Objective: How helpful would a properly functioning find, test, trace, isolate and support (FTTIS) system be now in the UK with new Covid19 infections at a low level and half the adult population immunised but with a highly transmissible variant becoming predominant? Design: a dynamic causal model of Covid-19 supplied with the latest available empirical data is used to assess the impact of a new highly transmissible variant. Setting: the United Kingdom. Participants: a population based study. Interventions: scenarios are used to explore a Covid-19 transmission rate 50% more and twice the current rate with or without a more effective FTTIS system. Main outcome measures: incidence, death rate and reproductive ratio Results: a small short third wave of infections occurs which does not occur if FTTIS effectiveness is improved from 25% to 30%. Conclusion: a modest improvement in FTTIS would prevent a third wave caused by a highly transmissible virus.

Aim COVID-19 pandemic affected majority of students worldwide because school closures were one of the first and frequently taken measures in tackling epidemic. This study analysed trends in COVID-19 morbidity and mortality from the beginning of pandemic in Croatia, in relation to schools opening and closing. Methods Data on COVID-19 positive patients in Croatia from week 9 of 2020 to week 10 of 2021 in Croatia were analysed using joinpoint regression. Analysis also included hospitalizations and mortality trends for age groups 26 to 65 and 66+ from week 30 of 2020. Study design Retrospective data review. Results Schools opened in fall after the summer holidays in week 37. Joinpoint regression analysis revealed a statistically significant increase in cumulative incidence rates of COVID-19 in all age groups until 50th week, except in the 19-25 age group which saw an increase until 49th week. During the period of increase there were periods of moderate increases and rapid increases in incidence that were present between 39/41 week and 43/44 week in all age groups except in those 0-6 years [from 40th till 43rd week in age groups 7-14 and 15-18, average percentage change (APC)=87.41, p=0.035, and APC=83.47, p=0.013; from 39th till 43rd in 19-25, APC=91.90, p=0.002; from 40th till 44th in 26-65, APC=74.79, p<0.001; from 41st till 44th in 66+, APC=81.95, p=0.004]. Steeper increase in hospitalizations was seen in 40th week for age groups 26 to 65 (40th C 45th week APC=34.67, p<0.001) and 66+ (40th C 45th week APC=38.76, p<0.001). Steeper increase in mortality started in 41st week for both age groups 26 to 65 and 66+ (41st C 46th week APC=59.59, p<0.001 and 41st C 45th week APC=70.28, p<0.001). Schools were closed for winter holidays in week 51. A steep decrease occurred in week 50 for cases, and in week 51 for mortality and hospitalizations. There was no significant increase in hospitalizations and mortality after schools were re-opened in week 03 of 2021 (primary schools) and week 07 (secondary schools). Conclusion COVID-19 morbidity and mortality trends in Croatia observed in fall 2020 in Croatia perhaps cannot completely exclude potential association of school opening in all age groups. However, in winter 2021 effect was completely lacking and numbers were independent of schools dynamics. The observed inconsistent pattern indicates that there were no association of school openings and COVID-19 morbidity and mortality trends in Croatia and that other factors were leading to increasing and decreasing numbers. This emphasizes the need to consider the introduction of other effective and less harmful measures by stakeholders, or at least to use school closures as a last resort.

'The Mask' has become a byword and a precious possession universally. Except for its use by the medical fraternity, answers to the common questions-whether it provides enough protection, which type is optimal for the general public and who really needs to don it, remain poorly understood. For a frontline healthcare worker, wearing mask is a necessity as an important person protection equipment, it is perhaps the most-powerful psychological symbol for the general public. Surprisingly, it even undermines all other recommended practices of infection control and breaking the transmission chain of Covid-19, like hand washing, personal hygiene and social distancing. 'The mask' has evolved with time and yet there is a need to further improve the design for safety, tolerability and comfort. In this review we present the journey of face mask, originating from the first masks aimed at stopping the bad smell to its industrial use to its all-important place in the medical field. Various types of face masks, their filtration efficiency, reusability and current recommendations for their use are presented.

