Medical Research Archives

Published by Knowledge Enterprises Journals
Online ISSN: 2375-1924
Print ISSN: 2375-1916
Publications
Vibrational optical coherence tomography (VOCT) has been used to non-invasively measure the resonant frequency and elastic modulus of different types of BCCs to compare the physical biomarker characteristics of each of these lesions. The results suggest that in very small lesions (about 0.05 mm in diameter) new 80Hz and 130Hz resonant frequency peaks are seen not present in normal skin or in healing wounds. In all other BCCs, new 80Hz, 130Hz and 260Hz resonant frequency peaks are found like those found in other carcinomas including SCC and melanoma. Small BCCS are characterized by new 80Hz and 130Hz in the absence of a significant 50Hz peak unlike actinic keratoses that are characterized by 50Hz, 80Hz and 130Hz peaks. In the absence of the 260Hz peak, small BCCs appear to be a precursor to larger BCCs. Pigmented BCCs exhibit a larger ratio of the 50Hz/80Hz peaks compared to the other BCC types in addition to peaks at 130Hz and 260Hz suggesting that benign melanocyte lesions contribute to the 50 Hz peak. Further studies are needed to understand the factors that drive differences in shape and invasiveness of cancerous BCCs. While all BCCs were found to contain new cell and blood vessel resonant frequencies that coincide with fibrotic tissue encapsulating the tumors in the papillary dermis, other factors must drive differences in the shape and invasiveness of the different BCCs. It is hypothesized that the new cells and blood vessels formed lead to the deposition of fibrous tissue in all BCCs and is partially driven by an epithelial-mesenchyme transition. It is concluded that fibrotic tissue is found encapsulating all cancerous BCCs and that this layer of tissue may limit invasiveness and metastatic behavior of this tumor type. In general, tumor shape and invasiveness are likely influenced by the exact cellular mutations in each lesion type and the extent of UV light damage experienced by the surrounding extracellular matrix.
 
Objective Adverse childhood experiences (ACEs) are associated with poor health outcomes in adulthood. We developed ACE risk profiles using a domain-specific approach and examined ACEs as risk factors for diagnosed physical and mental health conditions. Method A computer-assisted telephone survey was conducted with a random sample of adults in Alberta, Canada. Eight questions were asked on adversity during childhood, based on the original ACE survey and modified to reflect the Canadian context and research methodology. Descriptive and multivariable analyses were conducted. Results Among the 1207 respondents, the majority were married or living common-law (65.8%), had completed post-secondary education (78.2%), and were Caucasian (86.2%) with a mean age of 52.4 years (SD=16.3). Approximately one-third (27.3%) experienced at least one type of abuse, and almost half (49.5%) experienced at least one form of household dysfunction. ACEs were highly interrelated. Sixty-three percent fell into the low risk profile, with the remaining 37% divided among the three higher risk profiles. Overall, ACE risk profile was significantly associated with diagnosed mental health condition/addiction and chronic pain, controlling for sociodemographic characteristics. Conclusion The ACE risk profile of ACEs in both the abuse domain and the household dysfunction domain conferred the greatest risk for poor health outcomes in adulthood. Given the interrelated of ACEs, a more comprehensive approach to conceptualization of ACEs is warranted. Results have implications for prevention of ACEs and recovery from ACEs to decrease disease burden. Strategies may include effective programs to prevent exposure to toxic stress and support nurturing and stable relationships for children and families.
 
Resistance to clinical anti-androgens is an ongoing problem in the treatment of castration-resistant prostate cancer (CRPC). Although second generation anti-androgens demonstrate initial clinical benefit, patients often develop resistance to these therapies, evidenced by rising serum PSA levels and disease progression. Several mechanisms including the expression of androgen receptor (AR) splice variants contribute to the reactivation of AR signaling in drug-resistant prostate cancer. Novel therapies that target AR signaling and suppress growth in castration-resistant and anti-androgen-resistant prostate cancer are essential for the effective management of advanced disease. We developed a synthetic small molecule analog of mahanine, SH-I-125, a compound with the ability to disrupt androgen receptor signaling and induce apoptosis in castration-resistant and drug-resistant prostate cancer cellular models. SH-I-125 disrupted AR signaling and induced apoptosis in CRPC cells and anti-androgen-resistant prostate cancer cells in a manner more effective than clinical anti-androgens, enzalutamide and ARN509. Furthermore, SH-I-125 decreased full-length AR and its splice variant AR-V7 levels in 22Rv1 prostate cancer cells by a proteasome-dependent mechanism. These findings indicate the therapeutic potential of SH-I-125 in prostate cancer patients that have progressed on currently approved therapies for CRPC.
 
microRNA miR-126 was among the early discovered miRNAs that are expressed specifically in the vasculature and have critical functions in vascular development. Recent studies have started to unveil potentially important function of miR-126 in vascular diseases, including atherosclerosis, coronary artery disease, stroke and diabetic vasculopathy. The action of miR-126 reflects its function in angiogenesis and inflammation. The expression of miR-126 is downregulated in a variety of vascular diseases, and miR-126 overexpression appears to beneficial for most vascular disease models. In the minireview, we summarize the historic and current research regarding miR-126 function and mechanisms in the vascular system, its link to long noncoding RNAs (lncRNA), as well as the potential of miR-126-based therapeutics for vascular diseases. To explain the seemingly conflicting function of miR-126 from different studies, an integrated hypothesis is proposed that miR-126 has strand- and cell type-specific functions in angiogenesis and inflammation, making it beneficial in many different vascular disease models.
 
Latin Copies of the First Edition (1543) Vesalius Epitome in Europe
The purpose of this study is to confirm the locations of known copies and find previously unreported copies in most countries of the world of the first edition (1543) Epitome of De Humani Corporis Fabrica authored by Andreas Vesalius in Latin and the German translation. The locations of the two previous studies have been updated, and contacts were made at numerous institutions of higher learning, museums, and libraries. A total of 125 copies of the 1543 Epitome were recorded. Of these copies, 109 were present in a total of 82 universities and institutional libraries in the world. Besides confirming the presence of the Epitome at the previously recorded sites, we have found that 95 were published in Latin and 30 in German, all dated 1543 and one additional dated 1555. Private copies of the Epitome, which are very few (4%), were more difficult to locate.
 
The human immunodeficiency virus infection is endemic in Africa. The introduction of the antiretroviral treatment has changed the prognosis of this disease and increase the life expectancy of the infected patients. Therefore some of this patients may need orthopedic prosthesis indicated for trauma or advanced osteoarthritis. Infection is very common in this group of patients and this risk may be increased with the usage of prosthetic material. The objectives of this study was to determine the current management of these patients based on the reported literature and to assess the complications in this population compare to the general population. Material and Methods We have conducted a prospective chart review of the medical records of all HIV infected patients operated for a total hip arthroplasty in our service at the Central Hospital of Yaoundé. During this period, 62 Total hip replacements were performed. All patients supposed to undergo this procedure were previously screened in order to obtain their HIV status. The minimum follow-up period after surgery was 3 months. Operated patients were on HAART or they were naive. We noticed any complications. Results During the last 08 years, fifteen patients underwent surgery for total hip replacement. We made seventeen hips arthroplasties. Complications rate at short term and mean term was comparable to the non-infected HIV population. Discussion Several factors can promote osteonecrosis of femoral head. Do they influence the complications after surgery in the HIV positive population? Keys-words: Total hip replacement, H.I.V., Highly active anti-retroviral therapy, avascular necrosis of femoral head.
 
