INTRODUCTION: Clinicians have faced unprecedented challenges in care delivery during the COVID-19 pandemic due to increases in patient volume/acuity, alongside fears of COVID-19 exposure. Increased burnout rates are associated with chronic health condition risk and adverse organizational outcomes. It remains unclear whether sleep is associated to burnout in clinicians treating COVID-19 patients. METHODS: A cross-sectional electronic survey was distributed via email across 3 hospital listserves from September to November, 2020. Clinicians delivering direct care to COVID-19 patients were eligible. Clinician burnout was measured using a single item from AHRQs Mini-Z survey. We assessed sleep using the Pittsburgh Sleep Quality Index (PSQI). Binary logistic regressions were used to determine the relationship between PSQI global score (global sleep quality) and burnout, controlling for age, race/ethnicity, gender, length of time employed, whether clinical role changed during COVID-19, and anxiety. In a separate model, we investigated the association between burnout and independent PSQI subcomponents: 1) sleep duration (Hours of sleep per night), and 2) subjective sleep quality (How would you rate your sleep quality overall) entered together, with the above covariates. RESULTS: The final sample included 315 clinicians, predominantly nurses (57% White, 15% Hispanic/Latino, 89% female). Burnout symptoms were reported by 61.6%, and poor global sleep quality (PSQI global score >5) in 84.4% of participants. Poor global sleep quality (PSQI global score >5 vs. 5) was significantly associated with the presence of burnout symptoms (OR: 2.52, 95% CI: 1.20C5.28, p=0.015). In the secondary model, self-reported sleep quality (rating of fairly or very bad vs. rating of fairly or very good) was significantly associated with burnout (OR: 4.13, 95% CI: 2.33C7.32, p<0.05), whereas short sleep duration (<6 h vs. 6 h) was not (OR: 0.726, 95% CI: 0.41C1.30, p=0.28). CONCLUSION: Poor sleep quality is common and associated with increased burnout in clinicians delivering care to COVID-19 patients. Interestingly, sleep quality appears to be more strongly related to burnout than sleep duration. Increased evidence about the negative implications of poor sleep and burnout are emerging. Interdisciplinary efforts aimed at promoting effective sleep quality in clinicians during this pandemic may lead to improvements in long-term clinician physical and psychological health. Support (if any):

Objective: The new coronavirus disease 2019 (COVID-19) is a major health problem worldwide. The surveillance of seropositive individuals serves as an indicator to the extent of infection spread and provides an estimation of herd immunity status among population. Reports from different countries investigated this issue among healthcare workers (HCWs) who are "at risk" and "sources of risk" for COVID-19. This study aims to investigate the seroprevalence of COVID-19 among HCWs in one of the COVID-19 referral centers in Makkah, Saudi Arabia using three different serological methods. Methods: In-house developed enzyme-linked immunoassay (ELISA), commercially available electro-chemiluminescence immunoassay (ECLIA), and microneutralization (MN) assay were utilized to determine the seroprevalence rate among the study population. 204 HCWs participated in the study. Both physicians and nurses working in the COVID-19 and non COVID-19 areas were included. Twelve out of 204 were confirmed cases of COVID-19 with variable disease severity. Samples from recovered HCWs were collected four weeks post diagnosis. Results: The overall seroprevalence rate was 6.3% (13 out of 204) using the in-house ELISA and MN assay and it was 5.8% (12 out of 204) using the commercial ECLIA. Among HCWs undiagnosed with COVID-19, the seroprevalence was 2% (4 out 192). Notably, neutralizing antibodies were not detected in 3 (25%) out 12 confirmed cases of COVID-19. Conclusions: Our study, similar to the recent national multi-center study, showed a low seroprevalence of SARS-Cov-2 antibodies among HCWs. Concordance of results between the commercial electro-chemiluminescence immunoassay (ECLIA), in-house ELISA and MN assay was observed. The in-house ELISA is a promising tool for the serological diagnosis of SARS-CoV-2 infection. However, seroprevalence studies may underestimate the extent of COVID-19 infection as some cases with mild disease did not have detectable antibody responses.