The COVID pandemic and the measures which were taken had effect over the mental health of persons. The current paper proposes a concept that supports the performance of students by analyzing three ways of distance learning, namely text, text and illustrations, including charts, video. An electroencephalogram headset allows the detection of brainwaves and the developed web application enhances the process of distance learning. The electrodes of the headset are placed at contact with the user head and monitor the activity of the left and right frontal regions, along with the temporal lobe. Mood, focus, stress, relaxation, engagement, excitement and interest are triggered as numerical values by using the headset. The users provide information about their daily activities, including learning and evaluation processes. According to the study, users had the highest long term attention while using text and illustrations, followed by watching videos. This is caused by the fact that the text contained the code for the programs which were presented in the video. Also, the users feel comfortable while using the application and they started to pay more attention to the connection between stress, health, education and well being. The results triggered by the headset had higher values while students studied for the first time using videos. When they wanted to remember the information, the text and illustrations way of learning was the best option. Based on the study outcomes, the instructional design can be enhanced. Moreover, the results improved as the students became more equilibrated and confident in themselves. Teachers, professors and parents are able to collaborate and enhance training. While studying online under lockdown, students have found the proposed solution to be good because their inner state influences their productivity while solving problems.

The global coronavirus (CoV) disease 2019 (COVID-19) pandemic has resulted in a worldwide shortage of viral transport media and raised questions about specimen stability. The objective of this study was to determine the stability of severe acute respiratory syndrome CoV 2 (SARS-CoV-2) RNA in specimen transport media under various storage conditions. Transport media tested included UTM, UTM-RT, ESwab, M4, and saline (0.9% NaCl). Specimen types tested included nasopharyngeal/oropharyngeal swabs in the above-named transport media, bronchoalveolar lavage (BAL) fluid, and sputum. A high-titer SARS-CoV-2 remnant patient specimen was spiked into pooled SARS-CoV-2 RNA-negative specimen remnants for the various medium types. Aliquots of samples were stored at 18C to 26C, 2C to 8C, and -10C to -30C and then tested at time points up to 14 days. Specimens consistently yielded amplifiable RNA with mean cycle threshold differences of <3 over the various conditions assayed, thus supporting the use and transport of alternative collection media and specimen types under a variety of temperature storage conditions.

The spread of COVID-19 may change the long-term care industry in ways that will last long after the pandemic has ended, and the diligent pharmacist needs to be aware of how to adjust to those changes.

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection spreaded rapidly worldwide, as far as it has become a global pandemic. Therefore, the introduction of serological tests useful for the determination of IgM and IgG antibodies, it has become the main diagnostic tool, useful for tracking the spread of the virus and consequently its containment. In our study we compared point of care test (POCT) lateral flow immunoassay (FIA) vs automated chemiluminescent immunoassay (CLIA), in order to assess their specificity and sensibility against COVID-19 antibodies detection. Results: : We find that different specificities and sensitivities for IgG and IgM tests. Notably IgM POCT FIA method vs CLIA method (gold standard) has a low sensitivity (0.526), while POCT FIA method vs CLIA method (gold standard) test has a much higher sensitivity (0.937);further, with respect of IgG, FIA and CLIA could arguably provide the same information. Conclusions: : FIA method could be helpful in assessing in short time, the possible contagiousness of subjects that for work reasons cannot guarantee social distancing.

The emergence of novel viral infections of zoonotic origin and mutations of existing human pathogenic viruses represent a serious concern for public health. It warrants the establishment of better interventions and protective therapies to combat the virus and prevent its spread. Surface glycoproteins catalyzing the fusion of viral particles and host cells have proven to be an excellent target for antivirals as well as vaccines. This review focuses on recent advances for computational structure-based design of antivirals and vaccines targeting viral fusion machinery to control seasonal and emerging respiratory viruses.

The AHA Scientific Sessions, the annual meeting of the Amer-ican Heart Association, highlights the latest cutting-edge basic, translational and clinical research in cardiovascular diseases. This year, the conference took place virtually due to the COVID-19 pandemic and comprised several days of live sessions and on-demand virtual content, including posters and prerecorded presentations.

