Many universities and colleges worldwide suspended classroom teaching due to the novel coronavirus pandemic and switched to online teaching. The current cross-sectional study was carried out to analyze the impact of lockdown due to coronavirus disease 2019 (COVID-19) pandemic on the academic performance of veterinary medical students and researchers. Veterinary medical students and researchers were invited to answer an online google form questionnaire. A total of 1398 participants were from 92 different countries answered the questionnaire with response rate of 94.52%. The data showed that COVID-19 pandemic lockdown affected the academic performance of most participants (96.7%) with varying degrees. The mean evaluation scores for the online education in general was 5.06 ± 2.43 while that for the practical parts was 3.62± 2.56. Although online education provides an opportunity for self-study. The main challenge online education faces in veterinary medical science is how to give practical lessons. Since most of the subjects are practical; therefore, it is not easy to learn it online. Students think that it is difficult to fulfill the veterinary competencies only with online education system. Online education can be improved by making it more interactive, showing medical procedures in real situations, giving concise information, and providing 3D virtual tools to mimic the real situation.

The emergence of SARS-CoV-2 mutations pose significant challenges to diagnostic tests as these mutations can reduce the sensitivity of commonly used RT-PCR assays. Therefore, there is a need to design diagnostic assays with multiple targets to enhance sensitivity. In this study, we identified a novel diagnostic target, nsp10 gene, using nanopore sequencing. Firstly, we determined the analytical sensitivity and specificity of our COVID-19-nsp10 assay. The COVID-19-nsp10 assay had the limit of detection of 74 copies/mL (95% confidence interval: 48-299 copies/mL) and did not show cross-reactivity with other respiratory viruses. Next, we determined the diagnostic performance of the COVID-19-nsp10 assay using 261 respiratory specimens, including 147 SARS-CoV-2-positive specimens belonging to ancestral strain and Alpha, Beta, Gamma, Delta, Mu, Eta, Kappa, Theta and Omicron lineages. Using the LightMix E-gene RT-PCR assay as the reference method, the diagnostic sensitivity and specificity of the COVID-19-nsp10 assay were 100%. The median Cp values for the LightMix E-gene RT-PCR and our COVID-19-nsp10 RT-PCR were 22.48 (range: 12.95-36.60) and 25.94 (range 16.37-36.87), respectively. The Cp values of the COVID-19-nsp10 RT-PCR assay correlated well with those of the LightMix E-gene RT-PCR assay (Spearman’s ρ = 0.968; P<0.0001). In conclusion, nsp10 is a suitable target for SARS-CoV-2 RT-PCR assay.

The COVID-19 pandemic changed the world of medical education, moving it years ahead of time into the future. Many concepts needed to be changed, so did the methodologies. Nevertheless, clinical assessment remained tricky. This work highlights the outcome of the work of College of Medicine and Medical Sciences at the Arabian Gulf University in Bahrain in performing virtual clinical examination using Zoom™. Tips in this article are meant to help plan, implement and evaluate clinical assessments virtually.

At the beginning of 2023 the Italian former prime minister, the former health minister and 17 others including the current president of Lombardy region, were placed under investigation on suspicion of aggravated culpable epidemic in connection with the government’s response at the start of the COVID-19 pandemic. The charges revolve around the failure by authorities to take adequate measures to prevent the spread of the virus in the Bergamo area, which experienced a significant excess of deaths during the initial outbreak. The aim of this paper is to analyse pandemic data of Italy and Lombardy region in the first 10 days of the pandemic, spanning from the 24th of February 2020 to the 4th of March 2020. The objective is to determine whether the use early warning indicators could have facilitated the identification of a critical increase in infections. This identification, in turn, would have enabled the timely formulation of strategies for pandemic containment, thereby reducing the number of deaths. In conclusion, to translate our findings into practical guidelines, we propose a low-cost early warning method for infectious respiratory diseases with asymptomatic carriers.

Introduction: Suicide is the second leading cause of death among 15 to 19-years-olds in Europe. From the beginning of COVID-19 pandemic, literature confirms a significant increase in mental health disease in children and adolescents. At Bambino Gesù Pediatric Hospital emergency department (Rome, Italy) there was a dramatic increase of suicidal attempts, and particularly a rise of suicidal jumpers. Many of these patients presented vertebral fractures. Material and Methods: This retrospective study includes all suicidal jumpers with vertebral fractures treated at our Pediatric Hospital from April 1, 2017 to March 31, 2023. We collected and compared data from three years before to three years after pandemic spreading analyzing vertebral fractures. Results: From April 1 2019 to March 31, 2020 141 cases of suicide attempt arrived at Bambino Gesù Pediatric Hospital emergency department. Five of these patients were suicidal jumpers but none had a vertebral fracture. From April 1, 2020 to March 31, 2023, 362 cases of suicide attempts arrived in the same emergency department and 19 were suicidal jumpers; 12 reported vertebral fractures and were included in this study. Mean age was 14 years. Most common level of fracture was L1. Four patients presented with preoperative neurologic impairment and two cases recovered completely. There was a transforaminal sacral fracture, a spinopelvic dissociation and an Anderson-D’Alonso C2 type II fracture. Two cases with thoracolumbar vertebral fractures were conservatively treated. Seven patients were treated by percutaneous pedicle fixation to achieve an indirect decompression and to restore a better sagittal balance. Only three patients needed an open spinal surgery by posterior approach and in two cases a posterior decompression was performed. One case with cervical fractures was treated by Halo-Vest. Conclusions: Recent literature highlights concern about the consequences of COVID-19 pandemic on pediatric population mental health. This is the first report that shows a significant increase in vertebral body fractures due to suicide jumping attempt. The comparison between three years pre and post pandemic is sufficient to demonstrate a sharp increase of these cases. This could be a new epidemiological phenomenon that could persist or even increase over time because of COVID-19 pandemic.

Pandemic restrictions and reduced social opportunities led to increased loneliness throughout affected countries. Considering that stressful situations activate the attachment system and engage various coping strategies, the present study explored the role of attachment dimensions and coping styles in perceived social isolation and the subsequent effect on emotional distress. Data was collected using an online survey between the third and fourth waves in Romania during the second year of the pandemic. Correlational analyses presented significant relationships between all variables measured. Regression analysis showed that attachment insecurity could predict up to half of the variance in loneliness and one-third of emotional distress. Coping styles that predicted both loneliness and emotional distress were problem-focused and socially supported coping, though the effect was minimal. Emotion-focused coping presented a protective role against loneliness. Finally, moderation analysis revealed how loneliness fully mediated the relationship between insecure attachment styles and emotional distress. Further implications for research on loneliness, and pandemic resilience are discussed.

It is no news that the COVID–19 pandemic has affected many persons in different ways. As the number of reported cases rises across the globe, efforts are geared towards production and administration of effective vaccines for the disease. However, many developing countries are faced with the dilemma of how to slow the spread and flatten the curves of the disease as the available vaccines are not enough. Interestingly, the dynamics of the disease can be analysed to get useful insights to enhance the making of suitable preventive policies that will slow the spread, ultimately flatten the curves of the disease and also help in managing any future occurrence. In this work, the aim is to analyse the dynamics, and estimate the basic reproduction number of the second wave of the pandemic in Nigeria using a Susceptible-Infected-Recovered-Deceased (SIRD) compartmental–based model. The dynamics of the disease is described by a system of nonlinear ordinary differential equations. The model takes into consideration the current control policies in place - social distancing, mask usage, personal hygiene and quarantine. Available data provided by Nigeria Centre for Disease Control (NCDC), World Health Organization (WHO) and Wolfram Data Repository were used for the computations. The Quasi–Newton algorithm was implemented in fitting the proposed model to the available data and a sensitivity analysis was presented. Major parameters - effective contact rate, average recovery time, average mortality rate, and overall effectiveness of the control policies - influencing the dynamics of the disease, and the basic reproduction numbers were estimated. The turning points of the disease during the second wave were also obtained. The proposed model gave estimated values for the parameters influencing the spread of the disease. Also, the measure of the overall effectiveness of the current control policies gave insight into how effective the measures are.

The socio-economic benefits of globalization cannot be overemphasized. However, the global spread of infectious diseases has so followed a parallel course. The recent wave of pandemics with emerging new diseases has shown that no part of the world is immune from the spread of infectious diseases. COVID-19 like previous pandemics has exposed inadequacies of our healthcare systems and global capacity for prevention, early detection, and response in pandemic outbreaks. Given the highly interconnected global economy and the high potential for passim spread of infections, every nation must not only come up with concerted efforts to prevent and better prepare for pandemics, international solidarity and engagements will also be critical to ensure a long-lasting and sustainable solution. We are only as strong as our weakest health system, global support to strengthen all health systems around the world is the most effective way to be pandemic – ready. ‘All for one and one for all’.

The COVID-19 pandemic has presented the world with increased challenges. The response to this pandemic has led to a sudden disruption of routine medical and elective surgical care. Most hospitals across the globe have had to change the way outpatient clinics are carried out and postpone non-urgent elective surgical procedures. NHS England ceased all elective general surgeries to train and re-deploy their staff to support the increased pressures from COVID-19 in an intensive care setting. However, with a decline of reported cases and deaths, the return to undertaking non-urgent elective services is imminent. In May 2020, Radha and Afzal published the first evidence-based guidelines for the resumption of elective orthopaedic services titled “Evidence based suggestions for the return to elective orthopaedic surgery following the COVID-19 Pandemic”. The pathway presented is adapted from the “Evidence based suggestions for the return to elective orthopaedic surgery following the COVID-19 Pandemic” and could potentially be used as a model for other surgical specialities. We present a three-phased return back to urological services. Safe resumption of elective care is possible but needs to be carefully planned.

(1)Background: When the COVID-19 pandemic arrived, changes had to be made to several management aspects at our Pediatric Oncology Center. We investigated how the families per-ceived these changes. (2) Methods: Two questionnaires were developed at the Pediatric Oncology Unit of the Istituto Nazionale dei Tumori in Milan, to explore how the pandemic has affected the experience of patients who had been or were being treated at our hospital, and their families. These were administered to three samples of individuals. (3) Results: Between July and October 2020, 120 questionnaires were administered to parents of patients. The impact of school closures and the impossibility of attending sports and social activities outside the hospital were regarded as im-portant. 77.5% of parents judged the social distancing to have affected their children. Regarding the changes introduced in the management of the ward and outpatient clinic, most parents’ opinions were positive. Differences in the opinions expressed by Groups 2 and 3 were statistically significant on the topic of relationships on the ward and staff workload. The aspect most negatively affected by the pandemic was the support that patients’ parents were able to give each other. Regardless of whether patients were treated before the pandemic or after the first lockdown, their parents of all indicated a strong degree of satisfaction with the care received, and with the organizational ar-rangements. (4) Conclusions: The results of our study point us in the right direction to further improve our daily work and better respond to the needs of our patients and their families.

School closures (SC) were adopted globally as a COVID-19 disease pandemic containment strategy. This extreme measure provoked a disruption of the educational system involving hundreds of million children worldwide. The return of children to school has been variable and is still an unresolved and contentious issue. Importantly the process has not been directly correlated to the severity of the pandemic s impact and has fueled the widening of disparities, disproportionately affecting the most vulnerable populations. Available evidence shows SC added little benefit to COVID-19 control whereas the harms related to SC severely affected children and adolescents. This unresolved issue has put children and young people at high risk of social, economic and health-related harm for years to come, triggering severe consequences during their lifespan. In this article we describe the process of SC and the reopening timetable across the globe. We highlight the data regarding the international state of educational systems around the world, putting emphasis on the rights of children to come back to school.

This study is a two-phase hybrid study on the behavioral activities of undergraduate students during the COVID-19 pandemic lockdown. A questionnaire survey of students during the whole school period and a semistructured interviews with 13 undergraduates of different majors were conducted. First, we found that compared with primary and secondary school students, undergraduates showed many problems with self-time management. Second, the behavior of undergraduates at home may result from multiple factors, such as past experience, professional identity and behavioral habits. When secondary school provided a relatively relaxed learning environment or secondary school teachers placed more emphasis on continuous effort, and when students had a strong sense of the social value of their undergraduate major, students worked harder and achieved more during the pandemic. Otherwise, it was easier for students to slack off and be passive during the pandemic. Altogether, this study deepens our understanding of undergraduates' self-management of free time, and the differences in the values underlying different behaviors and the formation process of various behaviors.

The challenge of accessing finance by entrepreneurs from traditional financial sources is pervasive. The COVID-19 pandemic further exacerbated the problem of limited access to finance from banks. Against this backdrop, the objective of the study was to determine the factors driving crowdfunding success during the COVID-19 pandemic in Africa. The ordinary least squares (OLS) and probit regression models were estimated to analyse 216 crowdfunding projects in Africa. The results of the study documented that targeted amount (TA), and COVID-19 pandemic were negative and significant drivers of crowdfunding success. Furthermore, comments (CMM) and duration (DRN) were negative and significantly affected crowdfunding success. Conversely, images (IM), videos (VD), backers (BCK), and updates (UPD) were positive and significantly affected crowdfunding success. The study contributes to the body knowledge by investigating the drivers of crowdfunding success during the COVID-19 pandemic period which hitherto had not been researched on extenisvely.