Planar UV-C LEDs still suffer from low efficiency, mainly due to substrate crystalline quality, p doped conductivity and extraction efficiency. One possible way to overcome partly these issues is to realize the whole UV structure on AlGaN pyramids by selective area growth in order to benefit from the advantages of such structures, i.e. the dislocation filtering and the semi polar planes. We present here a detailed study about the epitaxy of AlGaN nano-sized pyramids by metal organic vapor phase epitaxy (MOVPE) on patterned templates presenting different holes apertures and pitches as 1.5 m and 4 m or 100 nm and 250 nm respectively. While increasing the Al content, their height decreases while the thickness of the deposition on the mask increases whatever the design of the mask. Those changes of the pyramid shapes and deposition are directly linked to the properties of Al adatoms, i.e. low Al diffusion length. Using the conventional growth mode for the epitaxy of those pyramids did not permit the incorporation of Al from the base of the pyramids to their truncated apex. Its presence was concentrated on the edges and top of the pyramids. On the contrary, a pulsed growth mode, coupled with a strongly reduced pitch, allowed an incorporation of Al since the base of the nanopyramid, and a decrease of the deposition height on the mask. These results can be explained by the desorption of Ga species, due to the presence of H2 in the reactor chamber during the step without the metal precursors, leading to a higher Al/Ga ratio. It is even enhanced inside the holes by the reduced pitch.

Antibodies, and the B cell and plasma cell populations responsible for their production, are key components of the human immune systems response to SARS-CoV-2, which has caused the coronavirus disease 2019 (COVID-19) pandemic. Here, we review findings addressing the nature of antibody responses against SARS-CoV-2 and their role in protecting from infection or modulating COVID-19 disease severity. In just over a year, much has been learned, and replicated in independent studies, about human immune responses to this pathogen, contributing to the development of effective vaccines. Nevertheless, important questions remain about the duration and effectiveness of antibody responses, differences between immunity derived from infection compared to vaccination, the cellular basis for serological findings, and the extent to which viral variants will escape from current immunity.

BACKGROUND Occurrence of adverse drug reactions (ADRs) in COVID-19 patients has not been extensively studied. AIM The present study was conducted to analyze the pattern of suspected ADRs in COVID-19 Intensive Care Unit (ICU). METHODS In this cross-sectional study all the individual case study reports of patients admitted to the COVID ICU (August-October 2020) were analyzed for type of ADRs, system involved, suspected drug, onset time, time to revert and management. RESULTS Thirty six patients (out of 395 patients admitted) experienced 44 ADRs. Dermatological manifestations were the most frequent ADRs. Remdesivir was the most common drug associated with ADRs. The female gender, polypharmacy (>5 drugs) and presence of comorbidities were the independent risk factors for the occurrence of ADRs. CONCLUSION Use of many of these drugs in COVID-19 is experimental and literature does not guarantee the safety and efficacy. During these times of uncertainty, the results from present study reinforce the importance of monitoring patients.

Antigen tests for infectious diseases are inexpensive and easy-to-use, but the limit of detection (LOD) is generally higher than that of polymerase chain reaction (PCR) tests, which are considered the gold standard. In the present study, we combined a sandwich enzyme-linked immunosorbent assay (ELISA) with thionicotinamide-adenine dinucleotide (thio-NAD) cycling to improve the LOD of antigen tests for coronavirus disease 2019 (COVID-19). For recombinant nucleocapsid proteins of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the LOD of our ELISA with thio-NAD cycling was 2.9510-17 moles/assay. When UV-irradiated inactive SARS-CoV-2 was used, the minimum detectable virions corresponding to 2.6104 RNA copies/assay were obtained using our ELISA with thio-NAD cycling. The assay volume for each test was 100 L. The minimum detectable value was smaller than that of the latest antigen test using a fluorescent immunoassay for SARS-CoV-2, indicating the validity of our detection system for COVID-19 diagnosis.

The interaction between gas flow and liquid flow, governed by fluid dynamic principles, is of substantial importance in both fundamental science and practical applications. For instance, a precisely designed gas shearing on liquid solution may lead to efficacious production of advanced nanomaterials. Here, we devised a needleless Krmn vortex solution blow spinning system that uses a roll-to-roll nylon thread to deliver spinning solution, coupled with vertically blowing airflow to draw high-quality nanofibers with large throughput. A wide variety of nanofibers including polymers, carbon, ceramics, and composites with tunable diameters were fabricated at ultrahigh rates. The system can be further upgraded from single thread to multiple parallel threads and to the meshes, boosting the production of nanofibers to kilogram scale without compromising their quality.