OBJECTIVE Single-incision surgery is by now practicable in many fields of surgery, including surgery of the adrenal gland. We report on first experience with laparoscopic transperitoneal and retroperitoneoscopic single-incision adrenalectomy. PATIENTS AND METHODS Between September 2009 and February 2010, eight patients underwent single-incision adrenalectomy. Four patients received single-incision retroperitoneoscopic adrenalectomy, and four patients transperitoneal single-incision laparoscopic adrenalectomy. Technical feasibility and perioperative data are presented. RESULTS All patients had benign adrenal tumors (Conn's adenoma, n = 7; pheochromocytoma, n = 1). Tumor size ranged between 1.2 and 2.4 cm. Mean operation time was 76 minutes for single-incision retroperitoneoscopic adrenalectomy and 82 minutes for single-incision laparoscopic adrenalectomy. Blood loss was irrelevant in both groups. CONCLUSIONS Single-incision adrenalectomy is safe and feasible in appropriate operation time, both by the retroperitoneoscopic technique and by the laparoscopic technique. It is also associated with good cosmetic outcome.

We use the Belt and Road Initiative (BRI) economies to assess whether co-movements between individual BRI countries equity markets and Bitcoin, can optimize portfolio composition. The dynamic correlations between these two asset classes persist up to 21 days out-of-sample. During the Covid-19 pandemic, a simple hedging strategy could have improved high risk-averse investors utility, while still yielding positive returns after controlling for transaction costs. The distribution of hedge ratios and portfolio performance of a Bitcoin-BRI country hedged portfolio flattens after the country joins the BRI, indicating further research is needed to identify the underlying mechanism at work.

Partial gene sequencing for the bovine coronavirus at the World Genebank is available for many countries, which are distributed unevenly in five continents, but so far, no sequencing of strains has been recorded in Iran. One hundred ninety-four stool samples from calves with diarrhoea less than one-month old were collected from five different geographical regions of country in order to detect coronavirus and characterize it if coronavirus was found. Samples were screened for the presence of BCoV by using a commercially available ELISA kit. Furthermore, RT-PCR was carried out on positive samples for confirmation of the presence of N and S specific genes. Sequencing and phylogenetic analysis was carried out following RT-PCR tests. 7.2% of samples, were positive for BCoV and all stool samples from the South-West, Northeast and West regions of Iran were negative. The results showed that all the strains of coronavirus identified in Iran were completely in independent clusters and that they did not stand in the same cluster as any of the strains identified in other parts of the world. The strains from Iran were quite different from strains in other parts of the world but from the point of similarity these viruses showed some similarities to the European strains, such as those found in France, Croatia, Denmark and Sweden.

A diversity of strategies is evolved by RNA viruses to manipulate the host translation machinery in order to create an optimal environment for viral replication and progeny production. One of the common viral targets is the alpha subunit of eukaryotic initiation factor 2 (eIF-2alpha). In this report, we show that phosphorylation of eIF-2alpha was severely suppressed in human and animal cells infected with the coronavirus infectious bronchitis virus (IBV). To understand whether this suppression is through inhibition of protein kinase R (PKR), the double-stranded-RNA-dependent kinase that is one of the main kinases responsible for phosphorylation of eIF-2alpha, cells infected with IBV were analyzed by Western blotting. The results showed that the level of phosphorylated PKR was greatly reduced in IBV-infected cells. Overexpression of IBV structural and nonstructural proteins (nsp) demonstrated that nsp2 is a weak PKR antagonist. Furthermore, GADD34, a component of the protein phosphatase 1 (PP1) complex, which dephosphorylates eIF-2alpha, was significantly induced in IBV-infected cells. Inhibition of the PP1 activity by okadaic acid and overexpression of GADD34, eIF-2alpha, and PKR, as well as their mutant constructs in virus-infected cells, showed that these viral regulatory strategies played a synergistic role in facilitating coronavirus replication. Taken together, these results confirm that IBV has developed a combination of two mechanisms, i.e., blocking PKR activation and inducing GADD34 expression, to maintain de novo protein synthesis in IBV-infected cells and, meanwhile, to enhance viral replication.