SMEs constitute the backbone of the Syrian economy which have suffered manifold challenges due to the continuous Syrian war. Covid-19 added further pressures on Syrian SMEs and force them to take certain adaptation strategies to survive. This paper aims to investigate the main challenges that face Syrian SMEs during the pandemic and illustrate how they respond to adversities emerged from governmental intervention to control the spread of the virus. It also discusses the measures initiated by the government to support SMEs during the pandemic. Through interviewing persons from the Syrian SMEs ecosystem, we find that high interest rates on SMEs loans, decline on demand as well as high inflation represent the main challenges. SMEs respond to these challenges by marketing products online, stock procurement, and strengthen connections with stakeholders. We recommend the Syrian authorities reduce lending rates and increase loan size available to SMEs to help them overcome the pandemic adversities. Moreover, SMEs will immensely benefit from training on digital tools to enhance their expansion and survival opportunities. Furthermore, bazars should be organized around the year to give SMEs the opportunity to gain continuous access to markets. In addition, incubation services should be revised, particularly, to SMEs with great potential to grow to create the suitable environment for them to scale and flourish.

The Covid-19 pandemic caused very serious problems almost to the whole world, so every opportunity must be considered to improve the situation. Decontamination carried out from the air can also be considered for surface clearance of larger areas, so the possibility of this application should also be investigated regarding pandemic. There are many examples of the use of drones for disinfection to improve the epidemic situation, but good practices, as well as factors influencing the effectiveness, have not yet been identified. In the case of using drone for disinfections during a pandemic, based on the reports, we can clearly discover the adapted use of agricultural drones. In this paper, the authors perform calculations with different values of flight speed (10 to 50 km/h), flight altitude (1 to 5 m), and flow rate (1 to 5 l / min) to determine the possible amount of disinfectant fluid per unit area. The results show that by changing the parameters, the amount of disinfectant per unit area can be given within quite wide limits (30 - 0.24 g/m2). Although the results raise many new questions it can help to identify adequate flight parameters depending on different disinfectant liquids.

Background: The COVID-19 pandemic has hit the Spanish economy hard. The result is an unprecedented economic and social crisis due to uncertainty about the remedy, and due to the socio-economic effects on people’s lives. Methods: We performed a retrospective analysis of the macro-economic impact of COVID-19 in 2020, using the principal indicators of the Spanish economic and productive model. National statistics were examined in the search for impacts or anomalies occurring since the beginning of the pandemic. To estimate the strength of the impact on each of the indicators analysed, we used Bayesian structural time series. Results: In 2020, the cumulative impact on the Gross Domestic Product was of -11.41% [95% credible interval: -13.46; -9.29]. The indicator for Business Turnover fell by -9.37% [-12.71; -6.07]. The reduction in business activity was related to the sharp fall in demand. The Spanish employment market was strongly affected; our estimates showed a cumulative increase of 11.9% [4.27; 19.45] in the rate of unemployment during 2020. The autonomous communities which are economically the most heavily dependent on the services sector were those which recorded the worst indicators. Conclusions: Our estimates portray a dramatic situation in our country, and show all too clearly the fragility of a productive system which has to make the behavioural changes that are necessary to confront the COVID-19 pandemic.

Neuropsychiatric manifestations of COVID-19 include delirium, general malaise, headache, and psychiatric symptoms. These manifestations are related to the neuroinflammatory response to viral antigens and proinflammatory mediators/immune cells. Tetracyclines, such as minocycline, have antibacterial and anti-inflammatory properties. Saiko-keishi-to, a traditional Japanese Kampo medicine, also has anti-inflammatory properties. Given the anti-inflammatory properties of minocycline and Saiko-keishi-to, we describe two cases of COVID-19 with prolonged headaches and general malaise successfully treated with these medications.

The epidemic of Coronavirus Disease 2019 (Covid-19) has brought many changes to people's life. This study aims to analysis Chinese people's psychological change and life after quarantining Wuhan and explore the influencing factors. Based on data from a web-survey after quarantining Wuhan (N=3268), the principal-component-analysis (PCA), multiple-linear-regression (MLR), propensity-score-matching (PSM) were used to explore the psychological change of people in China and the influencing factors. 83.3% of the respondents said that the impact of the epidemic on their life had increased after quarantining Wuhan. A considerable proportion of people's anxiety increased, being reflected in negative emotion, behavioral response and physiological response. The proportion of people who said their anxiety had increased in Wuhan was higher than that in other regions (p <0.05). The anxiety of people who were in medical isolation increased less than those who were not (p <0.05). All three aspects of people’s anxiety were positively related with time of medical isolation and degree of the attention on the epidemic (p＜0.05) except the effect of attention degree on the physiological response (p＝0.06). The measure of medical isolation at home should be advocated. Yet people should reduce the concern for the epidemic while paying attention to self-protection.

late in December 2019 2019-nCoV was identified as the pathogen responsible for an outbreak of severe respiratory distress in Wuhan, China. The virus was detected in multiple countries during January, but it is believed widespread community transmission began late in February or early March. Since March the virus has caused over 100k confirmed deaths in the US, with some states more severely impacted, notably NY and NJ. Here I examine excess mortality at the national and state level from January through July 2020. I find that the increase in excess mortality began in late February, suggesting the pathogen was circulating undetected earlier than assumed. The timing and intensity of the increase in excess mortality varied across states, with two patterns emerging: an early, sharp increase reaching a peak during April-May, best exemplified by NY and NJ, and a shallower, sustained increase, reaching a peak in late July, observed mostly in the southern regions of the US.

Objective: The aim of our study was to perform a retrospective analysis of the volume of cervical screening tests, the number of patients treated with an excision method, and the incidence of invasive and non-invasive cervical during a pandemic and pre-pandemic period of 24 months. Results: There was a statistically significant age difference between the two study periods, both by the average age of patients and by age group. The mean difference was 32 years before the pan-demic and 35 years during the pandemic (p-value >0.05). The majority of patients presenting for investigations before and during the pandemic were in the 30-39-year-old age group (31.95%, respectively; 34.2% (p-value = 0.003). The biggest patient loss ratio identified by age group was in the 50–59 years: 14,53% in the pre-pandemic period and 9,1% in the pandemic period. In the pan-demic period, patients from rural areas presented in the clinical trial with a lower rate of 39.52% (83 patients) vs. 60.47% (127 patients) in urban areas. A higher percentage of patients experiencing cervicorrhagia as a clinical manifestation in the pandemic period vs. the prepandemic period, with an increase in more severe lesions in the pandemic period, has a statistical significance of 8% more newly diagnosed compared to the pre-pandemic period. Conclusion: The addressability of the patients during the COVID period was not affected in a drastic way in our study. We encountered a decrease in appointments in the age group 50–59 years and a decrease in patients with rural residence. In our study, we found an increase in cervicorrhagia as a reason for consultation in the pandemic period with a higher lesion degree, both on a pap smear and on a cervical biopsy.

In response to the COVID-19 crisis, decisionmakers in countries around the world adopted policies such as lockdowns, mask requirements, and once vaccines became available, vaccine mandates and vaccine passports. However, political polarization and differences in risk perceptions in the populous generated strong support for and opposition to such measures. This research identifies the factors with support for and against vaccine mandates and vaccine passports. An online survey of COVID-19 health experiences in the United States population was conducted. The survey collected information regarding potential reasons for why respondents might favor or oppose COVID-19 vaccine mandates and vaccine passports, including experiences with COVID-19 illness and COVID-19 vaccinations by respondents and those in their social circles. Analysis using a Logit regression technique was conducted to identify factors influencing the likelihood of opposing vaccine mandates and vaccine passports. The survey was completed by 2,840 participants between December 18 and 23, 2021. Respondents who knew someone who experienced a health problem following vaccination were more likely to oppose vaccine mandates (OR: 2.040, 95% CI: 1.635-2.254, and vaccine passports (OR: 1.691, 95% CI: 1.361-12.101)) Twenty-two percent (612 of 2,840) of respondents reported that they knew at least one person who had experienced a health problem following COVID-19 inoculation. Perceptions of vaccine safety based on personal experiences appear to be an important determinant of opposition to vaccine mandates and vaccine passports.

Majority of published articles have talked about the challenges faced by students in learning online however, little has been talked about what the teachers have gone through especially during these times of the pandemic. This paper discusses the factors university teachers face when teaching online. These factors include accessibility to the internet, level of interaction between teachers and students, costs incurred, availability of training and academic policies kept in place to enhance effectiveness of teaching online. These are further divided into personal, social and economic factors where the teachers’ age, gender, remuneration, availability of resources, location and the economic status of the country is discussed in relation to the effectiveness of online learning. Upon carrying out a literature review on articles written on the effectiveness of online learning with the main focus being teachers, it was noted that the main factors affecting the effectiveness of online learning was the availability of internet connection and training provided to teachers. In Kenya, majority of the rural areas lack access to the internet and devices to learn online which makes it difficult for a teacher to teach effectively given the pandemic constraints. This study sheds light on the need for institutions and governments to take input from their teachers and train them on how to make online learning more effective. It also shows the status of universities in Kenya which had to shift to learning online due to the pandemic. Majority of them took time to adapt to this new change due to the discussed factors. Therefore it is recommended that the Government should train teachers and address the issue of lack of internet and electricity in Kenya.

The issues mothers face in the academy have been discussed for decades. Routinely, new studies report significant differences between women and men at comparable career stages with respect to salary, service demands, publications, grant submissions, and overall funding rates. The COVID-19 pandemic is further exposing these inequalities as women scientists who are parenting while also engaging in a combination of academic related duties are falling further behind. COVID-19 is shaking the very foundations of our society and laying bare the many inequalities that defined our pre-COVID world. We can solve these inequities by investing strategically in creative solutions, thereby making the most of women’s contributions to scientific endeavors. Here we describe strategies that would make the academy more equitable for working mothers now and into the future. Importantly, while the data are clear that mothers are being disproportionally impacted by COVID-19, many groups could benefit from these same ideas. Now is the time to act. Rather than rebuilding what we once knew, let us be the architects of a new world.

Importance: The rapidly expanding 2019 novel coronavirus pandemic (COVID-19, caused by the SARS-CoV-2 virus) has challenged the medical community to an unprecedented degree. Physicians and healthcare workers are at added risk of exposure and infection during the course of the patient care. Due to the rapid spread of this disease through respiratory droplets, healthcare providers such as otolaryngologists-head & neck surgeons who come in close contact with the upper aerodigestive tract during diagnostic and therapeutic procedures are particularly at risk. Here we present a set of safety recommendations based on our review of literature and communications with physicians with first-hand knowledge of safety procedures during the 2019 COVID-19 pandemic.Observations: A high number of healthcare providers were infected during the first phase of the pandemic in Wuhan province. Subsequently, by adopting strict safety precautions, other regions were able to achieve high levels of safety for healthcare providers without jeopardizing the care of patients. We reviewed the most common procedures related to the examination and treatment of upper aerodigestive tract diseases. Each category was reviewed based on the potential risk imposed to healthcare workers. Specific recommendations were made, based on the literature, when available, or consensus best practices. Specific safety recommendations were made for performing tracheostomy in COVID-19 patients. Conclusions and Relevance: Preserving highly skilled healthcare work force is a top priority for any community and healthcare system. Based on the experience of healthcare systems in Asia and Europe, by following strict safety guidelines, the risk of exposure and infection of healthcare providers could be significantly reduced, while providing high levels of care. The provided recommendations could be used as broad guidance for all healthcare workers who are involved with the care of COVID-19 patients.

This research investigates a model for the COVID-19 outbreak in Indonesia by analyzing comorbid diseases, self-quarantine, government-provided quarantine, and immunization regimens. Some model parameters are derived from academic journals, others are extrapolated from data collected by the Indonesian Ministry of Health in 2020, and others are assumed. Evaluation of the model reveals non-endemic equilibrium points, endemic equilibrium points, and the basic reproduction number (BRN). The contact rate and infected probability factors impact the increase in the number of COVID-19-infected individuals with comorbid disease within a group. According to the sensitivity analysis of the BRN, the key parameters impacting the spread of COVID-19 are the rate of susceptible recruitment, the rate of contact, the COVID-19 infection death rate, and the likelihood of infection. In addition, sensitivity analyses are provided to examine the effect of parameter changes on subpopulations. We discovered that the natural death rate is the most sensitive parameter based on the sensitivity index after reaching equilibrium. Symmetry aspects appear in some of the visualization of the model’s solution and the BRN and parameters’ sensitivity.