Umbilical cord pathology accounts for 20–25% of stillbirths worldwide. Recent publications suggest that stillbirths could be prevented by routine 18 – 20-week ultrasound evaluations that include the full anatomy of the umbilical cord from the placenta to the fetal umbilicus. This manuscript reviews our current understanding of this field and includes suggestions for the future.
 
SARS-COV-2 emerged as pneumonia of unknown etiology and transforming into global pandemic leading mass casualties globally. It leads to serious complications with a wide range of symptoms and laboratory and radiological abnormalities. Methodology: This retrospective study included 191 admitted patients was conducted between 15 April 2020 and 31 August 2020 at university of Lahore teaching hospital, Lahore, Pakistan. Baseline demographics, clinical, laboratory and radiological characteristics were compared amongst disease severity categories with One way ANOVA and comparison amongst recovered and non-recovered was carried out by independent t test, Fisher’s exact and chi-square test respectively. All data were analysed in SPSS 25 and p-value <0.05 was considered significant. Results: Out of 191 patients enrolled in this study, majority were male and above 50 year age. Fever (68%) was the most common symptom though dyspnea was statistically significant (p-value<0.05) and diabetes (41.4%) being the most common comorbidity. A statistical significant downtrend in eosinophil counts were observed in critical and severe disease from non-severe disease and similar trend was observed in non-recovered (died) patients than recovered. A significant rise in neutrophil to lymphocyte ratio, crp, ferritin and d-dimer were observed amongst critical and severe disease and non-recovered patients (p-value<0.05). Patients with eosinopenia had low survival proportion at day 5 and 10 than those with relatively normal eosinophil counts. Conclusion: Patients with advanced age, multiple comorbidities, elevated hematological, deranged coagulation markers presented with more severe disease and had poor outcome. In particular, eosinopenia can play key role in early diagnosis, disease severity recognition and disease surveillance as it is an independent risk factor for prognosis.
 
The presence of secondary bacterial infection is important in viral infectious disease. Influenza is known to become more severe with secondary bacterial pneumonia in particular when the Streptococcus pneumoniae and Haemophilus influenzae are co-infected, but with COVID-19, there are thought to be few concomitant bacterial infections. However, mortality in COVID-19 patients also increases with secondary bacterial infections, mainly Staphylococcus aureus such as MRSA and Gram-negative bacilli, and vigilance is needed. Consequently, there is a rising trend in prescriptions for antibiotics, but more appropriate diagnosis and antimicrobial stewardship are needed to suppress antimicrobial resistance, and vaccination will be the key strategy to prevent the severe viral infections related with secondary bacterial infection.
 
Since the very first medical use of dexamethasone (DEX) in 1958, this glucocorticoid (GC) has been widely used in various clinical applications. Compared to other GCs, DEX is highly potent and comes in multiple formulations for ease of local and systemic administrations. Recently, DEX has a new application for treating COVID-19 patients. DEX mainly inhibits expressions of inflammatory proteins and transcription factors necessarily for cell proliferation. DEX can both upregulate and downregulate expressions of the genes that facilitates anti- inflammatory effects and immunosuppression. Key proteins involved in DEX pathways are NF- B, AP-1, COX-2, and annexin A1. When used appropriately, DEX can minimize inflammatory pain and damage but it can also delay patient recovery by immunosuppression. Due to this duality, DEX should be used with caution for treatment considerations. Long-term systemic use could lead to debilitating adverse reactions and firm recommendations should be established in treating both acute and chronic disease with DEX.
 
Since the outbreak of the COVID-19 pandemic, there have been myriad signs and symptoms ascribed to this disease process. While some of the most notable features described since the initial months of the pandemic include cough, fever, myalgia, headache, dyspnea/hypoxia, anosmia, and multifocal pneumonia, the pandemic’s prolonged continuation has afforded ample opportunity to detect more subtle signs of the disease. Mediastinal adenopathy is one such sign that has been found in many patients with active COVID-19 infection, though the value of this finding in both prognostication and guiding treatment remains unknown. We did a timely brief review of mediastinal adenopathy in COVID-19 infection to shed more light on the potential implications of this finding. We conclude that Mediastinal Adenopathy in hospitalized COVID-19 patients has been associated with higher ICU admissions and higher mortality. Its non-specific nature and confounding etiology may prevent it from being a good marker for prognosticator of COVID-19 disease severity.
 
COVID 19 pandemic had a major impact on solid transplantation worldwide. This impact was felt more severely in resource constrained countries like India. In the initial phase of the pandemic, transplantation activities were halted. This was because of increased strain on the healthcare facilities by the pandemic and all non-urgent surgeries were disrupted. Also, there was concern among physicians about the risk of immunosuppression during the ongoing pandemic. After receiving guidance from national health authorities, transplantation activities were cautiously restarted. With increasing understanding about the pathophysiology of the viral infection transplantation activity increased over the months and both COVID- 19 infected individuals were accepted as donor and recipients. This was done after a thorough clinical, microbiological and radiological evaluation. Vaccination was made available early in India and guidelines for vaccination were adopted for all kidney transplant recipients. Like everywhere else, it was noted that vaccine efficacy was suboptimal in transplant recipients and breakthrough infections were common. COVID-19 associated mucormycosis was a unique feature during the second wave of the pandemic in India. It almost manifested as an epidemic and had devastating consequences in our country. This review aims to look at the response of Indian transplant physicians combating the COVID-19 pandemic in the last two years. Mention is also made about the mucormycosis infections (an epidemic within the pandemic) which was an important issue during the second wave of the pandemic.
 
We describe a rapid and reusable biophysical method to assay COVID-19. The method uses fluorescent sensors (i.e., molecular beacons) designed to detect a specific RNA sequence from COVID-19 but is general to any RNA of interest. The assay can be used concurrently with an internal control without the need for amplification. Molecular beacons are stem-loop structures in which a ~10 nucleotide loop region has the complementary sequence of a region of the target RNA, and a fluorophore and quencher are placed on the 5’ and 3’ ends of the stem. The energy of hybridization of the loop with its target is designed to be greater than the hybridization energy of the energy of the stem so that when the beacon encounters its target RNA, the structure opens resulting in dequenching of the fluorophore. Here, we designed a beacon to different COVID-19 variants that is completely quenched in its native form and undergoes a 50-fold increase in fluorescence when exposed to nanomolar amounts of synthetic viral oligonucleotide. No changes in intensity are seen when a control RNA (hGAPDH) is added. This increase in fluorescence with beacon opening can be completely reversed upon addition of single stranded DNA complementary to COVID-19 beacon loop region. Beacons can be attached to an inert matrix allowing their use and reuse in concentrated form and can be made from morphilino oligonucleotides that are resistant to RNases. We present an analysis of the parameters that will allow the development of test strips to detect virus in aerosol, body fluids and community waste.
 