BACKGROUND: The COVID-19 pandemic has caused overwhelming changes in individual and community daily-life, resulting from the public health measures implemented to contain it, and also from its psychological and socio-economic consequences. These shifts and consequences impacted the entire population, but some groups are more likely to be affected by these changes, including higher education students. OBJECTIVES: a) to investigate mental health status and its determinants among higher-education students in Portugal and Switzerland; and b) to explore adjustment patterns used by these students to overcome the impact of the COVID-19 pandemic. METHODS: A cross-sectional study with a mixed-methods sequential explanatory design was conducted in two phases. First, an online survey was conducted among higher education students in Portugal and Switzerland, in Portuguese and French respectively. A convenience sampling method was used. Second, some participants from the first phase were invited to participate in four online focus group discussions (two in each country) using a maximum variation sampling method. RESULTS: The survey was answered by 1,880 students. Portuguese students revealed higher levels of stress and anxiety, but lower depression symptoms and less resilient coping compared to Swiss respondents. Hope was identified as an explanatory variable for mental health symptoms in students from both countries. In the focus groups (n = 27), 13 adjustment strategies were found, which were subdivided into three spheres: personal, social, and contextual. CONCLUSIONS: The results suggest that the COVID-19 pandemic had a mild to moderate impact on most of the evaluated mental health variables. Nevertheless, the students reacted and mobilized positive short-term strategies, which need to be reinforced in order to prevent long-term psychological harm. In addition, our results can inform psychosocial interventions to minimize psychological impact, anxiety, depression, and stress due to sanitary crises or other population-wide problems or disasters.

Simulation-based learning is important for rare, high mortality cases, which are unlikely to be witnessed during clinical rotations but are likely to be encountered during future practice such as a subarachnoid hemorrhage. Neurology case simulations, especially those targeted at preclinical learners, are underrepresented in simulation pedagogy, and preclinical learners are underrepresented in a meta-analysis of the efficacy of simulation-based medical education. We designed a virtual simulation of subarachnoid hemorrhage for preclinical medical students, which can be implemented during restricted access to clinical learning. The simulation is 15 minutes long and requires only one standardized patient and one evaluator, which makes this simulation accessible to institutions with limited simulation resources. We adapted the validated questions from the Simulation Evaluation Tool - Modified for our post-simulation survey, which will detect the students level of confidence and their perceived learning post-simulation. The analysis of student experiences using this validated tool will contribute to the literature base surrounding the efficacy of virtual simulation as a training tool for preclinical learners.

The key purpose of this paper is to present an alternative viewpoint for combining expert opinions based on finite mixture models. Moreover, we consider that the components of the mixture are not necessarily assumed to be from the same parametric family. This approach can enable the agent to make informed decisions about the uncertain quantity of interest in a flexible manner that accounts for multiple sources of heterogeneity involved in the opinions expressed by the experts in terms of the parametric family, the parameters of each component density, and also the mixing weights. Finally, the proposed models are employed for numerically computing quantile-based risk measures in a collective decision-making context.

BACKGROUND Many series have shown the feasibility and safety of single-incision laparoscopic cholecystectomy (SILC), but this technique still has limitations such as instrument collisions and lack of triangulation. Recently, two single-incision platforms, robotic and SPIDER, have attempted to ameliorate such problems. This study aimed to compare three different techniques of single-incision cholecystectomy: standard laparoscopic, robotic, and SPIDER approaches. METHODS The authors retrospectively collected data from their first 166 single-incision robotic cholecystectomies (SIRCs) and compared the findings with the data from their first 166 SILCs and the first 166 s-generation SPIDER procedures. All the SILCs were performed with three trocars placed in one umbilical incision and with gallbladder retraction using a Prolene stitch on the right upper quadrant. All the robotic cases were managed using the da Vinci Single-Site Surgical System, and all the SPIDER procedures were performed using the SPIDER Surgical System. RESULTS The SILC, SIRC, and SPIDER groups consisted respectively of 129 (76.3%), 131 (78.9%), and 136 (81.9%) women with the respective mean ages of 44.5 14.3, 51.6 15.9, and 46.4 15.2 years. The mean body mass indexes (BMIs) were respectively 29.1 5.6, 29.4 6.2, and 27.5 4.8 kg/m(2), and the mean surgical times were 37.1 13.3, 63.0 25.2, and 52.8 18.7 min. The total hospital stays were respectively 1.3 5.3, 1.2 2.2, and 1.5 2.6 days, and complications were seen respectively in three SILC cases (1.8%), three SIRC cases (1.8%), and two SPIDER cases (1.2%). CONCLUSIONS The results of this study demonstrate similar results among the three platforms for most of the parameters measured. The SILC procedure appears to be superior to SIRC and SPIDER in terms of surgical time, but selection bias could be the cause. The SILS, SIRC, and SPIDER procedures all are similar in terms of complication profile. It can be concluded that SILC, SIRC, and SPIDER all are feasible and safe alternatives when used for single-incision cholecystectomy.