The Covid-19 pandemic has spread across the world since the beginning of 2020. Many regions have experienced its effects. The state of South Carolina in the USA has seen cases since early March 2020 and a primary peak in early April 2020. A lockdown was imposed on April 6th but lifting of restrictions started on April 24th. The daily case and death data as reported by NCHS (deaths) via the New York Times GitHUB repository have been analyzed and approaches to modeling of the data are presented. Prediction is also considered and the role of asymptomatic transmission is assessed as a latent unobserved effect. Two different time periods are examined and one step prediction is provided

This study describes body weight changes among participants of the NutriNet Brasil cohort (n = 14,259) during the covid-19 pandemic. We analyzed data reported before the pandemic onset (01/26/2020 to 03/18/2020) and about six months after (09/14/2020 to 10/19/2020). Our results show that 19.7% of the participants gained 2 kg. Weight gain was directly associated with male gender, lower education, and previous presence of overweight, and inversely associated with age. In turn, 15.2% lost 2kg, being directly associated with male gender and previous presence of overweight and inversely associated with age.

BACKGROUND: Patients with severe mental illness (SMI) may be at increased risk for COVID-19-related severe morbidity and mortality. There is limited research on the vaccination rates against COVID-19 in patients with SMI. AIMS: The objective of the present study is to explore vaccination rates and co-relations in patients with SMI, attending community mental health services, namely the Mobile Mental Health Units (MMHUs) in rural Greece. METHOD: All treatment engaged patients with SMI (schizophrenia-spectrum or bipolar disorder) with two MMHUs (MMHU of Kefalonia, Zakynthos and Ithaca, [MMHU KZI] and MMHU of the prefectures of Ioannina and Thesprotia [MMHU I-T]) in rural Greece were enrolled prospectively over a six-month period. The MMHU I-T had adopted a more proactive approach to patients' vaccination, by informing patients and caregivers for its benefits. RESULTS: Data were analyzed for 197 patients with SMI. The overall vaccination rate was 68.5% and did not differ from the respective rates in the general population. There were no differences in vaccination rates among patients attending the two MMHUs, nor among patients with different diagnoses (schizophrenia spectrum disorders or bipolar disorder). Vaccination was not associated with gender, educational level, history of alcohol and substance abuse, illness duration, or number of previous hospitalizations, whereas the effect size of age was moderate. In more than half non-vaccinated patients the refusal to get vaccinated was associated with fears and concerns as well as false beliefs that are encountered in the general population. CONCLUSION: In the present sample of treatment-engaged rural patients vaccination rates against COVID-19 appear to be satisfactory. There were no differences in vaccination rates with regard to the interventions that were applied to enhance vaccination. It seems that other forms of intervention should be applied to reluctant patients to modify their attitudes toward vaccination.

Primary ciliary dyskinesis (PCD) is an autosomal recessive disorder associated with impaired mucociliary clearance caused by defects in ciliary structure and function. The major clinical feature of PCD is recurring or persistent respiratory tract infection. Respiratory tract colonization with drug-resistant organisms impact the frequency of infections and lung function decline. Protective gear has been employed by caregivers in an attempt to control respiratory tract bacterial spread between patients with cystic fibrosis but use in PCD is not known. We conducted a web-based survey to investigate infection control and prevention practices of PCD centers in North America. The response rate was 87.0%. Prior to the COVID-19 pandemic, glove, gown and mask use was variable, and only 3.7% of centers used masks during encounters with PCD outpatients. After COVID-19 mandates are lifted, 48.1% of centers plan to continue to use masks during outpatient care, while the practice regarding use of gloves and gowns was not influenced by the current pandemic. There is no uniform practice for infection control in PCD care indicating the need for practice guidelines. Mitigation of respiratory virus transmission learned during the COVID-19 pandemic may impact future infection control approaches used for patients with PCD and other lung diseases.

OBJECTIVES Investigate whether resting-state EEG parameters recorded early poststroke can predict upper extremity motor impairment reflected by the Fugl-Meyer motor score (FM-UE) after six months, and whether they have prognostic value in addition to FM-UE at baseline. METHODS Quantitative EEG parameters delta/alpha ratio (DAR), brain symmetry index (BSI) and directional BSI (BSIdir) were derived from 62-channel resting-state EEG recordings in 39 adults within three weeks after a first-ever ischemic hemispheric stroke. FM-UE scores were acquired within three weeks (FM-UEbaseline) and at 26 weeks poststroke (FM-UEw26). Linear regression analyses were performed using a forward selection procedure to predict FM-UEw26. RESULTS BSI calculated over the theta band (BSItheta) ( = -0.40; p = 0.013) was the strongest EEG-based predictor regarding FM-UEw26. BSItheta ( = -0.27; p = 0.006) remained a significant predictor when added to a regression model including FM-UEbaseline, increasing explained variance from 61.5% to 68.1%. CONCLUSION Higher BSItheta values, reflecting more power asymmetry over the hemispheres, predict more upper limb motor impairment six months after stroke. Moreover, BSItheta shows additive prognostic value regarding FM-UEw26 next to FM-UEbaseline scores, and thereby contains unique information regarding upper extremity motor recovery. SIGNIFICANCE To our knowledge, we are the first to show that resting-state EEG parameters can serve as prognostic biomarkers of stroke recovery, in addition to FM-UEbaseline scores.