The advent of Corona Virus in 2019 (COVID-19) pandemic in the world has become a health threat to government and challenge to the public. This led to the imposition of social distancing and lockdown policy aimed at preventing the spread of this pandemic among the populace. The submission to these policies may have intrinsic implications on the public, regardless of the public health benefits to be derived. This study aims at assessing the critical effects of social distancing and lockdown for COVID-19 on the residents of Oyo state in Nigeria. The designed questionnaire focused on residents’ perception of the COVID-19 and their attitudes towards social distancing and view on lockdown. Questionnaire administration among 1567 participants was through computer based online survey to avoid closed contact and maintain social distancing from the participants. The results submitted that no difference exist (P < 0.05) in terms of effects of social distancing and lockdown based on residents’ socio-economic attributes. The economic life, religious life, business and movement of people as well as the education of the students, relationship among colleagues and planned events are mostly affected by social distancing and lockdown. This will abate residents’ welfare, safety and limiting human right consequently threaten residents’ health and social insecurity as well as urban and regional economic implications. This helps to develop potential thoughtful strategies to alleviate public health catastrophe especially amongst informal settlements’ residents in Oyo state, Nigeria.
 
Purpose: Viral infections had been historically observed in chronic disease development and complications including although not limited to hepatitis C, influenza A, cytomegalovirus (CMV), Epstein bar virus (EBV), HIV and herpes simplex. Epidemiologic data had implicated CMV, herpes simplex and hepatitis C in type II diabetes (T2D). With the observed increased incidence T2D in COVID-19 among children and adults, this review aimed to examine scientific literature on immune and endocrine systems dysregulation in T2D and pancreatic neoplasm. Materials & Method: A qualitative systematic review (QSR) was utilized in assessing the immune system deregulation and endocrine system involvement in chronic disease development such as T2D. The PubMed was the main search engine in studies identification with several search terms such as “SARS-CoV-2 and T2D”, “COVID-19 and T2D”, SARS-CoV-2 and insulin resistant”, etc. Results: Viral pathogens such as CMV, influenza A, and herpes simplex and hepatitis C infections have been implicated in decreased insulin sensitivity (IS) and increased insulin resistant (IR). Similarly, these pathogenic microbes increased the T2D incidence and complications. SARS-CoV-2 a COVID-19 causative pathogen had been observed in increased risk and incidence of T2D among children and adults. While data are not currently available on the precise mechanistic process, SARS-CoV-2 viral infection in T2D incidence may be explained by excess pro-inflammatory cytokines elaboration (cytokine storm) resulting in increased IR and decreased IS, leading to glucose intolerance and T2D. Further COVID-19 may increase pancreatic neoplasm in populations with increased incidence of COVID-19, due to pancreatic beta cells and insulin receptors dysregulation and cellular dysfunctionality as abnormal cellular proliferation. Conclusions/Recommendation: SARS-CoV-2 a causative pathogen in COVID-19 morbidity is associated with increased incidence of T2D, which is explained in part by immune and endocrine system integration dysregulation, resulting in cytokine storm, decreased IS and increased IR, implying glucose intolerance and T2D. Additionally this pathogenic microbe may result in increasing incidence of pancreatic neoplasm, a malignant neoplasm with the worst prognosis and excess mortality due to late stage at diagnosis and marginalized biomarkers of susceptibility and morbidity.
 
  • Richard ThorleyRichard Thorley
  • Joshua Graeme-WilsonJoshua Graeme-Wilson
  • Katrina CurtisKatrina Curtis
Prone positioning has been demonstrated to significantly reduce mortality in invasively ventilated patients with moderate to severe acute respiratory distress syndrome through several physiological mechanisms, including optimization of ventilation and perfusion and a reduction in ventilator-associated lung injury. The marked increase of hospitalisation rates of patients with acute hypoxaemic respiratory failure during the COVID-19 pandemic, and associated strain on healthcare resources, led to interest in the use of prone positioning in conscious self-ventilating, or “awake”, patients, as an adjunct to the provision of oxygen therapy and respiratory support. The adoption of this technique was with the intent of reducing the likelihood of progressive respiratory failure and thus the need for invasive mechanical ventilation. In this review we summarize the background, physiological mechanisms and current evidence for the use of awake prone positioning in both COVID-19 related hypoxaemic respiratory failure and that attributed to other aetiologies. Whilst several studies note an improvement in respiratory parameters including oxygenation, the effect on clinically important outcomes such as rates of intubation and mortality remain unclear. The evidence base beyond COVID-19 related respiratory failure remains constrained and there is a paucity of evidence to help identify those most likely to benefit from this therapy. There remains no agreed consensus on how to implement awake prone positioning and significant variation exists in practice. Several clinical questions should be the focus for future research studies of this treatment modality including how to identify early responders and non-responders to therapy.
 
  • Maria ArshadMaria Arshad
  • Hadiqa JaleelHadiqa Jaleel
  • Saleem IqbalSaleem Iqbal
  • [...]
  • Farkhanda GhafoorFarkhanda Ghafoor
Many studies have identified various risk factors associated with Covid-19, for example, individuals with comorbidities are at an increased risk of contracting the disease and developing severe symptoms than those without comorbidities, however, these findings are inconsistent. This study identifies various risk predictors of Covid-19 patients with and without comorbidities. Data of Covid-19 patients was retrieved from Patient Digital Library of Shalamar Hospital, Lahore and encompassed patients’ gender, age, symptoms and severity besides other vitals. Data of total 1,639 patients who were admitted at Pulmonology Unit of Shalamar Hospital was examined. Out of this, 180 Covid-19 patients were recruited for final analyses as they were fully in accordance with the eligibility criteria framed for this study. Of these, 137 were suffering from comorbidities and the analysis revealed that these comorbidities had significant effect on the end result of the Covid-19 illness (P=0.002) i.e. the mortality rate among the patients with comorbidities was found to be 33.6% (n=46) and that of patients with no comorbidities was 9.3% (n=4). Likewise, the recovery rate of patients without comorbidities was significantly high (90.7%, n=39). However, interestingly, presence or absence of comorbidities had no significant impact on severity of the disease. Moreover, O2 saturation < 90% is predicted as a risk factor of severity whereas age > 59, presence of comorbidities and severe symptoms are found to be the risk predictors for the outcome of the disease being recovered or expired.
 
