of SARS and side effects of drugs used to treat SARS should be discriminated.
[Comparative study of clinical characteristics and prognosis of clinically diagnosed SARS patients with positive and negative serum SARS coronavirus-specific antibodies test].
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), has reached a pandemic level Very recently, I reported a significantly higher prevalence of diabetes and hypertension in severe COVID-19 as compared with non-severe COVID-19 by the meta-analysis Considering that both diabetes and hypertension are risk factors for atherosclerosis, I further studied the prevalence of cardiovascular disease (CVD) in COVID-19 and found a significantly higher prevalence of CVD in severe patients than in non-severe patients I speculate that the preexisting vascular damage is associated with severity of COVID-19 A recent study showed that obese patients with COVID-19, despite their younger age, required more frequently assisted ventilation and access to intensive care units than normal weight patients I thought that if the reason that COVID-19 is likely to become severe in obese people could be elucidated, the mechanism for aggravation of COVID-19 would be understood As a result of considering a model of aggravation in obese people, I came up with the notion that pre-existing risk factors in obese people such as their vascular high-affinity for SARS-CoV-2, pro-inflammatory and pro-coagulant state and endothelial dysfunction may be likely to induce the development of "systemic severe coagulopathic vasculitis (SSCV)" in obese people I believe that SSCV may largely contribute to the development of severe COVID-19 Here, I will describe the points of action of drugs for treating COVID-19 by using the SSCV model
The Points of Action of Drugs for Treating COVID-19
Blockchain technology has a great potential for improving efficiency, security and privacy of Electronic Health Records (EHR) sharing systems. However, existing solutions relying on a centralized database are susceptible to traditional security problems such as Denial of Service (DoS) attacks and a single point of failure similar to traditional database systems. In addition, past solutions exposed users to privacy linking attacks and did not tackle performance and scalability challenges. In this paper, we propose a permissioned Blockchain based healthcare data sharing system that integrates Blockchain technology, decentralized file system and threshold signature to address the aforementioned problems. The proposed system is based on Istanbul Byzantine Fault Tolerant (IBFT) consensus algorithm and Interplanetary File System (IPFS). We implemented the proposed system on an enterprise Ethereum Blockchain known as Hyperledger Besu. We evaluated and compared the performance of the proposed system based on various performance metrics such as transaction latency, throughput and failure rate. Experiments were conducted on a variable network size and number of transactions. The experimental results indicate that the proposed system performs better than existing Blockchain based systems. Moreover, the decentralized file system provides better security than existing traditional centralized database systems while providing the same level of performance.
Secure Decentralized Electronic Health Records Sharing System based on Blockchains
Epidemics generally spread through a succession of waves that reflect factors on multiple timescales. On short timescales, superspreading events lead to burstiness and overdispersion, whereas long-term persistent heterogeneity in susceptibility is expected to lead to a reduction in both the infection peak and the herd immunity threshold (HIT). Here, we develop a general approach to encompass both timescales, including time variations in individual social activity, and demonstrate how to incorporate them phenomenologically into a wide class of epidemiological models through reparameterization. We derive a nonlinear dependence of the effective reproduction number [Formula: see text] on the susceptible population fraction S. We show that a state of transient collective immunity (TCI) emerges well below the HIT during early, high-paced stages of the epidemic. However, this is a fragile state that wanes over time due to changing levels of social activity, and so the infection peak is not an indication of long-lasting herd immunity: Subsequent waves may emerge due to behavioral changes in the population, driven by, for example, seasonal factors. Transient and long-term levels of heterogeneity are estimated using empirical data from the COVID-19 epidemic and from real-life face-to-face contact networks. These results suggest that the hardest hit areas, such as New York City, have achieved TCI following the first wave of the epidemic, but likely remain below the long-term HIT. Thus, in contrast to some previous claims, these regions can still experience subsequent waves.
Time-dependent heterogeneity leads to transient suppression of the COVID-19 epidemic, not herd immunity
Atmospheric components that can influence climate change can be classified as long-lived greenhouse gases and short-lived climate forcers (SLCFs), according to their lifetimes in the atmosphere. Considering the important roles of SLCFs in climate change and air quality, IPCC AR6 has for the first time the dedicated chapter for the assessment of SLCFs. This work summarizes the major conclusions on SLCFs, especially those since AR5, including the definition of SLCFs, changes in emissions and abundances of SLCFs, the effective radiative forcings of SLCFs and climate responses, projected future changes in climate and air quality under Shared Socioeconomic Pathways (SSPs), and the impact of COVID-19 lockdown on climate. We also discuss the uncertainties associated with the AR6 conclusions as well as the implications for climate and air quality in China. ? 2021 by the authors.