The COVID-19 pandemic has severely affected the food supply chain, including producers, retailers, wholesalers, and customers. To minimize the impacts caused by pandemics and epidemics on food supply chains, it is fundamental to implement effective policies that ensure continuity in the provision, affordability, and distribution of basic food items. This research aims to identify the main impacts of pandemics and epidemics on food supply chains and policies that can minimize these impacts. Based on a systematic literature review (SLR), 174 documents are analysed to propose a taxonomy of impacts on four supply chain links: demand-side, supply-side, logistics and infrastructure, and management and operation. The taxonomy presents the main impacts, as well as the respective mitigation policies simultaneously. In addition, the literature review leads to the development of a comprehensive causal loop diagram (CLD) with the identification of main variables and their relationship with food supply chains. Finally, a specific research agenda is proposed by identifying main research gaps. These findings provide a structured method for evaluating policies that ensure the functioning of food supply chains, particularly in disruptions such epidemics and pandemics.

This paper aims to contribute to the advancement of scientific knowledge about the impact of the COVID-19 pandemic on social workers and the social work profession in Romania. Research has shown that social work is a profession at high risk for developing the burnout syndrome, which has many detrimental effects on both social workers and the clients that they serve. Two conceptual models are used to frame the discussion: the theoretical framework of VUCA (volatility, uncer-tainty, complexity, and ambiguity) to discuss the challenges of the unprecedented context the COVID-19 pandemic has created for social workers; stress and burnout to explain the negative impact of this period of time. Based on convergent mixt methods, the study sample consisted of 83 social workers employed in statutory and private social services in Romania, from different fields of intervention. Results show that 25,3% of respondents suffer from a high level of burnout and 44.6% scored in a range that indicate a medium level of burnout. A group of 31.1% have managed to handle stress factors in a healthy manner. Main stressors found are especially personal (fear of contamination, personal and family) and work-related factors (workload, new legislative rules and decisions, inconsistency, instability, ambiguity of managerial decisions, or even their absence or non-assumption, lack of clarity of working procedures, limited managerial and supervisory support, limited financial resources), less than client related factors (lack of direct contact, risk of contami-nation in two ways, managing beneficiaries fears, difficulties related to technology and digital skills). Study results point to the importance of organizational support and developing a self-care plan that help protect against occupational stress and burnout. Recommendations are made putting forward the voice of fieldworkers and managers fostering initiatives and applications of sustainability-based measures and activities designed to deal with the challenges of the VUCA environment.

Background: A comprehensive response to the unprecedented SARS-CoV-2 (COVID-19) chal-lenges for public health and its impact on radiation oncology patients and personnel for resilience and adaptability is presented. Methods: The general recommendations included working remote-ly when feasible, implementation of screening/safety and personal protective equipment (PPE) guidelines, social distancing, regular cleaning of treatment environment, and testing for high-risk patients/procedures. All teaching conferences, tumor boards, and weekly chart rounds were con-ducted using a virtual platform. Additionally, specific recommendations were given to each sec-tion to ensure proper patient treatments. The impact of these measures, especially adaptability and resilience, were evaluated through specific questionnaire surveys. Results: These comprehen-sive COVID-19 related measures resulted in most staff expressing a consistent level of satisfaction in regards to personal safety, maintaining a safe work environment, continuing quality patient care and continuing educational activities during the pandemic. There was a significant reduction in patient treatments and on-site patient visits with an appeciable increase in the number of tele-medicine e-visits. Conclusions: Survey results demonstrated substantial adaptability and resili-ence, including in the rapid recovery of departmental activities during the reactivation phase. In the event of a future public health emergency, the measures implemented may be adopted with good outcomes by radiation oncology departments across the globe.

Background: The Royal College of Surgeons in Ireland - Bahrain (RCSI Bahrain) was closed due to COVID 19. The aim of this paper is to present our experience, in managing teaching and learning, during this pandemic. Methods: Following, ethical approval, several meetings were held with the senior faculty and student representatives to select alternative virtual approaches for teaching, learning and assessment with evidence-based instructional design. Informed consent was obtained from all study participants. All procedures were carried out in accordance with relevant guidelines and regulations. In alignment with global scenario, we decided upon early graduation for our students, and expedited the clinical examinations, with special permission from health and education ministries. Two major clinical examinations were redesigned to form a single hybrid clinical examination with two parts. Following all COVID 19 preventive measures, students were taken in groups of seven and simulated patients were substituted for real patients. No more than 40 students were present at any point of time, with no more than 10 examined in one block. 149 out of 152 RCSI students attended the clinical examinations and 524 students from the three RCSI campuses attended the written online examination. A structured survey was conducted to elicit students’ perceptions and participation was entirely voluntary. Results: 82% of students were happier to be joining the workforce early and, 22% expressed concerns. A comparison of student performance in these examinations against the equivalent components from semester one yielded no significant deviation in student performance, illustrating that the quality was consistent. Conclusion: We recommend that the government accredit online or distance learning programmes and explore appropriate methodologies for evaluation of online learning and assessment. Incorporating practical/clinical training, will continue to be a great challenge.

The constant news about the corona virus is scary. It is not possible to separate treatment for Cancer due to COVID-19. An effective treatment comparison strategy is needed. We need to have a handy tool to understand cancer progression in this unprecedented scenario. Linking different events of cancer progression is the need of the hour. It is a methodological challenge. We provide the solutions to overcome the issue with interval between two consecutive events in motivating head and neck cancer (HNC) data.

The pharmacology of azithromycin, and the actions of certain bee products, suggest the possibility of overlap with the pathophysiology of COVID-19 at several points in the disease process. First, intercellular epithelial tight junctions of the respiratory tract serve as a critical barrier to invaders. Pathophysiological factors capable of disrupting this epithelial barrier include viral virulence factors such as those observed for other coronaviruses; virulence factors derived from potentially synergistic pathogens such as Candida albicans and Porphyramonas gingivalis; and imbalances in the host inflammatory response. Azithromycin, and to a lesser extent, certain bee products, appear to have actions that oppose such processes. Second, the matrikine PGP or its derivatives may contribute to risk in individuals at high risk for serious COVID-19 infection, especially during reactivation; but azithromycin is capable of modulating PGP in some contexts. Third, the most serious COVID-19 infections are associated with massive upregulation of inflammatory cytokines such as IL-6, TNF alpha, and other inflammatory cytokines. The anti inflammatory actions of azithromycin and bee derived products such as melittin are potentially capable of modulating these processes, as well. Azithromycin is already in current use as a treatment for COVID-19; however, it's utility as a protector of epithelial barrier function would be most likely to be realized in prophylactic context rather than in a treatment context. Similarly, since the anti inflammatory effects of bee products take time, their effectiveness of melittin and other bee products would be expected to be maximized in a prophylactic context. In the context of the current pandemic, prophylaxis with azithromycin, bee products, or both, might be warranted for individuals at high risk for serious COVID-19 infection.

The SARS coronavirus 2 pandemic affected many areas of public life and industry. This also applies to research particularly that which relies on user test studies. In order to minimize the risk of infection, several aspects of experiment design including the setting might require alteration. In order to develop a step-by-step approach to plan a study with regard to infection protection, an extensive review of the latest research involving the SARS coronavirus 2 pandemic as a blueprint for dealing with other health situations. As a result, a six-step concept was developed that is applicable for user test studies in both stationary rooms and vehicles which can be adapted to the respective circumstances. The infection protection measures determined through research were implemented in the individual sub-steps from study planning to execution. They allow a step-by-step approach to prevent infections in user test studies during a pandemic and in situations where increased hygiene measures are required, in order to continue to carry out user test studies.

The COVID-19 pandemic has expanded globally and caused serious consequence in both health system and the economy. MPV is one of two oral antivirals for COVID-19 with mild-to-moderate symptoms that have received FDA approval so far. This study aims to evaluate the cost-utility of using MPV in COVID-19 treatment. To compare the utility costs of MPV and non-MPV treatments for COVID-19 patients, we used a decision tree model. Data on clinical efficacy, cost, and quality of life were gathered from previous studies. The incremental effective cost ratio (ICER) calculated based on costs incurred and quality-adjusted life years (QALY), was considered as primary out-come. The total cost of MPV treatment and not using MPV was 15,362,516 VND (618 USD) and 15,771,262 VND (634 USD), respectively. The estimated QALY with using-MPV was 28.33, while without MPV was 19.72. The ICER was dominant, resulting in savings of 47,453 VND/QALY (1.9 USD). MPV is a cost-effective medication used to treat COVID-19. In mild-to-moderate COVID-19 patients, MPV considerably lowers costs and improves quality of life. However, several clinical factors of the drug still need to be taken into account.

We report the treatment of a 21-year-old female Covid-19 patient by a novel combination of minocycline and a guanosine-restricted diet. Minocycline is an antibiotic with well documented broad spectrum anti-viral effects, including evidence of activity against SARS-CoV-2. Deprivation of guanosine has been documented as an effective anti-viral modality in vitro and in animal models, and specific in vitro activity against CoV-SARS-2 has been reported. The patient's symptoms resolved rapidly.

Background: Psychological sufferings are observed among dental students during their academic years, which had been intensified during the COVID-19 pandemic. Objectives: This study assessed the levels and identified factors associated with psychological distress, fear and coping experienced by dental undergraduate students in Bangladesh. Methods: A cross sectional online survey was conducted during October-November, 2021. The Kessler Psychological Distress Scale (K-10), Fear of COVID-19 Scale (FCV-19S) and Brief Resilient Coping Scale (BRCS) were used in order to assess psychological distress, fear and coping strategies respectively. Results: A total of 327 students participated; the majority (72%) were 19-23 years old and females (75%). One in five participants were infected with COVID-19 and 15% reported contact with COVID-19 cases. Negative financial impact (AOR 3.72, 95%CIs 1.28-10.8), recent or past COVID-19 infection, contact with COVID-19 cases were associated with higher levels of psychological distress; but being a 3rd year student (0.14, 0.04-0.55) and being satisfied about current social life (0.11, 0.03-0.33) were associated with lower levels of psychological distress. Being a 3rd year (0.17, 0.08-0.39) and a 4th year student (0.29, 0.12-0.71) were associated with lower levels of fear. Health care service use and feeling positive about life were associated with medium to high resilience coping. Conclusions: This study iden-tified dental students in Bangladesh who were at higher risk of psychological distress, fear and coping during the ongoing pandemic. Development of mental health support system within dental institution should be considered in addition to the academic and clinical teaching.

The increasingly rapid flow of technological development is now a tool to improve backwardness, renew the system, as well as a means of improvement in various aspects of life. For companies, the development of information and communication technology is a new innovation or breakthrough to improve service quality. Various benefits provided by technology and information. However, if not handled properly, technology and information will become a boomerang for an organization. HRIS is the application of HRM functions in the application of information and communication technology. The concept of HRIS as a digital form of HRM is increasing along with the outbreak of the Covid-19 pandemic which has caused a large loss impact on all lines of life. The limitation of social interaction in an effort to prevent the wider spread of covid-19 and the higher number of casualties causes business activities to stall. This research uses quantitative methods with a study sample of 100 randomly selected. This study aims to see how clarity of high-tech goals in human resources management, perceived benefits, perceived ease of use, company conditions that can influence attitudes towards HRIS.

The sudden pervasive of severe acute respiratory syndrome Covid-19 has been leading the universe into a prominent crisis. It has influenced each zone, for example, industrial area, horticultural zone, Public transportation, economic zone, and so on. So as to see how Covid-19 affected the globe, we conducted an investigation characterizing the effects of the pandemic over the world using Machine Learning (ML) method. Prediction is a typical data science exercise that helps the administration with function planning, objective setting, and anomaly detection. We propose an additive regression model with interpretable parameters that can be naturally balanced by experts with domain intuition about the time series. We focus on global data beginning from 22^nd January 2020, till 26^th April 2020 and performed dynamic map visualization of Covid-19 expansion globally by date wise and predicting the spread of virus on all countries and continents. The major advantages of this work include accurate analysis of country-wise as well as province/state-wise confirmed cases, recovered cases, deaths, prediction of pandemic viral attack and how far it is expanding globally.

The COVID-19 pandemic affected the perinatal emotional landscape in Italy, a country with high mortality and strict lockdown. This study explored the emotions and challenges of pregnant and post-partum women during the pandemic, using AI-based mixed-methods. The study analyzed 1774 women from the national survey COVID-ASSESS: 1136 pregnant and 638 post-partum. The survey had qualitative questions on emotions and feelings related to birth, communication with healthcare professionals, media, and peers and family. We used natural language processing and machine learning to classify emotions, identify themes, and extract citations from the data. Fear and anxiety replaced joy as dominant emotions during the pandemic: trust and joy decreased by 49.3% and 36.4%, respectively, while sadness and fear increased by 52.3% and 49.3%, respectively. The pandemic also induced loneliness, isolation, frustration, and anger. Women faced challenges related to birth, communication with HCPs, media, and peers and family. They also used coping strategies such as self-care, news limitation, and tried to cultivate gratitude and hope. The study provides a comprehensive exploration of the perinatal emotional landscape of Italian women during the pandemic. The findings underscore the significant psychological impact of the pandemic, and also highlights women’s resilience and coping strategies.