  • Hadiqa JaleelHadiqa Jaleel
  • Maria ArshadMaria Arshad
  • Saleem IqbalSaleem Iqbal
  • [...]
  • Farkhanda GhafoorFarkhanda Ghafoor
Background: Covid-19 outbreak is found to be associated with increased levels mental health issues among the general population. The high prevalence of fatigue, anxiety and depression was also reported in patients on hemodialysis during Covid-19 pandemic as compared to pre-pandemic studies. Aims: This article determines the level of fatigue, anxiety and depression due to the challenges faced by patients undergoing hemodialysis and their caregivers during the Covid-19 pandemic. Methods: This descriptive cross-sectional study was carried out in hemodialysis unit of a tertiary care hospital over the period of 3 months from August to October 2021, using validated questionnaire consisted of Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) and Hospital Anxiety and Depression Scale (HADS). Results: Among 115 patients (age; mean 53.45 ± 13.9 S.D), fatigue was seen in 80%, anxiety in 67%, depression in 82.6%. While in their caregivers, the prevalence of fatigue was 73.6%, anxiety was 52.7%, depression was 59.1%. Logistic regression analysis showed that gender and challenges e.g. feeling additional burden while visiting the hospital and fear of getting infection and feeling of isolation/loneliness were the main risk predictors of fatigue, anxiety and depression in patients and their caregivers. Conclusions: In Pakistan the prevalence of fatigue, anxiety and depression due to the challenges of Covid-19 pandemic was significantly high among patients undergoing hemodialysis and their caregivers as compared to pre-covid era. This study gives firm grounds for future researches, which should ascertain the suitable interventions to lessen the fatigue, anxiety, and depression due to the challenges of any future pandemic or epidemic among patients undergoing hemodialysis and their family members.
 
As the COVID-19 pandemic spread from the Far East throughout the world, while the inoculation was unavailable, countries introduced public health emergencies that engaged various non-pharmaceutical interventions (NPI). These restricted economic activity and private life. From the beginning, some countries at the source of the pandemic in the Far East implemented more comprehensive and restrictive NPI than Western countries. The former also experienced lower pandemic casualties. The United States of America (the U.S.) faced the first wave of the pandemic in April 2020, and by the end of 2021 recorded the largest nominal mortality in the world, ranking in the top 20 countries on the mortality rate per population. The country had pandemic plans in place and a capable healthcare system. This capability-mortality contrast motivated our investigation. The problem of confronting the pandemic has been studied by focusing on singular NPI. We took a more comprehensive approach by relying on a new research instrument labeled Pandemic Containment Strategy Index (PCSI) which covers 10 areas of NPI. Our investigation covered the period from the start of 2020 until May 31, 2021. We used two samples of American states and publicly available data sources, and covered the first pandemic wave (n=26 states) and the post-first wave period (n=9 states). We found that the U.S. restrictions on freedom of movement and business operations were in the mid-to-high range in the first wave, while the country underperformed in several NPI areas the PCSI addresses. Based on the PCSI classification of containment strategies, America's prevailing strategy was permissive. Central coordination was missing, tensions between medical and government authorities surfaced, and tests and protective equipment were lacking. In the post-first wave period, American states experienced additional and larger waves, while the strategic and operational problems continued. Our study contributes to understanding COVID-19 pandemic in the U.S. and the global context, and it has implications for the future study of the PCSI in particular and NPI in general.
 
The purpose of this paper is to investigate the impact that the coronavirus pandemic has had on people with disabilities and underlying health conditions by analysing their personal stories. The research questions explored in this paper are (1) what impact did lockdown have on disabled people’s mental health? and (2) were there any positive impacts of lockdown? To answer these research questions, 46 personal stories from the first year of the pandemic from March 2020 to March 2021, when restrictions were imposed on people’s lives, were selected from the internet to examine how lockdown and self-isolation impacted people’s lives. The data was analysed using two corpus software: first, LIWC (Pennebaker, Conglomerates, 2022), to see what the language reveals about people’s emotional struggles during the pandemic through analysing stylistic features such as the use of words for cognitive processes, emotional affect and personal pronouns; secondly, SketchEngine was used to search for keywords and to analyse concordance lines. The results from the data analysis reveals that paradoxically, while the first year of the pandemic has had a massive impact on mental health breakdown, it has also at the same time, given people the opportunity to find themselves and to explore avenues they would not have done, if not for the lockdown. The results also show that the duration of the lockdown had a severe impact on mental health, particularly anxiety and depression. In terms of language use, there was a high frequency of use of cognitive processes, first person singular pronouns and negative emotions. The high use of cognitive processes revealed that through their stories, the writers were reappraising and reflecting on the events they have experienced; the use of first person singular pronouns illustrated the self-focus of the writers and the negative emotions showcased their immersion in the events and the state of their mental health condition. The low number of positive emotions reveal the upheaval caused by the pandemic.
 
Worries about getting the virus and worrying about finances have been associated with negative mood states including anxiety and depression during COVID-19 lockdowns. In this Survey Monkey study conducted during a COVID-19 lockdown (N= 260 respondents), 88% reported worrying about getting the virus and 72% worrying about their finances. Correlation analyses suggested that worries about the virus and about finances were related to each other and were, in turn, positively related to scores on scales measuring COVID-related stress, negative mood states including anxiety and depression, fatigue, sleep disturbances, and posttraumatic stress symptoms. These problems were common to both types of worries as was the lack of health activities including exercise, self-care, and touching partners and children. Some findings were unique to each of the worries. Worrying about the virus was related to being active on social media, connecting with friends, and housekeeping and paperwork. Worrying about finances was correlated with caregiving, unemployment, less schooling, and alcohol use. The results of this survey are limited by the self-reported data from a non-representative sample that is cross-sectional. Nonetheless, they highlight the negative effects of worries about the virus and about finances during a COVID-19 lockdown.
 
Since late 2019, SARS-CoV-2 has differentially impacted geographies and population demographics as it spread. As of June 30, 2020, two hotspots within the United States of America—the states of Georgia and Michigan—exhibited similar numbers of cases while Michigan had over twice the case fatality rate (CFR) of Georgia. Given the similar populations, land areas, and pandemic timelines of these states, such a large difference is unexpected. The primary goal of this paper is to examine why Michigan experienced much higher COVID-19 mortality than Georgia, which may point to at-risk comorbidities and vulnerable populations. We examined publicly available data on demographics, rates of comorbidities, environmental factors, and other population differences at the state and local levels (the cities of Detroit, Michigan; Atlanta, Georgia; and Albany, Georgia) that have known or identified associations with health outcomes. We also outlined the timeline of the pandemic in each state to determine if the actions of state governments may have contributed to the observed difference in CFR. While the difference in state CFR may imply that Michigan handled the pandemic poorly, the data show that inherent characteristics of Detroit may have led to the higher statewide CFR. Notable differences between the states include elderly populations, agricultural statistics, and drinking habits. Notable differences between the cities included population density, health system quality, per capita income, race, education, media access, and air pollution. Hypertension (among blacks), diabetes (at the city level), chronic kidney disease, asthma, heart disease, and cancer differed in prevalence by location and were associated with increased severity and/or mortality of COVID-19. There were more deaths due to COVID-19 in African American communities and nursing homes in Michigan. A combination of these factors likely explains the differential impact between these two states.
 