The roles of short-lived climate forcers in a changing climate
Introduction: Noninvasive ventilation (NIV) has been used to alleviate hypoxemia and dyspnea, but there is no consensus on the application of NIV in patients with coronavirus disease 2019 (COVID-19). Some staff use NIV as the rescue therapy which might lead to the adverse outcomes. This study was to identify early factors associated with intubation to help the medical staff select appropriate patients for receiving NIV treatment. Methods: Patients with laboratory-confirmed COVID-19 who were treated with NIV in emergency department or ICU of the Third People's Hospital (the only designated hospital for treating COVID-19 in Shenzhen) between January 1 and August 31, 2020, were retrospectively analyzed. Results: Thirty-nine patients with COVID-19 treated with NIV were included; of them, 16 (41%) received endotracheal intubation and 3 (8%) died. Significant differences were observed between intubated and non-intubated patients in PaO(2)/FiO(2) before NIV initiation, hospitalization duration, NIV as the rescue therapy, and PaO(2)/FiO(2) of 200 mmHg after 1C2 h of NIV initiation. Notably, 1C2 h after NIV initiation, a PaO(2)/FiO(2) of 200 mmHg (odds ratio [OR], 9.35; 95% confidence interval [CI], 1.84C47.62; P = 0.007) and NIV as the rescue therapy (OR, 5.43; 95% CI, 1.09C27.12; P = 0.039) were the risk factors for intubation. Conclusions: In patients with COVID-19-related acute hypoxemic respiratory failure receiving NIV, close attention should be paid to PaO(2)/FiO(2) after 1C2 h of NIV initiation. Also, using NIV as rescue therapy should draw our awareness that it might delay escalation of respiratory support and lead to adverse outcomes.
Noninvasive Ventilation in Patients With COVID-19-Related Acute Hypoxemic Respiratory Failure: A Retrospective Cohort Study
Introduction Coronavirus disease 2019 (COVID-19) has emerged as a global pandemic that has placed an unprecedented burden on intensive care services worldwide. Identification of a reliable risk-stratification tool for COVID-19 patients is necessary for appropriate resource allocation, selection of clinical management pathways, and guidance of goals of care conversations with families and caregivers in the critical care setting. The Acute Physiologic Assessment and Chronic Health Evaluation (APACHE) II scoring system is one of several predictive models used to classify illness severity and estimate mortality risk on admission to the intensive care unit (ICU). Our retrospective study sought to evaluate the prognostic ability of the APACHE II score in COVID-19 patients according to endpoints of mortality and length of stay (LOS) as well as unfavorable clinical outcomes, including development of acute renal failure (ARF) requiring renal replacement therapy (RRT) and acute venous thromboembolic events (VTE). Methods This multicenter retrospective cohort study evaluated a randomized sample of 3,102 patients with confirmed COVID-19 disease admitted to the ICU from January 2020 to May 2020. A total of 395 patients with complete data points for appropriate APACHE II score calculation, absence of the preexisting comorbidities end-stage renal disease, and history of VTE were included. Linear and logistic regression models were employed to evaluate primary outcomes of mortality and LOS as well as secondary outcomes of VTE and ARF requiring continuous renal replacement therapy (CRRT) or hemodialysis (HD). Key results Among the 395 patients enrolled, total percent mortality and mean LOS were 37.0% and 12.92 days, respectively. Primary outcome analysis revealed a statistically significant increase in odds of mortality as well as in mean LOS with every additional point increase in APACHE II score from a baseline of zero. Specifically, for every point increase in the APACHE II score, odds of mortality increased by 12% (p value < 0.001), and average LOS increased by 0.2 days (p value < 0.001). In our secondary outcome analysis, 14.43% and 62.2% of the total sample population developed ARF requiring RRT and VTE, respectively. For every additional point increase in APACHE II score from a baseline of zero, odds of requiring CRRT or HD increased by 10% on average (95% CI (1.06, 1.15); p value < 0.001). Similarly, for every additional point increase in the APACHE II score from a baseline of zero, there was a corresponding increase in odds of VTE by 19% (95% CI (1.14, 1.24); p value < 0.001). Conclusions The APACHE II score is an effective predictive model of in-hospital mortality and unfavorable clinical outcomes, including prolonged LOS, ARF requiring CRRT or HD, and development of VTE. As therapeutic interventions for COVID-19 evolve, application of this risk-stratification tool may guide clinical management decisions in the critical care setting.