: Obsolescence and vacancy are part of the traditional building life cycle, as tenants leave properties and move to new ones. Flux, a period of uncertainty before the establishment of new direction, can be considered part of building DNA. What is new, due to structural disruptions in the way we work, is the rate and regularity of flux, reflected in obsolescence, vacancy, and impermanent use. Covid-19 has instantly accelerated this disruption. Retail failure has increased with even more consumers moving online. While employees have been working from home, rendering the traditional office building in the central business district, at least temporarily, obsolete. This article reflects on the situation by reporting findings from an 18-month research project into the practice of planning adaptation in the English built environment. Original findings based on interviews with a national sample of local authority planners, combined with an institutional analysis of planning practice since the 1947 Town and Country Planning Act, suggest that the discipline of planning in England is struggling with the reality of flux. There is a demand for planning to act faster, due to the speed of change in the built environment, and liberal political concerns with planning regulation. This is reflected in relaxations to permitted development rules and building use categories. However, participants also indicate that there is a concurrent need for the planning system to operate in a more measured way, to plan the nuanced complexity of a built environment no longer striated by singular use categories at the local level. This notion of flux suggests a process of perpetual change, turbulence, and volatility. However, our findings suggest that within this process, there is a temporal dialectic between an accelerating rate of change in the built environment and a concomitant need to plan in a careful way to accommodate adaptation. We situate these findings in a novel reading of the complex adaptive systems literature, arguing that planning practice needs to embrace uncertainty, rather than eradicate it, in order to enable built environment adaptation. These findings are significant because they offer a framework for understanding how successful building adaptation can be enabled in England, moving beyond the negativity associated with the adaptation of buildings in recent years. This is achieved by recognizing the complex interactions involved in the adaptation process between respective stakeholders and offering an insight into how respective scales of planning governance can coexist successfully.

The severity of COVID-19 has resulted in a global rush to find the right antiviral treatment to conquer the pandemic and to treat patients. This requires reliable studies to support treatment. In a recently published study by Gautret et al. the authors concluded that hydroxychloroquine monotherapy and hydroxychloroquine in combination with azithromycin reduced viral load. However, this trial has several major methodological issues, including the design, outcome measure and the statistical analyses. In this paper we discuss the background, clinical evidence, pharmacology and methodological issues related to this clinical trial. We understand the rush to release results, however in case conclusions are far reaching the evidence needs to be robust.

Buffer solutions do not simply regulate pH, but also change the properties of protein molecules. The zeta potential of lysozyme varies significantly at the same buffer concentration, in the order Tris > phosphate > citrate, with citrate even inverting the zeta potential, usually positive at pH 7.15, to a negative value. This buffer-specific effect is a special case of the Hofmeister effect. Here we present a theoretical model of these buffer-specific effects using a Poisson-Boltzmann description of the buffer solution, modified to include dispersion forces of all ions interacting with the lysozyme surface. Dispersion coefficients are determined from quantum chemical polarizabilites calculated for each ion for tris, phosphate, and citrate buffer solutions. The lysozyme surface charge is controlled by charge regulation of carboxylate and amine sites of the component amino acids. The theoretical model satisfactorily reproduces experimental zeta potentials, including change of sign with citrate, when hydration of small cosmotropic ions (Na+, H+, OH-) is included.

[...]the burnout rate among health care workers was increasing even prior to the pandemic (Reith, 2018), suggesting that this increase may worsen stressors in an already strained workforce. Because health care workers represent those on whom we are relying most for their resilience within our communities worldwide, and because of the complexities of their current situation, it is vital to bring more attention to their experiences and needs at this time. The pandemic can result in a deterioration of family support structures and stress recovery routines outside of work, causing a disruption to the balance of work and nonwork norms on which health care workers may have relied. [...]the work environment changes during the pandemic may cause some nurses to experience a stronger sense of fit than before the pandemic. Career implications of PCE fit dynamics in health care Although some cases of enhanced fit are likely as described above, many health care workers may have preferred their work environment before COVID-19, where there were presumably lower levels of time pressure, stress, and fear of virus exposure.