Recently, the nasal cavity has been highlighted as an ideal route of administration for interventions as it is the portal of entry of the severe acute respiratory syndrome coronavirus (SARS-CoV-2). The present study aimed to demonstrate the feasibility and efficacy of intranasally administered Chlorpheniramine Maleate (CPM) spray to treat coronavirus disease 2019 (COVID-19). Methods: The present study used a two-phase, non-clinical to clinical approach. The non-clinical phase evaluated CPM’s antiviral activity against SARS-CoV-2 delta (B.1.617.2) strain via a highly differentiated three-dimensional in vitro model of normal, human-derived tracheal/bronchial epithelial cells. CPM was tested in duplicate inserts of the tissue models of the human airway. Virus yield reduction assays measured antiviral activity on day six after infection. For the clinical phase, COVID-19 symptomatic (polymerase chain reaction positive) patients were recruited and assigned to a 7-day CPM treatment (n=32) or placebo (PLB; n=13). Close safety monitoring of all patients was conducted before and after administering the drug. The primary outcomes monitored were time to symptom resolution (days), progression to hospitalization, emergency room visits, and symptoms of the severity of the disease using a visual analog scale (VAS) on a scale of 1-10 (no symptoms to worst symptoms). Results: The virus yielded a reduction in the assay such that the CPM solution log reduction value was 2.69 and Remdesivir 0.12, demonstrating much high antiviral activity of CPM. Results of the clinical phase demonstrate that VAS scores between the groups were evident after using CPM for two days (day 3). The CPM group VAS were significantly lower (P<0.001) starting from day three compared with day one. In contrast, there were no statistically significant (P>0.05) changes in the PLB during the 7-day treatment window. No subjects in the intervention group were hospitalized, while two in the PLB required hospitalization (15.4%; X2=5.15, P=0.023). Besides some mild discomfort felt by subjects immediately after applying the spray, the participants reported neither adverse reactions nor side effects. Conclusion: If taken together, the results of the present two-phase study point towards the conclusion that CPM is an antiviral agent that can be administered intranasally to treat COVID-19 effectively.
 
Since the first reports of a novel corona virus appearing in Wuhan, China, the expanding pandemic has been treated as an almost unique, unprecedented event. Both academic and popular reports have called it "unprecedented" and at best, "the worst in a century." A brief glance at history argues, however, that there is little unusual about COVID-19 except, perhaps, the rapidity of its global spread. Otherwise its clinical and social realities are familiar, similar to a host of epidemic and pandemic experiences throughout our history. What may be most notable is that our failure to recognize recurring patterns of infectious disease introduction and expansion has caused a general failure to recognize the root sources of microbial evolution and population invasion. And assuming its uniqueness today may prevent us from systemic changes to prepare for the next.
 
Background. The COVID-19 pandemic led to decreased physical activity, as well as increased stress, especially for pregnant women. Exercise is effective for decreasing stress and improving overall maternal and infant health. To date, research has not determined whether an at-home exercise program during pregnancy elicits similar results to in-person exercise. Objective. To examine the effect of in-person vs at-home moderate-intensity exercise training during pregnancy on maternal cardiovascular and birth outcomes during the COVID-19 pandemic. Methods. Pregnant women were recruited between 13-16 weeks’ gestation and randomized to either an exercise or control group. No control subjects were included in this analysis; exercisers were asked to complete at least 50-minutes of moderate-intensity activity 3 times each week either in-person (n=20) or at-home (n-17). Both groups were provided individualized exercise prescriptions including a 5-minute warm-up, 50-minutes of exercise related to group allocation, and a cool-down period. Maternal resting heart rate and blood pressure (BP) were recorded at 16- and 36-weeks' gestation. Gestational weight gain and birth outcomes were obtained via electronic health record at delivery. Results. From enrollment to late pregnancy, at-home exercisers have significant increases in systolic and diastolic BP (SBP and DBP, p<0.001 and 0.0003, respectively) whereas the in-person group did not (p=0.30 and 0.78, respectively). In-person exercisers had lower SBP and DBP in late pregnancy (p=0.04 and 0.01, respectively) relative to at-home exercisers. At-home exercise was correlated with higher late pregnancy SBP (r=-0.34, p=0.04), DBP (r=-0.42,p=0.01), and SBP change (r=-0.496, p=0.002). Group allocation was a predictor for late pregnancy DBP (p=0.007) and SBP change (0.036). There were no differences in infant birth outcomes. Conclusion. Supervised in-person exercise training with the proper precautions has similar birth outcomes and may be more beneficial for maternal cardiovascular health relative to at-home training.
 
Due to the ongoing COVID-19 pandemic, efforts to promote health and well-being by reducing harms related to alcohol misuse are likely to be adversely affected by changing sales and policy environments, as well as social distancing requirements imposed to halt virus transmission. In response, the AB InBev Foundation adapted an initiative originally developed to reduce harmful alcohol drinking in five global “City Pilot” demonstration sites that sponsored partnerships between local coalitions and public institutions to reduce alcohol-related harms. Little is known about the effects of a prolonged pandemic on access to alcohol, alcohol misuse and related harms, and ongoing interventions designed to prevent or mitigate these harms. Participants in Community Steering Committees (SteerCos) associated with each City Pilot provided information about the history of the project and the context of implementation during the COVID-19 pandemic. We found that, where feasible, the City Pilots adapted their in-person prevention strategies for online delivery. They also modified the purpose of a Foundation-sponsored fund that was originally intended to support community-based alcohol harm prevention efforts. As repurposed, this fund financed local COVID-19 prevention and emergency response efforts and generated goodwill with community partners.
 
To date, few report cases of spontaneous pneumothorax, pneumomediastinum and subcutaneous emphysema without any cause of trauma have been observed in patients with COVID-19 pneumonia. We present a case of a 66-year-old male patient who developed such complication on day 19 of hospitalization, without requiring non-invasive or invasive ventilator. CT thorax scan revealed widespread bilateral ground glass opacities with pneumothorax, pneumomediastinum, and subcutaneous emphysema, which were resolved totally on the following 29 days. We highlight preexisting mechanisms for pulmonary air-leak syndrome and importance of prompt recognition to establish adequate therapy in patients with COVID-19 pneumonia.
 
We analyzed data from a serological study performed on 2,765 samples from the Israeli National Sera Bank (INSB), established in 1997 in the Israel Center for Disease Control (ICDC) collected from children aged 0-<16 years during January 2020-March 2021. Trends in seropositivity rates to SARS-CoV-2 were evaluated using Joinpoint within specific age groups and compared to educational institutions activity. Seropositivity rates increased significantly in the 0-<6 and 12-<16 years age groups and were parallel in the 0-<6 years age group and partially parallel in the 12-<16 years to educational institutions activities. Non-significant increase in seropositivity rates were observed in the age groups 6-<10 and 10-<12 years. Apparently, exposure to SARS-CoV-2 in children was driven not only by educational activities but also by other factors.
 