A Retrospective Review of Outcomes in Intensive Care Unit Patients Infected With SARS-Cov2 in Correlation to Admission Acute Physiologic Assessment and Chronic Health Evaluation II Scores
BACKGROUND: The impact of immune-related conditions on the outcomes of coronavirus disease 2019 (COVID-19) is poorly understood. Determinants of COVID-19 outcomes among patients with psoriasis are yet to be established. OBJECTIVE: Th objective of this study was to characterize a large cohort of patients with psoriasis with COVID-19 and to identify predictors of COVID-19-associated hospitalization and mortality. METHODS: A population-based nested case-control study was performed using the computerized database of Clalit Health Services, Israel. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence (CIs) of predictors for COVID-19-associated hospitalization and mortality. RESULTS: The study population included 3151 patients with psoriasis who tested positive for COVID-19. Subclinical COVID-19 infection occurred in 2818 (89.4%) of the patients while 122 (3.9%), 71 (2.3%), 123 (3.9%), and 16 (0.5%) of the patients experienced a mild, moderate, severe, and critical disease, respectively. Overall, 332 (10.5%) patients were hospitalized and 50 (1.6%) patients died because of COVID-19 complications. Intake of methotrexate independently predicted COVID-19-associated hospitalization (adjusted OR 2.30; 95% CI 1.11C4.78; p = 0.025). Use of biologic agents was not associated with COVID-19-associated hospitalization (OR 0.75; 95% CI 0.32C1.73; p = 0.491) or mortality (OR 0.85; 95% CI 0.12C6.21; p = 0.870). Older age, the presence of comorbid cardiovascular diseases, metabolic syndrome, chronic obstructive pulmonary disease, and chronic renal failure independently predicted both COVID-19-associated hospitalization and mortality. CONCLUSIONS: The use of oral methotrexate was associated with an increased odds of COVID-associated hospitalization, whereas the use of biologic drugs was not associated with worse outcomes of COVID-19 among patients with psoriasis. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40257-021-00605-8.
Coronavirus Disease 2019 (COVID-19)-Associated Hospitalization and Mortality in Patients with Psoriasis: A Population-Based Study
BACKGROUND: Diagnostic tests for respiratory infections can be costly and time-consuming. Improved characterization of specific respiratory pathogens by identifying frequent signs, symptoms and demographic characteristics, along with improving our understanding of coinfection rates and seasonality, may improve treatment and prevention measures. METHODS: Febrile respiratory illness (FRI) and severe acute respiratory infection (SARI) surveillance was conducted from October 2011 through March 2013 among three US populations: civilians near the USCMexico border, Department of Defense (DoD) beneficiaries, and military recruits. Clinical and demographic questionnaire data and respiratory swabs were collected from participants, tested by PCR for nine different respiratory pathogens and summarized. Age stratified characteristics of civilians positive for influenza and recruits positive for rhinovirus were compared to other and no/unknown pathogen. Seasonality and coinfection rates were also described. RESULTS: A total of 1444 patients met the FRI or SARI case definition and were enrolled in this study. Influenza signs and symptoms varied across age groups of civilians. Recruits with rhinovirus had higher percentages of pneumonia, cough, shortness of breath, congestion, cough, less fever and longer time to seeking care and were more likely to be male compared to those in the no/unknown pathogen group. Coinfections were found in 6% of all FRI/SARI cases tested and were most frequently seen among children and with rhinovirus infections. Clear seasonal trends were identified for influenza, rhinovirus, and respiratory syncytial virus. CONCLUSIONS: The age-stratified clinical characteristics associated with influenza suggest that age-specific case definitions may improve influenza surveillance and identification. Improving identification of rhinoviruses, the most frequent respiratory infection among recruits, may be useful for separating out contagious individuals, especially when larger outbreaks occur. Overall, describing the epidemiology of pathogen specific respiratory diseases can help improve clinical diagnoses, establish baselines of infection, identify outbreaks, and help prioritize the development of new vaccines and treatments.