This study aims to determine the effect of the COVID-19 Pandemic on the financial performance of BUMN companies in the construction sector listed on the Indonesia Stock Exchange for the 2016-2020 quarterly period and its development based on the assessment contained in the Decree of the Minister of State-Owned Enterprises Number: KEP-100/ MBU./2002. This study uses technical trend analysis. In this study the population used is a state-owned company in the construction sector listed on the Indonesia Stock Exchange for the 2016-2020 quarterly period. There are four companies. The data collection technique used is documentation in the form of company financial reports for 2016-2020 and uses evaluation techniques based on the Decree of the Minister of State-Owned Enterprises Number: KEP-100/ MBU./2002. The study results based on trend analysis indicate that the COVID-19 pandemic influences the financial performance of BUMN in the construction sector in the form of a decrease in the company's financial performance. Penelitian ini bertujuan untuk mengetahui pengaruh Pandemi COVID -19 terhadap kinerja keuangan perusahaan BUMN bidang Konstruksi yang terdaftar di Bursa Efek Indonesia periode kuartalan tahun 2016-2020 dan perkembangannya berdasarkan penilaian yang terdapat di Surat Keputusan Menteri Badan Usaha Milik Negara Nomor: KEP-100/ MBU./2002. Penelitian ini menggunakan teknis analisis trend. Dalam penelitian ini, populasi yang digunakan adalah perusahaan BUMN bidang konstruksi yang terdaftar di Bursa Efek Indonesia periode kuartal tahun 2016-2020 terdapat 4 perusahaan. Teknik pengumpulan data yang digunakan adalah dokumentasi berupa laporan keuangan perusahaan tahun 2016-2020 dan menggunakan teknik evaluasi. Hasil penelitian berdasarkan analisis tren menunjukkan bahwa adanya pengaruh pandemi COVID-19 terhadap kinerja keuangan BUMN bidang konstruksi, berupa menurunnya kinerja keuangan perusahaan.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has rapidly spread throughout the world since December 2019 to become a global public health emergency for the elevated deaths and hospitalizations in Intensive Care Units. The severity spectrum of SARS-CoV-2 pneumonia ranges from mild to severe clinical conditions. The clinical course of SARS-CoV-2 disease is correlated with multiple factors including host characteristics (genetics, immune status, age, and general health), viral load and, above all, the host distribution of the airways and lungs of the viral receptor cells. In this review, we will briefly summarize the current knowledge of the characteristics and management of coronavirus disease 2019-pneumonia. However, other studies are needed to better understand the pathogenetic mechanisms induced by SARS-Cov-2 infection, and to evaluate the long-term consequences of the virus on the lungs.

The risk of vitamin D insufficiency in humans is a global problem that requires improving ways to increase vitamin D intake. Supplements are a primary means for increasing vitamin D intake, but without a clear consensus on what constitutes vitamin D sufficiency, there is toxicity risk with taking supplements. Chickens have been used in many vitamin D-related research studies, especially studies involving vitamin D supplementation. Our state-of-the-art review evaluates vitamin D metabolism and how the different hydroxylated forms are synthesized. We provide an overview with how vitamin D is absorbed, transported, excreted, and what tissues in the body store vitamin D metabolites. We also discuss a number of studies involving vitamin D supplementation with broilers and laying hens. Vitamin D deficiency and toxicity are also described and how they can be caused. The vitamin D receptor (VDR) is important for vitamin D metabolism. However, there is much more that can be understood with VDR in chickens. Potential research aims involving vitamin D and chickens should explore VDR mechanisms which could lead to newer insights with VDR. Utilizing chickens in future research to help with elucidating vitamin D mechanisms has great potential to advance human nutrition. Finding ways to increase vitamin D intake will be necessary because the coronavirus 2019 disease (COVID-19) pandemic is leading to increased risk of vitamin D deficiency in many populations. Chickens can provide a dual purpose with addressing pandemic-caused vitamin D deficiency: 1) vitamin D supplementation gives chickens added value with possibly leading to vitamin D-enriched meat and egg products; and 2) chickens use in research provides data for translational research. Expanding vitamin D-related research in chickens to include more nutritional aims in vitamin D status has great implications with developing better strategies to improve human health.