The Covid-19 pandemic arrived abruptly and had a negative impact on the various sectors of society, including the educational field. The objective of this study was to know the influence of Covid-19 on the socio-emotional aspect of school communities in a Brazilian capital. A cross-sectional survey was carried out in the first year of the Covid-19 pandemic in the city of Fortaleza, Ceará, Brazil. The study took place in June and July 2020. A total of 172 directors of municipal and state schools responded to an electronic questionnaire. Issues related to the socio-emotional conditions of students, teachers, coordinators and other members of the school community were addressed. The results were described by means of frequencies, percentages, mean and standard deviation. The study showed that, in the view of school directors, the Covid-19 pandemic strongly and negatively influenced the socio-emotional aspects of students, teachers, coordinators and other professionals belonging to the state and municipal school community of Fortaleza. The teachings of the present pandemic serve as an example for facing future public health emergencies, as in the case of the next pandemic “X”. Mainly with regard to the formulation and implementation of consistent public policies for the school community, with special support for: mental and emotional health, health care and hygiene to face the pandemic, operationalization of digital information and communication technologies, developing communication and the network collaboration between schools, families and students, among others.
 
  • Senay AgcaSenay Agca
  • John BirgeJohn Birge
  • Jing WuJing Wu
We provide evidence that the COVID-19 pandemic has incentivized U.S. firms to rebalance the trade-off between manufacturing cost efficiency and supply chain resilience in their sourcing decisions. Over the past few decades, companies have been outsourcing production to low-cost countries such as China in pursuit of cost-efficiency. However, the risk of supply chain disruptions has been receiving heightened attention recently, as countries strive to prioritize scarce resources for domestic needs during the global pandemic. Our research shows that while China’s supply chain has proved resilient, U.S. companies have increased their access to medical supplies through domestic production. As a result, COVID-19 has highlighted the importance of local capacity and changed the traditional perception of outsourcing from a purely economic efficiency focus to one emphasizing the need to balance risks in global exposures.
 
The COVID-19 pandemic has significantly altered children's daily routines. The health impacts of our obesogenic environment are exacerbated by COVID-19. Many clinicians have concerns that the lack of structured activity, increased stress and altered eating behaviors would lead to increases in adiposity in children. The present study examined changes in body composition as a result of the COVID-19 pandemic in pediatric patients in larger bodies and demonstrates significant increases in total body fat, percent body fat (%fat), and BMI z-score, as well as markers of insulin resistance. In this retrospective, longitudinal study, body composition was measured by dual energy x-ray absorptiometry (DXA) within a multidisciplinary pediatric fitness clinic at an academic medical center. Visit dates were categorized into Pre-COVID-19 (before 4/1/2020) and Peri-COVID-19 (on or after 4/1/2020). Linear mixed effects modeling was conducted to evaluate changes in clinical and laboratory outcomes from Pre- to Peri-COVID-19. Baseline assessment was obtained from 650 patients with higher BMI scores (52% male) with a mean (SD) age of 12.3 (3.2) years. The adjusted mean BMI z-score (BMIz) was significantly higher in the Peri-COVID-19 sample when compared to the Pre-COVID-19 samples (2.31 vs. 2.25, P < 0.0001) which can be attributed to greater total fat mass (TFM) of 93.0 (90.0-96.4) lbs. (P = 0.007) and %FAT of 40.2% (39.2-41.2) as compared to the Pre-COVID-19 patients. The COVID-19 pandemic influenced social determinants and lifestyle factors. Most notable changes observed were negative changes in physical activity and screen time. The need for social isolation in a pandemic has resulted in worsening obesity and its comorbidities, and pediatricians need to be aware of this issue. The COVID-19 pandemic exerts disproportionate burden on children and families, magnifying their vulnerability to changes in body composition and chronic disease risk.
 
COVID-19-attributed case and death rates for the U.S.A. were analyzed through May 2020 in three ways – for all 50 states, the country’s largest counties, and the largest counties in California – and found to be statistically significantly higher for states and counties with compared to those without 5G millimeter wave (mmW) technology. 5G mmW index was a statistically significant factor for the higher case and rates in all three analyses, while population density, air quality and latitude were significant for only one or two of the analyses. For state averages, cases per million were 79% higher (p = 0.012), deaths per million were 94% higher (p = 0.049), cases per test were 68% higher (p = 0.003) and deaths per test were 81% higher (p = 0.025) for states with vs. without mmW. For county averages, cases per million were 87% higher (p = 0.005) and deaths per million were 165% higher (p = 0.012) for counties with vs. without mmW. While higher population density contributed to the higher mean case and death rates in the mmW states and counties, exposure to mmW had about the same impact as higher density of mmW states on mean case and death rates and about three times as much impact as higher density for mmW counties on mean case and death rates. Based on multiple linear regression, if there was no mmW exposure, case and death rates would be 18-30% lower for 5G mmW states and 39-57% lower for 5G mmW counties. This assessment clearly shows exposure to 5G mmW technology is statistically significantly associated with higher COVID-19 case and death rates in the U.S.A. The mechanism–should this be a causal relationship–may relate to changes in blood chemistry, oxidative stress, an impaired immune response, an altered cardiovascular and/or neurological response.
 
Analysis of U.S. counties revealed that political views were strongly related to COVID-19 deaths per 100,000 residents. Death rates were much higher in counties that strongly supported Trump in the 2020 presidential election than in counties where he received a lower proportion of the vote. The relationship between political views and COVID-19 deaths remained strong in regression models after other relevant variables were statistically controlled. The relationship between political views and COVID-19 deaths rates was especially strong after vaccines were generally available to the general public. Results from this study indicate that persons in Trump leaning counties tended to not follow the advice of health experts, including wearing masks, social distancing, and getting vaccinated against the COVID-19 virus. Such actions resulted in thousands of unnecessary deaths.
 