Epidemiology of Pathogen-Specific Respiratory Infections among Three US Populations
There have been clinical descriptions of diverse neurological effects in COVID-19 disease, involving up to 36% of patients. It appears likely that most of these are not caused by viral brain invasion but by systemic accompaniments of critical illness such as coagulopathy, deleteriously upregulated immune response, autoimmune mechanisms, hypoxia or multiorgan failure. Anosmia or hyposmia is present in a majority of COVID-19 patients, and there is early and severe involvement of the nasopharyngeal mucosa and olfactory epithelium. Preliminary studies by our group have found massive gene expression changes in olfactory bulb, but the magnitude of these changes are not different between subjects with detectable versus non-detectable olfactory bulb SARS-CoV-2 RNA. As spontaneous discharge of olfactory epithelial afferents dictates intra-olfactory bulb neurophysiological activity and connectivity, we hypothesized that olfactory bulb deafferentation during COVID-19 is responsible for a large fraction of our observed olfactory bulb transcriptional changes. As the olfactory marker protein (OMP-1) is a specific marker of olfactory epithelial afferents to the olfactory bulb and is severely depleted in animal model lesions of olfactory epithelium, we quantified OMP-1-immunoreactivity in the olfactory bulb of subjects dying with or without COVID-19. Additionally, we quantified olfactory bulb tyrosine hydroxylase (TH), which is often also reduced after olfactory epithelium lesions, and SNAP-25, a pan-synaptic marker. COVID-19 cases (n = 18) were generally elderly and were not significantly different in age or gender distribution from the non-COVID-19 cases (n = 28). Both COVID-19 and non-COVID-19 cases had a wide range of neuropathological diagnoses. The area occupied by OMP-1 immunoreactivity in COVID-19 cases was significantly less, about 60% of that in control cases but amongst subjects with COVID-19, there was no significant difference between OBT-SARS-CoV-2-PCR-positive and negative cases. There were no significant group differences for TH or SNAP-25, supporting a selective effect for OMP-1. We suggest that olfactory dysfunction, and some of the COVID-19-associated transcriptional changes that we have reported for the olfactory bulb and amygdala, may be due to olfactory bulb deafferentation and subsequent transsynaptic effects. Additionally, animal models of olfactory bulb deafferentation or bulbectomy indicate a possibility for widespread changes in interconnected brain regions, providing a possible substrate for diverse post-acute COVID-19 neurological sequelae.
Deafferentation of Olfactory Bulb in Subjects Dying with COVID-19
At the end of 2019 the worlds population was tested by the presence of the COVID-19 virus which in a short time was classified as a pandemic by the World Health Organization (WHO). Millions of people have been affected by the infection and also tens of thousands have died. One of the prevention of transmission of the COVID-19 virus is by implementing a culture of clean living and implementing strict health protocols. Meanwhile the fact is that the implementation of a culture awareness of clean living and health protocols is still low. The purpose of this activity is to provide knowledge of senior high school of Muhammadiyah II Beji-Depok students about clean and healthy living habits and also to provide assistance in adding hand washing and ablution facilities. This community service activity was carried out face-to-face and was carried out from August to December 2020. The result of this activity was the implementation of socialization related to the culture of clean living giving free masks and the construction of hand washing facilities.
Clean and healthy living culture education to protect the students from COVID-19 in senior high school of Muhammadiyah II Beji Depok
To combat highly infectious Severe Acute Respiratory SyndromeICLE Coronavirus 2 (SARS-CoV-2), scientists and researchers are toiling hard globally to develop effective drugs and vaccines. By exploring the structural proteins of SARS-CoV-2 can be a feasible way to find an effective vaccine. In this study by using in-silico tools, we recommended B-cell and T-cell epitopes of spike protein from a Bangladeshi isolate which can be considered for incorporation into a vaccine against the SARS-CoV-2. Homology modelling, energy minimization process, and finally Ramachandran model was used for the prediction of a more stable conformation of the spike protein. The most important peptides were screened through the VaxiJen server followed by the IEDB server and CTLPred Score predicted and analysed the desired epitopes. In the final analysis, the peptide EVRQIAPGQTGKIADY (starting from 91) showed the highest antigenicity score (1.3837) as a B-cell epitope although GSTPCNGVEGFNCYFP, starting at 161, showed highest score (0.91) in an initial analysis. On the contrary, as a T-cell epitope, 71 KLNDLCFTNV-80 was found with the highest antigenicity score (2.6927) which was also found as an epitope in further analysis. A combination of B-cell and T-cell epitopes may evoke a humoral and cell-mediated immune response which will possibly lead to an effective vaccine. Further, the various computational analyses will provide valuable information that will pave the way for modelling a novel vaccine against SARS-CoV-2. ? 2020, Bangladesh Society for Microbiology, Immunology and Advanced Biotechnology. All rights reserved.