Purpose: To evaluate nursing leaders' perception towards communication and relationship management competencies while using digital platforms during the COVID-19 pandemic. Background: Communication and relationship management competencies among nursing leaders will ensure healthcare models are successfully implemented. Nursing leaders can achieve effective leadership by mastering these competencies leading to an overall improvement in the quality of nursing care. However, digital platforms have been rapidly evolving in the healthcare ecosystem and have been significant during the battle with COVID-19. It is crucial to ensure that nursing leaders can use digital platforms to communicate and practice efficient management in their op-erations, especially during a crisis when their services are vital. Design: Descriptive, comparative study. Methods: The study was conducted between February to March 2021. A 5-item Linkert-type questionnaire was adopted from the American Organization for Nursing Executives (2005) and was sent to identified nursing leaders in Hamad Medical Corporation through the official email. Results: Two hundred fifty nurse leaders were invited to participate, but only 116 responded positively, translating to a response rate of 46.4%. The male participants represented a larger proportion of 64.10%, while the female was 35.90%. Regarding the questionnaire, the Cronbach alpha was α ˃ 0.987, indicating that all items revealed a sufficient level of internal consistency. The respondents had a minimum of 0 and a maximum of 52.6n in the communication and relationship management items. Influencing behavior, relationship management, and effective communica-tion had the lowest scores, which indicate low competency. The F value in ANOVA analysis was close to 1.0, implying that the null hypothesis is true. The significance value is <0.5 implying that there is a difference in response on effective communication proficiency of nurse leaders. Conclusions: Digital platforms are communication tools that are widely adopted to engage and reach nurses on numerous topics. Nurse leaders should capitalize on their benefits and generate critical discussions. The continued need to research nursing leadership competencies is critical as healthcare continues to change and evolve. Educational institutions and healthcare organizations must understand that nursing leaders should strive for professional development and knowledge acquisition to improve their communication and management.

The years 2019 to 2022 are being marked by the pandemic resulting from a viral infection, COVID-19. The demand and use of PPE has never been so high and it is often discarded without considering the correct disposal route and the environmental impact that this type and volume of waste can generate. The aim of this study was to analyze the increased demand for PPE used during the pandemic and, consequently, the generation of these wastes. In addition to this analysis, it is extremely important to raise the discussion about the treatment of these residues and the possibilities of more ecological personal protection equipment, such as biodegradable or reusable ones. The extensive use of PPE, which is mostly plastics and is not easily degraded, mainly leads to its accumulation in landfills but, if disposed of incorrectly, it could reach marine environments, contributing to the formation of microplastics in the oceans. Therefore, this article also aims to relate these themes to the Sustainable Development Goals, as efficient management aligned with sustainable development goals is essential to mitigate these anticipated problems and ensure a more sustainable future.

The Covid-19 pandemic and the initial focus on handwashing measures have again highlighted the importance of water access as an essential service in protecting human health. Yet, especially in southern cities, uneven geographies of water access – often mediated by fragmented and unequal infrastructure systems – may hamper the fight against infectious diseases. The spread of SARS-CoV-2 presented a dilemma for water providers as well as residents in water-deprived urban areas as they had to adhere to new hygiene standards and requirements, despite limited access to basic water infrastructure. Therefore, a deeper understanding of pandemic urban waterscapes – the infrastructure and governance systems as well as everyday practices and technologies – is necessary for ongoing debates on (post-) pandemic or zoonotic cities. In our paper, we focus on changes in urban (water) governance and government water projects in Nairobi since early 2020. We show that Covid-19 has contributed to changes in Nairobi’s waterscape but only in conjunction with recent changes in the city’s overall governance structure. However, if these waterscape changes lead to greater equity in water access, and if they have helped to curb the spread of SARS-CoV-2, is more than questionable.

The impact of nutrition on immunity is an intense area of research. Malnutrition is linked to a higher risk of microbial infections, while severe infections usually lead to a nutritional imbalance in affected patients. The nutritional status has an impact on the severity of the ongoing SARS-CoV-2 infection. Studies conducted on small numbers of patients have shown the benefits of maintaining optimal vitamin (B12 and D) and mineral (zinc and magnesium) balance in reducing the intensity of COVID-19. Although consuming a balanced diet with a healthy lifestyle is always desirable, the importance of such practice is even more meaningful during the COVID-19 pandemic. Keeping an optimal balance of vitamins and minerals through healthy dietary habits helps to maintain a robust immune system that is essential to combat invading microbial pathogens, including SARS-CoV-2.

The crux of the paper is to present a detailed analysis of COVID-19 data which is available on global basis. This analysis is performed using some specific package of R software. It provides various insights from the data and help to understand the current status of this pandemic in India so that effective measures can be formulated by policymakers. These insights include global summary of this disease, growth rate of this pandemic and performance of SIR model for the given global data. The analysis has been presented in different tables and graphs to understand the outputs of the problem in a more detailed point of view.

In the present time, the biggest problem of the world is the outbreak of novel coronavirus. Novel coronavirus (COVID-19), this one name has become a part of our daily lives over the past few months. Beyond the boundaries of medical science, coronavirus is now the main subject of research in all fields like Applied Mathematics, Economy, Philosophy, Sociology, Politics upto living room. The epidemic has brought unimaginable changes in our traditional habits and daily routines. Thousands of people in our country are fighting with the rest of the world to survive in various new situations. There are different kinds of coronavirus appeared in different times. In this time, Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is responsible for the coronavirus disease of 2019 (COVID-19). This virus was first identified towards the end of 2019 in the city of Wuhan in the province of Hubei in China. Within very short duration of time and very fast, it has spread throughout a large part of the world. In this study, the main aim is to investigate the spreading rate, death rate, recovery rate due to corona virus infection and to study the future of the coronavirus in India by using mathematical modeling based on the previous data. Mathematical models, in this situation, are the important tools in recruiting effective strategies to fight this epidemic. India is at high risk of spreading the disease and is facing many losses in socio-economic aspects. With current infection rates and existing levels of personal alertness, the number of infected people in India will increase at least in the next three months. Proper social awareness, maintain of social distance, large rate of testing and separation may break the chain of the Coronavirus-2.

The world is facing new challenges every day; however, with the spread of the pandemic around the world, this new challenge is different. The pandemic is increasing and concentrating various challenges simultaneously. Although different sectors are facing consequences, the most important sectors, that is, health and economy are the most affected. When the pandemic began, it was not known how long it would last, which complicated health and economic planning. Therefore, it is important for decision makers and the public to know the predictions and expectations of the future of these challenges. In this work, the current situation is analyzed. Then, an expectation model is developed based on the statistics of the pandemic using a growth rate model based on an exponential and logarithmic rate of increase. Based on the available open data about the pandemic spread, the model can successfully predict future expectations, including the duration and maximum number of cases of the pandemic. The model uses the equilibrium point as the day the cases decrease. The model can be used for planning and the development of strategies to overcome these challenges.

Background: A novel virulent coronavirus is what causes Novel Corona-virus Disease 2019 (nCOVID 19). It results in severe respiratory distress syndrome and potentially fatal infectious pneumonia. On March 12, 2020, the World Health Organization first labeled it a pandemic, which was then followed on the same day by a community health emergency of global concern. Vaccines against this deadly virus are now being created. Many drugs with different uses have been repurposed and tested for the prevention and treatment of the infection. Objective: The purpose of this review is to provide an in-depth analysis of data on possible pharmacological targets and available coronavirus treatments. Methods: Following the review protocol, a literature search was conducted. Results: Chloroquine phosphate and hydroxychloroquine, Remdesivir, and Lopinavir-Ritonavir in combination with or without interferon and convalescent plasma therapy are the main treatment candidates, according to the World Health Organization. This review article has elaborated on the current evidence of prospective pharmacological targets and related ongoing research, including inflammatory chemicals, bioactive peptides, beta cells, platelets, and the Angiotensin I Converting Enzyme 2 Receptor. This information was gathered from published journals. In addition, stories of medications and biological products like interferons and vaccinations that are utilized or could be utilized have been provided. Conclusion: There are a variety of pharmacological targets and therapeutic strategies that need more study.

Background: There is a lack of knowledge about how nurses and general practitioners (GPs) collaborated during the COVID-19 pandemicin primary care settings. Our study examined the roles of primary care nurses during the pandemic’s first wave, between March and June 2020, in Switzerland. Methods: The study involved all eight general practices implementing of a nursing role to the practice’s team. Primary care practice staff members (nurses, GPs and medical assistants) have been involved on the development of a new organizational model. A mixed-methods design study collected quantitative data using daily activity monitoring and an electronic survey. Additionally, eight nurses and nine GPs participated in a focus group discussion and individual interviews. Results: GPs recognized the substantial contributions, versatility, and autonomy of the primary care nurses in their practices during the pandemic. Those nurses experienced their involvement positively, mainly thanks to their perceived autonomy. The distribution of activities between primary care practice professionals was heterogenous due to extrinsic and intrinsic factors. Conclusion: Both nurses and GPs agreed that there was added value in having primary care nurses ingeneral practices in time of crisis, and this agreement will bolster plans to integrate this workforce across the canton. The development of nurses’ roles in primary care during the pandemic was reliant on many factors, including practice organization and Switzerland’s healthcare reimbursement and payment system

Background: Several reports indicate that long stay at home for online schools due to the COVID-19 pandemic changed the normal physical activity and body weight of school-age students. Previous studies revealed that almost 50% of school students complained of increased or decreased more than 3 kg of weight due to lower physical activity. This study aims to provide insight about the Body Mass Index (BMI) among school students during COVID-19 pandemic. Methods: A retrospective matched-longitudinal study was conducted in 2022 based on previous data about BMI-for-age percentile in school-age students aged 6 to 18 years. These data were collected the year before and during COVID-19 pandemic (2019-2021). Results: All the included students were Arabic (N = 53,580) and were not diagnosed with chronic illness. The outcomes showed that the overall percentage of students with normal weight was 54%, 56%, and 53% during the 2019-2021 years, respectively. Overweight among students increased during the COVID-19 pandemic years, as almost 10% of the students were overweight in 2019 compared with 12% in 2020 and 2021 years. Besides, obese students also increased in the 2020-2021 period compared with the 2019 year (15-17% vs. 10%). In contrast, underweight trends among students declined, as 26% reported in 2019 compared to 17-18% in 2020 and 2021. Conclusion: There are significant variations in Arabic school-age students regarding their BMI values. Obesity was highly detected among children and adolescents during the COVID-19 pandemic years compared to 2019, while underweight cases declined.

Coronavirus disease is a newly identified infectious disease that began in Wuhan, China in 2019 and is recognized as COVID-19. This virus has a serious impact on the planet that causes the deaths of millions of people; it produces unemployment and poverty. However, it has constructive environmental effects that reduce the amount of pollution in the atmosphere. Pakistan is also a developing economy caused by this deadly virus. Before 03 April 2021, the percentage of reported cases ranges from 682,888, with about 14,697 casualties and a total of 609,691 cases retrieved. Pakistan’s war against coronavirus can differ from advanced technical countries due to lack of resources. In this article, we will address the relation between COVID-19 and the environment in the particular case of Pakistan. There is evidence that this pandemic has lowered concentrations of greenhouse gases, including CO2 and NO2, as a consequence of global lock-down strategies.

There has been very widespread contagion of covid-19 in Kichwa indigenous communities in Ecuadorian Amazonia, but the peak of contagion has already passed, and total mortality has been remarkably low. The Kichwa people themselves typically attribute this to the widespread use of medicinal plants.

The COVID-19 pandemic was associated with increases in some healthcare-associated infections. We investigated the impact of the pandemic on rates and molecular epidemiology of Clostridioides difficile infection (CDI) within one VA Hospital. We anticipated that the potential widespread use of antibiotics for pneumonia during the pandemic might increase CDI rates given that antibiotics are a major risk for CDI. Hospital data on patients with CDI and recurrent CDI (rCDI) were reviewed pre-COVID-19 pandemic (2015 to 2019) and during the pandemic (2020 - 2021). Restriction endonuclease analysis (REA) strain typing was performed on CD isolates recovered from stool samples collected from 10/2019 – 3/2022. CDI case numbers declined 43.2% in 2020 – 2021 compared to the annual mean over the previous 5 years. Stool test positivity rate was also lower during the COVID-19 pandemic (14.3% vs. 17.2%; P = 0.013). Although inpatient volume declined, rates of CDI among inpatients were reduced by 34.2% in 2020 – 2021. Mean monthly cases of rCDI also declined significantly after 2020 [3.38 (95% CI: 2.89 – 3.87) vs. 1.92 (95% CI: 1.27 – 2.56); P = &lt;0.01]. Prior to the pandemic, REA group Y was the most prevalent CD strain among the major REA groups (27.3%). During the first wave of the pandemic from March 8, 2020, through June 30, 2020, there was an increase in the relative incidence of REA group BI (26.7% vs. 9.1%. After adjusting for CDI risk factors, a multivariable logistic regression model revealed that odds of developing an REA group BI CDI increased during the first pandemic wave (OR 6.41, 95% CI: 1.03 – 39.91) compared to the pre-pandemic period. In conclusion, the incidence of CDI and rCDI decreased significantly during the initial waves of the COVID-19 pandemic. In contrast, REA BI (Ribotype 027), a virulent, previously epidemic CD strain and frequently associated with hospital transmission and outbreaks, reappeared as a prevalent strain during the first wave of the pandemic.