As countries worldwide struggled to contain the COVID-19 pandemic in March and April of 2020, observers often remarked that countries with higher levels of regime legitimacy, state capacity, and political trust were more likely to curtail the spread of the virus. Remarkably, using quantitative data from 10 different sources, this article finds that this generalizable theory runs counter to expectations. Countries with higher levels of political legitimacy, trust, and capacity experienced greater increases in COVID cases during the onset of the pandemic, albeit the strength of these relationships is modest. To develop generalizable theories predicting virus containment, researchers should turn their attention to unique factors characterizing industrialized democracies that make a virus much harder to contain and expand their scope by using transdisciplinary approaches to understanding the pandemic
 
The COVID-19 pandemic has brought on many challenges to everyday life. The pandemic caused many lifestyles changes with social distancing becoming essential to prevent the spread of the virus and ensuring the safety of individuals. The main concerns were the influence on physical activity levels. Lockdown measurements restricted access to equipment and facilities that affected rugby players' training needs. Universities turned to online learning requiring student-athletes to spend more screen time, leading to sedentary behaviour affecting overall performance and well-being. This study aimed to explore the influences of COVID-19 lockdown measures on physical activity levels, screen time usage, and sedentary lifestyle among rugby players at a university in the Western Cape. Ethics was obtained from the University of the Western Cape Humanities and Social Sciences Research Ethics Committee (HS21/5/20). An exploratory qualitative approach was followed. Online semi-structured interviews were conducted with ten rugby players (5 males, 5 females), purposefully selected from a historical disadvantaged institution in the Western Cape. Data collected were transcribed verbatim, and Atlas Ti V9 was used to conduct thematic analysis. Trustworthiness was ensured using member checks, building a coherent justification for themes, rich, thick description to give context to the study, and describing the behaviour and experiences of the participants to convey the findings in a way that was understandable. The main findings of this study are summarised in three themes (physical activity, sedentary behaviour and screen time use) and eight sub-themes that emerged from the data. The key findings showed that most participants struggled to remain physically active throughout the strict lockdown measures due to a lack of support from coaches and the closure of sports facilities. Participants were once that it caused a significant decrease in a player's level of physical activity leading to an increase in sedentary behaviour and screen time usage. The changing institutional landscape also caused players to spend more time online, contributing to the sedentary lifestyle. Support from coaches during pandemics or situations where social engagement is restricted is of the essence. This includes emotional support, exercise programs, and sourcing equipment for rugby players to remain physically active and fit.
 
Many lives were saved in high-risk populations through the rapid development of COVID-19 vaccines. However, further mutation of new viral variants has reduced vaccine efficacy. Here we provide a review of the literature on pros and cons of vaccination and boost vs. naturally acquired immunity in young healthy adults. Our research indicates (1) being vaccinated, even after booster shots, demonstrates limits to protection from infection and spreading of the COVID-19 variants. (2) Young healthy adults predominantly develop mild or no symptoms after infection with SARS-CoV-2 variants, particularly Omicron, as such vaccination is not necessarily needed to protect young healthy adults. (3) Sequential vaccination with booster injections has been associated with reports of autoimmune complications. Complications not as commonly seen after natural infection. (4) Numerous assessments have revealed immunity imprinted through natural infection and durable protection against COVID-19 variants thereby supporting choice to natural infection in some. We conclude that for the young healthy adults, some of the risks and disadvantages afforded by vaccination prevail over the medical benefits. Moreover, Omicron as was observed, caused mild upper respiratory tract infection, and appeared to act in young healthy adults as an ideal “natural vaccine” to induce herd immunity, which in effect will diminish new variant development and may reduce duration of future pandemics in combination with vaccination of elderly and immune compromised.
 
Purpose: COVID-19, a respiratory disease caused by SARS-CoV-2 indicates subpopulation differentials in cumulative incidence (CmI) and mortality. We aimed to assess the racial/ethnic and geo-clustering in COVID-19 CmI and mortality in Delaware. Method: A cross-sectional ecologic design was used to assess COVID-19 mortality in April, May and November 2020. The binomial and poison regression models were utilized for race/ethnic and geo-clustering risk prediction, respectively. Results: As per late April, CmI remains to be flattened in DE, with the confirmed SARS-CoV-2, n=4575 (47.5 per 10,000), Sussex county (SC), n=2,114 (111.4 per 10,000), Kent county, n=728 (41.8 per 10,000) and New Castle county, n=1,701 (28.7 per 10,000). CmI was highest for Non-Hispanic blacks (NHB), 27% (n=1250) but lowest among Asian/Pacific Islanders, n=61 (1%). The disproportionate burden of COVID-19 CmI was highest among Hispanics, 100.2 per 10,000. COVID-19 cases were more prevalent among NHB (30%) and Hispanics (19%). Mortality was higher among NHB, 1.70 per 10,000 compared to Non-Hispanic whites (NHW), 1.34 per 10,000. COVID-19 mortality differed by race, with NHB relative to NHW 27% more likely to die, risk ratio (RR)=1.27, 95%CI, 0.85-1.89. Geo-clustering indicated a significant 50% increased mortality risk in SC compared to DE, incidence rate ratio (IRR)=1.50, 95%CI, 1.11-2.03.During November, the case fatality rate (CFR) in DE was 27 per 10,000, while in the US, the CFR was 25 per 10,000. Conclusions: The Delaware COVID-19 CmI indicates disproportionate burden on NHB and Hispanics; case clustering disproportionate burden in SC; and the risk of dying was highest among NHB.
 
The index case of COVID-19 in Uganda was reported on 20th March 2020. The first confirmed imported case of COVID-19 in Kigezi sub- region South Western Uganda, where Kabale University is located, was reported on April 24th 2020. On August 2nd 2020 the first COVID-19 community case was recorded in the Kigezi Sub-region. Right from the early days of the threat of COVID-19 spread in Uganda, Kabale University put in place multiple mechanisms and interventions to contain the pandemic including: A COVID-19 Study Group: set up in February 2020 to study the disease, carry out risk assessment and advise the University on how to be prepared to handle cases if the disease were to reach the environment of the University. A multidisciplinary Kabale University COVID-19 Task Force: set up on 30th March 2020 to advise the University on preparations to ensure safe continuity of business at the university during a possible outbreak of COVID-2019 by designing and implementing appropriate infection prevention and control (IPC) measures, the Standard Operating Procedures (SOPs), for the University community. COVID-19 Knowledge Attitudes & Practice (KAP) Study –to inform planning for safe maintenance of business continuity at the university in the face of the COVID-19 outbreak. Following a national lockdown, the purpose of the study was to guide development of necessary measures to be undertaken to minimize the spread of COVID-19 among students, staff and visitors when re-opening of the University became imminent. The study revealed high levels of knowledge (84% correct rate of response); an overall positive attitude (77% positive rate of response); but only moderate COVID-19 preventive practices (68.8% correct rate of preventive practice). Knowledge was higher among male students (p=0.033); students older than 20 years (p=0.000); and students taking health related courses such as Medicine or Nursing (p=0.019). Attitudes about COVID-19 were better among female students (p=0.034); and in students older than 20 years (p=0.000). Age and sex are significant predictors of COVID-19 prevention practices (p=0.001, p=0.000 respectively). These findings informed the need for: Effective behavioral change communication: to alert the university and the neighboring communities about COVID-19. The strategies to be used to achieve this were; Internal memos to the university community through e-mail, social media and written notices placed in strategic areas, Radio talk shows through several FM radio stations in Kabale town and, Branded health literacy print-outs in form of posters, leaflets and brochures. Promotion of good respiratory and oral and hand hygiene – to discourage; haphazard spitting, ejecting or smearing nasal mucus on public places, sneezing or coughing in public without protection, and promotion of frequent handwashing. Random COVID-19 testing – One such test in June 2021 revealed positivity rate of 17.8% Development of the Kabale University COVID-19 Standard Operating Procedures. The order of personal prevention priorities emphasized in the SOPs were; face masking, hand washing with running water and soap or disinfectant, hand sanitizing with 70% alcohol and, keeping a physical distance of at least 2 meters from one another etc. With vaccination, this order has now been revised to give top priority to vaccination, although we still equally emphasize maintenance of the previous strategies.
 