PURPOSE: To examine the impact of the COVID-19 pandemic on the presentation and care provided to patients with acute ischemic stroke (AIS) at the emergency department (ED). METHOD: A retrospective-archive study was conducted between January-April 2020, compared with the parallel months in 2017-2019, in a comprehensive stroke center. We compared the time from symptoms onset to ED arrival, the number of neurologic consultations completed in the ED, patients diagnosed with AIS, patients receiving acute treatment and hospital mortality. RESULTS: During January-April 2020, we found an increase in the proportion of stroke patients arriving at the ED within 6 h of symptom onset: 68-100% per month during the study period, compared with 28-42% per month in the previous years. The number of patients admitted to the ED with suspected AIS declined by 41%, compared to the parallel period in 2019. An increase was noted in the number of patients diagnosed with AIS who underwent treatment, with the number of s endovascular thrombectomy increasing throughout the examined year. CONCLUSION: During the COVID-19 pandemic, we observed a significant decline in the number of AIS patients admitted to the ED. Paradoxically, we have seen an increase in the proportion of patients who arrived shortly after the onset of symptoms and received timely treatment. Future studies might investigate the medical mechanism and ramifications of this phenomenon.

OBJECTIVES: To examine associations between demographics, people's beliefs, and compliance with behaviours recommended by the UK government to prevent the transmission of the SARS-CoV-2 virus that causes COVID-19. DESIGN: A two-wave online survey conducted one week apart during the national lockdown (April, 2020). MEASURES: A sample of 477 UK residents completed baseline measures from the reasoned action approach (experiential attitudes, instrumental attitudes, injunctive norms, descriptive norms, capacity, autonomy, and intention) and perceived susceptibility for each of the following recommended behaviours: limiting leaving home, keeping at least 2 m away from other people when outside and when inside shops, not visiting or meeting friends or other family members, and washing hands when returning home. Self-reported compliance with each of the recommended behaviours was assessed one week later. RESULTS: Rates of full compliance with the recommended behaviours ranged from 31% (keeping at least 2 m away from other people when inside shops) to 68% (not visiting or meeting friends or other family members). Capacity was a significant predictor of compliance with each of the five recommended behaviours. Increasing age and intentions were also predictive of compliance with three of the behaviours. CONCLUSIONS: Interventions to increase compliance with the recommended behaviours to prevent the transmission of the SARS-CoV-2 virus, especially those relating to social distancing, need to bolster people's intentions and perceptions of capacity. This may be achieved through media-based information campaigns as well as environmental changes to make compliance with such measures easier. Such interventions should particularly target younger adults.

PURPOSE: To ascertain whether physical activity (PA) is associated with better sperm quality in sperm donors. METHODS: A prospective caseCcontrol study was designed in an IVF center setting. A total of 207 sperm donation candidates from a relatively small geographical area were included in the study with no intervention. Donor candidates were subjected to conventional sperm analysis according to WHO criteria. Moreover, they answered a standardized questionnaire regarding their last week PA (IPAQ), with PA expressed in metabolic equivalents (METs)-min/week. Donors were classified into 4 groups: low, moderate, high and very high PA. Specific sports were included in the questionnaire. Semen samples from 43 accepted donors were used in artificial insemination by donor (AID) and IVF. The fertilization rates (FR) and pregnancy rates (PR) were studied. RESULTS: Semen volume, sperm concentration, progressive spermatozoa, non-progressive spermatozoa, total motile progressive spermatozoa and sperm morphology were similar in the four PA groups. No correlation between various semen parameters studied and METs was found. Running or cycling > 1 h/week did not influence sperm parameters. The AID PR was similar in the different PA groups. However, in IVF the mean donor FR was significantly higher in the high PA group and in the very high PA group. CONCLUSIONS: No detrimental effect was associated with PA, or even very high PA, regarding conventional sperm parameters. Moreover, a better FR was associated with high and very high PA in IVF cycles, which merits more studies. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12958-022-00946-x.

Abstract The epidemic of the 2019 novel coronavirus (2019-nCoV) infection has presented as a critical period. Until February 23th 2020, more than 77 000 cases of 2019-nCoV infection have been confirmed in China, which has a great impact on economy and society. It has also interferred with ordinary medical practice of oral and maxillofacial surgery seriously. In order to protect oral and maxillofacial surgery medical staff from 2019-nCoV infection during the outbreak period, this paper suggests the necessary medical protective measures for oral and maxillofacial surgery outpatient and ward.