Background: Brief Resolved Unexplained Events (BRUEs), formerly known as Apparent Life-Threatening Events (ALTE), are concerning episodes of short duration (typically &lt; 1 min) characterized by a change in breathing, consciousness, muscle tone, and/or skin color. In some cases, SARS-CoV-2 infection has been associated with episodes of BRUEs in previously healthy children.This study aimed to compare the demographic, respiratory, perinatal, and infectious characteristics in children affected by BRUE before the COVID-19 pandemic and after the spread of SARS-CoV-2. Methods: We conducted a retrospective observational study covering January 2018 to March 2020 (pre-COVID-19) and April 2023 (during the ongoing COVID-19 pandemic). Collected variables included clinical information during pregnancy and neonatal details of children with BRUE. Results: The number of children in the pre-COVID-19 period was 186 (41%); after the emergence and spread of SARS-CoV-2, it was 268 (59%). The risk of infection at birth for children developing BRUE was higher during the pandemic. Children were less likely to have ongoing symptomatic infection during BRUE during the pandemic (coefficient B = 0.783; p=0.009). Respiratory symptoms during BRUE were more frequent during the pandemic (coefficient B = 0.654; p=0.052). Fever during BRUE was less likely during the pandemic (coefficient B = -0.465, p=0.046). Conclusions: The study suggests that the COVID-19 pandemic has significantly impacted children with BRUE, potentially due to changes in hygiene practices and maternal-fetal infections.

Background We intend to examine whether the COVID-19 outbreak influences medical decision-making (MDM) among Non-COVID patients. Method We recruit 287 patients who admit to ER department due to cardiovascular complaints. Anxiety level was measured using three questionnaires (GAD-7, Beck Inventory, and the cardiac anxiety questionnaire). A fourth survey was designed to assess MDM considerations. Results 64% of patients were male (median age 54). Almost half of the patients were found to have moderate to severe levels of anxiety.79.3% of patients reported that the outbreak influenced their MDM. 44.5% of patients sought medical care 2-3 from the onset of symptoms. Coronary artery disease was found in only 26 patients (9.1%). Almost half of the patients stated that they would have gone earlier if not for the current pandemic. Conclusion Non-COVID patients seeking medical care had a high anxiety level that directly affected decision-making and put them at unnecessary risk.

The present novel corona virus (2019-nCoV) infection has created a global emergency situation by spreading all over the world in a large scale within very short time period. The infection induced death rate is also very high. There is no vaccine or anti-viral medicine for such infection. So at this moment a major worldwide problem is that how we can control this pandemic. On the other hand, India is a high population density country, where the corona virus disease (COVID-19) has started to spread from $1^{st}$ week of March, 2020 in a significant number of COVID-19 positive cases. Due to this high population density human to human social contact rate is very high in India. So control of the pandemic COVID-19 in early stage is very urgent and challenging problem. Mathematical models are employed in this paper to study the COVID-19 dynamics, to identify the influential parameters and to find the proper prevention strategies to reduce the outbreak size. In this work, we have formulated a deterministic compartmental model to study the spreading of COVID-19 and estimated the model parameters by fitting the model with reported data of ongoing pandemic in India. Sensitivity analysis has been done to identify the key model parameters. The basic reproduction number has been estimated from actual data and the effective basic reproduction number has been studied on the basis of reported cases. Some effective preventive measures and their impacts on the disease dynamics have also been studied. Future trends of the disease transmission has been Predicted from our model with some control measures. Finally, the positive measures to control the disease have been summarized.

Recycling and waste management have garnered immense popularity in recent years, but few studies have been carried out regarding these systems. Therefore, an in-depth literature review was done in order to highlight the different sectors of the recycling system that need to be reformed. Hence this study examined recycling and waste management systems within three categories–medical, municipal, and plastic–that were carried out pre and post COVID by reviewing previous studies, technical reports, and annual reports. This was done by visiting numerous academic search engines alongside online resources that were utilized to assemble literature related to waste and recycling systems. Continuing a recurring idea was that no matter the type of waste, further research regarding all waste should be carried out. Additionally, since recycling and waste management are a vital part of our society, and seeing how unpredictable events such as the pandemic may be, it is paramount that that research is done not only on how the pandemic has affected systems now, but also how we can learn from current issues to utilize them for future “waste shocks”.

This study aims to comparatively analyse the importance and performance of the health of Korean and Japanese adolescents during the prolonged coronavirus disease 2019 (COVID-19) pandemic. Data were collected from 1,341 sampled Korean and Japanese adolescents in September 2021 through online and offline surveys. The collected data were analysed with frequency analysis, reliability testing, t-test, and importance-performance analysis (IPA). The following results were obtained. First, adolescents in the two countries perceive various factors about health as important during the COVID-19 pandemic, but their performance is weak compared to their perceived importance. Second, Korean adolescents had greater perceived importance for all factors of health perception compared to their Japanese counterparts. Third, the difference in performance between Korean and Japanese adolescents was especially evident for ‘hygiene management’, and there were significant differences in performance in ‘disease management’ and ‘physical activity’. Fourth, in quadrant 4 of the IPA matrix, there were similarities and differences in a particular factor of health perception between Korean and Japanese adolescents. Based on these results, we proposed measures to emphasise the importance of health and enhance performance among Korean and Japanese adolescents.

Studies report variable effects of sex hormones on serious diseases. Severe disease and mortality rates in COVID-19 show marked gender differences that may be related to sex hormones. Sex hormones regulate the expression of the viral receptors ACE2 and TMPRSS2, which affect the extent of viral infection and consequently cause variable outcomes. In addition, sex hormones have complex regulatory mechanisms that affect the immune response to viruses. These hormones also affect metabolism through obesity, and severe disease can result from complications such as thrombosis. This review presents the latest research on the regulatory functions of hormones in viral receptors, immune responses, complications as well as their role in COVID-19 progression. It also discusses the therapeutical possibilities of these hormones by reviewing the recent findings of clinical and assay studies.

The research objects are the tax and budgetary policies of the Russian Federation. In this research, financial (budgetary) risks are understood as a decrease in the balance of the state (national) budget resulting from a reduction in revenues or an increase in expenditures. This research considers production in the main sectors of the economy as a key factor of financial risk in the COVID-19 pandemic. The research aims to analyze the main directions of the budgetary and tax policy of the Russian Federation aiming at supporting the economy and the population during the spread of COVID-19, which is especially relevant in connection with the expected recession in a number of sectors of the economy and a decrease in the level of employment and, accordingly, the well-being of citizens. In these conditions, it is necessary to adjust the budgetary and tax policy to preserve the state’s social obligations and expand social and economic support for businesses and citizens to smooth out the negative consequences of the impact of restrictive measures. The authors applied systemic and institutional approaches and statistical methods. The main results of the research reflect the need to (1) implement support measures (tax and budgetary incentives) for small and medium-sized enterprises, on which the crisis provoked by the COVID-19 pandemic has had the most destructive impact, and (2) to expand the volume of budgetary financing of social programs for financial risk management of the Russian economy during the COVID-19 pandemics.

The COVID-19 disease has infected many countries with generalised impacts on the different income categories. To test this hypothesis, we carried out a survey among households (n = 412) representing different income groups in Nigeria. We used validated food insecurity experience and socio-psychologic tools. We analysed the data obtained using descriptive and inferential statistics. The earning capacities of the respondents range from US$145/month for the low-income earners to US$1945/month for high-income earners. A total of 173 households (42%) ran out of food during the COVID-19 pandemic. All categories of households have experienced increasing dependency from the general public and perception of increasing insecurity, with the high-income earners having the greatest shift. In addition, increasing levels of anger and irritations have been experienced with all categories. Of the socio-demographic variables, only gender (p = 0.012), level of education of household head (p = 0.000), work hours per day (p = 0.006), and family income based on society class (p = 0.000) were significantly associated with food security and hunger due to the COVID-19 pandemic. Household heads with medium (OR: 4.36, 95% CI: 2.64 – 7.21, p &lt; 0.001) and high (OR: 30.27, 95% CI: 3.99 – 229.90, p &lt; 0.001) family income based on society class were more likely to have satisfactory experience on food security and hunger than respondents with low family income. Irrespective of the social class of the respondents, some respondents had negative experiences such as movement/change of location within the same city (17.68%), begin a new relationship (14.43%), recent change of job/loss of job (11.55%), movement to another city (10.81%), and separation from spouse or long-term relationship (10.07%). However, 231 (60.16%) reported satisfaction with their jobs despite the pandemic. Psychological stress due to impact of COVID-19 was observed to be more in the low income earning group than others. It is recommended that socio-economic groups should be mapped and support systems should target each group as per the needed support in terms of health, social, economic, and mental wellness; the government should show political commitments and transparency in food security and counselling supports. National authorities should prioritize empirical-based interventions on resources allocation during crises.

COVID-19 has become a part of everyone's day-to-day life, since the outbreak in 2019 the novel coronavirus disease (COVID-19) has caused more than 4.5 million deaths with over 200 million cases reported globally. Currently, the number of infections and deaths are gradually lowering in different countries however the underlying challenges still exist. COVID-19 threatens human life, social functioning and development. Although numerous studies have been carried out in the past to highlight the key challenges very limited studies have been conducted from an ordinary person's viewpoint. In the fight against COVID-19, humanity has been pushed to a level which cannot be accepted where establishing that balance is a priority. This study focuses on highlighting the common issues faced by the ordinary public in the current era. Five key areas were identified to be the most essential; education, technological adaptation, transportation, mental health and gender-based violence (GBV).

This paper reports on in-depth qualitative interviews conducted with 69 disabled people in England and Scotland, and with 28 key informants from infrastructure organisations in the voluntary and statutory sectors, about the impact of COVID-19, and measures taken to control it. Participants were recruited through voluntary organisations. As with everyone, the Pandemic has had a huge impact: we discuss the dislocations it has caused in everyday life; the failures of social care; the use of new technologies; and participants’ view on leadership and communication. We conclude with suggestions for urgent short term and medium term responses, so that the United Kingdom and other countries can respond better to this and other pandemics, and build a more inclusive world.

Background: Throughout the COVID-19 pandemic, hospital medical staff (HMS) have faced significant personal, workplace, and financial disruption. Many have experienced psychosocial burden, exceeding already concerning baseline levels. This study examines the types and predictors of coping strategies and help-seeking behaviours utilised by Australian junior and senior HMS during the first year of the pandemic. Methods: A cross-sectional online survey of Australian frontline healthcare workers was conducted between 27th August and 23rd October 2020. Data collected included demographics, personal and workplace disruptions, self-reported and validated mental health symptoms, coping strategies, and help-seeking. Results: The 9518 participants included 1966 hospital medical staff (62.1% senior, 37.9% junior). Both groups experienced a high burden of anxiety, depression, post-traumatic stress disorder, and burnout. Coping strategies varied by seniority, with maintaining exercise the most common strategy for both groups. Adverse mental health was associated with increased alcohol consumption. Engagement with professional support, although more frequent among junior staff, was uncommon in both groups. Conclusions: Junior and senior staff utilised different coping and help-seeking behaviours. Despite recognition of symptoms, very few HMS engaged formal support. The varied predictors of coping and help-seeking identified may inform targeted interventions to support these cohorts in current and future crises.

The COVID-19-medical emergency has ended worldwide, yet there is still a need to evaluate the psychological impact of these years of unprecedented changes on students’ life. Methods: This study aims to assess and compare COVID-19-related stressors (Relationships-and-Academic-Life; Isolation; Fear-of-Contagion) and psychophysical symptoms reported by university students in April-2020, April 2021, and April 2022. The predictive role of COVID-19-related stressors on psychophysical symptoms within each time was also tested. Data were collected among 637 university students in April-2020 (n = 197), April-2021 (n = 200), April-2022 (n = 240). Results: In April-2022, perceived Isolation and Fear-of-Contagion decreased from the peak registered in April-2021, but stress related to Relationships-and-Academic-Life remained noteworthy high. A sharp and ongoing increase in psychophysical symptoms was found, with more than 50% of students reporting clinical levels of Sleep-Disorders, Depression, Psychoticism, and Interpersonal-Sensitivity. In April-2022, students still perceiving stress related to Relationships-and-Academic-Life and Isolation were at risk for Anxiety, Somatization, and Sleep-Disorders, while those still perceiving stress related to Fear-of-Contagion were also at risk for Depression, Obsessive-Compulsive, and Psychoticism. Conclusion: Findings emphasized the long-lasting detrimental effects of the COVID-19-related stress. Interventions must pinpoint the complex post-pandemic adjustment process and their effects on university students' psychophysical health.