Prediction of b-cell and t-cell epitopes in the spike glycoprotein of sars-cov-2 in bangladesh: An in-silico approach
This research discusses the psychological well-being of employees affected by COVID-19 pandemic. This research was a descriptive study that used a quantitative approach. The subjects in the study were 118 employees who are working in an educational institution. Data were collected using the psychological well-being scale which was constructed based on the Ryffs (1989) concept of psychological well-being. Data analysis were carried out by compiling categorization and cross-tabulating in order to determine the psychological well-being of employees. The results showed that the psychological well-being of employees was in the high category. The dimension of psychological well-being that stands out is the life purpose followed by the positive relationships with others.Key words: Psychological well-being employees COVID-19 pandemic Penelitian ini membahas mengenai gambaran kesejahteraan psikologis pada karyawan terdampak pandemic COVID-19. Penelitian ini merupakan penelitian deskriptif yang menggunakan pendekatan kuantitatif. Subjek dalam penelitian adalah 118 karyawan yang bekerja di salah satu institusi pendidikan. Data dikumpulkan menggunakan skala kesejahteraan psikologis yang disusun berdasarkan konsep kesejahteraan psikologis dari Ryff (1989). Analisis data dilakukan dengan menyusun kategorisasi dan melakukan tabulasi silang guna mengetahui kesejahteraan psikologis karyawan. Hasil penelitian menunjukkan kesejahteraan psikologis yang dimiliki karyawan masuk ke dalam kategori tinggi. Dimensi kesejahteraan psikologis yang menonjol adalah tujuan hidup dilanjutkan dengan hubungan positif dengan orang lain.
Gambaran kesejahteraan psikologis pada karyawan terdampak pandemi COVID-19
Determining the clinical efficacy of analgesic drugs in amphibians can be particularly challenging. The current studyinvestigated whether a thermal nociceptive stimulus is useful for the evaluation of analgesic drugs in 2 amphibian species.The objectives of this study were 2-fold: 1) compare 2 models of nociception (thermal and mechanical) using 2 frog species; White's Tree Frogs (Litoria caerulea; WTF) and Northern Leopard Frogs (Lithobates pipiens; NLF) after administration of saline or morphine sulfate; and 2) evaluate antinociceptive efficacy of morphine sulfate at 2 doses in a common amphibian research species, the NLF, using a mechanical stimulus. Neither WTF nor NLF displayed consistent drug-dependent changes in withdrawal responses to a noxious thermal stimulus applied using the Hargreaves apparatus, but NLF exposed to the noxiousmechanical stimulus demonstrated a significant dose-dependent antinociceptive response to morphine sulfate. These resultsindicate that morphine is not antinociceptive in WTF, supporting previously reported results, and demonstrate the importanceof using an appropriate experimental antinociceptive test in amphibians. Our data suggest that nociception in amphibianspecies may be best evaluated by using mechanical nociceptive models, although species differences must also be considered.
Comparison of Thermal and Mechanical Noxious Stimuli for Testing Analgesics in White's Tree Frogs (Litoria caerulea) and Northern Leopard Frogs (Lithobates pipiens)
We study the problem of fairly allocating a divisible resource, also known as cake cutting, with an additional requirement that the shares that different agents receive should be sufficiently separated from one another. This captures, for example, constraints arising from social distancing guidelines. While it is sometimes impossible to allocate a proportional share to every agent under the separation requirement, we show that the well-known criterion of maximin share fairness can always be attained. We then establish several computational properties of maximin share fairness -- for instance, the maximin share of an agent cannot be computed exactly by any finite algorithm, but can be approximated with an arbitrarily small error. In addition, we consider the division of a pie (i.e., a circular cake) and show that an ordinal relaxation of maximin share fairness can be achieved. We also prove that an envy-free or equitable allocation that allocates the maximum amount of resource exists under separation.