Clinical trials that involve medical products are critical to advancing treatments in any medical field and are designed with careful thought and attention to detail. These details include careful assessment of safety parameters from patient safety visits, lab work and deliberately placed screening parameters. Meticulous planning for primary, secondary and correlative outcomes is completed by the study team and the biostatisticians involved in each study design. These precise measures are then methodically written as a clinical trial protocol and submitted to regulatory bodies such as the Food and Drug Administration (FDA) often as an Investigational Drug Application (IND) and also submitted to the Institutional Review Board (IRB) so that a study can have the appropriate regulatory approval to be tested for the desired outcome. The Principal Investigator (PI) and study team are required to follow these protocols and regulatory requirements with exactitude to maintain clinical trial integrity. While there are many models projecting variances in the timeframe of this pandemic, it is very possible that these modifications will be in place for months/years to come in varying intensities, so it is imperative that we understand them if we participate in clinical trials moving forward.
 
Background Coronavirus disease 2019, caused by SARS-COVID-19 has emerged as a pandemic. It usually causes severe respiratory disease. Characteristically it undergoes genetic variability and newer strains emerge as a result of genetic mutations or environmental factors. It makes it difficult to be treated. We used remdesivir in our hospital to treat covid-19 patients. The aim of our study was to evaluate the role of remdesivir in COVID-19 patients. Patients and Methods We conducted a descriptive cross sectional study on the patients admitted in the department of Medicine, Capital hospital, Islamabad, Pakistan from November 2020 to October 2021. All patients aged 14 years and above were included. Both SARS-CoV-2 positive patients by molecular biology and COVID suspected cases, selected on the basis of low oxygen saturation, deranged inflammatory markers, positive contact history and radiological findings with negative COVID19 PCR testing were included in the study. The data was compiled using Microsoft Excel and later was analyzed on SPSS version 24. Results Among 669 patients, 375 (56.1 %) were males and 294 (43.9%) were females. Median age of patients was 58.2 years. 349 (52.2%) were COVID PCR positive and 320 (47.8%) were PCR negative. Out of 669 patients 573 (85.7%) were discharged and 96 (14.3%) expired. Inflammatory markers before and after the treatment were measured with overall significant decrease (P-value 0.000) after treatment. Patients were divided into two groups, remdesivir given (n=436) and remdesivir not given (n=233). Hospital stay was of shorter duration among 249(57.6%) in remdesivir given group than in remdesivir not given group 183(42.4%). While evaluating outcome 370(64.6%) patients were discharged and 66(68.7%) expired in remdesivir given group and 203 (35.4%) patients were discharged and 30 (31.3%) expired in second group. Lactic dehydrogenase (LDH) level was raised (>480 U/L) in 378(68.5%) patients before taking remdesivir and was raised only in 209(47.9%) patients after taking remdesivir (P-0.027). Conclusion Our study revealed that Hospital stay was shorter (P-value 0.000) in remdesivir given group. There was no significant effect of remdesivir on patient’s outcome and mortality (P-value 0.250). Only Lactic dehydrogenase was significantly decreased (p-value 0.027) in remdesivir given group. Key words COVID-19, Remdesivir, outcome, Inflammatory markers
 
Health mis/disinformation can negatively impact health decisions and ultimately, health outcomes. Mis/disinformation related to COVID-19 vaccines has influenced vaccine hesitancy during a very critical time during the pandemic when globally, the vaccine was needed to attenuate the spread of the COVID-19 virus. This paper examines persuasive strategies used in Twitter posts, particular those with antivaccine sentiment. The authors developed a predictive model using variables based on the Elaboration Likelihood Model, Social Judgement Theory and the Extended Parallel Process Model to determine which persuasive tactics resulted in antivaccine, provaccine and neutral sentiment. The study also used machine learning to validate the persuasion variable algorithm to detect persuasion tactics in COVID-19 vaccine online discourse on Twitter. Understanding persuasive tactics used in antivaccine messaging can inform the development of a data-driven counter-response strategy.
 
From the initial outbreak in December 2019 in Wuhan, with the newly identified virus named “severe acute respiratory syndrome coronavirus 2” (SARS-CoV-2), different infectious variants have emerged, confirming the importance of preventive measures. Governments invest resources in information diffusion regarding the SARS-CoV-2 virus and variants and precautious measures. In public health emergencies and pandemic situations, trust is critical in risk communication and risk management and trusted information providers and communication channels may lead to certain desired behavior. Objectives: The focus of this research is to examine what information sources (providers and communication channels) the Greek generation Z cohort trusts, in information diffusion regarding the SARS-CoV-2 virus and the COVID-19 disease. It also examines if gender differences exist based on trust. Methods Eight information providers and six communication channels were tested for Gen Zers level of trust. An electronically distributed questionnaire collected data over a six-month period (N=1411) in 2020 (from June 1 to November 30, 2020), employing a nonprobability sampling method targeting the Generation Z cohort. Results Results reveal that the most trusted provider for COVID-19 related information are doctors and scientists, while the other unofficial information providers are more trusted than official. Published academic/scientific journals with COVID-19 related research is the most trusted communication channel. Gender comparisons for information providers uncovered seven statistically significant differences and one for communication channels.
 
This is an MBA project aiming to provide recommendation to a Principal in the hospitality industry wanting to start a global brand amidst a pandemic, which in certain parts of the world has evolved to become an endemic. Pandemic or not, Covid and its variants are global matters, thus of intimate concerns to a global brand development. The analysis will focus on both the macro (global) picture of the pandemic on the hospitality industry as well as a micro (regional) detail of the starting locality. This MBA project concentrates on the time period of Jan. 15- 31, 2022. The project asks the question: If we were to advise the launching of the brand given this 2-week intensive study of the issues involved, what are the pertinent information for the Principal to consider? Decision Intelligence interplayed with a partial SWOT analysis can inform the Principal of making crucial decisions. It is important to identify the Weakness(W) and the Threats (T) for a new brand in order for Strengths (S) and Opportunities (O) to nourish the growing of the brand.
 
Top-cited authors
Padet Siriyasatien
  • Chulalongkorn University
Apiwat Tawatsin
  • Ministry of Public Health, Thailand
Jenny Fairthorne
  • University of British Columbia - Vancouver
Nick de Klerk
  • University of Western Australia
Helen Margaret Leonard
  • University of Western Australia