The pandemic is fast moving, accelerating rapid changes that lead to new challenges and making organizations suffer an impact. A big mark has been left on the workplaces - places where we do business, because an ongoing change to remote work challenges the role of the office. It is highly possible that as the change is progressing, it is not only the workplace that will change its design, but also the way in which work will be planned, organized, done and controlled. However, as the restrictions ease up questions appear: What is the potential of office sustainability? How has the perception of flexible office space changed due to the COVID-19 pandemic? This paper used an online survey as a quantitative research method. In this paper, we looked at the employer’s vision of the office. We investigated employers’ perspectives of where and in what settings the work will be done in the post-pandemic time. Specifically, we discussed the changes employers will apply in terms of work environment and office layout. The findings suggest that an increasing mobile workforce and expansion of the new workstyle will not mean an office exodus, but will certainly have an impact on office utilization.

The Covid-19 pandemic has resulted in the closure of schools at every level, globally, forcing education to move online. Meeting the needs of students online for Science Lab classes, in particular, is a challenge since the physical labs are not available to the teachers or students. OLabs is a virtual Science Lab providing a complete learning environment of theory, experimental procedures, videos, animations, simulations, and assessments that capture real lab experiences with the relevant pedagogy. This study looks at the acquisition and behaviors of users, on the OLabs platform, during pre and Covid-19 times. Using Google Analytics, we observe that, during the pandemic time, users increasingly adopted OLabs as a new learning pedagogy for performing experiments as indicated by parameters like the number of users; the number of unique pages viewed per session; time spent on viewing content; bounce rate; and preference for content types such as theory, simulations, videos, and animations.

The severe disease outbreak COVID-19 pandemic impacted public health and safety and the educational systems worldwide. For fear of the further spread of diseases, most educational institutions, including Bangladesh, have postponed their face-to-face teaching. Therefore, this study explores public university student's perceptions towards online classes during the COVID-19 pandemic in Bangladesh. Data were collected among students of Islamic University, Kushtia, Bangladesh, through an online survey. The study followed both a qualitative and quantitative approach, where the survey technique was used as an instrument of data collection. Results showed that most students were facing difficulty participating in virtual classes and could not communicate with their friends correctly during online classes. They faced challenges in online schooling, and the majority of the students preferred conventional types of learning to virtual classes and did not understand the content of virtual classes easily. The study also explored that most students did not feel comfortable in online classes. Still, considering the present pandemic situation, they decided to participate in online classes to continue schooling. Besides, the study discovered that female students showed better real perceptions than male students regarding online classes, and urban students have more optimistic appreciation than rural students. Moreover, laptop or personal computer users showed more positive perceptions towards online education than mobile users. Furthermore, Broadband/ Wi-Fi users have more positive perceptions than mobile network users. These findings would be an essential guideline for governments, policymakers, technology developers, and university authorities for making better policy choices in the future.

Dental services are significantly impacted by the COVID-19 pandemic. Almost all dental procedures carry a high infection risk for providers and patients due to spread of aerosols. As a consequence, national public health agencies, and dental professional associations have issued guidelines for enhanced infection control, personal protection equipment and limiting care to urgent or emergency services. However, there is no dental service concept for disaster preparedness or response that might be applied. Similarly, pathways to care provision in a post-pandemic future are missing. We propose Safe Aerosol-free, Emergent Dentistry (SAFE Dentistry) as one approach to dental services during and emerging from pandemics. The concept’s starting point is the identification of the most common patient needs. The next step is to replace common treatments relating to the most common needs with alternative interventions with less infection risk because they do not generate aerosols. SAFE Dentistry is innovative, safe, and responds to the requirements of a pandemic and post-pandemic emergence where the risk of disease transmission remains high. SAFE Dentistry thereby ensures continuity of dental services while protecting providers and patients from infectious pathogens. Moreover, SAFE Dentistry allows dental service providers to remain operational and generate income even under pandemic conditions. Implementation and policy options for SAFE Dentistry include universal availability without co-payments by patients and a uniform bundled payment scheme for providers to simplify budgeting, reimbursement and to provide easier administration during a pandemic. Adaptations and adjustments of the concept are possible and encouraged, as long as the principle of avoiding aerosol-generation is maintained.

Background: The COVID-19 has put global health institutions on alert. Organizations such as the CDC and WHO have developed preparedness and prevention checklist of 2019-nCoV infection to be used by public and healthcare professionals. Since COVID 19 pandemic is unexpected and no country aware of it prior to outbreak, there is limited information on the overall preparations of healthcare providers in Ethiopia. Therefore, the aim of this study was to assess early healthcare professionals’ preparedness and response to COVID 19 Pandemic in Oromia regional state, Ethiopia. Methods: The study was conducted on healthcare professionals working in public hospitals of Oromia regional state. The study was carried out by online questionnaire prepared using SurveyMonkey©. The collected data was analyzed and One-way ANOVA was used to determine the significant differences between health professionals working in different hospitals. The statistical significance associations of variables of interest was determined at 95% confidence intervals. Results: Healthcare professionals in the public hospitals of Oromia regional state, Ethiopia perceived that they are not yet well prepared and may not respond to the pandemic quickly and efficiently. Even though, they have positive response towards identifying signs and symptoms, provide education and utilization of PPE, they are still lacking in practical responses like managing cases, implementing emergency plans and isolation procedures from many others. Conclusion: As the Federal Ministry of Health, Ethiopia Public health institute and Oromia health bureau are vigilant and continually conducting preventive measures programs, extensive and maximum effort should be done to improve healthcare providers’ preparedness and response towards any emergency related to COVID-19 pandemic.

The aim of study was to investigate epidemiology aspects of magnetic resonance imaging (MRI) during COVID-19 pandemic. The study comprised depersonalized residents of Tomsk and Tomsk Region (n = 1714). Invitations to take online survey were sent to 50,000 residents by target SMS with response rate of 1.2% (n = 727, Cohort 1). Cohort 2 comprised retrospective patients (n = 987) who underwent contrast-enhanced cardiac MRI (CMR) in 2019-2022. Referrals, clinical characteristics, diagnosis, gender, age, past COVID-19, MRI study protocols, and MRI data were analyzed. 29% of respondents in cohort 1 received MRI examination within past two years; 26% of respondents considered MRI the most informative imaging modality for detecting COVID-19 pneumonia; 12% of respondents reported MRI unavailable. Proportion of CMR among MRI studies increased during COVID-19 pandemic, and maximum incidence of cardiac diseases detected by MRI was in 2021. Incidence of myocardial fibrosis increased from ~67% in 2019 to ~84% in 2022. The rate of outpatient MRI studies significantly increased in 2020, but returned to pre-pandemic level in 2021. COVID-19 pandemic increased the need for MRI and CMR. Patients with history of COVID-19 had persistent and newly occurring symptoms of myocardial damage suggesting chronic cardiac involvement requiring continuous follow-up.

A striking aspect of COVID-19 is the difference in the outcome of the infection between different countries, and different ethnic groups within one country. We surveyed the literature on SARS-CoV-2 complemented with comparative publications on SARS-CoV and other coronaviruses to capture the current understanding of virus – host interactions including virus subtypes, transmission, zoonotic aspects, and potential host determinants.

In this paper we first provide a primer on SARS-CoV-2 and Covid-19 delineating the etiopathogenesis, epidemiology, clinical manifestations and the natural history of the disease. We then trace the evolution of the Covid-19 pandemic highlighting the characteristics of the epidemic in China where the pandemic originated, select countries of Europe which peaked during April, and Brazil, US and India where the pandemic has taken serious turns recently. We also project some possible trajectories for the mega cities of India based on the demographic characteristics of these cities in comparison to New York city. This is an updated version of the article from mid-April published online.

The study aimed to evaluate the after-effects of the COVID-19 pandemic on the sleep quality and patterns of women across different cultural settings within Iraq, spanning the period of 2022. A cross-sectional survey was administered to a diverse cohort of women from multiple provinces in Iraq. The survey measured various parameters, including sleep duration, onset latency, and disturbances. The post-pandemic period has seen a notable decline in sleep quality among the female population. Contributing factors include psychological stress, lifestyle changes due to the pandemic, and ongoing socio-economic challenges. The impact on sleep quality exhibited variation across different cultural groups, indicating a significant cultural influence on the pandemic's psychological aftermath. The study concludes that the post-pandemic phase has adversely affected the sleep health of women in Iraq, with cultural factors playing a critical role in these changes. There is a pressing need for culturally sensitive public health strategies to address sleep disturbances and mitigate their long-term effects on women's health. Public health initiatives should be tailored to address the specific cultural contexts within Iraq to improve sleep health among women. Further research is warranted to explore the long-term consequences of disturbed sleep patterns and the effectiveness of different intervention strategies.

During the Covid 19 pandemic, we saw a huge impact on the lives of individuals in cities. The way people responded was controlled and limited. The lockdown restricted a lot of movements in the cities as well as contained the citizens in their houses. Through a semi-structured interview, the research aims to understand the change in behaviour and response of individuals across various cities. The paper aims to understand how people change their day-to-day life in cities during the pandemic and while the restrictions getting released post the first wave. The paper also understands how the pandemic impacted urban spaces and what value they hold for people. By interviewing individuals from different cities, the data were transcribed and analysed to understand this behavioural change and the attitude of people. The outcome of the research was derived as a concept map through the codes generated during the research.

Pineapple is a highly demanded fruit in international markets, thanks to its unique appearance and flavor, high fiber content, vitamins, folic acid, and minerals. It makes the pineapple production and processing market a significant source of income for producing countries, such as Costa Rica. Nowadays, its processing produces a large amount of waste with negative consequences for the environment. However, pineapple waste is an essential source of cellulose, hemicellulose, lignin, and other high-value products like enzymes (bromelain). These by-products can be obtained by pineapple waste biorefinery, generating an additional source of export goods and foreign currency, framing pineapple processing in the concept of the circular economy. This review discusses how incorporating biorefinery in the pineapple production processes can contribute to the post-COVID 19 economy in Costa Rica. Pineapple production in Costa Rica is explored, and the contamination of generated residues is delineated. Furthermore, the primary processes for by-product extraction via biorefinery, their general characteristics and applications in the medical field, and their contribution to the circular economy are presented.

While it is not new that Nigeria is challenged by a huge infrastructure deficit, the COVID-19 pandemic has exposed the country’s comatose healthcare system. Given the country’s dwindling revenue, massive debt profile and the inability of the public-sector to efficiently manage public facilities in the country, this paper examines how the public-private partnership model of infrastructure procurement can be deployed as a solution for Nigeria’s healthcare crisis. In addition to the above, this paper takes a look at how a partnership with the private sector can aid Nigeria’s quest towards achieving healthcare-related Sustainable Development Goals. The paper also considers two healthcare-based projects as case studies to serve as lessons for future projects in the country. Among others, the paper recommends a holistic long-term solution for the country’s healthcare needs.

A novel coronavirus strain (severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) first appeared in December 2019 and can cause acute respiratory distress syndrome and death. However, there are only limited therapy choices and no vaccine for SARS-CoV-2 is currently available. Here we report about a case of a SARS-CoV-2 caused pneumonia successfully treated with thalidomide. Thalidomide is an immunomodulatory and anti-inflammatory agent and was combined with a low-dose glucocorticoid. We suggest, that the effects of thalidomide might be related to regulating immunity, inhibiting the inflammatory cytokine surge, alleviating anxiety to reduce oxygen consumption, relieving vomit and lung exudation.

The coronavirus disease 2019 (COVID-19) pandemic has caused considerable global disruption to clinical practice. This article will review the impact that the pandemic has had on oncology clinical trials. It will assess the effect of the COVID-19 situation on the initial presentation and investigation of patients with suspected cancer. It will also discuss the impact of the pandemic on the subsequent management of cancer patients and how clinical trial approval, recruitment and conduct were affected during the pandemic. An intriguing aspect of the pandemic is that clinical trials investigating treatments for COVID-19 and vaccinations against the causative virus, SARS-CoV-2, have been approved and conducted at unprecedented speed. In light of this, this re-view will also discuss the potential that this enhanced regulatory environment could have on the running of oncology clinical trials in the future.