Mind the Gap: Cake Cutting With Separation
Introduction. The coronavirus disease 2019 (COVID-19) is an acute infectious multisystem disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), man-ifested by acute respiratory symptoms. The novel coronavirus pneumonia (NCP) is the most common serious clinical mani-festation of SARS-CoV-2 infection. In the severe NCP, the sys-temic manifestations of the disease were also demonstrated, and one of the rare complications, first described in Wuhan (China), is pneumothorax. Case report. A 65-year-old female was admitted to the Clinic for Pulmonology with a high fever, shortness of breath, sore throat, and general weakness that started five days before. Laboratory findings revealed lympho-penia, elevated values of inflammatory markers, and liver le-sion. A chest X-ray (CXR) demonstrated diffusely accentuated interstitial pattern and reduced parenchymal transparency, left perihilar. Positive SARS-CoV-2 in a nasopharyngeal swab sam-ple was detected in the real-time reverse transcription-polymerase chain reaction (RT-PCR), confirming the diagnosis of NCP. Immediately, nasal oxygen therapy with a flow rate of 8 L/min, with chloroquine phosphate, antibiotics, and symp-tomatic treatment, was initiated. On the 8th day, her condition suddenly deteriorated, and she developed severe hypoxemia. A repeated CXR showed complete left-sided pneumotho-rax. Thoracic drainage was successfully performed with com-plete reexpansion of the lungs the very next day. The patient was released from the hospital in good general condition with normal arterial blood gases. Conclusion. Pneumothorax may develop as a complication in patients with pneumonia caused by SARS-CoV-2, without previous pulmonary comorbidities, due to alveolar damage. Acute deterioration with rapid oxygen desaturation in these patients should raise the suspicion of pneumothorax. Early diagnosis and prompt treatment are nec-essary to reduce mortality.
Pneumothorax in a patient with pneumonia caused by SARS-CoV-2: A case report
BACKGROUND: During the COVID-19 pandemic, residential lockdowns were implemented in numerous cities in China to contain the rapid spread of the disease. Although these stringent regulations effectively slowed the spread of COVID-19, they may have posed challenges to the well-being of residents. OBJECTIVE: This study aims to explore the effects of residential lockdown on the subjective well-being (SWB) of individuals in China during the COVID-19 pandemic. METHODS: The sample consisted of 1790 Sina Weibo users who were residents of cities that imposed residential lockdowns, of which 1310 users (73.18%) were female, and 3580 users who were residents of cities that were not locked down (gender-matched with the 1790 lockdown residents). In both the lockdown and nonlockdown groups, we calculated SWB indicators during the 2 weeks before and after the enforcement date of the residential lockdown using individuals original posts on Sina Weibo. SWB was calculated via online ecological recognition, which is based on established machine learning predictive models. RESULTS: The interactions of time (before the residential lockdown or after the residential lockdown) area (lockdown or nonlockdown) in the integral analysis (N=5370) showed that after the residential lockdown, compared with the nonlockdown group, the lockdown group scored lower in some negative SWB indicators, including somatization (F(1,5368)=13.593, P<.001) and paranoid ideation (F(1,5368)=14.333, P<.001). The interactions of time (before the residential lockdown or after the residential lockdown) area (developed or underdeveloped) in the comparison of residential lockdown areas with different levels of economic development (N=1790) indicated that the SWB of residents in underdeveloped areas showed no significant change after the residential lockdown (P>.05), while that of residents in developed areas changed. CONCLUSIONS: These findings increase our understanding of the psychological impact and cost of residential lockdown during an epidemic. The more negative changes in the SWB of residents in developed areas imply a greater need for psychological intervention under residential lockdown in such areas.
Subjective Well-Being of Chinese Sina Weibo Users in Residential Lockdown During the COVID-19 Pandemic: Machine Learning Analysis
We show that the acceleration index, a novel indicator that measures acceleration and deceleration of viral spread (Baunez et al. 2020a,b), is essentially a test-controlled version of the reproduction number. As such it is a more accurate indicator to track the dynamics of an infectious disease outbreak in real time. We indicate a discrepancy between the acceleration index and the reproduction number, based on the infectivity and test rates and we provide a formal decomposition of this difference. When applied to French data for the ongoing COVID-19 pandemic, our decomposition shows that the reproduction number consistently underestimates the resurgence of the pandemic since the summer of 2020, compared to the acceleration index which accounts for the time-varying volume of tests. From the comparison that we present here follows that the acceleration index is a sufficient statistic to track the pandemic's propagation, as it captures in real time the sizeable time variation featured by viral circulation.
The Acceleration Index as a Test-Controlled Reproduction Number: Application to COVID-19 in France