The 2019 novel coronavirus (previously 2019-nCoV) or coronavirus infectious disease 2019 (COVID-19) outbreak has been summarized as on March 29, 2020. COVID-19 is a highly transmittable and pathogenic viral infection caused by severe acute respiratory syndrome coronavirus 2 (SERS-CoV-2). The disease was first seen during an outbreak in Wuhan, China and continuous spreading from human to human around the sphere. The disease is uncontrolled and increasing the death toll through. The world is facing a global challenge to protect human lives caused by coronavirus outbreak. The number of infected patients is increasing day by day due to COVID-19 as a pandemic. The world health organization (WHO) has declared global public health emergency on January 30, 2020. The disease has been spread around 201 countries with total confirmed cases 634835 and death cases 29891 as on March 29, 2020. The goal of this review to summaries and update the clinical/medical features and suggestions for diagnosis of the COVID-19 as a pandemic. The discussion of the various therapeutic algorithms, risk, prevention and control based on the latest reports has been provided.

The research deals with the particularities of the initiation in the sport of kin ball, of 94 students (54 boys and 40 girls), without a history of practicing the sport intensively, and the measure of the influence of some components of the motor capacity. Kin ball is a sport that appeared in Canada, in an academic setting and can become an alternative sport in the common university curricula in Romania. The research was carried out in 4 research groups in 2019 and 2022, two of boys and two of girls, similarly, before and after the declaration of the acute phase of the Covid-19 Pandemic, generating physical activity constraints. The originality of the research refers to the initiation, unprecedented in Romania, in the Kin ball sport, through 20 training sessions, carried out in 10-day stages and the evaluation of some motor skills on the subjects. During the experiment, the following components were tested pre- and post-intervention Kin-Ball: palmar muscle strength using the dynamometer, general resistance by running as long as possible for 2 min and general coordination function - body balance, by the Matorin test. The statistical calculation included the application of the Kolmogorov-Smirnov test, depending on which parametric or non-parametric statistical significance tests were applied and the estimation of the size of the intervention effect. The results highlighted particularities of initiation in Kin ball, but also significant differences (p<0.05) in all measurements performed in 2022. The tests in 2019 recorded both significant and statistically insignificant differences, also highlighted by the calculation of the d indicator of to Cohen. The lower initial level of all motor components measured in 2022 and their significant improvement represent aspects that can be understood as collateral effects of the lack of movement during the pandemic.

Previous literature highlights the impact of COVID-19 on family functioning. Less is known about the impact of the pandemic on families of pediatric cancer patients. In order to determine universal and unique risk and resilience factors of these families during the pandemic, a qualitative analysis was conducted on families currently receiving cancer treatment at a midwestern hospital. Results of the data analysis depict ways in which these families have been impacted by and have adapted to COVID-19. These findings suggest that families of pediatric cancer patients have unique experiences in the context of COVID-19, in addition to universal experiences outlined in previous literature.

Total 219 countries and territories globally suffering from the recent pandemic COVID-19 is now in its second wave with more brutality, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) . It has several symptoms like as persistent fever; respiratory illnesses; cough; fatigue; shortness of breath; loss of appetite; persistent pain or pressure in the chest; dysgeusia; acute respiratory distress syndrome (ARDS) etc., and here the things to worry about is the development of pulmonary fibrosis after COVID-19 in both peoples who had died of due to acute respiratory distress syndrome (ARDS) or those who survived. Due to COVID-19, dysregulated immune response and wound repair mainly in elderly patients causes this secondary pulmonary fibrosis. Thus using anti-fibrotic agents could be meaningful in these circumstances although their efficacy in treating COVID-19 is subject to more detailed laboratory research works. In this review article you will get to know about the lung fibrosis generation due to COVID-19 infection, about anti-fibrotic agents and the currents challenges of this field.

The pandemic threat SARS-CoV-2 is now beyond control though the country of origin of this virus had already been limited for the new infection. Number of infected people and countries have been increasing day by day. Considering the previous pandemic flues, it is hypothesizing that COVID-19 will be reduced with warming the global environmental temperature. Therefore, the current study was aimed to analyze the effect of temperature and relative humidity (RH) on spreading of SARS-CoV-2 infection. The COVID-19 confirmed cases of 31 different states in China and 70 cities of 11 countries were obtained from several online databases. The real time temperature and humidity of the respective regions were taken from an online weather forecasting data source. Correlation analyses showed that SARS-CoV-2 infectivity and spreading negatively correlated with temperature of most of the states of China or cities of the world or in a country. The effect of humidity on COVID-19 was found to be positively correlated inside the China and difference of humidity was not found among countries and/or various regions of the world. Moreover, a minimum number of COVID-19 cases have been confirmed in the temperate regions compared to regions/countries compared to regions/countries with relatively low temperature. In conclusion, the SARS-CoV-2 infection has been found in a wide range of temperatures. It might be hypothesized that comparatively elevated air temperature could play a detrimental effect for SARS-CoV-2 spread.

Abstract: (1) Background: The Covid-19 pandemic has spread globally since January 2020 and is a threat to public health. This study aims to highlight the psychosocial impact on Greek nursing students and the challenges they received regarding the new sustainable educational reality, in the context of the sudden and exclusive application of distance education during the pandemic Covid-19; (2) Methods: Questionnaires were distributed through an online form (Lime Survey) to undergraduate nursing students enrolled in online courses. Data were collected between De-cember 2020 and January 2021 (3) Results: A total of 341 participants were included in the study. Some of the participants (9.1%) reported that being unemployed because of the Covid-19 affected their sustainability of life. Similarly, distance education had a negative impact on students' par-ticipation in social activities with their classmates (64.5%), while many of the participants were concerned that the sudden transition from face-to-face to distance education would have a negative impact on their future career (46.3%). Furthermore, the majority of students in this study seemed to disagree that distance education could be more effective than face-to-face education (72.1%); (4) Conclusions: It is undoubtedly proven that the effects of the Covid-19 pandemic have a great impact on the educational sector. These social and psychological changes endangered the viability of students in the Greek educational reality.

Background: The Covid-19 pandemic has globally impacted the lives of individuals, families, and children. In Italy, measures such as lockdowns and distance learning were implemented in schools, which affected the mental health of children and families. Methods: This article employs qualitative methodology to explore the experiences of children, parents, and teachers during the pandemic and lockdown, as well as the implementation of a death education project aimed at primary school children to help them process emotions and losses experienced during this period. Results: Distance learning posed challenges to the learning process and exacerbated social inequalities. Children suffered from limited social contact with friends and experienced negative emotions, including anger, fear, and concern for the health of their loved ones. The death education project provided a safe space for emotional expression and facilitated the acquisition of coping strategies. Open communication between adults and children about illness and death proved effective in mitigating the psychological impacts of loss and preventing traumatic bereavement. Conclusions: The findings highlight the utility of death education in enhancing children's ability to express their emotions and approach the topic of death morefrankly.

In response to the COVID-19 pandemic, social distancing measures were put into place to flatten the pandemic curve. It was projected older adults were at increased risk for poor psychological and health outcomes resulting from increased social isolation and loneliness. However, little re-search has supported this projection among community-dwelling older adults. While growing body of research has examined the impact of the COVID-19 pandemic on older adults, there is a paucity of qualitative research that captures the lived experience of community-dwelling older adults. The current study aimed to better understand the lived experience of community-dwelling older adults during the first six months of the pandemic. Semi-structured one on one interviews were conducting with independent living older adults aged 65 years and older. After achieving saturation, 22 interview were analyzed using inductive thematic analysis. Following a recursive process, two overarching themes emerged from the data: perceived threat and challenges of the pandemic and coping with the pandemic. Specifically, participants reflected on the threat of contracting the virus and challenges associated with living arrangement, social isolation, and financial insecurity. Participants shared their coping strategies to maintain health and wellbeing, including behavioral strategies, emotion-focused strategies, and social support. Overall, this re-search highlights resilience among older adults during the first six months of the pandemic.

During this epidemic of COVID-19, children are in need of much concentration and profound love of the senior family members. Although the measures taken by the organizations are necessary to prevent the spread of the novel coronavirus, they may be causing widespread mental health issues, including depression and loneliness. Therefore, it is imperative that parents have to spend the lion-share of time with children while listening to them cordially. Parents can participate in sports with them to help them stay fit so that they can enjoy commemorating moments. However, in this additional time, the parents can also make them habituated to practice the rules of health, so does social distancing.

Whilst large-scale changes in population behaviour are required to reduce the transmission of the SARS-COV-2 virus, the emergency context is not conducive to the sort of careful communications planning that would normally be required to meet such a task. Rapid strategic communications planning in a pandemic by governments is, however, possible and necessary. Steps include setting up a dedicated communications task force, mobilising partners and resources, developing a creative brief and theory of change and overseeing the creation, testing, roll out and revision of content. In this short guide we argue that a minimum of strategic planning can be undertaken rapidly, and that good use can be made of simple principles of behaviour change, even during pandemics. Our aim here is to provide a blueprint that governments and their partners, especially in low-income settings, can follow to design, coordinate and resource national communications efforts to combat the COVID-19 pandemic immediately and for the longer term.

The COVID-19 pandemic and associated restrictive measures implemented may considerably affect people’s lives. This study aimed to assess the well-being of Vietnamese people after COVID-19 lockdown measures were lifted and life gradually returned to normal. An online survey was organized from 21st to 25th April 2020 among Vietnamese residents aged 18 and over. Besides collecting socio-demographic and COVID-19-related data, the WHO-5 Well-Being Index (scored 0–25) was used to score participants’ well-being. A multivariate logistic regression model was used to determine the predictors of well-being. A total of 1922 responses were analyzed (mean age: 31 years; 30.5% male). Mean well-being score was 17.35±4.97. Determinants of high well-being score (≥13) included older age, eating healthy food, practising physical exercise, working from home, and adhering to the COVID-19 preventive measures. Female participants, persons worried about their relatives’ health, and smokers were more likely to have a low well-being score. In conclusion, after the lockdown measures were lifted, the Vietnamese people continued to follow COVID-19 preventive measures and most of them scored high on the well-being scale. Waiting to achieve large scale COVID-19 vaccine coverage, promoting preventive COVID-19 measures remains important, together with strategies to guarantee the well-being of the Vietnamese people.

In December 2019, an unusual cluster of pneumonia cases were reported in Wuhan and promptly confirmed to be caused by a new virus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) of which the disease it caused would be known as COVID-19. In March 2020, in the absence of any vaccines, and in response to the global spread of SARS-CoV-2 the UK implemented non-pharmaceutical intervention (NPI) measures in the form of a national lockdown to decelerate the spread. Compliance with NPIs can have significant impact on reducing disease transmission however there are currently no studies measuring compliance within the horse ownership world which naturally brings groups of people together during everyday caregiving activities. This article describes the reported horse owner compliance during the COVID-19 pandemic from March 2020 to December 2020 as deduced from 1036 respondents which completed an anonymous online survey between December 30th, 2020 and January 11th, 2021. Where rules/guidance did exist, there was good compliance with 92.76% of respondents indicating that they were following them. The most common rule/guidance implemented was social distancing, which was also the most common rule/guidance to be breached. Riding with others whilst at the yard (hacking or in an arena) and meeting up with non-household members (family and friends) when off the yard were also common rules/guidelines breached. Respondents who kept their horses at either DIY livery, or on a private yard were most likely to breach rules/regulations whereas respondents who kept their horses at full livery were least likely to breach rules/regulations. The results indicate that compliance of horse owners with COVID-19 rules/guidance is high when rules/guidance exists. However, just under half of respondents indicated that there were no rules/guidelines on their yards indicating that there is room for an increased contribution from the horse owning community by encouraging more yards to impose control measures where they currently do not exist.

COVID-19 appeared as an infectious disease of global health emergency and the highest public health concern of 21st century for this world due to its high-speed of spread across the globe. The disease started as one single case to a cluster of cases in Wuhan, China (Dec 2019) and within few months with its continuous upsurge of cases spreading globally which has created enormous threat and tension across the global Public health care field. Most significantly to share the fact that, this disease caused high level of Risk Group mortality, high morbidity, health care services burden, panic anxiety, mental trauma and tension, social and economic insecurity, which also collectively surfaced by diverse range of social reaction and political pressure across the world. Also with the appearance of new and unknown pathogenesis of the disease has created the most and significant attention and concern for the scientific community and political leaders as well. The disease also varies much with its pattern of virus, sign, symptoms, characteristics including its epidemiological and public health response (like prevention strategy, diagnoses, case management, treatment pattern) across the countries. However, this variance is comparatively less rather even more in commonality while it comes to basic public health prevention interventions like frequent hand washing, wearing face mask, maintaining social/physical distancing (2 - 6 meter in between), individual isolation and community quarantine for suspected exposure and lockdown in community areas where cases are identified. These are with the most commonly practiced public health interventions to deal with this disease in majority of the epicenters across countries. Also with the progress of the disease with its diverse categorical appearance of sign symptoms which are uniquely portraying this disease is more of a kind of COVID-19 syndrome than as COVID-19. Moreover, various factors including socio economic status, health status, population dynamics, health system and infrastructure, health behavioral pattern, nutrition and food habit and access to information and knowledge made this viral disease one of the historically counted on expensive disease of the modern world to fight for. Specially to mention here, the case fatality rate distinctively vary with the population dynamics and the health system infrastructure and ability factors which have already created clear evidence as explained in this paper how these factors are uniquely distinguished and different from country to country. Apart from the contextual differences, the various kind of ongoing preventive measures (like prevention, diagnosis and treatment) learnt every day from the emerging characteristics and pattern of this viral disease which are most commonly practiced across countries with a variance. According to the Public health prevention practice and interventions, the total world is connected and learning from each other’s public health experiences to fight for the virus. However, the world communities are eagerly waiting to see the result and outcome of the ongoing therapeutics and vaccine trial initiated in several countries, the people of the world are quite optimistic and hopeful that, global scientific community will be able to invent some miraculous and magic solution in upcoming months which ultimately will free the world from this most terrifying COVID-19 pandemic of 21st century.

Introduction: The majority of epidemiological reports focus on confirmed cases of COVID-19. In this study, we aim to assess the health and well-being of adults not infected with Covid-19 after two months of quarantine in Morocco. Materials and methods: Two months after the declaration of quarantine in Morocco following the Covid-19 epidemic, we carried out a descriptive cross-sectional study of 279 Moroccan citizens. We used the Short Form Health Survey (SF-12) as a determinant of quality of life, which is based on eight dimensions of health. The data were collected using an electronic questionnaire distributed online. The participants also indicated their socio-demographic data, their knowledge and practices regarding the Covid-19 pandemic and whether they had chronic health problems. Results: The quality of life of all participants was moderately disrupted during the Covid-19 pandemic with a mental health score (MCS) of 34.49 (± 6.44) and a physical health score (PCS) of 36.10 (± 5.82). Participants with chronic diseases scored lower with 29.28 (± 1.23) in mental health (MCS) and 32.51 (± 7.14) in physical health (PCS). The seriousness of COVID-19 has an impact on the quality of life and health well-being of people and this impact is more marked in people with chronic health problems. Conclusion: Our results confirm the need to pay attention to the health of people who have not been infected with the virus. Our results also point out that uninfected people with chronic illnesses may be more likely to have well-being problems due to quarantine restrictions.

Consumer behavior is unpredictable. The accelerated pace of life and daily changes in the desires and preferences of each individual require significant marketing efforts to fulfill needs. The impact of the COVID-19 pandemic has created significant disruptions in the market to which consumers have responded in a specific way. Our previous research on this topic [11], which included an analysis of various factors that influence consumer habits, was the basis for a new, more detailed analysis of the impact on individual consumption. The results of our previous research set psy-chological influence as a significant factor in consumer behavior. That is the main reason we put the impact of COVID-19 at the center of this research. The analysis was conducted on an existing sample of 559 respondents in the Republic of Croatia. The data obtained by the questionnaire were used to develop a hierarchical model. The Analytic Hierarchy Process (AHP) is a model based on deci-sion-making and was used to rank individual influences on consumer behavior due to the COVID-19 pandemic. These influences have had a significant impact on consumer buying habits.

Introduction. The outbreak of the COVID pandemic was a period of uncer-tainty and tension for healthcare managers, resulting from the lack of knowledge, i.e. about the transmission of the virus, but also from the lack of uniform organisational and treatment procedures. It was the period where the ability to prepare to a crisis situation, to adapt to the existing conditions and to draw conclusion from the situa-tion were critical to keep ICUs operating. The aim of this study was to show the prep-aration of an ICU in Poland to ensure resilience, and also the methods of reacting dur-ing the COVID-19 pandemic on both central and local level. Methods. Based on the EC and WHO guidelines on resilience a matrix of 6 elements and 13 standards as-signed to them was created, with a series of questions from a survey questionnaire. Results. Good management in resilient systems is free access to any resource. A free and transparent flow of information and also well motivated human resources in an appropriate number. Conclusion. Appropriate preparation, adaptation to the existing situation and effective management of crisis situations is an important element of ICU resilience.

: The purpose of this research was to verify the importance and performance of crisis management in Korean fitness center using Importance-Performance Analysis (IPA). For this study, 304 fitness center executives and managers in Seoul and Gyeonggi region were selected as from March 21 to May 17, 2020. Frequency analysis was performed using SPSS 24.0 and exploratory factor analysis was conducted to verify the validity and reliability. Priority analysis and IPA analysis were performed to compare the mean values, and the following results were obtained. First, in the first quadrant, there were 6 attributes besides keep social distancing between employees and customers. Second, in the second quadrant, there were four attributes in addition to regular disinfection of the gymnasium. Third, in the third quadrant, there were 6 attributes besides maintain furniture clean. Third, there were 6 attributes other than maintaining furniture clean in the third quadrant. Fourth, in the fourth quadrant, there are three attributes in addition to the restriction of face-to-face meetings. The conclusion is as follows. First, equip supplies for prevention of covid19, keep social distance, and check government support policies. Second, analyze of economic support policies, and research on their application methods. Third, Prepare various non-face-to-face communication methods and Untact(non-contact) marketing strategies. Fourth, make a checklist for factors with relatively little importance.

A global event such as the COVID-19 crisis presents new, often unexpected responses that are fascinating to investigate from both, scientific and social standpoints. Despite several documented similarities, the Coronavirus pandemic is clearly distinct from the 1918 flu pandemic in terms of our exponentially increased, almost instantaneous ability to access/share information, offering an unprecedented opportunity to visualise rippling effects of global events across space and time. Personal devices provide “big data” on people’s movement, the environment and economic trends, while access to the unprecedented flurry in scientific publications and media posts provides a measure of the response of the educated world to the crisis. Most bibliometric (co-authorship, co-citation, or bibliographic coupling) analyses ignore the time dimension, but COVID-19 has made it possible to perform a detailed temporal investigation into the pandemic. Here, we report a comprehensive network analysis based on more than 20000 published documents on viral epidemics, authored by over 75,000 individuals from 140 nations in the past one year of the crisis. In contrast to the 1918 flu pandemic, access to published data over the past two decades enabled a comparison of publishing trends between the ongoing COVID-19 pandemic and those of the 2003 SARS epidemic, to study changes in thematic foci and societal pressures dictating research over the course of a crisis.

Coronavirus that is also known as COVID-19 disease is produced by SARSCoV-2. This causative agent is highly contagious and can cause potentially fatal pneumonia worldwide with serious public health concerns. In the beginning among infected individuals, most of them were those who were mainly shown to the wet animal market in a big city of China known as Wuhan. So, it was suggested that this was almost certainly the zoonotic source of COVID-19illness. The transitional source of origin and their mode of transmission to humans were not known obviously. Conversely, from human to human rapidly transformation have been confirmed generally. Currently, there is no availability of FDA approved clinically antiviral drugs and/or vaccines to be used against the COVID-19. Afterward, SARS-CoV and MERS-CoV, the occurrence of SARS-CoV-2 has been manifested as the third sketch of an enormously pathogenic coronavirus into human population globally. In this review, we provide a brief overview of the history of COVID-19 in Pakistan up-to 18^th weeks after beginning, current situation, epidemiology, and its impact on the human population. Moreover, we focused on physiological variation during the incubation period, genome analysis of SARS-CoV2, supportive treatment approaches, and safety measures in the Pakistani population, which may be supportive for combating the risk of COVID-19 epidemic. We also reviewed the future approaches for the development of therapeutic interventions and vaccines to cope with the COVID-19 epidemic.

More than 1,000,000 confirmed cases of COVID-19 have been registered worldwide since the beginning of the pandemic in Wuhan on December 2019. The high mortality rate of COVID-19 is associated with age, gender and the presence of comorbidities. Biochemical data have shown that COVID-19 patients develop a local and systemic hyper-inflammatory response associated with poor outcome. Therefore, the understanding of the biological mechanisms underlying SARS-CoV-2-induced inflammation is a compelling need. Following this reasoning, here we will focus on the importance of the progressive age-related development of a pro-inflammatory state (aka inflamm-aging) in the understanding of the unbalanced inflammatory response against SARS-CoV-2 in aged people. In particular, we underpin the role of mitochondrial DNA and genomic DNA telomeric sequences in local and systemic mechanisms of inflammation. Indeed, the leakage of mtDNA out of its natural compartment (i.e. the mitochondrion), into the cytoplasm and in the extracellular environment is a powerful trigger of innate immunity and inflammation, as part of an evolutionary-conserved signaling mechanism of cellular damage (e.g. viral infection). High levels of circulating mtDNA are increased in aged people and set up as inflammatory markers of poor prognosis in intensive care unit patients. In turn, telomeric DNA, which can be released into the cytoplasm and in the extracellular environment upon cell damage, has been proven to exert potent anti-inflammatory activity. Since that aged people (particularly those affected by co-morbidity) are equipped with shortened telomeres, we posit that, in aged people affected by COVID-19 the release of mtDNA, coupled with insufficient telomeric DNA favors the onset of a detrimental inflammatory response. In this regard, we highlight that the mechanism of action of some currently used drugs, as well as potential new ones may be better understood under the light of the above-depicted theoretical framework thus explaining how studies on inflamm-aging may help to understand and combat COVID-19 pandemic.

The outbreak of COVID-19 in 2020 caused significant disruptions to global shipping and the world economy. This paper aims to investigate the impact of the pandemic on global shipping by analyzing the Baltic Dry Index (BDI). The BDI is a metric that reflects the worldwide shipping costs and directs related to supply and demand conditions, making it an indicator of economic production. The study utilizes data from 2019 to 2021, before and after the outbreak of COVID-19, and considers 13 independent variables, including raw materials, energy, stock market indexes, global port calls, and confirmed COVID-19 cases to investigate how to influent the BDI. The study employs stepwise regression to select variables and build models before and after the pandemic. The findings reveal that the key factors affecting the freight index BDI before the outbreak are: international scrap steel prices, iron ore prices, and the Commodity Research Bureau Index. However, after the COVID-19 outbreak, the factors affecting the BDI changed to the Shanghai Index, global port calls, and the number of confirmed COVID-19 cases.

According to current literature and preliminary data, hydroxychloroquine (HCQ) seems potentially effective in the treatment of patients with Covid-19 pneumonia. The concentrations of HCQ in lungs might be well above that of plasma. Most likely, this property of HCQ provides effective drug concentrations in lungs. HCQ has a gradual onset of action in the treatment of rheumatic diseases. This could be valid for the treatment of Covid-19 pneumonia. It was suggested that regular HCQ administration in animals for a certain time might result in gradual accumulation of HCQ in tissues. Reduced perfusion, somewhat distorted architecture of lung tissue, edema and, suggested gradual accumulation of HCQ in lung tissue might cause reduced HCQ concentrations in pneumonic areas of the lungs in Covid-19 pneumonia. Patients with Covid-19 pneumonia and extensive lung involvement might have less HCQ concentrations in their lungs than patients having limited lung involvement. Furthermore, patients with Covid-19 pneumonia and extensive lung involvement might have more viral load than patients having limited lung involvement. That’s why treatment of patients with advanced Covid-19 pneumonia using HCQ might result in treatment failure, however HCQ might be effective in the treatment of patients with mild and moderate Covid-19 pneumonia. Using HCQ in Covid-19 pneumonia prophylaxis seems logical since providing enough accumulation of HCQ in the healthy lungs, before the arrival of the SARS-CoV-2 virus, might prevent Covid-19 pneumonia. However, the purpose of this paper is not to recommend using or not using HCQ for the treatment or for the prophylaxis of Covid-19 pneumonia. The purpose of this paper is only to try to bring a new perspective on the role of HCQ in the treatment or in the prophylaxis of Covid-19 pneumonia. This paper proposes only hypotheses, which need further researches to be confirmed.

Aims: The study aims to take the COVID-19 pandemic as an example to provide a scientific reference for diabetic patients’ self-health management and nurses’ work for these patients when facing future pandemics. Review Methods: It conducted a comprehensive literature search and analysed relevant texts. This article reviews the daily health management of diabetic patients in the context of the COVID-19 pandemic and the role that nurses should play in this process. Results: Diabetic patients face challenges in self-health management during the pandemic, including disruptions in healthcare access, increased mental problems, and unhealthy lifestyles. Nurses serve as the front-line interface between these patients and the healthcare system. Adopting telehealth and remote consultation has effectively bridged the gap created by social distancing measures. Conclusion: Daily self-health management can significantly improve glycemic control and reduce the risk of diabetes-related complications, which is vital during the pandemic when patients may be experiencing disruptions to their routine care. Moreover, empowering patients through educational initiatives led by nurses can bring better self-monitoring, medication adherence, and lifestyle modifications, all of which are crucial in mitigating the effects of diabetes on the body’s immune response, thus reducing the severity of COVID-19 if contracted.